Biocompatible nanostructured chitosan scaffolds for enhanced diabetic wound healing: Innovations and strategies.

Nanostructured chitosan scaffolds have shown significant promise in promoting diabetic wound healing due to their excellent biocompatibility, biodegradability, and regenerative capabilities. These scaffolds possess high porosity and mechanical stability, supporting optimal cell adhesion, proliferation, and extracellular matrix deposition. They accelerate wound repair, achieving 40-60% faster wound closure, a two-to-threefold increase in collagen synthesis, and up to a 200% rise in vascular endothelial growth factor (VEGF) expression. Both in vitro and in vivo studies demonstrate enhanced wound closure, increased collagen deposition, and upregulated VEGF expression, promoting angiogenesis and tissue regeneration. Chitosan scaffolds also modulate key molecular pathways, effectively reducing oxidative stress and inflammation while stimulating cellular repair mechanisms. Recent advancements in fabrication techniques, such as nanotechnology, 3D printing, and electrospinning, have improved scaffold adaptability, enabling the development of multifunctional wound dressings with controlled drug release and enhanced bioactivity. Furthermore, chitosan-based scaffolds exhibit inherent antimicrobial, antioxidant, and anti-inflammatory properties, making them particularly suitable for managing chronic diabetic wounds. The incorporation of bioactive compounds, nanoparticles, and growth factors has further enhanced their therapeutic efficacy. While preclinical studies show promising outcomes, additional research is necessary to ensure clinical translation and large-scale production. This review highlights the potential of chitosan-based scaffolds as innovative biomaterials for diabetic wound management and their promising prospects for future clinical applications. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-025-04377-4.