Engineering Pro-Regenerative Hydrogels for Scarless Wound Healing

3D-bioprinted GelMA/gelatin/amniotic membrane extract (AME) scaffold loaded with keratinocytes, fibroblasts, and endothelial cells for skin tissue engineering

Gelatin-methacryloyl (GelMA) is a highly adaptable biomaterial extensively utilized in skin regeneration applications. However, it is frequently imperative to enhance its physical and biological qualities by including supplementary substances in its composition. The purpose of this study was to fabricate and characterize a bi-layered GelMA-gelatin scaffold using 3D bioprinting. The upper section of the scaffold was encompassed with keratinocytes to simulate the epidermis, while the lower section included fibroblasts and HUVEC cells to mimic the dermis. A further step involved the addition of amniotic membrane extract (AME) to the scaffold in order to promote angiogenesis. The incorporation of gelatin into GelMA was found to enhance its stability and mechanical qualities. While the Alamar blue test demonstrated that a high concentration of GelMA (20%) resulted in a decrease in cell viability, the live/dead cell staining revealed that incorporation of AME increased the quantity of viable HUVECs. Further, gelatin upregulated the expression of KRT10 in keratinocytes and VIM in fibroblasts. Additionally, the histological staining results demonstrated the formation of well-defined skin layers and the creation of extracellular matrix (ECM) in GelMA/gelatin hydrogels during a 14-day culture period. Our study showed that a 3D-bioprinted composite scaffold comprising GelMA, gelatin, and AME can be used to regenerate skin tissues.

Chitosan-based GOx@Co-MOF composite hydrogel: A promising strategy for enhanced antibacterial and wound healing effects

A novel composite hydrogel was synthesized via Schiff base reaction between chitosan and di-functional poly(ethylene glycol) (DF-PEG), incorporating glucose oxidase (GOx) and cobalt metal-organic frameworks (Co-MOF). The resulting CS/PEG/GOx@Co-MOF composite hydrogel was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), thermogravimetric analysis (TGA), and energy-dispersive X-ray spectroscopy (EDS). The results confirmed successful integration and uniform distribution of Co-MOF within the hydrogel matrix. Functionally, the hydrogel exploits the catalytic decomposition of glucose by GOx to generate gluconic acid and hydrogen peroxide (H2O2), while Co-MOF gradually releases metal ions and protects GOx. This synergy enhanced the antibacterial activity of the composite hydrogel against both Gram-positive (S. aureus) and Gram-negative bacteria (E. coli), outperforming conventional chitosan-based hydrogels. The potential of the composite hydrogel in treating wound infections was evaluated through antibacterial and wound healing experiments. Overall, CS/PEG/GOx@Co-MOF hydrogel holds great promise for the treatment of wound infections, paving the way for further research and potential clinical applications.

Polyglycerol Sebacate Elastomer: A Critical Overview of Synthetic Methods and Characterisation Techniques

Poly (glycerol sebacate) is a widely studied elastomeric copolymer obtained from the polycondensation of two bioresorbable monomers, glycerol and sebacic acid. Due to its biocompatibility and the possibility to tailor its biodegradability rate and mechanical properties, PGS has gained lots of interest in the last two decades, especially in the soft tissue engineering field. Different synthetic approaches have been proposed, ranging from classic thermal polyesterification and curing to microwave-assisted organic synthesis, UV crosslinking and enzymatic catalysis. Each technique, characterized by its advantages and disadvantages, can be tailored by controlling the crosslinking density, which depends on specific synthetic parameters. In this work, classic and alternative synthetic methods, as well as characterisation and tailoring techniques, are critically reviewed with the aim to provide a valuable tool for the reproducible and customized production of PGS for tissue engineering applications.

Multifunctional antibacterial hydrogels for chronic wound management

Chronic wounds have gradually evolved into a global health challenge, comprising long-term non-healing wounds, local tissue necrosis, and even amputation in severe cases. Accordingly, chronic wounds place a considerable psychological and economic burden on patients and society. Chronic wounds have multifaceted pathogenesis involving excessive inflammation, insufficient angiogenesis, and elevated reactive oxygen species levels, with bacterial infection playing a crucial role. Hydrogels, renowned for their excellent biocompatibility, moisture retention, swelling properties, and oxygen permeability, have emerged as promising wound repair dressings. However, hydrogels with singular functions fall short of addressing the complex requirements associated with chronic wound healing. Hence, current research emphasises the development of multifunctional antibacterial hydrogels. This article reviews chronic wound characteristics and the properties and classification of antibacterial hydrogels, as well as their potential application in chronic wound management.

Revolutionizing Wound Healing: Exploring Scarless Solutions through Drug Delivery Innovations

Human skin is the largest organ and outermost surface of the human body, and due to the continuous exposure to various challenges, it is prone to develop injuries, customarily known as wounds. Although various tissue engineering strategies and bioactive wound matrices have been employed to speed up wound healing, scarring remains a significant challenge. The wound environment is harsh due to the presence of degradative enzymes and elevated pH levels, and the physiological processes involved in tissue regeneration operate on distinct time scales. Therefore, there is a need for effective drug delivery systems (DDSs) to address these issues. The objective of this review is to provide a comprehensive exposition of the mechanisms underlying the skin healing process, the factors and materials used in engineering DDSs, and the different DDSs used in wound care. Furthermore, this investigation will delve into the examination of emergent technologies and potential avenues for enhancing the efficacy of wound care devices.

Signaling Pathways Triggering Therapeutic Hydrogels in Promoting Chronic Wound Healing

In recent years, there has been a significant increase in the prevalence of chronic wounds, such as pressure ulcers, diabetic foot ulcers, and venous ulcers of the lower extremities. The main contributors to chronic wound formation are bacterial infection, prolonged inflammation, and peripheral vascular disease. However, effectively treating these chronic wounds remains a global challenge. Hydrogels have extensively explored as wound healing dressing because of their excellent biocompatibility and structural similarity to extracellular matrix (ECM). Nonetheless, much is still unknown how the hydrogels promote wound repair and regeneration. Signaling pathways play critical roles in wound healing process by controlling and coordinating cells and biomolecules. Hydrogels, along with their therapeutic ingredients that impact signaling pathways, have the potential to significantly enhance the wound healing process and its ultimate outcomes. Understanding this interaction will undoubtedly provide new insights into developing advanced hydrogels for wound repair and regeneration. This paper reviews the latest studies on classical signaling pathways and potential targets influenced by hydrogel scaffolds in chronic wound healing. This work hopes that it will offer a different perspective in developing more efficient hydrogels for treating chronic wounds.

Multifunctional biomaterial hydrogel loaded with antler blood peptide effectively promotes wound repair

Diabetes is an epidemic in contemporary society, which seriously affects people's health. Therefore, it is imperative to develop a multifunctional wound dressing that can expedite the healing of diabetic wounds. In this study, quaternized oxidized sodium alginate (QOSA) and carboxymethyl chitosan (CMCS) formed hydrogel through Schiff base reaction, and the composite hydrogel was prepared by adding the antioxidant activity of deer antler blood polypeptide (D). The hydrogel exhibits favorable attributes, including a high swelling ratio, biocompatibility, and noteworthy antioxidant, antibacterial, and hemostatic properties. Finally, it was used to evaluate its effectiveness in repairing diabetic wounds. Upon evaluation, this hydrogel can effectively promote diabetic wound healing. It facilitates cell proliferation at the wound site, mitigates inflammatory responses, and enhances the expression of growth factors at the wound site. This suggests that this hydrogel holds significant promise as an ideal candidate for advanced wound dressings.

CaO2-Cu2O micromotors accelerate infected wound healing through antibacterial functions, hemostasis, improved cell migration, and inflammatory regulation

During the wound tissue healing process, the relatively weak driving forces of tissue barriers and concentration gradients lead to a slow and inefficient penetration of bioactive substances into the wound area, consequently showing an impact on the effectiveness of deep wound healing. To overcome these challenges, we constructed biocompatible CaO2-Cu2O "micromotors". These micromotors reacted with the fluids at the wound site, releasing oxygen bubbles and propelling particles deep into the wound tissue. In vitro experimental results revealed that these micromotors not only exhibited antibacterial and hemostatic functions but also facilitated the migration of dermal fibroblasts and vascular endothelial cells, while modulating the inflammatory microenvironment. A methicillin-resistant Staphylococcus aureus infected full-thickness-wound model was created in rats, in which CaO2-Cu2O micromotors markedly expedited the wound healing process. Specifically, CaO2-Cu2O provided a sterile microenvironment for wounds and increased the amounts of M1-type macrophages during infection and inflammation. During the proliferation and remodeling stages, the amount of M1 macrophages gradually decreased, while the amount of M2 macrophages increased, and CaO2-Cu2O did not prolong the inflammatory period. Furthermore, the introduction of a regenerated silk fibroin (RSF) film on the wound surface successfully enhanced the therapeutic effects of CaO2-Cu2O against the infected wound. The combined application of oxygen-producing CaO2-Cu2O micromotors and a RSF film demonstrates significant therapeutic potential and emerges as a promising candidate for the treatment of infected wounds.

Injectable Sealants Based on Silk Fibroin for Fast Hemostasis and Wound Repairing

Uncontrollable blood loss poses fatality risks and most recently developed sealants still share common limitations on controversial components, degradability, mechanical strength or gelation time. Herein, series of injectable sealants based on silk fibroin (SF) is developed. Random coil/β-sheet conformation transition in SF is achieved by forming dendritic intermediates under induction of the structurally compatible and chemically complementary assembly peptide (Ac-KAEA-KAEA-KAEA-KAEA-NH2 , KA16 ). A ratio of 1:5 (KA-SF-15) shown an accelerating gelation process (≈12 s) and enhanced mechanical strength at physiological conditions. The interweaved nanofibers effectively impeded the bleeding within 30 s and no obvious adverse effects are observed. The supramolecular interactions and in vivo degradation benefit the inflammatory host cells infiltration and cytokines diffusion. Without any exogenous factors, the increased expression of VEGF and PDGF led to a positive feedback regulation on fibroblasts and vascular endothelial cell growth/proliferation and promoted the wound healing. These findings indicated the few assembly-peptide can accelerate fibroin gelation transition at a limited physiological condition, and the injectable amino acid-based sealants show obvious advantages on biocompatibility, degradability, rapid gelation and matched strength, with strong potential to act as next generation of biomedical materials.

Glucose-Responsive Antioxidant Hydrogel Accelerates Diabetic Wound Healing

Diabetic complications can be ameliorated by inhibiting excessive oxidative stress with antioxidants. To enhance therapeutic intervention, it is crucial to develop intelligent scaffolds for efficient delivery of antioxidants to diabetic wounds. This study introduces reversible boronic bonds to create an intelligent antioxidant hydrogel scaffold. This study modifies gelatin methacryloyl (GelMA) with 4-carboxyphenyboronic acid (CPBA) to synthesize a derivative of GelMA (GelMA-CPBA), and then photo cross-links GelMA-CPBA with (-)-epigallocatechin-3-gallate (EGCG) to form GelMA-CPBA/EGCG (GMPE) hydrogel. The GMPE hydrogel responds to changes in glucose levels, and more EGCG is released as glucose level increases due to the dissociation of boronic ester bonds. The GMPE hydrogel shows good biocompatibility and biodegradability, and its mechanical property is similar to that of the skin tissue. Both in vitro and in vivo results demonstrate that the GMPE hydrogel scaffolds effectively eliminate reactive oxygen species (ROS), reduce the inflammation, and promote angiogenesis, thereby improve collagen deposition and tissue remodeling during diabetic wound healing. This strategy offers new insight into glucose-responsive scaffolds, and this responsive antioxidan hydrogel scaffold holds great potential for the treatment of chronic diabetic wounds.

Photo-crosslinked adhesive hydrogel loaded with extracellular vesicles promoting hemostasis and liver regeneration

Hepatectomy is an effective surgical method for the treatment of liver diseases, but intraoperative bleeding and postoperative liver function recovery are still key issues. This study aims to develop a composite hydrogel dressing with excellent hemostatic properties, biocompatibility, and ability to promote liver cell regeneration. The modified gelatin matrix (GelMA, 10%) was mixed with equal volumes of sodium alginate-dopamine (Alg-DA) at concentrations of 0.5%, 1%, and 2%. Then a cross-linking agent (0.1%) was added to prepare different composite hydrogels under UV light, named GelMA/Alg-DA-0.5, GelMA/Alg-DA-1 and GelMA/Alg-DA-2, respectively. All the prepared hydrogel has a porous structure with a porosity greater than 65%, and could be stabilized in a gel state after being cross-linked by ultraviolet light. Physicochemical characterization showed that the elastic modulus, water absorption, adhesion, and compressibility of the composite hydrogels were improved with increasing Alg-DA content. Furthermore, the prepared hydrogel exhibits in vitro degradability, excellent biocompatibility, and good hemostatic function. Among all tested groups, the group of GelMA/Alg-DA-1 hydrogel performed the best. To further enhance its application potential in the field of liver regeneration, adipose-derived mesenchymal stem cell exosomes (AD-MSC-Exo) were loaded into GelMA/Alg-DA-1 hydrogel. Under the same conditions, GelMA/Alg-DA-1/Exo promoted cell proliferation and migration more effectively than hydrogels without extracellular vesicles. In conclusion, the prepared GelMA/Alg-DA-1 composite hydrogel loaded with AD-MSC-Exo has great application potential in liver wound hemostasis and liver regeneration.

Double network hydrogel based on curdlan and flaxseed gum with photothermal antibacterial properties for accelerating infectious wound healing

The healing of infected wounds has always been a clinical challenge. With the increasing threat of drug resistance due to antibiotic overuse, it is imperative to improve antibacterial wound dressings. In this study, we designed a double network (DN) hydrogel via a "one pot method" with antibacterial activity, and natural polysaccharides with the potential to promote skin wound healing were used. That is, a DN hydrogel matrix was formed by the hydrogen bond crosslinking of curdlan and the covalent crosslinking of flaxseed gum under the action of borax. We added ε-polylysine (ε-PL) as a bactericide. Tannic acid/ferric ion (TA/Fe³⁺) complex was also introduced into the hydrogel network as a photothermal agent to induce photothermal antibacterial properties. The hydrogel had fast self-healing, tissue adhesion, mechanical stability, good cell compatibility and photothermal antibacterial activity. In vitro studies of hydrogel showed its ability to inhibit S. aureus and E. coli. In vivo experiments also demonstrated the significant healing effect of hydrogel when used to treat wounds infected by S. aureus by promoting collagen deposition and accelerating the formation of skin appendage. This work provides a new design for the preparation of safe antibacterial hydrogel wound dressings and demonstrates great potential for promoting wound healing of bacterial infections.

Release systems based on self-assembling RADA16-I hydrogels with a signal sequence which improves wound healing processes

Self-assembling peptides can be used for the regeneration of severely damaged skin. They can act as scaffolds for skin cells and as a reservoir of active compounds, to accelerate scarless wound healing. To overcome repeated administration of peptides which accelerate healing, we report development of three new peptide biomaterials based on the RADA16-I hydrogel functionalized with a sequence (AAPV) cleaved by human neutrophil elastase and short biologically active peptide motifs, namely GHK, KGHK and RDKVYR. The peptide hybrids were investigated for their structural aspects using circular dichroism, thioflavin T assay, transmission electron microscopy, and atomic force microscopy, as well as their rheological properties and stability in different fluids such as water or plasma, and their susceptibility to digestion by enzymes present in the wound environment. In addition, the morphology of the RADA-peptide hydrogels was examined with a unique technique called scanning electron cryomicroscopy. These experiments enabled us to verify if the designed peptides increased the bioactivity of the gel without disturbing its gelling processes. We demonstrate that the physicochemical properties of the designed hybrids were similar to those of the original RADA16-I. The materials behaved as expected, leaving the active motif free when treated with elastase. XTT and LDH tests on fibroblasts and keratinocytes were performed to assess the cytotoxicity of the RADA16-I hybrids, while the viability of cells treated with RADA16-I hybrids was evaluated in a model of human dermal fibroblasts. The hybrid peptides revealed no cytotoxicity; the cells grew and proliferated better than after treatment with RADA16-I alone. Improved wound healing following topical delivery of RADA-GHK and RADA-KGHK was demonstrated using a model of dorsal skin injury in mice and histological analyses. The presented results indicate further research is warranted into the engineered peptides as scaffolds for wound healing and tissue engineering.

Nanoarchitectonics of a Skin-Adhesive Hydrogel Based on the Gelatin Resuscitation Fluid Gelatinol®

Hydrogel materials are one of the most versatile representatives of biomaterials. Their widespread use in medical practice is due to their similarity to native biostructures regarding relevant properties. This article discusses the synthesis of hydrogels based on a plasma-substituting Gelatinol^® solution and modified tannin, carried out by direct mixing of the two solutions and brief heating. This approach makes it possible to obtain materials based on precursors that are safe for humans, while having antibacterial activity and high adhesion to human skin. Thanks to the synthesis scheme used, it is possible to obtain hydrogels with a complex shape before use, which is relevant in cases where industrial hydrogels do not fully satisfy the end use regarding their form factor. Using IR spectroscopy and thermal analysis, the distinctive aspects of mesh formation were shown in comparison with the hydrogels based on ordinary gelatin. A number of application properties, such as the physical and mechanical characteristics, permeability to oxygen/moisture, and antibacterial effect, were also considered. The sorption parameters of the material were characterized in a set of physiological buffers (pH 2-9) using Fick's first law and a pseudo-second order equation. The adhesive shear strength was determined in a model system. The synthesized hydrogels showed potential for the further development of materials based on plasma-substituting solutions.

Arnica montana L. associated with microcurrent accelerates the dermis reorganisation of skin lesions

The aim of this study was to test the effect of electrical stimulation in association with topical Arnica montana gel on organisational changes in the dermis during tissue repair. An experimental rat incisional skin lesion was used for the study. This involved making an incisional lesion on the dorsum of the animals using a scalpel. Ninety-six animals were used divided into the following groups: control (C), microcurrent (MC); topical treatment with Arnica montana gel (ARN); the ARN + microcurrent (ARN + MC). Treatments were administered daily, and injured tissue samples were collected and processed on Days 2, 6 and 10 for dermis analyses. Myeloperoxidase levels were greater in control than in treatment groups on Days 2 and 6. F4/80 expression was similar among all treatment groups and greater than that in control on Day 2. On Day 6, the expression of vascular endothelial growth factor was higher in the MC group than that in other groups, whereas transforming growth factor-β expression increased in the MC and ARN + MC groups on Day 10. The expression of matrix metalloproteinase-2 was higher in the ARN + MC group when compared with other groups on Day 10. Expression levels of collagen I were increased in the ARN and ARN + MC groups when compared with control and MC groups on Day 6, while expression of collagen III was enhanced in MC, ARN, and ARN + MC groups when compared with the control. The protocol combining microcurrent with topical application of ARN reduces the inflammatory process, increases myofibroblasts proliferation and decreases the presence of macrophages in the dermis during skin repair in rats.

A Schiff base hydrogel dressing loading extracts from Periplaneta Americana for diabetic wound healing

As a common complication of diabetic patients, the chronic wound of diabetes has a high incidence, expensive treatment, and recurrence probability, which causes long-term negative impacts on patients' daily life. In this study, the hydrogel was formed by Schiff base reaction between oxidized hyaluronic acid (OHA) and carboxymethyl chitosan (CMCS), and the composite hydrogel dressing was prepared by adding the active polypeptides extract of Periplaneta Americana (PAE). By mass spectrometer determined, PAE mainly includes vitellogenins that can trigger an immune response. The composite hydrogel has good swelling properties, proper fluidity, and a regular 3D network structure. The hydrogel has good cytocompatibility and can promote cell proliferation by L929 fibroblast assay. Finally, it was used to evaluate the effect of diabetic wound repair. The results showed that it could effectively promote wound healing, promote tissue and vascular regeneration, inhibit inflammatory factors, and promote the expression of growth factors. The OHA/CMCS/PAE hydrogels would be promising candidates for chronic wound healing applications.

The Role of Cell-Based Therapies in Acute Burn Wound Skin Repair: A Review

Tissue engineering solutions for skin have been developed over the last few decades with a focus initially on a two-layered structure with epithelial and dermal repair. An essential element of skin restoration is a source of cells capable of differentiating into the appropriate phenotype. The need to repair areas of skin when traditional techniques were not adequate addressed led to cell based therapies being developed initially as a laboratory-based tissue expansion opportunity, both as sheets of cultured epithelial autograft and in composite laboratory-based skin substitutes. The time to availability of the cell-based therapies has been solved in a number of ways, from using allograft cell-based solutions to the use of point of care skin cell harvesting for immediate clinical use. More recently pluripotential cells have been explored providing a readily available source of cells and cells which can express the broad range of phenotypes seen in the mature skin construct. The lessons learnt from the use of cell based techniques has driven the exploration of the use of 3D printing technology, with controlled accurate placement of the cells within a specific printed construct to optimise the phenotypic expression and tissue generation.

Bioceramic materials with ion-mediated multifunctionality for wound healing

Regeneration of both anatomic and functional integrity of the skin tissues after injury represents a huge challenge considering the sophisticated healing process and variability of specific wounds. In the past decades, numerous efforts have been made to construct bioceramic-based wound dressing materials with ion-mediated multifunctionality for facilitating the healing process. In this review, the state-of-the-art progress on bioceramic materials with ion-mediated bioactivity for wound healing is summarized. Followed by a brief discussion on the bioceramic materials with ion-mediated biological activities, the emerging bioceramic-based materials are highlighted for wound healing applications owing to their ion-mediated bioactivities, including anti-infection function, angiogenic activity, improved skin appendage regeneration, antitumor effect, and so on. Finally, concluding remarks and future perspectives of bioceramic-based wound dressing materials for clinical practice are briefly discussed.

Gellan Gum in Wound Dressing Scaffolds

Several factors, such as bacterial infections, underlying conditions, malnutrition, obesity, ageing, and smoking are the most common issues that cause a delayed process of wound healing. Developing wound dressings that promote an accelerated wound healing process and skin regeneration is crucial. The properties of wound dressings that make them suitable for the acceleration of the wound healing process include good antibacterial efficacy, excellent biocompatibility, and non-toxicity, the ability to provide a moist environment, stimulating cell migration and adhesion, and providing gaseous permeation. Biopolymers have demonstrated features appropriate for the development of effective wound dressing scaffolds. Gellan gum is one of the biopolymers that has attracted great attention in biomedical applications. The wound dressing materials fabricated from gellan gum possess outstanding properties when compared to traditional dressings, such as good biocompatibility, biodegradability, non-toxicity, renewability, and stable nature. This biopolymer has been broadly employed for the development of wound dressing scaffolds in different forms. This review discusses the physicochemical and biological properties of gellan gum-based scaffolds in the management of wounds.

Development of Antimicrobial nanocomposite scaffolds via Loading CZTSe Quantum Dots for wound dressing applications

The antimicrobial properties of scaffolds designed for use in wound healing are accepted as an important factor in the healing process to accelerate the wound healing process without causing inflammation. For this purpose, Chitosan-PVA composite membranes loaded with Cu2ZnSnSe4 quantum dots (CZTSe QDs) as an antibacterial and cytocompatible biomaterial to regulate the wound healing process were produced. CZTSe QDs particles were synthesized under hydrothermal conditions. Polymer-based nanocomposites with different concentrations of the synthesized nanoparticles were produced by the solvent casting method. After detailed physicochemical and morphological characterizations of CZTSe QDs and composite membranes, antibacterial activities and cell viability were extensively investigated against gram-positive and gram-negative bacterial and yeast strains, and L929 mouse fibroblast cells lines, respectively. The results show that the preparation of composite scaffolds at a QDs concentration of 3.3 % by weight has the best antimicrobial activity. Composite scaffold membranes, which can be obtained as a result of an easy production process, are thought to have great potential applications in tissue engineering as wound dressing material due to their high mechanical properties, wettability, strong antibacterial properties and non-toxicity.

Clinical Effect of Microneedle Injection Combined with Blood Transfusion in the Treatment of Severe Anemia Complicated with Vitiligo under Regenerative Medical Technology

To explore the clinical efficacy of microneedle injection combined with blood transfusion in the treatment of severe anemia complicated with vitiligo based on regenerative medical technology and provide the theoretical basis for the adoption of microneedle technology, 60 patients with severe anemia complicated with vitiligo were selected as research objects. With 15 patients in each group, they were randomly assigned to the control group (calcipotriol ointment external application), observation group A (external application of moist exposed burn ointment (MEBO), observation group B (external application of MEBO combined with blood transfusion), and observation group C (microneedle injection of MEBO combined with blood transfusion). Blood indexes and plaque recovery of patients in different periods were detected. The total protein (TP) content in group C (62.3 ± 3.3 g/L and 64.3 ± 2.88 g/L) was remarkably higher than that in the control group (51.3 ± 3.17 g/L and 52.4 ± 3.17 g/L) and group A (52.6 ± 2.91 g/L and 51.8 ± 2.98 g/L)) at the 5th and 7th weeks after the treatment (P < 0.05). The albumin (ALB) content in group C (42.9 ± 3.28 g/L and 45.3 ± 3.1 g/L) was signally higher than that in the control group (41.8 ± 3.44 g/L and 41.9 ± 3.23 g/L) and group A (41.3 ± 2.91 g/L and 42.1 ± 3.02 g/L) at the 5th and 7th weeks after the treatment, and the content was markedly higher than that in group B at 5th week (P < 0.05). The wound healing rates of group C at the 3rd, 5th, and 7th weeks after the treatment (38.44%, 56.6%, and 90.23%) were greatly higher than those of the control group, group A, and group B (P < 0.05). Besides, the wound healing rate of group B was higher than that of the control group and group A (40.3% and 75.8%) at the 5th and 7th weeks after the treatment (P < 0.05). To sum up, based on regenerative medical technology, microneedle injection (microneedling is a derma roller process that pricks the skin with minuscule needles. The goal of the treatment is to develop new collagen and skin tissue, resulting in skin that is smoother, firmer, and more toned) combined with blood transfusion had a good therapeutic effect on patients with severe anemia complicated with vitiligo, which could manifestly improve the blood indexes and skin plaques of patients, with a good clinical adoption effect.

The potential application of natural products in cutaneous wound healing: A review of preclinical evidence

Under normal circumstances, wound healing can be summarized as three processes. These include inflammation, proliferation, and remodeling. The vast majority of wounds heal rapidly; however, a large percentage of nonhealing wounds have still not been studied significantly. The factors affecting wound nonhealing are complex and diverse, and identifying an effective solution from nature becomes a key goal of research. This study aimed to highlight and review the mechanisms and targets of natural products (NPs) for treating nonhealing wounds. The results of relevant studies have shown that the effects of NPs are associated with PI3K-AKT, P38MAPK, fibroblast growth factor, MAPK, and ERK signaling pathways and involve tumor growth factor (TNF), vascular endothelial growth factor, TNF-α, interleukin-1β, and expression of other cytokines and proteins. The 25 NPs that contribute to wound healing were systematically summarized by an inductive collation of the six major classes of compounds, including saponins, polyphenols, flavonoids, anthraquinones, polysaccharides, and others, which will further direct the attention to the active components of NPs and provide research ideas for further development of new products for wound healing.

Tetrahedral framework nucleic acids promote diabetic wound healing via the Wnt signalling pathway

Objectives

To determine the therapeutic effect of tetrahedral framework nucleic acids (tFNAs) on diabetic wound healing and the underlying mechanism.

Materials and Methods

The tFNAs were characterized by polyacrylamide gel electrophoresis (PAGE), atomic force microscopy (AFM), transmission electron microscopy (TEM), dynamic light scattering (DLS) and zeta potential assays. Cell Counting Kit‐8 (CCK‐8) and migration assays were performed to evaluate the effects of tFNAs on cellular proliferation and migration. Quantitative polymerase chain reaction (Q‐PCR) and enzyme‐linked immunosorbent assay (ELISA) were used to detect the effect of tFNAs on growth factors. The function and role of tFNAs in diabetic wound healing were investigated using diabetic wound models, histological analyses and western blotting.

Results

Cellular proliferation and migration were enhanced after treatment with tFNAs in a high‐glucose environment. The expression of growth factors was also facilitated by tFNAs in vitro. During in vivo experiments, tFNAs accelerated the healing process in diabetic wounds and promoted the regeneration of the epidermis, capillaries and collagen. Moreover, tFNAs increased the secretion of growth factors and activated the Wnt pathway in diabetic wounds.

Conclusions

This study indicates that tFNAs can accelerate diabetic wound healing and have potential for the treatment of diabetic wounds.

Dual-Action Icariin-Containing Thermosensitive Hydrogel for Wound Macrophage Polarization and Hair-Follicle Neogenesis

Bone morphogenetic protein (BMP) pathway is essential for M2 macrophage polarization and hair-follicle neogenesis. Icariin, a flavonoid derived from Epimedium, is a mediator of the BMP pathway. Here, we develop a hydrogel formulation functionalized with icariin for regulation of macrophage polarization to accelerate wound healing and hair-follicle neogenesis. Compared to skin defects without icariin treatment, those treated with icariin+PEG hydrogel healed faster and had new hair follicles. Results in vivo showed that icariin+PEG hydrogel induced a higher level of M2 phenotypic transformation of macrophages. Moreover, icariin+PEG hydrogel significantly accelerated wound-repair process by reducing the invasion of inflammation, excessive deposition of collagen, immoderate activation of myofibroblasts, and increasing the regeneration of hair follicles. Furthermore, studies in vitro demonstrated that the icariin+PEG hydrogel induced macrophages to polarize to the M2 phenotype and dermal papilla cell to hair follicles. Finally, molecular analysis demonstrated that the icariin+PEG hydrogel increased the expression of BMP4 and Smad1/5 phosphorylation in skin wounds. These results demonstrate the therapeutic potential of icariin-containing thermosensitive hydrogels for inducing M2 macrophage polarization to accelerate wound healing and promote hair-follicle neogenesis by regulating the BMP pathway.

Gel dressing based on type I collagen modified with oligourethane and silica for skin wound healing

Cutaneous wound healing is a complex process that leads the skin reparation with the formation of scar tissue that typically lacks skin appendages. This fact drives us to find new strategies to improve regenerative healing of the skin. This study outlines, the contribution of colloidal silica particles and oligourethane crosslinking on the collagen material properties and the effect on skin wound healing in rats. We characterized the gel properties that are key forin-situgelation, which is accomplished by the latent reactivity of oligourethane bearing blocked isocyanate groups to crosslink collagen while entrapping silica particles. The swelling/degradation behavior and the elastic modulus of the composite gel were consistent with the modification of collagen type I with oligourethane and silica. On the other hand, these gels were characterized as scaffold for murine macrophages and human stem cells. The application of a composite gel dressing on cutaneous wounds showed a histological appearance of the recovered skin as intact skin; featured by the epidermis, hair follicles, sebaceous glands, subcutaneous adipose layer, and dermis. The results suggest that the collagen-based composite dressings are promising modulators in skin wound healing to achieve a regenerative skin closure with satisfactory functional and aesthetic scars.

NIR-regulated dual-functional silica nanoplatform for infected-wound therapy via synergistic sterilization and anti-oxidation

Nature-derived bioactive components and photothermal synergistic therapy bring potential strategies for fighting bacterial infection and accelerating would healing by virtue of their excellent therapeutic efficiencies and ignorable side effects, where photothermal property not only acts as sterilization energy but also as a doorkeeper to control the natural component release. Herein, by integrating the excellent antibacterial property of cinnamaldehyde (CA) and the outstanding photothermal performance of copper sulfide nanoparticles (CuS NPs), a multifunctional nanoplatform of SiO₂ @CA@CuS nanospheres (NSs) is constructed with silica nanosphere (SiO₂ NSs) as carrier. SiO₂ @CA@CuS NSs exhibit photothermal property, bacterial absorption capacity, extraordinary antibacterial activity and antioxidant property. Mechanism characteriazation and antibacterial experiment indicate that positive charged SiO₂ @CA@CuS can adhere to the negative charged surface of bacteria, and quickly kill bacteria through the synergistic action of the released CA and heat produced under near infrared light (NIR) irradiation at 980 nm. The sterilization efficiencies for Escherichia coli (E. coli) and S. aureus reach 99.86% and 99.84%, respectively. Furthermore, NIR-regulated SiO₂ @CA@CuS perform great biocompatibility, as well as effective effects for accelerating S. aureus-infected wound healing at a low photothermal temperature (45 °C) relying on synergistic sterilization and anti-oxidation.

Advances in spray products for skin regeneration

To date, skin wounds are still an issue for healthcare professionals. Although numerous approaches have been developed over the years for skin regeneration, recent advances in regenerative medicine offer very promising strategies for the fabrication of artificial skin substitutes, including 3D bioprinting, electrospinning or spraying, among others. In particular, skin sprays are an innovative technique still under clinical evaluation that show great potential for the delivery of cells and hydrogels to treat acute and chronic wounds. Skin sprays present significant advantages compared to conventional treatments for wound healing, such as the facility of application, the possibility to treat large wound areas, or the homogeneous distribution of the sprayed material. In this article, we review the latest advances in this technology, giving a detailed description of investigational and currently commercially available acellular and cellular skin spray products, used for a variety of diseases and applying different experimental materials. Moreover, as skin sprays products are subjected to different classifications, we also explain the regulatory pathways for their commercialization and include the main clinical trials for different skin diseases and their treatment conditions. Finally, we argue and suggest possible future trends for the biotechnology of skin sprays for a better use in clinical dermatology.

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Skin sprays represent a promising technique for wound healing applications.

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Skin sprays can deliver cells and hydrogels with great facility over large wounds.

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Many skin spray products have been studied, only a few have been commercialized.

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Numerous clinical trials study spray products for skin diseases like psoriasis.

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Improved spraying devices should be developed for different materials and cells.

Recent Advances in Bioengineered Scaffolds for Cutaneous Wound Healing

Wound healing is an evolved dynamic biological process. Though many research and clinical approaches have been explored to restore damaged or diseased skin, the current treatment for deep cutaneous injuries is far from being perfect, and the ideal regenerative therapy remains a significant challenge. Of all treatments, bioengineered scaffolds play a key role and represent great progress in wound repair and skin regeneration. In this review, we focus on the latest advancement in biomaterial scaffolds for wound healing. We discuss the emerging philosophy of designing biomaterial scaffolds, followed by precursor development. We pay particular attention to the therapeutic interventions of bioengineered scaffolds for cutaneous wound healing, and their dual effects while conjugating with bioactive molecules, stem cells, and even immunomodulation. As we review the advancement and the challenges of the current strategies, we also discuss the prospects of scaffold development for wound healing.

Polymer-Based Wound Dressing Materials Loaded with Bioactive Agents: Potential Materials for the Treatment of Diabetic Wounds

Diabetic wounds are severe injuries that are common in patients that suffer from diabetes. Most of the presently employed wound dressing scaffolds are inappropriate for treating diabetic wounds. Improper treatment of diabetic wounds usually results in amputations. The shortcomings that are related to the currently used wound dressings include poor antimicrobial properties, inability to provide moisture, weak mechanical features, poor biodegradability, and biocompatibility, etc. To overcome the poor mechanical properties, polymer-based wound dressings have been designed from the combination of biopolymers (natural polymers) (e.g., chitosan, alginate, cellulose, chitin, gelatin, etc.) and synthetic polymers (e.g., poly (vinyl alcohol), poly (lactic-co-glycolic acid), polylactide, poly-glycolic acid, polyurethanes, etc.) to produce effective hybrid scaffolds for wound management. The loading of bioactive agents or drugs into polymer-based wound dressings can result in improved therapeutic outcomes such as good antibacterial or antioxidant activity when used in the treatment of diabetic wounds. Based on the outstanding performance of polymer-based wound dressings on diabetic wounds in the pre-clinical experiments, the in vivo and in vitro therapeutic results of the wound dressing materials on the diabetic wound are hereby reviewed.

Spatiotemporally dynamic therapy with shape-adaptive drug-gel for the improvement of tissue regeneration with ordered structure

A spatiotemporally dynamic therapy (SDT) is proposed as a powerful therapeutic modality that provides spatially dynamic responses of drug-carriers for adapting to the wound microenvironment. Herein, dynamic chitosan-poly (ethylene glycol) (CP) Schiff-base linkages are employed to perform SDT by directly converting a liquid drug Kangfuxin (KFX) into a gel formation. The obtained KFX-CP drug-gel with shape-adaptive property is used to treat a representative oral mucositis (OM) model in a spatiotemporally dynamic manner. The KFX-CP drug-gel creates an instructive microenvironment to regulate signaling biomolecules and endogenous cells behavior, thereby promoting OM healing by the rule of dynamically adjusting shape to fit the irregular OM regions first, and then provides space for tissue regeneration, over KFX potion control and the general hydrogel group of CP hydrogel and KFX-F127. Most interestingly, the regenerated tissue has ordered structure like healthy tissue. Therefore, the SDT provides a new approach for the design of next generation of wound dressing and tissue engineering materials.

Immunomodulation of Skin Repair: Cell-Based Therapeutic Strategies for Skin Replacement (A Comprehensive Review)

The immune system has a crucial role in skin wound healing and the application of specific cell-laden immunomodulating biomaterials emerged as a possible treatment option to drive skin tissue regeneration. Cell-laden tissue-engineered skin substitutes have the ability to activate immune pathways, even in the absence of other immune-stimulating signals. In particular, mesenchymal stem cells with their immunomodulatory properties can create a specific immune microenvironment to reduce inflammation, scarring, and support skin regeneration. This review presents an overview of current wound care techniques including skin tissue engineering and biomaterials as a novel and promising approach. We highlight the plasticity and different roles of immune cells, in particular macrophages during various stages of skin wound healing. These aspects are pivotal to promote the regeneration of nonhealing wounds such as ulcers in diabetic patients. We believe that a better understanding of the intrinsic immunomodulatory features of stem cells in implantable skin substitutes will lead to new translational opportunities. This, in turn, will improve skin tissue engineering and regenerative medicine applications.

The Influence of Oxidant on Gelatin-Tannin Hydrogel Properties and Structure for Potential Biomedical Application

Nowadays, there is a widespread usage of sodium periodate as an oxidant for synthesizing gelatin-tannin hydrogels. The impact of iodine compounds could have a harmful effect on human health. The study focuses on the proposal of alternative oxidizing systems for tannin oxidation. Gelatin-tannin hydrogels were obtained based on the usage of H2O2/DMSO/KMnO4/KIO4 oxidants and characterized with sorption, thermal (TGA, DTG, DSC), mechanical, FTIR and other methods. The sorption experiments were carried out in a phosphate buffer (pH = 5.8/7.4/9) and distilled water and were investigated with Fick's law and pseudosecond order equation. The pH dependence of materials in acid media indicates the possibility of further usage as stimuli-responsive systems for drug delivery. Thermal transitions demonstrate the variation of structure with melting (306 ÷ 319 °C) and glass transition temperatures (261 ÷ 301 °C). The activation energy of water evaporation was calculated by isoconversional methods (Kissinger-Akahira-Sunose, Flynn-Wall-Ozawa) ranging from 4 ÷ 18 to 14 ÷ 38 kJ/mole and model-fitting (Coats-Redfern, Kennedy-Clark) methods at 24.7 ÷ 45.3 kJ/mole, indicating the smooth growth of values with extent of conversion. The network parameters of the hydrogels were established by modified Flory-Rehner and rubber elasticity theories, which demonstrated differences in values (5.96 ÷ 21.27·10-3 mol/cm3), suggesting the limitations of theories. The sorption capacity, tensile strength and permeability for water/oxygen indicate that these materials may find their application in field of biomaterials.

Harnessing Multifaceted Next-Generation Technologies for Improved Skin Wound Healing

Dysregulation of sequential and synchronized events of skin regeneration often results in the impairment of chronic wounds. Conventional wound dressings fail to trigger the normal healing mechanism owing to the pathophysiological conditions. Tissue engineering approaches that deal with the fabrication of dressings using various biomaterials, growth factors, and stem cells have shown accelerated healing outcomes. However, most of these technologies are associated with difficulties in scalability and cost-effectiveness of the products. In this review, we survey the latest developments in wound healing strategies that have recently emerged through the multidisciplinary approaches of bioengineering, nanotechnology, 3D bioprinting, and similar cutting-edge technologies to overcome the limitations of conventional therapies. We also focus on the potential of wearable technology that supports complete monitoring of the changes occurring in the wound microenvironment. In addition, we review the role of advanced devices that can precisely enable the delivery of nanotherapeutics, oligonucleotides, and external stimuli in a controlled manner. These technological advancements offer the opportunity to actively influence the regeneration process to benefit the treatment regime further. Finally, the clinical relevance, trajectory, and prospects of this field have been discussed in brief that highlights their potential in providing a beneficial wound care solution at an affordable cost.

An overview on the manufacturing of functional and mature cellular skin substitutes

There are different types of skin diseases due to chronic injuries that impede the natural healing process of the skin. Tissue engineering (TE) has focused on the development of bioengineered skin or skin substitutes that cover the wound, providing the necessary care to restore the functionality of injured skin. There are two types of substitutes: acellular skin substitutes (ASSs), which offer a low response of the body, and cellular skin substitutes (CSSs), which incorporate living cells and appear as a great alternative in the treatment of skin injuries due to them presenting a greater interaction and integration with the rest of the body. For the development of a CSS, it is necessary to select the most suitable biomaterials, cell components, and methodology of biofabrication for the wound to be treated. Moreover, these CSSs are immature substitutes that must undergo a maturing process in specific bioreactors, guaranteeing their functionality. The bioreactor simulates the natural state of maturation of the skin by controlling parameters such as temperature, pressure, or humidity, allowing a homogeneous maturation of the CSSs in an aseptic environment. The use of bioreactors not only contributes to the maturation of the CSSs, but also offers a new way of obtaining large sections of skin substitutes or natural skin from small portions acquired from the patient, donor, or substitute. Based on the innovation of this technology and the need to develop efficient CSSs, this work offers an update on bioreactor technology in the field of skin regeneration.

Advances in Skin Wound and Scar Repair by Polymer Scaffolds

Scars, as the result of abnormal wound-healing response after skin injury, may lead to loss of aesthetics and physical dysfunction. Current clinical strategies, such as surgical excision, laser treatment, and drug application, provide late remedies for scarring, yet it is difficult to eliminate scars. In this review, the functions, roles of multiple polymer scaffolds in wound healing and scar inhibition are explored. Polysaccharide and protein scaffolds, an analog of extracellular matrix, act as templates for cell adhesion and migration, differentiation to facilitate wound reconstruction and limit scarring. Stem cell-seeded scaffolds and growth factors-loaded scaffolds offer significant bioactive substances to improve the wound healing process. Special emphasis is placed on scaffolds that continuously release oxygen, which greatly accelerates the vascularization process and ensures graft survival, providing convincing theoretical support and great promise for scarless healing.

Engineering Polysaccharides for Tissue Repair and Regeneration

The success of repair or regeneration depends greatly on the architecture of 3D scaffolds that finely mimic natural extracellular matrix to support cell growth and assembly. Polysaccharides have excellent biocompatibility with intrinsic biological cues and they have been extensively investigated as scaffolds for tissue engineering and regenerative medicine (TERM). The physical and biochemical structures of natural polysaccharides, however, can barely meet all the requirements of tissue-engineered scaffolds. To take advantage of their inherent properties, many innovative approaches including chemical, physical, or joint modifications have been employed to improve their properties. Recent advancement in molecular and material building technology facilitates the fabrication of advanced 3D structures with desirable properties. This review focuses on the latest progress of polysaccharide-based scaffolds for TERM, especially those that construct advanced architectures for tissue regeneration.

Enzymatically-degradable hydrogel coatings on titanium for bacterial infection inhibition and enhanced soft tissue compatibility via a self-adaptive strategy

Ideal percutaneous titanium implants request both antibacterial ability and soft tissue compatibility. ZnO structure constructed on titanium has been widely proved to be helpful to combat pathogen contamination, but the biosafety of ZnO is always questioned. How to maintain the remarkable antibacterial ability of ZnO and efficiently reduce the corresponding toxicity is still challenging. Herein, a hybrid hydrogel coating was constructed on the fabricated ZnO structure of titanium, and the coating was proved to be enzymatically-degradable when bacteria exist. Then the antibacterial activity of ZnO was presented. When under the normal condition (no bacteria), the hydrogel coating was stable and tightly adhered to titanium. The toxicity of ZnO was reduced, and the viability of fibroblasts was largely improved. More importantly, the hydrogel coating provided a good buffer zone for cell ingrowth and soft tissue integration. The curbed Zn ion release was also proved to be useful to regulate fibroblast responses such as the expression of CTGF and COL-I. These results were also validated by in vivo studies. Therefore, this study proposed a valid self-adaptive strategy for ZnO improvement. Under different conditions, the sample could present different functions, and both the antibacterial ability and soft tissue compatibility were finely preserved.

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Enzymatically-degradable hydrogel coatings are prepared on the ZnO structure of titanium.

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The degradation of the hydrogel coating is accelerated when S. aureus exists and the remarkable antibacterial activity of ZnO is presented.

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The hydrogel coating is stable and tightly adhered on ZnO when no bacteria exists and the toxicity of ZnO is largely reduced.

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The fibroblast responses and soft tissue compatibility are improved.

Propolis loaded and genipin-crosslinked PVA/chitosan membranes; characterization properties and cytocompatibility/genotoxicity response for wound dressing applications

Loading propolis by a simple process using genipin as a crosslinking agent and fabrication of a novel PVA/Chitosan-Propolis membrane scaffolds were reported for wound dressing applications. The research is focused on the effects of propolis on characterization properties of membrane such as chemical structure, surface morphology, degradation ratio, crystallinity, hydrophilicity, water uptake capacity, water vapour transmission rate and mechanical aspect. It was noticed that water uptake capacity and hydrophilicity properties of membrane considerably affected by the propolis. By addition of (0.50, % v/v) propolis, the contact angle of the PVA/Chitosan membrane was remarkably decreased from 86.29° ± 3 to 45 ± 2°. 3-(4,5-dimethylthiazoyl-2-yl)-2,5-diphenylte-trazolium (MTT) bromide test and SEM were used to analyse the cytocompatibility of the membranes and morphology of cells on membrane. The propolis incorporated membrane showed cell proliferation rate 176 ± 13%, 775 ± 1%, and 853 ± 23%, at 24 h, 27 h and 120 h, respectively. SEM images also supported the cell behaviour on membrane. DNA fragmentation was also investigated with genotoxicity test. The studies on the interactions between membranes and MEF cells revealed that the incorporation of propolis into membrane promoted cell proliferation. These overall results presented that propolis incorporated membranes could have potentially appealing application as scaffolds for wound healing applications.

Sprayable hydrogel dressing accelerates wound healing with combined reactive oxygen species-scavenging and antibacterial abilities

Wound management poses a considerable economic burden on the global healthcare system, considering the impacts of wound infection, delayed healing and scar formation. To this end, multifunctional dressings based on hydrogels have been developed to stimulate skin healing. Herein, we describe the design, fabrication, and characterization of a sprayable hydrogel-based wound dressing loaded with cerium oxide nanoparticles (CeONs) and an antimicrobial peptide (AMP), for combined reactive oxygen species (ROS)-scavenging and antibacterial properties. We adopted a mussel-inspired strategy to chemically conjugate gelatin with dopamine motifs and prepared a hydrogel dressing with improved binding affinity to wet skin surfaces. Additionally, the release of AMP from the hydrogel demonstrated rapid release ablation and contact ablation against four representative bacterial strains, confirming the desired antimicrobial activities. Moreover, the CeONs-loaded hydrogel dressing exhibited favorable ROS-scavenging abilities. The biocompatibility of the multifunctional hydrogel dressing was further proven in vitro by culturing with HaCaT cells. Overall, the benefits of the developed hydrogel wound dressing, including sprayability, adhesiveness, antimicrobial activity, as well as ROS-scavenging and skin-remodeling ability, highlight its promissing translational potentials in wound management. STATEMENT OF SIGNIFICANCE: Various hydrogel-based wound-dressing materials have been developed to stimulate wound healing. However, from the clinical perspective, few of the current wound dressings meet all the intended multifunctional requirements of preventing infection, promoting rapid wound closure, and minimizing scar formation, while simultaneously offering the convenience of application. In the current study, we adopted a mussel-inspired strategy to functionalize the GelMA hydrogels with DOPA to fabricate GelMA-DOPA hydrogel which exhibited an enhanced binding affinity for wound surfaces, AMP HHC-36 and CeONs are further encapsulated into the GelMA-DOPA hydrogel to confer the hydrogel wound dressing with antimicrobial and ROS-scavenging abilities. The GelMA-DOPA-AMP-CeONs dressing offered the benefits of sprayability, adhesiveness, antimicrobial activity, as well as ROS-scavenging and skin-remodeling ability, which might address the therapeutic and economic burdens associated with chronic wound treatment and management.

Fibroblasts treated with macrophage conditioned medium results in phenotypic shifts and changes in collagen organization

In tissue regeneration, the goal is to regenerate tissue similar to what was damaged or missing while preventing fibrotic scarring, which may lead to decreased mechanical strength and dissimilar tissue characteristics compared to native tissue. We believe collagen orientation plays a critical role in wound contraction and scarring and that it is modulated by myofibroblasts. We used macrophage conditioned medium to simulate complex events that can influence the fibroblast phenotype during the wound healing process. In addition to examining the effect of macrophage phenotype on fibroblasts, we inhibited focal adhesion kinase (FAK), Rho-associated protein kinase (ROCK), and myosin II for fibroblasts cultured on both tissue culture plastic and methacrylated gellan gum to understand how different pathways and materials influence fibroblast responses. Collagen orientation, α-SMA expression, focal adhesion area, and cell migration were altered by inhibition of FAK, ROCK, or myosin II and macrophage phenotype, along with the substrate. An increase in either focal adhesion area or α-smooth muscle actin (α-SMA) expression correlated with an aligned collagen orientation. Gellan gum hydrogels upregulated α-SMA expression in ROCK inhibited conditioned media and downregulated the FAK area in FAK and ROCK inhibited conditioned media. Myosin II had no impact on the α-SMA expression on the substrate compared to coverslip except for M2 conditioned medium. Gellan gum hydrogel significantly increased cell migration under FAK and Myosin II mediated conditioned media and unconditioned media. Collectively, our study examined how macrophage phenotype influences fibroblast response, which would be beneficial in controlling scar tissue formation.

Advances in biodegradable and injectable hydrogels for biomedical applications

In situ-forming injectable hydrogels are smart biomaterials that can be implanted into living bodies with minimal invasion. Due to pioneer work of Prof. Sung Wan Kim in this field, injectable hydrogels have shown great potentials in many different biomedical applications. Biodegradable and injectable hydrogels can be administered at room temperature as viscous polymer sols. They will degrade after accomplishing their tasks. Before injecting into living bodies, active substances can be loaded into viscous polymer sols with a high loading efficiency by simple mixing. After injecting into living bodies, active substances-loaded hydrogels can be formed and active substances can be released in a controlled manner upon diffusion or polymer degradation. Due to their outstanding properties and unique features, injectable hydrogels are very promising in many biomedical applications including drug/protein/gene delivery, tissue engineering, and regenerative medicine. In this review, we briefly introduce recent development of several important types of in situ-forming injectable hydrogels reported by our group during the last three years. Important properties and potential applications (such as cancer therapy, insulin release and wound healing) of these injectable hydrogels are reviewed. Challenges and perspectives in this research field are also discussed.

Aloe vera: A Medicinal Plant Used in Skin Wound Healing

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

Alginate hydrogel dressings for advanced wound management

Wound healing is a complicated and continuous process affected by several factors, and it needs an appropriate surrounding to achieve accelerated healing. At present, various wound dressings are used for wound management, such as fiber, sponge, hydrogel, foam, hydrocolloid and so on. Hydrogels can provide mechanical support and moist environment for wounds, and are widely used in biomedical field. Alginate is a natural linear polysaccharide derived from brown algae or bacteria, consisting of repeating units of β-1,4-linked D-mannuronic acid (M) and L-guluronic acid (G) in different ratios. It is widely used in biomedical and engineering fields due to its good biocompatibility and liquid absorption capacity. Alginate-based hydrogels have been used in wound dressing, tissue engineering, and drug delivery applications for decades. In this review, we summarize the recent approaches in the chemical and physical preparation and the application of alginate hydrogels in wound dressings.

Epithelial differentiation of human adipose-derived stem cells (hASCs) undergoing three-dimensional (3D) cultivation with collagen sponge scaffold (CSS) via an indirect co-culture strategy

BACKGROUND

Three-dimensional (3D) cultivation with biomaterials was proposed to facilitate stem cell epithelial differentiation for wound healing. However, whether human adipose-derived stem cells (hASCs) on collagen sponge scaffold (CSS) better differentiate to keratinocytes remains unclear.

METHODS

3D cultivation with CSS on hASC epidermal differentiation co-cultured with HaCaT cells at air-liquid interface (ALI) was compared with two-dimensional (2D) form and cultivation without "co-culture" or "ALI." Cellular morphology, cell adhesion, and growth condition were evaluated, followed by the protein and gene expression of keratin 14 (K14, keratinocyte specific marker).

RESULTS

Typical cobblestone morphology of keratinocytes was remarkably observed in co-cultured hASCs at ALI, but those seeded on the CSS exhibited more keratinocyte-like cells under an invert microscope and scanning electron microscope. Desired cell adhesion and proliferation were confirmed in 3D differentiation groups by rhodamine-labeled phalloidin staining, consistent with H&E staining. Compared with those cultured in 2D culture system or without "ALI," immunofluorescence staining and gene expression analysis revealed hASCs co-cultured over CSS expressed K14 at higher levels at day 15.

CONCLUSIONS

CSS is positive to promote epithelial differentiation of hASCs, which will foster a deeper understanding of artificial dermis in skin wound healing and regeneration.

Bioinspired multifunctional biomaterials with hierarchical microstructure for wound dressing

Developing multifunctional wound dressing with desired mechanical strength is of great significance for the treatment of different types of skin wounds. Inspired by the close relationship between strength and hierarchical structure of nacre, hierarchical and porous graphene oxide-chitosan-calcium silicate (GO-CTS-CS) film biomaterials are fabricated by a combination of vacuum filtration-assisted assembly and freeze-drying methods. The bioinspired hierarchical materials emulate an orderly porous lamellar micron-scale structure and the "brick-and-mortar"-layered nanostructure. The hierarchical microstructure endows the GO-CTS-CS biomaterials with good tensile strength, compatible breathability, and water absorption. Furthermore, the hierarchical GO-CTS-CS biomaterials exhibit ideal photothermal performance, leading to significant photothermal antibacterial and antitumor efficacy. Further, the hierarchical GO-CTS-CS biomaterials show stimulatory effect on in vivo chronic wound healing. Therefore, such a high performance and multifunctional biomaterial is believed to offer a promising alternative to traditional wound dressing in future. STATEMENT OF SIGNIFICANCE: Although it is an effective strategy to prepare high-performance materials by mimicking the hierarchical microstructure of nacre, the preparation of nacre-inspired materials in tissue engineering fields still needs to be investigated. In this work, we prepared a nacre-inspired multifunctional graphene oxide-chitosan-calcium silicate (GO-CTS-CS) biomaterial with a hierarchical microstructure. The hierarchical microstructure endows the biomaterials with desired properties of strength, breathability, and water absorption. Further, the hierarchical GO-CTS-CS biomaterial showed good photothermal antibacterial/antitumor and wound healing effects. This work may provide an approach to combine the preparation of multifunctional biomaterials with bioinspired engineering by constructing a hierarchical microstructure, indicating that the assembling hierarchical microstructure in biomaterials is of great importance for tissue engineering and regenerative medicine.

Design of Nanocomposite Injectable Hydrogels for Minimally Invasive Surgery

Biocompatible hydrogels are materials that hold great promise in medicine and biology since the porous structure, the ability to entrap a large amount of water, and the tunability of their mechanical and tissue adhesive properties make them suitable for several applications, including wound healing, drug and cell delivery, cancer treatment, bioelectronics, and tissue regeneration. Among the possible developed systems, injectable hydrogels, owing to their properties, are optimal candidates for in vivo minimally invasive procedures. To be injectable, a hydrogel must be liquid before and during the injection, but it must quickly jellify after injection to form a soft, self-standing, solid material. The possibility to work with a liquid precursor encoding the functions that will be available after gelation allows the development of biocompatible materials that can be employed in surgery and, in particular, in noninvasive procedures. The underlying idea is to reach the target tissue by using just a needle, or by exploiting the natural body orifices, reducing surgery procedure time, induced pain, and risk of infections. Hydrogels with different properties can be obtained by changing the type of cross-linking, the cross-linking density or the molecular weight of the polymer, or by introducing pending functional groups. The introduction of a nanofiller in the hydrogel network allows for expanding the suite of the structural and functional properties and for better mimicking native tissues. In this Account, we discuss how to provide a hydrogel network with designed properties by playing with both the polymeric chains and the fillers. We present selected examples from the literature that show how to introduce stiffness, stretchability, adhesiveness, self-healing, anisotropy, antimicrobial activity, biodegradability, and conductivity in injectable hydrogels. We further describe how the chemical composition, the mechanical properties, and the microarchitecture of the hydrogel influence cell adhesion, proliferation, and differentiation. Examples of injectable hydrogels for innovative minimally invasive procedures are then discussed in detail; in particular, we showcase the use of hydrogels for tumor resection and as vascular chemoembolization agents. We further discuss how one can improve the rheological properties of injectable hydrogels to exploit them in osteochondral tissue engineering. The effect of the introduction of a conductive filler is then presented in relation to the development of electroactive scaffolds for cardiac-tissue engineering and neural and nerve repair. We believe that the rational design of biocompatible, injectable hybrid hydrogels with tunable properties will likely play a crucial role in reducing the invasiveness and improving the outcome of several clinical and surgical setups.

Regeneration of Dermis: Scarring and Cells Involved

There are many studies on certain skin cell specifications and their contribution to wound healing. In this review, we provide an overview of dermal cell heterogeneity and their participation in skin repair, scar formation, and in the composition of skin substitutes. The papillary, reticular, and hair follicle associated fibroblasts differ not only topographically, but also functionally. Human skin has a number of particular characteristics that are different from murine skin. This should be taken into account in experimental procedures. Dermal cells react differently to skin wounding, remodel the extracellular matrix in their own manner, and convert to myofibroblasts to different extents. Recent studies indicate a special role of papillary fibroblasts in the favorable outcome of wound healing and epithelial-mesenchyme interactions. Neofolliculogenesis can substantially reduce scarring. The role of hair follicle mesenchyme cells in skin repair and possible therapeutic applications is discussed. Participation of dermal cell types in wound healing is described, with the addition of possible mechanisms underlying different outcomes in embryonic and adult tissues in the context of cell population characteristics and extracellular matrix composition and properties. Dermal white adipose tissue involvement in wound healing is also overviewed. Characteristics of myofibroblasts and their activity in scar formation is extensively discussed. Cellular mechanisms of scarring and possible ways for its prevention are highlighted. Data on keloid cells are provided with emphasis on their specific characteristics. We also discuss the contribution of tissue tension to the scar formation as well as the criteria and effectiveness of skin substitutes in skin reconstruction. Special attention is given to the properties of skin substitutes in terms of cell composition and the ability to prevent scarring.