Ultrasound-induced piezoionic hydrogels with antibacterial and antioxidant properties for promoting infected diabetic wound healing

The effective treatment of infected diabetic wounds remains a major challenge due to bacterial infection and severe oxidative stress. Herein, an antibacterial and antioxidant piezoionic hydrogel (ANDT) is synthesized <i>via</i> a one-pot photocuring process of a precursor solution containing acrylic acid, <i>N</i>-isopropyl acrylamide, quaternary ammonium salt (DPAB), and tannic acid (TA). The ANDT hydrogel exhibits reliable adhesion and appropriate mechanical properties, which can provide a favorable physical barrier. Owing to the introduction of antibacterial DPAB and antioxidant TA, the ANDT hydrogel can reduce inflammation and create an optimal microenvironment for cellular growth. Furthermore, due to the piezoionic effects, the ANDT hydrogel under ultrasound stimulation can generate a biomimetic endogenous electric field to modulate cellular behaviors, thereby achieving an active pro-healing effect. The infected diabetic wound model demonstrates that the ANDT hydrogel combined with ultrasound therapy can effectively reduce inflammation, increase collagen deposition, and promote angiogenesis, thus accelerating the healing process of infected diabetic wounds. This work may provide a promising strategy for developing advanced wound dressing to promote infected diabetic wound healing.