article · International Journal of Nanomedicine
Diabetic foot ulcers remain difficult to treat because of biofilm infections, high oxidative stress, and persistent tissue maceration from excess fluid. To tackle these issues, a multifunctional hydrogel was developed by crosslinking polyvinyl alcohol and chitosan with boric acid, followed by the addition of a graphene oxide and cranberry extract nanohybrid. The resulting dressing demonstrated improved mechanical stretchability alongside electro-conductive, antioxidant, and self-healing characteristics. Under near-infrared light exposure, the material displays photothermal conversion that drives dynamic exudate removal to protect healing tissue. When tested against inflammation, the hydrogel significantly lowered markers including NLRP3, TNF-alpha, IL-6, and IL-1beta. Further tissue evaluations confirmed reduced inflammation and accelerated wound repair. These combined actions, alongside the promotion of new blood vessel formation, indicate that the hydrogel formulation provides a coordinated approach to managing complex diabetic wounds.
Diabetic foot ulcers frequently lead to severe complications due to bacterial biofilms and excessive wound fluids that delay natural healing. A dressing that physically stretches, manages exudate through light activation, and reduces inflammation offers an integrated approach to chronic wound care. By simultaneously addressing microbial risks and supporting tissue repair, such formulations could significantly improve treatment outcomes for diabetic patients.
The hydrogel could serve as an advanced photothermal wound dressing for healthcare providers managing chronic diabetic foot ulcers. Because the material was evaluated through laboratory, computational, and animal models, it represents applied research tested in vivo. Before real-world clinical use, substantial translational steps remain, including clinical trial validation, standardisation of near-infrared treatment protocols, and regulatory clearance for human medical application.
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Background: Diabetic foot ulcers present a formidable challenge due to colonization by biofilm-forming microorganisms, heightened oxidative stress, and continuous wound maceration caused by excessive exudation. Methods: To address these issues, we developed a robust, stretchable, electro-conductive, self-healing, antioxidant, and antibiofilm hydrogel. This hydrogel was synthesized through the crosslinking of polyvinyl alcohol (PVA) and chitosan (CH) with boric acid. To enhance its antimicrobial efficacy, graphene oxide (GO), produced via electrochemical exfoliation in a zinc ion-based electrolyte medium, was incorporated. For optimal antibiofilm performance, GO was functionalized with cranberry (CR) phenolic extracts, forming a graphene oxide-cranberry nanohybrid (GO-CR). Results: The incorporation of GO-CR into the hydrogel significantly improved its stretchability (280% for PVA/CH/GO-CR compared to 200% for PVA/CH). Additionally, the hydrogel demonstrated efficient photothermal conversion under near-infrared (NIR) light, enabling dynamic exudate removal, which is expected to minimize retained exudate between the wound and the dressing, reducing the risk of wound maceration. The hydrogel effectively reduced levels of lipopolysaccharide (LPS)-induced skin inflammation markers, significantly lowering the expression of NLRP3, TNF-α, IL-6, and IL-1β by 39.2%, 31.9%, 41%, and 52.3%, respectively. Histopathological and immunohistochemical analyses further confirmed reduced inflammation and enhanced wound healing. Conclusion: The PVA/CH/GO-CR hydrogel exhibits multifunctional properties that enhance wound healing ulcers. Its superior mechanical, antibacterial, and anti-inflammatory properties and ability to promote angiogenesis make it a promising candidate for effective wound management in diabetic patients.
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DOI: 10.2147/ijn.s482836
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