Mallanagoudra Priyanka, M Ramakrishna Sai Samanvitha, Jaiswal Sowmya, Keshava Prasanna Dhruthi, Seetharaman Rithika, Palaniappan Arunkumar, Kini Sudarshan
Nitte (Deemed to be University), Department of Bio & Nano Technology, Nitte University Centre for Science Education and Research, Mangalore 575018, Karnataka, India.
Human Organ Mimics Engineering (HOME) Labs, Centre for Biomaterials, Cellular and Molecular Theranostics (CBCMT), Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India.
Polymers (Basel). 2025 Aug 26;17(17):2303. doi: 10.3390/polym17172303.
Diabetes is emerging as a significant health and societal concern globally, impacting both young and old populations. In individuals with diabetic foot ulcers (DFUs), the wound healing process is hindered due to abnormal glucose metabolism and chronic inflammation. Minor injuries, blisters, or pressure sores can develop into chronic ulcers, which, if left untreated, may lead to serious infections, tissue necrosis, and eventual amputation. Current management techniques include debridement, wound dressing, oxygen therapy, antibiotic therapy, topical application of antibiotics, and surgical skin grafting, which are used to manage diabetic wounds and foot ulcers. This review focuses on a hydrogel-based strategy for phase-wise targeting of DFUs, addressing sequential stages of diabetic wound healing: hemostasis, infection, inflammation, and proliferative/remodeling phases. Hydrogels have emerged as a promising wound care solution due to their unique properties in providing a suitable wound-healing microenvironment. We explore natural polymers, including hyaluronic acid, chitosan, cellulose derivatives, and synthetic polymers such as poly (ethylene glycol), poly (acrylic acid), poly (2-hydroxyethyl methacrylate, and poly (acrylamide), emphasizing their role in hydrogel fabrication to manage DFU through phase-dependent strategies. Recent innovations, including self-healing hydrogels, stimuli-responsive hydrogels, nanocomposite hydrogels, bioactive hydrogels, and 3D-printed hydrogels, demonstrate enhanced therapeutic potential, improving patient outcomes. This review further discusses the applicability of various hydrogels to each phase of wound healing in DFU treatment, highlighting their potential to advance diabetic wound care through targeted, phase-specific interventions.
糖尿病正成为全球重大的健康和社会问题，影响着各个年龄段的人群。在患有糖尿病足溃疡（DFU）的个体中，由于葡萄糖代谢异常和慢性炎症，伤口愈合过程受到阻碍。轻微损伤、水泡或压疮可能发展成慢性溃疡，如果不进行治疗，可能会导致严重感染、组织坏死，最终导致截肢。目前的治疗技术包括清创、伤口敷料、氧疗、抗生素治疗、局部应用抗生素以及手术植皮，这些方法用于治疗糖尿病伤口和足部溃疡。本综述重点关注一种基于水凝胶的策略，用于对DFU进行阶段性靶向治疗，针对糖尿病伤口愈合的各个阶段：止血、感染、炎症以及增殖/重塑阶段。水凝胶因其在提供合适的伤口愈合微环境方面的独特性质，已成为一种有前景的伤口护理解决方案。我们探讨了天然聚合物，包括透明质酸、壳聚糖、纤维素衍生物，以及合成聚合物，如聚乙二醇、聚丙烯酸、聚甲基丙烯酸2-羟乙酯和聚丙烯酰胺，强调它们在通过阶段依赖性策略制备用于治疗DFU的水凝胶中的作用。最近的创新，包括自愈水凝胶、刺激响应水凝胶、纳米复合水凝胶、生物活性水凝胶和3D打印水凝胶，显示出增强的治疗潜力，改善了患者的治疗效果。本综述进一步讨论了各种水凝胶在DFU治疗中伤口愈合各阶段的适用性，强调它们通过靶向、阶段特异性干预推进糖尿病伤口护理的潜力。
