In vivo and molecular analysis of bacterial cellulose incorporated graphene oxide for diabetic wound healing

Various topical formulations and conventional dressings are used to address wound healing complications in diabetic patients, but an absolute choice is yet to be made. The synergy of bacterial cellulose and graphene oxide (BC-GO) was investigated to develop an advanced wound care material. Herein, the BC-GO film was prepared by ex-situ immersion method and structural features were analyzed through field emission scanning electron microscopy, Fourier transform infrared spectroscopy, and X-ray diffraction. Following physicochemical and antibacterial analysis, in-vivo wound healing activity of the BC-GO was determined in diabetic mice, and quantitative temporal expression of interleukin 1 ( IL-1α ), tumor necrosis factor ( TNF-α ) , vascular endothelial growth factor ( VEGF ) and platelets derived growth factor ( PDGF ) were measured. The BC-GO film exhibited convincing antibacterial potential, significantly higher than the control. The maximum inhibitory zone of BC-GO film was observed against S. aureus (24.6 ±0.5 mm) and E. coli (23 ±1 mm). By day 21, wounds treated with BC-GO film achieved complete closure as compared to those treated with commercial ointment, Polyfax TM and untreated control with residual wound area of 18.66 ±2.31 mm 2 and 36.66 ±8.13 mm 2 respectively. Histological analysis demonstrated lesser inflammatory response, earlier reepithelization, and better angiogenesis in BC-GO film treated wounds as compared with the stand-alone BC and Polyfax TM . Moreover, the lower expression of IL-1α and TNF-α and enhanced expression of VEGF and PDGF revealed the role of these genes in wound healing by BC-GO films. In conclusion, BC-GO can be a better choice for the treatment of complex and hard-to-heal diabetic wounds.