Temporary skin grafts based on hybrid graphene oxide-natural biopolymer nanofibers as effective wound healing substitutes: pre-clinical and pathological studies in animal models

Advances in graphene-based 2D materials for tendon, nerve, bone/cartilage regeneration and biomedicine

Two-dimensional (2D) materials, especially graphene-based materials, have important implications for tissue regeneration and biomedicine due to their large surface area, transport properties, ease of functionalization, biocompatibility, and adsorption capacity. Despite remarkable progress in the field of tissue regeneration and biomedicine, there are still problems such as unclear long-term stability, lack of in vivo experimental data, and detection accuracy. This paper reviews recent applications of graphene-based materials in tissue regeneration and biomedicine and discusses current issues and prospects for the development of graphene-based materials with respect to promoting the regeneration of tendons, neuronal cells, bone, chondrocytes, blood vessels, and skin, as well as applications in sensing, detection, anti-microbial activity, and targeted drug delivery.

Electrospun nanofibers synthesized from polymers incorporated with bioactive compounds for wound healing

The development of innovative wound dressing materials is crucial for effective wound care. It's an active area of research driven by a better understanding of chronic wound pathogenesis. Addressing wound care properly is a clinical challenge, but there is a growing demand for advancements in this field. The synergy of medicinal plants and nanotechnology offers a promising approach to expedite the healing process for both acute and chronic wounds by facilitating the appropriate progression through various healing phases. Metal nanoparticles play an increasingly pivotal role in promoting efficient wound healing and preventing secondary bacterial infections. Their small size and high surface area facilitate enhanced biological interaction and penetration at the wound site. Specifically designed for topical drug delivery, these nanoparticles enable the sustained release of therapeutic molecules, such as growth factors and antibiotics. This targeted approach ensures optimal cell-to-cell interactions, proliferation, and vascularization, fostering effective and controlled wound healing. Nanoscale scaffolds have significant attention due to their attractive properties, including delivery capacity, high porosity and high surface area. They mimic the Extracellular matrix (ECM) and hence biocompatible. In response to the alarming rise of antibiotic-resistant, biohybrid nanofibrous wound dressings are gradually replacing conventional antibiotic delivery systems. This emerging class of wound dressings comprises biopolymeric nanofibers with inherent antibacterial properties, nature-derived compounds, and biofunctional agents. Nanotechnology, diminutive nanomaterials, nanoscaffolds, nanofibers, and biomaterials are harnessed for targeted drug delivery aimed at wound healing. This review article discusses the effects of nanofibrous scaffolds loaded with nanoparticles on wound healing, including biological (in vivo and in vitro) and mechanical outcomes.

A review on background, process and application of electrospun nanofibers for tissue regeneration

Electrospinning is a versatile method which is used to synthesize nano/micro sized fibers under the influence of electric field. Electrospun nanoscaffolds are one of the widely accepted platforms for cultivating soft and hard tissues as they create a prefect micro-environment for cell adhesion, proliferation and differentiation. Nanoscaffolds are widely used in the field of tissue engineering due to their versatility in aiding the growth of different types of cells and tissues for varied applications. The composition, molecular weight and structure of polymer used to fabricate nanoscaffold plays an important role in determining the size and strength of the nanofibers prepared. This review gives information about the background, process and different types of polymers used in electrospinning. Recent advances in culturing liver cells, osteoblasts, skin cells, neural cells and coronary artery smooth muscle cells on nanoscaffolds are also elucidated.

Double-Network Chitosan-Based Hydrogels with Improved Mechanical, Conductive, Antimicrobial, and Antibiofouling Properties

In recent years, the antimicrobial activity of chitosan-based hydrogels has been at the forefront of research in wound healing and the prevention of medical device contamination. Anti-infective therapy is a serious challenge given the increasing prevalence of bacterial resistance to antibiotics as well as their ability to form biofilms. Unfortunately, hydrogel resistance and biocompatibility do not always meet the demands of biomedical applications. As a result, the development of double-network hydrogels could be a solution to these issues. This review discusses the most recent techniques for creating double-network chitosan-based hydrogels with improved structural and functional properties. The applications of these hydrogels are also discussed in terms of tissue recovery after injuries, wound infection prevention, and biofouling of medical devices and surfaces for pharmaceutical and medical applications.

Graphene-Based Materials for Inhibition of Wound Infection and Accelerating Wound Healing

Bacterial infection of the wound could potentially cause serious complications and an enormous medical and financial cost to the rapid emergence of drug-resistant bacteria. Nanomaterials are an emerging technology, that has been researched as possible antimicrobial nanomaterials for the inhibition of wound infection and enhancement of wound healing. Graphene is 2-dimensional (2D) sheet of sp² carbon atoms in a honeycomb structure. It has superior properties, strength, conductivity, antimicrobial, and molecular carrier abilities. Graphene and its derivatives, Graphene oxide (GO) and reduced GO (rGO), have antibacterial activity and could damage bacterial morphology and lead to the leakage of intracellular substances. Besides, for wound infection management, Graphene-platforms could be functionalized by different antibacterial agents such as metal-nanoparticles, natural compounds, and antibiotics. The Graphene structure can absorb near-infrared wavelengths, allowing it to be used as antimicrobial photodynamic therapy. Therefore, Graphene-based material could be used to inhibit pathogens that cause serious skin infections and destroy their biofilm community, which is one of the biggest challenges in treating wound infection. Due to its agglomerated structure, GO hydrogel could entrap and stack the bacteria; thus, it prevents their initial attachment and biofilm formation. The sharp edges of GO could destroy the extracellular polymeric substance surrounding the biofilm and ruin the biofilm biomass structure. As well as, Chitosan and different natural and synthetic polymers such as collagen and polyvinyl alcohol (PVA) also have attracted a great deal of attention for use with GO as wound dressing material. To this end, multi-functional polymers based on Graphene and blends of synthetic and natural polymers can be considered valid non-antibiotic compounds useful against wound infection and improvement of wound healing. Finally, the global wound care market size was valued at USD 20.8 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 5.4% from 2022 to 2027 (USD 27.2 billion). This will encourage academic as well as pharmaceutical and medical device industries to investigate any new materials such as graphene and its derivatives for the treatment of wound healing.

Nanomaterials and nanomaterials-based drug delivery to promote cutaneous wound healing

Various factors could damage the structure and integrity of skin to cause wounds. Nonhealing or chronic wounds seriously affect the well-being of patients and bring heavy burdens to the society. The past few decades have witnessed application of numerous nanomaterials to promote wound healing. Owing to the unique physicochemical characteristics at nanoscale, nanomaterials-based therapy has been regarded as a potential approach to promote wound healing. In this review, we first overview the wound categories, wound healing process and critical influencing factors. Then applications of nanomaterials with intrinsic therapeutic effect and nanomaterials-based drug delivery systems to promote wound healing are addressed in detail. Finally, current limitations and future perspectives of nanomaterials in wound healing are discussed.

Graphene Incorporated Electrospun Nanofiber for Electrochemical Sensing and Biomedical Applications: A Critical Review

The extraordinary material graphene arrived in the fields of engineering and science to instigate a material revolution in 2004. Graphene has promptly risen as the super star due to its outstanding properties. Graphene is an allotrope of carbon and is made up of sp²-bonded carbon atoms placed in a two-dimensional honeycomb lattice. Graphite consists of stacked layers of graphene. Due to the distinctive structural features as well as excellent physico-chemical and electrical conductivity, graphene allows remarkable improvement in the performance of electrospun nanofibers (NFs), which results in the enhancement of promising applications in NF-based sensor and biomedical technologies. Electrospinning is an easy, economical, and versatile technology depending on electrostatic repulsion between the surface charges to generate fibers from the extensive list of polymeric and ceramic materials with diameters down to a few nanometers. NFs have emerged as important and attractive platform with outstanding properties for biosensing and biomedical applications, because of their excellent functional features, that include high porosity, high surface area to volume ratio, high catalytic and charge transfer, much better electrical conductivity, controllable nanofiber mat configuration, biocompatibility, and bioresorbability. The inclusion of graphene nanomaterials (GNMs) into NFs is highly desirable. Pre-processing techniques and post-processing techniques to incorporate GNMs into electrospun polymer NFs are precisely discussed. The accomplishment and the utilization of NFs containing GNMs in the electrochemical biosensing pathway for the detection of a broad range biological analytes are discussed. Graphene oxide (GO) has great importance and potential in the biomedical field and can imitate the composition of the extracellular matrix. The oxygen-rich GO is hydrophilic in nature and easily disperses in water, and assists in cell growth, drug delivery, and antimicrobial properties of electrospun nanofiber matrices. NFs containing GO for tissue engineering, drug and gene delivery, wound healing applications, and medical equipment are discussed. NFs containing GO have importance in biomedical applications, which include engineered cardiac patches, instrument coatings, and triboelectric nanogenerators (TENGs) for motion sensing applications. This review deals with graphene-based nanomaterials (GNMs) such as GO incorporated electrospun polymeric NFs for biosensing and biomedical applications, that can bridge the gap between the laboratory facility and industry.

Recent advances and challenges in graphene-based nanocomposite scaffolds for tissue engineering application

Graphene-based nanocomposites have recently attracted increasing attention in tissue engineering because of their extraordinary features. These biocompatible substances, in the presence of an apt microenvironment, can stimulate and sustain the growth and differentiation of stem cells into different lineages. This review discusses the characteristics of graphene and its derivatives, such as their excellent electrical signal transduction, carrier mobility, outstanding mechanical strength with improving surface characteristics, self-lubrication, antiwear properties, enormous specific surface area, and ease of functional group modification. Moreover, safety issues in the application of graphene and its derivatives in terms of biocompatibility, toxicity, and interaction with immune cells are discussed. We also describe the applicability of graphene-based nanocomposites in tissue healing and organ regeneration, particularly in the bone, cartilage, teeth, neurons, heart, skeletal muscle, and skin. The impacts of special textural and structural characteristics of graphene-based nanomaterials on the regeneration of various tissues are highlighted. Finally, the present review gives some hints on future research for the transformation of these exciting materials in clinical studies.

Progress in the Development of Graphene-Based Biomaterials for Tissue Engineering and Regeneration

Over the last few decades, tissue engineering has become an important technology for repairing and rebuilding damaged tissues and organs. The scaffold plays an important role and has become a hot pot in the field of tissue engineering. It has sufficient mechanical and biochemical properties and simulates the structure and function of natural tissue to promote the growth of cells inward. Therefore, graphene-based nanomaterials (GBNs), such as graphene and graphene oxide (GO), have attracted wide attention in the field of biomedical tissue engineering because of their unique structure, large specific surface area, good photo-thermal effect, pH response and broad-spectrum antibacterial properties. In this review, the structure and properties of typical GBNs are summarized, the progress made in the development of GBNs in soft tissue engineering (including skin, muscle, nerve and blood vessel) are highlighted, the challenges and prospects of the application of GBNs in soft tissue engineering have prospected.

Biomedical applications of chitosan-graphene oxide nanocomposites

Chitosan (CS) and graphene oxide (GO) nanocomposites have received wide attention in biomedical fields due to the synergistic effect between CS which has excellent biological characteristics and GO which owns great physicochemical, mechanical, and optical properties. Nanocomposites based on CS and GO can be fabricated into a variety of forms, such as nanoparticles, hydrogels, scaffolds, films, and nanofibers. Thanks to the ease of functionalization, the performance of these nanocomposites in different forms can be further improved by introducing other functional polymers, nanoparticles, or growth factors. With this background, the current review summarizes the latest developments of CS-GO nanocomposites in different forms and compositions in biomedical applications including drug and biomacromolecules delivery, wound healing, bone tissue engineering, and biosensors. Future improving directions and challenges for clinical practice are proposed as well.

Nanofiber Systems as Herbal Bioactive Compounds Carriers: Current Applications in Healthcare

Nanofibers have emerged as a potential novel platform due to their physicochemical properties for healthcare applications. Nanofibers’ advantages rely on their high specific surface-area-to-volume and highly porous mesh. Their peculiar assembly allows cell accommodation, nutrient infiltration, gas exchange, waste excretion, high drug release rate, and stable structure. This review provided comprehensive information on the design and development of natural-based polymer nanofibers with the incorporation of herbal medicines for the treatment of common diseases and their in vivo studies. Natural and synthetic polymers have been widely used for the fabrication of nanofibers capable of mimicking extracellular matrix structure. Among them, natural polymers are preferred because of their biocompatibility, biodegradability, and similarity with extracellular matrix proteins. Herbal bioactive compounds from natural extracts have raised special interest due to their prominent beneficial properties in healthcare. Nanofiber properties allow these systems to serve as bioactive compound carriers to generate functional matrices with antimicrobial, anti-inflammatory, antioxidant, antiseptic, anti-viral, and other properties which have been studied in vitro and in vivo, mostly to prove their wound healing capacity and anti-inflammation properties.

Graphene-Oxide Porous Biopolymer Hybrids Enhance In Vitro Osteogenic Differentiation and Promote Ectopic Osteogenesis In Vivo

Over the years, natural-based scaffolds have presented impressive results for bone tissue engineering (BTE) application. Further, outstanding interactions have been observed during the interaction of graphene oxide (GO)-reinforced biomaterials with both specific cell cultures and injured bone during in vivo experimental conditions. This research hereby addresses the potential of fish gelatin/chitosan (GCs) hybrids reinforced with GO to support in vitro osteogenic differentiation and, further, to investigate its behavior when implanted ectopically. Standard GCs formulation was referenced against genipin (Gp) crosslinked blend and 0.5 wt.% additivated GO composite (GCsGp/GO 0.5 wt.%). Pre-osteoblasts were put in contact with these composites and induced to differentiate in vitro towards mature osteoblasts for 28 days. Specific bone makers were investigated by qPCR and immunolabeling. Next, CD1 mice models were used to assess de novo osteogenic potential by ectopic implantation in the subcutaneous dorsum pocket of the animals. After 4 weeks, alkaline phosphate (ALP) and calcium deposits together with collagen synthesis were investigated by biochemical analysis and histology, respectively. Further, ex vivo materials were studied after surgery regarding biomineralization and morphological changes by means of qualitative and quantitative methods. Furthermore, X-ray diffraction and Fourier-transform infrared spectroscopy underlined the newly fashioned material structuration by virtue of mineralized extracellular matrix. Specific bone markers determination stressed the osteogenic phenotype of the cells populating the material in vitro and successfully differentiated towards mature bone cells. In vivo results of specific histological staining assays highlighted collagen formation and calcium deposits, which were further validated by micro-CT. It was observed that the addition of 0.5 wt.% GO had an overall significant positive effect on both in vitro differentiation and in vivo bone cell recruitment in the subcutaneous region. These data support the GO bioactivity in osteogenesis mechanisms as being self-sufficient to elevate osteoblast differentiation and bone formation in ectopic sites while lacking the most common osteoinductive agents.

A Review on Graphene Based Materials and Their Antimicrobial Properties

Graphene-based materials are found as excellent resources and employed as efficient anti-microbial agents, and they have been receiving significant attention from scientists and researchers in this regard. By giving special attention to recent applications of graphene-based materials, the current review is dedicated to unveiling the antimicrobial properties of graphene and its hybrid composites and their preparation methods. Different factors like the number of layers, concentration, size, and shape of the antibacterial activity are thoroughly discussed. Graphene-based materials could damage the bacteria physically by directly contacting the cell membrane or wrapping the bacterial cell. It can also chemically react to bacteria through oxidative stress and charge transfer mechanisms. This review explains such mechanisms thoroughly and summarizes the antibacterial applications (wound bandages, coatings, food packaging, etc.) of graphene and its hybrid materials.

Bio-nanocomposites of graphene with biopolymers; fabrication, properties, and applications

The unique properties of graphene and graphene oxide (GO) nanocomposites make them suitable for a wide range of medical, industrial, and agricultural applications. The addition of graphene or GO to a polymeric matrix can ameliorate its thermo-mechanical, electrical, and barrier characteristics. The present paper reviews the literature on graphene/GO-based bio-nanocomposites and examines the various fabrication methods, such as chemical vapor deposition, chemical synthesis, microwave synthesis, the solvothermal method, molecular beam epitaxy, and colloidal suspension. Each procedure potentially has its disadvantages, especially for mass production. Therefore, introducing an effective method for fabricating graphene on a large scale with high quality is essential. Recent studies have shown that graphene-based bio-nanocomposites are promising materials given their excellent performance in the development of biosensors, drug delivery systems, antimicrobials, modified electrodes, and energy storage systems among other applications. In this review, we evaluate the various procedures used for developing graphene/GO-based bio-nanocomposites and examine the features and applications of the related products. Furthermore, the toxicity of these compounds and attempts to uncover the optimal combinations of biopolymers and carbon nanomaterials for industrial applications will be discussed.

Biomedical Applications of Electrospun Graphene Oxide

Graphene oxide (GO) has broad potential in the biomedical sector. The oxygen-abundant nature of GO means the material is hydrophilic and readily dispersible in water. GO has also been known to improve cell proliferation, drug loading, and antimicrobial properties of composites. Electrospun composites likewise have great potential for biomedical applications because they are generally biocompatible and bioresorbable, possess low immune rejection risk, and can mimic the structure of the extracellular matrix. In the current review, GO-containing electrospun composites for tissue engineering applications are described in detail. In addition, electrospun GO-containing materials for their use in drug and gene delivery, wound healing, and biomaterials/medical devices have been examined. Good biocompatibility and anionic-exchange properties of GO make it an ideal candidate for drug and gene delivery systems. Drug/gene delivery applications for electrospun GO composites are described with a number of examples. Various systems using electrospun GO-containing therapeutics have been compared for their potential uses in cancer therapy. Micro- to nanosized electrospun fibers for wound healing applications and antimicrobial applications are explained in detail. Applications of various GO-containing electrospun composite materials for medical device applications are listed. It is concluded that the electrospun GO materials will find a broad range of biomedical applications such as cardiac patches, medical device coatings, sensors, and triboelectric nanogenerators for motion sensing and biosensing.

Comparison of mouse, rat and rabbit models for adipose - Derived stem cells (ASC) research

PURPOSE OF THE STUDY

Cellular therapies are becoming more popular and there is a big demand for suitable animal model for research in field of tissue engineering. Both the small (rodents) and large animals have their advantages for cellular therapy experiments. Appropriate animal research model would be a bridge between basic research and clinical medicine. The aim of this study was to compare mouse, rat and rabbit as animal models useful for adipose - derived stem cell research.

MATERIALS AND METHODS

Quantity, phenotype, clonogenic and differentiation potential of cells isolated from different localizations of adipose tissue from WAG and LEW/W rat strains, rabbit and mouse were analysed.

RESULTS

The highest number of cells from 1 g of tissue were isolated from cervical white fat of LEW/W rat. ASCs isolated from rat had also the highest clonogenic potential. Phenotype and capability to differentiate into osteogenic, adipogenic and chondrogenic lineages are at the same level for rat and rabbit.

CONCLUSIONS

Rat as a research model can be a rational solution between large animal models and typical laboratory mice because of their size, genetic homogenity, availability of genetically modified stains and possibility to perform research mimicking clinical applications.

Novel Poly(vinyl alcohol)/Chitosan/Modified Graphene Oxide Biocomposite for Wound Dressing Application

Rapid absorption of wound exudate and prevention of wound infection are prerequisites for wound dressing to accelerate wound healing. In this study, a novel kind of promising wound dressing is developed by incorporating polyhexamethylene guanidine (PHMG)-modified graphene oxide (mGO) into the poly(vinyl alcohol)/chitosan (PVA/CS) matrix, conferring the dressing the required mechanical properties, higher water vapor transmission rate (WVTR), less swelling time, improved antibacterial activity, and more cell proliferation compared to the PVA/CS film crosslinked by genipin. In vivo experiments indicate that the PVA/CS/mGO composite film can accelerate wound healing via enhancement of the re-epithelialization. PVA/CS/mGO composite film with 0.5 wt% mGO sheets displays the best wound healing properties, as manifested by the 50% higher antibacterial rate compared to GO and the wound healing rate of the mouse using this dressing is about 41% faster than the control group and 31% faster than the pure PVA/CS dressing. The underlying mechanism of the accelerated wound healing properties may be a result of the improved antibacterial ability to eradicate pathogenic bacteria on the wound area and maintain an appropriate moist aseptic wound healing environment to accelerate re-epithelialization. These findings suggest that this novel composite PVA/CS/mGO film may have promising applications in wound dressing.

Skin substitutes for acute and chronic wound healing: an updated review

Background: Skin substitutes are designed to accelerate wound healing by providing replacement of extracellular matrix and can be used to promote healing of both acute and chronic wounds.Aim: To describe advantages, disadvantages, and indications for different skin substitutes with the intention of providing a systematic framework that clinicians can easily utilize in clinical practice.Materials and method: We conducted a PubMed, Cochrane Library, and company website search for publications using various search terms associated with skin substitutes.Results: Skin substitutes can be categorized as epidermal, dermal, and composite, depending on the skin component they contain, and further split into different categories depending on their composition and source of material, including xenograft, acellular allograft, cellular allograft, autograft, and synthetic skin substitutes. Because there is no ideal option for skin substitutes that meet all the criteria for optimal wound healing, there is ongoing research evaluating and developing different skin substitute options.Conclusion: Our model of skin substitutes was organized based on the different layers of cutaneous involvement and the origin of the product material. We believe that this framework provides a practical guide for selection of the most appropriate skin substitute based on clinical indication.

Graphene oxide coated shell-core structured chitosan/PLLA nanofibrous scaffolds for wound dressing

Graphite oxide (GO) and chitosan (CS) nanofibers have aroused intense interest as wound dressing due to their physicochemical, antimicrobial properties and nanotopography. In this study, GO nanosheets were coated on shell (chitosan, CS)-core (L-polylactic acid, PLLA) structured nanofibrous scaffolds to create a synergistic microenvironment for wound healing. Through scanning electron microscopy (SEM) and atomic force microscopy (AFM) tests, results showed that the surface of GO-coated CS/PLLA nanofibers presented corrugated wrinkles and rougher than that of CS/PLLA nanofibers, and the GO nanosheets did not destroy the structure of nanofibers. X-ray photoelectron spectroscopy (XPS) and thermogravimetric analysis (TGA) demonstrated that GO nanosheets were successfully coated on CS/PLLA nanofibrous scaffolds. Furthermore, the coatings of GO nanosheets significantly improved the hydrophilicity of CS/PLLA nanofibrous scaffolds. GO-coated CS/PLLA nanofibrous scaffolds revealed more excellent antimicrobial activity to Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus) than that of CS/PLLA nanofibrous scaffolds, meanwhile, they promoted the proliferation of pig iliac endothelial cells (PIECs). Rats wounds covered by GO-coated CS/PLLA nanofibrous scaffolds were healed better than other groups on pathological section. This type of nanofibrous scaffolds with GO nanosheets would possess an excellent potential in wound healing process.

Core-sheath gelatin based electrospun nanofibers for dual delivery release of biomolecules and therapeutics

Coaxial electrospinning with the ability to use simultaneously two separate solvents provides a promising strategy for drug delivery. Nevertheless, controlled release of hydrophilic and sensitive therapeutics from slow biodegradable polymers is still challenging. To address this gap, we fabricated core-sheath fibers for dual delivery of lysozyme, as a model protein, and phenytoin sodium as a small therapeutic molecule. The sheath was processed by a gelatin solution while the core fibers were fabricated from an aqueous gelatin/PVA solution. Microstructural studies by transmission and scanning electron microscopy reveal the formation of homogeneous core-sheath nanofibers with an outer and inner diameter of 180 ± 48 nm and 106 ± 30 nm, respectively. Thermal gravimetric analysis determines that the mass loss of the core-sheath fibers fall between the mass loss values of individual sheath and core fibers. Swelling studies indicate higher water absorption of the core-sheath mat compared to the separate sheath and core membranes. In vitro drug release studies in Phosphate Buffered Saline (PBS) determine sustained release of the therapeutics from the core-sheath structure. The release trails three stages including non-Fickian diffusion at the early stage followed by the Fickian diffusion mechanism. The present study shows a useful approach to design core-sheath nanofibrous membranes with controlled and programmable drug release profiles.

Skin regenerative medicine advancements in the Islamic Republic of Iran: a concise review

In the last decade, the Islamic Republic of Iran has witnessed significant improvement and growth in the field of interdisciplinary medicine and in its translation to patients, including the field of cell and stem cell therapy. The main aim of this report is to highlight various advances in regenerative medicine for skin and dermatology using stem cell technology, and its translation to clinic in the past two decades, in Iranian academic centers, clinical institutes and hospitals. While there have been numerous positive advances in clinical outcomes reported in Iran, there is no comparative analytical information on these studies. Here we present a historical overview of the progress and key advancements seen in skin regeneration in this country, review the research frameworks, regulatory approach and pathways and offer perspectives for the future.

Development of nanotechnology for advancement and application in wound healing: a review

Wound healing is a series of different dynamic and complex phenomena. Many studies have been carried out based on the type and severity of wounds. However, to recover wounds faster there are no suitable drugs available, which are highly stable, less expensive as well as has no side effects. Nanomaterials have been proven to be the most promising agent for faster wound healing among all the other wound healing materials. This review briefly discusses the recent developments of wound healing by nanotechnology, their applicability and advantages. Nanomaterials have unique physicochemical, optical, and biological properties. Some of them can be directly applied for wound healing or some of them can be incorporated into scaffolds to create hydrogel matrix or nanocomposites, which promote wound healing through their antimicrobial, as well as selective anti- and pro-inflammatory, and proangiogenic properties. Owing to their high surface area to volume ratio, nanomaterials have not only been used for drug delivery vectors but also can affect wound healing by influencing collagen deposition and realignment and provide approaches for skin tissue regeneration.

The effects of graphene and mesenchymal stem cells in cutaneous wound healing and their putative action mechanism

This study provides a review of the therapeutic potential of graphene dressing scaffolds and mesenchymal stem cells (MSCs) and their synergistic effects with respect to cutaneous wound healing. This study also considers their putative action mechanism based on the antibacterial, immunomodulating, angiogenic, matrix remodeling effects of materials belonging to the graphene family and MSCs during the wound healing process. In addition, this study discusses the cytocompatibility of graphene, its uses as a platform for skin substitutes, the properties it possesses with respect to providing protection against microbial invasion as well as strategies aimed at minimizing the chance of the occurrence of sepsis. MSCs are capable of secreting several factors that exert a therapeutic impact on reparative processes and tissue regeneration. In light of experiments conducted to date, graphene combined with MSCs appears to have the potential to enhance both the wound healing process and infection control at the injury site.

Skin Tissue Substitutes and Biomaterial Risk Assessment and Testing

Tremendous progress has been made over the past few decades to develop skin substitutes for the management of acute and chronic wounds. With the advent of tissue engineering and the ability to combine advanced manufacturing technologies with biomaterials and cell culture systems, more biomimetic tissue constructs have been emerged. Synthetic and natural biomaterials are the main constituents of these skin-like constructs, which play a significant role in tissue grafting, the body's immune response, and the healing process. The act of implanting biomaterials into the human body is subject to the body's immune response, and the complex nature of the immune system involves many different cell types and biological processes that will ultimately determine the success of a skin graft. As such, a large body of recent studies has been focused on the evaluation of the performance and risk assessment of these substitutes. This review summarizes the past and present advances in in vitro, in vivo and clinical applications of tissue-engineered skins. We discuss the role of immunomodulatory biomaterials and biomaterials risk assessment in skin tissue engineering. We will finally offer a roadmap for regulating tissue engineered skin substitutes.

Graphene Materials in Antimicrobial Nanomedicine: Current Status and Future Perspectives

Graphene materials (GMs), such as graphene, graphene oxide (GO), reduced GO (rGO), and graphene quantum dots (GQDs), are rapidly emerging as a new class of broad-spectrum antimicrobial agents. This report describes their state-of-the-art and potential future covering both fundamental aspects and biomedical applications. First, the current understanding of the antimicrobial mechanisms of GMs is illustrated, and the complex picture of underlying structure-property-activity relationships is sketched. Next, the different modes of utilization of antimicrobial GMs are explained, which include their use as colloidal dispersions, surface coatings, and photothermal/photodynamic therapy agents. Due to their practical relevance, the examples where GMs function as synergistic agents or release platforms for metal ions and/or antibiotic drugs are also discussed. Later, the applicability of GMs in the design of wound dressings, infection-protective coatings, and antibiotic-like formulations ("nanoantibiotics") is assessed. Notably, to support our assessments, the existing clinical applications of conventional carbon materials are also evaluated. Finally, the key hurdles of the field are highlighted, and several possible directions for future investigations are proposed. We hope that the roadmap provided here will encourage researchers to tackle remaining challenges toward clinical translation of promising research findings and help realize the potential of GMs in antimicrobial nanomedicine.

Differential effects of graphene materials on the metabolism and function of human skin cells

Graphene-related materials (GRMs) such as graphene oxide (GO) and few-layer graphene (FLG) are used in multiple biomedical applications; however, there is still insufficient information available regarding their interactions with the main biological barriers such as skin. In this study, we explored the effects of GO and FLG on HaCaTs human skin keratinocytes, using NMR-based metabolomics and fluorescence microscopy to evaluate the global impact of each GRM on cell fate and damage. GO and FLG at low concentrations (5 μg mL-1) induced a differential remodeling of the metabolome, preceded by an increase in the level of radical oxygen species (ROS) and free cytosolic Ca2+. These changes are linked to a concentration-dependent increase in cell death by triggering apoptosis and necrosis, the latter being predominant at higher concentrations of the nanostructures. In addition, both compounds reduce the ability of HaCaT cells to heal wounds. Our results demonstrate that the GO and FLG used in this study, which mainly differ in their oxidation state, slightly trigger differential effects on HaCaTs cells, but with evident outcomes at the cellular and molecular levels. Their behavior as pro-apoptotic/necrotic substances and their ability to inhibit cell migration, even at low doses, should be considered in the development of future applications.

Synthesis of graphene oxide-quaternary ammonium nanocomposite with synergistic antibacterial activity to promote infected wound healing

BACKGROUND

Bacterial infection is one of the most common complications in burn, trauma, and chronic refractory wounds and is an impediment to healing. The frequent occurrence of antimicrobial-resistant bacteria due to irrational application of antibiotics increases treatment cost and mortality. Graphene oxide (GO) has been generally reported to possess high antimicrobial activity against a wide range of bacteria in vitro. In this study, a graphene oxide-quaternary ammonium salt (GO-QAS) nanocomposite was synthesized and thoroughly investigated for synergistic antibacterial activity, underlying antibacterial mechanisms and biocompatibility in vitro and in vivo.

METHODS

The GO-QAS nanocomposite was synthesized through amidation reactions of carboxylic group end-capped QAS polymers with primary amine-decorated GO to achieve high QAS loading ratios on nanosheets. Next, we investigated the antibacterial activity and biocompatibility of GO-QAS in vitro and in vivo.

RESULTS

GO-QAS exhibited synergistic antibacterial activity against bacteria through not only mechanical membrane perturbation, including wrapping, bacterial membrane insertion, and bacterial membrane perforation, but also oxidative stress induction. In addition, it was found that GO-QAS could eradicate multidrug-resistant bacteria more effectively than conventional antibiotics. The in vitro and in vivo toxicity tests indicated that GO-QAS did not exhibit obvious toxicity towards mammalian cells or organs at low concentrations. Notably, GO-QAS topically applied on infected wounds maintained highly efficient antibacterial activity and promoted infected wound healing in vivo.

CONCLUSIONS

The GO-QAS nanocomposite exhibits excellent synergistic antibacterial activity and good biocompatibility both in vitro and in vivo. The antibacterial mechanisms involve both mechanical membrane perturbation and oxidative stress induction. In addition, GO-QAS accelerated the healing process of infected wounds by promoting re-epithelialization and granulation tissue formation. Overall, the results indicated that the GO-QAS nanocomposite could be applied as a promising antimicrobial agent for infected wound management and antibacterial wound dressing synthesis.