Innovative Applications of Cutting-Edge Nanomaterials in Diabetic Wound Healing

Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia. Diabetic wound healing faces severe challenges, such as low treatment efficiency and susceptibility to infection due to its complex pathological microenvironment. Conventional treatments like antimicrobial dressings and debridement are limited by issues such as low drug bioavailability and poor tissue penetration. In recent years, nanomaterials have demonstrated significant potential in diabetic wound management by leveraging their unique physicochemical properties and multifunctional integration capabilities. They enable precise intervention in the wound microenvironment through targeted delivery, controlled release, and synergistic multi-mechanistic actions involving antibacterial, antioxidant, immunomodulatory, and pro-angiogenic aspects. This review systematically summarizes innovative applications of various cutting-edge nanomaterials in diabetic wound repair, including metal nanomaterials (e.g., Ag, Au), metal-organic frameworks (MOFs), polymeric nanomaterials (e.g., chitosan), ceramic nanomaterials, carbon- based nanomaterials (e.g., graphene, carbon quantum dots), lipid nanoparticles (LNPs), and exosomes. For instance, silver-loaded Prussian blue-chitosan nanocomposite (Ag@Chi-PB NPs) under near-infrared (NIR) laser activation achieved eradication rates of 65% and 60% against Methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli) biofilms, respectively. Trisulfide lipid nanoparticles (TS LNPs) loaded with Interleukin-4 (IL4)-mRNA in diabetic mouse models reduced reactive oxygen species levels by 7-fold and increased M2 macrophage proportion to 53%. Moreover, a graphene-based composite hydrogel achieved nearly 99.7% wound closure within 14 days, demonstrating excellent conductivity and promoting re-epithelialization. This review focuses on the latest mechanistic insights and application advances of nanomaterials in chronic diabetic wound therapy, aiming to provide systematic and forward- looking academic references for researchers and clinicians and to promote their clinical translation.