A fabric-reinforced polysaccharide-based hydrogel with conductive, adhesive, antibacterial and anti-inflammatory for monitoring and treatment of diabetic wounds

• Carboxymethyl chitosan (CMC) and oxidized konjac glucan (OKGM) macromonomers and tannic acid (TA) and iron (III) chloride were utilized to fabricate hydrogels with self-repairing properties, good tissue adhesion and electrical conductivity. • To endow the antibacterial and mechanical properties of interpenetrating network (IPN) hydrogels, the fabric reinforced polysaccharide-based hydrogels were obtained by combining the Shiff base hydrogels with quaternary ammonium salt modified cotton fabric. • The hydrogel might regulate cell metabolism, differentiation and vascular endothelial growth factor (VEGF) function, by down-regulating IL-6, TNF-α, TGF-β1 and up-regulating CD31, CD206, VEGF. Diabetic foot ulcers are a major complication of diabetes mellitus, imposing a huge burden on patients and society. In this study, we developed hydrogels with self-repairing properties, strong tissue adhesion, and electrical conductivity by using carboxymethyl chitosan, oxidized konjac glucan macromonomers, tannic acid, and iron (III) chloride. To enhance their antibacterial and mechanical properties, fabric-reinforced polysaccharide-based hydrogels were created by combining the above hydrogels with quaternary ammonium salt-modified cotton fabric, forming interpenetrating network structures. The results showed that the hydrogels achieved an adhesion strength of 12.74 kPa and a bacterial inhibition rate above 99 %. Additionally, the migration of Fe³⁺ ions within the crosslinked network provided good electrical conductivity. The hydrogel also showed potential to regulate cell metabolism, differentiation, and vascular endothelial growth factor (VEGF) function. Importantly, both in vitro and in vivo data demonstrated that the hydrogel exhibited excellent antibacterial properties (99.8 %) and eradicated bacterial biofilms. Besides, it reduced inflammation by down-regulating IL-6, TNF-α, and TGF-β1, and accelerated chronic wound healing by promoting faster wound closure, increasing granulation tissue thickness, enhancing collagen deposition, and stimulating angiogenesis, as evidenced by the up-regulation of CD31, CD206, and VEGF. These findings highlighted the hydrogel's great potential as an effective treatment for diabetic wounds.