Glucose-Activated Janus Wound Dressing for Enhanced Management of Infected and Exudative Diabetic Wounds

Diabetic wounds, often multifactorial and affecting multiple organs, pose substantial challenges to patient well-being, drawing significant interest in biomedical engineering. The demanding wound microenvironment, marked by heightened glucose levels, local exudate, and bacterial infections, emphasizes the pressing demand for advanced wound dressings to meet escalating clinical needs. Herein, a Janus wound dressing with an integration of an antimicrobial hydrophobic nanofiber layer and a 3D hydrophilic sponge was designed and prepared to manage and utilize wound exudate. The hydrophobic layer skillfully combined electrospun poly(ε-caprolactone) (PCL) nanofiber membranes (ENMs) and metal-organic frameworks (MOFs) with peroxidase-like properties by solvent etching, and glucose oxidase (GOx) was grafted through ligand interaction. GOx acts to consume glucose while modulating pH, thus suitable pH and self-supplied H₂O₂ were able to activate the catalytic activity of MOFs to generate ^•OH. Additionally, hydrophilic 3D sponges are constructed using gas foaming technology, which are tactfully combined with hydrophobic ENMs to form a Janus structure, which can transport exudate through the antimicrobial layer to the sponge layer, while sufficient glucose contact with GOx enhances the antimicrobial properties of the designed Janus wound dressing. Experimental results demonstrate the effectiveness of the cascade effect of GOx@PCL/MOF ENMs, ultimately releasing reactive oxygen species and exhibiting robust antibacterial properties. In vivo animal experiments reveal the ability of the Janus wound dressing to mitigate methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections in the early stages, thereby expediting the wound healing process. In vivo animal study, the Janus wound dressing achieved a healing rate of 54% on day 3. Our findings underscore the substantial potential of the Janus wound dressings in promoting the healing of chronic diabetic wounds.