From water to medicine: the transformative role of hydrogels in diabetic wound healing

Slow tissue repair, chronic inflammation, poor angiogenesis, and increased susceptibility to infection make diabetic wound healing a significant global medical concern. Hydrogel-based dressing is an innovative approach to diabetic wound treatment, replacing traditional treatments like surgery, antibiotics, and dressings that often fail to restore the complex wound microenvironment. This review focuses on significant advancements in hydrogel formulations, including their composition, properties, and medical uses. It begins with an overview of the diabetic wound healing process and current treatment strategies. Hydrogels provide moist environment for healing, which are three-dimensional networks of hydrophilic polymers that can hold almost 90% of water and are categorized according to their crosslinking technique (physical and chemical) and their source (natural, synthetic, or hybrid). Among these, injectable hydrogels are popular due to their simplicity of use, capacity to fill a variety of irregularly shaped wounds, and in situ gelation, promoting tissue regeneration and reducing the risk of infection. Finally, we conclude with clinical case studies utilizing hydrogels derived from sodium alginate, placenta-derived mesenchymal stem cells (PDMSC), and collagen-polyacrylate-metal-organic frameworks (MOFs) have shown notable results in wound healing, including improved tissue repair, enhanced chronic wound management, and reduced infection. Despite these advancements, hydrogels continue to encounter issues with mechanical strength, degradation control, and large-scale production. Hydrogel-based wound dressings have potential for individualized treatment of diabetic wounds keeps growing as research and biomaterial technologies advance. This review also highlights novel classification, real-world case studies, and emerging clinical trends, providing a comprehensive perspective that is not commonly addressed in existing literature.