Breathable, antifreezing, mechanically skin-like hydrogel textile wound dressings with dual antibacterial mechanisms

Dynamic silicone hydrogel gauze coatings with dual anti-blood adhesion mechanism for rapid hemostasis and minimal secondary damage

Hemostatic materials that can rapidly control bleeding without causing secondary damage or sharp pain upon removal are receiving increasing demands in acute trauma treatments and first-aid supplies. Here, we report the development of a dynamic silicone hydrogel coating on medical gauze to enable rapid hemostasis and synergistic anti-blood adhesion properties. The silicone hydrogel can spontaneously form oriented cross-linked structures on fibrous medical gauze through a solution-processing method to achieve macroscopic superhydrophobicity with microscopic surface slipperiness, resulting in excellent anti-blood adhesion with the on-wound peeling force at ~0 millinewton. The development of dynamic silicone hydrogel coating on medical gauze enables a unique integration of advanced features including instant bleeding control, excellent anti-blood adhesion, and excellent air permeability. The proposed strategy is also suitable for scalable production, making it promising in the applications of trauma management.

Enhancing the porosity of chitosan sponges with CBD by adding antimicrobial violacein

Given the growing interest in non-toxic materials with good anti-inflammatory and antimicrobial mechanical properties, this work focuses on preparing chitosan sponges with violacein and cannabis oil crosslinked with dialdehyde chitosan. The sponge was tested for its physicochemical and biological properties, presenting a high swelling rate, good thermal stability, and satisfactory mechanical properties. The obtained sponge's water vapor transmission rate was 2101 g/m2/day and is within the recommended values for ideal wound dressings. Notably, adding violacein favorably affected the material's porosity, which is essential for dressing materials. In addition, studies have shown that the designed material interacts with human serum albumin and exhibits good antioxidant and anti-inflammatory properties. The antibacterial properties of the prepared biomaterial were assessed using the Microtox test against A. fisherii (Gram-negative bacterium) and S. aureus (Gram-positive bacterium). The investigated material provides potential therapeutic benefits due to the synergistic action of chitosan, violacein, and cannabis oil so that it could be used as a dressing material. The natural origin of the substances could provide an attractive and sustainable alternative to traditional commercially available dressings.

Engineering High-Performance Composite Cellulose Materials for Fast Hemostasis

The development of an effective hemostatic agents is of vital importance for saving wounded individuals from uncontrolled hemorrhage, which is the main reason for preventable death after accidental injury. However, current high-performance hemostatic agents suffer from a cumbersome preparation procedures and poor biocompatibility. Here, we engineered a cellulosic-derived aerogel material by simply controlling the drying process of cellulose regeneration for fast hemostasis. Four different freeze-drying pretreatments were investigated. As compared with the other three, the cellulosic aerogel material prepared without freezing pretreatment exhibited the lowest crystallinity (21.3%) and the highest body fluid absorption capacity (20.3 times that of its own weight) due to its super hierarchical porous structure, which led to an excellent hemostatic performance in vitro blood coagulation (≈100 s). Moreover, the addition of gelatin and diatomite in the material could tune the functional groups and electrostatic properties of the aerogel and further enhance its hemostatic performance. Various characterizations, including X-ray diffraction (XRD), fourier transform infrared spectroscopy (FTIR), X-ray nanocomputed tomography (CT), scanning electron microscopy (SEM), and zeta potential analysis, were carried out to probe the structure-function relationship of the prepared material, and its mechanism of fast hemostasis was thereafter revealed. The results indicate that the developed aerogel is a cost-effective and feasibly scalable hemostatic material suitable for practical use in industry.

Nature's coatings: Sodium alginate as a novel coating in safeguarding plants from frost damages

Frost damage remains a significant challenge for agricultural practices worldwide, leading to substantial economic losses and food insecurity. Practically, traditional methods for frost management have proven ineffective and come with several drawbacks, such as energy consumption and limited efficacy. Hence, proposing an anti-freezing coating can be an innovative idea. The potential of sodium alginate (SA) to construct anti-freezing hydrogels has been explored in several sciences. SA hydrogels can form protective films around plants as a barrier against freezing temperatures and ice crystals on the plant's surface. Sodium alginate exhibits excellent water retention, enhancing plant hydration during freezing conditions. This coating can provide insulation, effectively shielding the plant from frost damage. The advantages of SA as a coating material, such as its biocompatibility, biodegradability, and non-toxic nature, are highlighted. Therefore, the proposed use of SA as an innovative coating material holds promise for safeguarding plants from frost damage. Following SA potential and frost's huge damage, the present review provides a comprehensive overview of the recent developments in SA-based anti-freezing hydrogels, their applications, and their potential in agriculture as anti-freezing coatings. However, further research and field trials are necessary to optimize the application methods and understand the long-term effects on productivity.

Antibacterial, Fatigue-Resistant, and Self-Healing Dressing from Natural-Based Composite Hydrogels for Infected Wound Healing

The treatment of infected wounds faces substantial challenges due to the high incidence and serious infection-related complications. Natural-based hydrogel dressings with favorable antibacterial properties and strong applicability are urgently needed. Herein, we developed a composite hydrogel by constructing multiple networks and loading ciprofloxacin for infected wound healing. The hydrogel was synthesized via a Schiff base reaction between carboxymethyl chitosan and oxidized sodium alginate, followed by the polymerization of the acrylamide monomer. The resultant hydrogel dressing possessed a good self-healing ability, considerable compression strength, and reliable compression fatigue resistance. In vitro assessment showed that the composite hydrogel effectively eliminated bacteria and exhibited an excellent biocompatibility. In a model of Staphylococcus aureus-infected full-thickness wounds, wound healing was significantly accelerated without scars through the composite hydrogel by reducing wound inflammation. Overall, this study opens up a new way for developing multifunctional hydrogel wound dressings to treat wound infections.

Antibacterial Micelles-Loaded Carboxymethyl Chitosan/Oxidized Konjac Glucomannan Composite Hydrogels for Enhanced Wound Repairing

Antibacterial hydrogels have emerged as a promising approach for effective wound treatment. However, despite extensive research on the fabrication of antibacterial hydrogels, it remains challenging to develop injectable, biocompatible, transparent, and mass-producible hydrogels with antibacterial properties. In this study, we successfully fabricated an antibacterial drug-loaded composite hydrogel, named CC45/OKG40/HS, through a Schiff base reaction between carboxymethyl chitosan (CC) and oxidized konjac glucomannan (OKG), followed by the encapsulation of stevioside-stabilized honokiol (HS) micelles. The CC45/OKG40/HS hydrogel exhibited several favorable properties, including a short gel time (<10 min), high water content (>92%), injectability, good adhesiveness, self-healing ability, and high transparency. In vitro experiments confirmed its excellent antibacterial properties, antioxidant activities, and high biocompatibility (no cytotoxicity, hemolysis ratio <5%). Furthermore, in vivo evaluation demonstrated that the CC45/OKG40/HS0.5 hydrogel accelerated wound healing by relieving inflammatory responses and enhancing re-epithelization. Given its feasibility for mass production, the findings showed that the CC45/OKG40/HS hydrogel has the potential as an advanced antibacterial wound dressing for commercial use.

Pluronic F127-Lipoic Acid Adhesive Nanohydrogel Combining with Ce3+/Tannic Acid/Ulinastatin Nanoparticles for Promoting Wound Healing

Developing strong anti-inflammatory wound dressings is of great significance for protecting inflammatory cutaneous wounds and promoting wound healing. The present study develops a nanocomposite Pluronic F127 (F127)-based hydrogel dressing with injectable, tissue adhesive, and anti-inflammatory performance. Briefly, Ce3+/tannic acid/ulinastatin nanoparticles (Ce3+/TA/UTI NPs) are fabricated. Meanwhile, α-lipoic acid is bonded to the ends of F127 to prepare F127-lipoic acid (F127LA) and its nanomicelles. Due to the gradual viscosity change instead of mutation during phase transition, the mixed Ce3+/TA/UTI NPs and F127LA nanomicelles show well-performed injectability at 37 °C and can form a semisolid composite nanohydrogel that can tightly attach to the skin at 37 °C. Furthermore, ultraviolet (UV) irradiation without a photoinitiator transforms the semisolid hydrogel into a solid hydrogel with well-performed elasticity and toughness. The UV-cured composite nanohydrogel acts as a bioadhesive that can firmly adhere to tissues. Due to the limited swelling property, the hydrogel can firmly adhere to tissues in a wet environment, which can seal wounds and provide a reliable physical barrier for the wounds. Ce3+/TA/UTI NPs in the hydrogel exhibit lipopolysaccharide (LPS)-scavenging ability and reactive oxygen species (ROS)-scavenging ability and significantly reduce the expression of inflammatory factors in wounds at the early stage, accelerating LPS-induced wound healing.

Flexible Accelerated-Wound-Healing Antibacterial Hydrogel-Nanofiber Scaffold for Intelligent Wearable Health Monitoring

Flexible epidermal sensors hold significant potential in personalized healthcare and multifunctional electronic skins. Nonetheless, achieving both robust sensing performance and efficient antibacterial protection, especially in medical paradigms involving electrophysiological signals for wound healing and intelligent health monitoring, remains a substantial challenge. Herein, we introduce a novel flexible accelerated-wound-healing biomaterial based on a hydrogel-nanofiber scaffold (HNFS) via electrostatic spinning and gel cross-linking. We effectively engineer a multifunctional tissue nanoengineered skin scaffold for wound treatment and health monitoring. Key features of HNFS include high tensile strength (24.06 MPa) and elasticity (214.67%), flexibility, biodegradability, and antibacterial properties, enabling assembly into versatile sensors for monitoring human motion and electrophysiological signals. Moreover, in vitro and in vivo experiments demonstrate that HNFS significantly enhances cell proliferation and skin wound healing, provide a comprehensive therapeutic strategy for smart sensing and tissue repair, and guide the development of high-performance "wound healing-health monitoring" bioelectronic skin scaffolds. Therefore, this study provides insights into crafting flexible and repairable skin sensors, holding potential for multifunctional health diagnostics and intelligent medical applications in intelligent wearable health monitoring and next-generation artificial skin fields.

Highly Bioactive MXene-M2-Exosome Nanocomposites Promote Angiogenic Diabetic Wound Repair through Reconstructing High Glucose-Derived Immune Inhibition

The repair of diabetic wounds remains challenging, primarily due to the high-glucose-derived immune inhibition which often leads to the excessive inflammatory response, impaired angiogenesis, and heightened susceptibility to infection. However, the means to reduce the immunosuppression and regulate the conversion of M2 phenotype macrophages under a high-glucose microenvironment using advanced biomaterials for diabetic wounds are not yet fully understood. Herein, we report two-dimensional carbide (MXene)-M2 macrophage exosome (Exo) nanohybrids (FM-Exo) for promoting diabetic wound repair by overcoming the high-glucose-derived immune inhibition. FM-Exo showed the sustained release of M2 macrophage-derived exosomes (M2-Exo) up to 7 days and exhibited broad-spectrum antibacterial activity. In the high-glucose microenvironment, relative to the single Exo, FM-Exo could significantly induce the optimized M2a/M2c polarization ratio of macrophages by activating the PI3K/Akt signaling pathway, promoting the proliferation, migration of fibroblasts, and angiogenic ability of endothelial cells. In the diabetic full-thickness wound model, FM-Exo effectively regulated the polarization status of macrophages and promoted their transition to the M2 phenotype, thereby inhibiting inflammation, promoting angiogenesis through VEGF secretion, and improving proper collagen deposition. As a result, the healing process was accelerated, leading to a better healing outcome with reduced scarring. Therefore, this study introduced a promising approach to address diabetic wounds by developing bioactive nanomaterials to regulate immune inhibition in a high-glucose environment.

One-step fabrication of cell sheet-laden hydrogel for accelerated wound healing

Full-thickness skin wounds are have continued to be reconstructive challenges in dermal and skin appendage regeneration, and skin substitutes are promising tools for addressing these reconstructive procedures. Herein, the one-step fabrication of a cell sheet integrated with a biomimetic hydrogel as a tissue engineered skin for skin wound healing generated in one step is introduced. Briefly, cell sheets with rich extracellular matrix, high cell density, and good cell connections were integrated with biomimetic hydrogel to fabricate gel + human skin fibroblasts (HSFs) sheets and gel + human umbilical vein endothelial cells (HUVECs) sheets in one step for assembly as a cell sheet-laden hydrogel (CSH). The designed biomimetic hydrogel formed with UV crosslinking and ionic crosslinking exhibited unique properties due to the photo-generated aldehyde groups, which were suitable for integrating into the cell sheet, and ionic crosslinking reduced the adhesive force toward the substrate. These properties allowed the gel + cell sheet film to be easily released from the substrate. The cells in the harvested cell sheet maintained excellent viability, proliferation, and definite migration abilities inside the hydrogel. Moreover, the CSH was implanted into a full-thickness skin defects to construct a required dermal matrix and cell microenvironment. The wound closure rate reached 60.00 ± 6.26% on the 2nd day, accelerating mature granulation and dermis formation with skin appendages after 14 days. This project can provide distinct guidance and strategies for the complete repair and regeneration of full-thickness skin defects, and provides a material with great potential for tissue regeneration in clinical applications.

Fabrication of dual physically cross-linked polyvinyl alcohol/agar hydrogels with mechanical stability and antibacterial activity for wound healing

Bacterial infection is one of the most critical obstacles in wound healing, and severe bacterial infections can lead to inflammatory conditions and delay the healing process. Herein, a novel hydrogel based on polyvinyl alcohol (PVA), agar, and silk-AgNPs was prepared using a straightforward one-pot physical cross-linking method. The in situ synthesis of AgNPs in hydrogels exploited the reducibility of tyrosine (Tyr tyrosine) in silk fibroin, which endowed the hydrogels with outstanding antibacterial qualities. In addition, the strong hydrogen bond cross-linked networks of agar and the crystallites formed by PVA as the physical cross-linked double network of the hydrogel gave it excellent mechanical stability. The PVA/agar/SF-AgNPs (PASA) hydrogels exhibited excellent water absorption, porosity, and significant antibacterial effects against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Furthermore, in vivo experimental results confirmed that the PASA hydrogel significantly promoted wound repair and skin tissue reconstruction by reducing inflammation and promoting collagen deposition. Immunofluorescence staining showed that the PASA hydrogel enhanced CD31 expression to promote angiogenesis while decreasing CD68 expression to reduce inflammation. Overall, the novel PASA hydrogel showed great potential for bacterial infection wound management.

Advances in preparation and application of antibacterial hydrogels

Bacterial infections, especially those caused by drug-resistant bacteria, have seriously threatened human life and health. There is urgent to develop new antibacterial agents to reduce the problem of antibiotics. Biomedical materials with good antimicrobial properties have been widely used in antibacterial applications. Among them, hydrogels have become the focus of research in the field of biomedical materials due to their unique three-dimensional network structure, high hydrophilicity, and good biocompatibility. In this review, the latest research progresses about hydrogels in recent years were summarized, mainly including the preparation methods of hydrogels and their antibacterial applications. According to their different antibacterial mechanisms, several representative antibacterial hydrogels were introduced, such as antibiotics loaded hydrogels, antibiotic-free hydrogels including metal-based hydrogels, antibacterial peptide and antibacterial polymers, stimuli-responsive smart hydrogels, and light-mediated hydrogels. In addition, we also discussed the applications and challenges of antibacterial hydrogels in biomedicine, which are expected to provide new directions and ideas for the application of hydrogels in clinical antibacterial therapy.

Chitosan-based double network hydrogel loading herbal small molecule for accelerating wound healing

Skin injuries are one of the most common clinical traumas worldwide, and wound dressings are considered to be one of key factors in wound healing. Natural polymer-based hydrogels have been developed as ideal materials for a new generation of dressings due to their excellent biocompatibility and wetting ability. However, the inadequate mechanical performances and lack of efficacy in promoting wound healing have limited the application of natural polymer-based hydrogels as wound dressings. In this work, a double network hydrogel based on natural chitosan molecules was constructed to enhance the mechanical properties, and emodin, a herbal natural product, was loaded into the hydrogel to improve the healing effect of the dressing. The structure of the chitosan-emodin network formed by Schiff base reaction and microcrystalline network of biocompatible polyvinyl alcohol endowed hydrogels with excellent mechanical properties and ensured its integrity as wound dressings. Moreover, the hydrogel showed excellent wound healing properties due to the loading of emodin. The hydrogel dressing could promote cell proliferation, cell migration, and secretion of growth factors. The animal experimental results also demonstrated that the hydrogel dressing facilitated the regeneration of blood vessels and collagen and accelerated wound healing.

Diffusion-Limited Processes in Hydrogels with Chosen Applications from Drug Delivery to Electronic Components

Diffusion is one of the key nature processes which plays an important role in respiration, digestion, and nutrient transport in cells. In this regard, the present article aims to review various diffusion approaches used to fabricate different functional materials based on hydrogels, unique examples of materials that control diffusion. They have found applications in fields such as drug encapsulation and delivery, nutrient delivery in agriculture, developing materials for regenerative medicine, and creating stimuli-responsive materials in soft robotics and microrobotics. In addition, mechanisms of release and drug diffusion kinetics as key tools for material design are discussed.

Natural biomarocmolecule-based antimicrobial hydrogel for rapid wound healing: A review

Antibacterial hydrogels are a type of hydrogel that is designed to inhibit the growth of bacteria and prevent infections. These hydrogels typically contain antibacterial agents that are either integrated into the polymer network or coated onto the surface of the hydrogel. The antibacterial agents in these hydrogels can work through a variety of mechanisms, such as disrupting bacterial cell walls or inhibiting bacterial enzyme activity. Some examples of antibacterial agents that are commonly used in hydrogels include silver nanoparticles, chitosan, and quaternary ammonium compounds. Antibacterial hydrogels have a wide range of applications, including wound dressings, catheters, and medical implants. They can help to prevent infections, reduce inflammation, and promote tissue healing. In addition, they can be designed with specific properties to suit different applications, such as high mechanical strength or controlled release of antibacterial agents over time. Hydrogel wound dressings have come a long way in recent years, and the future looks very promising for these innovative wound care products. Overall, the future of hydrogel wound dressings is very promising, and we can expect to see continued innovation and advancement in this field in the years to come.

Hydrogel fibers for wearable sensors and soft actuators

Owing to superior softness, wetness, responsiveness, and biocompatibility, bulk hydrogels are being intensively investigated for versatile functions in devices and machines including sensors, actuators, optics, and coatings. The one-dimensional (1D) hydrogel fibers possess the metrics from both the hydrogel materials and structural topology, endowing them with extraordinary mechanical, sensing, breathable and weavable properties. As no comprehensive review has been reported for this nascent field, this article aims to provide an overview of hydrogel fibers for soft electronics and actuators. We first introduce the basic properties and measurement methods of hydrogel fibers, including mechanical, electrical, adhesive, and biocompatible properties. Then, typical manufacturing methods for 1D hydrogel fibers and fibrous films are discussed. Next, the recent progress of wearable sensors (e.g., strain, temperature, pH, and humidity) and actuators made from hydrogel fibers is discussed. We conclude with future perspectives on next-generation hydrogel fibers and the remaining challenges. The development of hydrogel fibers will not only provide an unparalleled one-dimensional characteristic, but also translate fundamental understanding of hydrogels into new application boundaries.

Dual modes reinforced silk adhesives for tissue repair: Integration of textiles and inorganic particles in silk gel for enhanced mechanical and adhesive strength

Skin wound healing in dynamic environments remains challenging. Conventional gels are not ideal dressing materials for wound healing due to difficulties in completely sealing wounds and the inability to deliver drugs quickly and precisely to the injury. To tackle these issues, we propose a multifunctional silk gel that rapidly forms strong adhesions to tissue, has excellent mechanical properties, and delivers growth factors to the wound. Specifically, the presence of Ca²⁺ in the silk protein leads to a solid adhesion to the wet tissue through a chelation reaction with water-trapping behavior; the integrated chitosan fabric and CaCO₃ particles ensure enhanced mechanical strength of the silk gel for better adhesion and robustness during wound repair; and the preloaded growth factor further promoted wound healing. The results showed the adhesion and tensile breaking strength were as high as 93.79 kPa and 47.20 kPa, respectively. MSCCA@CaCO₃-aFGF could remedy the wound model in 13 days, with 99.41 % wound shrinkage without severe inflammatory responses. Due to strong adhesion properties and mechanical strength, MSCCA@CaCO₃-aFGF can be a promising alternative to conventional sutures and tissue closure staples for wound closure and healing. Therefore, MSCCA@CaCO₃-aFGF is expected to be a strong candidate for the next generation of adhesives.

Reversible adhesives with controlled wrinkling patterns for programmable integration and discharging

Switchable and minimally invasive tissue adhesives have great potential for medical applications. However, on-demand adherence to and detachment from tissue surfaces remain difficult. We fabricated a switchable hydrogel film adhesive by designing pattern-tunable wrinkles to control adhesion. When adhered to a substrate, the compressive stress generated from the bilayer system leads to self-similar wrinkling patterns at short and long wavelengths, regulating the interfacial adhesion. To verify the concept and explore its application, we established a random skin flap model, which is a crucial strategy for repairing severe or large-scale wounds. Our hydrogel adhesive provides sufficient adhesion for tissue sealing and promotes neovascularization at the first stage, and then gradually detaches from the tissue while a dynamic wrinkling pattern transition happens. The gel film can be progressively ejected out from the side margins after host-guest integration. Our findings provide insights into tunable bioadhesion by manipulating the wrinkling pattern transition.

Collagen hydrogel with multiple antimicrobial mechanisms as anti-bacterial wound dressing

Wound infection by multidrug-resistant bacteria seriously threatens human life. Chronic wounds, with necrosis, persistent inflammation, and covered by hypoxic tissue, seriously hinder anti-infection treatments. Herein, we have developed a multifunctional hydrogel dressing with antibacterial activity in the hypoxia environment to promote wound healing. The hydrogel comprises Cypate-conjugated antimicrobial peptides (AMP-Cypates), liposome-encapsulated perfluorodecalin, and recombinant type III collagen. AMP-Cypates exhibited outstanding antibacterial activity, jointly achieved through antimicrobial peptide (AMP) activity, photothermal therapy (PTT), and photodynamic therapy (PDT). The perfluorodecalin liposomes act as the oxygen carrier to mitigate wound hypoxia condition and enhance the efficacy of PDT. The recombinant type III collagen in the hydrogel further promoted the healing of the wounds together with the eradication of bacterial infection. Taken together, the hydrogel dressing provides a platform for integrating multiple antimicrobial mechanisms for the rapid removal of bacterial infection and the healing of chronic wounds.

A biocompatible double-crosslinked gelatin/ sodium alginate/dopamine/quaterniazed chitosan hydrogel for wound dressings based on 3D bioprinting technology

438Severe skin injuries can cause serious problems, which could affect the patient's normal life, if not dealt properly in a timely and effective manner. It is an urgent requirement to develop personalized wound dressings with excellent antibacterial activity and biocompatibility to match the shape of the wound to facilitate clinical application. In this study, a bioink (GAQ) based on gelatin (Gel)/sodium alginate (SA)/ quaternized chitosan (QCS) was prepared, and GAQ hydrogel dressing grafting with dopamine (GADQ) was fabricated by an extrusion three-dimensional (3D) printing technology. QCS was synthesized by modifying quaternary ammonium group on chitosan, and its structure was successfully characterized by nuclear magnetic resonance (1H NMR) and Fourier-transform infrared spectroscopy (FT-IR). Our results showed that the GADQ hydrogel dressing that was double-crosslinked by EDC/ NHS and Ca²⁺ had good tensile strength, considerable swelling ratio, and effective antioxidation properties. It also showed that GADQ1.5% had 93.17% and 91.06% antibacterial activity against Staphylococcus aureus and Escherichia coli, respectively. Furthermore, the relative survival ratios of fibroblast cells seeded on these hydrogels exceeded 350% after cultured for 7 days, which proved the biocompatibility of these hydrogels. Overall, this advanced 3D-printed GADQ1.5% hydrogels with effective antioxidation, excellent antibacterial activity and good biocompatibility had a considerable application potential for wound healing.

Efficacy of modified isolation in incontinence associated dermatitis

OBJECTIVE

To analyze the value of modified isolation in preventing the occurrence of incontinence associated dermatitis (IAD) in patients with incontinence, and to provide high value skin care intervention for the patients.

METHODS

Clinical data of 204 patients were collected for retrospective analysis. The patients were divided into a conventional group (conventional skin care protocol, n=102) and a modified group (modified isolation care protocol, n=102) according to the different treatment regimens. The differences in the incidence of IAD, time to IAD, required weekly care, cost of nursing supplies, perineal skin status and nursing satisfaction were compared between the two groups.

RESULTS

Compared with the conventional group, the modified group had a greatly lower incidence of IAD (42.16% vs. 2.94%), longer time to IAD occurrence (5.75±1.25 vs. 12.50±1.50), less required weekly care (43.05±8.41 vs. 13.54±2.57), lower cost of nursing supplies (330.16±98.44 vs. 115.53±32.58), and a better correlation between perineal skin status and nursing satisfaction (all P<0.05).

CONCLUSION

Modified isolation can greatly reduce the incidence of IAD in incontinent patients, improve their status of the perineal skin, increase patient satisfaction with care, and reduce the cost of required nursing supplies. So, modified isolation may serve as the preferred care protocol for incontinent patients.

A strong and tough gelatin/polyvinyl alcohol double network hydrogel actuator with superior actuation strength and fast actuation speed

Hydrogels are widely used in actuators that are applied in numerous fields such as multifunctional sensors, soft robots, artificial muscles, manipulators and microfluidic valves, and yet their applications in soft robots and artificial muscles are often limited by low actuation strength and slow actuation speed. Here, we develop a hydrogel actuator with high actuation strength (contraction strength of 850 kPa), fast actuation speed (response time of 90 s) and high energy density (output working density of 72 kJ m^-3) by introducing a storing-releasing elastic potential energy method into a double network hydrogel. The high actuation strength is owing to the double network hydrogel, which possesses a high elastic modulus of 1.3 MPa, fracture strength of 1.8 MPa, and fracture energy of 16 kJ m^-2. The fast actuation speed is due to the storing-releasing elastic potential energy method, which stretches the hydrogel and locks the hydrogel at deformed shape under external stimuli to store the elastic potential energy and then makes the hydrogel contract rapidly under new stimuli to release the pre-stored energy. A capture actuator and a hand muscle actuator are fabricated to achieve strong and fast actuation. The hydrogel actuator has shown potential applications in soft robots and artificial muscles.