Disorder of these physiological processes causes persistent inflammation and dys functional epithelial formation. Even tually, it leads to wound nonunion and increases the risk of infection. [2] Accu mulating evidence indicates that for accelerating diabetic wound healing, it is crucial to avoid excessive inflammation, including secretion of inflammatory fac tors in chronic wounds and inappropriate macrophage differentiation. [3] The clas sically activated macrophages (M1) and alternatively activated macrophages (M2) are two typical phenotypes of macro phages. [4] The M1 phenotype macro phages in diabetic wounds continue to release proinflammatory cytokines, such as tumor necrosis factor alpha (TNFα), which stimulate apoptosis of cells (fibro blasts, keratinocytes, and endothelial cells) and disorder collagen deposition, while M2 macrophages can accelerate fibroblast proliferation, orchestrate anti inflammatory responses, stabilize angiogenesis, and promote extracellular matrices (ECM) remodeling. [5] The ineffective transition of macrophages from M1 to M2 phenotype can lead to wound nonunion or scar formation. [6] Therefore, inducing the antiinflammatory transformation of macrophages could be a promising approach for developing clinical treatment of diabetic wounds.
Diabeticwound treatment faces significant challenges in clinical settings. Alternative treatment approaches are needed. Continuous bleeding, disordered inflammatory regulation, obstruction of cell proliferation, and disturbance of tissue remodeling are the main characteristics of diabetic wound healing. Hydrogels made of either naturally derived or synthetic materials can potentially be designed with a variety of functions for managing the healing process of chronic wounds. Here, a hemostatic and anti-inflammatory hydrogel patch is designed for promoting diabetic wound healing. The hydrogel patch is derived from dual-cross-linked methacryloyl-substituted Bletilla Striata polysaccharide (B) and gelatin (G) via ultraviolet (UV) light. It is demonstrated that the B-G hydrogel can effectively regulate the M1/ M2 phenotype of macrophages, significantly promote the proliferation and migration of fibroblasts in vitro, and accelerate angiogenesis. It can boost wound closure by normalizing epidermal tissue regeneration and depositing collagen appropriately in vivo without exogenous cytokine supplementation. Overall, the B-G bioactive hydrogel can promote diabetic wound healing in a simple, economical, effective, and safe manner.