Synthesis and evaluation of novel absorptive and antibacterial polyurethane membranes as wound dressing

Rapid eradication of vancomycin and methicillin-resistant Staphylococcus aureus by MDP1 antimicrobial peptide coated on photocrosslinkable chitosan hydrogel: in vitro antibacterial and in silico molecular docking studies

Introduction

Antibiotic resistance and weak bioavailability of antibiotics in the skin due to systemic administration leads to failure in eradication of vancomycin- and methicillin-resistant Staphylococcus aureus (VRSA and MRSA)-associated wound infections and subsequent septicemia and even death. Accordingly, this study aimed at designing a photocrosslinkable methacrylated chitosan (MECs) hydrogel coated by melittin-derived peptide 1 (MDP1) that integrated the antibacterial activity with the promising skin regenerative capacity of the hydrogel to eradicate bacteria by burst release strategy.

Methods

The MECs was coated with MDP1 (MECs-MDP1), characterized, and the hydrogel-peptide interaction was evaluated by molecular docking. Antibacterial activities of MECs-MDP1 were evaluated against VRSA and MRSA bacteria and compared to MECs-vancomycin (MECs-vanco). Antibiofilm activity of MECs-MDP1 was studied by our novel 'in situ biofilm inhibition zone (IBIZ)' assay, and SEM. Biocompatibility with human dermal fibroblast cells (HDFs) was also evaluated.

Results and Discussion

Molecular docking showed hydrogen bonds as the most interactions between MDP1 and MECs at a reasonable affinity. MECs-MDP1 eradicated the bacteria rapidly by burst release strategy whereas MECs-vanco failed to eradicate them at the same time intervals. Antibiofilm activity of MECs-MDP1 were also proved successfully. As a novel report, molecular docking analysis has demonstrated that MDP1 covers the structure of MECs and also binds to lysozyme with a reasonable affinity, which may explain the inhibition of lysozyme. MECs-MDP1 was also biocompatible with human dermal fibroblast skin cells, which indicates its safe future application. The antibacterial properties of a photocrosslinkable methacrylated chitosan-based hydrogel coated with MDP1 antimicrobial peptide were successfully proved against the most challenging antibiotic-resistant bacteria causing nosocomial wound infections; VRSA and MRSA. Molecular docking analysis revealed that MDP1 interacts with MECs mainly through hydrogen bonds with reasonable binding affinity. MECs-MDP1 hydrogels eradicated the planktonic state of bacteria by burst release of MDP1 in just a few hours whereas MECs-vanco failed to eradicate them. inhibition zone assay showed the anti-biofilm activity of the MECs-MDP1 hydrogel too. These findings emphasize that MECs-MDP1 hydrogel would be suggested as a biocompatible wound-dressing candidate with considerable and rapid antibacterial activities to prevent/eradicate VRSA/MRSA bacterial wound infections.

From Poly(glycerol itaconate) Gels to Novel Nonwoven Materials for Biomedical Applications

Electrospinning is a process that has attracted significant interest in recent years. It provides the opportunity to produce nanofibers that mimic the extracellular matrix. As a result, it is possible to use the nonwovens as scaffolds characterized by high cellular adhesion. This work focused on the synthesis of poly(glycerol itaconate) (PGItc) and preparation of nonwovens based on PGItc gels and polylactide. PGItc gels were synthesized by a reaction between itaconic anhydride and glycerol. The use of a mixture of PGItc and PLA allowed us to obtain a material with different properties than with stand-alone polymers. In this study, we present the influence of the chosen ratios of polymers and the OH/COOH ratio in the synthesized PGItc on the properties of the obtained materials. The addition of PGItc results in hydrophilization of the nonwovens' surface without disrupting the high porosity of the fibrous structure. Spectral and thermal analyzes are presented, along with SEM imagining. The preliminary cytotoxicity research showed that nonwovens were non-cytotoxic materials. It also helped to pre-determine the potential application of PGItc + PLA nonwovens as subcutaneous tissue fillers or drug delivery systems.

Preparation and evaluation of antibacterial wound dressing based on vancomycin-loaded silk/dialdehyde starch nanoparticles

One of the main reasons infected wounds go untreated is that antibiotic-resistant bacteria mainly cause infection. Vancomycin is an antibiotic used against Gram-positive bacteria, such as MRSA, but it has limited intravenous use due to its toxicity. This study describes using a local drug delivery approach at the wound site. The aim is to prepare a silk dressing containing dialdehyde starch nanoparticles loaded with vancomycin that can cure infection through the controlled release of antibiotics. First, the starch was oxidized by sodium periodate solution and converted to dialdehyde starch. Dialdehyde starch was converted into nanoparticles by the microemulsion method. Simultaneously, with nanoparticle formation, the antibiotic vancomycin (VAN), added to the solution, was loaded into the dialdehyde starch nanoparticles (DASNP). The wound dressing (SF/DASNP/VAN) was prepared by adding nanoparticles containing antibiotics to the silk fibroin (SF) solution, and then, the solution containing the nanoparticles was freeze-dried, and the nanoparticles were placed inside the silk matrix. Drug release of dressings was performed by immersion in phosphate-buffered saline, and cytotoxicity by MTT assay and antibacterial properties of dressings were investigated by the inhibition zone method. The morphology of the SF/DASNP/VAN dressing, its biocompatibility, antibacterial efficiency, and antibiotic release kinetics were assessed. The synthesized dressing has the desired biocompatibility with 69% cell viability and shows antibacterial properties against MRSA with a growth inhibition zone diameter of 12 mm. Also, VAN was successfully incorporated into the dressing, resulting in a 144-h continuous release profile. It may be concluded that the fabricated dressing based on silk and dialdehyde starch nanoparticles opens up a new option for topical administration of antibiotics. We believe its properties can be considered a new dressing for infectious wounds by reducing infection associated with controlled drug delivery.

Breathable and Wearable Strain Sensors Based on Synergistic Conductive Carbon Nanotubes/Cotton Fabrics for Multi-directional Motion Detection

Flexible strain-sensitive sensors have been receiving intensive attention in many aspects ranging from human motion capture to health-related signal monitoring. However, the fabric strain sensor with multi-directional sensing capability, besides having a wide strain range and high response sensitivity, is still very challenging and deserves further exploration. Here, we have prepared a wearable cotton fabric strain sensor uniformly decorated with single-walled carbon nanotubes through a facile solution process. The unique hierarchical architecture of the cotton fabric woven from twisted yarns combined with the conductive carbon nanotube network endows the fabric strain sensors with attractive performance, including low detection limit, large workable strain range, fascinating stability and durability, excellent direction-dependent strain response, and good air permeability. The strain sensor without polymer encapsulation can not only monitor subtle and large multi-directional motions but also fit well to the human body with satisfactory comfort, demonstrating its potential application in wearable electronics and intelligent clothing.

Breathable Strain/Temperature Sensor Based on Fibrous Networks of Ionogels Capable of Monitoring Human Motion, Respiration, and Proximity

Wearable strain and temperature sensors are desired for human-machine interfaces, health monitoring, and human motion monitoring. Herein, the fibrous mat with aligned nanofibers of ionic liquid (IL)/thermoplastic polyurethane (TPU) ionogels is fabricated via an electrospinning technique. The resultant fibrous mat is cut into a rectangle specimen and electrodes are loaded along the direction perpendicular to the nanofiber orientation to design a high-performance multimodal sensor based on an ionic conducting mechanism. As a strain sensor, the obtained sensor exhibits a wide strain working range (0-200%), a fast response and recovery (119 ms), a low detection limit (0.1%), and good reproducibility because of the reversible and deformable ionic conductive pathways of the sensor. Moreover, the sensor also exhibits excellent temperature-sensing behaviors, including a monotonic thermal response, high sensitivity (2.75% °C^-1), high accuracy (0.1 °C), a fast response time (2.46 s), and remarkable repeatability, attributable to the negative temperature coefficient behavior of the IL/TPU fibrous mat. More interestingly, the IL/TPU fibrous sensor possesses good breathability, which is desired for wearable electronics. Because of these excellent sensing capabilities in strain and temperature, the sensor can not only monitor tiny and large human motions but also detect respiration and proximity, exhibiting enormous potential in wearable electronics.

Antibacterial and Biocompatible Hydrogel Dressing Based on Gelatin- and Castor-Oil-Derived Biocidal Agent

Favored antibacterial activity associated with excellent biocompatibility, mechanical durability, and exudate handling needs to be addressed by modern dressing to achieve the desired wound healing. This paper deals with developing a new green and facile approach to manufacturing nonleachable antibacterial gelatin-based films for wound dressing. Therefore, a reactive methoxy-silane-functionalized quaternary ammonium compound bearing a fatty amide residue originating from castor oil (Si-CAQ) was initially synthesized. The antibacterial dressings were then fabricated via sol-gel and condensation reactions of the mixture containing gelatin, Si-CAQ, (3-glycidyloxypropyl) trimethoxysilane, and poly(vinyl alcohol). By utilizing bioactive polymers as starting materials and eliminating organic solvents during the dressing preparation, desirable clinical safety could be ensured. The gelatin-based films presented appropriate mechanical properties, such as flexibility and strength, in both dried and hydrated states (tensile strength >6 MPa and elongation >100). It is due to the in situ generations of the inorganic silicon domain in the organic framework via the sol-gel cross-linking process. The prepared dressings exhibited desirable features, including excellent biocompatibility (cell viability >95%), proper wound-exudate-managing characteristics (equilibrium water contact (EWA) 280-350% and water vapor transmission rate (WVTR) 2040-2200 g/m²/day), fluid handling capacity (FHC) (3-3.35 g), as well as commendable hemocompatibility. The promising bactericidal activity of the dressing against Bacillus subtilis, methicillin-resistant Staphylococcus aureus, and Escherichia coli strains with a contact-killing efficacy of 100% could prevent infection development at the wounded area. As evaluated by the wound scratch assay, the desired fibroblast cell growth, migration, and proliferation indicated the capability of the dressing to facilitate the healing process by encouraging fibroblast cell migration to the damaged area. In vivo wound-healing results showed that the prepared biocidal dressing stimulates wound healing and enhances epithelialization, collagen maturation, and vascularization of wounds due to their antibacterial effects and accelerated cellular functions.

High-Performance Foam-Shaped Strain Sensor Based on Carbon Nanotubes and Ti3C2Tx MXene for the Monitoring of Human Activities

The flexible strain sensor is of significant importance in wearable electronics, since it can help monitor the physical signals from the human body. Among various strain sensors, the foam-shaped ones have received widespread attention owing to their light weight and gas permeability. However, the working range of these sensors is still not large enough, and the sensitivity needs to be further improved. In this work, we develop a high-performance foam-shaped strain sensor composed of Ti₃C₂T_x MXene, multiwalled carbon nanotubes (MWCNTs), and thermoplastic polyurethane (TPU). MXene sheets are adsorbed on the surface of a composite foam of MWCNTs and TPU (referred to as TPU/MWCNTs foam), which is prefabricated by using a salt-templating method. The obtained TPU/MWCNTs@MXene foam works effectively as a lightweight, easily processable, and sensitive strain sensor. The TPU/MWCNTs@MXene device can deliver a wide working strain range of ∼100% and an outstanding sensitivity as high as 363 simultaneously, superior to the state-of-the-art foam-shaped strain sensors. Moreover, the composite foam shows an excellent gas permeability and suitable elastic modulus close to those of skin, indicating its being highly comfortable as a wearable sensor. Owing to these advantages, the sensor works effectively in detecting both subtle and large human movements, such as joint motion, finger motion, and vocal cord vibration. In addition, the sensor can be used for gesture recognition, demonstrating its perspective in human-machine interaction. Because of the high sensitivity, wide working range, gas permeability, and suitable modulus, our foam-shaped composite strain sensor may have great potential in the field of flexible and wearable electronics in the near future.

Synthesis and property of polyurethane elastomer for biomedical applications based on nonaromatic isocyanates, polyesters, and ethylene glycol

Polyurethane (PU) elastomers were synthesized by the reaction of HDI or IPDI diisocyanates and poly(ε-caprolactone) (PCL or poly(ethylene adipate) (PA) diols and ethylene glycol as a polymer chain extender. IR, 1H, and 13C NMR spectroscopy and X-ray analysis were used for the structural analysis of the formed films. The molecular weight distribution was examined by GPC chromatography. Based on the measured contact angles, free surface energy parameters were calculated. The obtained results were analyzed for the possible use of these polyurethanes as biomaterials. The most promising in this respect was PU-3, which was synthesized from IPDI and PCL. This was due to its high molecular weight of approximately 90,000, the presence of a crystalline phase, and the relatively high hydrophobicity, with a SEP value below 25 mJ/m2. These films showed a good resistance to hydrolysis during incubation in Baxter physiological saline during 6 weeks. Both Gram-positive (Bacillus sp.) and Gram-negative (Pseudomonas sp.) types of bacterial strains were used to test the biodegradation property. Synthesized PUs are biodegradable and showed moderate or even mild cytotoxicity against human normal fibroblasts (BJ) and immortalized keratinocytes (HaCaT), estimated with direct contact assay. The most biocompatible was PU-3 film, which revealed rather mild reactivity against both cell lines, and the least was PU-2 film, synthesized from HDI and PA (severe toxicity for HaCaTs).

Ciprofloxacin-Modified Degradable Hybrid Polyurethane-Polylactide Porous Scaffolds Developed for Potential Use as an Antibacterial Scaffold for Regeneration of Skin

The aim of the performed study was to fabricate an antibacterial and degradable scaffold that may be used in the field of skin regeneration. To reach the degradation criterion for the biocompatible polyurethane (PUR), obtained by using amorphous α,ω-dihydroxy(ethylene-butylene adipate) macrodiol (PEBA), was used and processed with so-called "fast-degradable" polymer polylactide (PLA) (5 or 10 wt %). To meet the antibacterial requirement obtained, hybrid PUR-PLA scaffolds (HPPS) were modified with ciprofloxacin (Cipro) (2 or 5 wt %) and the fluoroquinolone antibiotic inhibiting growth of bacteria, such as Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus, which are the main causes of wound infections. Performed studies showed that Cipro-modified HPPS, obtained by using 5% of PLA, possess suitable mechanical characteristics, morphology, degradation rates, and demanded antimicrobial properties to be further developed as potential scaffolds for skin tissue engineering.

Hydrogel Dressings for Advanced Wound Management

BACKGROUND

Composed in a large extent of water and due to their nonadhesiveness, hydrogels found their way to the wound dressing market as materials that provide a moisture environment for healing while being comfortable to the patient. Hydrogels' exploitation is constantly increasing after evidences of their even broader therapeutic potential due to resemblance to dermal tissue and ability to induce partial skin regeneration. The innovation in advanced wound care is further directed to the development of so-called active dressings, where hydrogels are combined with components that enhance the primary purpose of providing a beneficial environment for wound healing.

OBJECTIVE

The objective of this review is to concisely describe the relevance of hydrogel dressings as platforms for delivery of active molecules for improved management of difficult- to-treat wounds. The emphasis is on the most recent advances in development of stimuli- responsive hydrogels, which allow for control over wound healing efficiency in response to different external modalities. Novel strategies for monitoring of the wound status and healing progress based on incorporation of sensor molecules into the hydrogel platforms are also discussed.

Laser-Processed Nature-Inspired Deformable Structures for Breathable and Reusable Electrophysiological Sensors toward Controllable Home Electronic Appliances and Psychophysiological Stress Monitoring

Physiological monitoring through skin patch stretchable devices has received extensive attention because of their significant findings in many human-machine interaction applications. In this paper, we present novel nature-inspired, kiri-spider, serpentine structural designs to sustain mechanical deformations under complex stress environments. Strain-free mechanical structures involving stable high areal coverage (spiderweb), three-dimensional out-of-plane deformations (kirigami), and two-dimensional (2D) stretchable (2D spring) electrodes demonstrated high levels of mechanical loading under various strains, which were verified through theoretical and experimental studies. Alternative to conventional microfabrication procedures, sensors fabricated by a facile and rapid benchtop programmable laser machine enabled the realization of low-cost, high-throughput manufacture, followed by transferring procedures with a nearly 100% yield. For the first time, we demonstrated laser-processed thin (∼10 μm) flexible filamentary patterns embedded within the solution-processed polyimide to make it compatible with current flexible printed circuit board electronics. A patch-based sensor with thin, breathable, and sticky nature exhibited remarkable water permeability >20 g h^-1 m^-2 at a thickness of 250 μm. Moreover, the reusability of the sensor patch demonstrated the significance of our patch-based electrophysiological sensor. Furthermore, this wearable sensor was successfully implemented to control human-machine interfaces to operate home electronic appliances and monitor mental stress in a pilot study. These advances in novel mechanical architectures with good sensing performances provide new opportunities in wearable smart sensors.

Antimicrobial wound dressings with high mechanical conformability prepared through thiol-yne click photopolymerization reaction

Radical mediated photochemical thiol-yne click polymerization of thiol-terminated polyurethane prepolymers, with poly(ethylene glycol) soft segment at two different molecular weights, a propargyl terminated urethane crosslinker and silver salt was utilized to prepare versatile wound dressings containing well-dispersed Ag° nanoparticles produced via in situ reduction of Ag⁺ ions. The dressings with optimized chemical structure showed desirable fluid handling capacity (up to 4.84 g/10 cm² d^-1) to provide moist environment over damaged tissue. They were permeable to oxygen and carbon dioxide, therefore, the processes related to tissue regeneration of wound bed could be continued without problem. Their appropriate tensile strength (up to 3.87 MPa) and suitable conformability (less than 0.1% permanent set) enabled protection of damaged skin tissue from external physical forces during the healing process, even for wounds present at organs with a high degree of freedom. The proper cytocompatibility of the prepared dressings and their ability to support growth and proliferation of fibroblast cells as determined by wound scratch healing assay showed the potential utility of the dressings to motivate wound healing progression by migration of cells to the damaged area. In addition, these dressings with in situ formed silver nanoparticles exhibited promising antimicrobial activity against different bacterial and fungal strains, and consequently could encourage wound healing process by prevention from infection in the wound site.

Polyurethane/siloxane membranes containing graphene oxide nanoplatelets as antimicrobial wound dressings: in vitro and in vivo evaluations

Preserving wounds from bacterial and fungal infections and retaining optimum moist environment over damaged tissue are major challenges in wound care management. Application of wound dressings with antimicrobial activity and appropriate wound exudates handling ability is of particular significance for promoting wound healing. To this end, preparation and evaluation of novel wound dres1sings made from polyurethane/siloxane network containing graphene oxide (GO) nanoplatelets are described. The particular sol-gel hydrolysis/condensation procedure applied for the preparation of dressings leads to an appropriate distribution of GO nanoplatelets in the dressing membranes. The crosslinked siloxane domains and the presence of GO nanoplatelets within polymeric chains offered necessary mechanical strength for dressings. Meanwhile, a combination of hydrophilic and hydrophobic moieties in dressing backbone enabled suitable wound exudate management. Therefore, both of physical protection from external forces and preservation of moist environment over wound were attained by using the designed dressings. Widespread antimicrobial activity against gram-positive, gram-negative and fungal strains was recorded for the dressing with the optimum amount of GO, meanwhile, very good cytocompatibility against fibroblast cells was noted for these dressings. In vivo assay of the GO containing dressing on rat animal model reveals that the dressing can promote wound healing by complete re-epithelization, enhanced vascularization and collagen deposition on healed tissue.

Quaternary ammonium-based biomedical materials: State-of-the-art, toxicological aspects and antimicrobial resistance

Microbial infections affect humans worldwide. Many quaternary ammonium compounds have been synthesized that are not only antibacterial, but also possess antifungal, antiviral and anti-matrix metalloproteinase capabilities. Incorporation of quaternary ammonium moieties into polymers represents one of the most promising strategies for preparation of antimicrobial biomaterials. Various polymerization techniques have been employed to prepare antimicrobial surfaces with quaternary ammonium functionalities; in particular, syntheses involving controlled radical polymerization techniques enable precise control over macromolecular structure, order and functionality. Although recent publications report exciting advances in the biomedical field, some of these technological developments have also been accompanied by potential toxicological and antimicrobial resistance challenges. Recent evidenced-based data on the biomedical applications of antimicrobial quaternary ammonium-containing biomaterials that are based on randomized human clinical trials, the golden standard in contemporary medicinal science, are included in the present review. This should help increase visibility, stimulate debates and spur conversations within a wider scientific community on the implications and plausibility for future developments of quaternary ammonium-based antimicrobial biomaterials.

Future Prospects for Scaffolding Methods and Biomaterials in Skin Tissue Engineering: A Review

Over centuries, the field of regenerative skin tissue engineering has had several advancements to facilitate faster wound healing and thereby restoration of skin. Skin tissue regeneration is mainly based on the use of suitable scaffold matrices. There are several scaffold types, such as porous, fibrous, microsphere, hydrogel, composite and acellular, etc., with discrete advantages and disadvantages. These scaffolds are either made up of highly biocompatible natural biomaterials, such as collagen, chitosan, etc., or synthetic materials, such as polycaprolactone (PCL), and poly-ethylene-glycol (PEG), etc. Composite scaffolds, which are a combination of natural or synthetic biomaterials, are highly biocompatible with improved tensile strength for effective skin tissue regeneration. Appropriate knowledge of the properties, advantages and disadvantages of various biomaterials and scaffolds will accelerate the production of suitable scaffolds for skin tissue regeneration applications. At the same time, emphasis on some of the leading challenges in the field of skin tissue engineering, such as cell interaction with scaffolds, faster cellular proliferation/differentiation, and vascularization of engineered tissues, is inevitable. In this review, we discuss various types of scaffolding approaches and biomaterials used in the field of skin tissue engineering and more importantly their future prospects in skin tissue regeneration efforts.

Active Release of Nitric Oxide-Releasing Dendrimers from Electrospun Polyurethane Fibers

The fabrication of electrospun composite polyurethane fibers capable of dual-action antibacterial dendrimer release is reported. Generation 4 (G4) poly(amidoamine) dendrimers were functionalized with octyl alkyl chain or quaternary ammonium (QA) moieties followed by modification of the resulting secondary amines with N-diazeniumdiolate nitric oxide (NO) donors to produce dual-action antibacterial dendrimers. Control and NO-releasing dendrimers were doped into polyurethane solutions prior to electrospinning of the polymer to yield well-defined dendrimer-doped composite polyurethane fibers. The fiber mats were semi-porous (≥30% porosity) and exhibited high water uptake (>100% relative to fiber mass). Dendrimer- and NO-release characteristics (rates and totals) were dependent on the dendrimer modification and polyurethane composition, with total dendrimer- and NO-release amounts ranging from 10 - 80 μg/mg and 0.027 - 0.072 μmol NO/mg, respectively. The antibacterial action of the fibers was evaluated against Gram-negative and Gram-positive bacterial strains. Nitric oxide-releasing fibers demonstrated broad-spectrum bactericidal action at short (2 h) and long (24 h) timescales.

Advanced Therapeutic Dressings for Effective Wound Healing--A Review

Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care.

Smart Dressings Based on Nanostructured Fibers Containing Natural Origin Antimicrobial, Anti-Inflammatory, and Regenerative Compounds

A fast and effective wound healing process would substantially decrease medical costs, wound care supplies, and hospitalization significantly improving the patients' quality of life. The search for effective therapeutic approaches seems to be imperative in order to avoid the aggravation of chronic wounds. In spite of all the efforts that have been made during the recent years towards the development of artificial wound dressings, none of the currently available options combine all the requirements necessary for quick and optimal cutaneous regeneration. Therefore, technological advances in the area of temporary and permanent smart dressings for wound care are required. The development of nanoscience and nanotechnology can improve the materials and designs used in topical wound care in order to efficiently release antimicrobial, anti-inflammatory and regenerative compounds speeding up the endogenous healing process. Nanostructured dressings can overcome the limitations of the current coverings and, separately, natural origin components can also overcome the drawbacks of current antibiotics and antiseptics (mainly cytotoxicity, antibiotic resistance, and allergies). The combination of natural origin components with demonstrated antibiotic, regenerative, or anti-inflammatory properties together with nanostructured materials is a promising approach to fulfil all the requirements needed for the next generation of bioactive wound dressings. Microbially compromised wounds have been treated with different essential oils, honey, cationic peptides, aloe vera, plant extracts, and other natural origin occurring antimicrobial, anti-inflammatory, and regenerative components but the available evidence is limited and insufficient to be able to draw reliable conclusions and to extrapolate those findings to the clinical practice. The evidence and some promising preliminary results indicate that future comparative studies are justified but instead of talking about the beneficial or inert effects of those natural origin occurring materials, the scientific community leads towards the identification of the main active components involved and their mechanism of action during the corresponding healing, antimicrobial, or regenerative processes and in carrying out systematic and comparative controlled tests. Once those natural origin components have been identified and their efficacy validated through solid clinical trials, their combination within nanostructured dressings can open up new avenues in the fabrication of bioactive dressings with outstanding characteristics for wound care. The motivation of this work is to analyze the state of the art in the use of different essential oils, honey, cationic peptides, aloe vera, plant extracts, and other natural origin occurring materials as antimicrobial, anti-inflammatory and regenerative components with the aim of clarifying their potential clinical use in bioactive dressings. We conclude that, for those natural occurring materials, more clinical trials are needed to reach a sufficient level of evidence as therapeutic agents for wound healing management.

Breathable and Stretchable Temperature Sensors Inspired by Skin

Flexible electronics attached to skin for healthcare, such as epidermal electronics, has to struggle with biocompatibility and adapt to specified environment of skin with respect to breath and perspiration. Here, we report a strategy for biocompatible flexible temperature sensors, inspired by skin, possessing the excellent permeability of air and high quality of water-proof by using semipermeable film with porous structures as substrate. We attach such temperature sensors to underarm and forearm to measure the axillary temperature and body surface temperature respectively. The volunteer wears such sensors for 24 hours with two times of shower and the in vitro test shows no sign of maceration or stimulation to the skin. Especially, precise temperature changes on skin surface caused by flowing air and water dropping are also measured to validate the accuracy and dynamical response. The results show that the biocompatible temperature sensor is soft and breathable on the human skin and has the excellent accuracy compared to mercury thermometer. This demonstrates the possibility and feasibility of fully using the sensors in long term body temperature sensing for medical use as well as sensing function of artificial skin for robots or prosthesis.

Natural and synthetic polymers for wounds and burns dressing

In the last years, health care professionals faced with an increasing number of patients suffering from wounds and burns difficult to treat and heal. During the wound healing process, the dressing protects the injury and contributes to the recovery of dermal and epidermal tissues. Because their biocompatibility, biodegradability and similarity to macromolecules recognized by the human body, some natural polymers such as polysaccharides (alginates, chitin, chitosan, heparin, chondroitin), proteoglycans and proteins (collagen, gelatin, fibrin, keratin, silk fibroin, eggshell membrane) are extensively used in wounds and burns management. Obtained by electrospinning technique, some synthetic polymers like biomimetic extracellular matrix micro/nanoscale fibers based on polyglycolic acid, polylactic acid, polyacrylic acid, poly-ɛ-caprolactone, polyvinylpyrrolidone, polyvinyl alcohol, polyethylene glycol, exhibit in vivo and in vitro wound healing properties and enhance re-epithelialization. They provide an optimal microenvironment for cell proliferation, migration and differentiation, due to their biocompatibility, biodegradability, peculiar structure and good mechanical properties. Thus, synthetic polymers are used also in regenerative medicine for cartilage, bone, vascular, nerve and ligament repair and restoration. Biocompatible with fibroblasts and keratinocytes, tissue engineered skin is indicated for regeneration and remodeling of human epidermis and wound healing improving the treatment of severe skin defects or partial-thickness burn injuries.

Nanomaterials for membrane fouling control: accomplishments and challenges

We report a review of recent research efforts on incorporating nanomaterials-including metal/metal oxide nanoparticles, carbon-based nanomaterials, and polymeric nanomaterials-into/onto membranes to improve membrane antifouling properties in biomedical or potentially medical-related applications. In general, nanomaterials can be incorporated into/onto a membrane by blending them into membrane fabricating materials or by attaching them to membrane surfaces via physical or chemical approaches. Overall, the fascinating, multifaceted properties (eg, high hydrophilicity, superparamagnetic properties, antibacterial properties, amenable functionality, strong hydration capability) of nanomaterials provide numerous novel strategies and unprecedented opportunities to fully mitigate membrane fouling. However, there are still challenges in achieving a broader adoption of nanomaterials in the membrane processes used for biomedical applications. Most of these challenges arise from the concerns over their long-term antifouling performance, hemocompatibility, and toxicity toward humans. Therefore, rigorous investigation is still needed before the adoption of some of these nanomaterials in biomedical applications, especially for those nanomaterials proposed to be used in the human body or in contact with living tissue/body fluids for a long period of time. Nevertheless, it is reasonable to predict that the service lifetime of membrane-based biomedical devices and implants will be prolonged significantly with the adoption of appropriate fouling control strategies.