Ultrasmall MnO_<i>x</i> Nanodots Catalyze Glucose for Reactive Oxygen Species‐Dependent Sequential Anti‐Infection and Regeneration Therapy

Abstract

The management of diabetic wounds poses significant challenges due to persistent bacterial infections and chronic inflammation caused by hyperglycemia. Herein, a sequential two‐phase treatment strategy involving a reactive oxygen species (ROS) burst in the first phase for anti‐infection is proposed, followed by a benign level of ROS in the second phase for wound regeneration. To this end, ultra‐small manganese oxide nanodots (BM‐NDs) are incorporated into a gelatin methacrylamide (GelMA) hydrogel via a ROS‐responsive linker to form GelMA@BM dressing. The BM‐NDs catalyze a self‐cascade reaction that decomposes glucose into hydrogen peroxide, generates hydroxyl radicals (·OH), and simultaneously depletes glutathione. Upon application on diabetic wounds, BM‐NDs are rapidly released from the hydrogel due to endogenous ROS exposure, leading to high levels of ·OH that effectively eliminate bacteria and promote macrophage polarization to M1 phenotype, thereby facilitating phagocytosis of bacteria. With the consumption of glucose and degradation of BM‐NDs, ROS in the wound area declines to a benign level, which stimulates polarization of M2 macrophages and promotes wound healing. This two‐phase treatment strategy based on GelMA@BM dressing demonstrates potent antibacterial and pro‐healing efficacy, showcasing its potential for clinical translation.