Tendon Decellularized Extracellular Matrix Composited with Chitosan with Loading Skin Precursor Stem Cell Exosome for Enhanced Diabetic Wound Healing

This study addresses the challenge of diabetic wound healing by developing a decellularized extracellular matrix (dECM)-based hydrogel system loaded with exosomes from skin-derived precursor cells (SKPs). The engineered hydrogels enhance exosome retention and utilization, promoting angiogenesis, antibacterial effects, and reactive oxygen species (ROS) scavenging. In vitro, the hydrogels improved endothelial cell functions and macrophage polarization towards the M2 phenotype. In vivo, using a diabetic rat model, the hydrogels accelerated wound closure, increased microvessel density, improved collagen deposition, and reduced inflammation. These findings suggest that SKPs exosome-loaded dECM hydrogels could be an effective treatment for diabetic wounds.