Abstract
Infected diabetic foot ulcer (DFU) endangers patients through complex complications, which seriously increase the risk of amputation, prolongation of disability time and mortality, as well as bring a heavy burden to the medical system. This review focuses on the emerging biomedical engineering therapy of DFU and deeply analyzes the multiple pathogenic factors driving these intractable DFU wounds, including impaired angiogenesis, inflammatory disorder, microbial biofilm formation, and impaired immune response. It also synthesizes current clinical treatments and elaborates on their limitations that underscore the need for innovative solutions. The core of the review delves into recent breakthroughs in responsive antimicrobial biomaterials, emphasizing their stimuli-triggered mechanisms that enable targeted drug release, enhanced bacterial eradication, and tissue regeneration promotion. Furthermore, it explores future trajectories for multifunctional biomaterials, envisioning integrated systems that combine antimicrobial, anti-inflammatory, and pro-healing properties to address the complex pathophysiology of infected DFU. By bridging current clinical challenges with biomaterial innovations, it can provide actionable insights for developing patient-centric therapeutic strategies in biomedical engineering.