A Bioflexible Janus Dressing with Unidirectional Drainage for Dynamic pH Monitoring, Exudate Management, and Immune Modulation in Diabetic Wound Healing

Excessive exudate accumulation and chronic inflammation are major barriers to diabetic wound repair, leading to infection risk and impaired tissue regeneration. Conventional dressings lack elasticity and intimate skin conformability, often adhering to fragile tissue and causing secondary trauma. Herein, we developed an ultra-conformable Janus dressing composed of a gentamicin sulfate (GS)-loaded styrene–ethylene–butylene–styrene (SEBS) immune-modulating layer and a PEO–PPO–PEO triblock copolymer (F127)/curcumin (Cur)-loaded thermoplastic polyurethane (TPU) pH-visualizing layer. The asymmetric design integrates differences in surface wettability and fiber porosity between the two layers and enables unidirectional and anti-gravity transport of wound exudate from the SEBS/GS side to the TPU/F127/Cur side, effectively preventing fluid reflux and reducing infection risk. The soft and elastic polymeric matrix ensures intimate wound conformity and mechanical protection, while facilitating angiogenesis and collagen deposition. Furthermore, the pH-responsive dressing not only absorbs inflammatory exudates, but also provides visual, dynamic monitoring of the healing process through pH-dependent color changes. In vitro assays and histological analyses demonstrated that GS-mediated immunomodulation via inflammation suppression and microenvironment improvement markedly accelerated wound closure in diabetic models within 12 days. This multifunctional dressing offers a promising pathway toward next-generation, intelligent, and patient-friendly therapies for chronic diabetic wounds. Graphical