Advanced radiation-crosslinked CM-chitosan/gelatin hydrogel for diabetic ulcer treatment with reducing application frequency.

AIMS: The study aims to assess whether a radiation-crosslinked carboxymethyl-chitosan/gelatin hydrogel can exhibit superior healing properties in diabetic wounds through collagen synthesis, epithelial maturation, inflammation regulation and angiogenesis, and determine if it can be applied on alternate days to reduce patient compliance pressure.

METHODS

The study used a full-thickness diabetic wound rat model. The hydrogel was applied either daily or on alternate days. H&E, Masson's trichrome, Sirius red and immunohistochemical staining were employed. Two patients with diabetes were recruited for case studies where the hydrogel was applied on alternate days.

RESULTS

Under the application of the hydrogel, accelerated healing was observed, with enhanced re-epithelialization and dermal differentiation. The treated groups developed mature skin characteristics absent in the control group, and a well-organized collagen network was observed. There was also accelerated macrophage infiltration, phenotype shift and enhanced angiogenesis at different healing stages. In addition, two patients were positive with alternate-day application of the hydrogel.

CONCLUSIONS

The radiation-crosslinked carboxymethyl-chitosan/gelatin hydrogel shows great potential as a promising modality for diabetic wound management, with both daily and alternate-day applications having immunomodulatory and pro-angiogenic functions.