The treatment of diabetic foot ulcers with advanced nanomaterials

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Diabetic foot ulcers (DFUs) represent a severe global health crisis characterized by impaired healing, persistent infections, and high amputation rates. To address this multifaceted pathophysiology—including infection, chronic inflammation, ischemia, oxidative stress, and defective extracellular matrix (ECM) remodeling—recent research has focused on advanced multifunctional nanomaterial systems. This review explores recent advances in multifunctional nanomaterial systems designed to address the multifaceted pathophysiology of DFUs, including infection, chronic inflammation, ischemia, oxidative stress, and defective ECM remodeling. Nanocomposite dressings—such as chitosan-based scaffolds, hydrogels, liposomes, and electrospun nanofibers—integrate antimicrobial agents, angiogenesis promoters, and immunomodulators to synergistically combat drug-resistant pathogens, polarize macrophages toward reparative phenotypes, neutralize reactive oxygen species, and enhance collagen deposition. Stimuli-responsive designs (pH, ROS, enzyme, or light-triggered) enable spatiotemporal control of therapeutic release. Preclinical studies demonstrate accelerated wound closure (>90% within 14–21 d) through coordinated antimicrobial, anti-inflammatory, and regenerative mechanisms. Despite promising results, challenges remain in scalable manufacturing, regulatory approval, and clinical translation, and therefore, future directions include personalized systems dynamically adapting therapy based on real-time biomarkers.