Conductive Materials for Healing Wounds: Their Incorporation in Electroactive Wound Dressings, Characterization, and Perspectives

The impact of copper nanoparticles surfactant on the structural and biological properties of chitosan/sodium alginate wound dressings

Multifunctional wound dressings based on hydrogels are an efficacious and practicable strategy in therapeutic processes and accelerated chronic wound healing. Here, copper (Cu) nanoparticles were added to chitosan/sodium alginate (CS/SA) hydrogels to improve the antibacterial properties of the prepared wound dressings. Due to the super-hydrophobicity of Cu nanoparticles, polyethylene glycol (PEG) was used as a surfactant, and then added to the CS/SA-based hydrogels. The CS/SA/Cu hydrogels were synthesized with 0, 2, 3.5, and 5 wt% Cu nanoparticles. The structural and morphological properties in presence of PEG were evaluated using Fourier-transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), and field emission scanning electron microscopy (FESEM). The biodegradation and swelling properties of the hydrogels were investigated in phosphate buffer saline (PBS) at 37 °C for up to 30 days. Cell viability and adhesion, as well as antibacterial behavior, were investigated via MTT assay, FESEM, and disk diffusion method, respectively. The obtained results showed that PEG provided new intra- and intermolecular bonds that affected significantly the hydrogels' degradation and swelling ratio, which increased up to ~1200 %. Cell viability reached ~110 % and all samples showed remarkable antibacterial behavior when CS/SA/Cu containing 2 wt% was introduced. This study provided new insights regarding the use of PEG as a surfactant for Cu nanoparticles in CS/SA hydrogel wound dressing, ultimately affecting the chemical bonding and various properties of the prepared hydrogels.

Electrical Stimulating Redox Membrane Incorporated with PVA/Gelatin Nanofiber for Diabetic Wound Healing

Chronic wounds adversely affect the quality of life. Although electrical stimulation has been utilized to treat chronic wounds, there are still limitations to practicing it due to the complicated power system. Herein, an electrostimulating membrane incorporated with electrospun nanofiber (M-sheet) to treat diabetic wounds is developed. Through the screen printing method, the various alternate patterns of both Zn and AgCl on a polyurethane substrate, generating redox-mediated electrical fields are introduced. The antibacterial ability of the patterned membrane against both E. coli and S. aureus is confirmed. Furthermore, the poly(vinyl alcohol) (PVA)/gelatin electrospun fiber is incorporated into the patterned membrane to enhance biocompatibility and maintain the wet condition in the wound environment. The M-sheet can improve cell proliferation and migration in vitro and has an immune regulatory effect by inducing the polarization of macrophage to the M2 phenotype. Finally, when applied to a diabetic skin wound model, the M-sheet displays an accelerated wound healing rate and enhances re-epithelialization, collagen synthesis, and angiogenesis. It suggests that the M-sheet is a simple and portable system for the spontaneous generation of electrical stimulation and has great potential to be used in the practical wound and other tissue engineering applications.

Conductive Hyaluronic Acid/Deep Eutectic Solvent Composite Hydrogel as a Wound Dressing for Promoting Skin Burn Healing Under Electrical Stimulation

Burns can cause severe damage to the skin due to bacterial infection and severe inflammation. Although conductive hydrogels as electroactive burn-wound dressings achieve remarkable effects on accelerating wound healing, issues such as imbalance between their high conductivity and mechanical properties, easy dehydration, and low transparency must be addressed. Herein, a double-network conductive eutectogel is fabricated by integrating polymerizable deep eutectic solvents (PDESs)including acrylamide/choline chloride/glycerol (acrylamide-polymerization crosslink) and thiolated hyaluronic acid (disulfide-bonding crosslink). The introduction of PDESs provides the eutectogel with a conductivity (up to 0.25 S·m-1) and mechanical strength (tensile strain of 59-77%) simulating those of natural human skin, as well as satisfactory tissue adhesiveness, self-healing ability, and antibacterial properties. When combined with exogenous electrical stimulation, the conductive eutectogel exhibits the ability to reduce inflammation, stimulate cell proliferation and migration, promote collagen deposition and angiogenesis, and facilitate skin tissue remodeling. This conductive eutectogel shows great potential as a dressing for healing major burn wounds.

Dual Drug-Loaded Coaxial Nanofiber Dressings for the Treatment of Diabetic Foot Ulcer

Introduction

Diabetes mellitus is frequently associated with foot ulcers, which pose significant health risks and complications. Impaired wound healing in diabetic patients is attributed to multiple factors, including hyperglycemia, neuropathy, chronic inflammation, oxidative damage, and decreased vascularization.

Rationale

To address these challenges, this project aims to develop bioactive, fast-dissolving nanofiber dressings composed of polyvinylpyrrolidone loaded with a combination of an antibiotic (moxifloxacin or fusidic acid) and anti-inflammatory drug (pirfenidone) using electrospinning technique to prevent the bacterial growth, reduce inflammation, and expedite wound healing in diabetic wounds.

Results

The fabricated drug-loaded fibers exhibited diameters of 443 ± 67 nm for moxifloxacin/pirfenidone nanofibers and 488 ± 92 nm for fusidic acid/pirfenidone nanofibers. The encapsulation efficiency, drug loading and drug release studies for the moxifloxacin/pirfenidone nanofibers were found to be 70 ± 3% and 20 ± 1 µg/mg, respectively, for moxifloxacin, and 96 ± 6% and 28 ± 2 µg/mg, respectively, for pirfenidone, with a complete release of both drugs within 24 hours, whereas the fusidic acid/pirfenidone nanofibers were found to be 95 ± 6% and 28 ± 2 µg/mg, respectively, for fusidic acid and 102 ± 5% and 30 ± 2 µg/mg, respectively, for pirfenidone, with a release rate of 66% for fusidic acid and 80%, for pirfenidone after 24 hours. The efficacy of the prepared nanofiber formulations in accelerating wound healing was evaluated using an induced diabetic rat model. All tested formulations showed an earlier complete closure of the wound compared to the controls, which was also supported by the histopathological assessment. Notably, the combination of fusidic acid and pirfenidone nanofibers demonstrated wound healing acceleration on day 8, earlier than all tested groups.

Conclusion

These findings highlight the potential of the drug-loaded nanofibrous system as a promising medicated wound dressing for diabetic foot applications.

A novel conductive microtubule hydrogel for electrical stimulation of chronic wounds based on biological electrical wires

Electrical stimulation (ES) is considered a promising therapy for chronic wounds via conductive dressing. However, the lack of a clinically suitable conductive dressing is a serious challenge. In this study, a suitable conductive biomaterial with favorable biocompatibility and conductivity was screened by means of an inherent structure derived from the body based on electrical conduction in vivo. Ions condensed around the surface of the microtubules (MTs) derived from the cell's cytoskeleton are allowed to flow in the presence of potential differences, effectively forming a network of biological electrical wires, which is essential to the bioelectrical communication of cells. We hypothesized that MT dressing could improve chronic wound healing via the conductivity of MTs applied by ES. We first developed an MT-MAA hydrogel by a double cross-linking method using UV and calcium chloride to improve chronic wound healing by ES. In vitro studies showed good conductivity, mechanical properties, biocompatibility, and biodegradability of the MT-MAA hydrogel, as well as an elevated secretion of growth factors with enhanced cell proliferation and migration ability in response to ES. The in vivo experimental results from a full-thickness diabetic wound model revealed rapid wound closure within 7d in C57BL/6J mice, and the wound bed dressed by the MT-MAA hydrogel was shown to have promoted re-epithelization, enhanced angiogenesis, accelerated nerve growth, limited inflammation phases, and improved antibacterial effect under the ES treatment. These preclinical findings suggest that the MT-MAA hydrogel may be an ideal conductive dressing for chronic wound healing. Furthermore, biomaterials based on MTs may be also promising for treating other diseases.

An antibacterial membrane based on Janus bacterial cellulose with nano-sized copper oxide through polydopamine conjugation for infectious wound healing

Bacterial cellulose (BC) produced by Acetobacter xylinum has great advantages in wound dressing. However, the structural limitation under static culture, and lack of antibacterial properties restrict its application, especially for infectious wound healing. The present study reported an original wound dressing, which was composed of a Janus BC membrane with antibacterial nano-sized copper oxide (CuO) through polydopamine (PDA) conjugation to promote wound healing under infectious condition. The finished product (CuO/PDA/BC membrane) exhibited favorable air permeability, high hydrophilicity and good mechanical properties, as well as strong antibacterial effects by the sustained release of CuO and photothermal effect of CuO/PDA. Furthermore, CuO/PDA/BC membrane inhibited inflammatory response and promoted wound healing in an infectious wound model in vivo. These results suggested that our CuO/PDA/BC membrane had great potential as wound dressing for infectious wound healing.

Novel Functional Dressing Materials for Intraoral Wound Care

Intraoral wounds represent a particularly challenging category of mucosal and hard tissue injuries, characterized by the unique structures, complex environment, and distinctive healing processes within the oral cavity. They have a common occurrence yet frequently inflict significant inconvenience and pain on patients, causing a serious decline in the quality of life. A variety of novel functional dressings specifically designed for the moist and dynamic oral environment have been developed and realized accelerated and improved wound healing. Thoroughly analyzing and summarizing these materials is of paramount importance in enhancing the understanding and proficiently managing intraoral wounds. In this review, the particular processes and unique characteristics of intraoral wound healing are firstly described. Up-to-date knowledge of various forms, properties, and applications of existing products are then intensively discussed, which are categorized into animal products, plant extracts, natural polymers, and synthetic products. To conclude, this review presents a comprehensive framework of currently available functional intraoral wound dressings, with an aim to provoke inspiration of future studies to design more convenient and versatile materials.

Accelerated Wound Healing by Electrospun Multifunctional Fibers with Self-Powered Performance

Wound healing has been a persistent clinical challenge for a long time. Electrical stimulation is an effective therapy with the potential to accelerate wound healing. In this work, the self-powered electrospun nanofiber membranes (triples) were constructed as multifunctional wound dressings with electrical stimulation and biochemical capabilities. Triple was composed of a hydrolyzable inner layer with antiseptic and hemostatic chitosan, a hydrophilic core layer loaded with conductive AgNWs, and a hydrophobic outer layer fabricated by self-powered PVDF. Triple exhibited presentable wettability and acceptable moisture permeability. Electrical performance tests indicated that triple can transmit electrical signals formed by the piezoelectric effect to the wound. High antibacterial activities were observed for triple against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, with inhibition rates of 96.52, 98.63, and 97.26%, respectively. In vitro cell assays demonstrated that triple cells showed satisfactory proliferation and mobility. A whole blood clotting test showed that triple can enhance hemostasis. The innovative self-powered multifunctional fibers presented in this work offer a promising approach to addressing complications and expediting the promotion of chronic wound healing.

Chitosan/dialdehyde cellulose hydrogels with covalently anchored polypyrrole: Novel conductive, antibacterial, antioxidant, immunomodulatory, and anti-inflammatory materials

In this work, conductive composite hydrogels with covalently attached polypyrrole (PPy) nanoparticles are prepared. Hydrogels are based on partially re-acetylated chitosan soluble at physiological pH without any artificial structural modifications or need for an acidic environment, which simplifies synthesis and purification. Low-toxic and sustainable dialdehyde cellulose (DAC) was used for crosslinking chitosan and covalent anchoring of PPy colloidal particles. The condensation reaction between DAC and PPy is reported for the first time and improves not only the anchoring of PPy particles but also control over the properties of the final composite. The soluble chitosan and PPy particles are shown to act in synergy, which improves the biological properties of the materials. Prepared composite hydrogels are non-cytotoxic, non-irritating, antibacterial, can capture reactive oxygen species often related to excessive inflammation, have conductivity similar to human tissues, enhance in vitro cell growth (migration assay), and have immunomodulatory effects related to the stimulation of neutrophils and macrophages. The covalent attachment of PPy also strengthens the hydrogel network. The aldol condensation as a method for PPy covalent anchoring thus presents an interesting possibility for the development of advanced biomaterials in the future.

Conductive hydrogels based on tragacanth and silk fibroin containing dopamine functionalized carboxyl-capped aniline pentamer: Merging hemostasis, antibacterial, and anti-oxidant properties into a multifunctional hydrogel for burn wound healing

Hydrogels possessing both conductive characteristics and notable antibacterial and antioxidant properties hold considerable significance within the realm of wound healing and recovery. The object of current study is the development of conductive hydrogels with antibacterial and antioxidant properties, emphasizing their potential for effective wound healing, especially in treating third-degree burns. For this purpose, various conductive hydrogels are developed based on tragacanth and silk fibroin, with variable dopamine functionalized carboxyl-capped aniline pentamer (CAP@DA). The FTIR analysis confirms that the CAP powder was successfully synthesized and modified with DA. The results show that the incorporation of CAP@DA into hydrogels can increase the porosity and swellability of the hydrogels. Additionally, the mechanical and viscoelastic properties of the hydrogels are also improved. The release of vancomycin from the hydrogels is sustained over time, and the hydrogels are effective in inhibiting the growth of Methicillin-resistant Staphylococcus aureus (MRSA). In vitro cell studies of the hydrogels show that all hydrogels are biocompatible and support cell attachment. The hydrogels' tissue adhesiveness yielded a satisfactory hemostatic outcome in a rat-liver injury model. The third-degree burn was created on the dorsal back paravertebral region of the rats and then grafted with hydrogels. The burn was monitored for 3, 7, and 14 days to evaluate the efficacy of the hydrogel in promoting wound healing. The hydrogels revealed treatment effect, resulting in enhancements in wound closure, dermal collagen matrix production, new blood formation, and anti-inflammatory properties. Better results were obtained for hydrogel with increasing CAP@DA. In summary, the multifunctional conducive hydrogel, featuring potent antibacterial properties, markedly facilitated the wound regeneration process.

Resorbable conductive materials for optimally interfacing medical devices with the living

Implantable and wearable bioelectronic systems are arising growing interest in the medical field. Linking the microelectronic (electronic conductivity) and biological (ionic conductivity) worlds, the biocompatible conductive materials at the electrode/tissue interface are key components in these systems. We herein focus more particularly on resorbable bioelectronic systems, which can safely degrade in the biological environment once they have completed their purpose, namely, stimulating or sensing biological activity in the tissues. Resorbable conductive materials are also explored in the fields of tissue engineering and 3D cell culture. After a short description of polymer-based substrates and scaffolds, and resorbable electrical conductors, we review how they can be combined to design resorbable conductive materials. Although these materials are still emerging, various medical and biomedical applications are already taking shape that can profoundly modify post-operative and wound healing follow-up. Future challenges and perspectives in the field are proposed.

Stimuli-Responsive 3D Printable Conductive Hydrogel: A Step toward Regulating Macrophage Polarization and Wound Healing

Conductive hydrogels (CHs) are promising alternatives for electrical stimulation of cells and tissues in biomedical engineering. Wound healing and immunomodulation are complex processes that involve multiple cell types and signaling pathways. 3D printable conductive hydrogels have emerged as an innovative approach to promote wound healing and modulate immune responses. CHs can facilitate electrical and mechanical stimuli, which can be beneficial for altering cellular metabolism and enhancing the efficiency of the delivery of therapeutic molecules. This review summarizes the recent advances in 3D printable conductive hydrogels for wound healing and their effect on macrophage polarization. This report also discusses the properties of various conductive materials that can be used to fabricate hydrogels to stimulate immune responses. Furthermore, this review highlights the challenges and limitations of using 3D printable CHs for future material discovery. Overall, 3D printable conductive hydrogels hold excellent potential for accelerating wound healing and immune responses, which can lead to the development of new therapeutic strategies for skin and immune-related diseases.

Sodium hyaluronate hydrogel for wound healing and human health monitoring based on deep eutectic solvent

Hydrogel dressings traditionally promote wound healing by maintaining moisture and preventing infection rather than by actively stimulating the skin to regulate cell behavior. Electrical stimulation (ES) is known to modulate skin cell behavior and to promote wound healing. This study describes the first multifunctional conductive hydrogel for wound healing and health monitoring based on a deep eutectic solvent (DES). Sodium hyaluronate and polydopamine constituted the hydrogel skeleton, and tea tree oil and Panax notoginseng extract were used as the active ingredients to induce adhesion, promote antioxidant and antibacterial activity, and support biocompatibility of the hydrogel. The inclusion of DES increases the temperature resistance of the hydrogel and improves its environmental adaptability. We used a small, portable coin battery-powered to provide electrical stimulation. Treatment with both the hydrogel and ES resulted in a stronger therapeutic effect than that provided by the commercial DuoDERM dressing. The hydrogel detected movement and strain when applied as a sensor. Overall, this study reports the development of a multifunctional conductive hydrogel dressing based on DES as a wound healing and health monitor.

Rational Design of Multifunctional Hydrogels for Wound Repair

The intricate microenvironment at the wound site, coupled with the multi-phase nature of the healing process, pose significant challenges to the development of wound repair treatments. In recent years, applying the distinctive benefits of hydrogels to the development of wound repair strategies has yielded some promising results. Multifunctional hydrogels, by meeting the different requirements of wound healing stages, have greatly improved the healing effectiveness of chronic wounds, offering immense potential in wound repair applications. This review summarized the recent research and applications of multifunctional hydrogels in wound repair. The focus was placed on the research progress of diverse multifunctional hydrogels, and their mechanisms of action at different stages of wound repair were discussed in detail. Through a comprehensive analysis, we found that multifunctional hydrogels play an indispensable role in the process of wound repair by providing a moist environment, controlling inflammation, promoting angiogenesis, and effectively preventing infection. However, further implementation of multifunctional hydrogel-based therapeutic strategies also faces various challenges, such as the contradiction between the complexity of multifunctionality and the simplicity required for clinical translation and application. In the future, we should work to address these challenges, further optimize the design and preparation of multifunctional hydrogels, enhance their effectiveness in wound repair, and promote their widespread application in clinical practice.

Antibacterial self-healing bilayer dressing for epidermal sensors and accelerate wound repair

This study aimed to investigate the effect of the bilayer hydrogel as a wound dressing on the wound-healing rate. We synthesized a self-healing hydrogel with optimized formulation by introducing natural polymer (chitosan) and arginine to the hydrogel composition. We then characterized the hydrogels using FT-IR, thermal analysis, mechanical testing, and in vitro and in vivo assay. The resulting bilayer wound dressing offers a lot of desirable characteristics, including good self-healing and repeatable adhesiveness. Likewise, the conductive bilayer wound dressing could be used to analyze the patient's healthcare data in real-time as epidermal sensors. Bilayer wound dressings remarkably have broad antibacterial efficacy against Gram-positive and Gram-negative bacteria. The potential applications of this bilayer wound dressing are illustrated by detectable body movement and conductivity. The wound-healing rate of bilayer wound dressings containing chitosan and arginine was higher, but those without the aforementioned ingredients had lower wound-healing efficacy. Additionally, promoting collagen synthesis and reducing wound infection has a considerable therapeutic impact on wounds. These results could have significant implications for the development of high-performance wound dressings.

Long-Lived Photoacid-Doped Conducting Composites Induce Photocurrent for Efficient Wound Healing

Electrical stimulation is an effective strategy for facilitating wound healing. However, it is hindered by unwieldy electrical systems. In this study, a light-powered dressing based on long-lived photoacid generator (PAG)-doped polyaniline composites is used, which can generate a photocurrent under visible light irradiation to interact with the endogenous electric field and facilitate skin growth. Light-controlled proton binding and dissociation result in oxidation and reduction of the polyaniline backbone, inducing charge transfer to generate a photocurrent. Due to the rapid intramolecular photoreaction of PAG, a long-lived proton-induced localized acidic environment is formed, which protects the wound from microbial infection. In summary, a simple and effective therapeutic strategy is introduced for light-powered and biocompatible wound dressings that show great potential for wound treatment.

Minimally invasive bioprinting for in situ liver regeneration

In situ bioprinting is promising for developing scaffolds directly on defect models in operating rooms, which provides a new strategy for in situ tissue regeneration. However, due to the limitation of existing in situ biofabrication technologies including printing depth and suitable bioinks, bioprinting scaffolds in deep dermal or extremity injuries remains a grand challenge. Here, we present an in vivo scaffold fabrication approach by minimally invasive bioprinting electroactive hydrogel scaffolds to promote in situ tissue regeneration. The minimally invasive bioprinting system consists of a ferromagnetic soft catheter robot for extrusion, a digital laparoscope for in situ monitoring, and a Veress needle for establishing a pneumoperitoneum. After 3D reconstruction of the defects with computed tomography, electroactive hydrogel scaffolds are printed within partial liver resection of live rats, and in situ tissue regeneration is achieved by promoting the proliferation, migration, and differentiation of cells and maintaining liver function in vivo.

Nanocomposite conductive hydrogels with Robust elasticity and multifunctional responsiveness for flexible sensing and wound monitoring

Flexible biosensors made from conductive hydrogels have shown tremendous potential in health management and human-machine interfaces. Nevertheless, it remains challenging to fabricate conductive hydrogels with robust resilience and long-term stability. Herein, we report a nanocomposite conductive hydrogel prepared through one-pot radical polymerization of 3-acrylamidophenylboronic acid (APBA) and acrylamide (AM) in the presence of LAPONITE® XLG nanosheet (XLG) stabilized carbon nanotubes (CNTs). Owing to the existence of various non-covalent interactions within the network (B-N coordination, hydrogen bond, and polymer chain entanglement), the hydrogels feature splendid mechanical properties with a tensile strength of 252-323 kPa, fracture strain of 880-1200%, Young's modulus of 48-50 kPa and fracture energy of 911-1078 J m^-2, and exhibit robust elasticity and fatigue resistance during 1000 consecutive tensile and compressive cycles. The hydrogels show remarkable sensing performances (gauge factor up to 9.43) and a broad sensing range of strain (1-300%) and pressure (1-80 kPa), enabling reliable and accurate monitoring of large and tiny motions in daily human life. Moreover, the conductive hydrogels could not only accelerate skin incision healing but also act as smart wearable sensors to monitor the skin wound healing process by detection of local temperature changes.

Electroactive nanofibrous membrane with temperature monitoring for wound healing

Developing functional dressings for promoting cellular activities and monitoring the healing progress is receiving increasingly widespread attention. In this study, Ag/Zn electrodes were deposited on the surface of a polylactic acid (PLA) nanofibrous membrane which can mimic the extracellular matrix. When wetted by wound exudate, the Ag/Zn electrodes could generate an electric stimulation (ES), promoting the migration of fibroblasts that heal wounds. Moreover, the Ag/Zn@PLA dressing showed excellent antibacterial activity against E. coli (95%) and S. aureus (97%). The study found that the electrostatic (ES) effect and the release of metal ions mainly contribute to the wound healing properties of Ag/Zn@PLA. In vivo mouse models demonstrated that Ag/Zn@PLA could promote wound healing by improving re-epithelialization, collagen deposition, and neovascularization. Additionally, the integrated sensor within the Ag/Zn@PLA dressing can monitor the wound site's temperature in real-time, providing timely information on wound inflammatory reactions. Overall, this work suggests that combining electroactive therapy and wound temperature monitoring may provide a new strategy for designing functional wound dressings.

Revolutionizing Drug Delivery and Therapeutics: The Biomedical Applications of Conductive Polymers and Composites-Based Systems

The first conductive polymers (CPs) were developed during the 1970s as a unique class of organic substances with properties that are electrically and optically comparable to those of inorganic semiconductors and metals while also exhibiting the desirable traits of conventional polymers. CPs have become a subject of intensive research due to their exceptional qualities, such as high mechanical and optical properties, tunable electrical characteristics, ease of synthesis and fabrication, and higher environmental stability than traditional inorganic materials. Although conducting polymers have several limitations in their pure state, coupling with other materials helps overcome these drawbacks. Owing to the fact that various types of tissues are responsive to stimuli and electrical fields has made these smart biomaterials attractive for a range of medical and biological applications. For various applications, including the delivery of drugs, biosensors, biomedical implants, and tissue engineering, electrical CPs and composites have attracted significant interest in both research and industry. These bimodalities can be programmed to respond to both internal and external stimuli. Additionally, these smart biomaterials have the ability to deliver drugs in various concentrations and at an extensive range. This review briefly discusses the commonly used CPs, composites, and their synthesis processes. Further highlights the importance of these materials in drug delivery along with their applicability in various delivery systems.

Formation of PLGA-PEDOT: PSS Conductive Scaffolds by Supercritical Foaming

The usage of conjugated materials for the fabrication of foams intended to be used as therapeutic scaffolds is gaining relevance these days, as they hold certain properties that are not exhibited by other polymer types that have been regularly used until the present. Hence, this work aims to design a specific supercritical CO₂ foaming process that would allow the production of porous polymeric devices with improved conductive properties, which would better simulate matrix extracellular conditions when used as therapeutic scaffolds (PLGA-PEDOT:PSS) systems. The effects of pressure, temperature, and contact time on the expansion factor, porosity, mechanical properties, and conductivity of the foam have been evaluated. The foams have been characterized by scanning electron and atomic force microscopies, liquid displacement, PBS degradation test, compression, and resistance to conductivity techniques. Values close to 40% porosity were obtained, with a uniform distribution of polymers on the surface and in the interior, expansion factors of up to 10 orders, and a wide range of conductivity values (2.2 × 10^-7 to 1.0 × 10^-5 S/cm) and mechanical properties (0.8 to 13.6 MPa Young's modulus in compression test). The conductive and porous scaffolds that have been produced by supercritical CO₂ in this study show an interesting potential for tissue engineering and for neural or cardiac tissue regeneration purposes due to the fact that electrical conductivity is a crucial factor for proper cell function and tissue development.

Fabrication and desired properties of conductive hydrogel dressings for wound healing

Conductive hydrogels are platforms recognized as constituting promising materials for tissue engineering applications. This is because such conductive hydrogels are characterized by the inherent conductivity properties while retaining favorable biocompatibility and mechanical properties. These conductive hydrogels can be particularly useful in enhancing wound healing since their favorable conductivity can promote the transport of essential ions for wound healing via the imposition of a so-called transepithelial potential. Other valuable properties of these conductive hydrogels, such as wound monitoring, stimuli-response etc., are also discussed in this study. Crucially, the properties of conductive hydrogels, such as 3D printability and monitoring properties, suggest the possibility of its use as an alternative wound dressing to traditional dressings such as bandages. This review, therefore, seeks to comprehensively explore the functionality of conductive hydrogels in wound healing, types of conductive hydrogels and their preparation strategies and crucial properties of hydrogels. This review will also assess the limitations of conductive hydrogels and future perspectives, with an emphasis on the development trend for conductive hydrogel uses in wound dressing fabrication for subsequent clinical applications.

Multifunctional conductive hyaluronic acid hydrogels for wound care and skin regeneration

Although the main function of skin is to act as a protective barrier against external factors, it is indeed an extremely vulnerable tissue. Skincare, regardless of the wound type, requires effective treatments to prevent bacterial infection and local inflammation. The complex biological roles displayed by hyaluronic acid (HA) during the wound healing process have made this multifaceted polysaccharide an alternative biomaterial to prepare wound dressings. Therefore, herein, we present the most advanced research undertaken to engineer conductive and interactive hydrogels based on HA as wound dressings that enhance skin tissue regeneration either through electrical stimulation (ES) or by displaying multifunctional performance. First, we briefly introduce to the reader the effect of ES on promoting wound healing and why HA has become a vogue as a wound healing agent. Then, a selection of systems, chosen according to their multifunctional relevance, is presented. Special care has been taken to highlight those recently reported works (mainly from the last 3 years) with enhanced scalability and biomimicry. By doing that, we have turned a critical eye on the field considering what major challenges must be overcome for these systems to have real commercial, clinical, or other translational impact.

Polycaprolactone-MXene Nanofibrous Scaffolds for Tissue Engineering

New conductive materials for tissue engineering are needed for the development of regenerative strategies for nervous, muscular, and heart tissues. Polycaprolactone (PCL) is used to obtain biocompatible and biodegradable nanofiber scaffolds by electrospinning. MXenes, a large class of biocompatible 2D nanomaterials, can make polymer scaffolds conductive and hydrophilic. However, an understanding of how their physical properties affect potential biomedical applications is still lacking. We immobilized Ti3C2Tx MXene in several layers on the electrospun PCL membranes and used positron annihilation analysis combined with other techniques to elucidate the defect structure and porosity of nanofiber scaffolds. The polymer base was characterized by the presence of nanopores. The MXene surface layers had abundant vacancies at temperatures of 305-355 K, and a voltage resonance at 8 × 104 Hz with the relaxation time of 6.5 × 106 s was found in the 20-355 K temperature interval. The appearance of a long-lived component of the positron lifetime was observed, which was dependent on the annealing temperature. The study of conductivity of the composite scaffolds in a wide temperature range, including its inductive and capacity components, showed the possibility of the use of MXene-coated PCL membranes as conductive biomaterials. The electronic structure of MXene and the defects formed in its layers were correlated with the biological properties of the scaffolds in vitro and in bacterial adhesion tests. Double and triple MXene coatings formed an appropriate environment for cell attachment and proliferation with mild antibacterial effects. A combination of structural, chemical, electrical, and biological properties of the PCL-MXene composite demonstrated its advantage over the existing conductive scaffolds for tissue engineering.

Electroactive injectable hydrogel based on oxidized sodium alginate and carboxymethyl chitosan for wound healing

Electroactive hydrogel is of great significance in restoring wound currents, promoting cell proliferation, and accelerating the wound healing process. However, the poor dispersity and underlying toxicity of electronic conductive fillers and high concentration of ionic conductors in traditional electroactive hydrogel limited its application in medical care. Herein, an electroactive oxidized sodium alginate/carboxymethyl chitosan/silver nanoparticles (OSA/CMCS/AgNPs) hydrogel was constructed with no additional conductive fillers or synthesized conductive polymers being added, in which the dynamic imine bonds were rapidly formed between aldehyde groups in OSA and amino groups in CMCS, and AgNPs were further in situ formed by UV irradiation. The electroactive hydrogel exhibited the injectable property, strong self-healing ability, excellent biocompatibility, and high antibacterial activities. Moreover, the electroactive hydrogel can significantly promote the proliferation of L929 cells under electrical stimulation. Furthermore, the electroactive hydrogel was proved to significantly accelerate the wound healing process in the full-thickness skin defect model, exhibiting anti-inflammation, promoting the fibroblasts proliferation, angiogenesis, and collagen deposition under electrical stimulation. In summary, the current work explored a novel strategy to construct the polysaccharides-based electroactive hydrogel with good biocompatibility and multi-functions, which is promising to be used in deep wound treatment.

Polysaccharide-Based Multifunctional Hydrogel Bio-Adhesives for Wound Healing: A Review

Wound healing is a long-term and complex biological process that involves multiple hemostasis, inflammation, proliferation, and remodeling stages. In order to realize comprehensive and systematic wound management, appropriate wound treatment bio-adhesives are urgently needed. Hydrogel bio-adhesives have excellent properties and show unique and remarkable advantages in the field of wound management. This review begins with a detailed description of the design criteria and functionalities of ideal hydrogel bio-adhesives for wound healing. Then, recent advances in polysaccharide-based multifunctional hydrogel bio-adhesives, which involve chitosan, hyaluronic acid, alginate, cellulose, dextran, konjac glucomannan, chondroitin sulfate, and other polysaccharides, are comprehensively discussed. Finally, the current challenges and future research directions of polysaccharide-based hydrogel bio-adhesives for wound healing are proposed to stimulate further exploration by researchers.

Antibacterial, Adhesive, and Conductive Hydrogel for Diabetic Wound Healing

Diabetic mellitus is one of the leading causes of chronic wounds and remains a challenging issue to be resolved. Herein, a hydrogel with conformal tissue adhesivity, skin-like conductivity, robust mechanical characteristics, as well as active antibacterial function is developed. In this hydrogel, silver nanoparticles decorated polypyrrole nanotubes (AgPPy) and cobalt ions (Co²⁺ ) are introduced into an in situ polymerized poly(acrylic acid) (PAA) and branched poly(ethylenimine) (PEI) network (PPCA hydrogel). The PPCA hydrogel provides active antibacterial function through synergic effects from protonated PEI and AgPPy nanotubes, with a tissue-like mechanical property (≈16.8 ± 4.5 kPa) and skin-like electrical conductivity (≈0.048 S m^-1 ). The tensile and shear adhesive strength (≈15.88 and ≈12.76 kPa, respectively) of the PPCA hydrogel is about two- to threefold better than that of fibrin glue. In vitro studies show the PPCA hydrogel is highly effective against both gram-positive and gram-negative bacteria. In vivo results demonstrate that the PPCA hydrogel promotes diabetic wounds with accelerated healing, with notable inflammatory reduction and prominent angiogenesis regeneration. These results suggest the PPCA hydrogel provide a promising approach to promote diabetic wound healing.

Pulse Capacitive Coupling Electric Field Regulates Cell Migration, Proliferation, Polarization, and Vascularization to Accelerate Wound Healing

Objectives: Accelerating wound healing using continuous exogenous electrical stimulation is limited due to some serious side effects, including thermal damage. Many previous studies based on direct current contact stimulation may cause chemical burns or blisters, thereby increasing patients suffering. The aim of this study was to develop a safer and more convenient pulse capacitive coupling electrical field (PCCEF) stimulation to accelerate wound healing. Approach: A PCCEF-generating platform was self-designed to facilitate wound healing. The promoting effects and appropriate pulse width were explored by applying PCCEFs (54 mV/mm, 60 Hz) of different pulse widths to various cells involved in wound healing and mouse models for 2 h daily. Results: PCCEFs of ≥10 μs pulse width showed marked promotion of the migration and proliferation of human dermal fibroblasts and HaCaT cells, enhanced the M2-type polarization and YPA/TAZ expression of macrophages, and facilitated the wound healing of mouse models. Comprehensive histological results suggested that PCCEF of 100 μs pulse width exerted the most positive effects. Innovation: A safe and effective PCCEF was developed to promote wound healing, which prevented prolonged stimulation and averted direct contact. Conclusion: PCCEF accelerated wound healing, especially at the optimal 100 μs pulse width, and was expected to be translated to clinical application, helping alleviate patient suffering, while reducing side effects.

Elastic Fibers/Fabrics for Wearables and Bioelectronics

Wearables and bioelectronics rely on breathable interface devices with bioaffinity, biocompatibility, and smart functionality for interactions between beings and things and the surrounding environment. Elastic fibers/fabrics with mechanical adaptivity to various deformations and complex substrates, are promising to act as fillers, carriers, substrates, dressings, and scaffolds in the construction of biointerfaces for the human body, skins, organs, and plants, realizing functions such as energy exchange, sensing, perception, augmented virtuality, health monitoring, disease diagnosis, and intervention therapy. This review summarizes and highlights the latest breakthroughs of elastic fibers/fabrics for wearables and bioelectronics, aiming to offer insights into elasticity mechanisms, production methods, and electrical components integration strategies with fibers/fabrics, presenting a profile of elastic fibers/fabrics for energy management, sensors, e-skins, thermal management, personal protection, wound healing, biosensing, and drug delivery. The trans-disciplinary application of elastic fibers/fabrics from wearables to biomedicine provides important inspiration for technology transplantation and function integration to adapt different application systems. As a discussion platform, here the main challenges and possible solutions in the field are proposed, hopefully can provide guidance for promoting the development of elastic e-textiles in consideration of the trade-off between mechanical/electrical performance, industrial-scale production, diverse environmental adaptivity, and multiscenario on-spot applications.

Advanced Multifunctional Wound Dressing Hydrogels as Drug Carriers

Skin injuries, especially chronic wounds, remain a significant healthcare system problem. The number of burns, diabetic patients, pressure ulcers, and other damages is also growing, particularly in elderly populations. Several investigations are pursued in designing more effective therapeutics for treating different wound injuries. These efforts have resulted in developing multifunctional wound dressings to improve wound repair. For this, preparing multifunctional dressings using various methods has provided a new attitude to support effective skin regeneration. This review focuses on the recent developments in designing multifunctional hydrogel dressings with hemostasis, adhesiveness, antibacterial, and antioxidant properties.

Multifunctional GO Hybrid Hydrogel Scaffolds for Wound Healing

Hydrogel dressings have received extensive attention for the skin wound repair, while it is still a challenge to develop a smart hydrogel for adapting the dynamic wound healing process. Herein, we develop a novel graphene oxide (GO) hybrid hydrogel scaffold with adjustable mechanical properties, controllable drug release, and antibacterial behavior for promoting wound healing. The scaffold was prepared by injecting benzaldehyde and cyanoacetate group-functionalized dextran solution containing GO into a collection pool of histidine. As the GO possesses obvious photothermal behavior, the hybrid hydrogel scaffold exhibited an obvious stiffness decrease and effectively promoted cargo release owing to the breaking of the thermosensitive C=C double bond at a high temperature under NIR light. In addition, NIR-assisted photothermal antibacterial performance of the scaffold could be also achieved with the local temperature rising after irradiation. Therefore, it is demonstrated that the GO hybrid hydrogel scaffold with vascular endothelial growth factor (VEGF) encapsulation can achieve the adjustable mechanical properties, photothermal antibacterial, and angiogenesis during the wound healing process. These features indicated that the proposed GO hybrid hydrogel scaffold is potentially valuable for promoting wound healing and other biomedical application.

Antibacterial Conductive UV-Blocking Adhesion Hydrogel Dressing with Mild On-Demand Removability Accelerated Drug-Resistant Bacteria-Infected Wound Healing

The on-demand replacement of multifunctional hydrogel wound dressings helps to avoid bacterial colonization, and the on-demand painless peeling of tissue adhesive hydrogels on the wound site remains a major challenge to be solved. In this work, we design and develop a series of multifunctional dynamic Schiff base network hydrogels composed of cystamine-modified hyaluronic acid, benzaldehyde-functionalized poly(ethylene glycol)-co-poly(glycerol sebacate), and polydopamine@polypyrrole nanocomposite (PDA@PPy) with mild on-demand removability to enhance drug-resistant bacteria-infected wound healing. These hydrogels exhibited ideal injectable and self-healing properties, excellent tissue adhesion, in vivo hemostasis, good antioxidation, and conductivity. PDA@PPy inspired by melanin endows hydrogels with excellent antioxidant capacity, UV-blocking ability, and photothermal anti-infection ability. Based on the dynamic oxidation-reduction response of disulfide bonds inspired by the dissociation of the tertiary spatial structure transformation of poly-polypeptide chains, these hydrogels can achieve rapid painless on-demand removal under mild conditions by adding dithiothreitol. These multifunctional hydrogels significantly promoted collagen deposition and angiogenesis in the MRSA-infected full-thickness skin repair experiment. All the results showed that these multifunctional hydrogels with painless on-demand removal property showed great potential in clinical treatment of infected wounds.

A smart hydrogel patch with high transparency, adhesiveness and hemostasis for all-round treatment and glucose monitoring of diabetic foot ulcers

The treatment and management of diabetic foot ulcers (DFUs) is a pretty intractable problem for clinical nursing. Urgently, the "Black Box" status of the healing process prevents surgeons from providing timely analysis for more effective diagnosis and therapy of the wound. Herein, we designed a transparent monitoring system to treat and manage the DFUs with blood oozing and hard-healing, which resolved the problem of blind management for the other conductive patches. This system was prepared from a conductive hydrogel patch with ultra-high transparence (up to 93.6%), adhesiveness and hemostasis, which is engineered by assembling in situ formed poly(tannic acid) (PTA)-doped polypyrrole (PPy) nanofibrils in the poly(acrylamide-acrylated adenine) (P(AM-Aa)) polymer networks. Significantly, the high transparent conductive hydrogel patch can monitor the wound-healing status visually and effectively promote the healing of DFUs by accelerating hemostasis, improving communication between cells, preventing wound infection, facilitating collagen deposition, and promoting angiogenesis. In addition, the versatile hydrogel patch could realize indirect blood glucose monitoring by detecting the glucose levels on wounds, and further sense the movements with different magnitudes of human body timely. This research may provide a novel strategy in the design of chronic wound dressings for monitoring and treating the wounds synergistically.

Pressure-sensitive antibacterial hydrogel dressing for wound monitoring in bed ridden patients

Pressure ulcer is a common chronic injury in the bedridden population. The wound is easily subjected to secondary pressure injury due to the inconvenient mobility of patients, which greatly prolongs the hospital stay of patients and is highly prone to wound infection or other complications. It is urgent to develop a multifunctional wound dressing with pressure sensing, real-time monitoring, and wound therapy to overcome the secondary pressure injury during treatment. Here, a polyvinyl alcohol/acrylamide-ionic liquid hydrogel dressing is designed based on the antibacterial property and electrical conductivity of imidazolidine ionic liquids. Compared with existing pressure-sensing hydrogels, the hydrogel exhibits extremely high pressure sensitivity (9.19 kPa^-1). Meanwhile, the good real-time responsiveness, stable signal output as well as excellent mechanical properties enable the hydrogel to monitor human movement on a large scale, and transmit the pressure status of patient wounds to nursing staff in a timely manner to avoid secondary pressure injuries. In addition, this hydrogel dressing exhibits a wide range of antibacterial activities against Gram-negative and Gram-positive bacteria as well as fungi, and has a significant therapeutic effect on full-thickness skin wounds by inhibiting wound infection, rapidly eradicating inflammation, promoting proliferation and tissue remodeling. This multifunctional hydrogel dressing opens a therapeutic and regulatory two-pronged strategy avenue through chronic wound management and pressure sensing monitoring.

Influence of Electric Field on Proliferation Activity of Human Dermal Fibroblasts

In this work, an electrically conductive composite based on thermoplastic polyimide and graphene was obtained and used as a bioelectrode for electrical stimulation of human dermal fibroblasts. The values of the electrical conductivity of the obtained composite films varied from 10−15 to 102 S/m with increasing graphene content (from 0 to 5.0 wt.%). The characteristics of ionic and electronic currents flowing through the matrix with the superposition of cyclic potentials ± 100 mV were studied. The high stability of the composite was established during prolonged cycling (130 h) in an electric field with a frequency of 0.016 Hz. It was established that the composite films based on polyimide and graphene have good biocompatibility and are not toxic to fibroblast cells. It was shown that preliminary electrical stimulation increases the proliferative activity of human dermal fibroblasts in comparison with intact cells. It is revealed that an electric field with a strength E = 0.02–0.04 V/m applied to the polyimide films containing 0.5–3.0 wt.% of the graphene nanoparticles activates cellular processes (adhesion, proliferation).

Recent Development of Conductive Hydrogels for Tissue Engineering: Review and Perspective

In recent years, tissue engineering techniques have been rapidly developed and offer a new therapeutic approach to organ or tissue damage repair. However, most of tissue engineering scaffolds are nonconductive and cannot establish effective electrical coupling with tissue for the electroactive tissues. Electroconductive hydrogels (ECHs) have received increasing attention in tissue engineering owing to their electroconductivity, biocompatibility and high water content. In vitro, ECHs can not only promote the communication of electrical signals between cells, but also mediate the adhesion, proliferation, migration, and differentiation of different kinds of cells. In vivo, ECHs can transmit the electric signal to electroactive tissues and activate bioelectrical signaling pathways to promote tissue repair. As a result, implanting ECHs into damaged tissues can effectively reconstruct physiological functions related to electrical conduction. In this review, we first present an overview about the classifications and the fabrication methods of ECHs. And then, the applications of ECHs in tissue engineering, including cardiac, nerve, skin and skeletal muscle tissue, are highlighted. At last, we provide some rational guidelines for designing ECHs towards clinical applications. This article is protected by copyright. All rights reserved.

Accelerated Skin Wound Healing Using Flexible Photovoltaic-Bioelectrode Electrical Stimulation

Owing to the complex and long-term treatment of foot wounds due to diabetes and the limited mobility of patients, advanced clinical surgery often uses wearable flexible devices for auxiliary treatment. Therefore, there is an urgent need for self-powered biomedical devices to reduce the extra weight. We have prepared an electrically stimulated MEMS (Micro Electromechanical System) electrode integrated with wearable OPV (Organic photovoltaic). The wearable OPV is constructed of a bio-affinity PET-ITO substrate and a hundred-nanometer organic layer. Under sunlight and near-infrared light irradiation, a voltage and current are supplied to the MEMS electrode to generate an exogenous lateral electric field directed to the center of the wound. The results of in vitro cell experiments and diabetic skin-relieving biological experiments showed the proliferation of skin fibroblasts and the expression of transforming growth factors increased, and the skin wounds of diabetic mouse healed faster. Our research provides new insights for the clinical treatment of diabetes.

A healing promoting wound dressing with tailor-made antibacterial potency employing piezocatalytic processes in multi-functional nanocomposites

Developing a novel antibiotics-free antibacterial strategy is essential for minimizing bacterial resistance. Materials that not only kill bacteria but also promote tissue healing are especially challenging to achieve. Inspired by chemical conversion processes in living organisms, we develop a piezoelectrically active antibacterial device that converts ambient O₂ and H₂O to ROS by piezocatalytic processes. The device is achieved by mounting nanoscopic polypyrrole/carbon nanotube catalyst multilayers onto piezoelectric-dielectric films. Under stimuli by a hand-held massage device, the sterilizing rates for S. aureus and E. coli reach 84.11% and 94.85% after 10 minutes of operation, respectively. The antibacterial substrate at the same time preserves and releases drugs and presents negligible cytotoxicity. Animal experiments demonstrate that daily treatment for 10 minutes using the device effectively accelerates the healing of infected wounds on the backs of mice, promoting hair follicle generation and collagen deposition. We believe that this report provides a novel design approach for antibacterial strategies in medical treatment.

Development of Porous Polyvinyl Acetate/Polypyrrole/Gallic Acid Scaffolds Using Supercritical CO2 as Tissue Regenerative Agents

Scaffolds are advanced devices employed in tissue engineering, as they are intended to mimic the characteristics of extracellular matrices. In this respect, conjugated materials are gaining relevance in the manufacturing of the foams used for therapeutic scaffolds, since they can provide certain properties that are missing in the other polymers used to form the scaffolds. This work has, therefore, focused on the development of functional scaffolds formed by conjugated-non-conjugated polymers such as polyvinyl acetate and polypyrrole, impregnated with gallic acid as the model drug and produced by means of a supercritical CO₂ foaming/impregnation process. The effects from a series of parameters such as pressure, temperature, depressurization rate, and contact time of the scaffold production process have been determined. The impregnated foams have been characterized according to their morphology, including their porosity and expansion factor, their drug loading and delivering capabilities, and their mechanical and electrical properties. The characterization of the experiments was carried out using scanning electron microscopy, liquid displacement, in vitro release, electrochemical impedance spectroscopy, and compression techniques. The results from our tests have revealed a considerable influence of all the input variables studied, as well as relevant interactions between them. Values close to 35% porosity were obtained, with a drug release of up to 10 h with a fast initial release. The best operating conditions were 353 K, 30 MPa, 0.5 MPa/min depressurization rate, and 1 h contact time. By means of the supercritical foaming/impregnation technique, scaffolds with potential in tissue engineering due to their studied properties were obtained.

3D Printed Graphene-PLA Scaffolds Promote Cell Alignment and Differentiation

Traumas and chronic damages can hamper the regenerative power of nervous, muscle, and connective tissues. Tissue engineering approaches are promising therapeutic tools, aiming to develop reliable, reproducible, and economically affordable synthetic scaffolds which could provide sufficient biomimetic cues to promote the desired cell behaviour without triggering graft rejection and transplant failure. Here, we used 3D-printing to develop 3D-printed scaffolds based on either PLA or graphene@PLA with a defined pattern. Multiple regeneration strategies require a specific orientation of implanted and recruited cells to perform their function correctly. We tested our scaffolds with induced pluripotent stem cells (iPSC), neuronal-like cells, immortalised fibroblasts and myoblasts. Our results demonstrated that the specific “lines and ridges” 100 µm-scaffold topography is sufficient to promote myoblast and fibroblast cell alignment and orient neurites along with the scaffolds line pattern. Conversely, graphene is critical to promote cells differentiation, as seen by the iPSC commitment to neuroectoderm, and myoblast fusions into multinuclear myotubes achieved by the 100 µm scaffolds containing graphene. This work shows the development of a reliable and economical 3D-printed scaffold with the potential of being used in multiple tissue engineering applications and elucidates how scaffold micro-topography and graphene properties synergistically control cell differentiation.

Rational Design and Preparation of Functional Hydrogels for Skin Wound Healing

Skin wound healing often contains a series of dynamic and complex physiological healing processes. It is a great clinical challenge to effectively treat the cutaneous wound and regenerate the damaged skin. Hydrogels have shown great promise for skin wound healing through the rational design and preparation to endow with specific functionalities. In the mini review, we firstly introduce the design and construction of various types of hydrogels based on their bonding chemistry during cross-linking. Then, we summarize the recent research progress on the functionalization of bioactive hydrogel dressings for skin wound healing, including anti-bacteria, anti-inflammatory, tissue proliferation and remodeling. In addition, we highlight the design strategies of responsive hydrogels to external physical stimuli. Ultimately, we provide perspectives on future directions and challenges of functional hydrogels for skin wound healing.