Silver–curcumin hydrogel systems for diabetic wound healing: Formulation strategies, mechanisms, evaluation and therapeutic perspectives

Diabetic wounds, particularly diabetic foot ulcers, remain among the most burdensome complications of diabetes mellitus because persistent hyperglycaemia, oxidative stress, chronic inflammation, impaired angiogenesis and recurrent infection together stall the normal sequence of repair. Conventional dressings and systemic antibiotics seldom address these overlapping defects at once. Hydrogels are attractive topical carriers because their hydrated three-dimensional networks maintain a moist wound environment, absorb exudate and permit controlled release of loaded agents. Silver, in ionic and nanoparticulate form, provides broad-spectrum antimicrobial and anti-biofilm activity, whereas curcumin, the principal polyphenol of Curcuma longa, offers antioxidant, anti-inflammatory, pro-angiogenic and collagen-promoting actions but is limited by poor aqueous solubility and instability. Combining the two within a single hydrogel is therefore a rational multi-target strategy. This review summarises the pathophysiology of impaired diabetic healing, the properties of silver and curcumin relevant to wound care, polymer matrices, formulation and crosslinking strategies, proposed mechanisms of complementary action, and the physicochemical and biological methods used for evaluation. Safety, silver accumulation, regulatory and scale-up challenges are discussed, and future directions such as stimuli-responsive, injectable and sensor-integrated systems are outlined. Silver–curcumin hydrogels show considerable preclinical promise, but standardised testing and well-designed clinical trials are required before clinical translation.