An Ultrafast Self-Gelling Versatile Hydrogel for Rapid Infected Burn Wound Repair in Military Medicine

Military-related burn wounds present unique clinical challenges, including high infection risk, austere treatment environments, and the need for rapid hemostasis. In this study, the study develops a multifunctional PG@PAC powder hydrogel dressing composed of incorporating phenylboronic acid-modified oxidized dextran (POD), carbonic dihydrazide-modified gelatin (Gel-CDH), and the self-assembly nanoparticles of proanthocyanidins (PA) and chlorhexidine acetate (CHX). Upon contact with wound exudates, the powder rapidly self-assembled into a robust hydrogel via dynamic Schiff-base reactions, exhibiting strong tissue adhesion, self-healing ability, and mechanical properties comparable to natural skin. The PG@PAC (POD/Gel-CDH@PA/CHX) hydrogel possesses broad-spectrum antibacterial effects, powerful reactive oxygen species-scavenging activity, and excellent biocompatibility. It also facilitates macrophage polarization to the M2 phenotype, which lead to the decrease of pro-inflammatory cytokines and the increase of anti-inflammatory cytokines. In a murine model with S. aureus -infected burn wounds, PG@PAC treatment improves wound microenvironment, resulting in accelerated wound healing, augmented collagen deposition, decreased bacterial burden, and facilitated angiogenesis. These results indicate that PG@PAC is a potential all-in-one ready-to-use dressing for infected burn wound under resource-limited environments and provide a promising envision of battlefield wound management.