Optimization of human-like collagen composite polysaccharide hydrogel dressing preparation using response surface for burn repair

Nanocomposite Hydrogel for Real-Time Wound Status Monitoring and Comprehensive Treatment

Current skin sensors or wound dressings fall short in addressing the complexities and challenges encountered in real-world scenarios, lacking adequate capability to facilitate wound repair. The advancement of methodologies enabling early diagnosis, real-time monitoring, and active regulation of drug delivery for timely comprehensive treatment holds paramount significance for complex chronic wounds. In this study, a nanocomposite hydrogel is devised for real-time monitoring of wound condition and comprehensive treatment. Tannins and siRNA containing matrix metalloproteinase-9 gene siRNA interference are self-assembled to construct a degradable nanogel and modified with bovine serum albumin. The nanogel and pH indicator are encapsulated within a dual-crosslinking hydrogel synthesized with norbornene dianhydride-modified paramylon. The hydrogel exhibited excellent shape adaptability due to borate bonding, and the click polymerization reaction led to rapid in situ curing of the hydrogel. The system not only monitors pH, temperature, wound exudate alterations, and peristalsis during wound healing but also exhibits hemostatic, antimicrobial, anti-inflammatory, and antioxidant properties, modulates macrophage polarization, and facilitates vascular tissue regeneration. This therapeutic approach, which integrates the monitoring of pathological parameters with comprehensive treatment, is anticipated to address the clinical issues and challenges associated with chronic diabetic wounds and infected wounds, offering broad prospects for application.

Hydrogel-exosome system in tissue engineering: A promising therapeutic strategy

Characterized by their pivotal roles in cell-to-cell communication, cell proliferation, and immune regulation during tissue repair, exosomes have emerged as a promising avenue for "cell-free therapy" in clinical applications. Hydrogels, possessing commendable biocompatibility, degradability, adjustability, and physical properties akin to biological tissues, have also found extensive utility in tissue engineering and regenerative repair. The synergistic combination of exosomes and hydrogels holds the potential not only to enhance the efficiency of exosomes but also to collaboratively advance the tissue repair process. This review has summarized the advancements made over the past decade in the research of hydrogel-exosome systems for regenerating various tissues including skin, bone, cartilage, nerves and tendons, with a focus on the methods for encapsulating and releasing exosomes within the hydrogels. It has also critically examined the gaps and limitations in current research, whilst proposed future directions and potential applications of this innovative approach.

Collagen-β-cyclodextrin hydrogels for advanced wound dressings: super-swelling, antibacterial action, inflammation modulation, and controlled drug release

A key strategy in enhancing the efficacy of collagen-based hydrogels involves incorporating polysaccharides, which have shown great promise for wound healing. In this study, semi-interpenetrating polymeric network (semi-IPN) hydrogels comprised of collagen (Col) with the macrocyclic oligosaccharide β-cyclodextrin (β-CD) (20-80 wt.%) were synthesised. Fourier-transform infrared (FTIR) spectroscopy confirmed the successful fabrication of these Col/β-CD hydrogels, evidenced by the presence of characteristic absorption bands, including the urea bond band at ∼1740 cm-1, related with collagen crosslinking. Higher β-CD content was associated with increased crosslinking, higher swelling, and faster gelation. The β-CD content directly influenced the morphology and semi-crystallinity. All Col/β-CD hydrogels displayed superabsorbent properties, enhanced thermal stability, and exhibited slow degradation rates. Mechanical properties were significantly improved with contents higher than β-CD 40 wt.%. These hydrogels inhibited the growth of Escherichia coli bacteria and facilitated the controlled release of agents, such as malachite green, methylene blue, and ketorolac. The chemical composition of the Col/β-CD hydrogels did not induce cytotoxic effects on monocytes and fibroblast cells. Instead, they actively promoted cellular metabolic activity, encouraging cell growth and proliferation. Moreover, cell signalling modulation was observed, leading to changes in the expression of TNF-α and IL-10 cytokines. In summary, the results of this research indicate that these novel hydrogels possess multifunctional characteristics, including biocompatibility, super-swelling capacity, good thermal, hydrolytic, and enzymatic degradation resistance, antibacterial activity, inflammation modulation, and the ability to be used for controlled delivery of therapeutic agents, indicating high potential for application in advanced wound dressings.

A fingerprint-like supramolecular-assembled Ag3PO4/polydopamine/g-C3N4 heterojunction nanocomposite for enhanced solar-driven oxygen evolution in vivo

Biocompatible photocatalytic water-splitting systems are promising for tissue self-oxygenation. Herein, a structure-function dual biomimetic fingerprint-like silver phosphate/polydopamine/graphitic carbon nitride (Ag3PO4/PDA/g-C3N4) heterojunction nanocomposite is proposed for enhanced solar-driven oxygen (O2) evolution in vivo in situ. Briefly, a porous nitrogen-defected g-C3N4 nanovoile (CN) is synthesized as the base. Dopamine molecules are controllably inserted into the CN interlayer, forming PDA spacers (4.28 nm) through self-polymerization-induced supramolecular-assembly. Ag3PO4 nanoparticles are then in situ deposited to create Ag3PO4/PDA/CN. The fingerprint-like structure of PDA/CN enlarges the layer spacing, thereby accelerating mass transfer and increasing reaction sites. The PDA spacer roles as excellent light harvester, electronic-ionic conductor, and redox pair through conformational changes, resulting in tailored electronic band structure, optimized carrier behavior, and reduced electrochemical impedance. In physiological conditions, Ag3PO4/PDA/CN exhibits O2 evolution rate of 45.35 μmol⋅g-1⋅h-1, 9-fold of bulk g-C3N4. The biocompatibility and in vivo oxygen supply effectiveness for biomedical applications have been verified in animal models.

Subcutaneous injection of hyaluronic acid leading to emboliom and recanalization process monitored in real time by three-dimensional photoacoustic imaging

This study describes a method for real-time examination of the microvascular system based on the three-dimensional photoacoustic imaging system to prevent arterial complications, especially vascular embolism, during hyaluronic acid (HA) injections. Chicken embryos were used to simulate the superficial blood vessels of human skin, and then the target area was imaged by the photoacoustic imaging system for three-dimensional vascular imaging, and then the syringe and blood vessels were monitored, and the syringe angle and penetration depth were adjusted in time using an injection device to avoid puncturing the arterial vasculature and clogging the blood vessels. HA was then injected into smaller vessels on the dorsum of the tongue in mice and into thicker vessels on the dorsal portion of the tongue in rats to mimic embolization, and the post-operative recovery was reflected by the changes in the pixel dots of the extracted part of the blocked blood vessels, and it was observed that the blood flow in the area of the fine vessels was restored in about 3 days, whereas blood flow in the area of the large vessels was restored in only about 1 h. The method presented in this paper allows precise guidance of injectable filler HA, which has good application prospects in improving the safety of injection micro-plastic surgery and reducing the experience requirements for medical personnel.

Multifunctional hydrogel bioscaffolds based on polysaccharide to promote wound healing: A review

Various types of skin wounds pose challenges in terms of healing and susceptibility to infection, which can have a significant impact on physical and mental well-being, and in severe cases, may result in amputation. Conventional wound dressings often fail to provide optimal support for these wounds, thereby impeding the healing process. As a result, there has been considerable interest in the development of multifunctional polymer matrix hydrogel scaffolds for wound healing. This review offers a comprehensive review of the characteristics of polysaccharide-based hydrogel scaffolds, as well as their applications in different types of wounds. Additionally, it evaluates the advantages and disadvantages associated with various types of multifunctional polymer and polysaccharide-based hydrogel scaffolds. The objective is to provide a theoretical foundation for the utilization of multifunctional hydrogel scaffolds in promoting wound healing.

Marine-derived polysaccharides and their therapeutic potential in wound healing application - A review

Polysaccharides originating from marine sources have been studied as potential material for use in wound dressings because of their desirable characteristics of biocompatibility, biodegradability, and low toxicity. Marine-derived polysaccharides used as wound dressing, provide several benefits such as promoting wound healing by providing a moist environment that facilitates cell migration and proliferation. They can also act as a barrier against external contaminants and provide a protective layer to prevent further damage to the wound. Research studies have shown that marine-derived polysaccharides can be used to develop different types of wound dressings such as hydrogels, films, and fibres. These dressings can be personalised to meet specific requirements based on the type and severity of the wound. For instance, hydrogels can be used for deep wounds to provide a moist environment, while films can be used for superficial wounds to provide a protective barrier. Additionally, these polysaccharides can be modified to improve their properties, such as enhancing their mechanical strength or increasing their ability to release bioactive molecules that can promote wound healing. Overall, marine-derived polysaccharides show great promise for developing effective and safe wound dressings for various wound types.

In vitro and in vivo evaluation of alginate hydrogel-based wound dressing loaded with green chemistry cerium oxide nanoparticles

Interactive wound dressings have displayed promising outcomes in enhancing the wound healing process. This study focuses on creating a nanocomposite wound dressing with interactive and bioactive properties, showcasing potent antioxidant effects. To achieve this, we developed cerium oxide nanoparticles utilizing curcumin as both the reducing and capping agent. Characterization techniques such as SEM, EDX, DLS, Zetasizer, FTIR, and XRD were utilized to analyze the cerium oxide nanoparticles synthesized through a green approach. The image analysis on the obtained TEM images showed that the curcumin-assisted biosynthesized CeO2NPs have a size of 18.8 ± 4.1 nm. The peaks located at 28.1, 32.7, 47.1, 56.0, 58.7, 69.0, and 76.4 correspond to (111), (200), (220), (311), (222), (400), and (331) crystallographic planes. We applied the Debye-Scherrer equation and observed that the approximate crystallite size of the biosynthesized NPs is around 8.2 nm based on the most intensive broad Bragg peak at 28.1°. The cerium oxide nanoparticles synthesized were integrated into an alginate hydrogel matrix, and the microstructure, porosity, and swelling behavior of the resulting wound dressing were assessed. The characterization analyses provided insights into the physical and chemical properties of the green-synthesized cerium oxide nanoparticles and the alginate hydrogel-based wound dressing. In vitro studies demonstrated that the wound dressing based on alginate hydrogel exhibited favorable antioxidant properties and displayed hemocompatibility and biocompatibility. Animal studies conducted on a rat full-thickness skin wound model showed that the alginate hydrogel-based wound dressing effectively accelerated the wound healing process. Overall, these findings suggest that the alginate hydrogel-based wound dressing holds promise as a highly effective material for wound healing applications.

Smart and versatile biomaterials for cutaneous wound healing

The global increase of cutaneous wounds imposes huge health and financial burdens on patients and society. Despite improved wound healing outcomes, conventional wound dressings are far from ideal, owing to the complex healing process. Smart wound dressings, which are sensitive to or interact with changes in wound condition or environment, have been proposed as appealing therapeutic platforms to effectively facilitate wound healing. In this review, the wound healing processes and features of existing biomaterials are firstly introduced, followed by summarizing the mechanisms of smart responsive materials. Afterwards, recent advances and designs in smart and versatile materials of extensive applications for cutaneous wound healing were submarined. Finally, clinical progresses, challenges and future perspectives of the smart wound dressing are discussed. Overall, by mapping the composition and intrinsic structure of smart responsive materials to their individual needs of cutaneous wounds, with particular attention to the responsive mechanisms, this review is promising to advance further progress in designing smart responsive materials for wounds and drive clinical translation.

Utilization of Lyotropic Liquid Crystalline Gels for Chronic Wound Management

Management of chronic wounds is becoming a serious health problem worldwide. To treat chronic wounds, a suitable healing environment and sustained delivery of growth factors must be guaranteed. Different therapies have been applied for the treatment of chronic wounds such as debridement and photodynamic therapy. Among them, growth factors are widely used therapeutic drugs. However, at present, growth factor delivery systems cannot meet the demand of clinical practice; therefore new methods should be developed to meet the emerging need. For this reason, researchers have tried to modify hydrogels through some methods such as chemical synthesis and molecule modifications to enhance their properties. However, there are still a large number of limitations in practical use like byproduct problems, difficulty to industrialize, and instability of growth factor. Moreover, applications of new materials like lyotropic liquid crystalline (LLC) on chronic wounds have emerged as a new trend. The structure of LLC is endowed with many excellent properties including low cost, ordered structure, and excellent loading efficiency. LLC can provide a moist local environment for the wound, and its lattice structure can embed the growth factors in the water channel. Growth factor is released from the high-concentration carrier to the low-concentration release medium, which can be precisely regulated. Therefore, it can provide sustained and stable delivery of growth factors as well as a suitable healing environment for wounds, which is a promising candidate for chronic wound healing and has a broad prospective application. In conclusion, more reliable and applicable drug delivery systems should be designed and tested to improve the therapy and management of chronic wounds.

Marine Biomaterials: Hyaluronan

The marine-derived hyaluronic acid and other natural biopolymers offer exciting possibilities in the field of biomaterials, providing sustainable and biocompatible alternatives to synthetic materials. Their unique properties and abundance in marine sources make them valuable resources for various biomedical and industrial applications. Due to high biocompatible features and participation in biological processes related to tissue healing, hyaluronic acid has become widely used in tissue engineering applications, especially in the wound healing process. The present review enlightens marine hyaluronan biomaterial providing its sources, extraction process, structures, chemical modifications, biological properties, and biocidal applications, especially for wound healing/dressing purposes. Meanwhile, we point out the future development of wound healing/dressing based on hyaluronan and its composites and potential challenges.

Role of medicinal herbs and phytochemicals in post burn management

Burn management is a natural and distinctly programmed process involving overlapping phases of hemostasis, inflammation, proliferation and remodeling. Burn wound healing involves initiation of inflammation, re-epithelialization, granulation, neovascularization and wound contraction. Despite the availability of multiple preparations for management of burn wound, there is dire need for efficacious alternative agents. Current approaches for burn wound management include pharmaceutical agents and antibiotics. However, high cost of synthetic drugs and accelerated resistance to antibiotics is challenging for both developed and developing nations. Among alternative options, medicinal plants have been a biocompatible, safe and affordable source of preventive/curative approaches. Due to cultural acceptance and patient compliance, there has been a focus on the use of botanical drugs and phytochemicals for burn wound healing. Keeping in consideration of medicinal herbs and phytochemicals as suitable therapeutic/adjuvant agents for burn wound management, this review highlights therapeutic potential of 35 medicinal herbs and 10 phytochemicals. Among these, Elaeis guineensis, Ephedra ciliate and Terminalia avicennioides showed better burn wound healing potential with varied mechanisms such as modulation of TNF-alpha, inflammatory cytokines, nitric oxide, eicosanoids, ROS and leukocyte response. Phytochemicals (oleanolic acid, ursolic acid, kirenol) also showed promising role in burn wound management though various pathways involving such as down regulation of TNF-alpha, IL-6 and inflammatory mediators including plasma proteases and arachidonic acid metabolites. This review provides a pavement for therapeutic/adjuvant use of potential botanical drugs and novel druggable phyto-compounds to target skin burn injury with diverse mechanisms, affordability and safety profile.

Pharmacological Functions, Synthesis, and Delivery Progress for Collagen as Biodrug and Biomaterial

Collagen has been widely applied as a functional biomaterial in regulating tissue regeneration and drug delivery by participating in cell proliferation, differentiation, migration, intercellular signal transmission, tissue formation, and blood coagulation. However, traditional extraction of collagen from animals potentially induces immunogenicity and requires complicated material treatment and purification steps. Although semi-synthesis strategies such as utilizing recombinant E. coli or yeast expression systems have been explored as alternative methods, the influence of unwanted by-products, foreign substances, and immature synthetic processes have limited its industrial production and clinical applications. Meanwhile, macromolecule collagen products encounter a bottleneck in delivery and absorption by conventional oral and injection vehicles, which promotes the studies of transdermal and topical delivery strategies and implant methods. This review illustrates the physiological and therapeutic effects, synthesis strategies, and delivery technologies of collagen to provide a reference and outlook for the research and development of collagen as a biodrug and biomaterial.

Antibacterial Conductive Collagen-Based Hydrogels for Accelerated Full-Thickness Wound Healing

Antibacterial conductive hydrogels have been extensively utilized in tissue repair and regeneration on account of their unique electrochemical performances and advantages of anti-pathogenic bacterial infection. Here, multi-functional collagen-based hydrogels (CHLY) with adhesivity, conductivity, and antibacterial and antioxidant activities were developed by introducing cysteine-modified ε-poly(l-lysine) (ε-PL-SH) and in situ-polymerized polypyrrole (PPy) nanoparticles to induce full-thickness wound healing. CHLY hydrogels have a low swelling ratio, good compressive strength, and viscoelasticity due to chemical crosslinking, chelation, physical interaction, and nano-reinforcements in the matrix network of hydrogels. CHLY hydrogels possess excellent tissue adhesion ability, low cytotoxicity, enhanced cell migration ability, and good blood coagulation performance without causing hemolysis. Interestingly, the chemical conjugation of ε-PL-SH in the hydrogel matrix gives hydrogels an inherently robust and broad-spectrum antibacterial activity, while the introduction of PPy endows hydrogels with superior free radical scavenging capacity and good electroactivity. Significantly, CHLY hydrogels have advantages in alleviating persistent inflammatory response as well as promoting angiogenesis, epidermis regeneration, and orderly collagen deposition at the wound sites through their multi-functional synergies, thus effectively accelerating full-thickness wound healing and improving wound healing quality. Overall, our developed multi-functional collagen-based hydrogel dressing demonstrates promising application prospects in the field of tissue engineering to induce skin regeneration.

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

Hydrogels are emerging as the most promising dressings due to their excellent biocompatibility, extracellular matrix mimicking structure, and drug loading ability. However, existing hydrogel dressings exhibit limited breathability, poor environmental adaptability, potential drug resistance, and limited drug options, which extremely restrict their therapeutic effect and working scenarios. Here, the current research introduces the first paradigm of hydrogel textile dressings based on novel gelatin glycerin hydrogel (glyhydrogel) fibers fabricated by the Hofmeister effect based wet spinning. Benefiting from the unique knitted structure, the textile dressing features excellent breathability (1800 times that of the commercially available 3 M dressing) and stretchability (535.51 ± 38.66%). Furthermore, the glyhydrogel textile dressing can also withstand the extreme temperature of −80 °C, showing the potential for application in subzero environments. Moreover, the introduction of glycerin endows the textile dressing with remarkable antibacterial property and expands the selection of loaded drugs (e.g., clindamycin). The prepared glyhydrogel textile dressing shows an excellent infected wound healing effect with a complete rat skin closure within 14 days. All these functions have not been achievable by traditional hydrogel dressings and provide a new approach for the development of hydrogel dressings.

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A brand-new dressing, hydrogel textile, has been fabricated for the first time with unprecedented breathability.

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An innovative preparation process for hydrogel fiber has been proposed for the first time.

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More outstanding glyhydrogel textile dressing has been created to show extremely low-temperature resistance.

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Dual mechanisms of antibiotic-free glycerin and lipophilic antibiotics provide a powerful antibacterial treatment.

Application of Collagen-Based Hydrogel in Skin Wound Healing

The repair of skin injury has always been a concern in the medical field. As a kind of biopolymer material with a special network structure and function, collagen-based hydrogel has been widely used in the field of skin injury repair. In this paper, the current research and application status of primal hydrogels in the field of skin repair in recent years are comprehensively reviewed. Starting from the structure and properties of collagen, the preparation, structural properties, and application of collagen-based hydrogels in skin injury repair are emphatically described. Meanwhile, the influences of collagen types, preparation methods, and crosslinking methods on the structural properties of hydrogels are emphatically discussed. The future and development of collagen-based hydrogels are prospected, which is expected to provide reference for the research and application of collagen-based hydrogels for skin repair in the future.

Synthesis and Properties of Biodegradable Hydrogel Based on Polysaccharide Wound Dressing

The metabolic disorder of the wound microenvironment can lead to a series of serious symptoms, especially chronic wounds, which result in significant pain in patients. At present, there is no effective and widely used wound dressing. Therefore, it is important to develop new multifunctional wound dressings. Hydrogel is an ideal wound dressing for medical nursing because of its abilities to absorb exudate and maintain wound wetting, its excellent biocompatibility, and its ability to provide a moist environment for wound repair. Because of these features, hydrogel overcomes the shortcomings of traditional dressings. Therefore, hydrogel has high medical value and is widely studied. In this study, a biodegradable hydrogel based on polysaccharide was synthesized and used as a wound dressing. The swelling degree and degradability of hydrogel were characterized as the characteristics of the wound dressing. The results showed that the prepared hydrogel was degraded with trypsin and in the soil environment. Furthermore, the wound dressing can effectively inhibit the bacterial environment, promote the deposition of the collagen structure of the wound tissue, and accelerate the healing of the wound. The proposed hydrogel has value in practical medical nursing application.

Renewable marine polysaccharides for microenvironment-responsive wound healing

Marine polysaccharides (MPs) are an eco-friendly and renewable resource with a distinctive set of biological functions and are regarded as biological materials that can be in contact with tissues and body fluids for an extended time and promote tissue or organ regeneration. Skin tissue is easily invaded by the external environment due to its softness and large surface area. However, the body's natural physiological healing process is often too slow or suffers from the incomplete restoration of skin structure and function. Functional wound dressings are crucial for skin tissue engineering. Herein, popular MPs from different sources are summarized systematically. In particular, the structure-effectiveness of MP-based wound dressings and the physiological remodeling process of different wounds are reviewed in detail. Finally, the prospect of MP-based smart wound dressings is stated in conjunction with the wound microenvironment and provides new opportunities for high-value biomedical applications of MPs.

Icy core-shell composite nanofibers with cooling, antibacterial and healing properties for outdoor burns

Burns are usually difficult to treat because their susceptibe to bacterial infections. When burns is accompanied by hyperthermia, the heat accumulated on the skin will causes extensive tissue damage. Most dressings focus on the treatment process, while ignoring the first-aid treatment to remove hyperthermia. To make matters worse, when outdoors, it is hard to find clean water to wash and cool the burned area. A dressing which can simultaneously realize first-time cooling and repairing treatment of the burned area can shorten treatment time, and is especially beneficial for outdoor use. In this study, a handheld coaxial electrospinning device is developed for preparing platelet-rich plasma @Polycaprolactone-epsilon polylysine (PRP@PCL/ε-PL) core-shell nanofibers. The nanofibers can be synchronously transformed into ice fibers during the spinning process, and directly deposited on the skin. The whole process is convenient to use outdoor. Via dual cooling mechanisms, first aid can take away the excessive heat in the burn area by nanofibers. These core-shell nanofibers also show its excellent antimicrobial and tissue regeneration-promoting properties. Therefore, it achieves first-time cooling and repair treatment of the burned area at the same time. Moreover, due to direct in-situ deposition of this handheld coaxial electrospinning, better antimicrobial properties, and faster healing performance are achieved. By using this integrated strategy that combines cooling, antibacterial and healing promotion, the burn recovery time is shortened from 21 days to 14 days.

Analysis of risk factors related to acute radiation dermatitis in breast cancer patients during radiotherapy

Aims

To investigate the incidence and influencing factors of acute radiation dermatitis (ARD) induced by radiotherapy in postoperative patients with breast cancer.

Methods and Materials

A retrospective analysis was conducted on 598 patients with breast cancer who received postoperative radiotherapy from November 18, 2014 to September 14, 2019. The radiotherapy technology included two-dimensional radiotherapy, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and tomotherapy. The occurrence of ARD in patients was then followed up and recorded. The independent risk factors for radiation-induced dermatitis were analyzed by using an orderly logistic regression model.

Results

Of the 598 patients, 431 had mild skin reactions, including pigmentation and dry desquamation (grade 1), 151 developed wet desquamation and tender erythema (grade 2), and 16 had severe skin reactions, including flaky wet scaling and erosion (grade 3). There were no grade 4 skin reactions. The severity of ARD was independent of the following factors: Age, diabetes, allergy, quadrant, pathological type, the clinical stage, the tumor stage, triple-negative breast cancer, ki-67 expression, adjuvant chemotherapy, endocrine therapy, targeted therapy, radiotherapy area, and boost irradiation. However, it was found to be dependent on the body mass index, surgery type, radiotherapy technique, node stage, and the prophylactic use of topical agents.

Conclusions

ARD in response to postoperative radiotherapy in patients with breast cancer is common and mild. Clinicians and patients need to cultivate awareness of the potential risk factors involved and then intervene to alleviate skin reactions and improve the quality of life.

A Combination Therapy Using Electrical Stimulation and Adaptive, Conductive Hydrogels Loaded with Self-Assembled Nanogels Incorporating Short Interfering RNA Promotes the Repair of Diabetic Chronic Wounds

In addition to oxidative stress and impaired angiogenesis, the overexpression of metalloproteinases (MMPs) and proinflammatory cytokines, which are promoted by hyperglycemia, causes chronic inflammation in diabetic wounds. Herein, TA-siRNA nanogels are prepared for the first time on the basis of the self-assembling interaction between tannic acid (TA) and short interfering RNA (siRNA). The efficient, biodegradable nanogels are cross-linked with poly(vinyl alcohol) (PVA), human-like collagen (HLC), TA, and borax to prepare adaptive, conductive PHTB (TA-siRNA) hydrogels. In response to high levels of reactive oxygen species (ROS), the ROS-responsive borate ester bonds in the hydrogels are oxidized and broken, and TA-siRNA nanogels are released into cells to reduce the expression of the MMP-9. Moreover, the TA and HLC promote collagen expression, reduce inflammation, and ROS level. It is found that electrical stimulation (ES) promotes the in vivo release of TA-siRNA nanogels from PHTB (TA-siRNA) hydrogels and endocytosis of the nanogels. The combination therapy using ES and PHTB (TA-siRNA) hydrogels accelerates the healing of diabetic wounds by reducing the levels of ROS and MMP-9 and promoting the polarization of macrophages, production of collagen, and angiogenesis. This study provides insights on the design of functional gene-delivery and efficient therapeutic strategies to promote the repair of diabetic chronic wounds.

Computational Investigation to Design Ofloxacin-Loaded Hybridized Nanocellulose/Lipid Nanogels for Accelerated Skin Repair

The pharmaceutical application of biomaterials has attained a great success. Rapid wound healing is an important goal for many researchers. Hence, this work deals with the development of nanocellulose crystals/lipid nanogels loaded with ofloxacin (OFX) to promote skin repair while inhibiting bacterial infection. Ofloxacin-loaded hybridized nanocellulose/lipid nanogels (OFX-HNCNs) were prepared and evaluated adopting a computational method based on regression analysis. The optimized nanogels (OFX-HNCN7) showed a spherical outline with an encapsulation efficiency (EE), particle size (PS) and zeta potential (ZP) values of 97.53 ± 1.56%, 200.2 ± 6.74 nm and -26.4 ± 0.50 mV, respectively, with an extended drug release profile. DSC examination of OFX-HNCN7 proved the amorphization of the encapsulated drug into the prepared OFX-HNCNs. Microbiological studies showed the prolonged inhibition of bacterial growth by OFX-HNCN7 compared to the free drug. The cytocompatibility of OFX-HNCN7 was proved by Sulforhodamine B assay. Tissue repair was evaluated using the epidermal scratch assay based on cell migration in human skin fibroblast cell line, and the results depicted that cell treated with OFX-HNCN7 showed a faster and more efficient healing compared to the control. In overall, the obtained findings emphasize the benefits of using the eco-friendly bioactive nanocellulose, hybridized with lipid, to prepare a nanocarrier for skin repair.

Developing a new treatment for superficial fungal infection using antifungal Collagen-HSAF dressing

Fungal pathogens are common causes of superficial clinical infection. Their increasing drug resistance gradually makes existing antifungal drugs ineffective. Heat stable antifungal factor (HSAF) is a novel antifungal natural product with a unique structure. However, the application of HSAF has been hampered by very low yield in the current microbial producers and from extremely poor solubility in water and common solvents. In this study, we developed an effective mode of treatment applying HSAF to superficial fungal infections. The marine-derived Lysobacter enzymogenes YC36 contains the HSAF biosynthetic gene cluster, which we activated by the interspecific signaling molecule indole. An efficient extraction strategy was used to significantly improve the purity to 95.3%. Scanning electron microscopy images revealed that the Type I collagen-based HSAF (Col-HSAF) has a transparent appearance and good physical properties, and the in vitro sustained-release effect of HSAF was maintained for more than 2 weeks. The effective therapeutic concentration of Col-HSAF against superficial fungal infection was explored, and Col-HSAF showed good biocompatibility, lower clinical scores, mild histological changes, and antifungal capabilities in animals with Aspergillus fumigatus keratitis and cutaneous candidiasis. In conclusion, Col-HSAF is an antifungal reagent with significant clinical value in the treatment of superficial fungal infections.

Skin-inspired injectable adhesive gelatin/HA biocomposite hydrogel for hemostasis and full-thickness dermal wound healing

An insufficient adhesion to wet surfaces and biased functions for therapeutic efficacy are limitations to the application of gelatin and hyaluronic acid. Herein, we developed a simple double-injection approach to prepare a skin-inspired gelatin/HA-based injectable remoistenable adhesive hydrogel (HI/DA-Gel) through a simultaneous crosslinking and bio-compositing strategy of genipin incorporated with dopamine (DA) grafted gelatin and N-hydroxy succinimide (NHS) merged with hyaluronic acid. The integrative crosslinking and bio-compositing strategy led to the formation of a HI/DA-Gel with a highly skin-bionic interconnected internal double network 3D-structure with elevated surface wettability, thermal-stablity, adhesive and mechanical properties as expected. In vitro/in vivo biostudies showed that HI/DA-Gel enhanced collagen deposition, hemostatic effects and upregulated the production of CD31, showing an effective hemostasis and full-thickness dermal wound healing strategy. This work proposes a novel facile double-injection approach for the design of gelatin/ hyaluronic acid multi-functional injectable bio-composite hydrogels for integrated therapeutic effects.

Bilayer Hydrogels for Wound Dressing and Tissue Engineering

A large number of different skin diseases such as hits, acute, and chronic wounds dictate the search for alternative and effective treatment options. The wound healing process requires a complex approach, the key step of which is the choice of a dressing with controlled properties. Hydrogel-based scaffolds can serve as a unique class of wound dressings. Presented on the commercial market, hydrogel wound dressings are not found among proposals for specific cases and have a number of disadvantages—toxicity, allergenicity, and mechanical instability. Bilayer dressings are attracting great attention, which can be combined with multifunctional properties, high criteria for an ideal wound dressing (antimicrobial properties, adhesion and hemostasis, anti-inflammatory and antioxidant effects), drug delivery, self-healing, stimulus manifestation, and conductivity, depending on the preparation and purpose. In addition, advances in stem cell biology and biomaterials have enabled the design of hydrogel materials for skin tissue engineering. To improve the heterogeneity of the cell environment, it is possible to use two-layer functional gradient hydrogels. This review summarizes the methods and application advantages of bilayer dressings in wound treatment and skin tissue regeneration. Bilayered hydrogels based on natural as well as synthetic polymers are presented. The results of the in vitro and in vivo experiments and drug release are also discussed.

Non-Mulberry Silk Fiber-Based Composite Scaffolds Containing Millichannels for Auricular Cartilage Regeneration

Tissue engineering has made significant progress as a cartilage repair alternative. It is crucial to promote cell proliferation and migration within three-dimensional (3D) bulk scaffolds for tissue regeneration through either chemical gradients or physical channels. In this study, by developing optimized silk fiber-based composite scaffolds, millimeter-scaled channels were created in the corresponding scaffolds via facile physical percussive drilling and subsequently utilized for auricular cartilage regeneration. We found that by the introduction of poly-l-lactic acid porous microspheres (PLLA PMs), the channels incorporated into the Antheraea pernyi (Ap) silk fiber-based scaffolds were reinforced, and the mechanical features were well maintained. Moreover, Ap silk fiber-based scaffolds reinforced by PLLA PMs containing channels (CMAF) exhibited excellent chondrocyte proliferation, migration, and synthesis of cartilage-specific extracellular matrix (ECM) in vitro. The biological evaluation in vivo revealed that CMAF had a higher chondrogenic capability for an even deposition of the specific ECM component. This study suggested that multihierarchical CMAF may have potential application for auricular cartilage regeneration.

Wound dressing adherence: a review

Wound dressing adherence is an important problem that is frequently encountered in wound care, and is associated with both clinical and economic burdens. However, only a few review articles have focused on this issue. The objective of this review was to present a comprehensive discussion of wound dressing adherence, including the mechanism of dressing adherence, adverse consequences (clinical burdens and economic burdens), factors affecting adherence (dressing-, patient- and wound-related factors, and factors related to the wound care procedure), tests to assess dressing adherence (in vitro assay, in vivo assay and clinical trials), and reduction of wound adherence (modification of dressing adherence and special care in particular patients). Accordingly, this review article emphasises an awareness of dressing adherence, and is intended to be an informative source for the development of new dressings and for wound management.

Antibacterial Cellulose Nanocrystal-Incorporated Hydrogels With Satisfactory Vascularization for Enhancing Skin Regeneration

Wound healing of skin defects remains a significant clinical problem due to inflammation, infection, and dysangiogenesis; especially, the promotion of microvasculature formation in healing of chronic wound or deep skin defects is critical as it supplies oxygen and nutrients to the impaired tissue, relieving uncontrolled inflammatory responses. The cellulose nanocrystals (CNCs) in the liquid crystalline phase, which facilitates cell proliferation and migration, has been shown to improve vascularization effectively. Therefore, we developed a novel injectable hydrogel based on Schiff base and coordination of catechol and Ag. The obtained hydrogels (CCS/CCHO-Ag) exhibited in situ forming properties, satisfactory mechanical performance, controlled release of Ag, antibacterial capacity, and biocompatibility. In addition, the hydrogels could also entirely cover and firmly attach wounds with irregular shapes, so as to reduce the re-injury rate. More importantly, experiments in vitro and in vivo demonstrated that CCS/CCHO-Ag hydrogels can promote neovascularization and tissue regeneration, thanks to their anti-inflammatory and antibacterial effects. In conclusion, these multifunctional hydrogels are well on the way to becoming competitive biomedical dressings, which show tremendous potential application in the field of tissue engineering.

Recent Advances in Bioengineered Scaffolds for Cutaneous Wound Healing

Wound healing is an evolved dynamic biological process. Though many research and clinical approaches have been explored to restore damaged or diseased skin, the current treatment for deep cutaneous injuries is far from being perfect, and the ideal regenerative therapy remains a significant challenge. Of all treatments, bioengineered scaffolds play a key role and represent great progress in wound repair and skin regeneration. In this review, we focus on the latest advancement in biomaterial scaffolds for wound healing. We discuss the emerging philosophy of designing biomaterial scaffolds, followed by precursor development. We pay particular attention to the therapeutic interventions of bioengineered scaffolds for cutaneous wound healing, and their dual effects while conjugating with bioactive molecules, stem cells, and even immunomodulation. As we review the advancement and the challenges of the current strategies, we also discuss the prospects of scaffold development for wound healing.

Rhein incorporated silk fibroin hydrogels with antibacterial and anti-inflammatory efficacy to promote healing of bacteria-infected burn wounds

Advanced dressings that can simultaneously prevent bacterial colonization/infection and reduce inflammation are highly desired. A simple strategy was developed to incorporate an anti-inflammatory and antibacterial drug rhein into the structure of silk fibroin (SF) matrix to fabricate a hydrogel dressing. The SF/Rhein hydrogels showed fibrous network nanostructure, high water content (~90%), high water adsorption ability (>2 folds of its own weight), acceptable mechanical strength, biocompatibility and antibacterial properties, suitable as dressings for the treatment of bacterial infected wounds. The SF/Rhein hydrogels enhanced the healing rate of burn wounds by reducing inflammation, expediting angiogenesis, and promoting skin appendages formation, being a promising candidate as wound dressings.

Advances in Modified Hyaluronic Acid-Based Hydrogels for Skin Wound Healing

Hyaluronic acid (HA) is a natural linear anionic polysaccharide with many unique characteristics such as excellent biocompatibility and biodegradability, native biofunctionality, hydrophilicity, and non-immunoreactivity. HA plays crucial roles in numerous...

Functional Hydrogel Dressings for Treatment of Burn Wounds

The therapy of burns is a challenging clinical issue. Burns are long-term injuries, and numerous patients suffer from chronic pain. Burn treatment includes management, infection control, wound debridement and escharotomy, dressing coverage, skin transplantation, and the use of skin substitutes. The future of advanced care of burn wounds lies in the development of “active dressings”. Hydrogel dressings have been employed universally to accelerate wound healing based on their unique properties to overcome the limitations of existing treatment methods. This review briefly introduces the advantages of hydrogel dressings and discusses the development of new hydrogel dressings for wound healing along with skin regeneration. Further, the treatment strategies for burns, ranging from external to clinical, are reviewed, and the functional classifications of hydrogel dressings along with their clinical value for burns are discussed.

Development of novel hyaluronic acid/human-like collagen bio-composite membranes: A facile "surface modification-assembly" approach

The merits of hyaluronic acid (HA) as a representative biological carbohydrate polymers especially in bioactivity and tailorability makes it ideal building block for the engineering of tissue engineering scaffolds. HA-based bio-composites integrate the characteristics of multi-component materials, possessing versatility and further improving the therapeutic efficacy. Human like collagen (HLC), which is hydrophilic, biomimetic, and bio-safe, with human tissue-derived collagen biofunction, has attracted extensive attention worldwide. Herein, we developed a novel method for HA/HLC bio-composite membranes preparation, comprising one-step surface modification-assembly process by which the HLC self-assembles are simultaneously loaded on the oxidized-modified HA (oxi-HA) from the surface/interface micro-scale. Comprehensive material characterizations and in vitro/in vivo biostudies proved that the HLC/oxi-HA composite membranes exhibited significantly enhanced biological activity, hemostatic performances, and wound healing properties compared to that of the pristine HA. The results of this study highlight the great potential of the prepared biomimetic HLC/oxi-HA bio-composites as a new generation of multifunctional HA-based wound-healing materials.

Harnessing Multifaceted Next-Generation Technologies for Improved Skin Wound Healing

Dysregulation of sequential and synchronized events of skin regeneration often results in the impairment of chronic wounds. Conventional wound dressings fail to trigger the normal healing mechanism owing to the pathophysiological conditions. Tissue engineering approaches that deal with the fabrication of dressings using various biomaterials, growth factors, and stem cells have shown accelerated healing outcomes. However, most of these technologies are associated with difficulties in scalability and cost-effectiveness of the products. In this review, we survey the latest developments in wound healing strategies that have recently emerged through the multidisciplinary approaches of bioengineering, nanotechnology, 3D bioprinting, and similar cutting-edge technologies to overcome the limitations of conventional therapies. We also focus on the potential of wearable technology that supports complete monitoring of the changes occurring in the wound microenvironment. In addition, we review the role of advanced devices that can precisely enable the delivery of nanotherapeutics, oligonucleotides, and external stimuli in a controlled manner. These technological advancements offer the opportunity to actively influence the regeneration process to benefit the treatment regime further. Finally, the clinical relevance, trajectory, and prospects of this field have been discussed in brief that highlights their potential in providing a beneficial wound care solution at an affordable cost.

Antibacterial Dual Network Hydrogels for Sensing and Human Health Monitoring

Polymer-based conductive hydrogels have the synergistic advantages of high conductivity and tissue-like properties, making them promising candidates for the construction of flexible electronic devices. However, conductive hydrogel materials can easily absorb microorganisms due to their high water content. To address the problem that conductive hydrogels are susceptible to infection by external pathogens when monitoring wounds and when used in implanted organs, tannic acid-borax (TA-B) complexes are introduced into classical dual network polyacrylamide/agarose (PAM/Agar) hydrogels to form PAM/Agar/TA-B hydrogel conductors. These hydrogels are antibacterial and have good mechanical properties, light transmission, electrical conductivity, and adhesion. TA-B increases the compressive stress of the PAM/Agar/TA-B hydrogel by 58.14% compared to a PAM/Agar hydrogel. The PAM/Agar/TA-B hydrogel can be used as an electronic conductor for electronic skin and wearable sensors. Outstanding biocompatibility allows the hydrogel to be used as a monitoring device at wounds to monitor heartbeat, skin wounds, and internal tissue status in real time. In summary, an antibacterial strain sensing matrix that is safe for human health monitoring is developed.

Ascorbic acid-loaded polyvinyl alcohol/cellulose nanofibril hydrogels as precursors for 3D printed materials

We proposed a simple method to process hydrogels containing polyvinyl alcohol and cellulose nanofibrils (PVA/CNF) to prepare volumetric architectures by direct ink writing (DIW). The presence of CNF in the aqueous PVA suspensions conferred rheology profiles that were suitable for extrusion and solidification in pre-designed shapes. The viscoelastic behavior of the hybrid inks enabled precise control on processability and shape retention, for instance, as demonstrated in multilayered lattice structures of high fidelity. After lyophilization, the obtained 3D-printed hydrogels presented a very high porosity, with open and interconnected pores, allowing a high-water uptake capacity (up to 1600%). The mechanical strength of the composite 3D-printed materials matched those of soft tissues, opening opportunities for skin applications. As such, drug-loaded samples revealed a controlled and efficient delivery of an antioxidant (ascorbic acid) in PBS buffer media at 23 °C (~80% for 8 h). Altogether, PVA/CNF hydrogels were introduced as suitable precursors of 3D-lattice geometries with excellent physical and mechanical characteristics.

Collagen-based formulations for wound healing: A literature review

Wounds have always been the point of concern owing to the involvement of infections and the level of severity. Therefore, the management of wounds always requires additional effort for comprehensive healing and subsequent removal of the scar from the wound site. The role of biomaterials in the management of chronic wounds has been well established. One of such biomaterials is collagen (Col) that is considered to be the crucial component of most of the formulations being developed for wound healing. The role of Col extracted from marine invertebrates remains an unmarked origin of the proteinaceous constituent in the evolution of innovative pharmaceuticals. Col is a promising, immiscible, fibrous amino acid of indigenous origin that is ubiquitously present in extracellular matrices and connective tissues. There are different types of Col present in the body such as type I, II, III, IV, and V however the natural sources of Col are vegetables and marine animals. Its physical properties like high tensile strength, adherence nature, elasticity, and remodeling contribute significantly in the wound healing process. Col containing formulations such as hydrogels, sponges, creams, peptides, and composite nanofibers have been utilized widely in wound healing and tissue engineering purposes truly as the first line of defense. Here we present the recent advancements in Col based dosage forms for wound healing. The Col based market of topical preparations and the published reports identify Colas a useful biomaterial for the delivery of pharmaceuticals and a platform for tissue engineering.

Subcutaneous toxicity of a dual ionically cross-linked atelocollagen and sodium hyaluronate gel: Rat in vivo study for biological safety evaluation of the injectable hydrogel

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Hydrogel wound dressings are commonly used to stop bleeding and enhance healing.

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Hyaluronic acid and collagen are beneficial for wound healing, however, each polymer has limitations.

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A dual hydrogel combining the benefits of both biopolymers can be more effective for the treatment of various wound types.

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A composite of collagen and sodium hyaluronate did not generate significant subacute toxicity or reactivity in vivo.

Hydrogels are commonly used in wound dressing, as they retain moisture, accelerate healing, and break down necrotic tissue. This process enhances patient comfort levels while simultaneously reducing pain caused by dead tissue. The purpose of this study was to investigate the in vivo toxicity of a dual hydrogel consisting of type I atelocollagen cross-linked with sodium hyaluronate hydrogel used for wound dressing.

Porcine type I atelocollagen was cross-linked with sodium hyaluronate to form the hydrogel. For subcutaneous implantation, 0.5 ml of dual hydrogel was injected into two different sites of twenty rats per group. High density polyethylene rods were implanted subcutaneously to serve as a control material. Hematological assessment, blood biochemistry, histopathological, and histological evaluations were scored and graded after 4 weeks. A bioreactivity rating was used for evaluation of subacute toxicity.

Differences observed in blood chemical analysis and hematological analysis between control and test groups were within normal variations and considered unrelated to the test article implantation. No significant implantation-related lesions were observed in any of the major organs of all test animals. The overall histopathological index of the test article implantation sites was evaluated as 0. The bioreactivity rating was evaluated as non-irritant after 4-week subcutaneous implantation.

Overall, these results indicate that the dual hydrogel of type I atelocollagen and sodium hyaluronate is biologically and chemically safe for clinical application as a wound dressing.

Hydrogel Preparation Methods and Biomaterials for Wound Dressing

Wounds have become one of the causes of death worldwide. The metabolic disorder of the wound microenvironment can lead to a series of serious symptoms, especially chronic wounds that bring great pain to patients, and there is currently no effective and widely used wound dressing. Therefore, it is important to develop new multifunctional wound dressings. Hydrogel is an ideal dressing candidate because of its 3D structure, good permeability, excellent biocompatibility, and ability to provide a moist environment for wound repair, which overcomes the shortcomings of traditional dressings. This article first briefly introduces the skin wound healing process, then the preparation methods of hydrogel dressings and the characteristics of hydrogel wound dressings made of natural biomaterials and synthetic materials are introduced. Finally, the development prospects and challenges of hydrogel wound dressings are discussed.

Antioxidant and multi-sensitive PNIPAAm/keratin double network gels for self-stripping wound dressing application

Hydrogel is a potential wound dressing material due to its ability to maintain a humid environment, the strong absorptive capacity of exuded tissue fluid, and gas exchange function. Herein, poly(N-isopropyl acrylamide)/keratin double network (PNIPAAm/keratin DN) gels were fabricated through covalent and ionic double cross-linking strategy. The effects of PNIPAAm/keratin ratios on the morphology and swelling rate of gels were characterized. The DN gels could swell up from 2600% to 4600% in proportion to the keratin content, demonstrating their great ability to absorb tissue fluid. The gels possessed thermo-sensitiveness, imparting self-stripping property. Moreover, the antibacterial chlorhexidine acetate (CHX) was loaded into gels with a post-fabrication drug-loading strategy. The release behavior showed that CHX-loaded DN gels exhibited multiple responsive characteristics (temperature, pH, and ROS). Furthermore, the drug-loaded gels showed greater antibacterial activity than free CHX due to the sustained drug release effect. Meanwhile, the antioxidant efficiency of PNIPAAm/keratin DN gels was ca. 33.1%, while the PNIPAAm gel was just ca. 18.2%, indicating the strong oxidation resistance of DN gels. In the Sprague Dawley (SD) rat skin defect model, the hydrogel had better tissue regeneration ability than the commercial film. Taken together, the multifunctional PNIPAAm/keratin DN gels are potential candidates for clinical wound treatment.

Skin wounds, the healing process, and hydrogel-based wound dressings: a short review

Skin wounds are damage to the epithelial layer and the integrity of living tissue. The healing mechanism is dynamic and complex, and often treatments with wound dressings help in tissue regeneration, reducing the risk of infections. Polymeric hydrogels become good candidates for wet curing process. These materials prevent dehydration of the tissue and avoid discomfort to the patient when changing the dressing. In this short review, we demonstrate the importance of the healing process, the types of skin wounds, and the hydrogels that are potentially attractive as wound dressings.

Recent trends on burn wound care: hydrogel dressings and scaffolds

Acute and chronic wounds can cause severe physical trauma to patients and also result in an immense socio-economic burden. Thus, wound management has attracted increasing attention in recent years. However, burn wound management is still a major challenge in wound management. Autografts are often considered the gold-standard for burn care, but their application is limited by many factors. Hence, ideal burn dressings and skin substitute dressings are desirable. With the development of biomaterials and progress of tissue engineering technology, some innovative dressings and tissue engineering scaffolds, such as nanofibers, films, foams and hydrogels, have been widely used in the field of biomedicine, especially in wound management. Among them, hydrogels have attracted tremendous attention with their unique advantages. In this review, we discuss the challenges in burn wound management, several crucial design considerations with respect to hydrogels for burn wound healing, and available polymers for hydrogels in burn wound care. In addition, the potential application and plausible prospect of hydrogels are also highlighted.

Recent advances on polymeric hydrogels as wound dressings

Severe hemorrhage is a leading cause of high mortality in critical situations like disaster, accidents, and warfare. The resulting wounds could induce severe physical and psychological trauma to patients and also bring an immense socio-economic burden. Hence, rapid hemostasis and wound healing techniques have become critical initiatives for life-saving treatment. Although traditional methods relying on bandages and gauzes are effective in controlling hemorrhage, they suffer from several limitations: nonbiodegradability, being susceptible to infection, being unsuitable for the irregular wound, secondary tissue damage, and being almost ineffective for wound healing. Owing to the merits of high porosity, good biocompatibility, tunable physicochemical properties, and being beneficial for wound healing, hydrogels with excellent performance have drawn intensive attention and numerous novel effective hydrogel dressings have been widely developed. In this Review, after introducing some commonly used strategies for the synthesis of hydrogels, the most recent progress on polymer-based hydrogels as wound dressings is discussed. Particularly, their hemostasis, antibacterial, and biodegradation properties are introduced. Finally, challenges and future perspectives about the development of hydrogels for wound dressings are outlined.

Combination of lyophilized adipose-derived stem cell concentrated conditioned medium and polysaccharide hydrogel in the inhibition of hypertrophic scarring

BACKGROUND

Mesenchymal stem cell-based acellular therapies have been widely exploited in managing hypertrophic scars. However, low maintenance dose and transitory therapeutic effects during topical medication remain a thorny issue. Herein, this study aimed to optimize the curative effect of adipose-derived stem cell conditioned medium (ADSC-CM) in the prevention of hypertrophic scarring.

METHODS

In the present study, ADSC-CM was concentrated via the freeze-drying procedure. The efficacy of different dose groups (CM, CM5, CM10) was conducted on the proliferation, apoptosis, and α-smooth muscle actin (α-SMA) expression of human keloid fibroblasts (HKFs) in vitro. Incorporation of adipose-derived stem cell concentrated conditioned medium (ADSCC-CM) into polysaccharide hydrogel was investigated in rabbit ear, in vivo. Haematoxylin-eosin (H&E) and Masson's trichrome staining were performed for the evaluation of scar hyperplasia.

RESULTS

We noted that ADSCC-CM could downregulate the α-SMA expression of HKFs in a dose-dependent manner. In the rabbit ear model, the scar hyperplasia in the medium-dose group (CM5) and high-dose group (CM10) was inhibited with reduced scar elevation index (SEI) under 4 months of observation. It is noteworthy that the union of CM5 and polysaccharide hydrogel (CM5+H) yielded the best preventive effect on scar hyperplasia. Briefly, melanin, height, vascularity, and pliability in the CM5+H group were better than those of the control group. Collagen was evenly distributed, and skin appendages could be regenerated.

CONCLUSIONS

Altogether, ADSCC-CM can downregulate the expression of α-SMA due to its anti-fibrosis effect and promote the rearrangement of collagen fibres, which is integral to scar precaution. The in situ cross bonding of ADSCC-CM and polysaccharide hydrogel could remarkably enhance the therapeutic outcomes in inhibiting scar proliferation. Hence, the alliance of ADSCC-CM and hydrogel may become a potential alternative in hypertrophic scar prophylaxis.