Polymeric hydrogels for burn wound care: Advanced skin wound dressings and regenerative templates

Improved Cooling Performance of Hydrogel Wound Dressings via Integrating Thermal Conductivity and Heat Storage Capacity for Burn Therapy

Burn injury has become a crucial public health issue worldwide. It is necessary to explore new methods to reduce heat damage and improve healing efficiency during burn injury treatment. In this study, a kind of hydrogel combining heat storage capacity and thermal conductivity was fabricated via a one-pot method for burn therapy. The novel hydrogel was easily prepared by in situ cross-linking polymerization, using poly(ethylene glycol) (PEG) derivatives, oligo(ethylene glycol) methacrylate and 2-(2-methoxyethoxy) ethyl methacrylate, as thermally responsive base materials and hydroxylated multiwall carbon nanotubes (CNT-OH) as thermally conductive fillers. By dispersing CNT-OH, a thermally conductive network was formed in the hydrogel, leading to an increase in the thermal conductivity. The cooling performance, thermal conductivity, heat storage property, swelling performance, rheological and mechanical properties, biocompatibility, in vivo cooling effect, and wound healing properties of the prepared hydrogel were systematically investigated. The hydrogel consisted of thermally responsive PEG derivatives, and CNT-OH performed a function of rapid heat absorption, further reduced thermal damage, and promoted wound healing. The improved cooling performance of the hydrogel was ascribed to the improved thermal conductivity, enhanced heat storage capacity, and good adhesive ability. Thus, the hydrogel has great potential to be practically applied in burn therapy, laser treatment, cooling fabrics, heat-protective clothing, and other emergency scenarios.

Development and Evaluation of Hydrogel Wound Dressings Loaded with Herbal Extracts

The current study aimed to develop carbomer based hydrogel dressings, incorporating ethanolic extracts of Rosmarinus officinalis aerial parts, Achillea millefolium and Calendula officinalis flowers. The pharmaceutical properties of the obtained hydrogels, as well as their texture and antimicrobial activity, were further evaluated. Five wound dressing formulations based on carbopol were prepared. The addition of the ethanolic extracts to the formulation slightly lowered the pH of the hydrogels, as expected. The Rosmarinus officinalis aerial parts extract loaded hydrogel proved to be the firmest one. In terms of consistency and viscosity, the behavior of the five hydrogels was relatively similar. Based on the texture analysis, the texture of the hydrogels has been affected to some extent by the addition of the ethanolic extracts, decreasing their consistency, firmness, and adhesiveness. The hydrogel loaded with Rosmarinus officinalis aerial parts extract and the one incorporating the blend of extracts (mixture of the three above-mentioned extracts) proved to have a good antimicrobial activity. The studied hydrogel formulations could serve as a basis for the development of novel wound dressing materials, although more extended in vivo studies would be needed in order to support current results.

Investigation of acute effects of topical Alpinia officinarum (galangal) treatment in experimental contact type burns and comparison with topical silver sulfadiazine treatment

BACKGROUND

It was aimed to determine whether Alpinia officinarum (AO) (galangal), which has been regarded to be effective on wound healing, is healing on experimental contact type burns and compare its effects with silver sulfadiazine (SSD).

METHODS

Thirty-five rats were divided into five groups of seven rats each group. Superficial second degree burns were formed by contacting a 1×1 cm copper tip which was kept at 100°C constant temperature to the three shaved areas on the back of rats without applying any pressure for 10 s. All groups were irrigated with a 100 cc saline solution for 2 min. Any procedure or treatment was not applied to Group I (Control). Group II (Burn Control) was only irrigated, Group III (SSD) was applied topical SSD 4 times, with 6-h intervals (at h 0, 6, 12 and 18), Group IV (Galangal) was applied topical AO 4 times, and Group V (Gel) was applied placebo topical material, used for the preparation of topical AO, 4 times. Wound healing findings were evaluated histopathologically.

RESULTS

In the galangal group, it was found that collagen discoloration didn't penetrate into deep dermis compared to other groups; epidermis, hair follicles, and sebaceous glands remained protected compared to the burn control group, and there was a thicker layer of epidermis. It was found that the galangal group was the closest group to the control group histologically. In the galangal group, it was determined that the number of vessels and total hair follicles were significantly higher in the 8th h and 4th h respectively (p<0.05), while epidermal thickness and number of degenerated hair follicles were significantly higher in all hours compared to other three groups (p<0.05). It was determined that galangal group had the lowest scores in the evaluation of edema, polymorphonuclear leukocytes infiltration, collagen discoloration, injury of vessels, hair follicles and sebaceous glands in comparisons between groups and within groups' own processes.

CONCLUSION

Administrating AO containing gel 4 times a day within the first 24 h is effective in the experimental contact type second degree burn model. It is significantly superior to SSD treatment, especially in the first 8 h of administration.

Nano-silver functionalized polysaccharides as a platform for wound dressings: A review

The healing of defected skin tissue is a complex process, especially for chronic wounds. Poor healing of these wounds may cause extensive suffering and high cost for patients. Traditional wound dressings are typically designed for a single function and they cannot satisfy all requirements for the whole process of wound healing. Therefore, it is necessary to develop new types of wound dressings with multiple functions for wound healing. In particular, adding an antibacterial function has been shown to be of great benefit during tissue repair. Nano‑silver is widely used in wound treatment because of various advantages, such as its wide antibacterial spectrum and lower drug resistance. Therefore, wound dressings loaded with nano‑silver have attracted widespread attention in wound healing. Naturally derived polysaccharides hold great potential as wound dressings, because of their abundant availability, low prices and good biocompatibility. In this review, nano‑silver functionalized polysaccharide-based wound dressings are systematically reviewed, including their preparation methods, antibacterial performances and classification of nano‑silver wound dressings. Moreover, the toxicity of nano‑silver based wound dressings is discussed and the prospective research direction is elaborated. This review aims to provide readers with an overview of the latest developments in silver nanotechnology, and to provide a little guidance for the research of nano‑silver functionalized polysaccharide-based wound dressings.

Conductive Biomaterials as Bioactive Wound Dressing for Wound Healing and Skin Tissue Engineering

Conductive biomaterials based on conductive polymers, carbon nanomaterials, or conductive inorganic nanomaterials demonstrate great potential in wound healing and skin tissue engineering, owing to the similar conductivity to human skin, good antioxidant and antibacterial activities, electrically controlled drug delivery, and photothermal effect. However, a review highlights the design and application of conductive biomaterials for wound healing and skin tissue engineering is lacking. In this review, the design and fabrication methods of conductive biomaterials with various structural forms including film, nanofiber, membrane, hydrogel, sponge, foam, and acellular dermal matrix for applications in wound healing and skin tissue engineering and the corresponding mechanism in promoting the healing process were summarized. The approaches that conductive biomaterials realize their great value in healing wounds via three main strategies (electrotherapy, wound dressing, and wound assessment) were reviewed. The application of conductive biomaterials as wound dressing when facing different wounds including acute wound and chronic wound (infected wound and diabetic wound) and for wound monitoring is discussed in detail. The challenges and perspectives in designing and developing multifunctional conductive biomaterials are proposed as well.

Saudi Honey: A Promising Therapeutic Agent for Treating Wound Infections

Treatment of wounds, especially chronic ones, is a major challenge in healthcare, with serious clinical and economic burdens. Multiple treatment approaches, including the usage of silver and iodine, have dramatically improved wound healing and reduced the incidence of infection. However, once infected by drug-resistant bacteria, treatment of wounds becomes a serious complication, with limited availability of effective antibiotic drugs, leading to high morbidity and mortality. Therefore, alternative therapeutic agents are required to address this gap in wound management. The introduction of manuka honey as a therapeutic agent against infected wounds was the result of extensive research about its activity against both planktonic and biofilm bacterial growth. Likewise, several types of Saudi honey (e.g., Sidr and Talh) showed promising in vitro and in vivo antimicrobial activity against wound pathogens. This short review summarizes literature that investigated the activity of common types of Saudi honey in relation to wound infections and explores their clinical utility.

Highly Crosslinked Agar/Acrylic Acid Hydrogels with Antimicrobial Properties

Hydrogels are three-dimensional soft polymeric materials that can entrap huge amounts of water. They are widely attractive in the biomedicine area because of their outstanding applications such as biosensors, drug delivery vectors, or matrices for cell scaffolds. Generally, the low mechanical strength and fragile structure of the hydrogels limit their feasibility, but this is not the case. In this work, acrylic acid-agar hydrogels with excellent mechanical properties were synthesized using gamma radiation as a crosslinking promoter. The obtained hydrogels exhibited a water absorption capacity up to 6000% in weight without breaking and keeping their shape; additionally, they showed a noticeable adhesion to the skin. The synthesized materials were characterized by infrared spectroscopy (FTIR-ATR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), and mechanical testing. Additionally, their water uptake capacity and critical pH were studied. Net(Agar/AAc) hydrogel exhibited a noticeable capacity to load silver nanoparticles (AgNPs), which endowed it with antimicrobial activity that was demonstrated when challenged against Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA) on in vitro conditions.

Controllable Release of Povidone-Iodine from Networked Pectin@Carboxymethyl Pullulan Hydrogel

Povidone-iodine (PI) is a common antiseptic reagent which is used for skin infections and wound healing. The control release of PI is quite important to heal the deep and intense wounds. Herein, the preparation of biodegradable pectin@carboxymethyl pullulan (Pe@CMP) hydrogel was carried out and applied for controllable release of PI. CMP was synthesized by interaction of monochloroacetic acid with pullulan at different ratios. The Pe@CMP hydrogel was then prepared by crosslinking of pectin with CMP in presence of glutaraldehyde as cross linker. After carboxymethylation, COOH contents were enlarged to be 24.2-51.2 mmol/kg and degree of substitution was 0.44-0.93. The rheological properties of Pe@CMP hydrogel were enlarged by increment of pectin ratio. Swelling ratio in water (16.0-18.0%) was higher than that of artificial sweat (11.7-13.2%). Pe@CMP hydrogel containing 20% pectin, exhibited the lowest release and 57.7% from PI was released within 360 min. The biological activity of the released PI was monitored to be highly efficient. The kinetic of release was fitted well to the first ordered reaction and Higuchi models. The mechanism of release was explained by the swelling of hydrogel. The networked structure of hydrogel was opened by swelling and PI was released from the outer pores followed by inner pores, achieving the controllable release.

Novel fabrication of antibiotic containing multifunctional silk fibroin injectable hydrogel dressing to enhance bactericidal action and wound healing efficiency on burn wound: In vitro and in vivo evaluations

The development of biologically active multifunctional hydrogel wound dressings can assist effectively to wound regeneration and also has influenced multiple functions on wound injury. Herein, we designed a carbon-based composited injectable silk fibroin hydrogel as multifunctional wound dressing to provide effective anti-bacterial, cell compatibility and in vivo wound closure actions. Importantly, the fabricated injectable hydrogel exhibit sustained drug delivery properties, anti-oxidant and self-healing abilities, which confirm that composition of hydrogel is highly beneficial to tissue adhesions and burn wound regeneration ability. Frequently, designed injectable hydrogel can be injected into deep and irregular burn wound sites and would provide rapid self-healing and protection from infection environment with thoroughly filled wound area. Meanwhile, incorporated carbon nanofillers improve injectable hydrogel strength and also offer high fluid uptake to hydrogel when applied on the wound sites. In vitro MTT cytotoxicity assay on human fibroblast cell lines establish outstanding cytocompatibility of the injectable hydrogel and also have capability to support cell growth and proliferations. In vivo burn wound animal model results demonstrate that the hydrogel dressings predominantly influenced enhanced wound contraction and also promoted greater collagen deposition, granulation tissue thickness and vascularization. This investigation's outcome could open a new pathway to fabricate multifunctional biopolymeric hydrogel for quicker burn wound therapy and effectively prevents microenvironment bacterial infections.

In vivo evaluation of a recombinant N-acylhomoserine lactonase formulated in a hydrogel using a murine model infected with MDR Pseudomonas aeruginosa clinical isolate, CCASUP2

Failure in the treatment of P. aeruginosa, due to its broad spectrum of resistance, has been associated with increased patient mortality. One alternative approach for infection control is quorum quenching which was found to decrease virulence of such pathogen. In this study, the efficiency of a recombinant Ahl-1 lactonase formulated as a hydrogel was investigated to control the infection of multidrug resistant (MDR) P. aeruginosa infected burn using a murine model. The recombinant N-acylhomoserine lactonase (Ahl-1) was formulated as a hydrogel. To test its ability to control the infection of MDR P. aeruginosa, a thermal injury model was used. Survival rate, and systemic spread of the infection were evaluated. Histopathological examination of the animal dorsal skin was also done for monitoring the healing and cellular changes at the site of infection. Survival rate in the treated group was 100% relative to 40% in the control group. A decrease of up to 3 logs of bacterial count in the blood samples of the treated animals relative to the control group and a decrease of up to 4 logs and 2.3 logs of bacteria in lung and liver samples, respectively were observed. Histopathological examination revealed more enhanced healing process in the treated group. Accordingly, by promoting healing of infected MDR P. aeruginosa burn and by reducing systemic spread of the infection as well as decreasing mortality rate, Ahl-1 hydrogel application is a promising strategy that can be used to combat and control P. aeruginosa burn infections.

Design of a biofluid-absorbing bioactive sandwich-structured Zn-Si bioceramic composite wound dressing for hair follicle regeneration and skin burn wound healing

The deep burn skin injures usually severely damage the dermis with the loss of hair follicle loss, which are difficult to regenerate. Furthermore, severe burns often accompanied with large amount of wound exudates making the wound moist, easily infected, and difficult to heal. Therefore, it is of great clinical significance to develop wound dressings to remove wound exudates and promote hair follicle regeneration. In this study, a sandwich-structured wound dressing (SWD) with Janus membrane property was fabricated by hot compression molding using hydrophilic zinc silicate bioceramics (Hardystonite, ZnCS) and hydrophobic polylactic acid (PLA). This unique organic/inorganic Janus membrane structure revealed excellent exudate absorption property and effectively created a dry wound environment. Meanwhile, the incorporation of ZnCS bioceramic particles endowed the dressing with the bioactivity to promote hair follicle regeneration and wound healing through the release of Zn2+ and SiO3 2- ions, and this bioactivity of the wound dressing is mainly attributed to the synergistic effect of Zn2+ and SiO3 2- to promote the recruitment, viability, and differentiation of hair follicle cells. Our study demonstrates that the utilization of the Janus membrane and synergistic effect of different type bioactive ions are effective approaches for the design of wound dressings for burn wound healing.

Comparative Investigation of Collagen-Based Hybrid 3D Structures for Potential Biomedical Applications

Collagen is a key component for devices envisaging biomedical applications; however, current increasing requirements impose the use of multicomponent materials. Here, a series of hybrid collagen-based 3D materials, comprising also poly(ε-caprolactone) (PCL) and different concentrations of hyaluronic acid (HA)-in dense, porous or macroporous form-were characterized in comparison with a commercially available collagen sponge, used as control. Properties, such as water uptake ability, water vapour sorption, drug loading and delivery, were investigated in correlation with the material structural characteristics (composition and morphology). Methylene blue (MB) and curcumin (CU) were used as model drugs. For spongeous matrices, it was evidenced that, in contrast to the control sample, the multicomponent materials favor improved sustained release, the kinetics being controlled by composition and cross-linking degree. The other characteristics were within an acceptable range for the intended purpose of use. The obtained results demonstrate that such materials are promising for future biomedical applications (wound dressings and lab models).

Biopolymer and Synthetic Polymer-Based Nanocomposites in Wound Dressing Applications: A Review

Biopolymers are materials obtained from a natural origin, such as plants, animals, microorganisms, or other living beings; they are flexible, elastic, or fibrous materials. Polysaccharides and proteins are some of the natural polymers that are widely used in wound dressing applications. In this review paper, we will provide an overview of biopolymers and synthetic polymer-based nanocomposites, which have promising applications in the biomedical research field, such as wound dressings, wound healing, tissue engineering, drug delivery, and medical implants. Since these polymers have intrinsic biocompatibility, low immunogenicity, non-toxicity, and biodegradable properties, they can be used for various clinical applications. The significant advancements in materials research, drug development, nanotechnology, and biotechnology have laid the foundation for changing the biopolymeric structural and functional properties. The properties of biopolymer and synthetic polymers were modified by blending them with nanoparticles, so that these materials can be used as a wound dressing application. Recent wound care issues, such as tissue repairs, scarless healing, and lost tissue integrity, can be treated with blended polymers. Currently, researchers are focusing on metal/metal oxide nanomaterials such as zinc oxide (ZnO), cerium oxide (CeO₂), silver (Ag), titanium oxide (TiO₂), iron oxide (Fe₂O₃), and other materials (graphene and carbon nanotubes (CNT)). These materials have good antimicrobial properties, as well as action as antibacterial agents. Due to the highly antimicrobial properties of the metal/metal oxide materials, they can be used for wound dressing applications.

Recent trends on burn wound care: hydrogel dressings and scaffolds

Acute and chronic wounds can cause severe physical trauma to patients and also result in an immense socio-economic burden. Thus, wound management has attracted increasing attention in recent years. However, burn wound management is still a major challenge in wound management. Autografts are often considered the gold-standard for burn care, but their application is limited by many factors. Hence, ideal burn dressings and skin substitute dressings are desirable. With the development of biomaterials and progress of tissue engineering technology, some innovative dressings and tissue engineering scaffolds, such as nanofibers, films, foams and hydrogels, have been widely used in the field of biomedicine, especially in wound management. Among them, hydrogels have attracted tremendous attention with their unique advantages. In this review, we discuss the challenges in burn wound management, several crucial design considerations with respect to hydrogels for burn wound healing, and available polymers for hydrogels in burn wound care. In addition, the potential application and plausible prospect of hydrogels are also highlighted.

Hydrogel containing (1 → 6)-β-D-glucan (lasiodiplodan) effectively promotes dermal wound healing

A hydrogel containing exocellular (1 → 6)-β-D-glucan (lasiodiplodan, LAS) was developed and its wound healing potential was evaluated. β-Glucans have attracted much interest by the cosmetic industry sector because of their bioactive and functional properties and in promoting skin health. In the present work an β-glucan was studied as a healing biomaterial that has not hitherto been reported in the scientific literature. LAS produced by the ascomycete Lasiodiplodia theobromae MMPI was used in the formulation of a healing hydrogel. Physicochemical and microbiological quality parameters, antioxidant potential and stability of the formulation was evaluated. FTIR, thermal analysis and SEM techniques were also employed in the characterization. Wistar rats were used as a biological model to investigate the wound healing potential. Histological analyses of cutaneous tissue from the dorsal region were conducted after 4, 7, 10 and 14 days of treatment, and evaluated re-epithelialization, cell proliferation and collagen production. Physicochemical stability, microbiological quality and antioxidant potential, especially in relation to its ability to scavenge hydroxyl radicals were found. The hydrogel stimulated cell re-epithelialization and proliferation during all days of the treatment, and stimulated an increase of collagen fibers. Lasiodiplodan showed immunomodulatory activity in wound healing and this biomacromolecule could be an alternative compound in wound care.

Hybrid 3D Printing of Advanced Hydrogel-Based Wound Dressings with Tailorable Properties

Despite the extensive utilization of polysaccharide hydrogels in regenerative medicine, current fabrication methods fail to produce mechanically stable scaffolds using only hydrogels. The recently developed hybrid extrusion-based bioprinting process promises to resolve these current issues by facilitating the simultaneous printing of stiff thermoplastic polymers and softer hydrogels at different temperatures. Using layer-by-layer deposition, mechanically advantageous scaffolds can be produced by integrating the softer hydrogel matrix into a stiffer synthetic framework. This work demonstrates the fabrication of hybrid hydrogel-thermoplastic polymer scaffolds with tunable structural and chemical properties for applications in tissue engineering and regenerative medicine. Through an alternating deposition of polycaprolactone and alginate/carboxymethylcellulose gel strands, scaffolds with the desired architecture (e.g., filament thickness, pore size, macro-/microporosity), and rheological characteristics (e.g., swelling capacity, degradation rate, and wettability) were prepared. The hybrid fabrication approach allows the fine-tuning of wettability (approx. 50–75°), swelling (approx. 0–20× increased mass), degradability (approx. 2–30+ days), and mechanical strength (approx. 0.2–11 MPa) in the range between pure hydrogels and pure thermoplastic polymers, while providing a gradient of surface properties and good biocompatibility. The controlled degradability and permeability of the hydrogel component may also enable controlled drug delivery. Our work shows that the novel hybrid hydrogel-thermoplastic scaffolds with adjustable characteristics have immense potential for tissue engineering and can serve as templates for developing novel wound dressings.

Electrospun nanofibers promote wound healing: theories, techniques, and perspectives

At present, the clinical strategies for treating chronic wounds are limited, especially when it comes to pain relief and rapid wound healing. Therefore, there is an urgent need to develop alternative treatment methods. This paper provides a systematic review on recent researches on how electrospun nanofiber scaffolds promote wound healing and how the electrospinning technology has been used for fabricating multi-dimensional, multi-pore and multi-functional nanofiber scaffolds that have greatly promoted the development of wound healing dressings. First, we provide a review on the four stages of wound healing, which is followed by a discussion on the evolvement of the electrospinning technology, what is involved in electrospinning devices, and factors affecting the electrospinning process. Finally, we present the possible mechanisms of electrospun nanofibers to promote wound healing, the classification of electrospun polymers, cell infiltration favoring fiber scaffolds, antibacterial fiber scaffolds, and future multi-functional scaffolds. Although nanofiber scaffolds have made great progress as a type of multi-functional biomaterial, major challenges still remain for commercializing them in a way that fully meets the needs of patients.

Pristine Gellan Gum-Collagen Interpenetrating Network Hydrogels as Mechanically Enhanced Anti-inflammatory Biologic Wound Dressings for Burn Wound Therapy

Gellan gum is a biologically inert natural polymer that is increasingly favored as a material-of-choice to form biorelevant hydrogels. However, as a burn wound dressing, native gellan gum hydrogels do not drive host's biology toward regeneration and are mechanically inadequate wound barriers. To overcome these issues, we fabricateda gellan gum-collagen full interpenetrating network (full-IPN) hydrogel that can house adipose-derived mesenchymal stem cells (ADSCs) and employ their multilineage differentiation potential and produce wound-healing paracrine factors to reduce inflammation and promote burn wound regeneration. Herein, a robust temperature-dependent simultaneous IPN (SIN) hydrogel fabrication process was demonstrated using applied rheology for the first time. Subsequently after fabrication, mechanical characterization assays showed that the IPN hydrogels were easy to handle without deforming and retained sufficient mass to effect ADSCs' anti-inflammation property in a simulated wound environment. The IPN hydrogels' increased stiffness proved conducive for mechanotransduced cell adhesion. Scanning electron microscopy revealed theIPN's porous network, which enabled encapsulated ADSCs to spread and proliferate, for up to 3 weeks of culture, further shown by cells' dynamic filopodia extension observed in 3D confocal images. Successful incorporation of ADSCs accorded the IPN hydrogels with biologic wound-dressing properties, which possess the ability to promote human dermal fibroblast migration and secrete an anti-inflammatory paracrine factor, TSG-6 protein, as demonstrated in the 2D scratch wound assay and ELISA, respectively. More importantly, upon application onto murine full thickness burn wounds, our biologic wound dressing enhanced early wound closure, reduced inflammation, and promoted complete skin regeneration. Altogether, our results highlight the successful mechanical and biological enhancement of the inert matrix of gellan gum. Through completely natural procedures, a highly applicable biologic wound dressing is introduced for cell-based full thickness burn wound therapy.

bFGF and collagen matrix hydrogel attenuates burn wound inflammation through activation of ERK and TRK pathway

Burn injuries are most challenging to manage since it causes loss of the integrity of large portions of the skin leading to major disability or even death. Over the years, hydrogels are considered as a significant delivery system for wound treatment because of several advantages over other conventional formulations. We hypothesized that the bFGF-collagen-AgSD incorporated hydrogel formulation can accelerate the rate of burn healing in animal model and would promote fibroblast cell proliferation. Neovascularization and re-epithelialization is a hall mark of burn wound healing. In the present study, histopathological investigation and scanning electron microscopy of skin tissue of Wistar rats showed almost complete epithelialisation after 16 days in the treatment group. The developed hydrogel showed significantly accelerated wound closure compared with a standard and control group. The faster wound closure resulted from increased re-epithelialization and granulation tissue formation because of the presence of collagen and growth factor. Expressions of proteins such as TrkA, p- TrkA, ERK1/2, p-ERK1/2, NF-kβ, and p-NF-kβ involved in nerve growth factor (NGF) signalling pathway were analysed by western blot. All the findings obtained from this study indicated that the hydrogel can be considered as a promising delivery system against second degree burn by faster healing.

Antibacterial polysaccharide-based hydrogel dressing containing plant essential oil for burn wound healing

BACKGROUND

Polysaccharide-based hydrogels have been developed for many years to treat burn wounds. Essential oils extracted from aromatic plants generally exhibit superior biological activity, especially antibacterial properties. Studies have shown that antibacterial hydrogels mixed with essential oils have great potential for burn wound healing. This study aimed to develop an antibacterial polysaccharide-based hydrogel with essential oil for burn skin repair.

METHODS

Eucalyptus essential oil (EEO), ginger essential oil (GEO) and cumin essential oil (CEO) were employed for the preparation of effective antibacterial hydrogels physically crosslinked by carboxymethyl chitosan (CMC) and carbomer 940 (CBM). Composite hydrogels were prepared and characterized using antimicrobial activity studies, Fourier-transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, gas chromatography-mass spectrometery, rheological analysis, viscosity, swelling, water loss rate and water vapor transmission rate studies. In addition, the biocompatibility of hydrogels was evaluated in vivo by cytotoxicity and cell migration assays and the burn healing ability of hydrogels was tested in vivo using burn-induced wounds in mice.

RESULTS

The different essential oils exhibited different mixing abilities with the hydrogel matrix (CMC and CBM), which caused varying levels of reduction in essential oil hydrogel viscosity, swelling and water vapor transmission. Among the developed hydrogels, the CBM/CMC/EEO hydrogel exhibited optimal antibacterial activities of 46.26 ± 2.22% and 63.05 ± 0.99% against Staphylococcus aureus and Escherichia coli, respectively, along with cell viability (>92.37%) and migration activity. Furthermore, the CBM/CMC/EEO hydrogel accelerated wound healing in mouse burn models by promoting the recovery of dermis and epidermis as observed using a hematoxylin-eosin and Masson's trichrome staining assay. The findings from an enzyme-linked immunosorbent assay demonstrated that the CBM/CMC/EEO hydrogel could repair wounds through interleukin-6 and tumor necrosis factor-α downregulation and transforming growth factor-β, vascular endothelial growth factor (VEGF) and epidermal growth factor upregulation.

CONCLUSIONS

This study successfully prepared a porous CBM/CMC/EEO hydrogel with high antibacterial activity, favorable swelling, optimal rheological properties, superior water retention and water vapor transmission performance and a significant effect on skin repair in vitro and in vivo. The results indicate that the CBM/CMC/EEO hydrogel has the potential for use as a promising burn dressing material for skin burn repair.

Enzyme-Crosslinked Gelatin Hydrogel with Adipose-Derived Stem Cell Spheroid Facilitating Wound Repair in the Murine Burn Model

Engineered skin that can facilitate tissue repair has been a great advance in the field of wound healing. A well-designed dressing material together with active biological cues such as cells or growth factors can overcome the limitation of using auto-grafts from patients. Recently, many studies showed that human adipose-derived stem cells (hASCs) can be used to promote wound healing and skin tissue engineering. hASCs have already been widely applied for clinical trials. hASCs can be harvested abundantly because they can be easily isolated from fat tissue known as the stromal vascular fraction (SVF). On the other hand, increasing studies have proven that cells from spheroids can better simulate the biological microenvironment and can enhance the expression of stemness markers. However, a three-dimensional (3D) scaffold that can harbor implanted cells and can serve as a skin-repaired substitute still suffers from deficiency. In this study, we applied a gelatin/microbial transglutaminase (mTG) hydrogel to encapsulate hASC spheroids to evaluate the performance of 3D cells on skin wound healing. The results showed that the hydrogel is not toxic to the wound and that cell spheroids have significantly improved wound healing compared to cell suspension encapsulated in the hydrogel. Additionally, a hydrogel with cell spheroids was much more effective than other groups in angiogenesis since the cell spheroid has the possibility of cell-cell signaling to promote vascular generation.

Rational design and latest advances of polysaccharide-based hydrogels for wound healing

Acute and chronic wounds cause severe physical trauma to patients and also bring an immense socio-economic burden. Hydrogels are considered to be effective wound dressings. Polysaccharides possessing distinctive properties such as biocompatibility, biodegradability, and nontoxicity are promising candidates to structure hydrogels for wound healing. Polysaccharide-based hydrogels can provide suitable moisture for the wound and act as a shield against bacteria. Adequate mechanical properties, degradability, and therapeutic agent controlled release of polysaccharide-based hydrogels have been already characterized for effective utilization. This review presented several crucial design considerations about hydrogels for wound healing, and the current state of polysaccharide (chitosan, alginate, hyaluronic acid, cellulose, dextran, and starch)-based hydrogels as wound dressings was also summarized. The commonly used crosslinking techniques, including physical, chemical, and enzymatic crosslinking, are discussed in detail. Finally, we outline the challenges and perspectives about the improvement of polysaccharide-based hydrogels.

Acceleration of Wound Healing in Diabetic Rats through Poly Dimethylaminoethyl Acrylate-Hyaluronic Acid Polymeric Hydrogel Impregnated with a Didymocarpus pedicellatus Plant Extract

Wound is the major health problem associated with skin damages and arises because of various types of topical injuries. Furthermore, wounds in patients with diabetes take a relatively long time to heal. Currently, herbal medicines have been extensively used for wound care and management. Here, we engineered polymeric hybrid hydrogel of dimethylaminoethyl acrylate and hyaluronic acid (pDMAEMA-HA), which was impregnated with a herbal extract of Didymocarpus pedicellatus. The developed polymeric hybrid hydrogel system can be used for effective therapy of incurable wounds. Therefore, the development of D. pedicellatus-impregnated pDMAEMA-HA (pDPi-DMAEMA-HA) hybrid hydrogel was accomplished by the synthesis of pDMAEMA-HA hydrogel via the optimization of various reaction parameters followed by impregnation of herbal drugs D. pedicellatus. The developed hydrogel composite was well characterized via various techniques, and swelling kinetics was performed to analyze the water uptake property. The swelling ratio was found to be 1600% in both types of hydrogels. To evaluate the wound healing of these polymeric hydrogels, the Wistar rats full-thickness excision wound model was utilized. The healing strength of hydrogels was determined using measurement of wound contraction and histopathological study. The results of wound healing by these polymeric hydrogels revealed that animals treated with the pDPi-DMAEMA-HA hybrid hydrogel group were found to have a higher level of wound closure as compared to marketed formulation as well as polymeric hybrid hydrogel. The histopathologic examinations implied that pDPi-DMAEMA-HA hybrid hydrogel and polymeric hybrid hydrogel-treated groups exhibited enhanced cutaneous wound repair as well as high level of cellular repair and maintenance compared to the standard group because of hyaluronic acid roles in various stages of wound repair.

Biologically active PET/polysaccharide-based nanofibers post-treated with selenium/Tragacanth Gum nanobiocomposites

Polysaccharide-based nanofibers from Tragacanth Gum (TG) and polyethylene terephthalate (PET) were post-treated with selenium nanoparticles (Se NPs) and also stabilized with TG (SeNPs/TG). DLS, FE-SEM, EDX, TEM, and XRD were employed to verify the synthesis of Se NPs. The relatively narrow size distribution of SeNPs/TG showed through TEM and DLS investigations comparing with Se NPs. The Se NPs formation with and without TG was studied with FTIR confirmed the final stabilized solution due to the bonded hydroxyl groups of TG with Se NPs. Also, a relatively higher antioxidant reported on SeNPs/TG at 0.5-5 mg/mL using DPPH scavenging ability. The Se NPs and SeNPs/TG solutions specified remarkable inhibition against Staphylococcus aureus and Candida albicans; however, no significant antibacterial activities observed on the treated nanofibers. Finally, the uniform migration of fibroblast cells in wound healing of the treated nanofibers with SeNPs/TG proved the value of the products in medical applications.

Fabrication and evaluation of gelatin/hyaluronic acid/chondroitin sulfate/asiatic acid based biopolymeric scaffold for the treatment of second-degree burn wounds - Wistar rat model study

An extracellular matrix (ECM) mimicking architecture was introduced with gelatin glycosaminoglycans like hyaluronic acid and chondroitin sulfate and a triterpenoid using asiatic acid, possessing biodegradable and biocompatible properties that mark the functionality for the treatment of second-degree burn wounds. In the present work, a foam-based scaffold was fabricated and sterilized with gamma radiation at a 2.5 Mrad dose. The scaffolds were further characterized for morphology, swelling, degradation behaviour, release of bioactive components, ATR-FTIR, mechanical, thermal properties and compared with control. In vitro cytocompatibility of the developed scaffold was studied with L929 mouse fibroblast cells and human mesenchymal stem cells based on deoxyribonucleic acid and lactate dehydrogenase assay. Additionally, the developed scaffold was evaluated for its biocompatibility on the Wistar rat to assess any toxicity induced to the animal based on blood biochemistry and histopathology analysis. Finally, we assessed the efficacy of developed foam scaffolds on the second-degree burn wound-induced Wistar rat with a scaffold alone and a scaffold seeded with human bone-marrow-derived mesenchymal stem cells in a wound healing study for 28 d. The wound contraction assay, histopathology, immunohistochemistry analysis and pro-healing marker quantification using hexosamine, hydroxyproline, and pro-inflammatory markers like TNF-α and MMP-2 were carried out and compared with the commercially available wound dressing. The results revealed that foam-based ECM mimic was cytocompatible, biocompatible and biodegradable in 18 ± 3 d in in vivo conditions and the scaffold fostered the process of healing of second-degree burns within 28 d of treatment. The obtained result proved that the scaffold has a potential for clinical settings in second-degree burn wound treatment.

Drug-impregnated, pressurized gas expanded liquid-processed alginate hydrogel scaffolds for accelerated burn wound healing

While the benefits of both hydrogels and drug delivery to enhance wound healing have been demonstrated, the highly hydrophilic nature of hydrogels creates challenges with respect to the effective loading and delivery of hydrophobic drugs beneficial to wound healing. Herein, we utilize pressurized gas expanded liquid (PGX) technology to produce very high surface area (~200 m²/g) alginate scaffolds and describe a method for loading the scaffolds with ibuprofen (via adsorptive precipitation) and crosslinking them (via calcium chelation) to create a hydrogel suitable for wound treatment and hydrophobic drug delivery. The high surface area of the PGX-processed alginate scaffold facilitates >8 wt% loading of ibuprofen into the scaffold and controlled in vitro ibuprofen release over 12-24 h. In vivo burn wound healing assays demonstrate significantly accelerated healing with ibuprofen-loaded PGX-alginate/calcium scaffolds relative to both hydrogel-only and untreated controls, demonstrating the combined benefits of ibuprofen delivery to suppress inflammation as well as the capacity of the PGX-alginate/calcium hydrogel to maintain wound hydration and facilitate continuous calcium release to the wound. The use of PGX technology to produce highly porous scaffolds with increased surface areas, followed by adsorptive precipitation of a hydrophobic drug onto the scaffolds, offers a highly scalable method of creating medicated wound dressings with high drug loadings. STATEMENT OF SIGNIFICANCE: While medicated hydrogel-based wound dressings offer clear advantages in accelerating wound healing, the inherent incompatibility between conventional hydrogels and many poorly water-soluble drugs of relevance in wound healing remains a challenge. Herein, we leveraged supercritical fluids-based strategies to both process and subsequently impregnate alginate, followed by post-crosslinking to form a hydrogel, to create a very high surface area alginate hydrogel scaffold loaded with high hydrophobic drug contents (here, >8 wt% ibuprofen) without the need for any pore-forming additives. The impregnated scaffolds significantly accelerated burn wound healing while also promoting regeneration of the native skin morphology. We anticipate this approach can be leveraged to load clinically-relevant and highly bioavailable dosages of hydrophobic drugs in hydrogels for a broad range of potential applications.

Natural Polymer-Based Antimicrobial Hydrogels without Synthetic Antibiotics as Wound Dressings

Wound healing is usually accompanied by bacterial infection. The excessive use of synthetic antibiotics leads to drug resistance, posing a significant threat to human health. Hydrogel-based wound dressings aimed at mitigating bacterial infections have emerged as an effective wound treatment. The review presented herein particularly focuses on the hydrogels originating from natural polymers. To further enhance the performance of wound dressings, various strategies and approaches have been developed to endow the hydrogels with excellent broad-spectrum antibacterial activity. Those that are summarized in the current review are the hydrogels with intrinsic or stimuli-triggered bactericidal properties and others that serve as vehicles for loading antibacterial agents without synthetic antibiotics. Specific attention is paid to antimicrobial mechanisms and the antibacterial performance of hydrogels. Practical antibacterial applications to accelerate the wound healing employing these antibiotic-free hydrogels are also introduced along with the discussion on the current challenges and perspectives leading to new technologies.

Degradable Hydrogels for the Delivery of Immune-modulatory Proteins in the Wound Environment

Chronic wounds represent a growing clinical problem for which limited treatment strategies exist. Defects in immune cell-mediated healing play an important role in chronic wound development, presenting an attractive clinical target in the treatment of chronic wounds. However, efforts to improve healing through the application of growth factors and cytokines have been limited by the rapid degradation and diffusion of these molecules in the wound environment. In this study we sought to overcome the challenge of rapid diffusion through the development of a hydrogel delivery system in which protein cargo can be released into the wound environment at a constant and tunable rate. This system was used to deliver the intercellular adhesion molecule-1 (ICAM-1) in order to target endogenous cells upstream of growth factor and cytokine production and circumvent the issue of their rapid degradation. We demonstrated that our delivery system was able to release cargo at different and highly controllable rates and thereby improved cargo retention in the wound environment. Additionally, treatment with ICAM-1 in the delivery system improved healing in both ICAM-1-deficient mice and an aged mouse model of delayed healing, highlighting a potential clinical benefit for this protein in the treatment of chronic wounds.

Asymmetric Membranes: A Potential Scaffold for Wound Healing Applications

Currently, due to uprising concerns about wound infections, healing agents have been regarded as one of the major solutions in the treatment of different skin lesions. The usage of temporary barriers can be an effective way to protect wounds or ulcers from dangerous agents and, using these carriers can not only improve the healing process but also they can minimize the scarring and the pain suffered by the human. To cope with this demand, researchers struggled to develop wound dressing agents that could mimic the structural and properties of native skin with the capability to inhibit bacterial growth. Hence, asymmetric membranes that can impair bacterial penetration and avoid exudate accumulation as well as wound dehydration have been introduced. In general, synthetic implants and tissue grafts are expensive, hard to handle (due to their fragile nature and poor mechanical properties) and their production process is very time consuming, while the asymmetric membranes are affordable and their production process is easier than previous epidermal substitutes. Motivated by this, here we will cover different topics, first, the comprehensive research developments of asymmetric membranes are reviewed and second, general properties and different preparation methods of asymmetric membranes are summarized. In the two last parts, the role of chitosan based-asymmetric membranes and electrospun asymmetric membranes in hastening the healing process are mentioned respectively. The aforementioned membranes are inexpensive and possess high antibacterial and satisfactory mechanical properties. It is concluded that, despite the promising current investigations, much effort is still required to be done in asymmetric membranes.

Hydrogel Dressings for the Treatment of Burn Wounds: An Up-To-Date Overview

Globally, the fourth most prevalent devastating form of trauma are burn injuries. Ideal burn wound dressings are fundamental to facilitate the wound healing process and decrease pain in lower time intervals. Conventional dry dressing treatments, such as those using absorbent gauze and/or absorbent cotton, possess limited therapeutic effects and require repeated dressing changes, which further aggravate patients' suffering. Contrariwise, hydrogels represent a promising alternative to improve healing by assuring a moisture balance at the burn site. Most studies consider hydrogels as ideal candidate materials for the synthesis of wound dressings because they exhibit a three-dimensional (3D) structure, which mimics the natural extracellular matrix (ECM) of skin in regard to the high-water amount, which assures a moist environment to the wound. There is a wide variety of polymers that have been used, either alone or blended, for the fabrication of hydrogels designed for biomedical applications focusing on treating burn injuries. The aim of this paper is to provide an up-to-date overview of hydrogels applied in burn wound dressings.

Improvement in mechanical properties and biodegradability of PLA using poly(ethylene glycol) and triacetin for antibacterial wound dressing applications

Wound is among the most common injuries. A suitable wound dressing has a significant effect on the healing process. In this study, a porous wound dressing was prepared using poly (lactic acid) (PLA) and two plasticizers, polyethylene glycol (PEG) and triacetin (TA), through solvent casting method. For antibacterial activities, metronidazole was incorporated in the structure. The morphology was investigated by scanning electron microscopy (SEM). In addition, the effect of plasticizers ratio on porosity growth was evaluated. It was also observed that each had a unique effect on the structure's porosity. The mechanical properties confirmed the effect of both plasticizers on increasing polymer softness and flexibility, and the most similar formulations to human skin in terms of mechanical properties were introduced. According to the results, TA had stronger effect on mechanical properties. The differential scanning calorimetry (DSC) showed the effect of increasing plasticizer concentration on crystalline structure and Tm reduction of PLA. The water contact angle measurement showed that both plasticizers enhanced hydrophilic characteristics of PLA, and this effect was weaker in PEG-containing formulations. The in vitro degradation study showed biodegradability, as a desirable property in wound dressing. Results suggested that higher degradation can be obtained by both plasticizers at the same time. The results also showed that PEG was more effective in enhancing water absorbency. In vitro drug release study indicated an explosive release and the highest amount was 85% over 186 h. The antibacterial activity test confirmed the effectiveness of the drug in preventing bacterial growth in the drug-containing formulations, while it showed the antibacterial property of TA. MTT assay was performed and the cellular toxicity of the formulations was checked and those that revealed the least toxicity were introduced.

Engineering Tough, Injectable, Naturally Derived, Bioadhesive Composite Hydrogels

Engineering mechanically robust bioadhesive hydrogels that can withstand large strains may open new opportunities for the sutureless sealing of highly stretchable tissues. While typical chemical modifications of hydrogels, such as increasing the functional group density of crosslinkable moieties and blending them with other polymers or nanomaterials have resulted in improved mechanical stiffness, the modified hydrogels have often exhibited increased brittleness resulting in deteriorated sealing capabilities under large strains. Furthermore, highly elastic hydrogels, such as tropoelastin derivatives are highly expensive. Here, gelatin methacryloyl (GelMA) is hybridized with methacrylate-modified alginate (AlgMA) to enable ion-induced reversible crosslinking that can dissipate energy under strain. The hybrid hydrogels provide a photocrosslinkable, injectable, and bioadhesive platform with an excellent toughness that can be tailored using divalent cations, such as calcium. This class of hybrid biopolymers with more than 600% improved toughness compared to GelMA may set the stage for durable, mechanically resilient, and cost-effective tissue sealants. This strategy to increase the toughness of hydrogels may be extended to other crosslinkable polymers with similarly reactive moieties.

A liposome/gelatin methacrylate nanocomposite hydrogel system for delivery of stromal cell-derived factor-1α and stimulation of cell migration

Chronic, non-healing skin and soft tissue wounds are susceptible to infection, difficult to treat clinically, and can severely reduce a patient's quality of life. A key aspect of this issue is the impaired recruitment of mesenchymal stem cells (MSCs), which secrete regenerative cytokines and modulate the phenotypes of other effector cells that promote healing. We have engineered a therapeutic delivery system that can controllably release the pro-healing chemokine stromal cell derived factor-1α (SDF-1α) to induce the migration of MSCs. In order to protect the protein cargo from hydrolytic degradation and control its release, we have loaded SDF-1α in anionic liposomes (lipoSDF) and embedded them in gelatin methacrylate (GelMA) to form a nanocomposite hydrogel. In this study, we quantify the release of SDF-1α from our hydrogel system and measure the induced migration of MSCs in vitro via a transwell assay. Lastly, we evaluate the ability of this system to activate intracellular signaling in MSCs by using Western blots to probe for the phosphorylation of key proteins in the mTOR pathway. To our knowledge, this is the first study to report the delivery of liposomal SDF-1α using a nanocomposite approach. The results of this study expand on our current understanding of factors that can be modified to affect MSC behavior and phenotype. Furthermore, our findings contribute to the development of new hydrogel-based therapeutic delivery strategies for clinical wound healing applications. STATEMENT OF SIGNIFICANCE: Chronic, non-healing wounds promote an inflammatory environment that inhibits the migration of mesenchymal stem cells (MSCs), which secrete pro-healing and regenerative cytokines. The goal of this project is to apply principles of tissue engineering to achieve controllable release of the pro-healing chemokine SDF-1α to modulate the intracellular signaling and migratory behavior of MSCs. In this work, we introduce a nanocomposite strategy to tailor the release of SDF-1α using a liposome/gelatin methacrylate hydrogel approach. We are the first group to report the delivery of liposomal SDF-1α using this strategy. Our findings aim to further elucidate the role of MSCs in directing wound healing and guide the development of immunomodulatory and therapeutic delivery strategies for clinical wound healing applications.

Injectable Enzyme-Based Hydrogel Matrix with Precisely Oxidative Stress Defense for Promoting Dermal Repair of Burn Wound

Burn wound healing remains a challenging health problem worldwide due to the lack of efficient and precise therapy. Inherent oxidative stress following burn injury is importantly responsible for prolonged inflammation, fibrotic scar, and multiple organ failure. Herein, a bioinspired antioxidative defense system coupling with in situ forming hydrogel, namely, multiresponsive injectable catechol-Fe³⁺ coordination hydrogel (MICH) matrix, is engineered to promote burn-wound dermal repair by inhibiting tissue oxidative stress. This MICH matrix serves as the special traits of "Fe-superoxide dismutases," small molecular antioxidant (vitamin E), and extracellular matrix (ECM) in alleviating cellular oxidative damage, which demonstrates precise scavenging on reactive oxygen species (ROS) of different cellular locations, blocking lipid peroxidation and cell apoptosis. In in vivo burn-wound treatment, this MICH promptly integrates with injured surrounding tissue to provide hydration microenvironment and physicochemical ECM for burn wounds. Importantly, the MICH matrix suppresses tissue ROS production, reducing the inflammatory response, prompting re-epithelization and neoangiogenesis during wound healing. Meanwhile, the remodeling skin treated with MICH matrix demonstrates low collagen deposition and normal dermal collagen architecture. Overall, the MICH prevents burn wound progression and enhances skin regeneration, which might be a promising biomaterial for burn-wound care and other disease therapy induced by oxidative stress.

Stem bark extract of Poincianella pluviosa incorporated in polymer film: Evaluation of wound healing and anti-staphylococcal activities

Poincianella pluviosa has already been described as capable of healing skin wounds. In an attempt to prolong contact of the drug with the wound, it was proposed in this study to evaluate wound healing using a crude extract (CE) of P. pluviosa incorporated in carboxymethylcellulose polymer films. The chromatographic profile of the semipurified fraction of P. pluviosa was evaluated by ultra-high performance liquid chromatography (UHPLC), confirming the compounds gallic acid, geraniin, and ellagic acid. The films were evaluated for their physical and mechanical properties, water vapor permeability, moisture absorption capacity, and FTIR spectroscopy. For in vivo experiments, wounds were made on the back of rats and treated daily for 4, 7, 10, or 14 days with film containing CE or control film. At the end of each period, skin permeation analysis and histological analysis were made using re-epithelialisation, cell proliferation, and collagen formation. Statistical significance was determined by GraphPad Prism using t test and Mann-Whitney test. Anti-staphylococcal activity was evaluated with standard strains of Staphylococcus aureus, methicillin-resistant, and coagulase negative. It was demonstrated that the presence of CE in the films increased the capacity to absorb water and decreased resistance and permeability. The CE of the film permeated the skin, reaching the dermis and was able to influence re-epithelisation, cell proliferation, and collagen formation. Satisfactory results were observed against S. aureus strains, particularly coagulase negative. Films with CE of P. pluviosa can be an alternative in the wound healing, protecting against opportunistic infections and giving comfort to the patient.

Inclusion of Cross-Linked Elastin in Gelatin/PEG Hydrogels Favourably Influences Fibroblast Phenotype

The capacity of a biomaterial to innately modulate cell behavior while meeting the mechanical property requirements of the implant is a much sought-after goal within bioengineering. Here we covalently incorporate soluble elastin into a gelatin–poly (ethylene glycol) (PEG) hydrogel for three-dimensional (3D) cell encapsulation to achieve these properties. The inclusion of elastin into a previously optimized gelatin–PEG hydrogel was then evaluated for effects on entrapped fibroblasts, with the aim to assess the hydrogel as an extracellular matrix (ECM)-mimicking 3D microenvironment for cellular guidance. Soluble elastin was incorporated both physically and covalently into novel gelatin/elastin hybrid PEG hydrogels with the aim to harness the cellular interactivity and mechanical tunability of both elastin and gelatin. This design allowed us to assess the benefits of elastin-containing hydrogels in guiding fibroblast activity for evaluation as a potential dermal replacement. It was found that a gelatin–PEG hydrogel with covalently conjugated elastin, supported neonatal fibroblast viability, promoted their proliferation from 7.3% to 13.5% and guided their behavior. The expression of collagen alpha-1(COL1A1) and elastin in gelatin/elastin hybrid gels increased 16-fold and 6-fold compared to control sample at day 9, respectively. Moreover, cells can be loaded into the hydrogel precursor solution, deposited, and the matrix cross-linked without affecting the incorporated cells adversely, thus enabling a potential injectable system for dermal wound healing.

A hydrogen sulfide-releasing alginate dressing for effective wound healing

For wounds with heavy exudate levels, a dressing that can help to absorb wound exudate and improve the wound healing process is highly desired. Hydrogen sulfide (H₂S) has been recognized as an important gasotransmitter that can improve angiogenesis which is crucial for wound healing. In this study, a functional sodium alginate (SA) dressing with H₂S-releasing property (SA/JK-1) was fabricated by incorporating JK-1 molecule, a pH-dependent H₂S donor, into SA sponge. The resultant SA/JK-1 sponge provided a moist and protective healing environment and was capable of releasing H₂S consistently under acidic pH condition by absorbing exudate at the wound interface. The H₂S release of JK-1 donor was prolonged by the SA sponge compared with JK-1 in solution. Cell study in vitro indicated that SA/JK-1 not only exhibited good cyto-compatibility, but also improved fibroblast proliferation and migration. In addition, the effects of the SA/JK-1 dressing on wound healing was evaluated using an in vivo full thickness dermal defect model, which revealed that SA/JK-1 can significantly improve wound healing process with enhanced granulation tissue formation, re-epithelialization, collagen deposition and angiogenesis, due to the H₂S released from JK-1. Taken together, our results showed that SA dressing doped with H₂S donor could potentially serves as an effective wound healing strategy. STATEMENT OF SIGNIFICANCE: The gasotransmitter H₂S has been proven to improve the wound healing process in nanofibrous dressing due to its biological functions on angiogenesis. However, for non-healing wounds with heavy exudates, a wound dressing that can absorb wound exudates and controlled gasotransmitter release to improve the wound healing process is still in urgent need. Here we fabricated a sodium alginate (SA) sponge incorporated with H₂S donor JK-1 (SA/JK-1), which showed strong water uptake capability, and released H₂S under acidic condition. The SA/JK-1 sponge exhibited biocompatibility to fibroblasts and promoted cell migration in vitro, and exhibited obviously positive influence on wound healing in vivo. This H₂S donor doped alginate wound dressing represents a promising strategy for treatment of non-healing wound.

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.