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Review
. 2022 Jul 6;14(14):2764.
doi: 10.3390/polym14142764.

Current Advances in the Development of Hydrogel-Based Wound Dressings for Diabetic Foot Ulcer Treatment

Viviana R Güiza-Argüello  1 , Víctor A Solarte-David  2 , Angie V Pinzón-Mora  3 , Jhair E Ávila-Quiroga  3 , Silvia M Becerra-Bayona  3
Affiliations
Review

Current Advances in the Development of Hydrogel-Based Wound Dressings for Diabetic Foot Ulcer Treatment

Viviana R Güiza-Argüello et al. Polymers (Basel). .

Abstract

Diabetic foot ulcers (DFUs) are one of the most prevalent complications associated with diabetes mellitus. DFUs are chronic injuries that often lead to non-traumatic lower extremity amputations, due to persistent infection and other ulcer-related side effects. Moreover, these complications represent a significant economic burden for the healthcare system, as expensive medical interventions are required. In addition to this, the clinical treatments that are currently available have only proven moderately effective, evidencing a great need to develop novel strategies for the improved treatment of DFUs. Hydrogels are three-dimensional systems that can be fabricated from natural and/or synthetic polymers. Due to their unique versatility, tunability, and hydrophilic properties, these materials have been extensively studied for different types of biomedical applications, including drug delivery and tissue engineering applications. Therefore, this review paper addresses the most recent advances in hydrogel wound dressings for effective DFU treatment, providing an overview of current perspectives and challenges in this research field.

Keywords: diabetic foot; hydrogel; tissue engineering; wound dressing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chronic wound healing process. Diabetic foot ulcers are characterized by continuous inflammation, persistent infections, and necrosis. In these wounds, the balance between Matrix Metalloproteinases (MMPs) and Tissue Inhibitors of Metalloproteinases (TIMPs) is altered, preventing proper remodeling of the extracellular matrix (ECM). Moreover, inflammation is persistent, with high infiltration of immune cells, a response triggered by an increase in interleukins (IL) and pro-inflammatory cytokines associated with cells, such as neutrophils and type I monocytes (pro-inflammatory), which respond to infectious agents. Similarly, there is an increase in reactive oxygen species (ROS), exacerbating the degradation of tissue components. Synergically, these events limit cell migration, angiogenesis, and ECM remodeling, leading to wound chronicity. Created with BioRender.com on 1 June 2022.
Figure 2
Figure 2
Therapeutic effects of hydrogel dressings during wound healing. Created with BioRender.com on 1 June 2022.
Figure 3
Figure 3
Natural polymers used for the design of hydrogel dressings for DFU treatment.
Figure 4
Figure 4
Ionic crosslinking of sodium alginate to produce calcium alginate hydrogels.
Figure 5
Figure 5
Synthetic polymers used for the design of hydrogel dressings for DFU treatment.
Figure 6
Figure 6
Hydrogel fabrication through chemical crosslinking via: (A) 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC chemistry), and (B) and (C) UV photopolymerization using Irgacure 2959.
See this image and copyright information in PMC

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