Carboxymethyl chitosan-based hydrogels containing fibroblast growth factors for triggering diabetic wound healing

Triggering the repair process of diabetic wounds is a huge clinical challenge due to microbial infection, the reduced migration and proliferation of fibroblasts, decreased angiogenesis and collagen formation caused by the long-term negative stimulation of high blood glucose levels. Herein, bio-multifunctional benzaldehyde-terminated 4-arm PEG (4-arm-PEG-CHO)/carboxymethyl chitosan (CMCS)/basic fibroblast growth factor (bFGF) hydrogels (BP/CS-bFGF) are prepared via the dynamic Schiff base reaction for diabetic wound treatment. BP/CS-bFGF hydrogel dressing shows strong wet-tissue adhesion, self-mending, and antibacterial property. Biological assessments display that the BP/CS-bFGF hydrogel has excellent biocompatibility and fast hemostasis capacity. Importantly, BP/CS-bFGF hydrogel dressing significantly accelerates full-thickness diabetic wound repair by increasing the production of Ki67, promotes the generation of epithelialization and collagen, induces the formation of hair follicles, and enhances neovascularization by upregulating the production of CD31 and CD34. Thus, our work demonstrates that BP/CS-bFGF hydrogel dressing displays great potential for diabetic chronic wound management.