Synergistic Immuno-Antimicrobial Spongy Scaffold Heals Chronic Diabetic Wounds

Chronic diabetic wounds pose a significant clinical challenge due to ongoing inflammation, bacterial infections, and excessive fluid exudate. Traditional dressings often do not address these interrelated issues effectively. In this study, we present a multifunctional composite sponge created by integrating curcumin-modified mesoporous ceria nanoparticles (CeO₂-cur) into a scaffold made from acellular dermal matrix (ADM) and poly(vinyl alcohol) (PVA). This scaffold is designed to simultaneously manage exudate, combat bacterial infections, and modulate the inflammatory environment. The developed scaffold exhibits a high swelling ratio and excellent fluid retention, ensuring a balanced moist environment that promotes healing. In vitro studies revealed its strong antibacterial activity against both S. aureus and E. coli, as well as its ability to enhance cell adhesion and migration, and effectively shift macrophages from a pro-inflammatory M1 to a pro-repair M2 phenotype. When applied to full-thickness wounds in a diabetic mouse model, this dressing significantly accelerated wound closure, improved angiogenesis, and facilitated organized collagen deposition. Safety assessments indicated no adverse effects. This research demonstrates a synergistic therapeutic strategy that combines multiple essential functions into a single platform, offering a promising approach for the clinical management of chronic diabetic wounds.