A Potent Antifouling and Antimicrobial Wound Dressing to Accelerate Diabetic Wound Healing

Diabetic wounds are a severe and prevalent complication of diabetes, often resulting in high healthcare costs and an increased risk of amputation. Infection and insufficient angiogenesis are two primary factors that severely impede diabetic wound healing. In this study, we developed a potent antifouling and antimicrobial SBHA hydrogel incorporating zwitterionic and N-halamine moieties. The zwitterionic moieties effectively resist protein adsorption and bacterial adhesion while simultaneously promoting angiogenesis, thereby accelerating wound repair. Meanwhile, the N-halamine moieties exhibit excellent broad-spectrum antibacterial activity, achieving a bactericidal efficacy of 99.999% within 5 min of contact. Importantly, in vivo studies demonstrate that SBHA hydrogels used as wound dressings significantly accelerate the healing of diabetic infected wounds in rats, reaching a healing rate of up to 93.3% on day 13 compared with the control group. This enhanced therapeutic outcome may be attributed to the ability of the SBHA dressing to prevent infection, promote angiogenesis, modulate macrophage polarization, upregulate the anti-inflammatory cytokine IL-10, and suppress the pro-inflammatory cytokine IL-6. Collectively, these results highlight the potential of SBHA hydrogels as advanced wound dressings and provide a promising strategy for diabetic wound healing.