Fault-Tolerant Adhesive Intelligent Hydrogels Accelerate Diabetic Wound Healing through On-Demand Release of Photothermal/Nitric Oxide and Real-Time Monitoring

Diabetic wounds suffer from delayed healing due to impaired angiogenesis, bacterial infection, and mechanical damage from dressing changes. This study developed an AP-G-OSA-GB-ICG hydrogel via Schiff base and borate ester bonds. The temperature-responsive conductive system integrates photothermal therapy (PTT) and nitric oxide (NO) release for synergistic antibacterial effects. Graphene oxide-BNN6 (GB) and indocyanine green (ICG) eliminate bacteria via near-infrared (NIR) photothermal effects, while light-triggered NO from BNN6 promotes angiogenesis. Gelatin-based thermal responsiveness enables body temperature-triggered adhesion switching to reduce neotissue damage. Graphene oxide (GO) endows electrical conductivity for potential physiological signal monitoring. In type 1 diabetic SD rats, the hydrogel with NIR irradiation and NO release achieved 100% wound closure at day 14. Masson trichrome staining showed orderly collagen fiber deposition, CD31 and α-SMA immunostaining confirmed a significant increase in vessel density. Hematoxylin and eosin (H&E) staining further revealed the absence of significant inflammatory cell infiltration. This multifunctional system integrates antibacterial activity, angiogenesis promotion, intelligent adhesion, and physiological monitoring, offering a mechanistically innovative and clinically translatable strategy for diabetic wound precision treatment.