Electrical stimulation-based conductive hydrogel for immunoregulation, neuroregeneration and rapid angiogenesis in diabetic wound repair

Diabetic wounds are hard-healing chronic wounds, mainly caused by wound infection, excessive inflammation, diabetic neuropathy, and peripheral vascular disease. Hence, comprehensive improvement of diabetic wound healing is of great significance in clinical practice. However, the current research on diabetic wounds mainly focuses on wound infection and angiogenesis, lacking the exploration of neuroregeneration and immunomodulation. In this study, we develop a multifunctional conductive hydrogel (PACPH) based on polydopamine-modified silver nanoparticles (AgNPs@PDA), cellulose nanocrystals (CNC)/polypyrrole (PPy) composites, and polyvinyl alcohol as an efficient wound dressing. The PACPH scaffold features multiple functions, including desirable mechanical properties, tissue adhesion, conductivity, and broad-spectrum antibacterial activity. Inspired by the endogenous electric field, the strategy of combining hydrogel with electrical stimulation (ES) is also proposed to accelerate the healing of diabetic wounds. Notably, the participation of ES can effectively promote nerve repair, realize the polarization of macrophages toward the M2 phenotype, and rapid angiogenesis, comprehensively improving the healing of diabetic wounds. This advanced collaborative strategy opens a new avenue in treating diabetic wounds.