Literature Study: The Effect of Giving Chitosan Water Gel (Hydrogel) on Healing Diabetic Ulcers Based on In Vivo Studies with Animal Models

Zahratul Noreisza Rakhmadi, Erina Yatmasari, Prawesty Diah Utami


Diabetic ulcers are one of the most common chronic complications and cause infection, gangrene to leg amputation if the treatment given is not appropriate. Chitosan has anti-microbial properties that make the wound area smaller and are anti-inflammatory to reduce pain. Water gel (hydrogel), which is water, is easily absorbed by the skin and penetrates perfectly into the wound so that it provides a moist effect and prevents bacteria from entering. This study aims to determine the effect of giving chitosan water gel (hydrogel) on the healing of diabetic ulcers. This study uses a literature study method by searching for related journals using keywords, then selected based on the last 5 years and indexed in SINTA, Google Scholar or Scopus, and the final results are 13 journals. This study took place in May - November 2021. The results of this study reported that the administration of chitosan water gel (hydrogel) combined with other ingredients for healing diabetic ulcers gave the same results. The results obtained are reducing inflammation, re-epithelializing wounds, accelerating angiogenesis, accelerating the formation of collagen and granulation tissue, and accelerating wound healing. Although all studies have the same results, the healing time produced by each study is different, this is because each ingredient used has a different content. The average wound changes were seen on the 3rd, 5th, 7th day and the wound healed completely on the 14th day. This study concludes that the administration of chitosan water gel (hydrogel) affects the healing of diabetic ulcer wounds in combination with other ingredients. because the time needed to close the wound is faster.


Wound healing, diabetic ulcer, chitosan, water gel (hydrogel)

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Aljebory, A. M., Alsalman, T. M., Aljebory, A., & Alsalman, T. M. (2017). Chitosan Nanoparticles: Review Article. Imperial Journal of Interdisciplinary Research (IJIR, 3(7), 233–242.

Bai, H., Kyu-Cheol, N., Wang, Z., Cui, Y., Liu, H., Liu, H., Feng, Y., Zhao, Y., Lin, Q., & Li, Z. (2020). Regulation of inflammatory microenvironment using a self-healing hydrogel loaded with BM-MSCs for advanced wound healing in rat diabetic foot ulcers. Journal of Tissue Engineering, 11.

Chen, X., Cao, X., Jiang, H., Che, X., Xu, X., Ma, B., Zhang, J., & Huang, T. (2018). SIKVAV-modified chitosan hydrogel as a skin substitute for wound closure in mice. Molecules, 23(10), 1–12.

Childs, D. R., & Murthy, A. S. (2017). Overview of Wound Healing and Management. Surgical Clinics of North America, 97(1), 189–207.

Cifuentes, A., Gómez-Gil, V., Ortega, M. A., Asúnsolo, Á., Coca, S., Román, J. S., Álvarez-Mon, M., Buján, J., & García-Honduvilla, N. (2020). Chitosan hydrogels functionalized with either unfractionated heparin or bemiparin improve diabetic wound healing. Biomedicine and Pharmacotherapy, 129(July), 110498.

Detty, A. U., Fitriyani, N., Prasetya, T., & Florentina, B. (2020). Karakteristik Ulkus Diabetikum Pada Penderita Diabetes Melitus. Jurnal Ilmiah Kesehatan Sandi Husada, 11(1), 258–264.

Divandra, C. V. R. (2020). Madu Sebagai Dressing Pada Penyembuhan Ulkus Diabetikum Honey as Dressing Treatment for Diabetic Ulcer Healing. Juni, 11(1), 532–539.

Golmohammadi, R., Najar-Peerayeh, S., Tohidi Moghadam, T., & Hosseini, S. M. J. (2020). Synergistic Antibacterial Activity and Wound Healing Properties of Selenium-Chitosan-Mupirocin Nanohybrid System: An in Vivo Study on Rat Diabetic Staphylococcus aureus Wound Infection Model. Scientific Reports, 10(1), 1–10.


Hutagalung, M. B. Z., Eljatin, D. S., Awalita, Sarie, V. P., Sianturi, G. D. A., & Santika, G. F. (2019). Diabetic Foot Infection (Infeksi Kaki Diabetik): Diagnosis dan Tatalaksana. Continuing Medical Education, 46(6), 414–418.

Janis, J. E., & Harrison, B. (2016). Wound healing: Part I. basic science. Plastic and Reconstructive Surgery, 138(3), 9S-17S.

Lee, Y. H., Hong, Y. L., & Wu, T. L. (2021). Novel silver and nanoparticle-encapsulated growth factor co-loaded chitosan composite hydrogel with sustained antimicrobility and promoted biological properties for diabetic wound healing. Materials Science and Engineering C, 118, 111385.

Li, J., & Mooney, D. J. (2016). Designing hydrogels for controlled drug delivery. Nature Reviews Materials, 1(12), 1–18.

Li, M., Ke, Q. F., Tao, S. C., Guo, S. C., Rui, B. Y., & Guo, Y. P. (2016). Fabrication of hydroxyapatite/chitosan composite hydrogels loaded with exosomes derived from miR-126-3p overexpressed synovial mesenchymal stem cells for diabetic chronic wound healing. Journal of Materials Chemistry B, 4(42), 6830–6841.

Martínez, S. P. H., González, T. I. R., Molina, M. A. F., Bollain Y Goytia, J. J., Sanmiguel, J. J. M., Triviño, D. G. Z., & Padilla, C. R. (2019). A novel gold calreticulin nanocomposite based on chitosan for wound healing in a diabetic mice model. Nanomaterials, 9(1).

Ningsih, A., Darwis, I., Graharti, R., Kedokteran, F., & Lampung, U. (2019). Terapi Madu Pada Penderita Ulkus Diabetikum Honey Therapy In Diabetic Ulcus Patients. Medula, 9(12), 192–197.

Patil, P. S., Fathollahipour, S., Inmann, A., Pant, A., Amini, R., Shriver, L. P., & Leipzig, N. D. (2019). Fluorinated Methacrylamide Chitosan Hydrogel Dressings Improve Regenerated Wound Tissue Quality in Diabetic Wound Healing. Advances in Wound Care, 8(8), 374–385.

Prasathkumar, M., & Sadhasivam, S. (2021). Chitosan/Hyaluronic acid/Alginate and assorted polymers loaded with honey, plant, and marine compounds for progressive wound healing—Know-how. International Journal of Biological Macromolecules, 186(April), 656–685.

Prastika, D. D., Setiawan, B., Saputro, A. L., Yudaniayanti, I. S., Wibawati, P. A., & Fikri, F. (2020). Pengaruh Kitosan Udang Secara Topikal Terhadap Kepadatan Kolagen dalam Penyembuhan Luka Eksisi pada Tikus Putih. Jurnal Medik Veteriner, 3(1), 101.

Putri, D. E. D., & Sriwidodo. (2016). Farmaka REVIEW ARTIKEL PERANAN EPIDERMAL GROWTH FACTOR PADA PENYEMBUHAN LUKA PASIEN ULKUS DIABETES Farmaka. Review Artikel: Peranan Epidermal Growth Factor Pada Penyembuhan Luka Pasien Ulkus Diabetes, 14, 1–11.

Ramadhian, M. R., & Widiastini, A. A. (2018). Kegunaan Ekstrak Daun Pepaya ( Carica papaya ) Pada Luka The Use of Papaya Leaf Extract ( Carica papaya ) On Wounds. J Agromedicine, 5(1), 513–517.

Restuningtyas, A. (2016). Pengaruh Kombinasi Perawatan Luka Modern Dengan Ozon Bagging Terhadap Proses Penyembuhan Ulkus Kaki Diabetik Pada Klien DiabetiS Melitus Di Rumah Rawat Luka Nirmala Jember. In Tifa Wisanti.

Sari, Y. O., Almasdy, D., & Fatimah, A. (2018). Evaluasi Penggunaan Antibiotik Pada Pasien Ulkus Diabetikum di Instalasi Rawat Inap (IRNA) Penyakit Dalam RSUP Dr. M. Djamil Padang. Jurnal Sains Farmasi & Klinis, 5(2), 102.

Shen, T., Dai, K., Yu, Y., Wang, J., & Liu, C. (2020). Sulfated chitosan rescues dysfunctional macrophages and accelerates wound healing in diabetic mice. Acta Biomaterialia, 117, 192–203.

Shi, Q., Qian, Z., Liu, D., Sun, J., Wang, X., Liu, H., Xu, J., & Guo, X. (2017). GMSC-derived exosomes combined with a chitosan/silk hydrogel sponge accelerates wound healing in a diabetic rat skin defect model. Frontiers in Physiology, 8(NOV), 1–16.

Shukla, R., Kashaw, S. K., Jain, A. P., & Lodhi, S. (2016). Fabrication of Apigenin loaded gellan gum–chitosan hydrogels (GGCH-HGs) for effective diabetic wound healing. International Journal of Biological Macromolecules, 91, 1110–1119.

Singh, Shailesh Kumar, Dhyani, A. dan D., & Juyal. (2017). Hydrogel : Preparation, Characterization, and Applications. The Pharma Innovation Journal, 6(6), 25–32.

Viezzer, C., Mazzuca, R., Machado, D. C., de Camargo Forte, M. M., & Gómez Ribelles, J. L. (2020). A new waterborne chitosan-based polyurethane hydrogel as a vehicle to transplant bone marrow mesenchymal cells improved wound healing of ulcers in a diabetic rat model. Carbohydrate Polymers, 231.

Xu, N., Wang, L., Guan, J., Tang, C., He, N., Zhang, W., & Fu, S. (2018). Wound healing effects of a Curcuma zedoaria polysaccharide with platelet-rich plasma exosomes assembled on chitosan/silk hydrogel sponge in a diabetic rat model. International Journal of Biological Macromolecules, 117(2017), 102–107.

Zhu, J., Jiang, G., Hong, W., Zhang, Y., Xu, B., Song, G., Liu, T., Hong, C., & Ruan, L. (2020). Rapid gelation of oxidized hyaluronic acid and succinyl chitosan for integration with insulin-loaded micelles and epidermal growth factor on diabetic wound healing. Materials Science and Engineering C, 117, 111273.



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