Ultrasound-switchable piezoelectric BiVO4/fullerene heterostructure for on-demand ROS modulation in MRSA-infected diabetic wound healing

Persistent microbial infections and excessive reactive oxygen species (ROS) accumulation severely impede diabetic wound healing. Herein, we developed an ultrasound-switchable BiVO 4 /fullerene piezoelectric heterostructure via a one-pot solvothermal method, enabling on-demand transition between bactericidal action and ROS scavenging for treating infected diabetic wounds. Under 8-min ultrasound (US) irradiation, the heterojunction sonosensitizer leveraged piezoelectric polarization to generate substantial ROS in real-time through a narrowed energy band gap and enhanced charge carrier separation and migration efficiency, resulting in the disruption of bacterial membrane integrity and 99.9 % eradication of methicillin-resistant Staphylococcus aureus (MRSA). Upon US withdrawal, the sonosensitizer spontaneously transitioned to an antioxidative state through fullerene-mediated ROS scavenging, effectively neutralizing excess ROS and restoring cellular redox balance. In an MRSA-infected diabetic wound model, this ultrasound-responsive duality effectively suppressed bacterial proliferation, reduced inflammation, enhanced angiogenesis, and ultimately accelerated wound healing within 14 days. This ultrasound-switchable therapeutic strategy offers promising insights for managing drug-resistant infections and other ROS-mediated biomedical challenges.