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Review | Open Access

Innovations in hydrogel therapies for diabetic wound healing: bridging the gap between pathophysiology and clinical application

Yao Wang1,2,‡, Haoming Wu3,‡, Yan Pan1, Yibo Xiao1, Yingying Chen1, Shuhao Yang4,5, Jun Wang4,5, Wanyue Feng1, Cheng Hu6, Xiangke Niu1, Xin Yong7, Jin Yang1( ), Xulin Hu1,8 ( )
Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu University, No. 82, North 2nd Section, 2nd Ring Road, Sichuan, Chengdu 610081, China
College of Pharmacy of Chengdu University, Chengdu University, No. 2025 Chengluo Avenue, Sichuan, Chengdu 610106, China
School of preclinical medicine of Chengdu University, Chengdu University, No. 2025 Chengluo Avenue, Sichuan, Chengdu 610106, China
Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China
Orthopedic Laboratory of Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China
National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Med-X Center for Materials, Sichuan University, No. 24, South Section of 1st Ring Road, Sichuan, Chengdu 610065, China
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy, Sichuan University, No. 20, Section 3, Renmin South Road, Sichuan, Chengdu 610041, China
Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Sichuan, Chengdu 610041, China

‡Yao Wang and Haoming Wu contributed equally to this work.

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Highlights

• The clinical management of diabetic wounds (DWs) and current treatment strategies are reviewed, including approved medications as well as wound dressings.

• The pathophysiology of DWs, including diabetic peripheral neuropathy, diabetic peripheral arterial disease and diabetic foot infections, is reviewed.

• The application of various multifunctional hydrogels in the pathophysiology of DWs is summarized.

• Challenges and prospects of hydrogels in clinical transformation of DW treatment.

Abstract

Diabetic wounds (DWs), which are complex and challenging to treat due to delayed healing and incomplete regeneration, pose a significant burden on global healthcare systems. Existing clinical interventions, which mainly comprise debridement, decompression, and wound dressings, have limited efficacy. In addition, DW pathogenesis is complex, with diabetic peripheral neuropathy, diabetic peripheral arterial disease, and diabetic foot infections further complicating wound management. Owing to their unique versatility, tunability, and hydrophilicity, hydrogels show promise in several biomedical applications, including DW management. They can effectively promote DW healing by loading therapeutic substances for on-demand release. Given the distinct physiological milieu of DWs, hydrogels with tailored attributes can be engineered to enable on-demand drug release, optimize the wound microenvironment, and cater to the diverse stages of wound healing. Based on the clinical status and pathophysiological features of DWs, this review explores hydrogel wound dressings with the following effects: hypoglycemic, nerve regeneration, vascular regeneration, anti-infective, and bone repair. Additionally, the strategy for applying hydrogels to DWs has been comprehensively studied to provide a robust theoretical foundation for DW treatment and pave the way for clinical translation.

Graphical Abstract

Keywords

Diabetic woundsWound healingBiomaterialsHydrogelsRegenerative medicine

References

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Burns & Trauma
Volume 13 Issue 7,
July 2025
Article number: tkaf025
DOI: 10.1093/burnst/tkaf025

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Cite this article:
Wang Y, Wu H, Pan Y, et al. Innovations in hydrogel therapies for diabetic wound healing: bridging the gap between pathophysiology and clinical application. Burns & Trauma, 2025, 13(7): tkaf025. https://doi.org/10.1093/burnst/tkaf025

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Received: 17 November 2024
Revised: 20 March 2025
Accepted: 02 April 2025
Published: 09 April 2025
© The Author(s) 2025. Published by Oxford University Press.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com