Chitosan-Based Hydrogels for Infected Wound Treatment

A chitosan/gelatin/aldehyde hyaluronic acid hydrogel coating releasing calcium ions and vancomycin in pH response to prevent the formation of bacterial biofilm

Osteomyelitis is a refractory disease of orthopedics, part of which is caused by medical implants. The main difficulties in treatment are the barrier effect after the formation of bacterial biofilm, and the difficulty in achieving sustained antibiotic intervention. In view of this situation, we studied a hydrogel coating that can release CaCl2 and vancomycin in pH-responsive manner. We used nano-TiO2 to modify Chitosan/ Gelatin/Aldehyde Hyaluronic Acid (CS/Gel/AHA) hydrogel, and combined with the dip-coating technique, prepared a coating with good mechanical strength. The hydrogel-loaded zeolitic imidazolate framework (ZIF) decomposes under acidic conditions, and the released Ca2+ act on the bacterial Bap protein to inhibit the formation of biofilm, and the released vancomycin kills free bacteria. The antibacterial coating achieved good bactericidal effect in both in vitro experiments and rat subcutaneous implant model. These results not only provide a new way to enhance the strength of hydrogels to prepare coatings, but also utilize a new approach to responsively inhibit the formation of biofilms, showing the promising application prospects of the coating in antibacterial treatment of medical implants.

Chitosan-Electrospun Fibers Encapsulating Norfloxacin: The Impact on the Biochemical, Oxidative and Immunological Profile in a Rats Burn Model

This study investigates the impact of chitosan-based nanofibers on burn wound healing in a rat model. Two formulations of chitosan nanofibers were prepared through electrospinning. The formulations were then incorporated with different amounts of norfloxacin and underwent surface modifications with 2-formylphenylboronic acid. The burn model was applied to Wistar male rats by the contact method, using a heated steel rod attached to a thermocouple. The effectiveness of the nanofibers was tested against a negative control group and a standard commercial dressing (Atrauman Ag) on the described model and evaluated by wound diameter, histological analysis and biochemical profiling of systemic inflammatory markers. The results showed that chitosan-based dressings significantly accelerated burn healing compared to the control treatments. The high-concentration norfloxacin-infused chitosan coated with 2-formylphenylboronic acid' groups exhibited significant improvements in wound closure and reduced inflammation compared to the other groups; antioxidant enzymes SOD and GPx expression was significantly higher, p < 0.05, whereas pro-oxidative markers such as cortisol were lower (p < 0.05). Macroscopically, the wound area itself was significantly diminished in the chitosan-treated groups (p < 0.05). Furthermore, a histological evaluation indicated enhanced epithelialization and granulation tissue formation within the experiment time frame, while the biochemical panel revealed lower levels of inflammatory cytokines and lower leukocyte counts in the treated groups. These findings highlight the potential of the studied chitosan nanofibers as novel nanosystems for next-generation wound therapies, as well as the clinical utility of the novel chitosan fibers obtained by electrospinning technique.

Nursing bibliometric analysis of wound infections

BACKGROUND

This paper aims to perform a bibliometric analysis of research pertaining to the nursing care of infected wounds. It also aims to examine the current focal points and trends in research development. The paper offers research references that may be useful for practitioners interested in related areas.

METHODS

The Web of Science Core Collection database was queried for publications pertaining to infected wound care. Publication trends and proportions were analyzed using Graphpad Prism v8.0.2. CiteSpace (6.2.4R [64-bit]) and VOSviewer (version 1.6.18) were employed to assess the literature and conduct mapping.

RESULTS

The Web of Science Core Collection database contains 3868 literature related to wound infection care, including 3327 articles and 541 reviews. The literature concerned 117 countries and territories, 4673 institutions, and 20,161 authors. The growth rate of literature was relatively slow before 2015 and markedly accelerated after 2016. Among them, the United States occupies the absolute dominance in research in this field, publishing 37.25% of the papers, and the United States occupies 8 of the top 10 scientific institutions that publish papers. The University of Harvard has published the largest number of papers. Keyword analysis shows a total of 1125 keywords, and through reference literature and time clustering analysis shows that wound healing, sepsis, spine surgery, postoperative infection, nanocrystalline silver, beta lactamase are the current research hotspots.

CONCLUSION

The escalating rate of literary expansion since 2016 suggests that this domain is garnering an increasingly significant amount of interest. Minimizing the risk of patient wound infection is crucial in reducing patients' discomfort and facilitating their prompt recovery. The literature analysis presented in this study serves as a valuable resource for comprehending the current state of the subject and identifying the current areas of focus.

Semi-Interpenetrating Hydrogel with Long-Term Intrinsic Antibacterial Properties Promotes Healing of Infected Wounds In Vivo

Bacterial infections significantly deteriorate the process of wound healing. The wound dressings loaded with antimicrobials are widely used to reduce bacterial infections. However, release-based sterilization may increase the risk of drug resistance of bacteria and complicate translation. Thus, the development of long-term intrinsic antibacterial wound dressings is highly desirable. In this study, an intrinsic antibacterial hydrogel (PVA/PPG-HBPL) consisting of poly(vinyl alcohol) (PVA), poly(polyethylene glycol methyl ether methacrylate-co-glycidyl methacrylate) (PPG), and hyperbranched poly-l-lysine (HBPL) was designed and fabricated. The mechanical properties of the PVA/PPG-HBPL hydrogel were enhanced by hydrogen bonding and semi-interpenetrating networks. It also possessed a favorable ability to absorb the wound exudates. The release of antibacterial HBPL was significantly decreased by the methods of cyclic freeze-thawing and covalent cross-linking during hydrogel fabrication, enabling the PVA/PPG-HBPL hydrogel with intrinsic and long-term antibacterial performance. The PVA/PPG-HBPL hydrogel dressing killed 99.9% of methicillin-resistant Staphylococcus aureus (MRSA) cultured on its surface without observable cytotoxicity in vitro. It observably shortened the healing process by 2 orders of magnitude of MRSA colonies compared with the control in the MRSA-infected full-thickness skin wound of rats in vivo even after being soaked in phosphate-buffered saline (PBS) for 21 days (PBS was changed every 3 days). The antibacterial hydrogels could kill wound bacteria in a timely manner, significantly reduce inflammatory cell infiltration, and promote neovascularization and collagen deposition.

Synthesis and synergistic antibacterial efficiency of chitosan-copper oxide nanocomposites

Copper and chitosan are used for biomedical applications due to their antimicrobial properties. In this study, a facile method for the synthesis of chitosan-copper oxide nanocomposites (nCuO-CSs) was modified, yielding stable colloidal nCuO-CSs suspensions. Using this method, nCuO-CSs with different copper-to-chitosan (50-190 kDa) weight ratios (1:0.3, 1:1, 1:3) were synthesized, their physicochemical properties characterized, and antibacterial efficacy assessed against Gram-negative Escherichia coli and Pseudomonas aeruginosa, and Gram-positive Staphylococcus aureus. The nCuO-CSs with a primary size of ∼10 nm and a ζ-potential of >+40 mV proved efficient antibacterials, acting at concentrations around 1 mg Cu/L. Notably, against Gram-negative bacteria, this inhibitory effect was already evident after a 1-h exposure and surpassed that of copper ions, implying to a synergistic effect of chitosan and nano-CuO. Indeed, using flow cytometry and confocal laser scanning microscopy, we showed that chitosan promoted interaction between the nCuO-CSs and bacterial cells, facilitating the shedding of copper ions in the close vicinity of the cell surface. The synergy between copper and chitosan makes these nanomaterials promising for biomedical applications (e.g., wound dressings).

Highly Compressible, Superabsorbent, and Biocompatible Hybrid Cryogel Constructs Comprising Functionalized Chitosan and St. John's Wort Extract

Biobased porous hydrogels enriched with phytocompounds-rich herbal extracts have aroused great interest in recent years, especially in healthcare. In this study, new macroporous hybrid cryogel constructs comprising thiourea-containing chitosan (CSTU) derivative and a Hypericum perforatum L. extract (HYPE), commonly known as St John's wort, were prepared by a facile one-pot ice-templating strategy. Benefiting from the strong interactions between the functional groups of the CSTU matrix and those of polyphenols in HYPE, the hybrid cryogels possess excellent liquid absorption capacity, mechanical resilience, antioxidant performance, and a broad spectrum of antibacterial activity simultaneously. Thus, owing to their design, the hybrid constructs exhibit an interconnected porous architecture with the ability to absorb over 33 and 136 times their dry weight, respectively, when contacted with a phosphate buffer solution (pH 7.4) and an acidic aqueous solution (pH 2). These cryogel constructs have extremely high compressive strengths ranging from 839 to 1045 kPa and withstand elevated strains of over 70% without developing fractures. Moreover, the water-swollen hybrid cryogels with the highest HYPE content revealed a complete and instant shape recovery after uniaxial compression. The incorporation of HYPE into CSTU cryogels enabled substantial improvement in scavenging reactive oxygen species and an expanded antibacterial spectrum toward multiple pathogens, including Gram-positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis), Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa), and fungi (Candida albicans). Cell viability experiments demonstrated the cytocompatibility of the 3D cryogel constructs, which did not induce changes in the fibroblast morphology. This work showcases a simple and effective strategy to immobilize HYPE extracts on CSTU 3D networks, allowing the development of novel multifunctional platforms with promising potential in hemostasis, wound dressing, and dermal regeneration scaffolds.

Advances and Challenges in Immune-Modulatory Biomaterials for Wound Healing Applications

Wound healing progresses through three distinct stages: inflammation, proliferation, and remodeling. Immune regulation is a central component throughout, crucial for orchestrating inflammatory responses, facilitating tissue repair, and restraining scar tissue formation. Elements such as mitochondria, reactive oxygen species (ROS), macrophages, autophagy, ferroptosis, and cytokines collaboratively shape immune regulation in this healing process. Skin wound dressings, recognized for their ability to augment biomaterials' immunomodulatory characteristics via antimicrobial, antioxidative, pro- or anti-inflammatory, and tissue-regenerative capacities, have garnered heightened attention. Notwithstanding, a lack of comprehensive research addressing how these dressings attain immunomodulatory properties and the mechanisms thereof persists. Hence, this paper pioneers a systematic review of biomaterials, emphasizing immune regulation and their underlying immunological mechanisms. It begins by highlighting the importance of immune regulation in wound healing and the peculiarities and obstacles faced in skin injury recovery. This segment explores the impact of wound metabolism, infections, systemic illnesses, and local immobilization on the immune response during healing. Subsequently, the review examines a spectrum of biomaterials utilized in skin wound therapy, including hydrogels, aerogels, electrospun nanofiber membranes, collagen scaffolds, microneedles, sponges, and 3D-printed constructs. It elaborates on the immunomodulatory approaches employed by these materials, focusing on mitochondrial and ROS modulation, autophagic processes, ferroptosis, macrophage modulation, and the influence of cytokines on wound healing. Acknowledging the challenge of antibiotic resistance, the paper also summarizes promising plant-based alternatives for biomaterial integration, including curcumin. In its concluding sections, the review charts recent advancements and prospects in biomaterials that accelerate skin wound healing via immune modulation. This includes exploring mitochondrial transplantation materials, biomaterial morphology optimization, metal ion incorporation, electrostimulation-enabled immune response control, and the benefits of composite materials in immune-regulatory wound dressings. The ultimate objective is to establish a theoretical foundation and guide future investigations in the realm of skin wound healing and related materials science disciplines.

Biomedical Trends in Stimuli-Responsive Hydrogels with Emphasis on Chitosan-Based Formulations

Biomedicine is constantly evolving to ensure a significant and positive impact on healthcare, which has resulted in innovative and distinct requisites such as hydrogels. Chitosan-based formulations stand out for their versatile utilization in drug encapsulation, transport, and controlled release, which is complemented by their biocompatibility, biodegradability, and non-immunogenic nature. Stimuli-responsive hydrogels, also known as smart hydrogels, have strictly regulated release patterns since they respond and adapt based on various external stimuli. Moreover, they can imitate the intrinsic tissues' mechanical, biological, and physicochemical properties. These characteristics allow stimuli-responsive hydrogels to provide cutting-edge, effective, and safe treatment. Constant progress in the field necessitates an up-to-date summary of current trends and breakthroughs in the biomedical application of stimuli-responsive chitosan-based hydrogels, which was the aim of this review. General data about hydrogels sensitive to ions, pH, redox potential, light, electric field, temperature, and magnetic field are recapitulated. Additionally, formulations responsive to multiple stimuli are mentioned. Focusing on chitosan-based smart hydrogels, their multifaceted utilization was thoroughly described. The vast application spectrum encompasses neurological disorders, tumors, wound healing, and dermal infections. Available data on smart chitosan hydrogels strongly support the idea that current approaches and developing novel solutions are worth improving. The present paper constitutes a valuable resource for researchers and practitioners in the currently evolving field.

Entrapment of Papain in Chitosan-Polyethylene Glycol Hybrid Nanohydrogels: Presenting a Model for Protein Delivery Systems

In this study, the process of manufacturing nanohydrogels containing papain and how to release it was investigated. Chitosan nanohydrogels and chitosan-polyethylene glycol hybrid nanohydrogels were used to entrapment of papain as a protein model. In order to evaluate and confirm different properties of nanohydrogels such as size, shape, the rate of swelling and flexibility, different methods was used. The maximum amount of papain entrapment was observed in 0.75% concentration of chitosan and 1% concentration of sodium Tripolyphosphate (TPP) as linker. The results of scanning electron microscope (SEM) and X-ray diffraction (XRD) patterns showed that nanohydrogels containing papain on a nano scale are very porous and swollen. Differential scanning calorimetry (DSC) thermograms analysis showed that nanohydrogels have relatively good water absorption capacity. Also, by adding polyethylene glycol to chitosan, the melting temperature of hybrid nanohydrogels decreased and this can be a reason for the formation of flexible structures in these nanohydrogels. In chitosan nanohydrogels, the highest release rate of papain was observed at pH lower than 7 and high temperatures, but by adding polyethylene glycol to the chitosan, in addition to increasing papain release, a proper and continuous release of papain was observed at temperature and pH close to physiological conditions, especially at low ratios of polyethylene glycol. According to the present results, hybrid nanohydrogels can have a good potential in protein delivery systems in terms of structure and release.

Multifunctional polydopamine/hemin-cyclodextrin reinforced chitosan nanocomposite hydrogel: A synergistic platform for wound healing

Chronic cutaneous wounds present a significant challenge for healthcare providers globally, with the risk of bacterial infections emerging as a particularly concerning issue. There is an increasing need to employ a combination of diverse antibacterial strategies to address infections comprehensively in chronic wounds. This study introduces a highly efficient antibacterial platform that encapsulates the NO precursor (BNN6) into β-cyclodextrin-modified hemin-bearing polydopamine nanoparticles called NO/CHPDA. These nanoparticles are seamlessly integrated into a hydrogel composite comprised of L-arginine grafted chitosan (Arg-CS) and oxide dextrans (oDex). The amalgamation of photothermal therapy (PTT), chemodynamic therapy (CDT), and nitric oxide (NO) antibacterial strategies within the NO/CHPDA@Arg-CS/oDex nanocomposite hydrogel demonstrates a synergistic and highly effective capacity to eradicate bacteria and accelerate the wound healing process in vivo. Remarkably, this nanocomposite hydrogel maintains excellent biocompatibility and induces minimal side effects. The resulting nanocomposite hydrogel represents a promising therapeutic solution for treating bacterial infections in wound healing applications.

Recent Advances of Chitosan-Based Hydrogels for Skin-Wound Dressings

The management of wound healing represents a significant clinical challenge due to the complicated processes involved. Chitosan has remarkable properties that effectively prevent certain microorganisms from entering the body and positively influence both red blood cell aggregation and platelet adhesion and aggregation in the bloodstream, resulting in a favorable hemostatic outcome. In recent years, chitosan-based hydrogels have been widely used as wound dressings due to their biodegradability, biocompatibility, safety, non-toxicity, bioadhesiveness, and soft texture resembling the extracellular matrix. This article first summarizes an overview of the main chemical modifications of chitosan for wound dressings and then reviews the desired properties of chitosan-based hydrogel dressings. The applications of chitosan-based hydrogels in wound healing, including burn wounds, surgical wounds, infected wounds, and diabetic wounds are then discussed. Finally, future prospects for chitosan-based hydrogels as wound dressings are discussed. It is anticipated that this review will form a basis for the development of a range of chitosan-based hydrogel dressings for clinical treatment.

Chitosan-Based Biomaterial in Wound Healing: A Review

Wound healing is an evolving and intricate technique that is vital to the restoration of tissue integrity and function. Over the past few decades, chitosan a biopolymer derived from chitin, became known as an emerging biomaterial in the field of healing wounds due to its distinctive characteristics including biocompatibility, biodegradability, affinity to biomolecules, and wound-healing activity. This natural polymer exhibits excellent healing capabilities by accelerating the development of new skin cells, reducing inflammation, and preventing infections. Due to its distinct biochemical characteristics and innate antibacterial activity, chitosan has been extensively researched as an antibacterial wound dressing. Chronic wounds, such as diabetic ulcers and liver disease, are a growing medical problem. Chitosan-based biomaterials are a promising solution in the domain of wound care. The article analyzes the depth of chitosan-based biomaterials and their impact on wound healing and also the methods to enhance the advantages of chitosan by incorporating bioactive compounds. This literature review is aimed to improve the understanding and knowledge about biomaterials and their use in wound healing.

Preparation, Characterization, and Anticancer Activity Assessment of Chitosan/TPP Nanoparticles Loaded with Echis carinatus Venom

AIMS AND BACKGROUND

Echis carinatus venom is a toxic substance naturally produced by special glands in this snake species. Alongside various toxic properties, this venom has been used for its therapeutic effects, which are applicable in treating various cancers (liver, breast, etc.).

OBJECTIVE

Nanotechnology-based drug delivery systems are suitable for protecting Echis carinatus venom against destruction and unwanted absorption. They can manage its controlled transfer and absorption, significantly reducing side effects.

METHODS

In the present study, chitosan nanoparticles were prepared using the ionotropic gelation method with emulsion cross-linking. The venom's encapsulation efficiency, loading capacity, and release rate were calculated at certain time points. Moreover, the nanoparticles' optimal formulation and cytotoxic effects were determined using the MTT assay.

RESULTS

The optimized nanoparticle formulation increases cell death induction in various cancerous cell lines. Moreover, chitosan nanoparticles loaded with Echis carinatus venom had a significant rate of cytotoxicity against cancer cells.

CONCLUSION

It is proposed that this formulation may act as a suitable candidate for more extensive assessments of cancer treatment using nanotechnology-based drug delivery systems.

Injectable, antibacterial, and oxygen-releasing chitosan-based hydrogel for multimodal healing of bacteria-infected wounds

Bacterial infection is one of the main challenges of wound healing. It imposes financial and healthcare costs. The emergence of antibiotic-resistant bacteria has increased concerns about this challenge, and made finding alternative solutions a crucial aim. We created a new, antibacterial, multifunctional hydrogel with synergistic chemodynamic and photothermal features for wound-healing applications. We fabricated a chitosan (CT)-based hydrogel containing tannic acid (TA), Fe, and MnO2 nanosheets (CT-TA-Fe-MnO2) via a simple method and characterized it. The antibacterial features (resulting from the production of reactive oxygen species within bacterial cells) and healing ability (via anti-inflammatory and hemostatic features) of the hydrogel were confirmed in vitro. In vivo results revealed the effectiveness of the CT-TA-Fe-MnO2 hydrogel in decreasing the hemostatic time, improving anti-inflammatory effects, and promoting wound healing during 14 days by enhancing the deposition and maturation of collagen fibers without affecting the vital organs. The fabricated CT-TA-Fe-MnO2 hydrogel could be a promising candidate with antibacterial and anti-inflammatory activities suitable for wound-healing applications.

Chitosan Hydrogels for Water Purification Applications

Chitosan-based hydrogels have gained significant attention for their potential applications in water treatment and purification due to their remarkable properties such as bioavailability, biocompatibility, biodegradability, environmental friendliness, high pollutants adsorption capacity, and water adsorption capacity. This article comprehensively reviews recent advances in chitosan-based hydrogel materials for water purification applications. The synthesis methods, structural properties, and water purification performance of chitosan-based hydrogels are critically analyzed. The incorporation of various nanomaterials into chitosan-based hydrogels, such as nanoparticles, graphene, and metal-organic frameworks, has been explored to enhance their performance. The mechanisms of water purification, including adsorption, filtration, and antimicrobial activity, are also discussed in detail. The potential of chitosan-based hydrogels for the removal of pollutants, such as heavy metals, organic contaminants, and microorganisms, from water sources is highlighted. Moreover, the challenges and future perspectives of chitosan-based hydrogels in water treatment and water purification applications are also illustrated. Overall, this article provides valuable insights into the current state of the art regarding chitosan-based hydrogels for water purification applications and highlights their potential for addressing global water pollution challenges.

Chitosan Hydrogel-Delivered ABE8e Corrects PAX9 Mutant in Dental Pulp Stem Cells

Hypodontia (dental agenesis) is a genetic disorder, and it has been identified that the mutation C175T in PAX9 could lead to hypodontia. Cas9 nickase (nCas9)-mediated homology-directed repair (HDR) and base editing were used for the correction of this mutated point. This study aimed to investigate the effect of HDR and the base editor ABE8e in editing PAX9 mutant. It was found that the chitosan hydrogel was efficient in delivering naked DNA into dental pulp stem cells (DPSCs). To explore the influence of the C175T mutation in PAX9 on the proliferation of DPSCs, hydrogel was employed to deliver PAX9 mutant vector into DPSCs, finding that the PAX9-containing C175T mutation failed to promote the proliferation of DPSCs. Firstly, DPSCs stably carrying PAX9 mutant were constructed. Either an HDR or ABE8e system was delivered into the above-mentioned stable DPSCs, and then the correction efficiency using Sanger sequencing and Western blotting was determined. Meanwhile, the ABE8e presented significantly higher efficiency in correcting C175T compared with HDR. Furthermore, the corrected PAX9 presented enhanced viability and differentiation capacity for osteogenic and neurogenic lineages; the corrected PAX9 even possessed extremely enhanced transcriptional activation ability. In summary, this study has powerful implications for studies into base editors, chitosan hydrogel, and DPSCs in treating hypodontia.