Diabetic wound microenvironment self-responsive hyaluronic acid hydrogel with painless dressing change for boosting drug-resistant bacteria infected wound healing.

The hyperglycemic microenvironment and persistent bacterial infections of diabetic patients significantly inhibit the wound healing process. Meanwhile, the developed adhesive hydrogel for wound healing still faces challenge of secondary damage during dressing change. Herein, a diabetic wound microenvironment self-adaptive hyaluronic acid hydrogel dressing, denoted as GOx@Co/TMB/FH, was rationally constructed for accelerated wound healing, which features facile preparation and enables non-damaging and painless removal from the wound site. The infected diabetic wound environment could trigger GOx@Co-based cascaded reaction to generate hydrogen peroxide and reactive oxygen species (ROS), realizing chemodynamic therapy (CDT). Meanwhile, TMB could be catalyzed as oxide TMB, presenting photothermal properties for therapy (PTT). The integration of CDT and PTT effectively promoted the diabetic wound healing infected with drug-resistant bacteria at low temperature, which was validated by both in vitro and in vivo experiments. More interestingly, the GOx@Co/TMB/FH gel was temperature-responsive that the gel could in-situ formed on wound sites, thus fitting the irregular wound shapes and depths to improve wound healing. The wound dressing could be easily removed with ice or cold water, having no damage on the wound for painless dressing change. The investigation demonstrated great potential of GOx@Co/TMB/FH gel for clinical translation in managing infected wounds under diabetic conditions.