A synergistic bio–electro–topological strategy based on an MXene/silk fibroin hydrogel and electrical stimulation for diabetic wound healing

Diabetic wound healing is impeded by a complex pathological microenvironment involving oxidative stress, infection, chronic inflammation, and impaired regeneration. To address these multifactorial barriers, a synergistic "bio-electro-topological" strategy is developed by integrating an electroactive, antioxidative, highly aligned nanofibrous hydrogel (SFMA@MX-A) with exogenous electrical stimulation (ES). This approach not only constructs a biomimetic, aligned fibrous topology for contact guidance but also assembles SAB@T-MXene into an anisotropic conductive network along the fiber axis, thereby addressing key challenges in MXene integration including nanosheet aggregation, restricted bioactive exposure, and limited conductivity. The resulting hydrogel not only directs cell migration and extracellular matrix organization, but also scavenges reactive oxygen species (ROS), while its synergizing integration with ES enhances proliferation, migration and angiogenesis signaling of fibroblasts and endothelial cells. In a diabetic full-thickness wound model, E/SFMA@MX-A significantly accelerates wound closure, promotes rapid re-epithelialization and organized collagen remodeling, and enhances angiogenesis. This study focuses on the synergistic integration of biological, electrical, and topological factors, with a primary emphasis on the precise regulation of the cellular microenvironment and cell behavior. It aims to achieve a sequence of processes ranging from ROS scavenging to ordered cell alignment and ultimately collagen remodeling, thereby effectively improving the quality of wound healing in diabetic patients.