Advanced cell-laden hydrogels for diabetic wound healing: Biomaterial design, therapeutic mechanisms, and translational challenges
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Diabetic wound healing remains a formidable clinical challenge due to persistent inflammation, impaired angiogenesis, elevated oxidative stress, and defective extracellular matrix remodeling. This review aims to comprehensively evaluate recent advancements in cell-laden hydrogels—serving as biomimetic 3D platforms—for accelerating diabetic wound repair. A systematic literature search was conducted across PubMed, Scopus, and Web of Science (covering studies up to 2026), focusing on natural, synthetic, and hybrid hydrogels incorporating stem cells, fibroblasts, keratinocytes, and endothelial cells. Synthesized findings indicate that these hydrogel matrices significantly enhance cell retention, viability, and paracrine activity within the hostile diabetic microenvironment; they drive therapeutic outcomes by modulating macrophage phenotypes (shifting from M1 to M2), promoting robust pro-angiogenic signaling, and accelerating re-epithelialization. However, analysis of current data regarding clinical translation reveals significant hurdles, including poor long-term post-transplantation cell survival, batch-to-batch variability, sterilization constraints, production scalability issues, and stringent regulatory barriers. Consequently, while cell-encapsulating hydrogels represent a highly promising approach for treating chronic diabetic wounds, successful clinical translation requires rigorous material standardization, deeper mechanistic validation, and well-designed clinical trials.
Language: English
Topic: Wound Healing and Treatments
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7223577891