Microfluidics, 3D bioprinted scaffold and organ-on-chip with biosensing activated therapeutic strategies for diabetic wound healing.

Diabetic foot ulcers (DFUs) represent one of the most severe complications of diabetes, arising from a complex systemic combination of neuropathy, vascular impairment, and impaired wound healing. These chronic wounds carry a high risk of infection, amputation, and mortality, which often leads to severe ulceration and amputation. Conventional diagnostic and monitoring strategies frequently fail to capture the dynamic microenvironment of DFUs, limiting timely therapeutic intervention. Recent advances in microfluidics and organ-on-a-chip technologies provide transformative opportunities for modelling DFUs, enabling precise recreation of the diabetic wound environment, including hypoxia, hyperglycaemia, inflammation, and microbial infection. Microfluidic wound models allow controlled study of cellular interactions, real-time monitoring of biochemical markers, and integration with biosensors for continuous assessment of glucose, lactate, pH, cytokines, and exosomal biomarkers. Furthermore, wearable and implantable microfluidic devices are emerging as platforms for non-invasive monitoring and personalized wound management. This review emphasizes the current state of the art in DFU pathophysiology, the clinical burden, and the limitations of existing management approaches, while highlighting the role of microfluidic and organ-on-chip technologies in advancing preclinical modelling, biosensing, therapeutic, and diagnostic development. By bridging engineering innovations with clinical needs, these technologies have the potential to revolutionize DFU research and pave the way for precision wound care strategies.