Abstract
BACKGROUND: Chronic diabetic wounds, particularly diabetic foot ulcers (DFUs), are prone to recurrent infection and delayed healing, resulting in substantial morbidity, mortality, and economic burden. Multifunctional wound dressings that combine antibacterial, antioxidant, conductive, and self-healing properties may help to address the complex microenvironment of chronic diabetic wounds. METHODS: In this study, ε-poly-L-lysine and amino-terminated polyethylene glycol were grafted onto carboxylated single-walled carbon nanotubes (SWCNTs) via amide coupling to obtain ε-PL-CNT-PEG. Aminated chondroitin sulfate (CS-ADH) and a catechol-metal coordination complex of protocatechualdehyde and Fe(3+) (PA@Fe) were then used to construct a dynamic covalently cross-linked hydrogel network through Schiff-base chemistry. The obtained hydrogels (Gel0-3, Gel4) were characterized for photothermal performance, rheological behavior, microstructure, swelling/degradation, adhesiveness, antioxidant capacity, electrical conductivity, cytocompatibility, hemocompatibility, and antibacterial activity in the presence and absence of near-infrared (NIR, 808 nm) irradiation. RESULTS: ε-PL-CNT-PEG showed good aqueous dispersibility, NIR-induced photothermal conversion, and improved cytocompatibility after surface modification. Incorporation of ε-PL-CNT-PEG into the PA@Fe/CS-ADH network yielded conductive hydrogels with porous microstructures and storage modulus (G') higher than loss modulus (G'') over the tested frequency range, indicating stable gel-like behavior. The hydrogels exhibited self-healing under alternating strain and macroscopic rejoining after cutting. Swelling and degradation studies demonstrated pH-dependent degradation, with faster degradation in mildly acidic conditions (pH 5.0), mimicking infected chronic diabetic wounds. The hydrogels adhered to diverse substrates and tolerated joint movements. Gel4 showed notable DPPH• and H(2)O(2) scavenging (≈65% and ≈60%, respectively, within several hours). The electrical conductivity was 0.19 ± 0.0X mS/cm for Gel0-3 and 0.21 ± 0.0Y mS/cm for Gel4 (mean ± SD, n = 3), falling within the range reported for human skin. In vitro, NIH3T3 cells maintained >90% viability in the presence of hydrogel extracts, and hemolysis ratios remained below 5%. Hydrogels containing ε-PL-CNT-PEG displayed enhanced antibacterial effects against Escherichia coli and Staphylococcus aureus, and NIR irradiation further reduced bacterial survival, with some formulations achieving near-complete inhibition under low-power (0.2-0.3 W/cm(2)) 808 nm irradiation. CONCLUSIONS: A dynamic, conductive hydrogel based on PA@Fe, CS-ADH, and ε-PL-CNT-PEG was successfully developed. The hydrogel combines photothermal antibacterial activity, antioxidant capacity, electrical conductivity, self-healing behavior, adhesiveness, cytocompatibility, and hemocompatibility. These properties suggest potential for application as a wound dressing for chronic diabetic wounds, including diabetic foot ulcers, although further in vivo studies are required to validate therapeutic efficacy.