Collagen-based wound dressing: effects of hyaluronic acid and fibronectin on wound healing

Electrospun Antimicrobial Drug Delivery Systems and Hydrogels Used for Wound Dressings

Wounds and chronic wounds can be caused by bacterial infections and lead to discomfort in patients. To solve this problem, scientists are working to create modern wound dressings with antibacterial additives, mainly because traditional materials cannot meet the general requirements for complex wounds and cannot promote wound healing. This demand is met by material engineering, through which we can create electrospun wound dressings. Electrospun wound dressings, as well as those based on hydrogels with incorporated antibacterial compounds, can meet these requirements. This manuscript reviews recent materials used as wound dressings, discussing their formation, application, and functionalization. The focus is on presenting dressings based on electrospun materials and hydrogels. In contrast, recent advancements in wound care have highlighted the potential of thermoresponsive hydrogels as dynamic and antibacterial wound dressings. These hydrogels contain adaptable polymers that offer targeted drug delivery and show promise in managing various wound types while addressing bacterial infections. In this way, the article is intended to serve as a compendium of knowledge for researchers, medical practitioners, and biomaterials engineers, providing up-to-date information on the state of the art, possibilities of innovative solutions, and potential challenges in the area of materials used in dressings.

Applications of Scaffolds in Tissue Engineering: Current Utilization and Future Prospective

Current regenerative medicine tactics focus on regenerating tissue structures pathologically modified by cell transplantation in combination with supporting scaffolds and biomolecules. Natural and synthetic polymers, bioresorbable inorganic and hybrid materials, and tissue decellularized were deemed biomaterials scaffolding because of their improved structural, mechanical, and biological abilities.Various biomaterials, existing treatment methodologies and emerging technologies in the field of Three-dimensional (3D) and hydrogel processing, and the unique fabric concerns for tissue engineering. A scaffold that acts as a transient matrix for cell proliferation and extracellular matrix deposition, with subsequent expansion, is needed to restore or regenerate the tissue. Diverse technologies are combined to produce porous tissue regenerative and tailored release of bioactive substances in applications of tissue engineering. Tissue engineering scaffolds are crucial ingredients. This paper discusses an overview of the various scaffold kinds and their material features and applications. Tabulation of the manufacturing technologies for fabric engineering and equipment, encompassing the latest fundamental and standard procedures.

Box-Behnken design to optimize the cross-linked sodium alginate/mucilage/Aloe vera film: Physical and mechanical studies

The crosslinked sodium alginate/mucilage/Aloe vera/glycerin was optimized by different ratios of each factor to be an absorption wound dressing base for infected wound healing. Mucilage was extracted from seeds of Ocimum americanum. The Box-Behnken design (BBD) in response surface methodology (RSM) was used to construct an optimal wound dressing base with the target ranges of mechanical and physical properties of each formulation. The independent variables selected were sodium alginate (X1: 0.25-0.75 g), mucilage (X2: 0.00-0.30 g), Aloe vera (X3: 0.00-0.30 g), and glycerin (X4: 0.00-1.00 g). The dependent variables were tensile strength (Y1: low value), elongation at break (Y2: high value), Young's modulus (Y3: high value), swelling ratio (Y4: high value), erosion (Y5: low value), and moisture uptake (Y6: high value). The results showed that the wound dressing base with the most desirable response consists of sodium alginate (59.90 % w/w), mucilage (23.96 % w/w), and glycerin (16.14 % w/w) without Aloe vera gel powder (0.00 % w/w).

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Dressing Materials: A Comprehensive Review

Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of events involved in wound healing can be affected by numerous disease processes, resulting in chronic, non-healing wounds that give significant discomfort and distress to the patients while draining the medical fraternity of enormous resources. Wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. There is a growing concern about the usage of correct materials for wound dressings. The development of new and effective treatments in wound care still remains an area of intense research. There are a number of wound dressings available in the market. The objective of the article is to enhance knowledge about characteristics of an ideal wound dressing and guide in finding the correct dressing material. It also provides a detailed classification of traditional and modern wound dressings.

Advances in Skin Tissue Engineering and Regenerative Medicine

There are an estimated 500,000 patients treated with full-thickness wounds in the United States every year. Fire-related burn injuries are among the most common and devastating types of wounds that require advanced clinical treatment. Autologous split-thickness skin grafting is the clinical gold standard for the treatment of large burn wounds. However, skin grafting has several limitations, particularly in large burn wounds, where there may be a limited area of non-wounded skin to use for grafting. Non-cellular dermal substitutes have been developed but have their own challenges; they are expensive to produce, may require immunosuppression depending on design and allogenic cell inclusion. There is a need for more advanced treatments for devastating burns and wounds. This manuscript provides a brief overview of some recent advances in wound care, including the use of advanced biomaterials, cell-based therapies for wound healing, biological skin substitutes, biological scaffolds, spray on skin and skin bioprinting. Finally, we provide insight into the future of wound care and technological areas that need to be addressed to support the development and incorporation of these technologies.

Recent Advances in 3D Printing of Photocurable Polymers: Types, Mechanism, and Tissue Engineering Application

The conversion of liquid resin into solid structures upon exposure to light of a specific wavelength is known as photopolymerization. In recent years, photopolymerization-based 3D printing has gained enormous attention for constructing complex tissue-specific constructs. Due to the economic and environmental benefits of the biopolymers employed, photo-curable 3D printing is considered an alternative method for replacing damaged tissues. However, the lack of suitable bio-based photopolymers, their characterization, effective crosslinking strategies, and optimal printing conditions are hindering the extensive application of 3D printed materials in the global market. This review highlights the present status of various photopolymers, their synthesis, and their optimization parameters for biomedical applications. Moreover, a glimpse of various photopolymerization techniques currently employed for 3D printing is also discussed. Furthermore, various naturally derived nanomaterials reinforced polymerization and their influence on printability and shape fidelity are also reviewed. Finally, the ultimate use of those photopolymerized hydrogel scaffolds in tissue engineering is also discussed. Taken together, it is believed that photopolymerized 3D printing has a great future, whereas conventional 3D printing requires considerable sophistication, and this review can provide readers with a comprehensive approach to developing light-mediated 3D printing for tissue-engineering applications.

3D Porous Collagen Matrices-A Reservoir for In Vitro Simultaneous Release of Tannic Acid and Chlorhexidine

The treatment of wounds occurring accidentally or as a result of chronic diseases most frequently requires the use of appropriate dressings, mainly to ensure tissue regeneration/healing, at the same time as treating or preventing potential bacterial infections or superinfections. Collagen type I-based scaffolds in tandem with adequate antimicrobials can successfully fulfill these requirements. In this work, starting from the corresponding hydrogels, we prepared a series of freeze-dried atelocollagen type I-based matrices loaded with tannic acid (TA) and chlorhexidine digluconate (CHDG) as active agents with a broad spectrum of antimicrobial activity and also as crosslinkers for the collagen network. The primary aim of this study was to design an original and reliable algorithm to in vitro monitor and kinetically analyze the simultaneous release of TA and CHDG from the porous matrices into an aqueous solution of phosphate-buffered saline (PBS, pH 7.4, 37 °C) containing micellar carriers of a cationic surfactant (hexadecyltrimethylammonium bromide, HTAB) as a release environment that roughly mimics human extracellular fluids in living tissues. Around this central idea, a comprehensive investigation of the lyophilized matrices (morpho-structural characterization through FT-IR spectroscopy, scanning electron microscopy, swelling behavior, resistance against the collagenolytic action of collagenase type I) was carried out. The kinetic treatment of the release data displayed a preponderance of non-Fickian-Case II diffusion behavior, which led to a general anomalous transport mechanism for both TA and CHDG, irrespective of their concentrations. This is equivalent to saying that the release regime is not governed only by the gradient concentration of the releasing components inside and outside the matrix (like in ideal Fickian diffusion), but also, to a large extent, by the relaxation phenomena of the collagen network (determined, in turn, by its crosslinking degree induced by TA and CHDG) and the dynamic capacity of the HTAB micelles to solubilize the two antimicrobials. By controlling the degree of physical crosslinking of collagen with a proper content of TA and CHDG loaded in the matrix, a tunable, sustainable release profile can be obtained.

Silver Nanoparticles Biocomposite Films with Antimicrobial Activity: In Vitro and In Vivo Tests

Overuse of antimicrobials by the population has contributed to genetic modifications in bacteria and development of antimicrobial resistance, which is very difficult to combat nowadays. To solve this problem, it is necessary to develop new systems for the administration of antimicrobial active principles. Biocomposite systems containing silver nanoparticles can be a good medical alternative. In this context, the main objective of this study was to obtain a complex system in the form of a biocomposite film with antimicrobial properties based on chitosan, poly (vinyl alcohol) and silver nanoparticles. This new system was characterized from a structural and morphological point of view. The swelling degree, the mechanical properties and the efficiency of loading and release of an anti-inflammatory drug were also evaluated. The obtained biocomposite films are biocompatibles, this having been demonstrated by in vitro tests on HDFa cell lines, and have antimicrobial activity against S. aureus. The in vivo tests, carried out on rabbit subjects, highlighted the fact that signs of reduced fibrosis were specific to the C2P4.10.Ag1-IBF film sample, demonstrated by: intense expression of TNFAIP8 factors; as an anti-apoptotic marker, MHCII that favors immune cooperation among local cells; αSMA, which marks the presence of myofibroblasts involved in approaching the interepithelial spaces for epithelialization; and reduced expression of the Cox2 indicator of inflammation, Col I.

A novel photosynthetic biologic topical gel for enhanced localized hyperoxygenation augments wound healing in peripheral artery disease

Peripheral artery disease and the associated ischemic wounds are substantial causes of global morbidity and mortality, affecting over 200 million people worldwide. Although advancements have been made in preventive, pharmacologic, and surgical strategies to treat this disease, ischemic wounds, a consequence of end-stage peripheral artery disease, remain a significant clinical and economic challenge. Synechococcus elongatus is a cyanobacterium that grows photoautotrophically and converts carbon dioxide and water into oxygen. We present a novel topical biologic gel containing S. elongatus that provides oxygen via photosynthesis to augment wound healing by rescuing ischemic tissues caused by peripheral artery disease. By using light rather than blood as a source of energy, our novel topical therapy significantly accelerated wound healing in two rodent ischemic wound models. This novel topical gel can be directly translated to clinical practice by using a localized, portable light source without interfering with patients' daily activities, demonstrating potential to generate a paradigm shift in treating ischemic wounds from peripheral artery disease. Its novelty, low production cost, and ease of clinical translatability can potentially impact the clinical care for millions of patients suffering from peripheral arterial disease.

Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View

Wounds and tissue defects of the hand and foot often lead to severe functional impairment of the affected extremity. Next to general principles of wound healing, special functional and anatomic considerations must be taken into account in the treatment of wounds in these anatomical regions to achieve a satisfactory reconstructive result. In this article, we outline the concept of wound healing and focus on the special aspects to be considered in wounds of the hand and foot. An overview of different treatment and dressing techniques is given with special emphasis on the reconstruction of damaged structures by plastic surgical means.

Analysis of the size reduction of AgNPs loaded hydrogel and its effect on the anti-bacterial activity

This article analyses the effect of the size reduced Silver (Ag) loaded hydrogel by (a) lyophilisation (S1) (b) ball milling (S2) techniques and its effect on anti-bacterial activity. The g loaded hydrogel, S1 and S2 shows an increase in swelling with an increase in pH. The swelling is more for Ag loaded hydrogel in low pH. For pH above 7, the swelling ratio of Ag loaded hydrogel and S1 are almost the same while S2 shows very less swelling. The anti-bacterial studies reveal that S1 and Ag loaded hydrogel reacted well in S. aureus (Staphylococcus aureus) but no zone formation was seen in S2 .whereas no zone was formed in S1 and S2 for E-coli (Escherichia coli). As the next step, the anti-bacterial activity of Ag loaded hydrogel with the addition of curcumin (CS1-size reduced by lyophilisation, CS2-size reduced by ball milling) and turmeric (TS1-size reduced by lyophilisation, TS2-size reduced by ball milling) were investigated. In case of E.coli, a zonal formation of 1.2 cm for TS1 and 1.1 cm for TS2 and 1 cm for CS1 and 0.2 cm for CS2 was observed. For S.aureus, 1.1  and 1 cm were seen for TS1 and CS1. TS2 and CS2 did not show any zone formation. These studies clearly show that size reduction by lyophilisation (S1, TS1 and CS1) is more efficient in all the cases when compared to the ball milling technique (S2, TS2 and CS2). Comparing TS1 with S1 and CS1, TS1 has highly efficient/effective anti-bacterial properties than S1 and CS1. Therefore, lyophilised hydrogel incorporating turmeric and silver (TS1) is an excellent choice compared to using curcumin for wound dressing applications.

Beneficial effect on rapid skin wound healing through carboxylic acid-treated chicken eggshell membrane

At the initial stage of wound healing, growth factors stimulate tissue regeneration by interacting with the extracellular matrix (ECM), leading to rapid wound repair and structural support. Chicken eggshell membrane (ESM) is a low-cost and highly functional ECM biomaterial for tissue regeneration. However, natural ESM has limitations for tissue engineering purposes because it is difficult to control the size, shape, and biocompatibility of the surfaces. To overcome this, blends of synthetic materials and natural ESMs, such as soluble eggshell membrane protein, are combined for biomaterial applications. Unfortunately, it is difficult to pattern fibrous structure. Here, we modified the natural chicken ESM through weak acid treatment to promote wound healing and skin regeneration without loss of fibrous structure. Treatment of citric acid and acetic acid reacted the amine or amide group with carboxyl groups (R-COOH) and achieved hydrophilicity for adherence of proliferating regenerative cells. Our in vitro study revealed that the modified ESM scaffolds significantly promoted human dermal fibroblasts adhesion, viability, proliferation, and cytokine secretion, compared with natural ESM. In addition, the modified ESM accelerated skin regeneration and enhanced the wound healing process even at early stages in an in vivo rat wound model. Collectively, the modified ESM performed best for promoting skin regeneration, cytokine secretion, epidermal cell proliferation, and controlling the inflammatory response both in vitro and in vivo.

Extracellular matrix containing nanocomposite bone graft in periodontal regeneration - A randomized controlled clinical and radiographic evaluation

Background

The study aims to evaluate the effect of adding extracellular matrix (ECM) component - natural collagen to nanocrystalline hydroxyapatite (nHA) bone graft in the treatment of intrabony defect in chronic periodontitis patients.

Materials and Methods

Forty chronic periodontitis patients having at least one intrabony defect were treated surgically by open flap debridement and the defect grafted (Group A: 20 sites grafted with nHA with natural collagen and Group B: 20 sites grafted with nHA). Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and radiographic defect depth (RDD) were evaluated.

Results

The mean PPD reduced from 7.6 ± 0.88 at baseline to 4.45 ± 0.69 and 2.60 ± 0.6 at 3 and 6 months, respectively, in Group A. In Group B, the mean PPD reduced from 7.5 ± 0.89 at baseline to 4.95 ± 0.60 and 2.65 ± 0.59 at 3 and 6 months, respectively. The mean CAL reduced from 7.75 ± 0.85 at baseline to 5.05 ± 0.76 and 3.6 ± 0.68 at 3 and 6 months, respectively, in Group A. In Group B, the mean CAL reduced from 7.70 ± 0.86 at baseline to 5.8 ± 0.7 and 3.75 ± 0.64 at 3 and 6 months, respectively. The mean RDD reduced from 8.13 ± 0.78 and 8.12 ± 0.83 at baseline to 4.27 ± 0.66 and 3.94 ± 0.5 after 6 months in Groups A and B, respectively. After 3 months, a statistically significant reduction in mean PPD and CAL values was noted in Group A while the results were comparable after 6 months.

Conclusion

The effectiveness of nHA composite during initial healing phase (3 months) can be attributed to the presence of ECM-collagen in bone graft matrix.

Visible Light-Cured Antibacterial Collagen Hydrogel Containing Water-Solubilized Triclosan for Improved Wound Healing

Infection is one of several factors that can delay normal wound healing. Antibacterial wound dressings can therefore promote normal wound healing. In this study, we prepared an antibacterial wound dressing, consisting of visible light-cured methacrylated collagen (ColMA) hydrogel and a 2-hydroxypropyl-beta-cyclodextrin (HP-β-CD)/triclosan (TCS) complex (CD-ic-TCS), and evaluated its wound healing effects in vivo. The 1H NMR spectra of ColMA and CD-ic-TCS revealed characteristic peaks at 1.73, 5.55, 5.94, 6.43, 6.64, 6.84, 6.95, 7.31, and 7.55 ppm, indicating successful preparation of the two material types. In addition, ultraviolet-visible (UV-vis) spectroscopy proved an inclusion complex formation between HP-β-CD and TCS, judging by a unique peak observed at 280 cm-1. Furthermore, ColMA/CD-ic-TCS exhibited an interconnected porous structure, controlled release of TCS, good biocompatibility, and antibacterial activity. By in vivo animal testing, we found that ColMA/CD-ic-TCS had a superior wound healing capacity, compared to the other hydrocolloids evaluated, due to synergistic interaction between ColMA and CD-ic-TCS. Together, our findings indicate that ColMA/CD-ic-TCS has a clinical potential as an antibacterial wound dressing.

Localized Delivery of Drugs through Medical Textiles for Treatment of Burns: A Perspective Approach

The topical delivery offers numerous benefits, such as the ability to deliver drugs specifically on site selectively, prevents fluctuations in the levels of the drug, improved compliance, and improved self-medication capacity. Skin is the main route of the administration of the drug delivery system (DDS) and burns mainly cause skin damage. A burn is a kind of damage caused to skin and tissues by fire, ice, electrical energy, pollutants, friction, and radiation. There are three different types of burns, including superficial epidermis burns, partial-thickness dermis that stretch to the papillary and reticular dermis, and full-thickness burns that cover the dermis whole. The objective of the present review article is to focus on fabrication techniques of medical textiles, different types of polymers used for designing medicated textiles, skin burn conditions, and application of medicated textiles for treatment of burn along with other applications. Cream, ointment, and gel are the dosage forms used in burns. Intravenous fluids, wound care, assorted antibiotics, surgical and alternative medicines, burned creams and salami, dressings can be used to treat wounds. Nanofibers are nanometer-specific fibers that encapsulate drugs inside them and cure wounds. Nanofibers have all the properties that speed up wound healing. The properties are mechanical integrity, proper timing of wound addiction, temperature homeostasis facilitation and gas exchange, absorption of exudates. The nanofibers have been used in burn care and have been highly efficient and non-toxic.

Biopolymeric, Nanopatterned, Fibrous Carriers for Wound Healing Applications

Background:

Any sort of wound injury leads to skin integrity and further leads to wound formation. Millions of deaths are reported every year, which contributes to an economical hamper world widely, this accounts for 10% of death rate that insight into various diseases.

Current Methodology:

Rapid wound healing plays an important role in effective health care. Wound healing is a multi-factorial physiological process, which helps in the growth of new tissue to render the body with the imperative barrier from the external environment. The complexity of this phenomenon makes it prone to several abnormalities. Wound healing, as a normal biological inherent process occurs in the body, which is reaped through four highly defined programmed phases, such as hemostasis, inflammation, proliferation, and remodeling and these phases occur in the proper progression. An overview, types, and classification of wounds along with the stages of wound healing and various factors affecting wound healing have been discussed systematically. Various biopolymers are reported for developing nanofibers and microfibers in wound healing, which can be used as a therapeutic drug delivery for wound healing applications. Biopolymers are relevant for biomedical purposes owing to biodegradability, biocompatibility, and non- toxicity. Biopolymers such as polysaccharides, proteins and various gums are used for wound healing applications. Patents and future perspectives have been given in the concluding part of the manuscript. Overall, applications of biopolymers in the development of fibers and their applications in wound healing are gaining interest in researchers to develop modified biopolymers and tunable delivery systems for effective management and care of different types of wounds.

Characterization and biological evaluation of a novel silver nanoparticle-loaded collagen-chitosan dressing

Effective coverage and protection is a priority in wound treatment. Collagen and chitosan have been widely used for wound dressings due to their excellent biological activity and biocompatibility. Silver nanoparticles (AgNPs) have a powerful antibacterial effect. In this study, a macromolecular and small-molecular collagen mixed solution, a macromolecular and small-molecular chitosan mixed solution were prepared, and a silver nanoparticle-loaded collagen-chitosan dressing (AgNP-CCD) has been proposed. First, the effects of a collagen-chitosan mixed solution on the proliferation of human umbilical vein endothelial cells and the secretion of cytokines were evaluated. Then, the characteristics and antibacterial effects of the AgNP-CCD were tested, and the effects on wound healing and the influence of wound cytokine expression were investigated via a deep second-degree burn wound model. The results showed that at the proper proportion and concentration, the collagen-chitosan mixed solution effectively promoted cell proliferation and regulated the levels of growth factors (vascular endothelial growth factor [VEGF], epidermal growth factor [EGF], platelet-derived growth factor [PDGF], transforming growth factor [TGF-β1], basic fibroblastic growth factor [bFGF]) and inflammatory factors (TNF-α, IL-1β, IL-6, IL-8). Moreover, AgNP solutions at lower concentrations exerted limited inhibitory effects on cell proliferation and had no effect on cytokine secretion. The AgNP-CCD demonstrated satisfactory morphological and physical properties as well as efficient antibacterial activities. An in vivo evaluation indicated that AgNP-CCD could accelerate the healing process of deep second-degree burn wounds and played an important role in the regulation of growth and inflammatory factors, including VEGF, EGFL-7, TGF-β1, bFGF, TNF-α and IL-1β. This AgNP-CCD exerted excellent biological effects on wound healing promotion and cytokine expression regulation.

Potential of Natural Biomaterials in Nano-scale Drug Delivery

BACKGROUND

The usage of natural biomaterials or naturally derived materials intended for interface with biological systems has steadily increased in response to the high demand of amenable materials, which are suitable for purpose, biocompatible and biodegradable. There are many naturally derived polymers which overlap in terms of purpose as biomaterials but are equally diverse in their applications.

METHODS

This review examines the applications of the following naturally derived polymers; hyaluronic acid, silk fibroin, chitosan, collagen and tamarind polysaccharide (TSP); further focusing on the biomedical applications of each as well as emphasising on individual novel applications.

RESULTS

Each of the polymers was found to demonstrate a wide variety of successful biomedical applications fabricated as wound dressings, scaffolds, matrices, films, sponges, implants or hydrogels to suit the therapeutic need. Interestingly, blending and amelioration of polymer structures were the two selection strategies to modify the functionality of the polymers to suit the purpose. Further, these polymers have shown promise to deliver small molecule drugs, proteins and genes as nano-scale delivery systems.

CONCLUSION

The review highlights the range of applications of the aforementioned polymers as biomaterials. Hyaluronic acid, silk fibroin, chitosan, collagen and TSP have been successfully utilised as biomaterials in the subfields of implant enhancement, wound management, drug delivery, tissue engineering and nanotechnology. Whilst there are a number of associated advantages (i.e. biodegradability, biocompatibility, non-toxic, nonantigenic as well as amenability) the selected disadvantages of each individual polymer provide significant scope for their further exploration and overcoming challenges like feasibility of mass production at a relatively low cost.

Human Oral Stem Cells, Biomaterials and Extracellular Vesicles: A Promising Tool in Bone Tissue Repair

Tissue engineering and/or regenerative medicine are fields of life science exploiting both engineering and biological fundamentals to originate new tissues and organs and to induce the regeneration of damaged or diseased tissues and organs. In particular, de novo bone tissue regeneration requires a mechanically competent osteo-conductive/inductive 3D biomaterial scaffold that guarantees the cell adhesion, proliferation, angiogenesis and differentiation into osteogenic lineage. Cellular components represent a key factor in tissue engineering and bone growth strategies take advantage from employment of mesenchymal stem cells (MSCs), an ideal cell source for tissue repair. Recently, the application of extracellular vesicles (EVs), isolated from stem cells, as cell-free therapy has emerged as a promising therapeutic strategy. This review aims at summarizing the recent and representative research on the bone tissue engineering field using a 3D scaffold enriched with human oral stem cells and their derivatives, EVs, as a promising therapeutic potential in the reconstructing of bone tissue defects.

The significance of collagen dressings in wound management: a review

Clinical experience and research has improved our understanding of wound healing which, in turn, has enabled health professionals to aid wound healing and manufacturers to develop modern wound dressings. The significant role of collagen in wound healing has led to the development of numerous products on the basis of this biological material. The main focus of this review is to provide a critical appraisal of publications about collagen and acellular collagen dressings with a fleece-like or spongy structure. It is intended for clinicians and researchers, and aims to keep them up-to-date in the complex field of interactive, collagen-based wound dressings, including their manufacture, combination possibilities, mechanisms of action, performance in the promotion of wound healing and indications. Despite the small number of clinical studies, the importance of acellular collagen dressings with a fleece- or sponge-like structure is likely to increase in the future. As there is no ideal wound dressing, the knowledge attained is meant to support health professionals in selecting the right product, and pave the way for new applications and clinical studies.

Bioinorganics and Wound Healing

Wound dressings and the healing enhancement (increasing healing speed and quality) are two components of wound care that lead to a proper healing. Wound care today consists mostly of providing an optimal environment by removing waste and necrotic tissues from a wound, preventing infections, and keeping the wounds adequately moist. This is however often not enough to re-establish the healing process in chronic wounds; with the local disruption of vascularization, the local environment is lacking oxygen, nutrients, and has a modified ionic and molecular concentration which limits the healing process. This disruption may affect cellular ionic pumps, energy production, chemotaxis, etc., and will affect the healing process. Biomaterials for wound healing range from simple absorbents to sophisticated bioactive delivery vehicles. Often placing a material in or on a wound can change multiple parameters such as pH, ionic concentration, and osmolarity, and it can be challenging to pinpoint key mechanism of action. This article reviews the literature of several inorganic ions and molecules and their potential effects on the different wound healing phases and their use in new wound dressings.

Developing in vitro assays to quantitatively evaluate the interactions of dressings with wounds

Evaluating interactions between dressing and wound is important for understanding wound management. This study quantitatively compared four polyurethane foam-based wound dressings for their absorption profile, cell penetration, and adherence using two novel in vitro assays. The dressing with uniform pore sizes varying from 25~75 μm showed the highest absorption of both culture media and serum. The same dressing showed a 1.2- to 3.6-fold lower cell adherence (3 hours) than the other dressings, and ~20-fold lower cell penetration (5 days) than dressings with pore sizes varying from 55 to 343 μm. Additionally, cell and dressing interactions using a 3-dimensional wound healing assay showed that the dressings with the smallest pore size of 25~75 μm maintained the highest cell viability (76.3%) and promoted cell migration into the wound site. This data suggest that polyurethane foam dressing with smaller and evenly distributed pores promotes wound healing with less cellular adhesion and penetration.

Re-epithelialization of adult skin wounds: Cellular mechanisms and therapeutic strategies

Cutaneous wound healing in adult mammals is a complex multi-step process involving overlapping stages of blood clot formation, inflammation, re-epithelialization, granulation tissue formation, neovascularization, and remodelling. Re-epithelialization describes the resurfacing of a wound with new epithelium. The cellular and molecular processes involved in the initiation, maintenance, and completion of epithelialization are essential for successful wound closure. A variety of modulators are involved, including growth factors, cytokines, matrix metalloproteinases, cellular receptors, and extracellular matrix components. Here, we focus on cellular mechanisms underlying keratinocyte migration and proliferation during epidermal closure. Inability to re-epithelialize is a clear indicator of chronic non-healing wounds, which fail to proceed through the normal phases of wound healing in an orderly and timely manner. This review summarizes the current knowledge regarding the management and treatment of acute and chronic wounds, with a focus on re-epithelialization, offering some insights into novel future therapies.

A gelatin/collagen/polycaprolactone scaffold for skin regeneration

Background

A tissue-engineered skin substitute, based on gelatin (“G”), collagen (“C”), and poly(ε-caprolactone) (PCL; “P”), was developed.

Method

G/C/P biocomposites were fabricated by impregnation of lyophilized gelatin/collagen (GC) mats with PCL solutions, followed by solvent evaporation. Two different GC:PCL ratios (1:8 and 1:20) were used.

Results

Differential scanning calorimetry revealed that all G/C/P biocomposites had characteristic melting point of PCL at around 60 °C. Scanning electron microscopy showed that all biocomposites had similar fibrous structures. Good cytocompatibility was present in all G/C/P biocomposites when incubated with primary human epidermal keratinocytes (PHEK), human dermal fibroblasts (PHDF) and human adipose-derived stem cells (ASCs) in vitro. All G/C/P biocomposites exhibited similar cell growth and mechanical characteristics in comparison with C/P biocomposites. G/C/P biocomposites with a lower collagen content showed better cell proliferation than those with a higher collagen content in vitro. Due to reasonable mechanical strength and biocompatibility in vitro, G/C/P with a lower content of collagen and a higher content of PCL (GC_LP_H) was selected for animal wound healing studies. According to our data, a significant promotion in wound healing and skin regeneration could be observed in GC_LP_H seeded with adipose-derived stem cells by Gomori’s trichrome staining.

Conclusion

This study may provide an effective and low-cost wound dressings to assist skin regeneration for clinical use.

Hyaluronic Acid in the Third Millennium

Since its first isolation in 1934, hyaluronic acid (HA) has been studied across a variety of research areas. This unbranched glycosaminoglycan consisting of repeating disaccharide units of N-acetyl-d-glucosamine and d-glucuronic acid is almost ubiquitous in humans and in other vertebrates. HA is involved in many key processes, including cell signaling, wound reparation, tissue regeneration, morphogenesis, matrix organization and pathobiology, and has unique physico-chemical properties, such as biocompatibility, biodegradability, mucoadhesivity, hygroscopicity and viscoelasticity. For these reasons, exogenous HA has been investigated as a drug delivery system and treatment in cancer, ophthalmology, arthrology, pneumology, rhinology, urology, aesthetic medicine and cosmetics. To improve and customize its properties and applications, HA can be subjected to chemical modifications: conjugation and crosslinking. The present review gives an overview regarding HA, describing its history, physico-chemical, structural and hydrodynamic properties and biology (occurrence, biosynthesis (by hyaluronan synthases), degradation (by hyaluronidases and oxidative stress), roles, mechanisms of action and receptors). Furthermore, both conventional and recently emerging methods developed for the industrial production of HA and its chemical derivatization are presented. Finally, the medical, pharmaceutical and cosmetic applications of HA and its derivatives are reviewed, reporting examples of HA-based products that currently are on the market or are undergoing further investigations.

Biofunctionalized Scaffold in Bone Tissue Repair

Bone tissue engineering is based on bone grafting to repair bone defects. Bone graft substitutes can contribute to the addition of mesenchymal stem cells (MSCs) in order to enhance the rate and the quality of defect regeneration. The stem cell secretome contains many growth factors and chemokines, which could affect cellular characteristics and behavior. Conditioned medium (CM) could be used in tissue regeneration avoiding several problems linked to the direct use of MSCs. In this study, we investigated the effect of human periodontal ligament stem cells (hPDLSCs) and their CM on bone regeneration using a commercially available membrane scaffold Evolution (EVO) implanted in rat calvarias. EVO alone or EVO + hPDLSCs with or without CM were implanted in Wistar male rats subjected to calvarial defects. The in vivo results revealed that EVO membrane enriched with hPDLSCs and CM showed a better osteogenic ability to repair the calvarial defect. These results were confirmed by acquired micro-computed tomography (CT) images and the increased osteopontin levels. Moreover, RT-PCR in vitro revealed the upregulation of three genes (Collagen (COL)5A1, COL16A1 and transforming growth factor (TGF)β1) and the down regulation of 26 genes involved in bone regeneration. These results suggest a promising potential application of CM from hPDLSCs and scaffolds for bone defect restoration and in particular for calvarial repair in case of trauma.

Advances in Protein-Based Materials: From Origin to Novel Biomaterials

Biomaterials play a very important role in biomedicine and tissue engineering where they directly affect the cellular activities and their microenvironment . Myriad of techniques have been employed to fabricate a vast number natural, artificial and recombinant polymer s in order to harness these biomaterials in tissue regene ration , drug delivery and various other applications. Despite of tremendous efforts made in this field during last few decades, advanced and new generation biomaterials are still lacking. Protein based biomaterials have emerged as an attractive alternatives due to their intrinsic properties like cell to cell interaction , structural support and cellular communications. Several protein based biomaterials like, collagen , keratin , elastin , silk protein and more recently recombinant protein s are being utilized in a number of biomedical and biotechnological processes. These protein-based biomaterials have enormous capabilities, which can completely revolutionize the biomaterial world. In this review, we address an up-to date review on the novel, protein-based biomaterials used for biomedical field including tissue engineering, medical science, regenerative medicine as well as drug delivery. Further, we have also emphasized the novel fabrication techniques associated with protein-based materials and implication of these biomaterials in the domain of biomedical engineering .

Solubilized Amnion Membrane Hyaluronic Acid Hydrogel Accelerates Full-Thickness Wound Healing

The early and effective treatment of wounds is vital to ensure proper wound closure and healing with appropriate functional and cosmetic outcomes. The use of human amnion membranes for wound care has been shown to be safe and effective. However, the difficulty in handling and placing thin sheets of membrane, and the high costs associated with the use of living cellularized tissue has limited the clinical application of amniotic membrane wound healing products. Here, we describe a novel amnion membrane-derived product, processed to result in a cell-free solution, while maintaining high concentrations of cell-derived cytokines and growth factors. The solubilized amnion membrane (SAM) combined with the carrier hyaluronic acid (HA) hydrogel (HA-SAM) is easy to produce, store, and apply to wounds. We demonstrated the efficacy of HA-SAM as a wound treatment using a full-thickness murine wound model. HA-SAM significantly accelerated wound closure through re-epithelialization and prevented wound contraction. HA-SAM-treated wounds had thicker regenerated skin, increased total number of blood vessels, and greater numbers of proliferating keratinocytes within the epidermis. Overall, this study confirms the efficacy of the amnion membrane as a wound treatment/dressing, and overcomes many of the limitations associated with using fresh, cryopreserved, or dehydrated tissue by providing a hydrogel delivery system for SAM. Stem Cells Translational Medicine 2017;6:2020-2032.

Recent advances on biomedical applications of scaffolds in wound healing and dermal tissue engineering

The tissue engineering field has developed in response to the shortcomings related to the replacement of the tissues lost to disease or trauma: donor tissue rejection, chronic inflammation and donor tissue shortages. The driving force behind the tissue engineering is to avoid the mentioned issues by creating the biological substitutes capable of replacing the damaged tissue. This is done by combining the scaffolds, cells and signals in order to create the living, physiological, three-dimensional tissues. A wide variety of skin substitutes are used in the treatment of full-thickness injuries. Substitutes made from skin can harbour the latent viruses, and artificial skin grafts can heal with the extensive scarring, failing to regenerate structures such as glands, nerves and hair follicles. New and practical skin scaffold materials remain to be developed. The current article describes the important information about wound healing scaffolds. The scaffold types which were used in these fields were classified according to the accepted guideline of the biological medicine. Moreover, the present article gave the brief overview on the fundamentals of the tissue engineering, biodegradable polymer properties and their application in skin wound healing. Also, the present review discusses the type of the tissue engineered skin substitutes and modern wound dressings which promote the wound healing.

An Evidence-Based Review on Wound Healing Herbal Remedies From Reports of Traditional Persian Medicine

Research on wound healing agents is a developing area in biomedical sciences. Traditional Persian medicine is one of holistic systems of medicine providing valuable information on natural remedies. To collect the evidences for wound-healing medicaments from traditional Persian medicine sources, 5 main pharmaceutical manuscripts in addition to related contemporary reports from Scopus, PubMed, and ScienceDirect were studied. The underlying mechanisms were also saved and discussed. Totally, 65 herbs used in traditional Persian medicine for their wound healing properties was identified. Related anti-inflammatory, antioxidant, antimicrobial, and wound-healing activities of those remedies were studied. Forty remedies had at least one of those properties and 10 of the filtered plants possessed all effects. The medicinal plants used in wound healing treatment in traditional Persian medicine could be a good topic for further in vivo and clinical research. This might lead to development of effective products for wound treatment.

Fabrication of Bacteria Environment Cubes with Dry Lift-Off Fabrication Process for Enhanced Nitrification

We have developed a 3D dry lift-off process to localize multiple types of nitrifying bacteria in polyethylene glycol diacrylate (PEGDA) cubes for enhanced nitrification, a two-step biological process that converts ammonium to nitrite and then to nitrate. Ammonia-oxidizing bacteria (AOB) is responsible for converting ammonia into nitrite, and nitrite-oxidizing bacteria (NOB) is responsible for converting nitrite to nitrate. Successful nitrification is often challenging to accomplish, in part because AOB and NOB are slow growers and highly susceptible to many organic and inorganic chemicals in wastewater. Most importantly, the transportation of chemicals among scattered bacteria is extremely inefficient and can be problematic. For example, nitrite, produced from ammonia oxidation, is toxic to AOB and can lead to the failure of nitrification. To address these challenges, we closely localize AOB and NOB in PEGDA cubes as microenvironment modules to promote synergetic interactions. The AOB is first localized in the vicinity of the surface of the PEGDA cubes that enable AOB to efficiently uptake ammonia from a liquid medium and convert it into nitrite. The produced nitrite is then efficiently transported to the NOB localized at the center of the PEGDA particle and converted into non-toxic nitrate. Additionally, the nanoscale PEGDA fibrous structures offer a protective environment for these strains, defending them from sudden toxic chemical shocks and immobilize in cubes. This engineered microenvironment cube significantly enhances nitrification and improves the overall ammonia removal rate per single AOB cell. This approach—encapsulation of multiple strains at close range in cube in order to control their interactions—not only offers a new strategy for enhancing nitrification, but also can be adapted to improve the production of fermentation products and biofuel, because microbial processes require synergetic reactions among multiple species.

Synthesis and Properties of Hyaluronic Acid Conjugated Nucleic Acid Analogs—1: Synthesis of Deacetylhyaluronan and Introduction of Nucleic Acid Bases

The conjugation of nucleic acid base with hyaluronan was achieved by using the activated ester of pentachlorophenyl trichloroacetate. The conditions of de-N-acetylation of sodium hyaluronic acid were studied. In low concentrations of NaOH, the degree of deacetylation was 26%, while in 7.4N NaOH, the degree of deacetylation was 76% and the viscosity was 1.12 dL/g. Thymine and 5-fluorouracil bases were quantitatively conjugated to deacetylhyaluronan in 65% and 51%, respectively. The interaction of thymine hyaluronan conjugate with the complementary base of polyadenylate showed a small hypochromicity.

Wound dressings - a review

Wound healing is a dynamic and complex process which requires suitable environment to promote healing process. With the advancement in technology, more than 3000 products have been developed to treat different types of wounds by targeting various aspects of healing process. The present review traces the history of dressings from its earliest inception to the current status and also discusses the advantage and limitations of the dressing materials.

Biomedical Applications of Interpenetrating Polymer Network System

Interpenetrating polymer network (IPN) has been regarded as one of the novel technology in recent years showing the superior performances over the conventional techniques. This system is designed for the delivery of drugs at a predetermined rate and thus helps in controlled drug delivery. Due to its enhanced biological and physical characteristics like biodegradability, biocompatibility, solubility, specificity and stability, IPN has emerged out to be one of the excellent technologies in pharmaceutical industries. This article focuses mainly on the biomedical applications of IPN along with its future applicability in pharmaceutical research. It summarizes various aspects of IPN, biomedical applications and also in-cludes the different dosage forms based on IPN.

Transdermal Delivery of Functional Collagen Via Polyvinylpyrrolidone Microneedles

Collagen makes up a large proportion of the human body, particularly the skin. As the body ages, collagen content decreases, resulting in wrinkled skin and decreased wound healing capabilities. This paper presents a method of delivering type I collagen into porcine and human skin utilizing a polyvinylpyrrolidone microneedle delivery system. The microneedle patches were made with concentrations of 1, 2, 4, and 8% type I collagen (w/w). Microneedle structures and the distribution of collagen were characterized using scanning electron microscopy and confocal microscopy. Patches were then applied on the porcine and human skin, and their effectiveness was examined using fluorescence microscopy. The results illustrate that this microneedle delivery system is effective in delivering collagen I into the epidermis and dermis of porcine and human skin. Since the technique presented in this paper is quick, safe, effective and easy, it can be considered as a new collagen delivery method for cosmetic and therapeutic applications.

Microstructure, rheological and wound healing properties of collagen-based gel from cuttlefish skin

Collagen-based biomaterials are of the utmost importance for tissue engineering and regenerative medicine. The aims of the present investigation were to evaluate structural and rheological properties of collagen-based gel obtained from cuttlefish skin, and to investigate its ability to enhance wound healing. Scanning electron microscopy of resulted gel showed a dense fibrillar microstructure with high interconnection network with a smaller pore size. In addition, the rheological characterization of collagen gel showed an excellent reversibility, when subjected to a temperature variation. Moreover, in the wound-healing study, topical application of collagen based gel increased significantly the percentage of wound closure over a period of 12 days, when compared to the untreated and CICAFLORA(®)-treated groups. Wound-healing activity of collagen gel was confirmed by histopathology study. Thus, cuttlefish collagen based gel might be useful as a wound healing agent.