Nanoengineered Tools in the Treatment of Diabetic Wounds: a Review on Next-Generation Multidimensional Therapeutic Approaches

‘Chronic wound’ is one of the serious complications of diabetes due to lingering hyperglycaemia, prolonged dysregulation of inflammation, neuropathy, microvascular complications and increased prone to infections. Treatment involves wound debridement, stabilized glycaemia, infection control, offloading and advanced therapies with stem cells or cell- and tissue-based products. Utilization of novel next-generation nano-tools such as nano formulations, multifunctional nanogels, matrix metalloproteinase, nanofibers, phototherapy, etc. has also been approached in-addition. The regulated release of bioactive molecules from these stimuli-responsive scaffolds consistent with the wound microenvironment supports poor wound healing. Correspondingly, it is continually being researched on using various nanocomposite designs to further improve these formulations in overcoming specific issues of poor wound healing and microvascular complications. In this review, we discuss these advanced nanoengineered tools, especially multidimensional hydrogels, 3D-printed technologies and stem cell therapy in detail as therapeutic management of diabetic wounds. We also highlight their formulation aspects and in vitro or in vivo evidence that supports our discussion.