Multifunctional carboxymethyl cellulose-based hydrogels with zwitterionic and silver nanowire components for wound management

Chronic wounds represent a major global health burden, while conventional dressings often fail to meet the complex requirements of chronic wound management, including infection control, moisture balance, and tissue regeneration. In this study, two multifunctional zwitterionic hydrogels-vinylpyridine carboxybetaine/sulfobetaine/silver nanowire/carboxymethyl cellulose (VCS/Ag/CMC) and acrylamide carboxybetaine/sulfobetaine/silver nanowire/carboxymethyl cellulose (ACS/Ag/CMC) - were synthesized. Structural analyses confirmed the successful incorporation of aromatic or aliphatic zwitterionic components and uniform distribution of silver nanowires within the CMC-based hydrogel networks. Both hydrogels exhibited favorable mechanical strength, high swelling capacity, controlled degradability, and sustained silver release, providing a balanced profile for chronic wound applications. <i>In vitro</i> studies demonstrated potent antibacterial and antioxidant activities, while <i>in vivo</i> experiments revealed accelerated wound closure, enhanced re-epithelialization, collagen deposition, and neovascularization. Moreover, the hydrogels promoted macrophage polarization toward the pro-healing M2 phenotype. Collectively, these findings highlight the promise of zwitterionic hydrogels as multifunctional platforms for chronic wound management and regenerative medicine.