3D-Printed Hydrating Masque for Diabetic Wounds Repair: A Nitric Oxide-Enhanced Tremella Polysaccharide-Based Scaffold for Improved Wound Comprehensive Regulation.

Diabetic wounds (DW) represent a significant global health challenge. Effective regulation of chronic inflammation, oxidative stress, and hydration levels is essential for achieving satisfactory DW healing. Drawing inspiration from the potent moisturizing properties of natural tremella polysaccharides (TP), we developed a 3D-printed scaffold (LZ@TMG) tailored for DW repair. Specifically, this study combined nitric oxide (NO) nanoreactors (L-Arg@ZIF-8) and gallium ions (Ga3 +) into a UV-curable TP (TrepMA) to form a composite bioink, which was 3D-printed into LZ@TMG scaffolds. These scaffolds effectively release NO and Ga3 + to inhibit bacterial growth during the early phase of wound healing. In the subsequent inflammatory and proliferative phases, the LZ@TMG scaffold modulates oxidative stress and inflammation while promoting angiogenesis. Furthermore, TP binds to Nrf2 to activate downstream endogenous antioxidant pathways, thereby enhancing intracellular antioxidant enzyme levels. In a mouse DW model, LZ@TMG reduced inflammation, promoted blood vessel and hair follicle regeneration, and accelerated wound healing. Furthermore, it enhanced aquaporin expression, improved skin hydration, and expedited re-epithelialization. Collectively, this study introduces a multifunctional 3D-printed scaffold inspired by natural moisturizing polysaccharides, providing a promising strategy for effective moist wound healing in diabetes.