In Vivo Drug-Eluting Smart Scaffold for Diabetic Wounds

Diabetic wound healing presents a major challenge due to impaired vascular function, chronic inflammation, and a defective immune response caused by hyperglycemia. Current wound care technologies, including hydrogels, growth factor therapies, and bioengineered skin substitutes, have inherent limitations and fail to address the complex healing requirements of diabetic wounds. In this study, we report the development of a silk fibroin-based scaffold that exhibits controlled drug delivery modulated by the presence of bioinspired surface patterns. We demonstrate remarkable in vivo efficacy of the patterned scaffold in a diabetic rat model. Wound healing and tissue regeneration were tracked using Swept-Source Optical Coherence Tomography (SS-OCT), histopathology, and molecular analysis (immunohistochemistry and quantitative PCR). We show that the scaffold significantly accelerates wound healing, as evidenced by enhanced cellular differentiation, angiogenesis, and extracellular matrix remodeling. These findings highlight the scaffold's ability to overcome the limitations of current wound care technologies by integrating structural support with sustained drug release. The approach not only improves wound closure and tissue regeneration but also provides a promising, bioinspired solution for targeted diabetic wound management with high potential for clinical translation.