Injectable Reactive Oxygen Species-Responsive Hydrogel Dressing with Sustained Nitric Oxide Release for Bacterial Ablation and Wound Healing

Skin wound healing strategies that promote sustainable healing, prevent bacterial infections, and cause only mild irritation are urgently needed for open wound therapy. In this study, a system that consists of a reactive oxygen species (ROS)-degradable hydrogel dressing, with encapsulated biosafe nitric oxide (NO) donor L-arginine (L-Arg), and a low level (100 x 10(-6) m) of the household disinfectant hydrogen peroxide (H2O2) is established for sustainable wound therapy and disinfection. Under stimulation with a low level of H2O2, NO is sustainably generated from L-Arg within the hydrogel dressing, which mediates macrophage and fibroblast chemotaxis to the wound site, as well as collagen synthesis, resulting in rapid wound healing and skin organ regeneration. The combination of H2O2 and NO also endows the system with a synergistic antibacterial ability to eliminate ampicillin-resistant Escherichia coli. In addition, a full-thickness skin wound model demonstrates that the ROS-degradable hydrogel dressing, with a wound exudate adsorption ability, shows effective wound healing promotion and a good biocompatibility, without any hazardous residues and skin irritation. This ROS-responsive, degradable, synergistic wound healing system provides an alternative strategy for sustainable wound treatment, both at home and in the clinic.