A pH-inspired hydrogel enables real-time monitoring and precise treatment of diabetic wounds

Diabetic wound healing remains a critical challenge due to a hyperglycemia-driven pathological change and lack of real-time diagnosis and monitoring, leading to delayed interventions and poor outcomes. We designed a pH-responsive multifunctional hydrogel (ZSC-SCHY) by encapsulating Scutellaria baicalensis-derived carbon quantum dots (SRC-CDs) into ZnS nanocages (ZS) within a carboxymethyl chitosan (CMCS)/sodium alginate (SA) hydrogel matrix. In vitro and in vivo evaluation showed that ZSC-SCHY dynamically converted the alkaline wound pH to a weakly acidic state. The pH-responsive fluorescence of SRC-CDs allowed real-time visual monitoring of wounds. Additionally, sustained release of Zn2+ and H2S enhanced deep-tissue penetration and promoted angiogenesis. Notably, ZSC-SCHY significantly enhanced migration, proliferation, and synaptogenesis of Schwann cells, while also supporting endothelial cell functions and tissue remodeling. ZSC-SCHY presented an integrated theranostic platform that simultaneously overcame monitoring deficits and multifactorial pathology in diabetic wounds.