Smart Dressings Based on Nanostructured Fibers Containing Natural Origin Antimicrobial, Anti-Inflammatory, and Regenerative Compounds

Extracellular matrix biomimetic polymeric membranes enriched with silver nanoparticles for wound healing

Severe skin injuries, including burns, represent a real concern for the global health-care system and therefore, there is an increased interest in developing wound dressings, in order to stimulate and enhance skin tissue repair. The aim of this study was to design novel hybrid materials, biomimetic to skin extracellular matrix and enriched with silver nanoparticles (nAg), in order to provide both dermal tissue regeneration and antimicrobial activity. Two material variants (variant A and variant B) consisting of type I collagen (COL), chondroitin sulfate (CS) and k-elastin peptides (EL) enriched with positively-charged nAg, were conditioned as membranes. UV exposure ensured both sterilisation and cross-linking of the materials. Physico-chemical characterization of the hybrid biomaterials showed values of density and swelling degree higher than those of COL membrane, while the process of in vitro degradation followed a similar pattern. Infrared spectroscopy and X-ray diffraction indicated alterations of the characteristic structural features and crystallinity of COL after blending with CS and EL and nAg embedding. Scanning electron microscopy observations revealed different surface morphologies of the hybrid membranes, according to their composition. In vitro studies on L929 fibroblasts and HaCaT keratinocytes showed that both hybrid membranes exhibited good cytocompatibility and promoted higher cell proliferation compared to COL sample, as evaluated by MTT and Live/Dead assays. The presence of actin filaments highlighted by fluorescent labelling confirmed the fibroblast and keratinocyte adhesion onto the surface of hybrid membranes. Most importantly, both materials showed an increased wound healing ability in an in vitro scratch assay model, stimulating cell migration at 24 h post-seeding. In addition, good antimicrobial activity was recorded, especially against Gram-positive bacterial strain. Altogether, our findings recommend COL-CS-EL-nAg hybrid membranes as good candidates for wound healing acceleration and bioengineering of skin tissue.

Aloe vera: A Medicinal Plant Used in Skin Wound Healing

Skin injury is a major problem threatening human physical and mental health, and how to promote wound healing has been the focus. Developing new wound dressings is an important strategy in skin regeneration. Aloe vera is a medicinal plant with a long history, complex constituents, and various pharmacological activities. Many studies have shown that A. vera plays an important role in promoting wound healing. Adding A. vera to wound dressing has become an ideal way. This review will describe the process of skin injury and wound healing and analyze the role of A. vera in wound healing. In addition, the types of wound dressing and the applications of A. vera in wound dressing will be discussed.

Preparation and Characterization of Electrospun Double-layered Nanocomposites Membranes as a Carrier for Centella asiatica (L.)

A wide range of naturally derived and synthetic biodegradable and biocompatible polymers are today regarded as promising materials for improving skin regeneration. Alongside this, these materials have been explored in conjunction with different types of antimicrobial and bioactive agents, especially natural-derived compounds, to enhance their biological properties. Herein, a double-layered nanocomposite dressing membrane was fabricated with two distinct layers. A bottom layer from Chitosan-Sodium tripolyphosphate (CS-TPP) and Poly(vinyl alcohol) (PVA) containing Centella asiatica (L.) (CA) was electrospun directly over a Polycaprolactone (PCL) layer to improve the biologic performance of the electrospun nanofibers. In turn, the PCL layer was designed to provide mechanical support to the damaged tissue. The results revealed that the produced double-layered nanocomposite membrane closely resembles the mechanical, porosity, and wettability features required for skin tissue engineering. On the other hand, the in vitro drug release profile of the PCL/PVA_CS-TPP containing CA exhibited a controlled release for 10 days. Moreover, the PVA_CS-TPP_CA's bottom layer displayed the highest antibacterial activity against Staphylococcus aureus (S. aureus) (99.96 ± 6.04%) and Pseudomonas aeruginosa (P. aeruginosa) (99.94 ± 0.67%), which is responsible for avoiding bacterial penetration while endowing bioactive properties. Finally, the 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay showed that this nanocomposite membrane was not cytotoxic for normal human dermal fibroblasts (NHDF) cells. Therefore, these findings suggest the potential use of the double-layered PCL/PVA_CS-TPP_CA as an efficient bionanocomposite dressing material.

Regenerative Wound Dressings for Skin Cancer

Skin cancer is considered the most prevalent cancer type globally, with a continuously increasing prevalence and mortality growth rate. Additionally, the high risk of recurrence makes skin cancer treatment among the most expensive of all cancers, with average costs estimated to double within 5 years. Although tumor excision is the most effective approach among the available strategies, surgical interventions could be disfiguring, requiring additional skin grafts for covering the defects. In this context, post-surgery management should involve the application of wound dressings for promoting skin regeneration and preventing tumor recurrence and microbial infections, which still represents a considerable clinical challenge. Therefore, this paper aims to provide an up-to-date overview regarding the current status of regenerative wound dressings for skin cancer therapy. Specifically, the recent discoveries in natural biocompounds as anti-cancer agents for skin cancer treatment and the most intensively studied biomaterials for bioactive wound dressing development will be described.

Nanotechnology-driven advances in the treatment of diabetic wounds

Diabetic foot ulcers (DFUs) are chronic severe complications of diabetes disease and remain a worldwide clinical challenge with social and economic consequences. Diabetic wounds can cause infection, amputation of lower extremities, and even death. Several factors including impaired angiogenesis, vascular insufficiency, and bacterial infections result in a delayed process of wound healing in diabetic patients. Treatment of wound infections using traditional antibiotics has become a critical status. Thus, finding new therapeutic strategies to manage diabetic wounds is urgently needed. Nanotechnology has emerged as an efficient approach for this purpose. This review aimed to summarize recent advances using nanotechnology for the treatment of diabetic wounds.

Nanofibrous cosmetic face mask for transdermal delivery of nano gold: synthesis, characterization, release and zebra fish employed toxicity studies

This study involves the generation of gold nanoparticles (Au NPs) via a novel natural/non-toxic methodology using tea and orange-peel extracts. These were then embedded into a novel blend composed of a polyethylene oxide and gelatin (PEO-Gel) fibre mat. The scanning electron microscopy results indicated that the addition of both collagen (COL) and ascorbic acid (AA) into the PEO-Gel system (PEO-Gel-AA-COL system) enhances the Au NP incorporation into nanofibres leading to a diameter of 164.60 ± 20.95 and 192.43 ± 39.14 nm in contrast to the spraying observed with the Au PEO-Gel system alone. Releasing studies conducted over 30 min indicated that the PEO-Gel-AA-COL-orange peel Au (OpAu) system accounts for a higher content of Au release than the green tea Au (GtAu) NP system where a maximum release could be attained within 10-30 min depending on the amount of Au NPs that have been incorporated. Moreover, the transdermal diffusion studies conducted using Strat membrane indicated that Au NPs from both formulations (PEO-Gel-AA-COL-GtAu nanofibre, PEO-Gel-AA-COL-OpAu nanofibre) have diffused through the stratum corneum and trapped in the dermis and epidermis indicating its transdermal deliverability. Additionally, 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay revealed that nanofibres have similar radical scavenging activity like AA standard. Toxicity evaluation on a zebra fish embryo model confirmed that both GtAu NPs and OpAu NPs do not induce any teratogenic activity and are safe to be used in the range of 1.0-167 µg ml-1.

Bio-extract amalgamated sodium alginate-cellulose nanofibres based 3D-sponges with interpenetrating BioPU coating as potential wound care scaffolds

In this work, sodium alginate (SA) based "all-natural" composite bio-sponges were designed for potential application as wound care scaffold. The composite bio-sponges were developed from the aqueous amalgamation of SA and cellulose nanofibres (CNFs) in bio-extracts like Rice water (Rw) and Giloy extract (Ge). These sponges were modified by employing a simple coating strategy using vegetable oil-based bio-polyurethane (BioPU) to tailor their physicochemical and biological properties so as to match the specific requirements of a wound care scaffold. Bio-sponges with shared interpenetrating polymeric network structures were attained at optimized BioPU coating formulation. The interpenetration of BioPU chains within the sponge construct resulted in the formation of numerous micro-networks in the interconnected microporous structure of sponges (porosity ≥75%). The coated sponge showed a superior mechanical strength (compressive strength ~3.8 MPa, compressive modulus ~35 MPa) with appreciable flexibility and recoverability under repeated compressive loading-unloading cycles. A tunable degradation behaviour was achieved by varying BioPU coating concentrations owing to the different degree of polymer chain entanglement within the sponge construct. The physical entanglement of BioPU chains with core structural components of sponge improved their structural stability by suppressing their full fragmentation in water-based medium without affecting its swelling behaviour (swelling ratio > 1000%). The coated sponge surface has provided a suitable moist-adherent physical environment to support the adhesion and growth of skin cells (HaCaT cells). The MTT (3-(4,5-dimethyl thiazolyl-2)-2,5-diphenyltetrazolium bromide) assay and hemolytic assay revealed the non-toxic and biocompatible nature of coated sponges in vitro. Moreover, no signs of skin erythema or edema were observed during in vivo dermal irritation and corrosion test performed on the skin of Sprague Dawley (SD) rats. Our initial observations revealed the credibility of these sponges as functional wound care scaffolds as well as its diverse potential as a suitable substrate for various tissue engineering applications.

Bovine Serum Albumin (BSA)/polyacrylonitrile (PAN) biohybrid nanofibers coated with a biomineralized calcium deficient hydroxyapatite (HA) shell for wound dressing

Here, for the first time, a nanofibrous (NF) wound dressing comprising biomineralized polyacrylonitrile (PAN) nanofibers is developed. In contrast to the majority of the currently available nanofibrous wound dressings that are based on natural polymers, PAN is a synthetic, industrial polymer, which has been rarely considered for this purpose. PAN NFs are first hydrolyzed to allow for tethering of biofunctional agents (here Bovine Serum Albumin (BSA)). Later, the biofunctionlized PAN NFs are biomineralized by immersion in simulated body fluid (SBF). As a result, core-shell, calcium deficient hydroxyapatite (HA)/BSA/PAN nanofibers form, that are mechanically stronger (elastic modulus; 8.5 vs. 6 MPa) compared to the untreated PAN NFs. The biomineralized PAN NFs showed promising bioactivity as reflected in the cell biology tests with fibroblast and keratinocyte cells. Hs68 fibroblasts and HaCat keratinocytes were found to be more viable in the presence of the biomineralized NFs than when they were co-cultured with the neat PAN NFs. Such mechanical and biological characteristics of the biomineralized PAN NFs are favorable for wound dressing applications.

Crustacean Proteases and Their Application in Debridement

Digestive proteases from marine organisms have been poorly applied to biomedicine. Exceptions are trypsin and other digestive proteases from a few cold-adapted or temperate fish and crustacean species. These enzymes are more efficient than enzymes from microorganism and higher vertebrates that have been used traditionally. However, the biomedical potential of digestive proteases from warm environment species has received less research attention. This review aims to provide an overview of this unrealised biomedical potential, using the debridement application as a paradigm. Debridement is intended to remove nonviable, necrotic and contaminated tissue, as well as fibrin clots, and is a key step in wound treatment. We discuss the physiological role of enzymes in wound healing, the use of exogenous enzymes in debridement, and the limitations of cold-adapted enzymes such as their poor thermal stability. We show that digestive proteases from tropical crustaceans may have advantages over their cold-adapted counterparts for this and similar uses. Differences in thermal stability, auto-proteolytic stability, and susceptibility to proteinase inhibitors are discussed. Furthermore, it is proposed that the feeding behaviour of the source organism may direct the evaluation of enzymes for particular applications, as digestive proteases have evolved to fill a wide variety of feeding habitats, natural substrates, and environmental conditions. We encourage more research on the biomedical application of digestive enzymes from tropical marine crustaceans.

Marine Algae Polysaccharides as Basis for Wound Dressings, Drug Delivery, and Tissue Engineering: A Review

The present review considers the physicochemical and biological properties of polysaccharides (PS) from brown, red, and green algae (alginates, fucoidans, carrageenans, and ulvans) used in the latest technologies of regenerative medicine (tissue engineering, modulation of the drug delivery system, and the design of wound dressing materials). Information on various types of modern biodegradable and biocompatible PS-based wound dressings (membranes, foams, hydrogels, nanofibers, and sponges) is provided; the results of experimental and clinical trials of some dressing materials in the treatment of wounds of various origins are analyzed. Special attention is paid to the ability of PS to form hydrogels, as hydrogel dressings meet the basic requirements set out for a perfect wound dressing. The current trends in the development of new-generation PS-based materials for designing drug delivery systems and various tissue-engineering scaffolds, which makes it possible to create human-specific tissues and develop target-oriented and personalized regenerative medicine products, are also discussed.

Nanoparticle-Based Therapeutic Approach for Diabetic Wound Healing

Diabetes mellitus (DM) is a common endocrine disease characterized by a state of hyperglycemia (higher level of glucose in the blood than usual). DM and its complications can lead to diabetic foot ulcer (DFU). DFU is associated with impaired wound healing, due to inappropriate cellular and cytokines response, infection, poor vascularization, and neuropathy. Effective therapeutic strategies for the management of impaired wound could be attained through a better insight of molecular mechanism and pathophysiology of diabetic wound healing. Nanotherapeutics-based agents engineered within 1-100 nm levels, which include nanoparticles and nanoscaffolds, are recent promising treatment strategies for accelerating diabetic wound healing. Nanoparticles are smaller in size and have high surface area to volume ratio that increases the likelihood of biological interaction and penetration at wound site. They are ideal for topical delivery of drugs in a sustained manner, eliciting cell-to-cell interactions, cell proliferation, vascularization, cell signaling, and elaboration of biomolecules necessary for effective wound healing. Furthermore, nanoparticles have the ability to deliver one or more therapeutic drug molecules, such as growth factors, nucleic acids, antibiotics, and antioxidants, which can be released in a sustained manner within the target tissue. This review focuses on recent approaches in the development of nanoparticle-based therapeutics for enhancing diabetic wound healing.

Efficacy of Bioactive Glass Nanofibers Tested for Oral Mucosal Regeneration in Rabbits with Induced Diabetes

The healing of oral lesions that are associated with diabetes mellitus is a matter of great concern. Bioactive glass is a highly recommended bioceramic scaffold for bone and soft tissue regeneration. In this study, we aimed to assess the efficacy of a novel formula of bioactive glass nanofibers in enhancing oral mucosal wound regeneration in diabetes mellitus. Bioactive glass nanofibres (BGnf) of composition (1–2) mol% of B₂O₃, (68–69) mol% of SiO₂, and (29–30) mol% of CaO were synthesized via the low-temperature sol-gel technique followed by mixing with polymer solution, then electrospinning of the glass sol to produce nanofibers, which were then subjected to heat treatment. X-Ray Diffraction analysis of the prepared nanofibers confirmed its amorphous nature. Microstructure of BGnf simulated that of the fibrin clot with cross-linked nanofibers having a varying range of diameter (500–900 nm). The in-vitro degradation profile of BGnf confirmed its high dissolution rate, which proved the glass bioactivity. Following fibers preparation and characterization, 12 healthy New Zealand male rabbits were successfully subjected to type I diabetic induction using a single dose of intravenous injection of alloxan monohydrate. Two weeks after diabetes confirmation, the rabbits were randomly divided into two groups (control and experimental groups). Bilateral elliptical oral mucosal defects of 10 × 3.5 mm were created in the maxillary mucobuccal fold of both groups. The defects of the experimental group were grafted with BGnf, while the other group of defects considered as a control group. Clinical, histological, and immune-histochemical assessment of both groups of wounds were performed after one, two and three weeks’ time interval. The results of the clinical evaluation of BGnf treated defects showed complete wound closure with the absence of inflammation signs starting from one week postoperative. Control defects, on the other hand, showed an open wound with suppurative exudate. On histological and immunohistochemical level, the BGnf treated defects revealed increasing in cell activity and vascularization with the absence of inflammation signs starting from one week time interval, while the control defects showed signs of suppurative inflammation at one week time interval with diminished vascularization. The results advocated the suitability of BGnf as bioscaffold to be used in a wet environment as the oral cavity that is full of microorganisms and also for an immune-compromised condition as diabetes mellitus.

Nanostructured Fibers Containing Natural or Synthetic Bioactive Compounds in Wound Dressing Applications

The interest in wound healing characteristics of bioactive constituents and therapeutic agents, especially natural compounds, is increasing because of their therapeutic properties, cost-effectiveness, and few adverse effects. Lately, nanocarriers as a drug delivery system have been actively investigated and applied in medical and therapeutic applications. In recent decades, researchers have investigated the incorporation of natural or synthetic substances into novel bioactive electrospun nanofibrous architectures produced by the electrospinning method for skin substitutes. Therefore, the development of nanotechnology in the area of dressings that could provide higher performance and a synergistic effect for wound healing is needed. Natural compounds with antimicrobial, antibacterial, and anti-inflammatory activity in combination with nanostructured fibers represent a future approach due to the increased wound healing process and regeneration of the lost tissue. This paper presents different approaches in producing electrospun nanofibers, highlighting the electrospinning process used in fabricating innovative wound dressings that are able to release natural and/or synthetic substances in a controlled way, thus enhancing the healing process.

Antibacterial biohybrid nanofibers for wound dressings

Globally, chronic wounds impose a notable burden to patients and healthcare systems. Such skin wounds are readily subjected to bacteria that provoke inflammation and hence challenge the healing process. Furthermore, bacteria induce infection impeding re-epithelialization and collagen synthesis. With an estimated global market of $20.4 billion by 2021, appropriate wound dressing materials e.g. those composed of biopolymers originating from nature, are capable of alleviating the infection incidence and of accelerating the healing process. Particularly, biopolymeric nanofibrous dressings are biocompatible and mostly biodegradable and biomimic the extracellular matrix structure. Such nanofibrous dressings provide a high surface area and the ability to deliver antibiotics and antibacterial agents locally into the wound milieu to control infection. In this regard, with the dangerous evolution of antibiotic resistant bacteria, antibiotic delivery systems are being gradually replaced with antibacterial biohybrid nanofibrous wound dressings. This emerging class of wound dressings comprises biopolymeric nanofibers containing antibacterial nanoparticles, nature-derived compounds and biofunctional agents. Here, the most recent (since 2015) developments of antibacterial biopolymeric nanofibrous wound dressings, particularly those made of biohybrids, are reviewed and their antibacterial efficiency is evaluated based on a comprehensive literature analysis. Lastly, the prospects and challenges are discussed to draw a roadmap for further progresses and to open up future research avenues in this area. STATEMENT OF SIGNIFICANCE: With a global market of $20.4 billion by 2021, skin wound dressings are a crucial segment of the wound care industry. As an advanced class of bioactive wound dressing materials, natural polymeric nanofibers loaded with antibacterial agents, e.g. antimicrobial nanoparticles/ions, nature-derived compounds and biofunctional agents, have shown a remarkable potential for replacement of their classic counterparts. Also, given the expanding concern regarding antibiotic resistant bacteria, such biohybrid nanofibrous wound dressings can outperform classical drug delivery systems. Here, an updated overview of the most recent (since 2015) developments of antibacterial biopolymeric nanofibrous wound dressings is presented. In this review, while discussing about the antibacterial efficiency of such systems, the prospects and challenges are highlighted to draw a roadmap for further progresses in this area.

Bioactive Properties of Nanofibres Based on Concentrated Collagen Hydrolysate Loaded with Thyme and Oregano Essential Oils

This research aimed to obtain biocompatible and antimicrobial nanofibres based on concentrated collagen hydrolysate loaded with thyme or oregano essential oils as a natural alternative to synthesis products. The essential oils were successfully incorporated using electrospinning process into collagen resulting nanofibres with diameter from 471 nm to 580 nm and porous structure. The presence of essential oils in collagen nanofibre mats was confirmed by Attenuated Total Reflectance -Fourier Transform Infrared Spectroscopy (ATR-FTIR), Ultraviolet-visible spectroscopy (UV-VIS) and antimicrobial activity. Scanning Electron Microscopy with Energy Dispersive Spectroscopy analyses allowed evaluating the morphology and constituent elements of the nanofibre networks. Microbiological tests performed against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans showed that the presence of essential oils supplemented the new collagen nanofibres with antimicrobial properties. The biocompatibility of collagen and collagen with essential oils was assessed by in vitro cultivation with NCTC clone 929 of fibroblastic cells and cell viability measurement. The results showed that the collagen and thyme or oregano oil composites have no cytotoxicity up to concentrations of 1000 μg·mL^-1 and 500 μg mL^-1, respectively. Optimization of electrospinning parameters has led to the obtaining of new collagen electrospun nanofibre mats loaded with essential oils with potential use for wound dressings, tissue engineering or protective clothing.

Soya protein isolate-polyethylene oxide electrospun nanofiber membrane with bone marrow-derived mesenchymal stem cell for enhanced bone regeneration

In this study, we prepared an electrospun nanofiber membrane from soya protein isolate (SPI) and polyethylene oxide (PEO) loaded with rat bone marrow-derived mesenchymal stem cells (rBMSC), as a cell-scaffold approach to enhance bone regeneration. Different ratios of SPI:PEO (7:0, 7:1, 7:3, 7:5, and 0:7) was investigated to obtain uniform nanofibers, and crosslinked with EDC/NHS to stabilize the membranes. SPI/PEO membrane (7:3) was found to create more uniform and stable nanofibers at a flow rate of 9 µL/min, spun in a cylindrical collector rotating at 350 r/min, 23 kV DC voltage, and needle tip to collector distance of 13 cm. The loaded rBMSC were pre-differentiated to ensure commitment towards osteoblastic lineage. The SPI/PEO electrospun nanofiber membranes were successful in allowing for cell attachment and growth of the rBMSC and was further investigated in vivo using a rat skull defect model. New bone formation was observed for the optimized SPI/PEO electrospun nanofiber membrane (7:3) with and without rBMSC, but with faster new bone formation for SPI/PEO electrospun nanofiber membrane loaded with rBMSC as compared to SPI/PEO electrospun nanofiber membrane only and control (defect only).

Hyaluronic Acid (HA)-Based Silk Fibroin/Zinc Oxide Core-Shell Electrospun Dressing for Burn Wound Management

Burn injuries represent a major life-threatening event that impacts the quality of life of patients, and places enormous demands on the global healthcare systems. This study introduces the fabrication and characterization of a novel wound dressing made of core-shell hyaluronic acid-silk fibroin/zinc oxide (ZO) nanofibers for treatment of burn injuries. The core-shell configuration enables loading ZO-an antibacterial agent-in the core of nanofibers, which in return improves the sustained release of the drug and maintains its bioactivity. Successful formation of core-shell nanofibers and loading of zinc oxide are confirmed by transmission electron microscopy, Fourier-transform infrared spectroscopy, and energy dispersive X-ray. The antibacterial activity of the dressings are examined against Escherichia coli and Staphylococcus aureus and it is shown that addition of ZO improves the antibacterial property of the dressing in a dose-dependent fashion. However, in vitro cytotoxicity studies show that high concentration of ZO (>3 wt%) is toxic to the cells. In vivo studies indicate that the wound dressings loaded with ZO (3 wt%) substantially improves the wound healing procedure and significantly reduces the inflammatory response at the wound site. Overall, the dressing introduced herein holds great promise for the management of burn injuries.

Growth Factors Delivery System for Skin Regeneration: An Advanced Wound Dressing

Standard treatments of chronic skin ulcers based on the direct application of dressings still present several limits with regard to a complete tissue regeneration. Innovative strategies in tissue engineering offer materials that can tune cell behavior and promote growth tissue favoring cell recruitment in the early stages of wound healing. A combination of Alginate (Alg), Sericin (SS) with Platelet Lysate (PL), as a freeze-dried sponge, is proposed to generate a bioactive wound dressing to care skin lesions. Biomembranes at different composition were tested for the release of platelet growth factors, cytotoxicity, protective effects against oxidative stress and cell proliferation induction. The highest level of the growth factors release occurred within 48 h, an optimized time to burst a healing process in vivo; the presence of SS differently modulated the release of the factors by interaction with the proteins composing the biomembranes. Any cytotoxicity was registered, whereas a capability to protect cells against oxidative stress and induce proliferation was observed when PL was included in the biomembrane. In a mouse skin lesion model, the biomembranes with PL promoted the healing process, inducing an accelerated and more pronounced burst of inflammation, formation of granulation tissue and new collagen deposition, leading to a more rapid skin regeneration.

Chemisorption and sustained release of cefotaxime between a layered double hydroxide and polyvinyl alcohol nanofibers for enhanced efficacy against second degree burn wound infection

Zn–Al layered double hydroxides (LDHs) were synthesized by a chemical method, while polyvinyl alcohol (PVA) nanofibers were fabricated by an electrospinning approach; we also synthesized Zn–Al LDH/cefotaxime (cefotax), Zn–Al LDH@PVA, and Zn–Al LDH/cefotax@PVA (LCP). Characterizations were performed by X-ray diffraction, Fourier transform infrared spectroscopy, field emission scanning electron microscopy, high-resolution transmission electron microscopy, energy dispersive X-ray spectroscopy, Brunauer–Emmett–Teller analysis, thermogravimetric-differential thermal analysis techniques, dynamic light scattering, X ray-florescence, and carbon, hydrogen, and nitrogen (CHN) analyses. The adsorption isotherm of cefotax and its entrapment percentage, release, and kinetics were also investigated. The results confirmed the elemental constituents of the mentioned formulas, which exhibited different degrees of crystallinity and different morphologies. Besides, these formulas were tested in vitro as antimicrobial agents and applied in vivo against second-degree wound burns induced in rats' skin. The adsorption of cefotax occurred chemically, and the experimental data were fitted with different isotherm models, where the Freundlich and Toth models gave the best fits. The entrapment percentage in LDH/cefotax was 77.41% and in LDH/cefotax@PVA, it was 67.83%. The sustained release of cefotax from LDH and LCP was attainable; the release percentages were 89.31% and 81.55% in up to 12 h, respectively. The release kinetics of cefotax from LDH fitted well with first-order kinetics, while that for LCP was parabolic. The formulas showed uneven antimicrobial effects against Gram-positive and Gram-negative bacteria; the best effect was exhibited by Zn–Al LDH/cefotax@PVA due to its sustained release. Finally, investigating the possibility of using these formulas in the clinical setting should be considered.

This study succeeded to formulate, characterize, and investigate cefotax release and kinetics, and to compare cetofax with other known antibacterial agents.

Natural Antibacterial Reagents (Centella, Propolis, and Hinokitiol) Loaded into Poly[(R)-3-hydroxybutyrate-co-(R)-3-hydroxyhexanoate] Composite Nanofibers for Biomedical Applications

Centella asiatica, propolis, and hinokitiol, as natural antibacterial reagents, were integrated into the poly[(R)-3-hydroxybutyrate-co-(R)-3-hydroxyhexanoate] (PHBH) polymer to produce antibacterial wound dressings, using electrospinning process. The results showed that the fiber diameters and surface morphology of PHBH composite nanofibers were influenced by the addition of ethanol–centella (EC), methanol–centella (MC), ethanol–propolis (EP), and ethanol–hinokitiol (EH) at various ratios compared to pristine PHBH nanofibers. From FT-IR, the nanofibrous samples with higher contents of natural antibacterial substances showed the peaks of carboxylic acid, aromatic ring, and tropolone carbon ring from centella, propolis, and hinokitiol, respectively. Furthermore, the tensile strength of neat PHBH nanofibers was increased from 8.00 ± 0.71 MPa up to 16.35 ± 1.78 MPa by loading of propolis (EP) 7% into PHBH. X-ray analysis explained that the loading of propolis (EP) was also able to increase the crystallinity in PHBH composite nanofibers from 47.0% to 54.5%. The antibacterial results demonstrated that PHBH composite nanofibers containing natural antibacterial products were potent inhibitors against the growth of Escherichia coli and Staphylococcus aureus, amongst them hinokitiol and propolis proved to be the most effective. Additionally, the release studies displayed that centella and hinokitiol had faster release from PHBH composite nanofibers in comparison to propolis.

Hydrogen Sulfide in Bone Tissue Regeneration and Repair: State of the Art and New Perspectives

The importance of hydrogen sulfide (H₂S) in the regulation of multiple physiological functions has been clearly recognized in the over 20 years since it was first identified as a novel gasotransmitter. In bone tissue H₂S exerts a cytoprotective effect and promotes bone formation. Just recently, the scientific community has begun to appreciate its role as a therapeutic agent in bone pathologies. Pharmacological administration of H₂S achieved encouraging results in preclinical studies in the treatment of systemic bone diseases, such as osteoporosis; however, a local delivery of H₂S at sites of bone damage may provide additional opportunities of treatment. Here, we highlight how H₂S stimulates multiple signaling pathways involved in various stages of the processes of bone repair. Moreover, we discuss how material science and chemistry have recently developed biomaterials and H₂S-donors with improved features, laying the ground for the development of H₂S-releasing devices for bone regenerative medicine. This review is intended to give a state-of-the-art description of the pro-regenerative properties of H₂S, with a focus on bone tissue, and to discuss the potential of H₂S-releasing scaffolds as a support for bone repair.

Biocompatible Aloe vera and Tetracycline Hydrochloride Loaded Hybrid Nanofibrous Scaffolds for Skin Tissue Engineering

Aloe vera (AV) and tetracycline hydrochloride (TCH) exhibit significant properties such as anti-inflammatory, antioxidant and anti-bacterial activities to facilitate skin tissue engineering. The present study aims to develop poly-ε-caprolactone (PCL)/ AV containing curcumin (CUR), and TCH loaded hybrid nanofibrous scaffolds to validate the synergistic effect on the fibroblast proliferation and antimicrobial activity against Gram-positive and Gram-negative bacteria for wound healing. PCL/AV, PCL/CUR, PCL/AV/CUR and PCL/AV/TCH hybrid nanofibrous mats were fabricated using an electrospinning technique and were characterized for surface morphology, the successful incorporation of active compounds, hydrophilicity and the mechanical property of nanofibers. SEM revealed that there was a decrease in the fiber diameter (ranging from 360 to 770 nm) upon the addition of AV, CUR and TCH in PCL nanofibers, which were randomly oriented with bead free morphology. FTIR spectra of various electrospun samples confirmed the successful incorporation of AV, CUR and TCH into the PCL nanofibers. The fabricated nanofibrous scaffolds possessed mechanical properties within the range of human skin. The biocompatibility of electrospun nanofibrous scaffolds were evaluated on primary human dermal fibroblasts (hDF) by MTS assay, CMFDA, Sirius red and F-actin stainings. The results showed that the fabricated PCL/AV/CUR and PCL/AV/TCH nanofibrous scaffolds were non-toxic and had the potential for wound healing applications. The disc diffusion assay confirmed that the electrospun nanofibrous scaffolds possessed antibacterial activity and provided an effective wound dressing for skin tissue engineering.

Lock Stock and Barrel of Wound Healing

Any kind of injury may lead to wound formation. As per World Health Organization Report, "more than 5 million people die each year due to injuries. This accounts for 9% of the world's population death, nearly 1.7 times the number of fatalities that result from HIV/AIDS, tuberculosis and malaria combined. In addition, ten million people suffer from non-fatal injuries which require treatment". This scenario leads to increased health and economic burden worldwide. Rapid wound healing is exigent subject-field in the health care system. It is imperative to be updated on wound care strategies as impaired wound healing may lead to chronic, non-healing wounds and thus further contributes to the national burden. This article is a comprehensive review of wound care strategies. The first and second part of this review article focuses on the understanding of wound, its types and human body's healing mechanism. Wound healing is natural, highly coordinated process that starts on its own, immediately after the injury. However, individual health condition influences the healing process. Discussion of factors affecting wound healing has also been included. Next part includes the detailed review of diverse wound healing strategies that have already been developed for different types of wound. A detailed description of various polymers that may be used has been discussed. Amongst drug delivery systems, oligomers, dendrimers, films, gels, different nano-formulations, like nanocomposites, nanofibers, nanoemulsions and nanoparticles are discussed. Emphasis on bandages has been made in this article.

A Critical Review and Perspective of Honey in Tissue Engineering and Clinical Wound Healing

Significance: Historically, honey has been regarded as a potent agent in bacterial inhibition and wound healing. An increased prevalence of antibiotic resistant pathogens spurred an initial resurgence in honey's clinical popularity, with it quickly finding a place in wound care and regenerative medicine. However, this renewed usage demanded a need for improved delivery and overall research of its bioactive properties. This review provides an overview of the antibacterial properties and clinical use of honey. Recent Advances: The past and present clinical use of honey is noted, focusing specifically on burns and ulcers, as these are the most common applications of the natural agent. While honey is often used without modification clinically, there are also commercially available products ranging from dressings to gels, which are discussed. Critical Issues: Despite these products growing in popularity, the need for improved delivery and a structure to support wound healing could improve the treatment method. Future Directions: Tissue engineering scaffolds can provide an alternative method of honey delivery with research focusing primarily on electrospun scaffolds, hydrogels, and cryogels. Current studies on these scaffolds are discussed with respect to their advantages and potential for future clinical work. Overall, this review provides a comprehensive overview of the properties of honey, its current use in wound healing, and the potential for future incorporation into tissue-engineered scaffolds to provide an innovative wound healing agent.

Natural composite dressings based on collagen, gelatin and plant bioactive compounds for wound healing: A review

Skin wound dressings are commonly used to stimulate and enhance skin tissue repair. Even if wounds seem easy to repair for clinicians and to replicate in an in vitro set-up for scientists, chronic wounds remain currently an open challenge in skin tissue engineering for patients with complementary diseases. The seemingly simple process of skin healing hides a heterogenous sequence of events, specific timing, and high level of organization and coordination among the involved cell types. Taken together, all these aspects make wound healing a unique process, but we are not yet able to completely repair the chronic wounds or to reproduce them in vitro with high fidelity. This review highlights the main characteristics and properties of a natural polymer, which is widely used as biomaterial, namely collagen and of its denatured form, gelatin. Available wound dressings based on collagen/gelatin and proposed variants loaded with bioactive compounds derived from plants are presented. Applications of these composite biomaterials are discussed with emphasis on skin wound healing. A perspective on current issues is given in the light of future research. The emerging technologies support the development of innovative dressings based exclusively on natural constituents, either polymeric or bioactive compounds.

Usos terapéuticos de nanomateriales y nanopartículas

La síntesis de nanomateriales y nanopartículas para usos médicos ha llevado a la generación de la nanomedicina, rama de la nanotecnología que permite diagnosticar, tratar y prevenir enfermedades y traumatismos, aliviar el dolor, preservar y mejorar la salud humana utilizando herramientas y conocimientos moleculares del cuerpo humano. Este artículo revisa las aplicaciones actuales y futuras de los nanomateriales en áreas biomédicas y presenta los riesgos de toxicidad que se podrían generar por su usoindiscriminado.

Opportunities of Bacterial Cellulose to Treat Epithelial Tissues

In this mini-review, we highlight the potential of the biopolymer bacterial cellulose to treat damaged epithelial tissues. Epithelial tissues are cell sheets that delimitate both the external body surfaces and the internal cavities and organs. Epithelia serve as physical protection to underlying organs, regulate the diffusion of molecules and ions, secrete substances and filtrate body fluids, among other vital functions. Because of their continuous exposure to environmental stressors, damage to epithelial tissues is highly prevalent. Here, we first compare the properties of bacterial cellulose to the current gold standard, collagen, and then we examine the use of bacterial cellulose patches to heal specific epithelial tissues; the outer skin, the ocular surface, the oral mucosa and other epithelial surfaces. Special emphasis is made on the dermis since, to date, this is the most widespread medical use of bacterial cellulose. It is important to note that some epithelial tissues represent only the outermost layer of more complex structures such as the skin or the cornea. In these situations, depending on the penetration of the lesion, bacterial cellulose might also be involved in the regeneration of, for instance, inner connective tissue.

Natural product-based nanomedicines for wound healing purposes: therapeutic targets and drug delivery systems

Wound healing process is an intricate sequence of well-orchestrated biochemical and cellular phenomena to restore the integrity of the skin and subcutaneous tissue. Several plant extracts and their phytoconstituents are known as a promising alternative for wound healing agents due to the presence of diverse active components, ease of access, and their limited side effects. The development of nanotechnological methods can help to improve the efficacy of different therapeutics as well as herbal-based products. Here, we present a review of the efficacy of the plant based-nanomaterials in the management of wounds and discuss the involved therapeutic targets. For this purpose, a profound search has been conducted on in vitro, in vivo, and/or clinical evidences evaluating the efficacy and pharmacological mechanisms of natural product-based nanostructures on different types of wounds. Different pharmacological targets are involved in the wound healing effects of herbal-based nanostructures, including suppressing the production of inflammatory cytokines and inflammatory transduction cascades, reducing oxidative factors and enhancing antioxidative enzymes, and promoting neovascularization and angiogenic pathways through increasing the expression of vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor. Moreover, nanostructure of plant extracts and their phytochemicals can enhance their bioavailability, control their release in the form of sustained delivery systems to the wound site, and enhance the permeability of these therapeutics to the underlying skin layers, which are all necessary for the healing process. Overall, various plant extracts and their natural compounds, used in nanoformulations, have demonstrated high activity in the management of wounds and thus can be assumed as future pharmaceutical drugs.

Enhanced extracellular matrix synthesis using collagen dressings loaded with Artemisia absinthium plant extract

The aim of this study was to develop three-dimensional porous composites of collagen (Col) incorporating polyphenolic-rich wormwood extract and to investigate their interaction with human skin cells, in order to optimize wound healing treatments. The scaffolds’ ultrastructure was observed by scanning electron microscopy, and biodegradability and bioactive compounds release were investigated in physiologic environment. Interaction of composites in direct and indirect contact with human skin cells was evaluated using two in vitro experimental models. ColWE scaffolds presented high porosity, swelling degree, and increased stability against enzymatic degradation, compared to Col scaffold. Composite scaffolds incorporating higher quantities of wormwood extract allowed better control of polyphenolics release. ColWE 0.5 variant favored the attachment and proliferation of human dermal fibroblasts and keratinocyte cells. In addition, the composite scaffold stimulated the synthesis of skin extracellular matrix components. All these results demonstrated that ColWE composites with improved physico-chemical and biological properties could be used in advanced wound healing applications.

Evaluation of the Antimicrobial Activity and Cytotoxicity of Different Components of Natural Origin Present in Essential Oils

Even though essential oils (EOs) have been used for therapeutic purposes, there is now a renewed interest in the antimicrobial properties of phytochemicals and EOs in particular. Their demonstrated low levels of induction of antimicrobial resistance make them interesting for bactericidal applications, though their complex composition makes it necessary to focus on the study of their main components to identify the most effective ones. Herein, the evaluation of the antimicrobial action of different molecules present in EOs against planktonic and biofilm-forming Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria was assessed. The bactericidal mechanisms of the different molecules, as well as their cytocompatibility, were also studied. Carvacrol, cinnamaldehyde, and thymol exhibit the highest in vitro antimicrobial activities against E. coli and S. aureus, with membrane disruption the bactericidal mechanism identified. The addition of those compounds (≥0.5 mg/mL) hampers S. aureus biofilm formation and partially eliminates preformed biofilms. The subcytotoxic values of the tested EO molecules (0.015–0.090 mg/mL) are lower than the minimum inhibitory and bactericidal concentrations obtained for bacteria (0.2–0.5 mg/mL) but are higher than that obtained for chlorhexidine (0.004 mg/mL), indicating the reduced cytotoxicity of EOs. Therefore, carvacrol, cinnamaldehyde, and thymol are molecules contained in EOs that could be used against E. coli– and S. aureus–mediated infections without a potential induction of bactericidal resistance and with lower cell toxicity than the conventional widely used chlorhexidine.

Wearable Technology for Chronic Wound Monitoring: Current Dressings, Advancements, and Future Prospects

Chronic non-healing wounds challenge tissue regeneration and impair infection regulation for patients afflicted with this condition. Next generation wound care technology capable of in situ physiological surveillance which can diagnose wound parameters, treat various chronic wound symptoms, and reduce infection at the wound noninvasively with the use of a closed loop therapeutic system would provide patients with an improved standard of care and an accelerated wound repair mechanism. The indicating biomarkers specific to chronic wounds include blood pressure, temperature, oxygen, pH, lactate, glucose, interleukin-6 (IL-6), and infection status. A wound monitoring device would help decrease prolonged hospitalization, multiple doctors' visits, and the expensive lab testing associated with the diagnosis and treatment of chronic wounds. A device capable of monitoring the wound status and stimulating the healing process is highly desirable. In this review, we discuss the impaired physiological states of chronic wounds and explain the current treatment methods. Specifically, we focus on improvements in materials, platforms, fabrication methods for wearable devices, and quantitative analysis of various biomarkers vital to wound healing progress.

Alginate in Wound Dressings

Alginate is a biopolymer used in a variety of biomedical applications due to its favourable properties, such as biocompatibility and non-toxicity. It has been particularly attractive in wound healing applications to date. It can be tailored to materials with properties suitable for wound healing. Alginate has been used to prepare different forms of materials for wound dressings, such as hydrogels, films, wafers, foams, nanofibres, and in topical formulations. The wound dressings prepared from alginate are able to absorb excess wound fluid, maintain a physiologically moist environment, and minimize bacterial infections at the wound site. The therapeutic efficacy of these wound dressings is influenced by the ratio of other polymers used in combination with alginate, the nature of cross linkers used, the time of crosslinking, nature of excipients used, the incorporation of nanoparticles, and antibacterial agents. This review provides a comprehensive overview of the different forms of wound dressings containing alginate, in vitro, and in vivo results.

An aligned porous electrospun fibrous membrane with controlled drug delivery - An efficient strategy to accelerate diabetic wound healing with improved angiogenesis

A chronic wound in diabetic patients is usually characterized by poor angiogenesis and delayed wound closure. The exploration of efficient strategy to significantly improve angiogenesis in the diabetic wound bed and thereby accelerate wound healing is still a significant challenge. Herein, we reported a kind of aligned porous poly (l-lactic acid) (PlLA) electrospun fibrous membranes containing dimethyloxalylglycine (DMOG)-loaded mesoporous silica nanoparticles (DS) for diabetic wound healing. The PlLA electrospun fibers aligned in a single direction and there were ellipse-shaped nano-pores in situ generated onto the surface of fibers, while the DS were well distributed in the fibers and the DMOG as well as Si ion could be controlled released from the nanopores on the fibers. The in vitro results revealed that the aligned porous composite membranes (DS-PL) could stimulate the proliferation, migration and angiogenesis-related gene expression of human umbilical vein endothelial cells (HUVECs) compared with the pure PlLA membranes. The in vivo study further demonstrated that the prepared DS-PL membranes significantly improved neo-vascularization, re-epithelialization and collagen formation as well as inhibited inflammatory reaction in the diabetic wound bed, which eventually stimulated the healing of the diabetic wound. Collectively, these results suggest that the combination of hierarchical structures (nanopores on the aligned fibers) with the controllable released DMOG drugs as well as Si ions from the membranes, which could create a synergetic effect on the rapid stimulation of angiogenesis in the diabetic wound bed, is a potential novel therapeutic strategy for highly efficient diabetic wound healing.

STATEMENT OF SIGNIFICANCE

A chronic wound in diabetic patients is usually characterized by the poor angiogenesis and the delayed wound closure. The main innovation of this study is to design a new kind of skin tissue engineered scaffold, aligned porous poly (l-lactic acid) (PlLA) electrospun membranes containing dimethyloxalylglycine (DMOG)-loaded mesoporous silica nanoparticles (DS), which could significantly improve angiogenesis in the diabetic wound bed and thereby accelerate diabetic wound healing. The results revealed that the electrospun fibers with ellipse-shaped nano-pores on the surface were aligned in a single direction, while there were DS particles distributed in the fibers and the DMOG as well as Si ions could be controllably released from the nanopores on the fibers. The in vitro studies demonstrated that the hierarchical nanostructures (nanopores on the aligned fibers) and the controllable released chemical active agents (DMOG drugs and Si ions) from the DS-PL membranes could exert a synergistic effect on inducing the endothelial cell proliferation, migration and differentiation. Above all, the scaffolds distinctly induced the angiogenesis, collagen deposition and re-epithelialization as well as inhibited inflammation reaction in the wound sites, which eventually stimulated the healing of diabetic wounds in vivo. The significance of the current study is that the combination of the hierarchical aligned porous nanofibrous structure with DMOG-loaded MSNs incorporated in electrospun fibers may suggest a high-efficiency strategy for chronic wound healing.