Applications of chitosan-based hydrogels in diabetic wound healing: A review

Chronic diabetic wounds are a significant health challenge due to impaired healing processes exacerbated by the pathophysiological environment associated with diabetes. Chitosan-based hydrogels have emerged as a promising therapeutic strategy due to their excellent biocompatibility, biodegradability, and capacity to facilitate wound healing. This review highlights the key properties of chitosan hydrogels and their potential application in the treatment of diabetic skin ulcers. The versatility of chitosan allows for modification and incorporation of various bioactive agents to improve antibacterial activity, enhance moisture retention, and respond to the specific needs of diabetic wounds, including oxidative stress, high glucose levels, and bacterial infection. We discuss various chitosan hydrogel formulations, including self-healing, pH-responsive, and ROS-responsive types, each tailored to specific wound healing requirements. Furthermore, we examine the mechanisms through which these hydrogels facilitate healing, focusing on their ability to improve angiogenesis, promote cell proliferation, and reduce inflammation. The review concludes by exploring future directions, including the integration of nanomaterials and stem cell therapies with chitosan hydrogels to enhance their effectiveness in diabetic wound healing.