Growth Hormone-Loaded 3D Printed Silk Fibroin-Cellulose Dressings for Ischemic Wounds

In this study, carboxymethyl cellulose-silk fibroin (CMC-SF) wound dressings loaded with growth hormone (GH) are developed for chronic wound care, particularly in diabetic ulcer regeneration. Designed with a porous and reproducible structure, the dressings enable rapid, localized GH release within 24 h and maintain high fluid absorption with minimal swelling, ensuring optimal conformity to the wound site. The inclusion of SF and GH significantly enhances cell proliferation, migration, and angiogenesis in vitro. The dressings also enable nontraumatic removal, as demonstrated in an in ovo model, supporting their suitability for clinical applications. In vivo testing in ischemic diabetic wounds shows accelerated tissue regeneration, reduced scarring, and improved healing quality. Proteomics and immunohistochemical analyses indicate that GH contributes to a more balanced inflammatory response, enhanced antioxidant activity and vascularization, and better regulation of tissue remodeling processes. Overall, the incorporation of GH within the CMC-SF dressings represents a promising and effective approach to support diabetic ulcer regeneration.