Vitamin B12-loaded polycaprolacton/gelatin nanofibrous scaffold as potential wound care material

Advancements in wound management: integrating nanotechnology and smart materials for enhanced therapeutic interventions

Wound management spans various techniques and materials tailored to address acute and chronic non-healing wounds, with the primary objective of achieving successful wound closure. Chronic wounds pose additional challenges, often necessitating dressings to prepare the wound bed for subsequent surgical procedures like skin grafting. Ideal dressing materials should not only expedite wound healing but also mitigate protein, electrolyte, and fluid loss while minimizing pain and infection risk. Nanotechnology has emerged as a transformative tool in wound care, revolutionizing the landscape of biomedical dressings. Its application offers remarkable efficacy in accelerating wound healing and combating bacterial infections, representing a significant advancement in wound care practices. Integration of nanotechnology into dressings has resulted in enhanced properties, including improved mechanical strength and controlled drug release, facilitating tailored therapeutic interventions. This review article comprehensively explores recent breakthroughs in wound healing therapies, with a focus on innovative medical dressings such as nano-enzymes. Additionally, the utilization of smart materials, like hydrogels and electroactive polymers, in wound dressings offers dynamic functionalities to promote tissue regeneration. Emerging concepts such as bio-fabrication, microfluidic systems, bio-responsive scaffolds, and personalized therapeutics show promise in expediting wound healing and minimizing scarring. Through an in-depth exploration of these advancements, this review aims to catalyze a paradigm shift in wound care strategies, promoting a patient-centric approach to therapeutic interventions.

Innovative approaches to wound healing: insights into interactive dressings and future directions

The objective of this review is to provide an up-to-date and all-encompassing account of the recent advancements in the domain of interactive wound dressings. Considering the gap between the achieved and desired clinical outcomes with currently available or under-study wound healing therapies, newer more specific options based on the wound type and healing phase are reviewed. Starting from the comprehensive description of the wound healing process, a detailed classification of wound dressings is presented. Subsequently, we present an elaborate and significant discussion describing interactive (unconventional) wound dressings. Latter includes biopolymer-based, bioactive-containing and biosensor-based smart dressings, which are discussed in separate sections together with their applications and limitations. Moreover, recent (2-5 years) clinical trials, patents on unconventional dressings, marketed products, and other information on advanced wound care designs and techniques are discussed. Subsequently, the future research direction is highlighted, describing peptides, proteins, and human amniotic membranes as potential wound dressings. Finally, we conclude that this field needs further development and offers scope for integrating information on the healing process with newer technologies.

Fabrication and evaluation of a bi-layered electrospun PCL/PVA patch for wound healing: Release of vitamins and silver nanoparticle

There is still little research on the co-delivery of vitamins and AgNPs to accelerate wound healing. In this study, a bi-layered electrospun PCL/PVA patch loaded with Vitamin C, Vitamin B12, and AgNPs was fabricated using a co-spinning technique. SEM, FTIR, degradation, swelling, tensile strength, disk diffusion, and MTT assay were studied. Nine rats were placed in three groups (control: no treatment, G1: without agents, and G2: with agents) for 14 days in an in-vivo study. H&E and Masson Trichrome staining were employed for histological analysis. Results showed that the final electrospun wound dressings depicted nanofibers with diameters ranging from 100 to 500 nm. The presence of AgNP enhanced the mechanical strength (40-50 MPs). An appropriate swelling (100 %) and degradation (50 %) rate was observed for groups with no significant difference (P > 0.05). G1 and G2 did not show a significant difference in terms of porosity (65 % vs. 69 %). Regarding WVTR, G2 demonstrated higher WVTR (88 vs. 95 g/m2. h). G2 showed a vitamin release of more than 90 % after 48 h. Compared to G1, G2 demonstrated good antibacterial activity (>3 cm) against E. Coli and S. aureous (P < 0.01), with cell viability of more than 93 % (P > 0.05). Furthermore, the in-vivo study approved that G2 accelerated wound healing in full-thickness wounds, compared to the control groups, with notable wound size reduction (8 mm), epithelialization, and collagen formation. The findings support the use of this simple but potent electrospun wound dressing for the healing of full-thickness wounds.

Revolutionizing Wound Healing: Exploring Scarless Solutions through Drug Delivery Innovations

Human skin is the largest organ and outermost surface of the human body, and due to the continuous exposure to various challenges, it is prone to develop injuries, customarily known as wounds. Although various tissue engineering strategies and bioactive wound matrices have been employed to speed up wound healing, scarring remains a significant challenge. The wound environment is harsh due to the presence of degradative enzymes and elevated pH levels, and the physiological processes involved in tissue regeneration operate on distinct time scales. Therefore, there is a need for effective drug delivery systems (DDSs) to address these issues. The objective of this review is to provide a comprehensive exposition of the mechanisms underlying the skin healing process, the factors and materials used in engineering DDSs, and the different DDSs used in wound care. Furthermore, this investigation will delve into the examination of emergent technologies and potential avenues for enhancing the efficacy of wound care devices.

Electrospinning of bovine serum albumin-based nano-fibers: From synthesis to medical prospects; Challenges and future directions

Bovine serum albumin (BSA) is a globular non-glycoprotein that has gotten a lot of attention because of its unique properties like biocompatibility, biodegradability, non-immunogenicity, non-toxicity, and strong resemblance to the natural extracellular matrix (ECM). Given its robust mechanical properties, such as interfacial tension, conductivity, swelling resistance, and viscoelasticity, it can be concluded that it is an appropriate matrix for producing novel BSA-based nanoconstructs. Thus, simple analytic methods are required for accurately detecting BSA as a model protein in medical sciences and healthcare. Furthermore, the characteristics mentioned above aid BSA in the electrospinning process, which results in fibers conjugated with other polymers. Electrospun synthesis has recently received much attention for its ability to produce stable, biomimicking, highly porous, 3D BSA-derived nano-fibers. As a result, BSA-based nano-fibers have achieved exclusive developments in the medical sector, such as tissue engineering for the remodeling of damaged tissue or organ repair by creating artificial ones. Meanwhile, they could be used as drug delivery systems (DDS) for target-specific drug delivery, wound dressings, and so on. This study illustrates the structural and physicochemical properties of BSA and the determination of BSA using various methods, by citing recent reports and current developments in the medical field. Furthermore, current challenges and future directions are also highlighted.

Matricaria chamomilla essential oil-loaded hybrid electrospun nanofibers based on polycaprolactone/sulfonated chitosan/ZIF-8 nanoparticles for wound healing acceleration

Recently, developing antibacterial wound dressings based on biomaterials display good biocompatibility and the potential to accelerate wound healing. For this aim, we prepared eco-friendly and biodegradable nanofibers (NFs) based on N-(3-sulfopropyl)chitosan/ poly (ε-caprolactone) incorporated by zeolite imidazolate framework-8 nanoparticles (ZIF-8 NPs) and chamomile essential oil (MCEO) via the electrospinning technique for their efficacy as wound dressing scaffolds. Fabricated NFs were characterized and studied for their structural, morphological, mechanical, hydrophilic, and thermal stability properties. The results of scanning electron microscopy (SEM) revealed that adding the ZIF-8 NPs/ MCEO, very slightly influenced the average diameter of NFs (PCL/SPCS (90:10) with 90 ± 32 nm). The developed uniform MCEO-loaded ZIF-8/PCL/SPCS NFs displayed better cytocompatibility, proliferation, and physicochemical properties (e.g. thermal stability and mechanical properties) than neat NFs. The results of cytocompatibility, DAPI (4',6-diamidino-2-phenylindole) staining study, and SEM micrographs demonstrated that formulated NFs had promising adhesion and proliferation against normal human foreskin fibroblasts-2 (HFF-2 cell line). The prepared NFs revealed excellent antibacterial activity against both Staphylococcus aureus and Escherichia coli with inhibition of 32.3 mm and 31.2 mm, respectively. Accordingly, the newly developed antibacterial NFs hold great potential as effective biomaterials for use as an active platform in wound healing applications.

Hypericum perforatum Oil and Vitamin A Palmitate-Loaded Gelatin Nanofibers Cross-Linked by Tannic Acid as Wound Dressings

Recent studies in wound dressing applications offer new therapies to promote the wound healing process. The main strategy of this study is to combine the traditional perspective of using medicinal oils with polymeric scaffolds manufactured by an engineering approach to fabricate a potential tissue engineering product that provides both new tissue formation and wound healing. Thus, Hypericum perforatum oil (HPO) and vitamin A palmitate (VAP) incorporated gelatin (Gt) nanofibrous scaffolds were successfully prepared by the electrospinning method. Tannic acid (TA) was used as the cross-linking agent. The amounts of VAP and HPO loaded in the base Gt solution [15% w/v in 4:6 v/v acetic acid/deionized water] were 5 and 50 wt % (based on the weight of Gt), respectively. The obtained scaffolds were studied regarding their microstructure, chemical structure, thermal stability, antibacterial activity, in vitro release study, and cellular proliferation assay. In the light of these studies, it was determined that VAP and HPO were incorporated successfully in Gt nanofibers cross-linked with TA. Release kinetic tests confirmed that the patterns of TA and VAP release were consistent with the Higuchi model, whereas HPO release was consistent with the first-order kinetic model. In addition, this membrane was biocompatible with L929 fibroblast cells and had antibacterial activity and thermal stability. This preliminary study suggests potential applicability of the proposed dressing to treat skin wounds in clinics.

Nanofiber Scaffolds as Drug Delivery Systems Promoting Wound Healing

Nanofiber scaffolds have emerged as a revolutionary drug delivery platform for promoting wound healing, due to their unique properties, including high surface area, interconnected porosity, excellent breathability, and moisture absorption, as well as their spatial structure which mimics the extracellular matrix. However, the use of nanofibers to achieve controlled drug loading and release still presents many challenges, with ongoing research still exploring how to load drugs onto nanofiber scaffolds without loss of activity and how to control their release in a specific spatiotemporal manner. This comprehensive study systematically reviews the applications and recent advances related to drug-laden nanofiber scaffolds for skin-wound management. First, we introduce commonly used methods for nanofiber preparation, including electrostatic spinning, sol-gel, molecular self-assembly, thermally induced phase separation, and 3D-printing techniques. Next, we summarize the polymers used in the preparation of nanofibers and drug delivery methods utilizing nanofiber scaffolds. We then review the application of drug-loaded nanofiber scaffolds for wound healing, considering the different stages of wound healing in which the drug acts. Finally, we briefly describe stimulus-responsive drug delivery schemes for nanofiber scaffolds, as well as other exciting drug delivery systems.

Skin Pigmentation Types, Causes and Treatment-A Review

Human skin pigmentation and melanin synthesis are incredibly variable, and are impacted by genetics, UV exposure, and some drugs. Patients' physical appearance, psychological health, and social functioning are all impacted by a sizable number of skin conditions that cause pigmentary abnormalities. Hyperpigmentation, where pigment appears to overflow, and hypopigmentation, where pigment is reduced, are the two major classifications of skin pigmentation. Albinism, melasma, vitiligo, Addison's disease, and post-inflammatory hyperpigmentation, which can be brought on by eczema, acne vulgaris, and drug interactions, are the most common skin pigmentation disorders in clinical practice. Anti-inflammatory medications, antioxidants, and medications that inhibit tyrosinase, which prevents the production of melanin, are all possible treatments for pigmentation problems. Skin pigmentation can be treated orally and topically with medications, herbal remedies, and cosmetic products, but a doctor should always be consulted before beginning any new medicine or treatment plan. This review article explores the numerous types of pigmentation problems, their causes, and treatments, as well as the 25 plants, 4 marine species, and 17 topical and oral medications now on the market that have been clinically tested to treat skin diseases.

Fabrication of a Vitamin B12-Loaded Carbon Dot/Mixed-Ligand Metal Organic Framework Encapsulated within the Gelatin Microsphere for pH Sensing and In Vitro Wound Healing Assessment

Bacterial invasion is a serious concern during the wound healing process. The colonization of bacteria is mainly responsible for the pH fluctuation at the wound site. Therefore, the fabrication of a proper wound dressing material with antibacterial activity and pH monitoring ability is necessary to acquire a fast healing process. Therefore, this work is dedicated to designing a vitamin B12-loaded gelatin microsphere (MS) decorated with a carbon dot (CD) metal-organic framework (MOF) for simultaneous pH sensing and advanced wound closure application. The resultant MS portrayed a high specific surface area and a hierarchically porous structure. Furthermore, the surface of the resultant MS contained numerous carboxyl groups and amine groups whose deprotonation and protonation with the pH alternation are accountable for the pH-sensitive properties. The vitamin B12 release study was speedy from the MOF structure in an acidic medium, which was checked by gelatin coating, and a controlled drug release behavior was observed. The system showed excellent cytocompatibility toward the L929 cell line and remarkable antibacterial performance against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus. Furthermore, the combined effect of Zn²⁺, the imidazole unit, and CDs produces an outstanding bactericidal effect on the injury sites. Finally, the in vitro wound model suggests that the presence of the vitamin B12-loaded gelatin MS accelerates the proliferation of resident fibroblast L929 cells and causes tissue regeneration in a time-dependent manner. The relative wound area, % of wound closure, and wound healing speed values are remarkable and suggest the requirement for assessing the response of the system before exploiting its prospective in vivo application.

Plasma-Initiated Grafting of Bioactive Peptide onto Nano-CuO/Tencel Membrane

A bioactive peptide has been successfully grafted onto nano-CuO impregnated Tencel membranes by a simple and rapid method involving a series of textile processes, and an atmospheric argon plasma treatment that requires no additional solvent or emulsifier. Surface morphology shows an apparent change from smooth, slightly roughened, and stripped with increasing plasma treatment time. The FT-IR characteristic peaks confirm the presence of the CuO nanoparticle and peptide on the extremely hydrophilic Tencel membranes that exhibit a zero-degree contact angle. Prepared nano-CuO/Tencel membranes with 90 s plasma treatment time exhibit excellent antimicrobial activity against E. coli and S. aureus, and promote fibroblast cell viability with the assistance of a grafted bioactive peptide layer on the membrane surface.

Honey-Loaded Reinforced Film Based on Bacterial Nanocellulose/Gelatin/Guar Gum as an Effective Antibacterial Wound Dressing

Recently, the use of bacterial nanocellulose (BNC) produced by Acetobacter, which has suitable properties for tissue engineering application as a perfect wound dressing, has attracted considerable attention. For this purpose, we successfully developed honey loaded BNC-reinforced gelatin/dialdehyde-modified guar gum films (H/BNC/Ge/D-GG). Prepared films were studied for their morphological, thermal stability, mechanical, water solubility and degradability properties. The physicochemical properties of the developed films with or without honey loading were studied. The results indicated that by enhancing the honey content of the film, the degradation behavior, adhesion and proliferation of NIH-3T3 fibroblast cells were improved. The films with 15 wt% of honey revealed inhibition activity against S. aureus (13.0±0.1 mm) and E. coli (15.0±1.0 mm) bacteria. Cell culture results demonstrated that the prepared films had good cytocompatibility. Based on the results, the prepared H/BNC/Ge/D-GG films appear to have high potential for antibacterial wound dressings.

Electrospinning: New Strategies for the Treatment of Skin Melanoma

Recent studies have shown a significant growth of skin cancer cases in northern regions of the world, in which its presence was not common. Skin cancer is one of the cancers that mostly affects the world's population, ranking fifth in studies conducted in the United States (USA). Melanoma is cancer that has the highest number of deaths worldwide since it is the most resistant skin cancer to current treatments. This is why alternatives for its treatment has been investigated considering nanomedicine concepts. This study approaches the role of this field in the creation of promising electrospun devices, composed of nanoparticles and nanofibers, among other structures, capable of directing and/or loading active drugs and/or materials with the objective of inhibiting the growth of melanoma cells or even eliminating those cells.

Effect of Vitamin C/Hydrocortisone Immobilization within Curdlan-Based Wound Dressings on In Vitro Cellular Response in Context of the Management of Chronic and Burn Wounds

Bioactive dressings are usually produced using natural or synthetic polymers. Recently, special attention has been paid to β-glucans that act as immunomodulators and have pro-healing properties. The aim of this research was to use β-1,3-glucan (curdlan) as a base for the production of bioactive dressing materials (curdlan/agarose and curdlan/chitosan) that were additionally enriched with vitamin C and/or hydrocortisone to improve healing of chronic and burn wounds. The secondary goal of the study was to compressively evaluate biological properties of the biomaterials. In this work, it was shown that vitamin C/hydrocortisone-enriched biomaterials exhibited faster vitamin C release profile than hydrocortisone. Consecutive release of the drugs is a desired phenomenon since it protects wounds against accumulation of high and toxic concentrations of the bioactive molecules. Moreover, biomaterials showed gradual release of low doses of the hydrocortisone, which is beneficial during management of burn wounds with hypergranulation tissue. Among all tested variants of biomaterials, dressing materials enriched with hydrocortisone and a mixture of vitamin C/hydrocortisone showed the best therapeutic potential since they had the ability to significantly reduce MMP-2 synthesis by macrophages and increase TGF-β1 release by skin cells. Moreover, materials containing hydrocortisone and its blend with vitamin C stimulated type I collagen deposition by fibroblasts and positively affected their migration and proliferation. Results of the experiments clearly showed that the developed biomaterials enriched with bioactive agents may be promising dressings for the management of non-healing chronic and burn wounds.

Alternative Wound Management: Translating Science into Practice

GENERAL PURPOSE

To present a scoping review of preclinical and clinical trial evidence supporting the efficacy and/or safety of major alternative wound care agents to summarize their effects on validated elements of wound bed preparation and wound management paradigms.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:1. Differentiate the effectiveness of the topical wound care agents included in this review.2. Compare the preventive efficacy of intravenous agents administered to trauma and surgical patients.3. Select the effectiveness of products in this review that are left in place after surgical procedures.4. Identify an oral agent that can be helpful in mitigating the effects of COVID-19.

Modifications of Wound Dressings with Bioactive Agents to Achieve Improved Pro-Healing Properties

The great variety of wounds and the lack of an effective universal treatment method has resulted in high demand for modern treatment strategies. Traditional approaches are often ineffective on a variety of chronic wounds, such as venous ulcers or the diabetic foot ulcer. There is strong evidence that naturally derived bioactive compounds have pro-healing properties, raising a great interest in their potential use for wound healing. Plant-derived compounds, such as curcumin and essential oils, are widely used to modify materials applied as wound dressings. Moreover, dressing materials are more often enriched with vitamins (e.g., L-ascorbic acid, tocopherol) and drugs (e.g., antibiotics, inhibitors of proteases) to improve the skin healing rate. Biomaterials loaded with the above-mentioned molecules show better biocompatibility and are basically characterized by better biological properties, ensuring faster tissue repair process. The main emphasis of the presented review is put on the novel findings concerning modern pro-healing wound dressings that have contributed to the development of regenerative medicine. The article briefly describes the synthesis and modifications of biomaterials with bioactive compounds (including curcumin, essential oils, vitamins) to improve their pro-healing properties. The paper also summarizes biological effects of the novel wound dressings on the enhancement of skin regeneration. The current review was prepared based on the scientific contributions in the PubMed database (supported with Google Scholar searching) over the past 5 years using relevant keywords. Scientific reports on the modification of biomaterials using curcumin, vitamins, and essential oils were mainly considered.