Application and development of stimulus-responsive hydrogel biomaterials for diabetic wound healing: a literature review

Diabetic wounds (DWs) are a severe complication of diabetes, defined as the presence of ulcers or deep tissue damage below the ankle in diabetic patients. DWs entail enormous psychological and economic burdens on diabetic patients. The microenvironment of diabetic wound healing is highly complex, characterized by hyperglycemia, excessive inflammation and elevated reactive oxygen species (ROS), making wound repair and healing extremely challenging. Traditional wound dressings have single function and insufficient adaptability to the wound environment, making it difficult to meet the complex needs of the healing process. As an emerging biomaterial, hydrogels offer distinct advantages over traditional dressings in terms of water absorption, breathability, biocompatibility, drug-carrying capacity, and environmental responsiveness, making them a subject of significant interest in the repair of diabetic wounds. Based on the diabetic wound microenvironment, we summarize and discuss hydrogel wound dressings responsive to temperature, pH, glucose, reactive oxygen species, enzymes, and multiple stimuli, integrating recent research advances in stimulus-responsive wound dressings.