Diabetic wounds have a complex microenvironment with hypoxia, excessive reactive oxygen species, chronic inflammation, and bacterial infection intertwined. We constructed a composite hydrogel loaded with phycocyanin-modified manganese dioxide nanoparticles by crosslinking carboxymethyl chitosan, 4-formylphenylboronic acid, and polyvinyl alcohol through Schiff base and boronate ester bonds. This hydrogel is injectable, self-healing, and tissue-adhesive. It rapidly degrades upon exposure to reactive oxygen species to release nanoparticles, which scavenge ROS and produce oxygen in situ to relieve hypoxia. The nanoparticles also have photothermal antibacterial effects under near-infrared light. In a full-thickness skin defect rat model, this system effectively kills bacteria, promotes macrophage M2 polarization, enhances angiogenesis and collagen deposition, and accelerates healing.  

This work integrates the injectability of dynamic covalent crosslinking with the oxygen-generating and photothermal functions of nanozymes into a single dressing, addressing the multifactorial challenges of diabetic wounds. In the future, the crosslinking density can be adjusted to match different exudate amounts or infection levels. The catalytic oxygen production rate of manganese dioxide can dynamically match the wound hypoxia level. The on-demand photothermal activation of the hydrogel is suitable for outpatient dressing changes, avoiding antibiotic overuse. Its immune-regulating effect suggests potential for combination with other local therapies. Long-term manganese accumulation and repeated light exposure safety still need further evaluation, but this multifunctional design provides a translatable material platform for the synergistic management of chronic wounds.  

Reference:  
DOI:10.1002/advs.76774  

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