1
|
Liu B, Zhu X, Feng C, Huang J, Yan D, Wang B. Bacteriostatic effect of Ag@TiO 2-Poly(p-dioxanone)-coated gauzes in vitro and in vivo on otitis media pathogens. Heliyon 2023; 9:e19375. [PMID: 37681170 PMCID: PMC10480629 DOI: 10.1016/j.heliyon.2023.e19375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023] Open
Abstract
The application of packing agents affects the final surgical outcomes in treating otitis media (OM) and introduces the risk of infection. To decrease the infectious risks of packing agents and even introduce positive bacteriostatic functions, a kind of PPDO-grafted Ag-incorporated TiO2 nanoparticles (Ag@TiO2-PPDO NP)-coated gauzes were prepared by a solution immersion method. Morphologies and in vitro Ag+ releasing of Ag@TiO2-PPDO NP coated gauzes were determined by scanning electron microscope (SEM) and inductively coupled plasma-mass spectrum (ICP-Ms). Ag@TiO2-PPDO NP could respond to visible light, which might make Ag@TiO2-PPDO NP inhibit the proliferation of bacteria continually and positively with irradiation of visible light. Then the bacteriostatic effects of these gauzes on OM pathogens were investigated in vitro and in vivo. These gauzes could inhibit the proliferation of pathogenic Staphylococcus aureus (S. aureus) and Streptococcus pneumoniae (S. pneumoniae) in vitro and rat subcutaneous infection models. Specifically, the bacteriostatic effect of these gauzes on S. aureus and S. pneumoniae could be enhanced with irradiation by visible light in vitro. Further, the rat external auditory canal infection model verified the enhanced bacteriostatic effect of Ag@TiO2-PPDO-coated gauzes on S. aureus with irradiation by visible light. The Ag@TiO2-PPDO-coated gauzes are promising for packing materials after OM surgery and could reduce postoperative antibiotic requirements.
Collapse
Affiliation(s)
- Biyao Liu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College & School of Clinical Medicine, North Sichuan Medical College, China
| | - Xin Zhu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Chengmin Feng
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Jing Huang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College & School of Clinical Medicine, North Sichuan Medical College, China
| | - Dazhong Yan
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Bing Wang
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, 637000, China
| |
Collapse
|
2
|
Vishwanath N, Whitaker C, Allu S, Clippert D, Jouffroy E, Hong J, Stone B, Connolly W, Barrett CC, Antoci V, Born CT, Garcia DR. Silver as an Antibiotic-Independent Antimicrobial: Review of Current Formulations and Clinical Relevance. Surg Infect (Larchmt) 2022; 23:769-780. [PMID: 36178480 DOI: 10.1089/sur.2022.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The increase of multi-drug-resistant organisms has revived the use of silver as an alternative antibiotic-independent antimicrobial. Although silver's multimodal mechanism of action provides low risk for bacterial resistance, high local and uncontrolled concentrations have shown toxicity. This has resulted in efforts to develop novel silver formulations that are safer and more predictable in their application. Optimization of silver as an antimicrobial is crucial given the growing resistance profile against antibiotics. This article reviews formulations of silver used as antimicrobials, focusing on the mechanisms of action, potential for toxicity, and clinical applications. Methods: A search of four electronic databases (PubMed, Embase, MEDLINE, and Cochrane Library) was conducted for relevant studies up to January 2022. Searches were conducted for the following types of silver: ionic, nanoparticles, colloidal, silver nitrate, silver sulfadiazine, silver oxide, silver carboxylate, and AQUACEL® (ConvaTec, Berkshire, UK). Sources were compiled based on title and abstract and screened for inclusion based on relevance and study design. Results: A review of the antimicrobial activity and uses of ionic silver, silver nanoparticles, colloidal silver, silver nitrate, silver sulfadiazine, silver oxide, Aquacel, and silver carboxylate was conducted. The mechanisms of action, clinical uses, and potential for toxicity were studied, and general trends between earlier and more advanced formulations noted. Conclusions: Early forms of silver have more limited utility because of their uncontrolled release of silver ions and potential for systemic toxicity. Multiple new formulations show promise; however, there is a need for more prospective in vivo studies to validate the clinical potential of these formulations.
Collapse
Affiliation(s)
- Neel Vishwanath
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - Colin Whitaker
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Sai Allu
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Drew Clippert
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - Elia Jouffroy
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - James Hong
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - Benjamin Stone
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - William Connolly
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Caitlin C Barrett
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA
| | - Valentin Antoci
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Christopher T Born
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Dioscaris R Garcia
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA.,Brown University, Providence, Rhode Island, USA.,Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| |
Collapse
|
3
|
Lumintang L, Adnyana MS, Riasa INP, Asmarajaya AAGN, Hamid AR, Sanjaya H. A Systematic Review: Topical Sucralfate for Burn Wound. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Topical sucralfate has been used for burn and non-burn skin and mucosal lesion with remarkable results. The healing rate of mucosa is faster than skin lesion.
AIM: A current systematic review was conducted to objectively evaluate wound healing benefits of topical sucralfate for burn wound and to show on which degree of burn wound it works compare with another topical agents of burn wound therapy.
METHODS: Databases were searched for relevant studies: Google Scholar, PUBMED, and ProQuest. Data sources were searched using MeSH terms: “topical sucralfate” and “burn wound” for all publications up to December 2018. All English papers were included. Only studies performed in humans were included in this study. A total of 2437 publications were found, of which 3 studies met the inclusion criteria and were relevant to be used in this systematic review. The primary outcome was burn wound healing.
DATA EXTRACTION: Data from retrieved studies were reviewed and tabulated according to year of publication, study design, human or animal studies, characteristics of the population, and outcomes.
DATA SYNTHESIS: A total of 2 randomized controlled trials (RCTs) and 1 observational comparative study were found. All trials are on second degree burn wound patients. Jadad score was used to assess the methodological quality of the RCTs. One RCT and one comparative study demonstrated favorable outcomes with the use of topical sucralfate. There is one publication with no significant differences.
CONCLUSIONS: This systematic review shows a noticeably beneficial effect of topical sucralfate for burn wound. It is better than other topical agent in wound healing rate, decreased infection rate and enhancement of epithelialization also granulation with no local or systemic adverse reactions. However, multicenter RCT with larger sample size are needed to make recommendation for burn wound treatment.
Collapse
|
4
|
Tanideh N, Keshavarzi F, Hemat Zadeh A, Daneshi S, Koohi-Hosseinabadi O, Mokhtari M, Sedighi A, Asadi-Yousefabad SL. Healing Effects of Human Amniotic Membrane and Burned Wool on the Second-degree Burn in Rats. Galen Med J 2021; 9:e1759. [PMID: 34466588 PMCID: PMC8343904 DOI: 10.31661/gmj.v9i0.1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/03/2020] [Accepted: 02/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background: This study aimed to compare sheep burnt wool and human amniotic membrane (AM) on second-degree burn wound healing in rats. Materials and Methods: Seventy-two adult male rats of Sprague Dawley underwent general anesthesia, and a deep second-degree burn was created on their skin by a hot iron plate. Afterward, human AM, silver sulfadiazine ointment (SSD), and sheep burned wool were used on wound area for burn treatment. On days 7, 14, and 21 of the experiment, the rats were sacrificed, and histopathological assessments were done. Results: Human AM, in comparison with other groups, significantly (P<0.05) showed better improvement in all pathologic variables. Burned wool showed significant improvement compared to the control group on day 7 in the angiogenesis, on day 14 in granulation tissue formation and epithelial formation, and on day 21 in new epithelial formation (P<0.05). Burned wool compared with SSD ointment in granulation tissue formation improved significantly (P<0.05) on days 7 and 14. Also, SSD ointment in comparison with the control group significantly improved (P<0.05) granulation tissue formation and macrophage on day 7. Conclusion: Human AM has a significant effect on the treatment of second-degree burn. Burned wool has a better effect on wound healing than SSD ointment and negative control group without treatment in terms of granulation tissue and epithelium formation.
Collapse
Affiliation(s)
- Nader Tanideh
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farideh Keshavarzi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sajad Daneshi
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Maral Mokhtari
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Sedighi
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh-Leili Asadi-Yousefabad
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Correspondence to: Seyedeh-Leili Asadi-Yousefabad, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Telephone Number: +989171463825 Email Address:
| |
Collapse
|
5
|
Haidari H, Bright R, Strudwick XL, Garg S, Vasilev K, Cowin AJ, Kopecki Z. Multifunctional ultrasmall AgNP hydrogel accelerates healing of S. aureus infected wounds. Acta Biomater 2021; 128:420-434. [PMID: 33857695 DOI: 10.1016/j.actbio.2021.04.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022]
Abstract
The increasing emergence of antibiotic resistance coupled with the limited effectiveness of current treatments highlights the need for the development of new treatment modalities. Silver nanoparticles (AgNPs) are a promising alternative with broad-spectrum antibacterial activity. However, the clinical translation of AgNPs have been hampered primarily due to the delivery of unsafe levels of silver ions (Ag+) resulting in cellular toxicity and their susceptibility to aggregation resulting in loss of efficacy. Here, we describe a safe and effective, thermo-responsive AgNP hydrogel that provides antibacterial effects in conjunction with wound promoting properties. Using a murine model of wound infection, we demonstrate that the applied AgNP hydrogel to the wound (12 µg silver) not only provides superior bactericidal activity but also reduces inflammation leading to accelerated wound closure when compared to industry-standard silver sulfadiazine (302 µg silver). The AgNP hydrogel-treatment significantly accelerated wound closure at day 4 post-infection (56 closure) compared to both blank hydrogel or Ag SD (74% and 91% closure respectively) with a concurrent increase in PCNA-positive proliferating cells corresponding with a significant 32% improvement in wound re-epithelization compared to the blank hydrogel. Treatment of infected wounds with AgNP hydrogel also decreased neutrophil infiltration, increased anti-inflammatory Ym-1 positive M2 macrophages, and reduced the number of caspase-1 positive apoptotic cells. Therefore, this novel multifunctional AgNP thermo-responsive hydrogel is potentially a safe and effective treatment at much lower concentration for the treatment of wound infections. STATEMENT OF SIGNIFICANCE: In this study, we describe the development of a multifunctional thermo-responsive hydrogel of ultrasmall silver nanoparticles (AgNPs) for controlled and optimized delivery of silver to infected wounds. The in vivo biological effects of the developed hydrogel showed significant S. aureus elimination from infected mouse wounds compared to a commercial antibacterial formulation. The developed AgNP hydrogel optimally regulates inflammatory responses to promote wound healing as indicated by increased cell proliferation and wound re-epithelization. Additionally, AgNP hydrogel shows significant potential in regulating neutrophil infiltration while increasing levels of anti-inflammatory M2 macrophages and reduces the number of apoptotic cells. Therefore, the multifunctional properties of the developed AgNP thermo-responsive hydrogel offers great clinical potential to control bacterial infections and promote wound healing.
Collapse
|
6
|
Horiuchi Y. Severe burns: A prospect for infection management with ozone nanobubble saline. Burns 2021; 47:1457-1458. [PMID: 34154897 DOI: 10.1016/j.burns.2021.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/14/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Yasuhiro Horiuchi
- Division of Dermatology, Tsuruse Orthopedic Clinic, 201-11 Fujikubo, Miyoshi, 354-0041, Saitama, Japan.
| |
Collapse
|
7
|
Kalalinia F, Taherzadeh Z, Jirofti N, Amiri N, Foroghinia N, Beheshti M, Bazzaz BSF, Hashemi M, Shahroodi A, Pishavar E, Tabassi SAS, Movaffagh J. Evaluation of wound healing efficiency of vancomycin-loaded electrospun chitosan/poly ethylene oxide nanofibers in full thickness wound model of rat. Int J Biol Macromol 2021; 177:100-110. [PMID: 33539956 DOI: 10.1016/j.ijbiomac.2021.01.209] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 01/22/2023]
Abstract
Electrospun hybrid nanofibers have been extensively regarded as drug carriers. This study tries to introduce a nano fibrous wound dressing as a new strategy for a topical drug-delivery system. The vancomycin (VCM)-loaded hybrid chitosan/poly ethylene oxide (CH/PEO) nanofibers were fabricated by the blend-electrospinning process. Morphological, mechanical, chemical, and biological properties of nanofibers were examined by SEM, FTIR, release profile study, tensile assay, Alamar Blue cytotoxicity evaluation, and antibacterial activity assay. In vivo wound healing activity of hybrid CH/PEO/VCM nanofibers was evaluated in full-thickness skin wounds of rats. The hybrid CH/PEO/VCM nanofibers were successfully fabricated in a nanometer. The CH/PEO/VCM 2.5% had higher Young's Modulus, better tensile strength, smaller fiber diameter with sustained-release profiles compared to CH/PEO/VCM 5%. All nanofibers did not show any significant cytotoxicity (P < 0.05) on the normal fibroblast cells. Also, VCM-load hybrid CH/PEO nanofibers successfully inhibited bacterial growth. The wound area in the rats treated with CH/PEO/VCM 2.5% was less than CH/PEO/VCM 5% treated group. According to histological evaluation, the CH/PEO/VCM 2.5% group showed the fastest wound healing than other treatment groups. Results of this study proposed that CH/PEO/VCM nanofibers could promote the wound healing process by reducing the side effects of VCM as a topical antimicrobial agent.
Collapse
Affiliation(s)
- Fatemeh Kalalinia
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zhila Taherzadeh
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafiseh Jirofti
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Chemical and Biomedical Engineering Department, University of Sistan and Baluchestan, Zahedan, Iran
| | - Nafise Amiri
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Foroghinia
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Beheshti
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bibi Sedigheh Fazly Bazzaz
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Pharmaceutical Control Department, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Hashemi
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran; Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azadeh Shahroodi
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Pishavar
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran; Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Abolghasem Sajadi Tabassi
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jebrail Movaffagh
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
8
|
Sajjad W, He F, Ullah MW, Ikram M, Shah SM, Khan R, Khan T, Khalid A, Yang G, Wahid F. Fabrication of Bacterial Cellulose-Curcumin Nanocomposite as a Novel Dressing for Partial Thickness Skin Burn. Front Bioeng Biotechnol 2020; 8:553037. [PMID: 33072719 PMCID: PMC7531241 DOI: 10.3389/fbioe.2020.553037] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
The current study aimed to fabricate curcumin-loaded bacterial cellulose (BC-Cur) nanocomposite as a potential wound dressing for partial thickness burns by utilizing the therapeutic features of curcumin and unique structural, physico-chemical, and biological features of bacterial cellulose (BC). Characterization analyses confirmed the successful impregnation of curcumin into the BC matrix. Biocompatibility studies showed the better attachment and proliferation of fibroblast cells on the BC-Cur nanocomposite. The antibacterial potential of curcumin was tested against Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa), Salmonella typhimurium (S. typhimurium), and Staphylococcus aureus (S. aureus). Wound healing analysis of partial-thickness burns in Balbc mice showed an accelerated wound closure up to 64.25% after 15 days in the BC-Cur nanocomposite treated group. Histological studies showed healthy granulation tissues, fine re-epithelialization, vascularization, and resurfacing of wound bed in the BC-Cur nanocomposite group. These results indicate that combining BC with curcumin significantly improved the healing pattern. Thus, it can be concluded that the fabricated biomaterial could provide a base for the development of promising alternatives for the conventional dressing system in treating burns.
Collapse
Affiliation(s)
- Wasim Sajjad
- Department of Biomedical Sciences, Pak-Austria Fachhochschule Institute of Applied Sciences and Technology, Haripur, Pakistan
| | - Feng He
- Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Huanggang Normal University, Huanggang, China
| | - Muhammad Wajid Ullah
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Muhammad Ikram
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Shahid Masood Shah
- Department of Biotechnology, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Romana Khan
- Department of Environmental Sciences, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Taous Khan
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Ayesha Khalid
- Department of Biotechnology, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Guang Yang
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Fazli Wahid
- Department of Biomedical Sciences, Pak-Austria Fachhochschule Institute of Applied Sciences and Technology, Haripur, Pakistan
| |
Collapse
|
9
|
Harma B, Gül M, Demircan M. The Efficacy of Five Different Wound Dressings on Some Histological Parameters in Children With Partial-Thickness Burns. J Burn Care Res 2020; 41:1179-1187. [DOI: 10.1093/jbcr/iraa063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.
Collapse
Affiliation(s)
- Birsen Harma
- Department of Pediatric Surgery, Pediatric Burn Unit, Turgut Özal Medical Center, Inönü University, Malatya, Turkey
| | - Mehmet Gül
- Department of Histology and Embryology, Faculty of Medicine, Inönü University, Malatya, Turkey
| | - Mehmet Demircan
- Department of Pediatric Surgery, Pediatric Burn Unit, Turgut Özal Medical Center, Inönü University, Malatya, Turkey
| |
Collapse
|
10
|
Sukmawati D, Eryani A, Damayanti L. Silver Sulfadiazine's Effect on Keratin-19 Expression as Stem Cell Marker in Burn Wound Healing. Biomedicine (Taipei) 2020; 10:5-11. [PMID: 33854915 PMCID: PMC7608848 DOI: 10.37796/2211-8039.1014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Burn wounds are one of the causes of cutaneous injury that involve both epidermal and dermal layers of skin. Silver sulfadiazine (SSD) has been widely used to treat burn wounds, however recent studies have found the treatment to have some drawbacks, such as cellular toxicity effects. Cutaneous wound regeneration is known to start from the basal layer of the epidermal epithelial cells, which are enriched with highly proliferative cells. Keratin-19 (K19) is one of the epidermal stem cell biomarkers found in the skin. This study aims to explore the expression of K19 in burn wound tissue and to investigate the effect of SSD on its expression. METHODS We created a burn wound model in Sprague Dawley rats and randomly divided them into control and SSD groups. Wound closure was evaluated (visitrak) overtime series followed by histological evaluation of K19 expression in the wound tissue (immunohistochemistry staining). RESULTS Our model successfully represents full-thickness damage caused by a burn wound. The SSD group showed a faster reduction of wound surface area (wound closure) compared to the control group with the peak at day 18 post wounding (p < 0.05). K19 expression was found in both groups and was distributed on epidermal layers, hair follicles and dermis of granulation tissue showing similar patterns. CONCLUSION Topical application of SSD on burn wounds showed superiority in wound closure and is likely to have no harmful effect on epidermal stem cells. However, further study is required to investigate the effect of silver species on cell viability and toxicity effects during long term treatment.
Collapse
Affiliation(s)
- Dewi Sukmawati
- Department of Histology, Faculty of Medicine Universitas Indonesia, Jln. Salemba Raya No. 6 Jakarta, 10430, Jakarta, Indonesia
| | - Astheria Eryani
- Department of Histology, Faculty of Medicine Tarumanagara University, Jln. Letjen S. Parman No.1, Tomang, Grogol Petamburan, Jakarta, 11440, Indonesia
| | - Lia Damayanti
- Department of Histology, Faculty of Medicine Universitas Indonesia, Jln. Salemba Raya No. 6 Jakarta, 10430, Jakarta, Indonesia
| |
Collapse
|
11
|
Xuan X, Zhou Y, Chen A, Zheng S, An Y, He H, Huang W, Chen Y, Yang Y, Li S, Xuan T, Xiao J, Li X, Wu J. Silver crosslinked injectable bFGF-eluting supramolecular hydrogels speed up infected wound healing. J Mater Chem B 2019; 8:1359-1370. [PMID: 31840731 DOI: 10.1039/c9tb02331c] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Topical wound dressings with various silver compositions that exhibit effective bacterial inhibition properties are often used to treat infected wounds. However, a silver dressing with no bioactive functionality will typically delay subsequent wound repair processes. Therefore, development of a simple wound dressing containing silver and loaded with a bioactive drug is a very attractive solution. Herein, we developed a silver crosslinked injectable chitosan-silver hydrogel as a silver immobilization matrix, loaded with basic fibroblast growth factor (bFGF) as its cargo (namely, bFGF@CS-Ag) for treatment of both acute and infected wounds. The in vivo results showed that bFGF@CS-Ag significantly enhanced infectious wound regeneration compared to that of acute wounds. Further investigation demonstrated that the improved wound repair by bFGF@CS-Ag was ascribed to the effectiveness of bacterial inhibition, the promotion of granulation formation, collagen deposition, neovascularization and re-epithelization, and to the reduction of the inflammatory response through promotion of M2 macrophage polarization. These results proved that the immobilization of silver in the hydrogel not only reduced the side effects of silver on the bioactivity of bFGF but also allowed elution of bFGF in a controlled release manner. Thus, this novel system has promising therapeutic potential for topical treatment of wounds.
Collapse
Affiliation(s)
- Xuan Xuan
- Department of Dermatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P. R. China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ait Abderrahim L, Taïbi K, Ait Abderrahim N, Boussaid M, Rios-Navarro C, Ruiz-Saurí A. Euphorbia honey and garlic: Biological activity and burn wound recovery. Burns 2019; 45:1695-1706. [DOI: 10.1016/j.burns.2019.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 01/24/2023]
|
13
|
Faisul Aris FA, Mohd Fauzi FNA, Tong WY, Syed Abdullah SS. Interaction of silver sulfadiazine wıth bacterial cellulose via ex-situ modification method as an alternative diabetic wound healing. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2019. [DOI: 10.1016/j.bcab.2019.101332] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
14
|
Cabbaroğlu D, Songür Kodik M, Uyanıkgil Y, Çetin Uyanıkgil EÖ, Karabey F, Kıyan S. Temas tipi yanıklarda Hypericum perforatum (sarı kantaron) ile tedavi: Deneysel bir çalışma. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.512502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
15
|
Rashaan ZM, Krijnen P, Kwa KA, van der Vlies CH, Schipper IB, Breederveld RS. Flaminal® versus Flamazine® in the treatment of partial thickness burns: A randomized controlled trial on clinical effectiveness and scar quality (FLAM study). Wound Repair Regen 2019; 27:257-267. [PMID: 30675745 PMCID: PMC6850327 DOI: 10.1111/wrr.12699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/30/2022]
Abstract
Although partial thickness burns are the most frequently reported burn injuries, there is no consensus on the optimal treatment. The objective of this study was to compare the clinical effectiveness and scar quality of Flaminal® Forte to silver sulfadiazine (Flamazine®) in the treatment of partial thickness burns. In this two-arm open label multicenter randomized controlled trial, adult patients with acute partial thickness burns and an affected total body surface area of less than 30% were randomized between Flaminal® Forte and Flamazine® and followed for 12 months. Dressing changes in the Flamazine® group were performed daily, and in the Flaminal® group during the first 3 days post burn and thereafter every other day until complete wound healing or surgery. Forty-one patients were randomly allocated to Flaminal® Forte and 48 patients to Flamazine®. The primary outcome was time to wound healing, which did not differ between the groups: median 18 days with Flaminal® Forte (range 8-49 days) versus 16 days with Flamazine® (range 7-48 days; p = 0.24). Regarding the secondary outcomes during hospital admission, there were no statistically significant differences between the groups concerning need for surgery, pain scores, pruritus, or pain-related and anticipatory anxiety. More patients in the Flaminal® group developed wound colonization (78% versus 32%, p < 0.001), but the treatment groups did not differ regarding the incidence of local infections and use of systemic antibiotics. In terms of scar quality, no statistically significant differences between both treatment groups were found regarding subjective scar assessment (Patient and Observer Scar Assessment Scale (POSAS)), scar melanin and pigmentation (DermaSpectrometer®), and scar elasticity and maximal extension (Cutometer®) during 12 month postburn. In conclusion, time to wound healing did not differ, but the use of Flaminal® Forte seemed favorable because less dressing changes are needed which lowers the burden of wound care.
Collapse
Affiliation(s)
- Zjir M. Rashaan
- Department of SurgeryLeiden University Medical CentreLeidenThe Netherlands
- Department of SurgeryRed Cross HospitalBeverwijkThe Netherlands
- Burn CentreRed Cross HospitalBeverwijkThe Netherlands
| | - Pieta Krijnen
- Department of SurgeryLeiden University Medical CentreLeidenThe Netherlands
| | - Kelly A.A. Kwa
- Department of SurgeryLeiden University Medical CentreLeidenThe Netherlands
- Burn CentreRed Cross HospitalBeverwijkThe Netherlands
| | - Cornelis H. van der Vlies
- Burn Centre and Department of SurgeryMaasstad HospitalRotterdamThe Netherlands
- Trauma Research Unit Department of Surgery, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Inger B. Schipper
- Department of SurgeryLeiden University Medical CentreLeidenThe Netherlands
| | - Roelf S. Breederveld
- Department of SurgeryLeiden University Medical CentreLeidenThe Netherlands
- Burn CentreRed Cross HospitalBeverwijkThe Netherlands
| |
Collapse
|
16
|
The downside of antimicrobial agents for wound healing. Eur J Clin Microbiol Infect Dis 2018; 38:39-54. [DOI: 10.1007/s10096-018-3393-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/26/2018] [Indexed: 02/01/2023]
|
17
|
Krishnan N, Velramar B, Ramatchandirin B, Abraham GC, Duraisamy N, Pandiyan R, Velu RK. Effect of biogenic silver nanocubes on matrix metalloproteinases 2 and 9 expressions in hyperglycemic skin injury and its impact in early wound healing in streptozotocin-induced diabetic mice. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 91:146-152. [PMID: 30033241 DOI: 10.1016/j.msec.2018.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 04/23/2018] [Accepted: 05/05/2018] [Indexed: 02/08/2023]
Abstract
Microbial contamination along with over expressions of matrix metalloproteinases 2 and 9 impairs wound healing in diabetic patients. Silver-based antimicrobial agents have been successfully used for treating non-healing chronic wounds associated with infection. However, topical application of silver-ion compounds impairs wound healing process. Thus, usage of biogenic silver nanoparticles appears as a new means to reduce the toxicity of silver compounds in the wound care system. Here, following our previous method, AgNPs was synthesized using the culture filtrate of Brevibacillus brevis KN8(2) then characterized by UV-visible spectrophotometry, TEM, SAED, XRD and DLS measurements. The antibacterial activity of AgNPs was evaluated against the most common wound infecting pathogens Pseudomonas aeruginosa and Staphylococcus aureus by well diffusion assay. Further, the wound healing efficacy of biogenic AgNPs was examined in streptozotocin-induced diabetic mice by measuring wound area closure, histopathology, mRNA and protein expressions of MMP-2, MMP-9. Our results demonstrates that besides antimicrobial activity, biogenic AgNPs decreased the mRNA and protein expression of MMP-2 and MMP-9 in wounded granulation tissues leads to early wound healing in diabetic mice. These findings revealed that biogenic AgNPs synthesized from B. brevis KN8(2) could be an effective therapeutic agent in the management of diabetic foot ulcer with/without infection.
Collapse
Affiliation(s)
- Natarajan Krishnan
- Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India.
| | - Balasubramanian Velramar
- Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India; Department of Biotechnology, School of Biosciences, Periyar University, Salem, Tamil Nadu, India
| | - Balamurugan Ramatchandirin
- Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | | | - Nivas Duraisamy
- Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| | - Rajesh Pandiyan
- Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India; Department of Civil Engineering, Yeungnam University, Gyeongsan, Republic of Korea
| | - Rajesh Kannan Velu
- Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India
| |
Collapse
|
18
|
Qiu Y, Zhang N, An YH, Wen X. Biomaterial Strategies to Reduce Implant-Associated Infections. Int J Artif Organs 2018; 30:828-41. [DOI: 10.1177/039139880703000913] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Although the prophylaxis in controlling sterility within the operating room environment has been greatly improved, implant-associated infection is still one of the most serious complications in implant surgeries due to the existence of immune depression in the peri-implant area. The antibacterial ability of materials themselves logically becomes an important factor in preventing implant-associated infections. With the understanding of the pathogenesis of implant-associated infections, many approaches have been developed through providing an anti-adhesive surface, delivering antibacterial agents to disrupt cell-cell communication and preventing bacteria aggregation or biofilm formation, or killing bacteria directly (lysing the cell membrane). In this article, we review the current strategies in improving the antibacterial ability of materials to prevent implant infection and further present promising tactics in materials design and applications.
Collapse
Affiliation(s)
- Y. Qiu
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
| | - N. Zhang
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
- Department of Cell Biology and Anatomy, Medical University of South Carolina, Charleston, South Carolina - USA
| | - Y. H. An
- Department of Orthopedic Surgery, Medical University of South Carolina, Charleston, South Carolina - USA
| | - X. Wen
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
- Department of Cell Biology and Anatomy, Medical University of South Carolina, Charleston, South Carolina - USA
- Department of Orthopedic Surgery, Medical University of South Carolina, Charleston, South Carolina - USA
| |
Collapse
|
19
|
Barkat MA, Harshita, Ahmad I, Ali R, Singh SP, Pottoo FH, Beg S, Ahmad FJ. Nanosuspension-Based Aloe vera Gel of Silver Sulfadiazine with Improved Wound Healing Activity. AAPS PharmSciTech 2017; 18:3274-3285. [PMID: 28584900 DOI: 10.1208/s12249-017-0817-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 05/23/2017] [Indexed: 11/30/2022] Open
Abstract
The present study focuses on the development and characterization of nanosuspension of a poorly soluble drug, silver sulfadiazine (SSD) incorporated in Aloe vera gel (AV-gel) for improving its therapeutic efficacy. The SSD solution in ammonia was subjected to nanoprecipitation in surfactant solution and particle size was optimized by varying concentration of surfactant. Optimized formulation constituted of 5.5% (w/v) Span 20 and 5.5% (w/v) Tween 80 as a dispersing agent and 0.5% (w/v) Poloxamer 188 as a co-surfactant. The prepared nanosuspension was evaluated for particle size, polydispersity index, surface morphology, and x-ray diffraction study. The optimized nanosuspension was incorporated into nanogel formulation with the addition of 1% AV-gel and 0.5% Carbopol 940 for topical delivery of nanosized SSD. Evaluation of in vitro drug release exhibited a significant enhancement in release rate of the drug from developed nanogel formulation (77.16 ± 3.241%) in comparison to marketed formulation (42.81 ± 1.452%) after 48 h. In vivo histopathological studies in rats for 14 days of application of prepared nanogel showed improvement in the wound healing potential as compared to marketed formulation.
Collapse
|
20
|
Khalid A, Khan R, Ul-Islam M, Khan T, Wahid F. Bacterial cellulose-zinc oxide nanocomposites as a novel dressing system for burn wounds. Carbohydr Polym 2017; 164:214-221. [DOI: 10.1016/j.carbpol.2017.01.061] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/09/2017] [Accepted: 01/17/2017] [Indexed: 12/18/2022]
|
21
|
Siczek K, Zatorski H, Chmielowiec-Korzeniowska A, Kordek R, Tymczyna L, Fichna J. Evaluation of anti-inflammatory effect of silver-coated glass beads in mice with experimentally induced colitis as a new type of treatment in inflammatory bowel disease. Pharmacol Rep 2017; 69:386-392. [PMID: 28267639 DOI: 10.1016/j.pharep.2017.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent studies point at the anti-inflammatory action of silver through induction of apoptosis of inflammatory cells via oxidative stress, promotion of wound healing as well as antimicrobial effect. Our aim was to design a new formulation based on silver and validate its anti-inflammatory activity in the mouse models of colitis. METHODS Silver-coated glass beads were prepared using a magnetron sputtering method and a standard magnetron sputtering gun equipped with pure silver target. Colitis was induced by the ic administration of TNBS into colon (to mimic Crohn's disease) and addition of DSS to drinking water (to imitate ulcerative colitis). Evaluation of inflammation was performed based on macroscopic and microscopic scoring, quantification of the myeloperoxidase activity and colonic microflora analysis. RESULTS Silver-coated glass beads administered ic alleviated intestinal inflammation in mouse models of colitis, induced by TNBS and DSS. This alleviation of colitis resulted principally from changes in the gut microflora. The anti-inflammatory action of the new formulation was associated predominantly with the presence of the silver nanolayer on the beads, and to a lesser extent the size of glass polymer units. CONCLUSIONS The application of the newly developed formulation employing silver-coated glass beads has the potential to be translated to clinical conditions for the efficient treatment of IBD.
Collapse
Affiliation(s)
- Krzysztof Siczek
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland; Department of Vehicles and Fundamentals of Machine Design, Faculty of Mechanical Engineering, Lodz University of Technology, Łódź, Poland
| | - Hubert Zatorski
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Anna Chmielowiec-Korzeniowska
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Radzisław Kordek
- Department of Pathology, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
| | - Leszek Tymczyna
- Department of Animal Hygiene and Environment, Faculty of Biology and Animal Breeding, University of Agriculture in Lublin, Lublin, Poland
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Łódź, Poland.
| |
Collapse
|
22
|
Akita S, Yoshimoto H, Tanaka K, Oishi M, Senju C, Mawatari S, Takahara E, Suzuki S, Hayashida K. Silver Sulfadiazine–Impregnated Hydrocolloid Dressing Is Beneficial in Split-Thickness Skin-Graft Donor Wound Healing in a Small Randomized Controlled Study. INT J LOW EXTR WOUND 2016; 15:338-343. [DOI: 10.1177/1534734616670988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Donor-site wound healing was tested with a silver sulfadiazine (SSD)-impregnated hydrocolloid dressing and hydrocolloid dressing applied manually by a physician on site. A total of 14 patients, 5 woman and 9 men (23-89 years old, average = 61.6 ± 18.70 years), were enrolled in this prospective controlled study. The degree of bleeding was significantly less with the SSD-impregnated than with the hydrocolloid dressing (P < .01). In the moisture meter analysis, the values of the effective contact coefficient and corneal thickness were significantly smaller with the SSD-impregnated dressing (P < .05). In the color analysis, the clarity was significantly lower with the hydrocolloid dressing after 3 months than that of intact neighboring skin (P < .01). Regarding red-green color, SSD-impregnated and hydrocolloid values were significantly greater than the intact skin value immediately after and at 3 months, and the hydrocolloid value was significantly greater than intact at 6 months (P < .01 immediately; P < .01 at 3 months and intact at 6 months) in redness. Regarding yellow-blue color, the hydrocolloid value was significantly lower than the intact skin value at 3 months (P < .05 and intact) in yellow. The extensibility was significantly lower with the hydrocolloid dressing than in intact skin immediately (P < .01), and viscoelasticity was significantly lower with the hydrocolloid dressing than in intact skin immediately and after 3 and 6 months (P < .01 immediately and at 6 months and P < .05 at 3 months). The SSD-impregnated hydrocolloid dressing led to superior wound healing, decreased the degree of bleeding, and demonstrated better corneal barrier function, clarity, color matching, and viscoelasticity in split-thickness donors.
Collapse
|
23
|
Venkateswaran S, Henrique Dos Santos OD, Scholefield E, Lilienkampf A, Gwynne PJ, Swann DG, Dhaliwal K, Gallagher MP, Bradley M. Fortified interpenetrating polymers - bacteria resistant coatings for medical devices. J Mater Chem B 2016; 4:5405-5411. [PMID: 27746915 PMCID: PMC5038341 DOI: 10.1039/c6tb01110a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/15/2016] [Indexed: 12/04/2022]
Abstract
Infections arising from contaminated medical devices are a serious global issue, contributing to antibiotic resistance and imposing significant strain on healthcare systems. Since the majority of medical device-associated infections are biofilm related, efforts are being made to generate either bacteria-repellent or antibacterial coatings aimed at preventing bacterial colonisation. Here, we utilise a nanocapsule mediated slow release of a natural antimicrobial to improve the performance of a bacteria repellent polymer coating. Poly(lauryl acrylate) nanocapsules containing eugenol (4-allyl-2-methoxyphenol) were prepared and entrapped within a interpenetrating network designed to repel bacteria. When coated on a catheter and an endotracheal tube, this hemocompatible system allowed slow-release of eugenol, resulting in notable reduction in surface-bound Klebsiella pneumoniae and methicillin resistant Staphylococcus aureus.
Collapse
Affiliation(s)
- Seshasailam Venkateswaran
- EaStCHEM School of Chemistry , University of Edinburgh , King's Buildings , West Mains Road , Edinburgh , EH9 3FJ , UK .
| | - Orlando David Henrique Dos Santos
- Laboratório de Fitotecnologia , Departamento de Farmácia , Escola de Farmácia , Universidade Federal de Ouro Preto , Ouro Preto , Minas Gerais 35400-000 , Brazil
| | - Emma Scholefield
- MRC Centre for Inflammation Research , The Queens Medical Research Institute , University of Edinburgh , 47 Little France Crescent , Edinburgh EH16 4TJ , UK
| | - Annamaria Lilienkampf
- EaStCHEM School of Chemistry , University of Edinburgh , King's Buildings , West Mains Road , Edinburgh , EH9 3FJ , UK .
| | - Peter J Gwynne
- School of Biological Sciences , University of Edinburgh, King's Buildings , West Mains Road , Edinburgh , EH9 3JF , UK
| | - David G Swann
- Critical Care , NHS Lothian , Royal Infirmary of Edinburgh , 51 Little France Crescent , Edinburgh , EH16 4SA , UK
| | - Kevin Dhaliwal
- MRC Centre for Inflammation Research , The Queens Medical Research Institute , University of Edinburgh , 47 Little France Crescent , Edinburgh EH16 4TJ , UK
| | - Maurice P Gallagher
- School of Biological Sciences , University of Edinburgh, King's Buildings , West Mains Road , Edinburgh , EH9 3JF , UK
| | - Mark Bradley
- EaStCHEM School of Chemistry , University of Edinburgh , King's Buildings , West Mains Road , Edinburgh , EH9 3FJ , UK .
| |
Collapse
|
24
|
Rashaan ZM, Krijnen P, van den Akker-van Marle ME, van Baar ME, Vloemans AFP, Dokter J, Tempelman FRH, van der Vlies CH, Breederveld RS. Clinical effectiveness, quality of life and cost-effectiveness of Flaminal® versus Flamazine® in the treatment of partial thickness burns: study protocol for a randomized controlled trial. Trials 2016; 17:122. [PMID: 26945575 PMCID: PMC4779241 DOI: 10.1186/s13063-016-1240-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 02/17/2016] [Indexed: 11/10/2022] Open
Abstract
Background Partial thickness burns are painful, difficult to manage and can have a negative effect on quality of life through scarring, permanent disfigurement and loss of function. The aim of burn treatment in partial thickness burns is to save lives, stimulate wound healing by creating an optimumly moist wound environment, to have debriding and analgesic effects, protect the wound from infection and be convenient for the patient and caregivers. However, there is no consensus on the optimal treatment of partial thickness wounds. Flaminal® and Flamazine® are two standard treatment options that provide the above mentioned properties in burn treatment. Nevertheless, no randomized controlled study has yet compared these two common treatment modalities in partial thickness burns. Thus, the aim of this study is to evaluate the clinical effectiveness, quality of life and cost-effectiveness of Flaminal® versus Flamazine® in the treatment of partial thickness burns. Methods/Design In this two-arm open multi-center randomized controlled trial, 90 patients will be randomized between Flaminal® and Flamazine® and followed for 12 months. The study population will consist of competent or temporarily non-competent (because of sedation and/or intubation) patients, 18 years of age or older, with acute partial thickness burns and a total body surface area (TBSA) of less than 30 %. The main study outcome is time to complete re-epithelialization (greater than 95 %). Secondary outcome measures include need for grafting, wound colonization/infection, number of dressing changes, pain and anxiety, scar formation, health-related quality of life (HRQoL), and costs. Discussion This study will contribute to the optimal treatment of patients with partial thickness burn wounds and will provide evidence on the (cost-)effectiveness and quality of life of Flaminal® versus Flamazine® in the treatment of partial thickness burns. Trial registration Netherlands Trial Register NTR4486, registered on 2 April 2014.
Collapse
Affiliation(s)
- Zjir M Rashaan
- Department of Surgery, Leiden University Medical Center, Postbus 9600, 2333 ZA, Leiden, The Netherlands. .,Burn Centre, Red Cross Hospital Beverwijk, Postbus 1074, 1942 LE, Beverwijk, The Netherlands.
| | - Pieta Krijnen
- Department of Surgery, Leiden University Medical Center, Postbus 9600, 2333 ZA, Leiden, The Netherlands.
| | | | - Margriet E van Baar
- Association of Dutch Burn Centres, Postbus 1015, 1940 EA, Beverwijk, The Netherlands. .,Burn Centre, Maasstad Hospital, PO Box 9100, 3079 DZ, Rotterdam, The Netherlands.
| | - Adrianus F P Vloemans
- Burn Centre, Red Cross Hospital Beverwijk, Postbus 1074, 1942 LE, Beverwijk, The Netherlands.
| | - Jan Dokter
- Burn Centre, Maasstad Hospital, PO Box 9100, 3079 DZ, Rotterdam, The Netherlands.
| | - Fenike R H Tempelman
- Burn Centre, Red Cross Hospital Beverwijk, Postbus 1074, 1942 LE, Beverwijk, The Netherlands.
| | - Cees H van der Vlies
- Burn Centre, Maasstad Hospital, PO Box 9100, 3079 DZ, Rotterdam, The Netherlands.
| | - Roelf S Breederveld
- Department of Surgery, Leiden University Medical Center, Postbus 9600, 2333 ZA, Leiden, The Netherlands. .,Burn Centre, Red Cross Hospital Beverwijk, Postbus 1074, 1942 LE, Beverwijk, The Netherlands. .,Association of Dutch Burn Centres, Postbus 1015, 1940 EA, Beverwijk, The Netherlands.
| |
Collapse
|
25
|
Esteban-Vives R, Young MT, Ziembicki J, Corcos A, Gerlach JC. Effects of wound dressings on cultured primary keratinocytes. Burns 2015; 42:81-90. [PMID: 26678326 DOI: 10.1016/j.burns.2015.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/05/2015] [Accepted: 06/25/2015] [Indexed: 12/22/2022]
Abstract
Autologous cell-spray grafting of non-cultured epidermal cells is an innovative approach for the treatment of severe second-degree burns. After treatment, wounds are covered with dressings that are widely used in wound care management; however, little is known about the effects of wound dressings on individually isolated cells. The sprayed cells have to actively attach, spread, proliferate, and migrate in the wound for successful re-epithelialization, during the healing process. It is expected that exposure to wound dressing material might interfere with cell survival, attachment, and expansion. Two experiments were performed to determine whether some dressing materials have a negative impact during the early phases of wound healing. In one experiment, freshly isolated cells were seeded and cultured for one week in combination with eight different wound dressings used during burn care. Cells, which were seeded and cultured with samples of Adaptic(®), Xeroform(®), EZ Derm(®), and Mepilex(®) did not attach, nor did they survive during the first week. Mepitel(®), N-Terface(®), Polyskin(®), and Biobrane(®) dressing samples had no negative effect on cell attachment and cell growth when compared to the controls. In a second experiment, the same dressings were exposed to pre-cultured cells in order to exclude the effects of attachment and spreading. The results confirm the above findings. This study could be of interest for establishing skin cell grafting therapies in burn medicine and also for wound care in general.
Collapse
Affiliation(s)
- Roger Esteban-Vives
- Bioreactor Group, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew T Young
- Bioreactor Group, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jenny Ziembicki
- University of Pittsburgh Medical Center, UPMC Mercy Trauma and Burn Center, Pittsburgh, PA, USA
| | - Alain Corcos
- University of Pittsburgh Medical Center, UPMC Mercy Trauma and Burn Center, Pittsburgh, PA, USA
| | - Jörg C Gerlach
- Bioreactor Group, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
26
|
Ito K, Saito A, Fujie T, Nishiwaki K, Miyazaki H, Kinoshita M, Saitoh D, Ohtsubo S, Takeoka S. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury. Acta Biomater 2015; 24:87-95. [PMID: 26079191 DOI: 10.1016/j.actbio.2015.05.035] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 05/21/2015] [Accepted: 05/27/2015] [Indexed: 01/01/2023]
Abstract
Partial-thickness burn injury has the potential for reepithelialization and heals within 3weeks. If the wound is infected by bacteria before reepithelization, however, the depth of disruption increases and the lesion easily progresses to the full-thickness dermal layers. In the treatment of partial-thickness burn injury, it is important to prevent the wound area from bacterial infection with an antimicrobial dressing. Here, we have tested the antimicrobial properties of polymeric ultra-thin films composed of poly(lactic acid) (termed "PLA nanosheets"), which have high flexibility, adhesive strength and transparency, and silver sulfadiazine (AgSD), which exhibits antimicrobial efficacy. The AgSD-loaded nanosheet released Ag(+) for more than 3days, and exerted antimicrobial efficacy against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro Kirby-Bauer test. By contrast, a cell viability assay indicated that the dose of AgSD used in the PLA nanosheets did not show significant cytotoxicity toward fibroblasts. In vivo evaluation using a mouse model of infection in a partial-thickness burn wound demonstrated that the nanosheet significantly reduced the number of MRSA bacteria on the lesion (more than 10(5)-fold) and suppressed the inflammatory reaction, thereby preventing a protracted wound healing process.
Collapse
|
27
|
Ojeda-Martínez ML, Yáñez-Sánchez I, Velásquez-Ordoñez C, Martínez-Palomar MM, Álvarez-Rodríguez A, Garcia-Sánchez MA, Rojas-González F, Gálvez-Gastélum FJ. Skin wound healing with chitosan thin films containing supported silver nanospheres. J BIOACT COMPAT POL 2015. [DOI: 10.1177/0883911515590495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dermal wound healing involves complex histo-molecular events aimed to repair the discontinuity of the epithelium. Employing nanometric silver particles provides an efficient antimicrobial effect for several dermal infections. The aim is to elucidate imminent advantages of silver nanoparticles, such as the possibility of modulating the epithelial cell repair process. Through the nanostructural implementation of chitosan thin films supporting silver nanoparticles, it was feasible to evaluate in vivo the efficacy and evolution of dermal recuperation after surgical damage. The characterization of chitosan silver nanoparticle films was performed by UV–visible spectra and Fourier transform infrared spectroscopy, X-ray diffraction, and high-resolution electron microscopy. An important dermal healing was accomplished in animals that were treated with chitosan films supporting silver nanoparticles, as confirmed by a histopathological analysis of the skin after 12 days of treatment. The developed chitosan thin film supporting an optimized amount of silver nanoparticles could be employed to treat diseases related to wound healing.
Collapse
Affiliation(s)
- Maria L Ojeda-Martínez
- Centro de Investigación en Nanociencia y Nanotecnología, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca, México
| | - Irinea Yáñez-Sánchez
- Centro de Investigación en Nanociencia y Nanotecnología, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca, México
| | - Celso Velásquez-Ordoñez
- Centro de Investigación en Nanociencia y Nanotecnología, Centro Universitario de los Valles, Universidad de Guadalajara, Ameca, México
| | - Maria M Martínez-Palomar
- Laboratorio de Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Adriana Álvarez-Rodríguez
- Laboratorio de Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | | | | | - Francisco J Gálvez-Gastélum
- Laboratorio de Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| |
Collapse
|
28
|
Kim JY, Jun JH, Kim SJ, Hwang KM, Choi SR, Han SD, Son MW, Park ES. Wound healing efficacy of a chitosan-based film-forming gel containing tyrothricin in various rat wound models. Arch Pharm Res 2015; 38:229-38. [PMID: 24715576 DOI: 10.1007/s12272-014-0368-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/12/2014] [Indexed: 11/25/2022]
Abstract
The objective of this study was to evaluate the healing effects of a chitosan-based, film-forming gel containing tyrothricin (TYR) in various rat wound models, including burn, abrasion, incision, and excision models. After solidification, the chitosan film layer successfully covered and protected a variety of wounds. Wound size was measured at predetermined timepoints after wound induction, and the effects of the film-forming gel were compared with negative (no treatment) and positive control groups (commercially available sodium fusidate ointment and TYR gel). In burn, abrasion and excision wound models, the film-forming gel enabled significantly better healing from 1 to 6 days after wound induction, compared with the negative control. Importantly, the film-forming gel also enabled significantly better healing compared with the positive control treatments. In the incision wound model, the breaking strength of wound strips from the group treated with the film-forming gel was significantly increased compared with both the negative and positive control groups. Histological studies revealed advanced granulation tissue formation and epithelialization in wounds treated with the film-forming gel. We hypothesize that the superior healing effects of the film-forming gel are due to wound occlusion, conferred by the chitosan film. Our data suggest that this film-forming gel may be useful in treating various wounds, including burn, abrasion, incision and excision wounds.
Collapse
Affiliation(s)
- Ju-Young Kim
- School of Pharmacy, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do, 440-746, Republic of Korea
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Toussaint J, Singer AJ. The evaluation and management of thermal injuries: 2014 update. Clin Exp Emerg Med 2014; 1:8-18. [PMID: 27752547 PMCID: PMC5052819 DOI: 10.15441/ceem.14.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 08/21/2014] [Accepted: 08/28/2014] [Indexed: 11/23/2022] Open
Abstract
Burns are among the most common injuries presenting to the emergency department. While burns, especially large ones, may be associated with significant morbidity and mortality, most are minor and can be managed by emergency practitioners and discharged home with close follow-up. In contrast, patients with large burns require aggressive management of their airway, breathing and circulation in order to reduce mortality and morbidity. While early endotracheal intubation of patients with actual or impending airway compromise and aggressive fluid resuscitation have been emphasized, it appears that the pendulum may have swung a bit too far towards the extreme. The current review will briefly cover the epidemiology, pathogenesis and diagnosis of burn injuries with greater emphasis on airway and fluid management. We will also discuss the local management of the burn wound, which is all that is required for most burn patients in the emergency department.
Collapse
Affiliation(s)
- Jimmy Toussaint
- Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Adam J Singer
- Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
30
|
Tran PL, Patel S, Hamood AN, Enos T, Mosley T, Jarvis C, Desai A, Lin P, Reid TW. A Novel Organo-Selenium Bandage that Inhibits Biofilm Development in a Wound by Gram-Positive and Gram-Negative Wound Pathogens. Antibiotics (Basel) 2014; 3:435-49. [PMID: 27025754 PMCID: PMC4790367 DOI: 10.3390/antibiotics3030435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/07/2014] [Accepted: 08/19/2014] [Indexed: 11/16/2022] Open
Abstract
Biofilm formation in wounds is a serious problem which inhibits proper wound healing. One possible contributor to biofilm formation in a wound is the bacteria growing within the overlying bandage. To test this mechanism, we used bandages that contained a coating of organo-selenium that was covalently attached to the bandage. We tested the ability of this coating to kill bacteria on the bandage and in the underlying tissue. The bandage material was tested with both lab strains and clinical isolates of Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis. It was found that the organo-selenium coated bandage showed inhibition, of biofilm formation on the bandage in vitro (7–8 logs), with all the different bacteria tested, at selenium concentrations in the coating of less than 1.0%. These coatings were found to remain stable for over one month in aqueous solution, 15 min in boiling water, and over 6 years at room temperature. The bandages were also tested on a mouse wound model where the bacteria were injected between the bandage and the wound. Not only did the selenium bandage inhibit biofilm formation in the bandage, but it also inhibited biofilm formation in the wound tissue. Since selenium does not leave the bandage, this would appear to support the idea that a major player in wound biofilm formation is bacteria which grows in the overlying bandage.
Collapse
Affiliation(s)
- Phat L Tran
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Saurabh Patel
- Department of Neonatology, University of Illinois, Chicago, IL 60607, USA.
| | - Abdul N Hamood
- Departments of Medical Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Tyler Enos
- South Western Medical Center, University of Texas, Dallas, TX 75390, USA.
| | - Thomas Mosley
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Courtney Jarvis
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Akash Desai
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Pamela Lin
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| | - Ted W Reid
- Departments of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| |
Collapse
|
31
|
Rashaan ZM, Krijnen P, Klamer RRM, Schipper IB, Dekkers OM, Breederveld RS. Nonsilver treatment vs. silver sulfadiazine in treatment of partial-thickness burn wounds in children: A systematic review and meta-analysis. Wound Repair Regen 2014; 22:473-82. [DOI: 10.1111/wrr.12196] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/08/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Zjir M. Rashaan
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
- Burn Center; Red Cross Hospital Beverwijk; Beverwijk The Netherlands
| | - Pieta Krijnen
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
| | - Rachel R. M. Klamer
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
| | - Inger B. Schipper
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
| | - Olaf M. Dekkers
- Department of Clinical Epidemiology; Leiden University Medical Center; Leiden The Netherlands
- Department of Endocrinology; Leiden University Medical Center; Leiden The Netherlands
| | - Roelf S. Breederveld
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
- Burn Center; Red Cross Hospital Beverwijk; Beverwijk The Netherlands
- Association of Dutch Burn Centers; Beverwijk The Netherlands
| |
Collapse
|
32
|
Tran PL, Hamood AN, Reid TW. Antimicrobial Coatings to Prevent Biofilm Formation on Medical Devices. SPRINGER SERIES ON BIOFILMS 2014. [DOI: 10.1007/978-3-642-53833-9_9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
33
|
Guthrie KM, Agarwal A, Teixeira LBC, Dubielzig RR, Abbott NL, Murphy CJ, Singh H, McAnulty JF, Schurr MJ. Integration of silver nanoparticle-impregnated polyelectrolyte multilayers into murine-splinted cutaneous wound beds. J Burn Care Res 2013; 34:e359-67. [PMID: 23511285 PMCID: PMC4609547 DOI: 10.1097/bcr.0b013e31827e7ef9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Silver is a commonly used topical antimicrobial. However, technologies to immobilize silver at the wound surface are lacking, while currently available silver-containing wound dressings release excess silver that can be cytotoxic and impair wound healing. We have shown that precise concentrations of silver at lower levels can be immobilized into a wound bed using a polyelectrolyte multilayer attachment technology. These silver nanoparticle-impregnated polyelectrolyte multilayers are noncytotoxic yet bactericidal in vitro, but their effect on wound healing in vivo was previously unknown. The purpose of this study was to determine the effect on wound healing of integrating silver nanoparticle/polyelectrolyte multilayers into the wound bed. A full-thickness, splinted, excisional murine wound healing model was employed in both phenotypically normal mice and spontaneously diabetic mice (healing impaired model). Gross image measurements showed an initial small lag in healing in the silver-treated wounds in diabetic mice, but no difference in time to complete wound closure in either normal or diabetic mice. Histological analysis showed modest differences between silver-treated and control groups on day 9, but no difference between groups at the time of wound closure. We conclude that silver nanoparticle/polyelectrolyte multilayers can be safely integrated into the wound beds of both normal and diabetic mice without delaying wound closure, and with transient histological effects. The results of this study suggest the feasibility of this technology for use as a platform to affect nanoscale wound engineering approaches to microbial prophylaxis or to augment wound healing.
Collapse
Affiliation(s)
- Kathleen M. Guthrie
- University of Wisconsin, School of Veterinary Medicine, Department of Surgical Sciences
| | - Ankit Agarwal
- University of Wisconsin, Department of Chemical and Biological Engineering
| | - Leandro B. C. Teixeira
- University of Wisconsin, School of Veterinary Medicine, Department of Pathobiological Sciences
| | - Richard R. Dubielzig
- University of Wisconsin, School of Veterinary Medicine, Department of Pathobiological Sciences
| | - Nicholas L. Abbott
- University of Wisconsin, Department of Chemical and Biological Engineering
| | - Christopher J. Murphy
- University of Wisconsin, School of Veterinary Medicine, Department of Surgical Sciences
- UC Davis, School of Medicine, Department of Ophthalmology and Vision Science
- UC Davis, School of Veterinary Medicine, Department of Surgical and Radiological Sciences
| | - Harpreet Singh
- Tufts University, Cummings School of Veterinary Medicine
| | - Jonathan F. McAnulty
- University of Wisconsin, School of Veterinary Medicine, Department of Surgical Sciences
| | - Michael J. Schurr
- University of Colorado-Denver, School of Medicine, Department of Surgery
| |
Collapse
|
34
|
Argentum-quarz solution in the treatment of anorectal fistulas: is it possible a conservative approach? Med Hypotheses 2012; 79:542-3. [PMID: 22867866 DOI: 10.1016/j.mehy.2012.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 07/10/2012] [Indexed: 11/22/2022]
Abstract
Patients suffering from chronic intestinal diseases (Crohn's disease, Ulcerative Colitis, Indeterminate Colitis) are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. The treatment of these complications are managed differently but, after an initial treatment based on medical or minimally invasive management, the solution of the pathological condition is always achieved by a surgical procedure. In the last few years prospective studies have proposed an alternative conservative therapeutic approach based on application of fibrin glue in the healing of patients with fistulas-in-ano. In this paper we suggest and discuss the therapeutic potential of silver and quarz in the conservative treatment of anorectal fistulas pointing out their role in modulating particular steps of the pathogenetic process which characterizes this pathological condition.
Collapse
|
35
|
Evaluation of biomechanical and histological properties of corrosive chemical burns. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2012. [DOI: 10.1007/s40005-012-0027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
36
|
Nanomaterial-Based Antibacterial Paper. NANO-ANTIMICROBIALS 2012. [PMCID: PMC7124105 DOI: 10.1007/978-3-642-24428-5_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Antibacterial materials are widely used in everyday life and plays important roles in the public health system. There are a wide range of materials that have been known to prevent attachment and proliferation of microbes on material surfaces. These include antibiotics, metal ions and quaternary ammonium compounds. Given the availability of these various antibacterial materials, concerns about antibiotics-resistance, environmental pollution, relatively complex processing and high cost have been of much recent interest. Antimicrobial properties of nanomaterials have been explored to meet these challenges. Various nanomaterials including silver nanoparticles (AgNPs), titanium oxide nanoparticles and carbon nanotubes (CNTs) have been found to be highly effective bacterial-killing materials. The most well-known examples are silver and silver-based compounds, which were well known to be antiseptic to a spectrum of bacterium even in ancient times. AgNPs have proven to possess high antibacterial activity with minimal perturbation to human cells. Consequently, widespread applications of AgNPs have been found in medical and environmental areas [1]. More recently, carbon nanomaterials have emerged as a type of novel antibacterial nanomaterials, including CNTs and graphene. In this chapter, we aim to provide a review on the fabrication of nanomaterials-based paper-like films and their antibacterial applications.
Collapse
|
37
|
Gurfinkel R, Palivatkel-Naim M, Gleisinger R, Rosenberg L, Singer AJ. Comparison of purified olive oil and silver sulfadiazine in the treatment of partial thickness porcine burns. Am J Emerg Med 2012; 30:79-83. [DOI: 10.1016/j.ajem.2010.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 09/07/2010] [Accepted: 10/02/2010] [Indexed: 11/30/2022] Open
|
38
|
Chao CYL, Zheng YP, Cheing GLY. A novel noncontact method to assess the biomechanical properties of wound tissue. Wound Repair Regen 2011; 19:324-9. [PMID: 21539649 DOI: 10.1111/j.1524-475x.2011.00694.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A novel noncontact optical coherence tomography based air-jet indentation system was developed for characterizing the biomechanical properties of soft tissue in a noncontact way. This study aimed to measure the stiffness of diabetic foot ulcer tissues by using this air-jet indentation system, and examining the test/retest reliability. Eight subjects with diabetes (seven males, one female), with a total of 10 foot ulcers between them, participated in the study. A total of 20 measuring sites located at the central wound bed (n=10) or peri-ulcer areas (n=10), respectively, were evaluated with the air-jet indentation system. Four cycles of loading and unloading, each with a duration of approximately 36 seconds at an indentation rate of 0.08 mm/s, were carried out for each indentation trial. The test/retest reliability was examined at all measuring points. The average stiffness coefficient of the peri-ulcer area (mean ± SD: 0.47 ± 0.15 N/mm) was significantly larger than that of the central wound bed area (mean ± SD: 0.35 ± 0.23 N/mm; p=0.042). A high value for test/retest reliability was shown (intraclass correlation coefficient: 0.986; Pearson's correlation: r=0.972, p<0.001). Our preliminary findings showed that the peri-ulcer area had greater stiffness than the central wound bed. This greater magnitude of hardness and inelasticity at the peri-ulcer region may scatter part of the contractile forces for wound contraction during the healing process. We found the novel air-jet system to be a reliable tool for characterizing the stiffness of soft tissues around the wound in a noncontact way.
Collapse
Affiliation(s)
- Clare Y L Chao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | |
Collapse
|
39
|
Pather N, Viljoen AM, Kramer B. A biochemical comparison of the in vivo effects of Bulbine frutescens and Bulbine natalensis on cutaneous wound healing. JOURNAL OF ETHNOPHARMACOLOGY 2011; 133:364-70. [PMID: 20937372 DOI: 10.1016/j.jep.2010.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 10/01/2010] [Accepted: 10/04/2010] [Indexed: 05/14/2023]
Abstract
AIM OF THE STUDY In South Africa the local population relies extensively on indigenous plants in the formulation of traditional medicines to treat skin ailments. The scientific merits of many of these plants used to treat wounds and burns are yet to be validated. Bulbine natalensis and Bulbine frutescens of the Asphodelaceae family are indigenous to only southern Africa and are widely used as a skin remedy. This study aimed to explore the scientific value of these plants through investigating the in vivo biochemical effects of Bulbine natalensis and Bulbine frutescens on cutaneous wounds. MATERIAL AND METHODS Excisional and incisional wounds treated with either B. natalensis or B. frutescens and mirrored control wounds were created on the back of 12 domestic pigs. Wound contraction was recorded daily. The excisional wounds, biopsied at days 2, 4, 7, 10 and 16, were used to analyse the biochemical composition of the wounds by estimating the total amount of protein, DNA, collagen and hexosamine present. The incisional wounds, biopsied at day 16, were used to test the tensile strength of the healed wounds using a tensiometer. RESULTS Wound contraction following treatment with Bulbine natalensis on days 2, 4 and 10 (p=.004, 0.007 and 0.03, respectively), and Bulbine frutescens on day 4 (p=0.004) increased significantly when compared to the corresponding untreated wounds. The tensile strength of the wounds treated with the leaf gels was significantly stronger than that of the untreated wounds. There was also a significant increase in the collagen, protein and DNA content of the Bulbine natalensis- and Bulbine frutescens-treated wounds compared with that of the untreated wounds (collagen content: p=0.014 and 0.018; protein content: p=0.03 and 0.04; DNA content p=0.04 and 0.04; respectively) over the 16-day experimental period. Treatment with both leaf gels followed the same pattern in hexosamine content with a maximum hexosamine content on day 4 followed by a steady decrease to day 16. No significant difference between the hexosamine content of the wounds of animals treated with either Bulbine frutescens or Bulbine natalensis was found. CONCLUSIONS These findings validate the traditional use of the leaf gel extracts of B. frutescens and B. natalensis in the treatment of wounds and may warrant further investigation towards producing a low-cost effective topical treatment for wounds.
Collapse
Affiliation(s)
- Nalini Pather
- Embryonic Differentiation and Development Research Programme, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | | |
Collapse
|
40
|
Agarwal A, Weis TL, Schurr MJ, Faith NG, Czuprynski CJ, McAnulty JF, Murphy CJ, Abbott NL. Surfaces modified with nanometer-thick silver-impregnated polymeric films that kill bacteria but support growth of mammalian cells. Biomaterials 2009; 31:680-90. [PMID: 19864019 DOI: 10.1016/j.biomaterials.2009.09.092] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 09/25/2009] [Indexed: 10/20/2022]
Abstract
Silver is widely used as a biocidal agent in ointments and wound dressings. However, it has also been associated with tissue toxicity and impaired healing. In vitro characterization has also revealed that typical loadings of silver employed in ointments and dressings (approximately 100 microg/cm(2)) lead to cytotoxicity. In this paper, we report the results of an initial study that sought to determine if localization of carefully controlled loadings of silver nanoparticles within molecularly thin films immobilized on surfaces can lead to antimicrobial activity without inducing cytotoxicity. Polymeric thin films of poly(allylamine hydrochloride) (PAH) and poly(acrylic acid) (PAA) were prepared by layer-by-layer deposition and loaded with approximately 0.4 microg/cm(2) to approximately 23.6 microg/cm(2) of silver nanoparticles. Bacterial killing efficiencies of the silver-loaded films were investigated against Staphylococcus epidermidis, a gram-positive bacterium, and it was determined that as little as approximately 0.4 microg/cm(2) of silver in the polymeric films caused a reduction of 6log(10)CFU/mL (99.9999%) bacteria in suspensions incubated in contact with the films (water-borne assays). Significantly, whereas the antibacterial films containing high loadings of silver were found to be toxic to a murine fibroblast cell line (NIH-3T3), the polymeric films containing approximately 0.4 microg/cm(2) of silver were not toxic and allowed attachment, and growth of the mammalian cells. Thus, the results of this study go beyond prior reports by identifying silver-impregnated, polymeric thin films that are compatible with in vitro mammalian cell culture yet exhibit antibacterial activity. These results support the hypothesis that localization of carefully controlled loadings of silver nanoparticles within molecularly thin polymeric films can lead to antimicrobial activity without cytotoxicity. More broadly, this strategy of modifying surfaces with minimal loadings of bioactive molecules indicates the basis of approaches that may permit management of microbial burden in wound beds without impairment of wound healing.
Collapse
Affiliation(s)
- Ankit Agarwal
- Department of Chemical and Biological Engineering, University of Wisconsin-Madison, WI 53706, USA
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Organoselenium coating on cellulose inhibits the formation of biofilms by Pseudomonas aeruginosa and Staphylococcus aureus. Appl Environ Microbiol 2009; 75:3586-92. [PMID: 19346348 DOI: 10.1128/aem.02683-08] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Among the most difficult bacterial infections encountered in treating patients are wound infections, which may occur in burn victims, patients with traumatic wounds, necrotic lesions in people with diabetes, and patients with surgical wounds. Within a wound, infecting bacteria frequently develop biofilms. Many current wound dressings are impregnated with antimicrobial agents, such as silver or antibiotics. Diffusion of the agent(s) from the dressing may damage or destroy nearby healthy tissue as well as compromise the effectiveness of the dressing. In contrast, the antimicrobial agent selenium can be covalently attached to the surfaces of a dressing, prolonging its effectiveness. We examined the effectiveness of an organoselenium coating on cellulose discs in inhibiting Pseudomonas aeruginosa and Staphylococcus aureus biofilm formation. Colony biofilm assays revealed that cellulose discs coated with organoselenium completely inhibited P. aeruginosa and S. aureus biofilm formation. Scanning electron microscopy of the cellulose discs confirmed these results. Additionally, the coating on the cellulose discs was stable and effective after a week of incubation in phosphate-buffered saline. These results demonstrate that 0.2% selenium in a coating on cellulose discs effectively inhibits bacterial attachment and biofilm formation and that, unlike other antimicrobial agents, longer periods of exposure to an aqueous environment do not compromise the effectiveness of the coating.
Collapse
|
42
|
Clifton-Koeppel R. Wound Care After Peripheral Intravenous Extravasation: What Is the Evidence? ACTA ACUST UNITED AC 2006. [DOI: 10.1053/j.nainr.2006.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
43
|
Lee ARC. Enhancing dermal matrix regeneration and biomechanical properties of 2nd degree-burn wounds by EGF-impregnated collagen sponge dressing. Arch Pharm Res 2005; 28:1311-6. [PMID: 16350860 DOI: 10.1007/bf02978217] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To better define the relationship between dermal regeneration and wound contraction and scar formation, the effects of epidermal growth factor (EGF) loaded in collagen sponge matrix on the fibroblast cell proliferation rate and the dermal mechanical strength were investigated. Collagen sponges with acid-soluble fraction of pig skin were prepared and incorporated with EGF at 0, 4, and 8 microg/1.7 cm2. Dermal fibroblasts were cultured to 80% confluence using DMEM, treated with the samples submerged, and the cell viability was estimated using MTT assay. A deep, 2nd degree- burn of diameter 1cm was prepared on the rabbit ear and the tested dressings were applied twice during the 15-day, post burn period. The processes of re-epithelialization and dermal regeneration were investigated until the complete wound closure day and histological analysis was performed with H-E staining. EGF increased the fibroblast cell proliferation rate. The histology showed well developed, weave-like collagen bundles and fibroblasts in EGF-treated wounds while open wounds showed irregular collagen bundles and impaired fibroblast growth. The breaking strength (944.1 +/- 35.6 vs. 411.5 +/- 57.0 Fmax, gmm(-2)) and skin resilience (11.3 +/- 1.4 vs. 6.5 +/- 0.6 mJ/mm2) were significantly increased with EGF-treated wounds as compared with open wounds, suggesting that EGF enhanced the dermal matrix formation and improved the wound mechanical strength. In conclusion, EGF-improved dermal matrix formation is related with a lower wound contraction rate. The impaired dermal regeneration observed in the open wounds could contribute to the formation of wound contraction and scar tissue development. An extraneous supply of EGF in the collagen dressing on deep, 2nd degree-burns enhanced the dermal matrix formation.
Collapse
Affiliation(s)
- Ae-Ri Cho Lee
- College of Pharmacy, Duksung Women's University, Seoul 132-714, Korea.
| |
Collapse
|
44
|
Losanoff JE, Millis JM. Susceptibility of prosthetic biomaterials to infection. Surg Endosc 2005; 20:174-5. [PMID: 16247570 DOI: 10.1007/s00464-005-0071-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Accepted: 02/10/2005] [Indexed: 10/25/2022]
|
45
|
Costagliola M, Agrosì M. Second-degree burns: a comparative, multicenter, randomized trial of hyaluronic acid plus silver sulfadiazine vs. silver sulfadiazine alone. Curr Med Res Opin 2005; 21:1235-40. [PMID: 16083533 DOI: 10.1185/030079905x56510] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS This multicenter, multinational, randomized, double-blind, controlled, parallel-group study, was designed to assess the efficacy and safety of a fixed combination topical medicinal product, containing 0.2% hyaluronic acid and 1% silver sulfadiazine (HA-SSD) (Connettivina Plus cream) versus 1% silver sulfadiazine cream alone (SSD), in the treatment of second-degree burns. METHODS 111 adult patients (age 18-75 years) of both sexes, with IIa-degree (superficial) and IIb-degree (deep dermal) burns, were randomized to receive HA-SSD or SSD. Treatments (approximately 5 g/100 cm2) were applied once a day until the wounds healed, but for no longer than 4 weeks. Burns had to have occurred within 48 hours from the start of treatment, be caused by thermal injury, and be confined to the trunk and/or upper and lower extremities. RESULTS Results showed that both the fixed combination HA-SSD, and SSD alone, were effective and well tolerated topical agents for the treatment of second-degree burns. All burns were healed except in one patient treated with SSD. It was also observed that the fixed combination HA-SSD caused a significantly more rapid re-epithelialization of burns, i.e. a shorter time to healing, than SSD alone. The difference recorded--4.5 days--was statistically significant (p = 0.0073). CONCLUSION The observed shorter time to healing caused by the fixed combination is clinically relevant and further demonstrates the wound healing activity of HA.
Collapse
Affiliation(s)
- M Costagliola
- Department of Plastic and Reconstructive Surgery, Centre Hospitalier Universitaire, Toulouse Rangueil, France
| | | |
Collapse
|
46
|
|