Diabetic wounds typically involve redox and immune homeostasis disorders, are prone to bacterial infection, and often lead to delayed healing and more severe prognosis. However, existing treatment strategies cannot simultaneously achieve potent antibacterial effects and temporal microenvironment regulation. This paper proposes a self-evolving hyaluronic acid/polyaspartic acid hydrogel dressing, which combines in situ integrated Ag+-to-Ag nanozyme conversion function and water-soluble Fe3N/Fe3O4 nanoheterogeneous junction (nHJ) to meet the complex requirements of the continuous healing stage. During the infectious inflammation stage, the self-oxyphotodynamic and photothermal effects based on nHJ, in combination with Ag+, synergistically act against multi-drug resistant biofilm-forming bacteria. Subsequently, the Ag nanozyme with superoxide variant enzyme/hydrogen peroxidase-like activity continuously recovers reactive oxygen species while generating oxygen, promoting the re-polarization of macrophages from M1 to M2, thereby facilitating the transformation from inflammation to proliferation. The accumulation of ammonia promotes cell proliferation, migration, and angiogenesis. This dressing demonstrates excellent biocompatibility and bioactivity in diabetic rat models, capable of accelerating the healing of full-thickness skin wounds infected with Staphylococcus aureus. This is verified through hemostasis, broad-spectrum antibacterial, antioxidant and immunomodulatory capabilities, enhanced oxygenation and cell proliferation, as well as extensive collagen deposition, angiogenesis and re-epithelialization. RNA sequencing results further reveal the activation of multiple healing signaling axes. Therefore, this platform provides a powerful dynamic strategy to achieve potent antibacterial activity and active temporal ecological niche regulation, guiding the healing of infectious diabetic wounds. This study was published under the title "Self-Evolving Hydrogel Dressing Temporally Accelerates Infected Diabetic Wound Healing" in Advanced Materials.
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DOI: 10.1002/adma.202523302