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The ability of autologous platelet-rich plasma (PRP) gel to promote rapid wound healing without immunological rejection has opened new avenues for the treatment of diabetic foot wounds. However, PRP gel still suffers from the quick release of growth factors (GFs) and requires frequent administration, thus resulting in decreased wound healing efficiency, higher cost as well as greater pain and suffering for the patients. In this study, the flow-assisted dynamic physical cross-linked coaxial microfluidic three-dimensional (3D) bio-printing technology, combined with the calcium ion chemical dual cross-linking method was developed to design PRP-loaded bioactive multi-layer shell-core fibrous hydrogels. The prepared hydrogels exhibited outstanding water absorption-retention capacity, good biocompatibility as well as a broad-spectrum antibacterial effect. Compared with clinical PRP gel, these bioactive fibrous hydrogels displayed a sustained release of GFs, reducing the administration frequency by 33 % availably during the wound treatment, but more prominent therapeutic effects such as effective reduced inflammation, in addition to promoting the growth of granulation tissue and angiogenesis, the formation of high-density hair follicles, and the generation of regular ordered and high-density collagen fiber network, which suggested great promise as exceptional candidates for treatment of diabetic foot ulcer in clinical settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Nanofibrous dressings exhibit high specific surface areas, good histocompatibility, enhanced wound healing, and reduced inflammation, which have broad technological implications for treating diabetic foot ulcers (DFUs). However, current nanofibrous dressings still suffer from high resistance to cell infiltration and multiple dressing changes. In this study, polycaprolactone (PCL) and collagen were adopted as electrospinning materials to prepare a 3D PCL/Collagen (PC) nanofibrous dressing (3D-PC) using aqueous phase fibre reassembly technology. The matrix metalloproteinases (MMPs) inhibitor doxycycline hyclate (DCH)-loaded halloysite nanotubes (HNTs) (DCH@HNTs) and antibacterial agent cephalexin (CEX) were loaded onto the dressing to prepare a multifunctional 3D drug-loaded PCL/Collagen nanofibrous dressing to promote DFU wound healing. The obtained 3D nanofibrous dressing exhibited high water absorption capacity and swelling capacity. It showed good antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) in vitro antibacterial test. In addition, the 3D nanofibrous dressing demonstrated good biocompatibility. It could significantly reduce the frequency of dressing changes and improve the healing of DFU wounds compared with the conventional multiple dressing changes method, suggesting a potential candidate for healing diabetic wounds., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The healing mechanism of diabetic foot wounds is very complicated, and it is difficult for a single-function medical dressing to achieve good therapeutic effects. We propose a simple coaxial biological 3D printing technology, which uses one-step 3D deposition to continuously produce multifunctional medical dressings on the basis of core-shell hydrogel fibers. These dressings have good biocompatibility, controlled drug-release performance, excellent water absorption and retention, and antibacterial and anti-inflammatory functions. In vivo experiments with type 2 diabetic rats were performed over a 14-day period to compare the performance of the multifunctional 3D dressing with a gauze control; the multifunctional 3D dressing reduced inflammation, effectively increased the post-healing thickness of granulation tissue, and promoted the formation of blood vessels, hair follicles, and highly oriented collagen fiber networks. Therefore, the proposed multifunctional dressing is expected to be suitable for clinical applications for healing diabetic foot wounds.