An injectable and self-healing hydrogel with antibacterial and angiogenic properties for diabetic wound healing

The treatment of diabetic wounds remains a global challenge. Compared with traditional wound dressings, there are higher requirements of antibacterial, anti-inflammatory and pro-angiogenic effects in diabetic wound dressings. Furthermore, it is desirable for dressings to self-adapt to wounds with different morphologies without extra processes and stably (suitable adhesive and self-healing abilities) provide a conducive environment for wound healing. Herein, we construct an injectable and self-healing hydrogel through the combination of chitosan (CS) and metal ions to efficiently improve infected and diabetic wound healing. Benefiting from the amino and hydroxy groups, the CS molecular chains are cross-linked with silver ions (Ag⁺) and copper ions (Cu²⁺) to promote the formation of the CS-Ag-Cu hydrogel, which releases Ag⁺ (an antibacterial agent) and Cu²⁺ (an angiogenic agent) over a prolonged period. Moreover, the hydrogel possesses appropriate adhesive ability, good water absorption ability, antibacterial capability and biocompatibility according to in vitro investigations. In vivo experimental results further prove that the CS-Ag-Cu hydrogel can dramatically accelerate tissue repair in a Staphylococcus aureus (S. aureus)-infected skin incision model in normal rats and diabetic wounds.