Recent advances in hyaluronic acid-based hydrogels for diabetic wound healing

Diabetic wound healing represents a complex biological challenge, often impeded by disrupted cellular processes and dysregulated inflammation, which can lead to chronic and non-healing wounds. Given the significant burden on patients and the healthcare system, there is an urgent need for advanced therapeutic strategies. Hyaluronic acid (HA)-based hydrogels have emerged as a promising solution due to their biocompatibility, biodegradability, and unique physiological functions. This review aims to provide a comprehensive overview of recent advances in HA-based hydrogels, highlighting their potential in addressing diabetic wound complications. Specifically, it examines challenges such as hyperglycemia-induced oxidative stress and impaired cellular signaling within the intricate diabetic wound microenvironment. Moreover, the review explores the composition and properties of HA, including its adhesive capabilities and role in reducing surgical trauma. Various crosslinking strategies and functional modifications are also discussed to endow HA-based hydrogels with antioxidant, antimicrobial, and growth factor-releasing capabilities. By summarizing the latest research and identifying areas for further exploration, this review contributes to the development of more effective HA-based hydrogel formulations for diabetic wound healing.