Angiogenesis, hemocompatibility and bactericidal effect of bioactive natural polymer-based bilayer adhesive skin substitute for infected burned wound healing

Three-dimensional printed polyelectrolyte construct containing mupirocin-loaded quaternized chitosan nanoparticles for skin repair

Despite substantial advancements in wound dressing development, effective skin repair remains a significant challenge, largely due to the persistent issue of recurrent infections. Three-dimensional printed constructs that integrate bioactive and antibacterial agents hold significant potential to address this challenge. In this study, a 3D-printed hydrogel scaffold composed of polyallylamine hydrochloride (PAH) and pectin (Pc), incorporated with mupirocin (Mp)-loaded quaternized chitosan nanoparticles (QC NPs) was fabricated. The primary objective of this study was to facilitate a controlled and sustained release of Mp via the QC NPs. The average size of QC-Mp nanoparticles was measured to be 66.05 nm and the average strand diameter and pore size of the 3D-printed construct were measured as 147.22 ± 5.83 and 388.44 ± 14.50 μm, respectively. The hemolysis rate of all scaffolds was below 2 %, indicating that they can be classified as non-hemolytic materials with sufficient blood compatibility. The PAH-Pc/QC-Mp scaffold exhibited significant antibacterial activity, enhanced cell viability in HaCat cells, sustained Mp release until day 7 (⁓60 %), and in-vivo wound healing promotion by stimulation of human keratinocytes. In conclusion, the proposed biocompatible construct demonstrates significant potential for the treatment of chronic and infected wounds by preventing infection and promoting accelerated wound healing.

Exploring nanobioceramics in wound healing as effective and economical alternatives

Wound healing is a sophisticated process for which various treatment methods have been developed. Bioceramics with the ability to release inorganic ions in biological environments play a crucial role in cellular metabolism and exhibit bactericidal activity, contributing to numerous physiological processes. Their multifaceted roles in biological systems highlight their significance. The release of different metallic ions from bioceramics enables the repair of both hard and soft tissues. These ions may be effective in cell motility, proliferation, differentiation, adhesion, angiogenesis, and antibiosis. Unlike conventional medications, the bioactivity and antibacterial properties of bioceramics are typically not associated with side effects or bacterial resistance. Bioceramics are commonly recognized for their capcity to facilitate the healing of hard tissues due to their exceptional mechanical properties. In this review, we first explore wound treatment and its prevalent methods, and subsequently, we discuss the application of three primary categories of bioceramics-oxide ceramics, silicate-based ceramics, and calcium-phosphate ceramics-in the context of wound treatment. This review introduces bioceramics as a cost-effective and efficient alternative for wound repair. Our aim is to inspire researchers to incorporate bioceramics with other biomaterials to achieve enhanced, economical, expedited, and safer wound healing.

Multifunctional Nanofiber Membranes Constructed by Microfluidic Blow-Spinning to Inhibit Scar Formation at Early Intervention Stage

Pathological scarring has been a challenge in skin injury repair since ancient times, and prophylactic treatment in the early stages of wound healing usually results in delayed wound healing. In this study, poly(ethylene oxide) (PEO) and chitosan (CTS) were used as carrier materials to construct multifunctional pirfenidone (PFD)/CTS/PEO (PCP) nanofiber membranes (NFMs) loaded with PFD by microfluidic blow-spinning (MBS). MBS is a good method for quickly, safely, and greenly constructing large-area manufacturing of inexpensive NFMs. PCP NFMs were uniform in external morphology, with diameters ranging from 200 to 500 nm. The encapsulation efficiency of the drug-loaded PCP NFMs was above 80%, which had a good slow release, visualization, water absorption, and biocompatibility. The inhibitory effect of PCP NFMs on normal human dermal fibroblasts was dose-dependent and inhibited the expression of the transforming growth factor-β1/SMAD family member 3 (TGF-β1/SMAD3) signaling pathway. PCP NFMs showed significant antibacterial effects against both Staphylococcus aureus and Escherichia coli. In the rabbit ear scar experiment, the wound healed about 70% on day 5 and almost completely on day 10 after PCP-3 NFMs treatment, with the thinnest scar tissue, skin color, tenderness close to normal tissue, and a Vancouver scar scale score of less than 5. PCP-3 NFMs had good effects on anti-inflammatory, wound healing, and collagen-I deposition reducing effects. In conclusion, PCP-3 NFMs can both promote wound healing and intervene to inhibit pathological scarring in advance, making them a potential multifunctional wound dressing for early prevention and treatment of pathological scarring.

Biomedical application of materials for external auditory canal: History, challenges, and clinical prospects

Biomaterials play an integral role in treatment of external auditory canal (EAC) diseases. Regarding the special anatomic structure and physiological characteristics of EAC, careful selection of applicable biomaterials was essential step towards effective management of EAC conditions. The bioactive materials can provide reasonable biocompatibility, reduce risk of host pro-inflammatory response and immune rejection, and promote the healing process. In therapeutic procedure, biomaterials were employed for covering or packing the wound, protection of the damaged tissue, and maintaining of normal structures and functions of the EAC. Therefore, understanding and application of biomaterials was key to obtaining great rehabilitation in therapy of EAC diseases. In clinical practice, biomaterials were recognized as an important part in the treatment of different EAC diseases. The choice of biomaterials was distinct according to the requirements of various diseases. As a result, awareness of property regarding different biomaterials was fundamental for appropriate selection of therapeutic substances in different EAC diseases. In this review, we firstly introduced the characteristics of EAC structures and physiology, and EAC pathologies were summarized secondarily. From the viewpoint of biomaterials, the different materials applied to individual diseases were outlined in categories. Besides, the underlying future of therapeutic EAC biomaterials was discussed.

Dual-functional gallium/chitosan/silk/umbilical cord mesenchymal stem cell exosome sponge scaffold for diabetic wound by angiogenesis and antibacteria

The treatment of diabetic wounds possessed significant challenges in clinical practice, which was accompanied with continuous infection, inflammation, and limited angiogenesis. Current wound dressings used for diabetic wound healing struggle to address these issues simultaneously. Therefore, Ga3+ was added to the chitosan/silk solution to confer potent antibacterial properties. Subsequently, umbilical cord mesenchymal stem cell exosomes (UCSC-Exo) were integrated into the gallium/chitosan/silk solution to enhance its angiogenesis-inducing activity. The mixture was lyophilized to prepare gallium/chitosan/silk/exosome sponge scaffolds (Ga/CSSF-Exo sponge scaffolds). The experiments of In vitro and in vivo demonstrated that Ga/CSSF-Exo sponge scaffolds exhibited sustained release of Ga3+ and bioactive exosomes, which effectively exerted continuous antibacterial effects and promoted angiogenesis. In diabetic rat wound models, Ga/CSSF-Exo sponge scaffolds facilitated angiogenesis, suppressed bacterial growth and inflammation, as well as promoted collagen deposition and re-epithelialization of wounds. Collectively, our findings suggested that Ga/CSSF-Exo held excellent potential for diabetic wound healing.

Near-Infrared Responsive Nanocomposite Hydrogel Dressing with Anti-Inflammation and Pro-Angiogenesis for Wound Healing

Anti-inflammatory and angiogenesis are two important factors in wound healing. Wound dressings with anti-inflammation and vascularization are essential to address complex interventions, expensive treatments, and uncontrolled release mechanisms. Based on the above considerations, we designed a near-infrared (NIR)-responsive hydrogel dressing, which is composed of mPDA-DFO@LA nanoparticles (mPDA: dopamine hydrochloride nanoparticles, DFO: deferoxamine, LA: lauric acid), valsartan (abbreviated as Va), and dopamine-hyaluronic acid hydrogel. The hydrogel dressing demonstrated injectability, bioadhesive, and photothermal properties. The results indicated the obtained dressing by releasing Va can appropriately regulate macrophage phenotype transformation from M1 to M2, resulting in an anti-inflammatory environment. In addition, DFO encapsulated by LA can be sustainably released into the wound site by NIR irradiation, which further prevents excessive neovascularization. Notably, the results in vivo indicated the mPDA-DFO@LA/Va hydrogel dressing significantly enhanced wound recovery, achieving a healing rate of up to 96% after 11 days of treatment. Therefore, this NIR-responsive hydrogel dressing with anti-inflammation, vascularization, and on-demand programmed drug release will be a promising wound dressing for wound infection.

Insect chitosan/pullulan/gallium photo-crosslinking hydrogels with multiple bioactivities promote MRSA-infected wound healing

Methicillin-resistant Staphylococcus aureus (MRSA) and other drug-resistant bacteria have become more common in recent years, which has made it extremely difficult to treat and heal many different kinds of wounds and caused enormous financial losses. Because of its unique "Trojan horse" function, Ga3+ has been recognized as a new possible candidate for inhibiting and eradicating drug-resistant bacteria. Furthermore, natural polysaccharide materials with outstanding biological characteristics, such as insect chitosan (CS) and pullulan (PUL), have attracted significant interest. In this study, we used quaternized-catechol chitosan (QDCS-PA), methacrylate-dialdehyde pullulan (DPUL-GMA), and gallium ion (Ga) to create a multi-crosslinked photo-enhanced hydrogel (Q-D/Ga/UV) with antimicrobial, hemostatic, self-healing, and injectable properties for promoting MRSA-infected wound healing. In vitro, the Q-D/Ga/UV hydrogels demonstrated good mechanical properties, antioxidant capabilities, biocompatibility, hemostatic properties, and antibacterial activity. The addition of gallium ions enhanced the hydrogels' mechanical properties, hemostatic capabilities, antibacterial activity, and ability to induce wound healing. Q-D/Ga/UV hydrogel significantly promoted wound contraction, collagen deposition, and angiogenesis while also suppressing inflammation in a whole-skin wound model of MRSA-infected rats. In conclusion, Q-D/Ga/UV hydrogels demonstrate significant promise for healing wounds infected with drug-resistant bacteria.

Multifunctional polysaccharide/metal/polyphenol double-crosslinked hydrogel for infected wound

Bacterial-infected wounds present a significant challenge in the medical field, posing a severe threat to public health. Traditional wound dressings have limited efficacy in treating bacterial-infected wounds, and antibiotics suffer from cytotoxicity and drug resistance. Consequently, an urgent requirement exists for developing multifunctional wound dressings capable of providing superior antimicrobial activity and expediting wound repair. In recent years, chitosan-based natural polysaccharide hydrogels have garnered attention for their biocompatibility, antimicrobial properties, and ability to aid in hemostasis. This study presents the development of a multi-functional, bi-dynamic network hydrogel for the treatment of wounds infected with bacteria. The hydrogel consists of a backbone of chitosan grafted with chlorogenic acid (CA-ECS), oxidized pullulan polysaccharides (OP), and zinc ions (Zn2+). The CA-ECS/OP/Zn2+ hydrogel displayed strong adhesion, good injectability, and high mechanical strength and was biodegradable and biocompatible. Furthermore, adding Zn2+ and CA enhanced the hydrogel's mechanical properties and antioxidant and antimicrobial activities. In a rat model of full-thickness skin wounds infected with S. aureus, the CA-ECS/OP/Zn2+ hydrogel demonstrated great anti-inflammatory, angiogenic, and folliculogenic properties, resulting in accelerated wound healing. The CA-ECS/OP/Zn2+ hydrogel has great potential for treating bacterial-infected wounds.

Graphene oxide-encapsulated baghdadite nanocomposite improved physical, mechanical, and biological properties of a vancomycin-loaded PMMA bone cement

Polymethyl methacrylate (PMMA) bone cement is commonly used in orthopedic surgeries to fill the bone defects or fix the prostheses. These cements are usually containing amounts of a nonbioactive radiopacifying agent such as barium sulfate and zirconium dioxide, which does not have a good interface compatibility with PMMA, and the clumps formed from these materials can scratch metal counterfaces. In this work, graphene oxide encapsulated baghdadite (GOBgh) nanoparticles were applied as radiopacifying and bioactive agent in a PMMA bone cement containing 2 wt.% of vancomycin (VAN). The addition of 20 wt.% of GOBgh (GOBgh20) nanoparticles to PMMA powder caused a 33.6% increase in compressive strength and a 70.9% increase in elastic modulus compared to the Simplex® P bone cement, and also enhanced the setting properties, radiopacity, antibacterial activity, and the apatite formation in simulated body fluid. In vitro cell assessments confirmed the increase in adhesion and proliferation of MG-63 cells as well as the osteogenic differentiation of human adipose-derived mesenchymal stem cells on the surface of PMMA-GOBgh20 cement. The chorioallantoic membrane assay revealed the excellent angiogenesis activity of nanocomposite cement samples. In vivo experiments on a rat model also demonstrated the mineralization and bone integration of PMMA-GOBgh20 cement within four weeks. Based on the promising results obtained, PMMA-GOBgh20 bone cement is suggested as an optimal sample for use in orthopedic surgeries.

MOF/MXene-loaded PVA/chitosan hydrogel with antimicrobial effect and wound healing promotion under electrical stimulation and improved mechanical properties

Electrical stimulation modulates cell behavior and influences bacterial activity, so highly conductive, antimicrobial hydrogels are suitable for promoting wound healing. In this study, highly conductive and antimicrobial Ti3C2Tx (MXene) hydrogels composed of chitosan and poly(vinyl alcohol) and AgCu- H2PYDC MOF were developed. In PVACS/MOF/MXene (PCMM) hydrogels, the MXene layer acts as an electrical conductor. The electrical conductivity is 0.61 ± 0.01 S·cm-1. PCMM hydrogels modulate cell behavior and provide ES antimicrobial capacity under ES at 1 V. The metal ions of MOF form coordination with chitosan molecules and increase the cross-linking density between chitosan molecules, thus improving the mechanical properties of the hydrogel (tensile strength 0.088 ± 0.04 MPa, elongation at break 233 ± 11 %). The PCMM gels had good biocompatibility. The PCMM hydrogels achieved 100 % antibacterial activity against E. coli and S. aureus for 12 h. 1 V electrical stimulation of PCMM hydrogel accelerated the wound healing process in mice by promoting cell migration and neovascularization, achieving 97 ± 0.4 % wound healing on day 14. The hydrogel dressing PCMM-0.1 with MOF addition of 0.1 % had the best wound healing promoting effect and which is a promising dressing for promoting wound healing and is a therapeutic strategy worth developing.

A double-layer cellulose/pectin-soy protein isolate-pomegranate peel extract micro/nanofiber dressing for acceleration of wound healing

Multi-layered wound dressings can closely mimic the hierarchical structure of the skin. Herein, a double-layer dressing material is fabricated through electrospinning, comprised of a nanofibrous structure as a healing-support layer or the bottom layer (BL) containing pectin (Pec), soy protein isolate (SPI), pomegranate peel extract (P), and a cellulose (Cel) microfiber layer as a protective/monitoring layer or top layer (TL). The formation of a fine bilayer structure was confirmed using scanning electron microscopy. Cel/Pec-SPI-P dressing showed a 60.05 % weight loss during 7 days of immersion in phosphate buffered solution. The ultimate tensile strength, elastic modulus, and elongation at break for different dressings were within the range of 3.14-3.57 MPa, 32.26-36.58 MPa, and 59.04-63.19 %, respectively. The release of SPI and phenolic compounds from dressings were measured and their antibacterial activity was evaluated. The fabricated dressing was non-cytotoxic following exposure to human keratinocyte cells. The Cel/Pec-SPI-P dressing exhibited excellent cell adhesion and migration as well as angiogenesis. More importantly, in vivo experiments on Cel/Pec-SPI-P dressings showed faster epidermal layer formation, blood vessel generation, collagen deposition, and a faster wound healing rate. Overall, it is anticipated that the Cel/Pec-SPI-P bilayer dressing facilitates wound treatment and can be a promising approach for clinical use.

Mupirocin loaded core-shell pluronic-pectin-keratin nanofibers improve human keratinocytes behavior, angiogenic activity and wound healing

In the current study, a core-shell nanofibrous wound dressing based on Pluronic-F127 (F127) containing 2 wt% mupirocin (Mup) core and pectin (Pec)-keratin (Kr) shell was fabricated through coaxial electrospinning technique, and the blended nanofibers were also fabricated from the same materials. The fiber diameter and specific surface area of the blended nanofibers were about 101.56 nm and 20.16 m2/g, while for core-shell nanofibers they were about 97.32 nm and 25.26 m2/g, respectively. The resultant blended and core-shell nanofibers experienced a degradation of 27.65 % and 32.28 % during 7 days, respectively. The drug release profile of core-shell nanofibers revealed a sustained release of Mup over 7 days (87.66 %), while the blended F127-Pec-Kr-Mup nanofibers had a burst release within the first few hours (89.38 % up to 48 h) and a cumulative release of 91.36 % after 7 days. Due to the controlled release of Mup, the core-shell structure significantly improved the human keratinocytes behavior, angiogenic potential and wound healing in a rat model compared to the blended structure. In conclusion, the F127-Mup/Pec-Kr core-shell nanofibrous wound dressing appears to be a promising candidate for the prevention of infection, and can potentially accelerate the recovery and healing of chronic and ischemic wounds.