Recent trends on wound management: New therapeutic choices based on polymeric carriers

Trends in polysaccharide-based hydrogels and their role in enhancing the bioavailability and bioactivity of phytocompounds

Over the years, polysaccharides such as chitosan, alginate, hyaluronic acid, k-carrageenan, xanthan gum, carboxymethyl cellulose, pectin, and starch, alone or in combination with proteins and/or synthetic polymers, have been used to engineer an extensive portfolio of hydrogels with remarkable features. The application of polysaccharide-based hydrogels has the potential to alleviate challenges related to bioavailability, solubility, stability, and targeted delivery of phytocompounds, contributing to the development of innovative and efficient drug delivery systems and functional food formulations. This review highlights the current knowledge acquired on the preparation, features and applications of polysaccharide/phytocompounds hydrogel-based hybrid systems in wound management, drug delivery, functional foods, and food industry. The structural, functional, and biological requirements of polysaccharides and phytocompounds on the overall performance of such hybrid systems, and their impact on the application domains are also discussed.

ROS-scavenging lipid-based liquid crystalline as a favorable stem cell extracellular vesicles delivery vector to promote wound healing

Wound management is a critical clinical challenge due to the dynamic and complex pathological characteristics of inflammation, proliferation, and matrix remodeling. To address this challenge, the regulation and management of this multi-stage pathological microenvironment may provide a feasible approach to wound healing. In this work, we synthesized a new lipid material (DA) with reactive oxygen species (ROS) scavenging effect to prepare DA-based liquid crystalline (DALC). Then, DALC was incorporated with adipose mesenchymal stem cells-derived extracellular vesicles (AMSC-EVs) to fabricate a novel scaffold dressing (EVs@DALC) for the treatment of the wound. DALC not only endowed EVs@DALC with ROS scavenging sites for relieving the oxidative stress and inflammation in the microenvironment of the wound site, but also facilitated cellular uptake and transfection of microRNA and growth factors contained in AMSC-EVs. Benefiting from DALC, AMSC-EVs effectively transferred microRNA and growth factors into the skin cells to induce cell proliferation and migration and accelerate angiogenesis. The results of wound healing effect in vivo indicate EVs@DALC achieved multi-stage pathological modulation for accelerating wound healing through alleviating inflammation, promoting cell proliferation and migration, and angiogenesis. Taken together, this work provides an effective strategy based on antioxidant lipid liquid crystalline delivering extracellular vesicles in treating skin wounds and paves a way for stem cell extracellular vesicles clinical translation.

Emerging trends and challenges in polysaccharide derived materials for wound care applications: A review

Polysaccharides are favourable and promising biopolymers for wound care applications due to their abundant natural availability, low cost and excellent biocompatibility. They possess different functional groups, such as carboxylic, hydroxyl and amino, and can easily be modified to obtain the desirable properties and various forms. This review systematically analyses the recent progress in polysaccharides derived materials for wound care applications, emphasizing the most commonly used cellulose, chitosan, alginate, starch, dextran and hyaluronic acid derived materials. The distinctive attributes of each polysaccharide derived wound care material are discussed in detail, along with their different forms, i.e., films, membranes, sponges, nanoemulsions, nanofibers, scaffolds, nanocomposites and hydrogels. The processing methods to develop polysaccharides derived wound care materials are also summarized. In the end, challenges related to polysaccharides derived materials in wound care management are listed, and suggestions are given to expand their utilization in the future to compete with conventional wound healing materials.

A comprehensive review of the application of 3D-bioprinting in chronic wound management

INTRODUCTION

Chronic wounds require more sophisticated care than standard wound care because they are becoming more severe as a result of diseases like diabetes. By resolving shortcomings in existing methods, 3D-bioprinting offers a viable path toward personalized, mechanically strong, and cell-stimulating wound dressings.

AREAS COVERED

This review highlights the drawbacks of traditional approaches while navigating the difficulties of managing chronic wounds. The conversation revolves around employing natural biomaterials for customized dressings, with a particular emphasis on 3D-bioprinting. A thorough understanding of the uses of 3D-printed dressings in a range of chronic wound scenarios is provided by insights into recent research and patents.

EXPERT OPINION

The expert view recognizes wounds as a historical human ailment and emphasizes the growing difficulties and expenses related to wound treatment. The expert acknowledges that 3D printing is revolutionary, but also points out that it is still in its infancy and has the potential to enhance mass production rather than replace it. The review highlights the benefits of 3D printing for wound dressings by providing instances of smart materials that improve treatment results by stimulating angiogenesis, reducing pain, and targeting particular enzymes. The expert advises taking action to convert the technology's prospective advantages into real benefits for patients, even in the face of resistance to change in the healthcare industry. It is believed that the increasing evidence from in-vivo studies is promising and represents a positive change in the treatment of chronic wounds toward sophisticated 3D-printed dressings.

From seaweed to healing: the potential of fucoidan in wound therapy

This bibliometric review examines the current state of research on fucoidan, a sulphated polysaccharide found in brown seaweed species, and its potential for wound healing. The review included 58 studies that investigated fucoidan's effects on wound healing, revealing that it possesses anti-inflammatory and antioxidant properties that could aid in the healing process. Fucoidan was also found to promote cell proliferation, migration, and angiogenesis, essential for wound healing. However, the optimal dosage, treatment duration, safety, and efficacy of fucoidan in various wound types and patient populations still require further investigation. Additionally, advanced wound dressings like hydrogels have garnered significant attention for their potential in wound healing. While this review indicates promise for fucoidan as a natural wound healing compound, it underscores the need for additional clinical trials to determine its optimal use as a commercial therapeutic agent in wound healing.

Recent advances in molecular mechanisms of skin wound healing and its treatments

The skin, being a multifaceted organ, performs a pivotal function in the complicated wound-healing procedure, which encompasses the triggering of several cellular entities and signaling cascades. Aberrations in the typical healing process of wounds may result in atypical scar development and the establishment of a persistent condition, rendering patients more vulnerable to infections. Chronic burns and wounds have a detrimental effect on the overall quality of life of patients, resulting in higher levels of physical discomfort and socio-economic complexities. The occurrence and frequency of prolonged wounds are on the rise as a result of aging people, hence contributing to escalated expenditures within the healthcare system. The clinical evaluation and treatment of chronic wounds continue to pose challenges despite the advancement of different therapeutic approaches. This is mainly owing to the prolonged treatment duration and intricate processes involved in wound healing. Many conventional methods, such as the administration of growth factors, the use of wound dressings, and the application of skin grafts, are used to ease the process of wound healing across diverse wound types. Nevertheless, these therapeutic approaches may only be practical for some wounds, highlighting the need to advance alternative treatment modalities. Novel wound care technologies, such as nanotherapeutics, stem cell treatment, and 3D bioprinting, aim to improve therapeutic efficacy, prioritize skin regeneration, and minimize adverse effects. This review provides an updated overview of recent advancements in chronic wound healing and therapeutic management using innovative approaches.

Infection-Free and Enhanced Wound Healing Potential of Alginate Gels Incorporating Silver and Tannylated Calcium Peroxide Nanoparticles

The treatment of chronic wounds involves precise requirements and complex challenges, as the healing process cannot go beyond the inflammatory phase, therefore increasing the healing time and implying a higher risk of opportunistic infection. Following a better understanding of the healing process, oxygen supply has been validated as a therapeutic approach to improve and speed up wound healing. Moreover, the local implications of antimicrobial agents (such as silver-based nano-compounds) significantly support the normal healing process, by combating bacterial contamination and colonization. In this study, silver (S) and tannylated calcium peroxide (CaO2@TA) nanoparticles were obtained by adapted microfluidic and precipitation synthesis methods, respectively. After complementary physicochemical evaluation, both types of nanoparticles were loaded in (Alg) alginate-based gels that were further evaluated as possible dressings for wound healing. The obtained composites showed a porous structure and uniform distribution of nanoparticles through the polymeric matrix (evidenced by spectrophotometric analysis and electron microscopy studies), together with a good swelling capacity. The as-proposed gel dressings exhibited a constant and suitable concentration of released oxygen, as shown for up to eight hours (UV-Vis investigation). The biofilm modulation data indicated a synergistic antimicrobial effect between silver and tannylated calcium peroxide nanoparticles, with a prominent inhibitory action against the Gram-positive bacterial biofilm after 48 h. Beneficial effects in the human keratinocytes cultured in contact with the obtained materials were demonstrated by the performed tests, such as MTT, LDH, and NO.

Biopolymer based nanoparticles and their therapeutic potential in wound healing - A review

Nanoparticles (NPs) have been extensively investigated for their potential in nanomedicine. There is a significant level of enthusiasm about the potential of NPs to bring out a transformative impact on modern healthcare. NPs can serve as effective wound dressings or delivery vehicles due to their antibacterial and pro-wound-healing properties. Biopolymer-based NPs can be manufactured using various food-grade biopolymers, such as proteins, polysaccharides, and synthetic polymers, each offering distinct properties suitable for different applications which include collagen, polycaprolactone, chitosan, alginate, and polylactic acid, etc. Their biodegradable and biocompatible nature renders them ideal nanomaterials for applications in wound healing. Additionally, the nanofibers containing biopolymer-based NPs have shown excellent anti-bacterial and wound healing activity like silver NPs. These NPs represent a paradigm shift in wound healing therapies, offering targeted and personalized solutions for enhanced tissue regeneration and accelerated wound closure. The current review focuses on biopolymer NPs with their applications in wound healing.

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.

Preparation and Investigation of Cellulose Acetate/Gelatin Janus Nanofiber Wound Dressings Loaded with Zinc Oxide or Curcumin for Enhanced Antimicrobial Activity

The skin, as the largest organ, serves as a protective barrier against external stimuli. However, when the skin is injured, wound healing becomes a complex process influenced by physiological conditions, bacterial infections, and inflammation. To improve the process of wound healing, a variety of wound dressings with antibacterial qualities have been created. Electrospun nanofibers have gained significant attention in wound dressing research due to their large specific surface area and unique structure. One interesting method for creating Janus-structured nanofibers is side-by-side electrospinning. This work used side-by-side electrospinning to make cellulose acetate/gelatin Janus nanofibers. Curcumin and zinc oxide nanoparticles were added to these nanofibers. We studied Janus nanofibers' physicochemical characteristics and abilities to regulate small-molecule medication release. Janus nanofibers coated with zinc oxide nanoparticles and curcumin were also tested for antibacterial activity. The Janus nanofibers with specified physicochemical characteristics were successfully fabricated. Nanofibers released small-molecule medicines in a controlled manner. Additionally, the Janus nanofibers loaded with curcumin exhibited excellent antibacterial capabilities. This research contributes to the development of advanced wound dressings for promoting wound healing and combating bacterial infections.

The potential role of Hypericum perforatum in wound healing: A literature review on the phytochemicals, pharmacological approaches, and mechanistic perspectives

St. John's Wort, commonly known as Hypericum perforatum L., is a flowering plant in the Clusiaceae family that traditionally been employed for treating anxiety, depression, wounds, burns, sunburn, irritation, and stomach ailments. This review provides a synopsis of H. perforatum L. phytoconstituents and their biological effects, highlighting its beneficial therapeutic properties for dermatological indications, as well as its antioxidant, antimicrobial, anti-inflammatory, and anti-angiogenic activity in various applications including wound healing and skin conditions such as eczema, sun burn and minor burns also spastic paralysis, stiff neck and mood disorders as anti-depressant and nerve pains such as neuralgia. The data were collected from several databases as Web of Science PubMed, ScienceDirect, Scopus and Google Scholar using the terms: "H. perforatum L.", "H. perforatum L. /phytochemistry," and "H. perforatum extracts/wound healing" collected from 1994 to 2023. The findings suggest H. perforatum L. acts through various mechanisms and plays a role in each phase of the wound healing process, including re-epithelialization, angiogenesis, wound contraction, and connective tissue regeneration. H. perforatum L. enhances collagen deposition, decreases inflammation, inhibits fibroblast migration, and promotes epithelialization by increasing the number of fibroblasts with polygonal shape and the number of collagen fibers within fibroblasts. H. Perforatum L. extracts modulate the immune response and reduce inflammation were found to accelerate the wound healing process via inhibition of inflammatory mediators' production like interleukin-6, tumor necrosis factor-α, cyclooxygenase-2 gene expression, and inducible nitric oxide synthase. Thus, H. perforatum L. represents a potential remedy for a wide range of dermatological problems, owing to its constituents with beneficial therapeutic properties. H. perforatum L. could be utilized in the development of novel wound healing therapies.

Advancements in wound healing: integrating biomolecules, drug delivery carriers, and targeted therapeutics for enhanced tissue repair

Wound healing, a critical biological process vital for tissue restoration, has spurred a global market exceeding $15 billion for wound care products and $12 billion for scar treatment. Chronic wounds lead to delayed or impaired wound healing. Natural bioactive compounds, prized for minimal side effects, stand out as promising candidates for effective wound healing. In response, researchers are turning to nanotechnology, employing the encapsulation of these agents into drug delivery carriers. Drug delivery system will play a crucial role in enabling targeted delivery of therapeutic agents to promote tissue regeneration and address underlying issues such as inflammation, infection, and impaired angiogenesis in chronic wound healing. Drug delivery carriers offer distinct advantages, exhibiting a substantial ratio of surface area to volume and altered physical and chemical properties. These carriers facilitate sustained and controlled release, proving particularly advantageous for the extended process of wound healing, that typically comprise a diverse range of components, integrating both natural and synthetic polymers. Additionally, they often incorporate bioactive molecules. Despite their properties, including poor solubility, rapid degradation, and limited bioavailability, various natural bioactive agents face challenges in clinical applications. With a global research, emphasis on harnessing nanomaterial for wound healing application, this research overview engages advancing drug delivery technologies to augment the effectiveness of tissue regeneration using bioactive molecules. Recent progress in drug delivery has poised to enhance the therapeutic efficacy of natural compounds in wound healing applications.

Platelet-derived extracellular vesicles: a new-generation nanostructured tool for chronic wound healing

Chronic nonhealing wounds pose a serious challenge to regaining skin function and integrity. Platelet-derived extracellular vesicles (PEVs) are nanostructured particles with the potential to promote wound healing since they can enhance neovascularization and cell migration and reduce inflammation and scarring. This work provides an innovative overview of the technical laboratory issues in PEV production, PEVs' role in chronic wound healing and the benefits and challenges in its clinical translation. The article also explores the challenges of proper sourcing, extraction techniques and storage conditions, and discusses the necessity of further evaluations and combinational therapeutics, including dressing biomaterials, M2-derived exosomes, mesenchymal stem cells-derived extracellular vesicles and microneedle technology, to boost their therapeutic efficacy as advanced strategies for wound healing.

Multifunctionalised skin substitute of hybrid gelatin-polyvinyl alcohol bioinks for chronic wound: injectable vs. 3D bioprinting

Chronic wounds are challenging to heal and increase global mortality. The effectiveness of skin graft is limited by rejection, fibrosis, and inadequate donor site. Multifunctionalised-hydrogel skin substitutes promoted higher wound healing by maintaining the moisture microenvironment and permit gas exchange/nourishment in prolong cell viability/activity. The purpose of this study was to evaluate a skin substitute using two strategies; via injectable and 3D bioprinting technique. New hydrogel formulations that composed of gelatin (GE) and polyvinyl-alcohol (PVA) were constructed using a pre-mix crosslinking approach with genipin (GNP) to generate the biodegradable and biocompatible skin substitute with reduced secondary traumatic wound. GPVA5_GNP (6% GE: 5% PVA crosslinked with GNP) was the most stable hydrogel for wound healing application with the longest enzymatic degradation and stable hydrogel for absorption of excess wound exudates. Primary human dermal fibroblasts (HDFs) migrated extensively through 3D bioprinted hydrogels with larger average pore sizes and interconnected pores than injectable hydrogels. Moreover, 3D bioprinted GPVA hydrogels were biocompatible with HDFs and demonstrated > 90% cell viability. HDFs maintained their phenotype and positively expressed collagen type-I, vinculin, short and dense F-actin, alpha-smooth muscle actin, and Ki67. Additionally, the presence of GNP demonstrated antioxidant capacity and high-ability of angiogenesis. The utilisation of the 3D bioprinting (layer-by-layer) approach did not compromise the HDFs' growth capacity and biocompatibility with selected bioinks. In conclusion, it allows the cell encapsulation sustainability in a hydrogel matrix for a longer period, in promoting tissue regeneration and accelerating healing capacity, especially for difficult or chronic wound.

Bilirubin/morin self-assembled nanoparticle-engulfed collagen/polyvinyl alcohol hydrogel accelerates chronic diabetic wound healing by modulating inflammation and ameliorating oxidative stress

Chronic diabetic wounds pose a serious threat to human health and safety because of their refractory nature and high recurrence rates. The formation of refractory wounds is associated with wound microenvironmental factors such as increased expression of proinflammatory factors and oxidative stress. Bilirubin is a potent endogenous antioxidant, and morin is a naturally active substance that possesses anti-inflammatory and antioxidant effects. Both hold the potential for diabetic wound treatment by intervening in pathological processes. In this study, we developed bilirubin/morin-based carrier-free nanoparticles (BMn) to treat chronic diabetic wounds. In vitro studies showed that BMn could effectively scavenge overproduced reactive oxygen species and suppress elevated inflammation, thereby exerting a protective effect. BMn was then loaded into a collagen/polyvinyl alcohol gel (BMn@G) for an in vivo study to maintain a moist environment for the skin and convenient biomedical applications. BMn@G exhibits excellent mechanical properties, water retention capabilities, and in vivo safety. In type I diabetic mice, BMn@G elevated the expression of the anti-inflammatory factor IL-10 and concurrently diminished the expression of the proinflammatory factor TNF-α in the tissues surrounding the wounds. Furthermore, BMn@G efficiently mediated macrophage polarization from the M1-type to the M2-type, thereby fostering anti-inflammatory effects. Additionally, BMn@G facilitated the conversion of type III collagen fiber bundles to type I collagen fiber bundles, resulting in a more mature collagen fiber structure. This study provides a promising therapeutic alternative for diabetic wound healing.

Bioactive self-assembling silk fibroin-sericin films for skin tissue engineering

The quest for an ideal wound dressing material has been a strong motivation for researchers to explore novel biomaterials for this purpose. Such explorations have led to the extensive use of silk fibroin (SF) as a suitable polymer for several applications over the years. Unfortunately, another major silk protein-sericin has not received its due attention yet in spite of having favorable biological properties. In this study, we report an approach of blending SF and silk sericin (SS) without the usage of chemical crosslinkers is made possible by the usage of formic acid which evaporates to induceβ-sheets formation to form cytocompatible films. Raman spectroscopy confirms the presence of SF/SS components in blend and formation ofβ-sheet in films.In situ, gelation kinetics studies were conducted to understand the change in gelation properties with addition of sericin into SF. Methyl thiazolyl tetrazolium and live/dead assays were performed to study cellular attachment, viability and proliferation on SF/SS films. The antibacterial properties of SF/SS films were tested using Gram-negative and Gram-positive bacteria. The re-structured SF/SS films were stable, transparent, show good mechanical properties, antibacterial activity and cytocompatibility, therefore can serve as suitable biomaterial candidates for skin regeneration applications.

Designing Composite Stimuli-Responsive Hydrogels for Wound Healing Applications: The State-of-the-Art and Recent Discoveries

Effective wound treatment has become one of the most important challenges for healthcare as it continues to be one of the leading causes of death worldwide. Therefore, wound care technologies significantly evolved in order to provide a holistic approach based on various designs of functional wound dressings. Among them, hydrogels have been widely used for wound treatment due to their biocompatibility and similarity to the extracellular matrix. The hydrogel formula offers the control of an optimal wound moisture level due to its ability to absorb excess fluid from the wound or release moisture as needed. Additionally, hydrogels can be successfully integrated with a plethora of biologically active components (e.g., nanoparticles, pharmaceuticals, natural extracts, peptides), thus enhancing the performance of resulting composite hydrogels in wound healing applications. In this review, the-state-of-the-art discoveries related to stimuli-responsive hydrogel-based dressings have been summarized, taking into account their antimicrobial, anti-inflammatory, antioxidant, and hemostatic properties, as well as other effects (e.g., re-epithelialization, vascularization, and restoration of the tissue) resulting from their use.

A Novel Potential Treatment for Diabetic Foot Ulcers and Non-Healing Ulcers - Case Series

Introduction: Appropriate care and treatment of a wound is the need of the hour whether it is an infected or a non-infected wound. If wound healing is delayed for some reason, it leads to serious complications and further increases the hospital stay and cost of treatment. Herein, we describe a novel antimicrobial wound dressing formulation (VG111), with an objective to generate the preliminary data showing the distinct advantages in various types of wounds.

Method: This case series involved the treatment of acute cases of wounds or chronic wounds that did not respond well to conventional wound healing treatments with VG111 in patients with different etiologies. Thirteen cases of patients that included patients with diabetes, pressure ulcers, burns, trauma, and others treated with VG111 showed rapid wound healing in all the cases, even obviating the need for a graft when complete skin regeneration occurred.

Result: This was illustrated by clearing of the wound infections, reduction/disappearance of the exudate, appearance of intense granulation, epithelialization, and anti-biofilm activity followed by complete wound closure. This VG111 precludes the need for systemic antimicrobial agents in localized infections and therefore, this single agent is an attempt to address the limitations and the drawbacks of the available products.

Conclusion: Despite patients belonging to the old age group and having comorbidities like diabetes, still VG111 showed effective rapid wound healing, and that too without any scar formation in hardto- heal, infected, and non-infected wounds.

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Synthesis of novel liquid phase exfoliation of chitosan/Bi2Se3 hybrid nanocomposites for in-vitro wound healing

Numerous studies have recently established the potential of chitosan (Chi) to enhance wound healing. Chi is a carbohydrate biopolymer that is biocompatible, low-cost, toxic-free, and has excellent antibacterial properties. In this study, we synthesized Chi/Bi2Se3 hybrid nanocomposites (NCs) using a liquid exfoliation approach. The physicochemical characterization of the hybrid NCs was investigated using X-ray diffraction, Fourier transforms infrared, Thermogravimetric, Scanning electron microscope, and Transmission electron microscope. The antibacterial ability has been investigated versus two pathogens, S. aureus and E. coli. In comparison to bare materials, the hybrid NCs demonstrated better antibacterial activity against both bacterial strains. As a result, the electrostatic attraction of positively charged Chi can easily attract the negatively charged surface of the bacteria cell membrane and NCs generate reactive oxygen species (ROS). This ROS can attack bacteria's intracellular components and eventually kill bacteria. The biocompatibility of the Chi/Bi2Se3 NCs was evaluated against L929 mice fibroblast cells, and there was no evident cytotoxicity. Furthermore, an in-vitro wound scratch test was carried out on L929 mouse fibroblast cells and the Chi/Bi2Se3 hybrid NCs promote wound healing and cell proliferation. These findings suggest that the Chi/Bi2Se3 hybrid NCs as a promising future material for bacteria-infected in-vivo wound healing.

Chitosan and chitosan/turmeric-based membranes for wound healing: Production, characterization and application

In the present study, chitosan and chitosan/turmeric-based membranes were produced, characterized and applied in in vivo experiments showing the applicability for skin wound repair. Chitosan 1 % (w/v), chitosan + glycerol 30 % (w/w) and chitosan + glycerol 30 % + turmeric 1.5 % (w/w) membranes were produced through the casting technique. Self-sustainable, homogeneous, and flexible membranes were obtained from all materials tested. The FTIR spectra showed the main vibrational bands for materials used in the chemical groups. The membranes containing glycerol are more flexible than those formed with pure chitosan. Membranes formed with glycerol and glycerol/turmeric are more hydrophilic compared to the membranes formed by pure chitosan. The in vivo results showed that the group who received the chi/gly/turmeric membrane had a statistically greater reduction in the injured area, as well as a better healing process in the histological analysis compared to the other experimental groups. The material developed here is from a natural source, low cost and easy to apply and can accelerate the process of repairing skin lesions.

Development of gallic acid-loaded ethylcellulose fibers as a potential wound dressing material

In this study, novel fibers were designed based on ethylcellulose (EC), loaded with different concentrations of gallic acid (GA) using the electrospinning technique, in order to investigate the potential of these materials as wound dressings. The chemical structure and morphology, along with the antimicrobial and biocompatibility tests of the EC_GA fibers were investigated. To observe the chemical interactions between the components, fourier transform infrared spectroscopy (FTIR) was used. The morphological analyzes were performed using scanning electron microscope (SEM). The uniaxial tensile test machine was used to obtain mechanical performance of the fibers. MTT assay was applied to get the biocompatibility properties of the fibers and antimicrobial test was applied to obtain the antimicrobial activity of the fibers. Based on the obtained results, the highest viability value of 67.4 % was obtained for 10%EC_100GA on the third day of incubation, demonstrating that with the addition of a higher concentration of GA, the cell viability increases. The antimicrobial tests, evaluated against Staphylococcus (S.) aureus, Escherichia (E.) coli, Pseudomonas (Ps.) aeruginosa and Candida (C.) albicans, showed a >90 % microbial reduction capacity correlated with a logarithmic reduction ranging from 0.63 to 1, for 10%EC_100 GA. In vitro release tests of GA from the fibers showed that GA was totally released from 10%EC_100 GA fibers after 2880 min, demonstrating a controlled release profile. These findings demonstrated that EC_GA fibers may be suitable for application in biomedical fields such as wound dressing materials. However, further studies should be performed to increase the biocompatibility properties of the fibers.

Co-electrospun PCL-collagen nanofibers containing saffron-synthesized gold nanoparticles as an antioxidant wound dressing

Oxidant environment and inflammation are the leading cause of chronic wounds such as diabetic ulcers. A dressing containing antioxidants would ensure accelerated wound healing. In this study, electrospun gold nanoparticle (GNP)-embedded nanofibers were developed. GNPs (about 7 nm) were synthesized using saffron extract as a reducing and capping agent (GNP-EXT). For comparison, nanoparticles of the same size were also synthesized using citrate (GNP-CIT). Nanoparticle colloids showed a zeta potential of -27 mV. FTIR confirmed the presence of the extract molecules on the nanoparticles. DPPH assay demonstrated the significant radical scavenging properties of the GNP-EXT. The effect of nanoparticles on the viability of NIH3T3 mouse fibroblast cells was evaluated with an MTT assay that showed no significant toxicity of nanoparticles even in the highest concentration of 250 ppm. Then poly (ɛ-caprolactone) (PCL)- Collagen nanofibers containing GNPs were electrospun. By using SEM, TEM, ATR-FTIR, and contact angle measurement, the nanofibers were characterized. Proper cell adhesion and spreading was observed on nanofibers by SEM and Alamar blue assay illustrated appropriate cyto-compatibility on the obtained nanofibers after 5 days of cell seeding. Wound healing assay also confirmed the cell supporting properties and biocompatibility. The results suggest that saffron-synthesized GNP-loaded nanofibers would be considered as potential wound dressings.

Evaluation of earthquake-related wounds; example of a university

BACKGROUND

It is a holistic assessment of the forms of the first few piles of wound care. The right approach in this process directly affects the healing stages and treatment rates of the wound.

OBJECTIVE

To examine earthquake injuries retrospectively and to contribute to the literature.

METHODS

The data of patients who were treated in a university hospital between February 10 and February 21 after the earthquake were evaluated retrospectively using the wound evaluation formula.

RESULTS

A total of 116 patients' wounds were evaluated. The mean age of the participants was 31 ± 19.5 (min = 1, max = 72), the mean wound follow-up day was 6.5 ± 3 (min = 1, max = 15), and the most common type of injury was crushing (45.7%).), the injury site was found to be the lower extremity region (73,3) the most. There were signs of infection in the wound area in 62.9% of the patients. The most signs of pocketing, exudate, and infection in the wound were found in amputation (p < 0.05). The wound type with the highest moisture content of the wound and healthy skin around the wound was found to be fasciotomy (p < 0.05). The highest mean percentage of black necrosis was found in crushing (p < 0.05).

CONCLUSION

The study gives us information about the type and location of the injury and the condition of the wound bed. Earthquakes are among the disasters that cause the most loss of life and injury in developing countries such as our country. This study is one of the rare studies evaluating the wound and its features in the literature of our country, and more studies are needed in this area.

Multifunctional lipid-based nanoparticles for wound healing and antibacterial applications: A review

Wound healing primarily involves preventing severe infections, accelerating healing, and reducing pain and scarring. Therefore, the multifunctional application of lipid-based nanoparticles (LBNs) has received considerable attention in drug discovery due to their solid or liquid lipid core, which increases their ability to provide prolonged drug release, reduce treatment costs, and improve patient compliance. LBNs have also been used in medical and cosmetic practices and formulated for various products based on skin type, disease conditions, administration product costs, efficiency, stability, and toxicity; therefore, understanding their interaction with biological systems is very important. Therefore, it is necessary to perform an in-depth analysis of the results from a comprehensive characterization process to produce lipid-based drug delivery systems with desired properties. This review will provide detailed information on the different types of LBNs, their formulation methods, characterisation, antimicrobial activity, and application in various wound models (both in vitro and in vivo studies). Also, the clinical and commercial applications of LBNs are summarized.

Thiolated chitosan hydrogel-embedded niosomes: A promising crocin delivery system toward the management of aphthous stomatitis

Aphthous stomatitis is a common inflammatory oral disease with challenging management. Crocin is a natural carotenoid that has shown great anti-inflammatory properties. The aim of this study was to develop thiolated chitosan (TCS)-based hydrogels containing niosomes to serve as a mucoadhesive crocin delivery system for aphthous stomatitis. Crocin-loaded niosomes were prepared and the impact of surfactant type, cholesterol content, and lipid to drug ratio on the characteristics of niosomes was evaluated. TCS was synthesized and the success of thiolation was investigated. The optimum niosomal formulation was loaded into the hydrogel and the hybrid system was characterized regarding the morphology, mucoadhesive properties, viscosity, chemical structure, in vitro drug release, and in vivo efficacy. The optimized niosome formulation showed 77% crocin entrapment, a particle diameter of 59 nm, and a zeta potential of -18 mV. The niosome-containing hydrogel exhibited pseudoplastic rheological behavior, mucoadhesive properties, suitable swelling, and sustained release of crocin. In vivo study revealed that the niosome-containing hydrogel improved ulcer healing and decreased the expression of tumor necrosis factor-alpha (TNF-α) and p53 while increasing the expression of vascular endothelial growth factor (VEGF) and alpha-smooth muscle actin (α-SMA). Collectively, TCS hydrogel-embedded crocin-loaded niosomes is a promising therapeutic option for aphthous stomatitis. CHEMICAL COMPOUNDS STUDIED IN THIS ARTICLE: Crocin (PubChem CID: 5281233) Chitosan (PubChem CID: 71853) Thioglycolic acid (PubChem CID: 1133) 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (PubChem CID: 2723939) 5,5'-dithiobis (2-nitrobenzoic acid) (PubChem CID: 6254) Cholesterol (PubChem CID: 5997).

Delivery of adipose-derived growth factors from heparinized adipose acellular matrix accelerates wound healing

Dermal white adipocytes are closely associated with skin homeostasis and wound healing. However, it has not been fully investigated whether adipose-derived products improve wound healing. Here, we obtained adipose acellular matrix (AAM) and adipose-derived growth factors (ADGFs) from human adipose tissue and fabricated an ADGF-loaded AAM via surface modification with heparin. The product, HEP-ADGF-AAM, contained an adipose-derived scaffold and released ADGFs in a controlled fashion. To test its efficacy in promoting wound healing, mice with full thickness wound received three different treatments: HEP-ADGF-AAM, AAM and ADM. Control mice received no further treatments. Among these treatments, HEP-ADGF-AAM best improved wound healing. It induced adipogenesis in situ after in vivo implantation and provided an adipogenic microenvironment for wounds by releasing ADGFs. HEP-ADGF-AAM not only induced adipocyte regeneration, but also enhanced fibroblast migration, promoted vessel formation, accelerated wound closure, and enhanced wound epithelialization. Moreover, there was a close interaction between HEP-ADGF-AAM and the wound bed, and collagen was turned over in HEP-ADGF-AAM. These results show that HEP-ADGF-AAM might substantially improve re-epithelialization, angiogenesis, and skin appendage regeneration, and is thus a promising therapeutic biomaterial for skin wound healing.

Wound healing performance of electrospun PVA/70S30C bioactive glass/Ag nanoparticles mats decorated with curcumin: In vitro and in vivo investigations

Biocompatible fibrous scaffold containing polyvinyl alcohol (PVA), 70S30C bioactive glass (BG), silver (Ag) nanoparticles and curcumin (Cur) was fabricated through electrospinning method. Scanning electron microscope (SEM) and Field emission scanning electron microscopy (FESEM) were employed to investigate the morphological characteristics of the scaffolds. In addition, biodegradability, hydrophilicity, and contact angle were studied as criteria for evaluating physical properties of the scaffolds. Tensile strength was reported to be 0.971 ± 0.093 MPa. Also, the viability of fibroblasts after 7 days of cell culture was 93.58 ± 1.36 %. The antibacterial activity against Escherichia coli and Staphylococcus aureus bacteria was illustrated using inhibition zones of 13.12 ± 0.69 and 14.21 ± 1.37 mm, respectively. Histological results revealed that tissue regeneration after 14 days of surgery was much higher for the dressing group compared to the blank group. According to the obtained results, the authors introduce the PVA-BG-Ag-Cur scaffold as a promising candidate for skin tissue engineering applications.

Molecularly engineered dual-network photothermal hydrogel delivery system with enhanced mechanical properties, antibacterial ability and angiogenic effect for accelerating wound healing

Bacterial infection caused by trauma and chronic wounds in the most mobile area remains a challenge in clinic. It is difficult to achieve the synergistic effects of antibacterial capacity and skin regeneration using conventional therapeutic methods. Developing a multi-functional hydrogel dressing that can cope with the complex wound environment will contribute to the healing and therapeutic effects. In this work, a novel Cur@PAM/TA-Cu photothermal hydrogel delivery system was prepared by engineering tannic acid (TA) into covalent cross-linked polyacrylamide (PAM) on which the chelating tannic acid-copper metal-polyphenolic network (TA-Cu MPN) was imposed to form dual-crosslinked networks, and the natural medicine curcumin was loaded eventually. The molecularly engineered dual-crosslinked networks resulted in enhanced mechanical properties including bio-adhesion, tensile strength and self-healing, which made the hydrogel suitable for dynamic wound and various application scenarios. In addition, the excellent photothermal capacity, antioxidant effect and biocompatibility of the hydrogel were demonstrated. Notably, this curcumin loaded photothermal hydrogel exhibited superior antibacterial capacity (almost 100% killing ratio to E. coli and S. aureus) under 808 nm laser irradiation. Meanwhile, the in vivo wound healing experiment results revealed that the anti-inflammation and proangiogenic effect of Cur@PAM/TA-Cu hydrogel successfully shortened the healing time of wound and the reconstruction of skin structure and function. Thus, this dual-crosslinked multi-functional hydrogel delivery system is a promising wound dressing for accelerating wound healing.

Prophylactic Use of Mepitel® Film to Prevent Radiation-Induced Moist Desquamation in Cancer Patients

Cancer patients had limited treatment options for decades, such as surgery, chemotherapy, and radiation therapy, alone or combined. However, there have been substantial improvements in recent years with the introduction of stem cell therapy, hormone therapy, anti-angiogenic treatments, immunotherapy, dendritic cell-based targeted therapy, ablation therapy, nanoparticles, natural antioxidants, radionics, chemodynamic therapy, sonodynamic therapy, and ferroptosis-based therapy. Radiation therapy, or radiotherapy, is a cancer treatment that employs high doses of radiation to eliminate cancer cells and shrink tumors. This treatment is effective as a primary, adjuvant, or palliative therapy. It is an essential, efficient, cost-effective intervention crucial for providing proper palliative oncology care. Although cancer treatment modalities such as intensity-modulated radiotherapy have advanced, they still risk harming the skin and surrounding healthy tissue. Radiotherapy may induce clinical toxicity leading to chronic or acute radiation dermatitis, depending on the toxicity caused by the therapy. Radiation dermatitis, whether in its chronic or acute form, can cause skin shedding that may result in the formation of wounds. Such shedding can also lead to non-healing ulcers and radionecrosis. Mepitel® film helps control radiation-induced moist desquamation in cancer patients. Clinical trials on the prophylactic use of Mepitel film on radiation-induced moist desquamation did not show similarities among patients from various countries; however, the film-based method is more beneficial than other methods. This review examines the various types of dressings utilized in managing radiation-induced dermatitis to enhance wound healing effectiveness while avoiding harm to newly developing tissues. Additionally, this review compares the effectiveness of using Mepitel film for treating radiation-induced moist desquamation to other methods.

Connective tissue matrices from placental disc for wound healing: mini-review

Wound management is a complex procedure that includes multiple factors that play major roles in the healing process. Extracellular matrix-based approaches are emerging strategies for promoting wound healing. The extracellular matrix is an extensive three-dimensional molecular network comprising a variety of fibrous proteins, glycosaminoglycans, and proteoglycans. One of the rich sources of extracellular matrix components is placental tissues, which have a long history of use in tissue repair and regeneration. PURPOSE OF WORK: This mini-review focuses on essential characteristics of placental disc, comparison of four commercially available placental connective matrices (Axiofill, Dermavest, Plurivest, and Interfyl) obtained from the placental disc, and their supporting studies in the use of wound healing applications.

Multifunctional hydrogel wound dressing with rapid on-demand degradation property based on aliphatic polycarbonate and chitosan

The multifunctional hydrogel dressings are effective strategy to treat chronic wounds of diabetes. In addition, the ability of selective degradation on demand to change dressings could provide better patient compliance. Here, an injectable, self-healing hydrogel with rapid degradability on-demand is designed to promote the healing of diabetes wounds. The block copolymer formed by aldehyde modified aliphatic cyclic carbonate monomer with polyethylene glycol (MBP) and chitosan (CS) were crosslinked through the Schiff base bond to obtain a hydrogel with excellent injectability and self-healing ability. Due to the presence of carbonate bonds in MBP, it showed the rapid on-demand degradation characteristics triggered by N-acetylcysteine (NAC). At the same time, gallic acid (GA) was loaded into the hydrogel, giving the hydrogel dressing antioxidant. In vivo and in vitro experiments showed that the hydrogel wound dressing possesses good natures, such as antibacterial, antioxidant, and friendly cell compatibility, which could promote wound healing. Overall, the multifunctional hydrogel wound dressings with rapid on-demand degradation characteristics are more practical for clinical applications.

Physical Properties and pH Environment of Foam Dressing Containing Eclipta prostrata Leaf Extract and Gelatin

Eclipta prostrata (E. prostrata) has several biological activities, including antibacterial and anti-inflammatory activities, that improve wound healing. It is well known that physical properties and pH environment are crucial considerations when developing wound dressings containing medicinal plant extracts in order to create an appropriate environment for wound healing. In this study, we prepared a foam dressing containing E. prostrata leaf extract and gelatin. Chemical composition was verified using Fourier-transform infrared spectroscopy (FTIR) and pore structure was obtained using scanning electron microscopy (SEM). The physical properties of the dressing, including absorption and dehydration properties, were also evaluated. The chemical properties were measured to determine the pH environment after the dressing was suspended in water. The results revealed that the E. prostrata dressings had a pore structure with an appropriate pore size (313.25 ± 76.51 µm and 383.26 ± 64.45 µm for the E. prostrata A and E. prostrata B dressings, respectively). The E. prostrata B dressings showed a higher percentage of weight increase in the first hour and a faster dehydration rate in the first 4 h. Furthermore, the E. prostrata dressings had a slightly acidic environment (5.28 ± 0.02 and 5.38 ± 0.02 for the E. prostrata A and E. prostrata B dressings at 48 h, respectively).

Evaluation of cashew gum-polyvinyl alcohol (CG-PVA) electrospun nanofiber mat for scarless wound healing in a murine model

Modern-day treatment for burns and wounds demands scarless healing which is becoming a challenging clinical problem. Thus, to alleviate such issues, it becomes essential to develop biocompatible and biodegradable wound dressing material for skin tissue regeneration, which could heal the wound in a very short span leaving no scars. The present study focuses on the development of nanofiber of Cashew gum polysaccharide-Polyvinyl alcohol using electrospinning. The prepared nanofiber was optimized based on uniformity of fiber diameter (FESEM), mechanical property (Tensile Strength), and optical contact angle (OCA) and was subjected to evaluation of: antimicrobial activity against Streptococcus aureus and Escherichia coli, hemocompatibility, and in-vitro biodegradability. The nanofiber was also characterized using different analytical techniques including thermogravimetric analysis, Fourier-transform infrared spectroscopy, and X-ray diffraction. The cytotoxicity was also investigated on L929 fibroblast cells using an SRB assay. The in-vivo wound healing assay showed accelerated healing in comparison to untreated wounds. The in-vivo wound healing assay and histopathological slides of regenerated tissue confirmed that the nanofiber has the potential to accelerate healing properties.

Wound healing activity and flavonoid contents of purslane (Portulaca grandiflora) of various varieties

Purslane has various varieties with different active metabolite contents that need to be explored further to find each variety's activity in wound healing. Different purslane herbs showed different antioxidant activities, suggesting they will have different flavonoid content and wound healing activity. This research aimed to evaluate purslane's total flavonoid content and wound-healing activity. The wounds induced on the rabbit back skin were divided into 6 treatment groups such as negative control, positive control, 10 and 20% purslane herbs extract varieties A, and 10 and 20% purslane herbs extract varieties C. Wounds were treated twice daily for 2 weeks, and measured on day 0, 7, 11, and 14. Total flavonoid content was measured with the AlCl3 colorimetric method. The wounds treated with 10 and 20% purslane herbs extract varieties A (Portulaca grandiflora magenta flower) have 0.32 ± 0.55 and 1.63 ± 1.96 mm wound diameters on day 7 and healed on day 11. The wounds treated with 10 and 20% purslane herbs extract varieties C (Portulaca grandiflora pink flower) showed 2.88 ± 0.51 and 0.84 ± 1.45 mm diameter and healed on day 11. The purslane herb A showed the highest wound healing activity, and purslane varieties A and C total flavonoid contents were 0.55 ± 0.02 and 1.58 ± 0.02% w/w, respectively.

Jellyfishes—Significant Marine Resources with Potential in the Wound-Healing Process: A Review

The wound-healing process is a significant area of interest in the medical field, and it is influenced by both external and patient-specific factors. The aim of this review paper is to highlight the proven wound-healing potential of the biocompounds found in jellyfish (such as polysaccharide compounds, collagen, collagen peptides and amino acids). There are aspects of the wound-healing process that can benefit from polysaccharides (JSPs) and collagen-based materials, as these materials have been shown to limit exposure to bacteria and promote tissue regeneration. A second demonstrated benefit of jellyfish-derived biocompounds is their immunostimulatory effects on growth factors such as (TNF-α), (IFN-γ) and (TGF), which are involved in wound healing. A third benefit of collagens and polysaccharides (JSP) is their antioxidant action. Aspects related to chronic wound care are specifically addressed, and within this general theme, molecular pathways related to tissue regeneration are explored in depth. Only distinct varieties of jellyfish that are specifically enriched in the biocompounds involved in these pathways and live in European marine habitats are presented. The advantages of jellyfish collagens over mammalian collagens are highlighted by the fact that jellyfish collagens are not considered transmitters of diseases (spongiform encephalopathy) or various allergic reactions. Jellyfish collagen extracts stimulate an immune response in vivo without inducing allergic complications. More studies are needed to explore more varieties of jellyfish that can be exploited for their biocomponents, which may be useful in wound healing.

Smart microneedle patches for wound healing and management

The number of patients with non-healing wounds is generally increasing globally, placing a huge social and economic burden on every country. The complexity of the wound-healing process remains a major health challenge despite the numerous studies that have been reported on conventional wound dressings. Therefore, a therapeutic system that combines diagnostic and therapeutic modalities is essential to monitor wound-related biomarkers and facilitate wound healing in real time. Microneedles, as a multifunctional platform, are promising for transdermal diagnostics and drug delivery. Their advantages are mainly reflected in painless transdermal drug delivery, good biocompatibility, and ease of self-administration. In this work, we review recent advances in the use of microneedle patches for wound healing and monitoring. The paper first provides a brief overview of the skin structure and the wound healing process, and then discusses the current state of research and prospects for the development of wound-related biomarkers and their real-time monitoring based on microneedle sensors. It summarizes the current state of research based on the unique design of microneedle patches, including biomimetic, conductive, and environmentally responsive, to achieve wound healing. It further summarizes the prospects for the application of different microneedle-based drug delivery modalities and drug delivery substances for wound healing, due to their superior transdermal drug delivery advantages. It concludes with challenges and expectations for the use of smart microneedle patches for wound healing and management.

Bioactive bacterial cellulose wound dressings for burns with collagen in-situ and chitosan ex-situ impregnation

Bacterial cellulose (BC) is a biopolymer that commonly used for wound dressings regarding to its high in-vitro and in-vivo biocompatibility. Moreover, the three-dimensional fibers in BC become an advantageous for bioactive wound dressing application as they serve as templates for impregnation other supportive materials. Chitosan and collagen are two of the materials that can be impregnated to optimize the BC properties for serve as wound dressing material. Collagen can help skin cells grow on the wound sites, where chitosan has anti-bacterial properties and can bind red blood cells. BC-based wound dressings were made by impregnating collagen via in-situ method followed by immersing chitosan via ex-situ method into BC fibers for 24 h. The intermolecular interactions of amine groups in the wound dressing were confirmed by FTIR. The XRD diffractogram showed wider peaks at 14.2°, 16.6°, and 22.4° due to the presence of collagen and chitosan molecules in the BC fibers. SEM images confirmed that chitosan and collagen could penetrate BC fibers well. Other tests, such as water content, porosity, antibacterial properties, and haemocompatibility, indicated that the wound dressing was non-hemolytic. In-vivo test indicated that BC/collagen/chitosan wound dressing supported the wound healing process on second degree burn.

An integrated management (Ayurveda and Modern medicine) of accidental burn injury: A case study

Burn injuries are frequent, horrifying, and life-threatening conditions that are still challenging to cure. Complications like scarring, keloid formation, and contractures are the main challenges for the treating surgeon. The Ayurvedic classics explain different treatment modalities for the management of burn wounds, like oral medicines, topical applications prepared with herbal medicines, ghee, oil, and typical wound dressing techniques like Patraadaana (wound covering with medicinal leaves), and fumigation therapy, etc. Here we report a case of accidental burn injury with a TBSA of 27% First degree (superficial) and 15% second degree (deep partial-thickness) burns with complaints of fever and burning sensation at the burn site. On the basis of the symptoms listed in the classical texts of Ayurveda, the case was diagnosed as Pramadadagdha (accidental burn). To properly manage the burn wound, an integrated therapy strategy was designed. Ropanaghrita (medicated ghee) was applied locally, followed by the application of Tinospora cordifolia leaves to cover the wound, fumigation therapy, and oral medications to hasten wound healing and reduce infection. In the first seven days, modern medicine was used as emergency care in addition to Ayurvedic management. Within 60 days of receiving treatment, the burn wound had entirely healed, and the patient was able to resume her regular work activities. In the current situation, the combined strategy produced encouraging burn management outcomes.

Flavonoids as Potential Wound-Healing Molecules: Emphasis on Pathways Perspective

Wounds are considered to be a serious problem that affects the healthcare sector in many countries, primarily due to diabetes and obesity. Wounds become worse because of unhealthy lifestyles and habits. Wound healing is a complicated physiological process that is essential for restoring the epithelial barrier after an injury. Numerous studies have reported that flavonoids possess wound-healing properties due to their well-acclaimed anti-inflammatory, angiogenesis, re-epithelialization, and antioxidant effects. They have been shown to be able to act on the wound-healing process via expression of biomarkers respective to the pathways that mainly include Wnt/β-catenin, Hippo, Transforming Growth Factor-beta (TGF-β), Hedgehog, c-Jun N-Terminal Kinase (JNK), NF-E2-related factor 2/antioxidant responsive element (Nrf2/ARE), Nuclear Factor Kappa B (NF-κB), MAPK/ERK, Ras/Raf/MEK/ERK, phosphatidylinositol 3-kinase (PI3K)/Akt, Nitric oxide (NO) pathways, etc. Hence, we have compiled existing evidence on the manipulation of flavonoids towards achieving skin wound healing, together with current limitations and future perspectives in support of these polyphenolic compounds as safe wound-healing agents, in this review.

Synthesis of Bio-Based Polyester from Microbial Lipidic Residue Intended for Biomedical Application

In the last decade, selectively tuned bio-based polyesters have been increasingly used for their clinical potential in several biomedical applications, such as tissue engineering, wound healing, and drug delivery. With a biomedical application in mind, a flexible polyester was produced by melt polycondensation using the microbial oil residue collected after the distillation of β-farnesene (FDR) produced industrially by genetically modified yeast, Saccharomyces cerevisiae. After characterization, the polyester exhibited elongation up to 150% and presented T_g of -51.2 °C and T_m of 169.8 °C. In vitro degradation revealed a mass loss of about 87% after storage in PBS solution for 11 weeks under accelerated conditions (40 °C, RH = 75%). The water contact angle revealed a hydrophilic character, and biocompatibility with skin cells was demonstrated. 3D and 2D scaffolds were produced by salt-leaching, and a controlled release study at 30 °C was performed with Rhodamine B base (RBB, 3D) and curcumin (CRC, 2D), showing a diffusion-controlled mechanism with about 29.3% of RBB released after 48 h and 50.4% of CRC after 7 h. This polymer offers a sustainable and eco-friendly alternative for the potential use of the controlled release of active principles for wound dressing applications.

Electrospun Naringin-Loaded Fibers for Preventing Scar Formation during Wound Healing

Hypertrophic scars (HTSs) are aberrant structures that develop where skin is injured complexly and represent the result of a chronic inflammation as a healing response. To date, there is no satisfactory prevention option for HTSs, which is due to the complexity of multiple mechanisms behind the formation of these structures. The present work aimed to propose Biofiber (Biodegradable fiber), an advanced textured electrospun dressing, as a suitable solution for HTS formation in complex wounds. Biofiber has been designed as a 3-day long-term treatment to protect the healing environment and enhance wound care practices. Its textured matrix consists of homogeneous and well-interconnected Poly-L-lactide-co-poly-ε-caprolactone (PLA-PCL) electrospun fibers (size 3.825 ± 1.12 µm) loaded with Naringin (NG, 2.0% w/w), a natural antifibrotic agent. The structural units contribute to achieve an optimal fluid handling capacity demonstrated through a moderate hydrophobic wettability behavior (109.3 ± 2.3°), and a suitable balance between absorbency (389.8 ± 58.16%) and moisture vapor transmission rate (MVTR, 2645 ± 60.43 g/m2 day). The flexibility and conformability of Biofiber to the body surfaces is due to its innovative circular texture, that also allow it to obtain finer mechanical properties after 72 h in contact with Simulated Wound Fluid (SWF), with an elongation of 352.6 ± 36.10%, and a great tenacity (0.25 ± 0.03 Mpa). The ancillary action of NG results in a prolonged anti-fibrotic effect on Normal Human Dermal Fibroblasts (NHDF), through the controlled release of NG for 3 days. The prophylactic action was highlighted at day 3 with the down regulation of the major factors involved in the fibrotic process: Transforming Growth Factor β1 (TGF-β1), Collagen Type 1 alpha 1 chain (COL1A1), and α-smooth muscle actin (α-SMA). No significant anti-fibrotic effect has been demonstrated on Hypertrophic Human Fibroblasts derived from scars (HSF), proving the potential of Biofiber to minimize HTSs in the process of early wound healing as a prophylactic therapy.

3D Printing as a Technological Strategy for the Personalized Treatment of Wound Healing

Wound healing is a dynamic process which involves stages of hemostasis, inflammation, proliferation and remodeling. Any error in this process results in abnormal wound healing, generating financial burdens for health systems and even affecting the physical and mental health of the patient. Traditional dressings do not meet the complexities of ideal treatment in all types of wounds. For this reason, in the last decades, different materials for drug delivery and for the treatment of wounds have been proposed reaching novel level of standards, such as 3D printing techniques. The use of natural or synthetic polymers, and the correct design of these printed products loaded with cells and/or combined with active compounds, can generate an effective system for the treatment of wounds, improving the healing process and generating customized dressings according to the patient needs. This manuscript provides a comprehensive review of different types of 3D printing techniques, as well as its use in wound healing and its different stages, including the advantages and limitations of additive manufacturing and future perspectives.

Effects of Drying Temperature and Solvents on In Vitro Diabetic Wound Healing Potential of Moringa oleifera Leaf Extracts

The delayed healing of wounds among people with diabetes is a severe problem worldwide. Hyperglycemia and increased levels of free radicals are the major inhibiting factors of wound healing in diabetic patients. Plant extracts are a rich source of polyphenols, allowing them to be an effective agent for wound healing. Drying temperature and extraction solvent highly affect the stability of polyphenols in plant materials. However, there is a need to optimize the extraction protocol to ensure the efficacy of the final product. For this purpose, the effects of drying temperature and solvents on the polyphenolic composition and diabetic wound healing activity of Moringa oleifera leaves were examined in the present research. Fresh leaves were oven dried at different temperatures (10 °C, 30 °C, 50 °C, and 100 °C) and extracted in three solvents (acetone, ethanol, and methanol) to obtain twelve extracts in total. The extracts were assessed for free radical scavenging and antihyperglycemic effects using DPPH (2,2-diphenylpicrylhydrazyl) and α- glucosidase inhibition assays. Alongside this, a scratch assay was performed to evaluate the cell migration activity of M. oleifera on the human retinal pigment epithelial cell line. The cytotoxicity of the plant extracts was assessed on human retinal pigment epithelial (RPE) and hepatocellular carcinoma (Huh-7) cell lines. Using high-performance liquid chromatography, phenolic compounds in extracts of M. oleifera were identified. We found that an ethanol-based extract prepared by drying the leaves at 10 °C contained the highest amounts of identified polyphenols. Moringa oleifera extracts showed remarkable antioxidant, antidiabetic, and cell migration properties. The best results were obtained with leaves dried at 10 °C and 30 °C. Decreased activities were observed with drying temperatures of 50 °C and above. Moreover, M. oleifera extracts exhibited no toxicity on RPE cells, and the same extracts were cytotoxic for Huh-7 cells. This study revealed that M. oleifera leaves extracts can enhance wound healing in diabetic conditions due to their antihyperglycemic, antioxidant, and cell migration effects. The leaves of this plant can be an excellent therapeutic option when extracted at optimum conditions.

Small extracellular vesicles from mesenchymal stem cells: A potential Weapon for chronic non-healing wound treatment

Chronic non-healing wounds have posed a severe threat to patients mentally and physically. Behavior dysregulation of remaining cells at wound sites is recognized as the chief culprit to destroy healing process and hinders wound healing. Therefore, regulating and restoring normal cellular behavior is the core of chronic non-healing wound treatment. In recent years, the therapy with mesenchymal stem cells (MSCs) has become a promising option for chronic wound healing and the efficacy has increasingly been attributed to their exocrine functions. Small extracellular vesicles derived from MSCs (MSC-sEVs) are reported to benefit almost all stages of wound healing by regulating the cellular behavior to participate in the process of inflammatory response, angiogenesis, re-epithelization, and scarless healing. Here, we describe the characteristics of MSC-sEVs and discuss their therapeutic potential in chronic wound treatment. Additionally, we also provide an overview of the application avenues of MSC-sEVs in wound treatment. Finally, we summarize strategies for large-scale production and engineering of MSC-sEVs. This review may possibly provide meaningful guidance for chronic wound treatment with MSC-sEVs.

Curcumin in Wound Healing-A Bibliometric Analysis

BACKGROUND

Curcumin has been widely used to treat a variety of diseases and disorders since ancient times, most notably for the purpose of healing wounds. Despite the large number of available reviews on this topic, a bibliometric tool-based meta-analysis is missing in the literature. Scope and approach: To evaluate the influence and significance of the countries, journals, organizations and authors that have contributed the most to this topic, the popular bibliometric markers, including article count, citation count, and Hirsch index (H-index), are taken into account. Their collaborative networks and keyword co-occurrence along with the trend analysis are also sketched out using the VOSviewer software. To the best of our knowledge, this is the first bibliometric review on the topic and hence it is envisaged that it will attract researchers to explore future research dimensions in the related field.

KEY FINDINGS AND CONCLUSIONS

India provided the most articles, making up more than 27.49 percent of the entire corpus. The International Journal of Biological Macromolecules published the most articles (44), and it also received the most citations (2012). The Journal of Ethnopharmacology (28 articles) and Current Pharmaceutical Design (20 articles) were the next most prolific journals with 1231 and 812 citations, respectively. The results indicate a significant increase in both research and publications on the wound-healing properties of curcumin. Recent studies have concentrated on creating novel medicine-delivery systems that use nano-curcumin to boost the effect of the curcumin molecule in therapeutic targeting. It has also been observed that genetic engineering and biotechnology have recently been employed to address the commercial implications of curcumin.

New insights into balancing wound healing and scarless skin repair

Scars caused by skin injuries after burns, wounds, abrasions and operations have serious physical and psychological effects on patients. In recent years, the research of scar free wound repair has been greatly expanded. However, understanding the complex mechanisms of wound healing, in which various cells, cytokines and mechanical force interact, is critical to developing a treatment that can achieve scarless wound healing. Therefore, this paper reviews the types of wounds, the mechanism of scar formation in the healing process, and the current research progress on the dual consideration of wound healing and scar prevention, and some strategies for the treatment of scar free wound repair.

Alginate/polyvinyl alcohol films for wound healing: Advantages and challenges

The skin is the largest organ in the human body and its physical integrity must be maintained for body homeostasis and to prevent the entry of pathogenic microorganisms. Sodium alginate (SA) and polyvinyl alcohol (PVA) are two polymers widely used in films for wound dressing applications. Furthermore, blends between SA and PVA improve physical, mechanical and biological properties of the final wound healing material when compared to the individual polymers. Different drugs have been incorporated into SA/PVA-based films to improve wound healing activity. It is noteworthy that SA/PVA films can be crosslinked with Ca²⁺ or other agents, which improves physicochemical and biological properties. Thus, SA/PVA associations are promising for the biomedical field, as a potential alternative for wound treatment. This review focuses on the main techniques for obtaining SA/PVA films, their physical-chemical characterization, drug incorporation, and the advantages and challenges of these films for wound healing.

How to maximize the therapeutic effect of exosomes on skin wounds in diabetes mellitus: Review and discussion

Chronic skin wound healing, especially in diabetes mellitus, is still unsolved. Although many efforts have been made to treat diabetic skin wounds, current strategies have achieved limited effectiveness. Nowadays, a great number of studies have shown that exosomes might be a promising approach for treating diabetic wounds. Many studies and reviews have focused on investigating and discussing the effectiveness and mechanism of exosomes. However, maximizing its value in treating skin wounds in diabetes mellitus requires further consideration. In this review, we reviewed and discussed the aspects that could be further improved in this process, including finding a better source of exosomes, engineering exosomes, adjusting dosage and frequency, and combining more efficient delivery methods. This review provided an overview and idea of what we can do to improve the therapeutic effect of exosomes on skin wounds in diabetes mellitus. Only by combining all the factors that affect the effectiveness of exosomes in diabetic wound healing can we further promote their clinical usefulness.