Enhanced Diabetic Wound Healing Using a Bioengineered Human Amniotic Membrane–Derived Scaffold Loaded With Oxygen‐Generating Microspheres

Background Challenging diabetic wound is known to be the most complication of diabetes. Besides the conventional treatments, some promising approaches, such as application of human amniotic membrane (HAM) and oxygen therapy, have been proposed to repair the diabetic wounds. In spite of their positive effects, none of these approaches are efficient enough to solve this problem. Therefore, we made an attempt to investigate if a HAM‐derived three‐dimensional microporous scaffold (HAMS) loaded with oxygen‐generating microspheres (OGMs) could effectively promote healing in diabetic rats. Methods The diabetic animals were randomly divided into diabetic, D‐HAMS, and D‐HAMS + OGM groups. Furthermore, nondiabetic untreated rats, i.e., healthy group, were labeled as controls. An annular ischemic 15‐mm diameter wound was created in the back of the animals, and HAMS or HAMS + OGM were grafted on the wound of related animals, i.e., D‐HAMS and D‐HAMS + OGM groups. Stereological, molecular, and tensiometrical assessments were performed 7, 14, and 21 days after surgery. Results It was found that compared to the diabetic group, both HAMS and HAMS + OGM transplantations caused a significant increase in the wound closure rate; the volumes of the newly generated epidermis and dermis; the density of the epidermal basal cells, fibroblasts, and blood vessels; the number of proliferating cells; and collagen deposition as well as biomechanical properties of healed wound, and these improvements were more apparent in the D‐HAMS + OGM‐group. In addition, the transcripts of Tgf-β , bFgf , and Vegf genes were notably upregulated in both the treated groups compared to those in the diabetic one and were greater in the D‐HAMS + OGM group. This is while expression of Tnf-α , Il-1β , and Hif-1α as well the numerical densities of neutrophils and macrophages dropped more significantly in the D‐HAMS + OGM group compared to those of the other diabetic groups. Conclusion In general, we found that the transplantation of HAMS loaded with OGM has more effect on diabetic wound healing.