Controlled water vapor transmission rate promotes wound-healing via wound re-epithelialization and contraction enhancement

Alginate-gum acacia based sponges as potential wound dressings for exuding and bleeding wounds

The improper management of wound exudates can expose the wound to bacterial invasion, skin maceration etc. thereby resulting in prolonged wound healing. Biopolymers are characterized by hydrophilic functional groups which when employed for the development of wound dressings promote the wound dressings capability to absorb a high amount of wound exudates. Alginate-gum acacia sponges were prepared from a combination of biopolymers such as sodium alginate and gum acacia in varying amounts with carbopol via crosslinking with 1 and 2% CaCl₂. The prepared sponges were loaded with a combination of ampicillin and norfloxacin. In vitro antibacterial analysis revealed that the antibacterial activity of the loaded antibiotics was retained and the sponges were effective against gram-positive and gram-negative bacteria. The sponges displayed rapid and high absorption capability in the range of 1022-2419% at pH 5.5 simulating wound exudates, and 2268-5042% at pH 7.4 simulating blood within a period of 1-3 h. Furthermore, the whole blood clotting studies further revealed low absorbance values when compared to the control revealing the good clotting capability of the sponges. The unique features of the sponges revealed their potential application for the management of infected, high exuding and bleeding wounds.

Development of Stimuli-Responsive Chitosan/ZnO NPs Transdermal Systems for Controlled Cannabidiol Delivery

One of the most common neurological diseases is epilepsy, which not only negatively affects the quality of people's life but also may lead to life-threatening situations when its symptoms such as seizures cannot be controlled medically. A very serious problem to be overcame is the untreatable form of this disease, which cannot be cured by any currently available medicines. Cannabidiol, which is a natural product obtained from Cannabis Sativa, brings a new hope to people suffering from drug-resistant epilepsy. However, the hydrophobic character of this compound significantly lowers its clinical efficiency. One of the promising methods of this substance bioactivity increase is delivery through the skin tissue. In this article, a new type of advanced transdermal systems based on chitosan and ZnO nanoparticles (NPs) has been developed according to Sustained Development principles. The chemical modification of the biopolymer confirmed by FT-IR method resulted in the preparation of the material with great swelling abilities and appropriate water vapor permeability. Obtained nanoparticles were investigated over their crystalline structure and morphology and their positive impact on drug loading capacity and cannabidiol controlled release was proved. The novel biomaterials were confirmed to have conductive properties and not be cytotoxic to L929 mouse fibroblasts.

Reusable Surface-Enhanced Raman Spectroscopy Membranes and Textiles via Template-Assisted Self-Assembly and Micro/Nanoimprinting

Surface-enhanced Raman spectroscopy (SERS) has emerged as a powerful tool for ultrasensitive fingerprint recognition of molecules with considerable potential in wearable biochemical sensing. However, previous efforts to fabricate wearable SERS devices by directly treating fabrics with plasmonic nanoparticles have generated a nonuniform assembly of nanoparticles, weakly adsorbed on fabrics via van der Waals forces. Here, we report the creation of washing reusable SERS membranes and textiles via template-assisted self-assembly and micro/nanoimprinting approaches. Uniquely, we employ the capillary force driven self-assembly process to generate micropatch arrays of Au nanoparticle (NP) aggregates within hydrophobic microstructured templates, which are then robustly bonded onto semipermeable transparent membranes and stretchable textiles using the UV-resist based micro/nanoimprinting technique. A mild reactive ion etching (RIE) treatment of SERS membranes and textiles can physically expose the SERS hotspots of Au NP-aggregates embedded within the polymer UV resist for further improvement of their SERS performance. Also, we demonstrate that the semipermeable transparent SERS membranes can keep the moisture content of meat from evaporating to enable stable in situ SERS monitoring of biochemical environments at the fresh meat surface. By contrast, stretchable SERS textiles can allow the spreading, soaking, and evaporation of solution analyte samples on the fabric matrix for continuous enrichment of analyte molecules at the hotspots in biochemical SERS detection. Due to the mechanical robustness of the UV-resist immobilized Au NP aggregates, simple detergent-water washing with ultrasound sonication or mechanical stirring can noninvasively clean contaminated hot spots to reuse SERS textiles. Therefore, we envision that washing reusable SERS membranes and textiles by template-assisted self-assembly and micro/nanoimprinting fabrication are promising for wearable biochemical sensing applications, such as wound monitoring and body fluid monitoring.

Surface modification of electrospun silk/AMOX/PVA nanofibers by dielectric barrier discharge plasma: physiochemical properties, drug delivery and in-vitro biocompatibility

The naturally obtained protein Bombyxmori silk is a biocompatible polymer with excellent mechanical properties and have the potential in controlled drug delivery applications. In this work, we have demonstrated dielectric barrier discharge (DBD) oxygen (O2) plasma surface modified electrospun Bombyxmori silk/Amoxicillin hydrochloride trihydrate (AMOX)/polyvinyl alcohol (PVA) nanofibers for drug release applications with controlled plasma treatment duration (1-10 min). The findings indicate that plasma treated electrospun nanofibers for 1-3 min exhibited significant enhancement in tensile strength, Young's modulus, wettability and surface energy. The plasma treated electrospun nanofibers for 1-5 min showed remarkable increase in AMOX released rate, whereas the electrospun nanofibers treated with plasma irradiation beyond 5 min showed only marginal increase. Moreover, the plasma treated nanofibers also exhibited good antibacterial activity against both E. coli (gram negative) and S. aureus (gram positive) bacteria. The untreated and the plasma treated silk/AMOX/PVA electrospun nanofibers for 1-3 min showed enhanced viability of primary adipose derived mesenchymal stem cells (ADMSCs) growth on them and much less hemolysis activity (< 5%). The in vitro biocompatibility of various electrospun nanofibers were further corroborated by live/dead imaging and cytoskeletal architecture assessment demonstrating enhanced cell adhesion and spreading on the plasma treated nanofibers for 1-3 min. The findings of the present study suggest that the silk/AMOX/PVA electrospun nanofibers with plasma treatment (1-3 min) due to their enhanced drug release ability and biocompatibility can be used as potential wound dressing applications.

The Cutaneous Wound Innate Immunological Microenvironment

The skin represents the first line of defense and innate immune protection against pathogens. Skin normally provides a physical barrier to prevent infection by pathogens; however, wounds, microinjuries, and minor barrier impediments can present open avenues for invasion through the skin. Accordingly, wound repair and protection from invading pathogens are essential processes in successful skin barrier regeneration. To repair and protect wounds, skin promotes the development of a specific and complex immunological microenvironment within and surrounding the disrupted tissue. This immune microenvironment includes both innate and adaptive processes, including immune cell recruitment to the wound and secretion of extracellular factors that can act directly to promote wound closure and wound antimicrobial defense. Recent work has shown that this immune microenvironment also varies according to the specific context of the wound: the microbiome, neuroimmune signaling, environmental effects, and age play roles in altering the innate immune response to wounding. This review will focus on the role of these factors in shaping the cutaneous microenvironment and how this ultimately impacts the immune response to wounding.

Autologous Platelet-Rich Plasma Enhances the Healing of Large Cutaneous Wounds in Dogs

Platelet-rich plasma (PRP) is known to play a crucial role in skin wound healing, in both Human and Veterinary Medicine. Remarkably, until now, no studies have reported PRP treatment in subacute full-thickness skin wounds of the dog. The aim of this study was to evaluate the effects of two consecutive applications of autologous PRP, with the second application after 15 days, in 6 dogs showing large subacute skin wounds. The percentage of contraction, re-epithelialization and healing in all treated patients indicated that no complications or side effects, associated with consecutive PRP treatments, occurred in any patient and all wounds achieved complete closure and re-epithelialization. Our results suggest a positive effect of repeated autologous topical PRP treatments in large cutaneous subacute wounds of different etiology. Therefore, this PRP treatment could represent a simple, cost-effective, and valid alternative to promote healing processes in subacute large wounds cases in dogs.

α-Lactalbumin-Based Nanofiber Dressings Improve Burn Wound Healing and Reduce Scarring

Skin wound especially burn injury is a major threat for public health. One of the pursuits in the current wound healing research is to identify new promising biological materials, which can not only promote tissue repair but also reduce scar formation. In this current study, the potentials of α-lactalbumin (ALA), a tryptophan-rich dietary protein acting as a precursor of neurotransmitter serotonin, to promote the burn wound healing and reduce the scar formation were investigated. The ALA was initially electrospun with polycaprolactone (PCL) to accomplish electrospun nanofibrous mats (ENMs), subsequently assessed for their physicochemical attributes and wound healing efficiency on a burn rat model, and then their healing mechanisms at cellular and molecular levels were explored. The results showed that ALA and PCL were physicochemically compatible in ENMs. The average diameter of various nanofibers was within 183-344 nm. Their wettability and mechanical properties could be readily modulated by adjusting the mass ratios of ALA and PCL from 1/9 to 1/2. The selected ENMs exhibited negligible cytotoxicity and satisfactory adhesion to fibroblasts and promoting the proliferation of the fibroblasts. As compared to pristine PCL based ENMs, the composite scaffolds could accelerate the wound healing process and exhibit effects comparable to a marketed wound dressing over 16 days. Moreover, the ALA/PCL based ENMs could increase the synthesis of type I collagen and decrease the expression of α-smooth muscle actin, conferring that the novel wound dressings could reduce the formation of scars. Collectively, this study demonstrates that the ALA is a promising biological material and could promote the regeneration of burn skins with reduced scar formation, when being loaded on ultrafine fibrous scaffolds, mimicking the structure of the natural extra cellular matrix.

Development of tannic acid-enriched materials modified by poly(ethylene glycol) for potential applications as wound dressing

The interests in the biomedical impact of tannic acid (TA) targeting production of various types of biomaterials, such as digital microfluids, chemical sensors, wound dressings, or bioimplants constantly increase. Despite the significant disadvantage of materials obtained from natural-based compounds and their low stability and fragility, therefore, there is an imperative need to improve materials properties by addition of stabilizing formulas. In this study, we performed assessments of thin films over TA proposed as a cross-linker to be used in combination with polymeric matrix based on chitosan (CTS), i.e. CTS/TA at 80:20 or CTS/TA at 50:50 and poly(ethylene glycol) (PEG) at the concentration of 10% or 20%. We evaluated their mechanical parameters as well as the cytotoxicity assay for human bone marrow mesenchymal stem cells, human melanotic melanoma (MNT-1), and human osteosarcoma (Saos-2). The results revealed significant differences in dose-dependent of PEG regarding the maximum tensile strength (σ_max) or impact on the metabolic activity of tissue culture plastic. We observed that PEG improved mechanical parameters prominently, decreased the hemolysis rate, and did not affect cell viability negatively. Enclosed data, confirmed also by our previous reports, will undoubtedly pave the path for the future application of tannic acid-based biomaterials to treat wound healing.

Vacuum sealing drainage with instillation in the treatment of necrotising soft-tissue infection: a retrospective analysis

Objective:

Necrotising soft-tissue infection is a rare but life-threatening infectious disease with high morbidity and mortality. It is typically caused by toxin-producing bacteria and characterised clinically by a very rapid progression of the disease with significant local tissue destruction. In this study, we intend to explore effective wound management to control the invasive infection and to decrease the high mortality.

Method:

This retrospective analysis explored the wound management and mortality in patients with necrotising soft-tissue infection. Extensive debridement, vacuum sealing drainage (VSD) with normal saline instillation combined with broad-spectrum or sensitive antibiotics, and supportive therapies were used.

Results:

All 17 patients included in the analysis survived. The microbiology of 11 patients was found to be polymicrobial. Of the patients, 14 were discharged with completely healed wounds and three were transferred to a local hospital after the systemic and invasive wound infection was controlled.

Conclusion:

Our experiences revealed the outstanding effect of VSD with instillation in removing the debris of necrotising tissue on the wound bed, in the continual and complete drainage of wound exudates, and in prompting wound healing.

Curcumin-Loaded Bacterial Cellulose/Alginate/Gelatin as A Multifunctional Biopolymer Composite Film

Multifunctional biopolymer composites comprising mechanically-disintegrated bacterial cellulose, alginate, gelatin and curcumin plasticized with glycerol were successfully fabricated through a simple, facile, cost-effective mechanical blending and casting method. SEM images indicate a well-distributed structure of the composites. The water contact angles existed in the range of 50-70°. Measured water vapor permeability values were 300-800 g/m2/24 h, which were comparable with those of commercial dressing products. No release of curcumin from the films was observed during the immersion in PBS and artificial saliva, and the fluid uptakes were in the range of 100-700%. Films were stretchable and provided appropriate stiffness and enduring deformation. Hydrated films adhered firmly onto the skin. In vitro mucoadhesion time was found in the range of 0.5-6 h with porcine mucosa as model membrane under artificial saliva medium. The curcumin-loaded films had substantial antibacterial activity against E. coli and S. aureus. The films showed non-cytotoxicity to human keratinocytes and human gingival fibroblasts but exhibited potent anticancer activity in oral cancer cells. Therefore, these curcumin-loaded films showed their potential for use as leave-on skin applications. These versatile films can be further developed to achieve desirable characteristics for local topical patches for wound care, periodontitis and oral cancer treatment.

Development of electrospun keratin/coenzyme Q10/poly vinyl alcohol nanofibrous scaffold containing mupirocin as potential dressing for infected wounds

Background

Nanostructured wound dressings produced by electrospinning biocompatible polymers possess great potential because they resemble the natural extracellular matrix and support cell adhesion, proliferation, and differentiation. This study seeks to fabricate mupirocin, keratin, and coenzyme Q10 (Co Q10)-loaded PVA electrospun scaffolds intended for wound healing application and to characterize their morphology, physical properties, antibacterial activity, and biocompatibility. Polyvinyl alcohol (PVA) (10% w/v), various concentrations of keratin/Co Q10 fibrous scaffolds (electrospun at a voltage of 50 kV, flow rate of 4 mL/h), and 2% mupirocin was designed and fabricated to activate keratinocytes in the wound bed, stimulate cell proliferation, and increase antimicrobial penetration.

Results

The diameters of the scaffolds were observed to be in the nanoparticulate range 2.11 ± 0.20 to 3.27 ± 0.10 nm. By 30 min, all the scaffolds had more than 50% of the cumulative concentration of mupirocin released with 51.06 ± 2.104% to 74.66 ± 1.72% of mupirocin released. At 1 h, 80% of the mupirocin in the scaffold was seen to have diffused out of the scaffold. Release of mupirocin was modulated; an initial burst release was followed by sustained release over 2 h. Electrospun keratin/Co Q10/PVA scaffold containing mupirocin showed excellent antimicrobial activity against all the clinical isolates of 2586, Staphylococcus aureus 2590, 2583, 2587, 2555. All the electrospun scaffolds showed higher cell viability values than the control at 48 and 72 h, with the optimized CoQ10 scaffold concentration being 0.05% w/w.

Conclusion

Electrospun nanofibers combining the biocompatibility potential of PVA with the bioactive nature of keratin (0.01% w/w) and CoQ10 (0.5% w/w) and the antibacterial property of mupirocin as a new potential for proper wound care was successfully developed. The cell line studies on this electrospun scaffold (PKCM 3) showed their ability to support the growth of keratinocytes hence the potential of developed scaffolds as a wound dressing. In vivo studies to further investigate the applications of the electrospun keratin/Co Q10/PVA nanofibrous scaffold as a wound dressing is however required.

Targeting Tunable Physical Properties of Materials for Chronic Wound Care

Chronic wounds caused by infections, diabetes, and radiation exposures are becoming a worldwide growing medical burden. Recent progress highlighted the physical signals determining stem cell fates and bacterial resistance, which holds potential to achieve a better wound regeneration in situ. Nanoparticles (NPs) would benefit chronic wound healing. However, the cytotoxicity of the silver NPs (AgNPs) has aroused many concerns. This review targets the tunable physical properties (i.e., mechanical-, structural-, and size-related properties) of either dermal matrixes or wound dressings for chronic wound care. Firstly, we discuss the recent discoveries about the mechanical- and structural-related regulation of stem cells. Specially, we point out the currently undocumented influence of tunable mechanical and structural properties on either the fate of each cell type or the whole wound healing process. Secondly, we highlight novel dermal matrixes based on either natural tropoelastin or synthetic elastin-like recombinamers (ELRs) for providing elastic recoil and resilience to the wounded dermis. Thirdly, we discuss the application of wound dressings in terms of size-related properties (i.e., metal NPs, lipid NPs, polymeric NPs). Moreover, we highlight the cytotoxicity of AgNPs and propose the size-, dose-, and time-dependent solutions for reducing their cytotoxicity in wound care. This review will hopefully inspire the advanced design strategies of either dermal matrixes or wound dressings and their potential therapeutic benefits for chronic wounds.

Healing Effect of Vicenin-2 (VCN-2) on Human Dermal Fibroblast (HDF) and Development VCN-2 Hydrocolloid Film Based on Alginate as Potential Wound Dressing

Chronic wounds represent serious globally health care and economic issues especially for patients with hyperglycemic condition. Wound dressings have a predominant function in wound treatment; however, the dressings for the long-lasting and non-healing wounds are still a significant challenge in the wound care management market. Astonishingly, advanced wound dressing which is embedded with a synthetic drug compound in a natural polymer compound that acts as drug release carrier has brought about promising treatment effect toward injured wound. In the current study, results have shown that Vicenin-2 (VCN-2) compound in low concentration significantly enhanced cell proliferation and migration of HDF. It also regulated the production of pro-inflammatory cytokines such as IL-6, IL-1β, and TNF-α from HDF in wound repair. Treatment of VCN-2 also has facilitated the expression of TGF-1β and VEGF wound healing maker in a dose-dependent manner. A hydrocolloid film based on sodium alginate (SA) incorporated with VCN-2 synthetic compound which targets to promote wound healing particularly in diabetic condition was successfully developed and optimized for its physico-chemical properties. It was discovered that all the fabricated film formulations prepared were smooth, translucent, and good with flexibility. The thickness and weight of the formulations were also found to be uniform. The hydrophilic polymer comprised of VCN-2 were shown to possess desirable wound dressing properties and superior mechanical characteristics. The drug release profiles have revealed hydrocolloid film, which is able to control and sustain the VCN-2 released to wound area. In short, hydrocolloid films consisting of VCN-2 formulations are suitably used as a potential wound dressing to promote restoration of wound injury.

Recent Progress and Perspectives on Polyurethane Membranes in the Development of Gas Sensors

In today's technology, gas sensors are of great importance in areas such as assessing environmental impacts, monitoring gas production facilities, measuring natural gas, controlling mines and gas leaks. Improving sensor sensitivity and decreasing the determination time is among the subjects that are continuously investigated. The use of polymeric membranes to make such improvements is common practice in the gas sensor field. By the development of polymeric membrane-based gas sensors and increasing the measurement sensitivity, accurate, sensitive, precise and fast measurements of toxic gases, volatile organic gases, and trace gases have been possible. Therefore, polyurethane membranes have been promising in the development of next-generation gas sensors based on membrane diffusion to ensure real-time and continuous monitoring of gases in industry and academic studies. This study aims to evaluate, compare and discuss the recent developments in the use of polyurethane membranes in existing gas detection technologies with chemical, electrical and optical measurement methods. In these measurement methods, polyurethane structures act as a selectively permeable membrane, an ideal matrix material for conductive additives or a suitable film structure for coating the conductive polymeric films. Conductive additives or conductive film structures for gas sensors play an important role in the detection of the gas structure with the change in electrical properties during the passage of gas molecules. This review has focused on important properties such as selectivity, detection time and measurement sensitivity concerning gas detection technology containing polyurethane, which has been used so far.

Concentration Dependent Effect of Human Dermal Fibroblast Conditioned Medium (DFCM) from Three Various Origins on Keratinocytes Wound Healing

Fibroblasts secrete many essential factors that can be collected from fibroblast culture medium, which is termed dermal fibroblast conditioned medium (DFCM). Fibroblasts isolated from human skin samples were cultured in vitro using the serum-free keratinocyte-specific medium (Epilife (KM1), or define keratinocytes serum-free medium, DKSFM (KM2) and serum-free fibroblast-specific medium (FM) to collect DFCM-KM1, DFCM-KM2, and DFCM-FM, respectively). We characterised and evaluated the effects of 100-1600 µg/mL DFCM on keratinocytes based on attachment, proliferation, migration and gene expression. Supplementation with 200-400 µg/mL keratinocyte-specific DFCM-KM1 and DFCM-KM2 enhanced the attachment, proliferation and migration of sub-confluent keratinocytes, whereas 200-1600 µg/mL DFCM-FM significantly increased the healing rate in the wound healing assay, and 400-800 µg/mL DFCM-FM was suitable to enhance keratinocyte attachment and proliferation. A real-time (RT²) profiler polymerase chain reaction (PCR) array showed that 42 genes in the DFCM groups had similar fold regulation compared to the control group and most of the genes were directly involved in wound healing. In conclusion, in vitro keratinocyte re-epithelialisation is supported by the fibroblast-secreted proteins in 200-400 µg/mL DFCM-KM1 and DFCM-KM2, and 400-800 µg/mL DFCM-FM, which could be useful for treating skin injuries.

Bacterial cellulose micro-nano fibres for wound healing applications

Bacterial cellulose (BC) is cellulose produced by a few limited species of bacteria in given conditions. BC has many remarkable properties such as its attractive mechanical properties, water uptake ability and biocompatibility which makes it a very desirable material to be used for wound healing. Inherently due to these important properties, the material is very resistant to easy processing and thus difficult to produce into useful entities. Additionally, being rate limited by the dependency on bacterial production, high yield is difficult to obtain and thus secondary material processing is sought after. In this review, BC is explained in terms of synthesis, structure and properties. These beneficial properties are directly related to the material's great potential in wound healing where it has also been trialled commercially but ultimately failed due to processing issues. However, more recently there has been increased frequency in scientific work relating to BC processing into hybrid polymeric fibres using common laboratory fibre forming techniques such as electrospinning and pressurised gyration. This paper summarises current progress in BC fibre manufacturing, its downfalls and also gives a future perspective on how the landscape should change to allow BC to be utilised in wound care in the current environment.

Hyaluronic Acid Reduces Bacterial Fouling and Promotes Fibroblasts' Adhesion onto Chitosan 2D-Wound Dressings

Wound healing is a dynamic process that can be seriously delayed by many factors including infectious complications. The development of dressings with intrinsic wound healing activity and/or releasing bioactive compounds may help with addressing such an issue. In this study, hyaluronic acid (HA) at different percentages (1–35%) was used to modify chitosan (CS) biological and physico-chemical properties in order to obtain 2D-matrices able to promote healing and protect from infection. HA incorporation in the CS matrix decreased film transparency and homogeneity, but improved film water uptake and surface wettability. The water vapor transmission rate (WVTR) increased up to a 5% HA content, where it reached the highest value (672 g/m² day), and decreased for higher HA contents. At all of the tested HA concentrations, HA affected mechanical properties providing matrices more flexible than pure CS with benefit for wound care. Pure CS films permitted S. epidermidis adhesion and biofilm formation. That was not true for CS/HA matrices, where HA at concentrations equal to or greater than 5% was able to avoid S. epidermidis adhesion. Fibroblasts adhesion also took benefit from the HA presence in the film, especially at 5% content, where the best adhesion and proliferation was found.

Hybrid Bilayer PLA/Chitosan Nanofibrous Scaffolds Doped with ZnO, Fe3O4, and Au Nanoparticles with Bioactive Properties for Skin Tissue Engineering

Burns affect almost half a million of Americans annually. In the case of full-thickness skin injuries, treatment requires a transplant. The development of bioactive materials that promote damaged tissue regeneration constitutes a great alternative to autografts. For this reason, special attention is focused on three-dimensional scaffolds that are non-toxic to skin cells and can mimic the extracellular matrix, which is mainly composed of nanofibrous proteins. Electrospinning, which enables the preparation of nanofibers, is a powerful tool in the field of biomaterials. In this work, novel hybrid poly (lactic acid)/chitosan biomaterials functionalized with three types of nanoparticles (NPs) were successfully developed. ZnO, Fe3O4, and Au NPs were investigated over their morphology by TEM method. The top layer was obtained from PLA nanofibers, while the bottom layer was prepared from acylated chitosan. The layers were studied over their morphology by the SEM method and their chemical structure by FT-IR. To verify their potential in burn wound treatment, the scaffolds' susceptibility to biodegradation as well as moisture permeability were calculated. Also, biomaterials conductivity was determined in terms of electrostimulation. Finally, cytotoxicity tests were carried out by XTT assay and morphology analysis using both fibroblasts cell line and primary cells. The hybrid nanofibrous scaffolds displayed a great potential in tissue engineering.

In situ Fabrication of Nano ZnO/BCM Biocomposite Based on MA Modified Bacterial Cellulose Membrane for Antibacterial and Wound Healing

Background

Developing an ideal wound dressing that meets the multiple demands of safe and practical, good biocompatibility, superior mechanical property and excellent antibacterial activity is highly desirable for wound healing. Bacterial cellulose (BC) is one of such promising class of biopolymers since it can control wound exudates and can provide moist environment to a wound resulting in better wound healing. However, the lack of antibacterial activity has limited its application.

Methods and Results

We prepared a flexible dressing based on a bacterial cellulose membrane and then modified it by chemical crosslinking to prepare in situ synthesis of nZnO/BCM via a facile and eco-friendly approach. Scanning electron microscopy (SEM) results indicated that nZnO/BCM membranes were characterized by an ideal porous structure (pore size: 30~ 90 μm), forming a unique string-beaded morphology. The average water vapor transmission of nZnO/BCM was 2856.60 g/m²/day, which improved the moist environment of nZnO/BCM. ATR-FITR further confirmed the stepwise deposition of nano-zinc oxide. Tensile testing indicated that our nanocomposites were flexible, comfortable and resilient. Bacterial suspension assay and plate counting methods demonstrated that 5wt. % nZnO/BCM possessed excellent antibacterial activity against S.aureus and E. coli, while MTT assay demonstrated that they had no measurable cytotoxicity toward mammalian cells. Moreover, skin irritation test and histocompatibility examination supported that 5wt. % nZnO/BCM had no stimulation to skin and had acceptable biocompatibility with little infiltration of the inflammatory cells. Finally, by using a bacteria-infected (S. aureus and E. coli) murine wound model, we found that nZnO/BCM could prevent in vivo bacterial infections and promote wound healing via accelerating the re-epithelialization and wound contraction, and these membranes had no obvious toxicity toward normal tissues.

Conclusion

Therefore, the constructed nZnO/BCM has great potential for biomedical applications as an efficient antibacterial wound dressing.

Xanthan Gum-Konjac Glucomannan Blend Hydrogel for Wound Healing

Hydrogels are considered to be the most ideal materials for the production of wound dressings since they display a three-dimensional structure that mimics the native extracellular matrix of skin as well as a high-water content, which confers a moist environment at the wound site. Until now, different polymers have been used, alone or blended, for the production of hydrogels aimed for this biomedical application. From the best of our knowledge, the application of a xanthan gum-konjac glucomannan blend has not been used for the production of wound dressings. Herein, a thermo-reversible hydrogel composed of xanthan gum-konjac glucomannan (at different concentrations (1% and 2% w/v) and ratios (50/50 and 60/40)) was produced and characterized. The obtained data emphasize the excellent physicochemical and biological properties of the produced hydrogels, which are suitable for their future application as wound dressings.

A novel bilayer zein/MMT nanocomposite incorporated with H. perforatum oil for wound healing

Recently, layered structures composed of nanofibers have gained attention as a novel material to mimic skin tissue in wound healing applications. The aim of this study is to develop a novel hybrid bilayer material composed of zein based composite film and nanofiber layers as a wound dressing material. The upper layer was composed of H. perforatum oil incorporated zein film including MMT and the bottom layer was comprised of 3D electrospun zein/MMT nanofibers to induce wound healing with the controlled release of H. perforatum oil. The bilayer composites were characterized in terms of mechanical test, WVP, water uptake and surface wettability. Antimicrobial activity of the wound dressings against microorganisms were investigated by disc diffusion method. In vitro cytotoxicity of monolayer film and bilayer structure was performed using WST-1 assay on HS2 keratinocyte and 3T3 cell lines. Results indicated that the prepared monolayer films showed appropriate mechanical and gas barrier properties and surface wettability for wound healing. Controlled release of H. perforatum oil was obtained from fabricated membranes up to 48 h. Bilayer membranes showed antimicrobial activity against E. coli, S. aureus, and C. albicans and did not show any toxic effect on NIH3T3 mouse fibroblast and HS2 keratinocyte cell lines. In vitro scratch assay results indicated that H. perforatum oil had a wound healing effect by inducing fibroblast migration. The proliferation study supported these results by increasing fibroblast proliferation on H. perforatum oil loaded bilayer membranes.

Preparation of Antimicrobial Hyaluronic Acid/Quaternized Chitosan Hydrogels for the Promotion of Seawater-Immersion Wound Healing

Wound immersion in seawater with high salt, high sodium, and a high abundance of pathogenic bacteria, especially gram-negative bacteria, can cause serious infections and difficulties in wound repair. The present study aimed to prepare a composite hydrogel composed of hyaluronic acid (HA) and quaternized chitosan (QCS) that may promote wound healing of seawater-immersed wounds and prevent bacterial infection. Based on dynamic Schiff base linkage, hydrogel was prepared by mixing oxidized hyaluronic acid (OHA) and hyaluronic acid-hydrazide (HA-ADH) under physiological conditions. With the addition of quaternized chitosan, oxidized hyaluronic acid/hyaluronic acid-hydrazide/quaternized chitosan (OHA/HA-ADH/O-HACC and OHA/HA-ADH/N-HACC) composite hydrogels with good swelling properties and mechanical properties, appropriate water vapor transmission rates (WVTR), and excellent stability were prepared. The biocompatibility of the hydrogels was demonstrated by in vitro fibroblast L929 cell culture study. The results of in vitro and in vivo studies revealed that the prepared antibacterial hydrogels could largely inhibit bacterial growth. The in vivo study further demonstrated that the antibacterial hydrogels exhibited high repair efficiencies in a seawater-immersed wound defect model. In addition, the antibacterial hydrogels decreased pro-inflammatory factors (TNF-α, IL-1β, and IL-6) but enhanced anti-inflammatory factors (TGF-β1) in wound. This work indicates that the prepared antibacterial composite hydrogels have great potential in chronic wound healing applications, such as severe wound cure and treatment of open trauma infections.

Carboxymethyl cellulose-human hair keratin hydrogel with controlled clindamycin release as antibacterial wound dressing

This study offers a new antibacterial wound dressing from carboxymethyl cellulose (CMC)-human hair keratin with topical clindamycin delivery. Keratin was successfully extracted from human hair. Different sponges fabricated by changing CMC to keratin ratio were characterized and compared. Halloysite nanotubes were used as carriers to control the clindamycin release. Various characterization techniques were used to determine the effects of keratin addition on the structure, morphology, physical properties, drug release, antibacterial activity, and cellular behavior of CMC hydrogels. As proved by SEM and EDS, porous structure with interconnected pores was successfully formed and clindamycin-loaded HNTs were uniformly dispersed within the porous structures. Increasing the keratin in CMC hydrogel not only lowered its water vapor transmission rate to a suitable range for wound healing but also improved the water stability of CMC hydrogel. The in vitro release study indicated that clindamycin was released slower in samples containing higher keratin and the Fickian diffusion mechanism controlled their release profile. The fabricated dressing effectively inhibits S. aureus bacterial colonies growth after 24 h. Fibroblast culturing on the fabricated sponges indicated that cellular attachment, proliferation, and spreading were significantly enhanced with increasing the keratin amount.

Fabrication of Chitosan/PVA/GO/CuO patch for potential wound healing application

Wound healing is a common issue in our day to day life. Our immune system repairs the damaged tissue by itself and its a time-consuming process. The GO/CuO nanocomposite (NC) was synthesized through the sol-gel method. XRD, FT-IR, Raman, and TEM analysis were used to analysis the physico-chemical properties of the sample. The GO/CuO patches were prepared using chitosan (Cs)/poly vinyl alcohol (PVA) due to its biocompatibility and biodegradable nature. The obtained patches showed better antimicrobial and wound healing property than recently reported materials. The GO/CuO NC plays a major part in angiogenesis process and in the synthesis, stabilization of extracellular matrix skin proteins. Thus, GO/CuO NC enhance the wound healing mechanism by increasing cell proliferation, antimicrobial property and rapid initiation of inflammatory. Moreover, the antimicrobial activity of CuO, GO, GO/CuO and GO/CuO patch were tested against bacteria causing wound infections. Cs/PVA patch and Cs/PVA/GO/CuO patch were analyzed for swelling, evaporation and degradation behavior. Increase in cell viability and migration of NIH3t3 cells by NC patch shows a potential way for wound healing applications.

Development of Chitosan/Silver Sulfadiazine/Zeolite Composite Films for Wound Dressing

Biopolymeric films with silver sulfadiazine (AgSD) are proposed as an alternative to the occlusive AgSD-containing creams and gauzes, which are commonly used in the treatment of conventional burns. While the recognized cytotoxicity of AgSD has been reported to compromise its use as an antimicrobial drug in pharmaceuticals, this limitation can be overcome by developing sustained-release formulations. Microporous materials as zeolites can be used as drug delivery systems for sustained release of AgSD. The purpose of this work was the development and characterization of chitosan/zeolite composite films to be used as wound dressings. Zeolite was impregnated with AgSD before the production of the composite films. The physicochemical properties of zeolites and the films were evaluated, as well as the antimicrobial activity of the polymeric films and the cytotoxicity of the films in fibroblasts Balb 3T3/c. Impregnated zeolite exhibited changes in FTIR spectra and XRD diffraction patterns, in comparison to non-impregnated composites, which corroborate the results obtained with EDX-SEM. The pure chitosan film was compact and without noticeable defects and macropores, while the film with zeolite was opaquer, more rigid, and efficient against Candida albicans and some gram-negative bacteria. The safety evaluation showed that although the AgSD films present cytotoxicity, they could be used in a concentration-dependent fashion.

Preparation of a novel asymmetric wettable chitosan-based sponge and its role in promoting chronic wound healing

Cutaneous chronic wounds are characterized by an impaired wound healing which may lead to infection. To surmount this problem, a novel quaternary ammonium chitosan nanoparticles (TMC NPs)/chitosan (CS)composite sponge with asymmetric wettability surfaces was successfully prepared. The optimum concentrations of TMC NPs and CS were 0.2 mg/mL and 2.0%, respectively. The incorporated TMC NPs could improve the antibacterial activity of the CS sponge. Asymmetric modification enables the CS sponge to have hydrophobic outer surface and hydrophilic inner surface. The hydrophobic surface of the sponge shows waterproof and anti-adhesion contaminant properties, whereas the hydrophilic surface preserves water-absorbing capability and efficiently inhibits the growth of bacteria. More importantly, in vivo chronic wound healing model evaluation reveals that TMC NPs/CS composite sponge promotes the wound healing and accelerates re-epithelialization and angiogenesis. And in vivo anti-infection test shows the TMC NPs/CS composite sponge could effectively prevent wound infection. These findings demonstrate that TMC NPs/CS composite sponge is a promising dressing material for chronic wounds.

Development of a poly(vinyl alcohol)/lysine electrospun membrane-based drug delivery system for improved skin regeneration

Nanofiber-based wound dressings are currently being explored as delivery systems of different biomolecules for avoiding skin infections as well as improve/accelerate the healing process. In the present work, a nanofibrous membrane composed of poly(vinyl alcohol) (PVA) and lysine (Lys) was produced by using the electrospinning technique. Further, anti-inflammatory (ibuprofen (IBP)) and antibacterial (lavender oil (LO)) agents were incorporated within the electrospun membrane through blend electrospinning and surface physical adsorption methods, respectively. The obtained results demonstrated that the PVA_Lys electrospun membranes incorporating IBP or LO displayed the suitable morphological, mechanical and biological properties for enhancing the wound healing process. Moreover, the controlled and sustained release profile attained for IBP was appropriate for the duration of the wound healing inflammatory phase, whereas the initial burst release of LO is crucial to prevent wound bacterial contamination. Indeed, the PVA_Lys_LO electrospun membranes were able to mediate a strong antibacterial activity against both S. aureus and P. aeruginosa, without compromising human fibroblasts viability. Overall, the gathered data emphasizes the potential of the PVA_Lys electrospun membranes-based drug delivery systems to be used as wound dressings.

Biofunctions of antimicrobial peptide-conjugated alginate/hyaluronic acid/collagen wound dressings promote wound healing of a mixed-bacteria-infected wound

The increase in severe infections caused by antibiotic drug resistance and the decrease in the number of new antibacterial drugs approved for use in the last few decades are driving the need for the development of new antimicrobial strategies. Antimicrobial peptides (AMPs) are a potential new class of antimicrobial drugs that are expected to solve the problem of global antibiotic drug resistance. Herein, the AMP Tet213 was immobilised onto the substrates of alginate (ALG), hyaluronic acid (HA), and collagen (COL) to form the ALG/HA/COL-AMP wound dressing. This wound dressing exhibited a high degree of swelling and the appropriate porosity, mechanical properties, and biodegradability. The Tet213-immobilised ALG/HA/COL dressings exhibited antimicrobial activity against three pathogenic bacterial strains (Gram-negative E. coli and Gram-positive MRSA and S. aureus) and facilitated the proliferation of NIH 3T3 fibroblast cells. In addition, the ALG/HA/COL-AMP antimicrobial dressings promoted wound healing, re-epithelialisation, collagen deposition, and angiogenesis. Moreover, the wound-healing effects of ALG/HA/COL-AMP surpassed the gauze and ALG/HA/COL compared to commercially available silver-based dressings (Aguacel Ag). These results suggest that the Tet213-conjugated ALG/HA/COL wound dressing, with its multiple biological activities, is a promising wound-dressing material.

Fluorinated Methacrylamide Chitosan Hydrogel Dressings Improve Regenerated Wound Tissue Quality in Diabetic Wound Healing

Objective: Oxygen therapy has shown promising results for treating diabetic wounds. However, clinically used oxygen therapies are cumbersome and expensive. Thus, there is a need to develop a localized oxygenating treatment that is easy to use and inexpensive. Approach: In this study, we tested a previously developed hydrogel sheet wound dressing based on fluorinated methacrylamide chitosan (MACF) for enhanced oxygenation and compared it with a commercial sheet hydrogel dressing, AquaDerm™, and no treatment controls in a splinted transgenic diabetic mouse wound model. Results: AquaDerm exhibited poor wound closure response compared with the MACF oxygenating hydrogel sheet dressing (MACF+O₂) and no treatment. Histological analysis revealed enhanced collagen synthesis and neovascularization upon MACF+O₂ treatment as indicated by higher collagen content and number of blood vessels/capillaries compared with AquaDerm and no treatment. MACF+O₂ also improved wound collagen fiber alignment, thus demonstrating improved skin tissue maturation. Nuclear magnetic resonance spectroscopy-based biodistribution analysis revealed that the degradation products of the MACF-based dressing did not accumulate in lung, liver, and kidney tissues of the treated animals after 14 days of treatment. Innovation: This study presents the first application of a unique oxygenating biomaterial (MACF) made into a moist hydrogel wound dressing for treating diabetic wounds. Conclusion: The results of this study confirm the benefits of this novel biomaterial approach for improving regenerated tissue structure in diabetic wound healing.

The impact of first-aid dressing design on healing of porcine partial thickness wounds

Literature describes that a well-maintained moist wound healing environment leads to faster healing by preventing scabbing and drying of the wound. A moist wound speeds healing by allowing for unimpeded movement of newly dividing epidermal cells in the wound. Contrary to what is described in literature and practiced by clinicians, first-aid dressings used at home by consumers advertise breathability and absorptivity as benefits. This manuscript examines the effects of dressing breathability and highly absorptive pads on healing and wound appearance in a porcine dermatome wound model, designed to mimic an abrasion injury. Partial thickness wounds were covered with an experimental silicone-polymer film dressing and various over-the-counter bandages for time frames ranging from 4 to 11 days. The progression of healing was quantified by histology and wound-size reduction measurements. The thickness and persistence of a scab or serocellular crust (SCC) over the injury was measured using both pixel density and optical coherence tomography to supplement visual observations, demonstrating new tools for quantification of SCC over wounds. The results of the experiments illustrate the impact of dressing features on the rate of wound reepithelialization and the formation of SCC. Both a low moisture vapor transmission rate (MVTR) and the absence of an absorptive layer were important in speeding wound healing. Surprisingly, use of a dressing with a low MVTR and a highly absorptive pad healed significantly more slowly than a comparative dressing with a low MVTR and no absorptive pad, even though both dressings had very little scab formation over the wound. This study shows that breathability and absorbency of dressings play independent roles in providing an optimal healing environment, and that these properties can vary widely among commercially available dressings.

Fabrication and Characterization of Low Methoxyl Pectin/Gelatin/Carboxymethyl Cellulose Absorbent Hydrogel Film for Wound Dressing Applications

In this study, hydrogel films composed of low methoxyl pectin (LMP), gelatin, and carboxymethyl cellulose (CMC) were fabricated. Glycerin was used as a plasticizer while glutaraldehyde (Glu) and calcium chloride (CaCl₂) were used as crosslinking agents in film preparation. Hydrogel films were morphologically characterized and evaluated for mechanical properties. In addition, the investigations for fluid uptake ability, water retention capacity, water vapor transmission rate, and integrity value of the invented films were performed. The results showed that F-Glu-Ca-G30 film demonstrated superior properties when compared to other prepared films. It demonstrated a high percentage of elongation at break (32.80%), fluid uptake ability (88.45% at 2 h), water retention capacity (81.70% at 2 h), water vapor transmission rate (1889 g/m²/day), and integrity value (86.42%). F-Glu-Ca-G30 film was subsequently selected for 10% w/w povidone iodine (PI) loading and tested for anti-Staphylococcus aureus activity using an agar diffusion assay. Notably, F-Glu-Ca-G30-PI film demonstrated a dramatic ability to inhibit microbial growth, when compared to both a blank film and iodine solution control. Our LMP/gelatin/CMC hydrogel film promises to be an effective dressing material with high fluid absorption capacity, fluid holding ability, and water vapor transmission rate. Incorporation of antibiotics such as povidone iodine into the films conferred its antimicrobial property thereby highlighting its potential dermatological use. However, further clinical studies of the application of this hydrogel film as wound dressing material is recommended.

Breathable hydrogel dressings containing natural antioxidants for management of skin disorders

Traditional wound dressings are not effective enough to regulate the moisture content and remove excessive exudate from the environment. Wet wound dressings formed from hydrogels such as alginate are widely used in clinical practice for treatment of skin disorders. Here, we functionalize alginate dressings with natural antioxidants such as curcumin and t-resveratrol to render them both anti-inflammatory and antibacterial. The hydrogel maintains excellent mechanical properties and oxygen permeability over time. The release rate of the compounds from the hydrogels is assessed and their impact on bacterial and cellular growth is evaluated. The antioxidant compounds act as bactericidal agents and improve cell viability. The optimal concentration of active compounds in the engineered alginate-based dressings is determined.

Low molecular weight ε-caprolactone-p-coumaric acid copolymers as potential biomaterials for skin regeneration applications

ε-caprolactone-p-coumaric acid copolymers at different mole ratios (ε-caprolactone:p-coumaric acid 1:0, 10:1, 8:1, 6:1, 4:1, and 2:1) were synthesized by melt-polycondensation and using 4-dodecylbenzene sulfonic acid as catalyst. Chemical analysis by NMR and GPC showed that copolyesters were formed with decreasing molecular weight as p-coumaric acid content was increased. Physical characteristics, such as thermal and mechanical properties, as well as water uptake and water permeability, depended on the mole fraction of p-coumaric acid. The p-coumarate repetitive units increased the antioxidant capacity of the copolymers, showing antibacterial activity against the common pathogen Escherichia coli. In addition, all the synthesized copolyesters, except the one with the highest concentration of the phenolic acid, were cytocompatible and hemocompatible, thus becoming potentially useful for skin regeneration applications.

Healing kinetics of diabetic wounds controlled with charge-biased hydrogel dressings

This study investigates the properties and use as wound-dressings of hydrogels made of anionic 3-sulfopropyl methacrylate (SA) and cationic [2-(methacryloyloxy)ethyl]trimethylammonium (TMA) to form poly(SA-co-TMA) gels with varying charge bias.