Multifunctional Tissue-Adhesive Cryogel Wound Dressing for Rapid Nonpressing Surface Hemorrhage and Wound Repair

Modified porous carboxymethyl chitin microspheres by an organic solvent-free process for rapid hemostasis

Rapid and effective hemorrhage control is essential to reduce mortality following traumatic injuries. Herein we developed an organic solvent-free process to prepare carboxymethyl chitin microsphere (CMCHm) in an aqueous two-phase system through heating and freeze-drying. To further enhance the hemostatic performance of CMCHm, we loaded calcium ions and in-situ polymerized dopamine to get modified hemostatic microspheres CMCHm-Ca²⁺ and CMCHm-PDA, respectively. The size of these microspheres was mainly distributed between 50 μm and 150 μm, and the porous microstructure was observed by SEM. The data of in vitro degradation, cell cytotoxicity, and hemolysis test indicated good biocompatibility of these microspheres. Importantly, CMCHm-Ca²⁺ and CMCHm-PDA displayed better hemostatic performance compared with CMCHm and the positive controls Yunnan baiyao® and Quickclean®. Especially, the bleeding time was reduced to 59 s (CMCHm-Ca²⁺) and 45 s (CMCHm-PDA) in the femoral artery/vein cut model, respectively. All these demonstrate CMCHm-Ca²⁺ and CMCHm-PDA hold great potential for rapid hemostasis.

Multifunctional hybrid sponge for in situ postoperative management to inhibit tumor recurrence

Disseminated tumor cells in bleeding and residual tumor cells in the resection tumor site are the primary factors that result in tumor recurrence after surgery. Safe and efficient local implantation of the drug depot system into the resection cavity to inhibit tumor recurrence would be of great benefit to reduce the mortality of postoperative patients. Here, a sandwich-like doxorubicin-triptolide-loaded fiber/(chitosan/gelatin) sponge, DTF/CGS, is fabricated, combining hemostatic, antibacterial, and chemotherapeutic capability. The CGS obtained via freeze-drying can efficiently prevent bleeding; meanwhile, the metastatic residual tumor cells are stuck with the clotted absorbed blood. Subsequently, dual drugs released from the electrospun fiber can further kill the stuck tumor cells in CGS and the disseminated tumor cells to significantly inhibit the tumor recurrence. This antitumor recurrence strategy by immediately implanting a multifunctional hybrid sponge for in situ postoperative management may possess great potential for preventing tumor recurrence.

Antimicrobial Polymer-Based Assemblies: A Review

An antimicrobial supramolecular assembly (ASA) is conspicuous in biomedical applications. Among the alternatives to overcome microbial resistance to antibiotics and drugs, ASAs, including antimicrobial peptides (AMPs) and polymers (APs), provide formulations with optimal antimicrobial activity and acceptable toxicity. AMPs and APs have been delivered by a variety of carriers such as nanoparticles, coatings, multilayers, hydrogels, liposomes, nanodisks, lyotropic lipid phases, nanostructured lipid carriers, etc. They have similar mechanisms of action involving adsorption to the cell wall, penetration across the cell membrane, and microbe lysis. APs, however, offer the advantage of cheap synthetic procedures, chemical stability, and improved adsorption (due to multipoint attachment to microbes), as compared to the expensive synthetic routes, poor yield, and subpar in vivo stability seen in AMPs. We review recent advances in polymer-based antimicrobial assemblies involving AMPs and APs.

Improvement of the wound healing properties of hydrogels with N-acetylcysteine through their modification with methacrylate-containing polymers

Hydrogels with antioxidant activity have shown to significantly improve the standard of care, because they promote efficient wound healing, i.e. regeneration. N-Acetylcysteine (NAC) is an antioxidant amino acid derivative that promotes complete tissue restoration. However, NAC has anticoagulant properties that may also hinder blood coagulation, which is crucial for hydrogels for wound healing applications. To take advantage of the regenerative activity of NAC while avoiding hampering the hemostasis stage during wound healing, we modified gelatin-NAC with the methacrylate-containing polymers 2-hydroxyethyl methacrylate (H) and poly(ethylene glycol) methyl ether methacrylate (P) to produce Gel-HP-NAC. These hydrogels clotted more blood and faster than Gel and Gel-NAC hydrogels, while maintaining fluid absorption properties adequate to promote wound healing. Similarly, there were more viable human skin fibroblasts after 10 days cultured in Gel-HP-NAC compared with Gel and Gel-NAC. A mouse full-thickness skin wound model demonstrated that Gel-HP-NAC hydrogels improved the wound healing process as compared to the untreated group as proved by the increased wound closure rates and re-epithelialization. Histology of the biopsied tissues indicated more organized collagen deposits on the wounds treated with either Gel-HP-NAC or Gel-NAC than untreated wounds. Our results show that modification of NAC-containing hydrogels through methacrylate-containing polymers improved their wound healing properties, including blood-clotting, and demonstrate the potential of Gel-HP-NAC hydrogels for wound treatment and tissue regeneration.

Dual-Dynamic-Bond Cross-Linked Antibacterial Adhesive Hydrogel Sealants with On-Demand Removability for Post-Wound-Closure and Infected Wound Healing

The design and development of a smart bioadhesive hydrogel sealant with self-healing and excellent antibacterial activity to achieve high wound closure effectiveness and post-wound-closure care is highly desirable in clinical applications. In this work, a series of adhesive antioxidant antibacterial self-healing hydrogels with promising traits were designed through dual-dynamic-bond cross-linking among ferric iron (Fe), protocatechualdehyde (PA) containing catechol and aldehyde groups and quaternized chitosan (QCS) to enable the closure of skin incisions and promotion of methicillin-resistant Staphylococcus aureus (MRSA)-infected wound healing. The dual-dynamic-bond cross-linking of a pH-sensitive coordinate bond (catechol-Fe) and dynamic Schiff base bonds with reversible breakage and re-formation equips the hydrogel with excellent autonomous healing and on-demand dissolution or removal properties. Additionally, the hydrogel presents injectability, good biocompatibility and antibacterial activity, multifunctional adhesiveness, and hemostasis as well as NIR responsiveness. The in vivo evaluation in a rat skin incision model and infected full-thickness skin wound model revealed the high wound closure effectiveness and post-wound-closure care of the smart hydrogels, demonstrating its great potential in dealing with skin incisions and infected full-thickness skin wounds.

Synergistic enhancement of tendon-to-bone healing via anti-inflammatory and pro-differentiation effects caused by sustained release of Mg2+/curcumin from injectable self-healing hydrogels

Poor healing response after rotator cuff reconstruction is multifactorial, with the inflammatory microenvironment and deficiency of stem cell differentiation factors at the lesion site being most relevant. However, there is a lack of effective tissue engineering strategies that can simultaneously exert anti-inflammatory and pro-differentiation effects to promote rotator cuff healing.

Methods: In this study, we synthesized and characterized a novel active drug delivery vector that successfully overcame the challenge of simultaneous high-efficiency loading and controlled release of Mg²⁺ and curcumin. The anti-inflammatory and pro-differentiation effects of the composite hydrogel were evaluated in vitro and in vivo. Moreover, healing of the rotator cuff tendon-to-bone interface was studied by histology, immunofluorescence, and biomechanical tests.

Results: The composite hydrogel exhibited excellent biocompatibility and injectability, good adhesiveness, and rapid self-healing. The released curcumin showed obvious anti-inflammatory and antioxidation effects, which protected stem cells and tendon matrix. Furthermore, released Mg²⁺ promoted stem cell aggregation and chondrogenesis. Moreover, biomechanical tests and histological results of a rat rotator cuff tear model at 8 weeks after surgery indicated that the composite hydrogel significantly enhanced tendon-to-bone healing.

Conclusions: The composite hydrogel mediated sustained in situ release of curcumin and Mg²⁺ to effectively promote rotator cuff tendon-to-bone healing via anti-inflammatory and pro-differentiation effects. Therefore, this composite hydrogel offers significant promise for rotator cuff repair.

Development of Inherently Antibacterial, Biodegradable, and Biologically Active Chitosan/Pseudo-Protein Hybrid Hydrogels as Biofunctional Wound Dressings

Developing a new family of hydrogel-based wound dressings that could have a dual biofunctionality of antibacterial and biological responses is highly desirable. In this study, an inherently effective antibacterial and biodegradable hydrogel dressing without the need for impregnated antibiotics was designed, synthesized, characterized, and examined for its effect on macrophages, which initiated inflammatory activity and activated both NO and TNF-α production for the purpose of achieving a better and faster wound healing. The purposes of this research was to develop a novel family of cationic biodegradable hydrogels based on arginine-based poly(ester urea urethane) (Arg-PEUU) and glycidyl methacrylate-modified chitosan (CS-GMA) that has both inherent antibacterial and bioactive functionality as a wound healing dressing for accelerated healing of contaminated or infected wounds. These hybrid hydrogels present a well-defined three-dimensional microporous network structure and have a high water absorption ability, and their biodegradation is effectively accelerated in the presence of lysozymes. The hemolytic activity test, MTT assay, and live/dead assay of these hybrid hydrogels indicated that they had no cytotoxicity toward red blood cells, NIH-3T3 fibroblast cells, and human vascular endothelial cells, thus corroborating their cytocompatibility. Furthermore, these hybrid hydrogels could elevate the release of both produced NO and TNF-α by stimulating and activating RAW 264.7 macrophages, augmenting their antibacterial biological response. The antibacterial assay of these hybrid hydrogels demonstrated their excellent antibacterial activity without the need for impregnated antibacterial agents. Taken together, this new family of biodegradable, antibacterial, and biologically responsive hybrid hydrogels exhibits great potential as biofunctional antibacterial wound dressing candidates for wound healing.

Antibacterial effect against both Gram-positive and Gram-negative bacteria via lysozyme imprinted cryogel membranes

The development of novel biocompatible and cost effective cryogel membrane which shows enhanced antimicrobial properties in order to use for several approaches such as wound dressing, scaffold or food packaging was aimed in this study. A super macro porous lysozyme imprinted cryogel membranes showing antibacterial effect against both Gram-positive and Gram-negative bacteria were prepared by using molecular imprinting technique. N-methacryloyl-(L)-histidine methyl ester (MAH) was used as the pseudo specific ligand and complexed with Cu⁺⁺ in order to provide metal ion coordination between MAH and template molecule (lysozyme). Comparing the antibacterial activity of different lysozyme concentrations, cryogel membranes were prepared in three different concentrations. To synthesize Poly (hydroxyethyl methacrylate-N-methacryloyl-(L)-histidine methylester) P(HEMA-MAH) cryogel membrane, free radical polymerization initiated by N, N, N', N'-tetramethylene diamine (TEMED) and ammonium persulfate (APS) was carried out at -12 °C. The characterization of the lysozyme imprinted cryogel membrane was accomplished by using scanning electron microscopy (SEM), swelling degree measurements and Fourier transform infrared spectroscopy-attenuated total reflectance (FTIR-ATR) spectroscopy. The cytotoxicity test of produced membrane was performed by using mouse fibroblast cell line L929. The antibacterial activity of P(HEMA-MAH) lysozyme molecular imprinted [P(HEMA-MAH) Lyz-MIP] cryogel membranes against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) were determined by Kirby-Bauer membranes diffusion and viable cell counting methods. When the antibacterial effect of P(HEMA-MAH) Lyz-MIP cryogel membranes were evaluated, it was found that P(HEMA-MAH) Lyz-MIP cryogel membranes had stronger antibacterial effects against Gram-negative E. coli bacteria even in low lysozyme concentrations. In addition, 100% bacterial inhibition was detected for both of two bacteria at increasing lysozyme concentrations.

A Biodegradable Chitosan-Polyurethane Cryogel with Switchable Shape Memory

Cryogels are matrices that are formed in moderately frozen solutions of monomeric or polymeric precursors. They have the advantages of interconnected macropores, structural stability, and compressibility. Meanwhile, thermally induced shape memory is an attractive feature of certain functional materials. Although there have been several studies concerning shape-memory cryogels, little work has been conducted on shape-memory cryogels with biodegradability. In this study, a water-based biodegradable difunctional polyurethane with a shape-memory property was synthesized and used as the nanoparticulate crosslinker to react with chitosan to form a shape-memory cryogel. The thermally induced shape-memory mechanism was clarified using in situ wide-angle X-ray scattering (WAXS) and small-angle X-ray scattering (SAXS) during the shape-memory process. The in situ WAXS showed the changes of crystallinity in the crosslinker and the cryogel during the shape fixation and recovery processes. The in situ SAXS revealed the orientation of crystallinity of the crosslinker and the cryogel as the mechanism for shape memory. The strip-shape cryogel was deformed at 50 °C to U-shape and fixed at - 20 °C, which was squeezable at 25 °C and returned to the strip-shape at 50 °C in air. The shape recovery was further tested in water at two different temperatures. The injected cryogel recovered the U-shape in 4 °C water, representing elastic recovery, and transformed to a long strip in 37 °C water, representing the switchable shape memory. Moreover, the shape-memory cryogel sheet with a large dimension (10 mm × 10 mm × 1.1 mm cryogel sheet) or with complex structures (N, T, and U shapes) could be fixed as a rod, injected through a 16 G needle, and return to its original shape in 37 °C water, all of which could not be achieved by the conventional cryogel. Human mesenchymal stem cells grown in the shape-memory cryogel scaffolds displayed long-term proliferation and chondrogenic potential. Their unique injectability and cytocompatibility suggested potential applications of shape-memory cryogels as injectable and expandable templates for tissue engineering and minimally invasive surgery.

Mussel-inspired double cross-linked hydrogels with desirable mechanical properties, strong tissue-adhesiveness, self-healing properties and antibacterial properties

Developing multifunctional hydrogels with good mechanical properties, tissue-adhesiveness, self-healing properties and antioxidant, blood clotting and antibacterial properties is highly desirable for biomedical applications. In this study, a series of multifunctional chitosan-based double cross-linked hydrogels were prepared using a facile method based on quaternized chitosan (QCS) and polyacrylamide (PAM) using polydopamine (PDA) as a novel connecting bridge. Investigation on the content of dopamine (DA) and QCS revealed that the catechol-mediated interactions played an important role in the hydrogel properties. Results showed that the hydrogel exhibited the best mechanical properties when QCS = 12 wt% and DA = 0.4 wt%. Tensile and compressive strength was 13.3 kPa and 67.8 kPa, respectively, and the hydrogel presented strong and repeatable tissue-adhesiveness (27.2 kPa) to porcine skin, as well as good stretchability (1154%). At room temperature, the hydrogel exhibited high self-healing efficiency (90% after 2 h of healing). Antibacterial test results showed that the hydrogel killed 99.99% S. aureus and E. coli. Moreover, the vaccarin-loaded hydrogel exhibited a pH-responsive drug release profile with superior cytocompatibility compared to the pure hydrogel. In summary, this strategy combined double cross-linking and catechol-mediated chemistry to shed new light on the fabrication of novel multifunctional hydrogels with desirable mechanical properties, strong tissue adhesiveness and self-healing abilities.

Catechol functionalized chitosan/active peptide microsphere hydrogel for skin wound healing

Chitosan-based thermosensitive hydrogels have been widely used in drug delivery and tissue engineering, but their poor bioactivity has limited their further applications. Integral active oyster peptide microspheres (OPM) with an average particle diameter of 3.9 μm were prepared with high encapsulation efficiency (72.8%) and loading capacity (11.9%), exhibiting desirable sustained release effects. Using catechol functionalized chitosan (CS-C) as the polymeric matrix, OPM as the filler, and β-sodium glycerophosphate (β-GP) as a thermal sensitizer, the thermosensitive hydrogel CS-C/OPM/β-GP was prepared. Besides, the application of the hydrogel on wound healing was studied, and its biosafety was evaluated. The results of cell migration in vitro showed that the cell migration rate of CS-C/OPM/β-GP reached 97.47 ± 5.41% within 48 h, indicating that the hydrogel accelerated the migration of L929 cells. As demonstrated in the mouse skin wound experiment, CS-C/OPM/β-GP hydrogel not only inhibited the aggregation of diversified inflammatory cells and accelerated the generation of collagen fibers and new blood vessels of the wound, but also enhanced the synthesis of total protein (TP) in granulation tissue, and up-regulated the expression of Ki-67 and VEGF in the injury, thereby achieving fast wound healing. Safety evaluation results showed that CS-C/OPM/β-GP hydrogel was not cytotoxic to L929 cells, and the hemolysis ratio was less than 5% within 1 mg/mL. In conclusion, CS-C/OPM/β-GP hydrogel is expected as a promising medical dressing for wound healing.

Injectable, self-healing and pH responsive stem cell factor loaded collagen hydrogel as a dynamic bioadhesive dressing for diabetic wound repair

As one of the serious complications of diabetes, diabetic ulcers induce several clinical problems. Although a variety of wound dressings are commonly employed, their role is too simple to integrate wound adaptation, therapeutics and effectiveness. To meet this comprehensive need, an injectable hydrogel (Col/APG) consisting of collagen and polyethylene glycol was prepared and loaded with umbilical cord stem cell factor (SCF) for the treatment of diabetic wounds. The physico-chemical properties of the Col/APG hydrogel, including rheology, self-shaping and self-healing, were demonstrated to adapt to the wound. After loading with the SCF, the adhesion strength of the resulting Col/APG + SCF hydrogel was enhanced to 17 kPa and it also showed favorable biocompatibility. A rapid cellular response, sufficient collagen deposition and marked neovascularization were observed in the whole cortex defect model of a diabetic rat after the Col/APG + SCF hydrogel was applied. Additionally, the skew toward M2 macrophages, credited with providing the anti-inflammatory function, also existed in both hydrogel groups. These findings suggested that the Col/APG hydrogel is a desirable scaffold and the Col/APG hydrogel loaded stem cell factor as a dressing is a promising treatment for diabetic tissue regeneration.

Tough and biodegradable polyurethane-curcumin composited hydrogel with antioxidant, antibacterial and antitumor properties

The functionalization of tough and biodegradable hydrogels is an important way to broaden their applications in biomedical field. However, most of the hydrophobic functional drugs are difficult to incorporate with the hydrogels. In this work, curcumin (Cur), a hydrophobic functional drug, was chosen to composite with polyurethane (PU) to obtain PU-Cur hydrogels by a direct and simple in-situ copolymerization. The incorporation of curcumin in PU hydrogel increases the crosslink but reduces the hydrophilicity and degradation rate of PU-Cur hydrogels. Thus, it can increase the mechanical strength to a maximum of 6.4±0.8 MPa and initial modulus to a maximum of 3.0±0.4 MPa. More importantly, curcumin incorporated in PU networks is not deactivated. The degradation products of PU-Curs at relatively low concentrations (2.5 mg/mL) can scavenge free radicals very efficiently (maximum over 90%), which exhibits strong antioxidant properties to improve wound healing. Moreover, based on the photochemical activity of curcumin, notable inhibition effects of the degradation products of PU-Curs against bacteria (maximum over 80%) and cancer cells are demonstrated with blue light treatment as a photodynamic therapy (PDT). Therefore, the beneficial effects of curcumin are retained in PU-Cur hydrogels, suggesting potential use as wound dressings or tumor isolation membranes. This work proposes a promising strategy to combine hydrophobic functional drugs with hydrophilic hydrogels for applications in a wide range of biomaterials.

A facile and large-scale synthesis of a PVA/chitosan/collagen hydrogel for wound healing

PVA/chitosan/collagen hydrogel prepared by simple freezing and thawing method has high antibacterial properties and excellent wound healing ability.