Development of a bioadhesive hydrogel with antioxidant activity for enhanced diabetic wound healing

Diabetic chronic wounds which often lead to amputation remain a significant unresolved challenge in clinical practice, posing serious risks to patient health and survival. Existing clinical treatments such as topical administration, traditional dressings and debridement are often inadequate to address the complex pathological microenvironment (chronic inflammation, oxidative stress, etc.) of diabetic chronic wounds, resulting in long treatment cycles and poor outcomes for patients. To address the key pathological factors that impede wound healing, a functional hydrogel dressing was developed in this study using natural polyphenol tannic acid (TA) and biocompatible polyvinyl alcohol (PVA), and aldehyde phenylboronic acid (FPBA) and cyanophenylboronic acid (CPBA) as small molecule crosslinkers. The polyphenol-based hydrogel exhibited strong tissue adhesion, ensuring stable adherence to the wound site after application, thereby preventing infection and mechanical re-injury. And the G-PT hydrogel loaded with TA markedly reduced reactive oxygen species (ROS) production and effectively inhibited DNA damage. Meanwhile, they reduced the levels of early inflammatory factors IL-1β, IL-6 and TNF-α, promoted the polarization of macrophages toward an anti-inflammatory phenotype. In vitro and in vivo evaluations demonstrated that the hydrogel significantly promoted the healing of both acute skin incisions and chronic diabetic wounds by mitigating oxidative stress and regulating macrophage polarization. These findings highlight the therapeutic potential of this multifunctional hydrogel dressing as a promising strategy for treating diabetic wounds.