Design and synthesis of a new topical agent for halting blood loss rapidly: A multimodal chitosan-gelatin xerogel composite loaded with silica nanoparticles and calcium

Development of ROS-responsive collagen-based hemostatic sponges for the repair of MRSA-infected wounds

Uncontrolled bleeding and infections, particularly from drug-resistant bacteria like Methicillin-Resistant Staphylococcus aureus (MRSA), pose significant challenges in clinical wound management, delaying healing, increasing patient discomfort, and elevating healthcare costs. This study introduces a novel reactive oxygen species (ROS)-responsive collagen-based hemostatic sponge designed to enhance wound healing and minimize blood loss, especially in MRSA-infected wounds. By chemically modifying the carboxyl groups of collagen with amino-rich oligomers, the primary amino content was increased, enhancing drug loading capacity-particularly for vancomycin-while also improving the sponge's mechanical properties, hemostatic performance, and biological stability. The ROS-responsive covalent bonding of vancomycin facilitated controlled vancomycin release in response to ROS, offering superior antibacterial efficacy and specifically targeting MRSA more effectively than conventional non-ROS-responsive approaches. In MRSA-infected full-thickness skin repair models, the ROS-responsive vancomycin-loaded sponge significantly enhanced wound healing and skin regeneration compared to both the physical adsorption group and the non-ROS-responsive release group. These results underscore the potential of the ROS-responsive collagen composite as an advanced hemostatic material with enhanced antibacterial capabilities, providing rapid hemostasis and improved healing outcomes for complex or infected wounds.

Zeolite firmly anchored regenerated cellulose aerogel for efficient and biosafe hemostasis

Zeolite-based hemostats are commercially available but are still troubled by the adverse effects of exothermic heat-caused tissue damage and detached zeolite-induced distal thrombosis. Here, we developed a facile and robust method to fabricate zeolite-embedded regenerated cellulose aerogel (Z-RCA) for safe and efficient hemostasis. Zeolite particles were extensively entangled by regenerated cellulose nanofibers via hydrogen bonds during the cellulose regeneration process, thus reducing the probability of zeolite detaching from aerogel. Additionally, the low loading ratio of zeolite (∼3.0 wt%) decreased the exothermic heat to promote a low-temperature enhancement of 3.4 °C during the hemostatic process. The aerogel quickly absorbed tremendous blood while releasing calcium ions, synergistically assisting zeolite to promote blood coagulation. In animal experiments, Z-RCA stopped bleeding faster than Quikclot and reduced blood loss by 62.1 wt%. Overall, the study produced a safe and efficient zeolite-based hemostat.

A review on natural biopolymers in external drug delivery systems for wound healing and atopic dermatitis

Despite the advantages of topical administration in the treatment of skin diseases, current marketed preparations face the challenge of the skin's barrier effect, leading to low therapeutic effectiveness and undesirable side effects. Hence, in recent years the management of skin wounds, the main morbidity-causing complication in hospital environments, and atopic dermatitis, the most common inflammatory skin disease, has become a great concern. Fortunately, new, more effective, and safer treatments are already under development, with chitosan, starch, silk fibroin, agarose, hyaluronic acid, alginate, collagen, and gelatin having been used for the development of nanoparticles, liposomes, niosomes and/or hydrogels to improve the delivery of several molecules for the treatment of these diseases. Biocompatibility, biodegradability, increased viscosity, controlled drug delivery, increased drug retention in the epidermis, and overall mitigation of adverse effects, contribute to an effective treatment, additionally providing intrinsic antimicrobial and wound healing properties. In this review, some of the most recent success cases of biopolymer-based drug delivery systems as part of nanocarriers, semi-solid hydrogel matrices, or both (hybrid systems), for the management of skin wounds and atopic dermatitis, are critically discussed, including composition and in vitro, ex vivo and in vivo characterization, showing the promise of these external drug delivery systems.

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.

Etamsylate loaded oxidized Konjac glucomannan-ε-polylysine injectable hydrogels for rapid hemostasis and wound healing

Uncontrollable bleeding is a crucial factor that can lead to fatality. Therefore, the development of hemostatic dressings that enable rapid hemostasis is of utmost importance. Hydrogels with injectability, self-healing ability, and adhesiveness hold significant potential as effective hemostatic dressings. Herein, a composite hydrogel was fabricated by the oxidized Konjac glucomannan and ε-polylysine. After the encapsulation of a hemostatic drug, etamsylate, an oxidized Konjac glucomannan/ε-polylysine/etamsylate (OKGM/PL/E) composite hydrogel that possesses favorable properties including injectability, self-healing ability, tissue adhesiveness, hemocompatibility and cytocompatibility was fabricated. The OKGM/PL/E hydrogel demonstrated the ability to effectively adhere red blood cells and seal wounds, enabling rapid control of hemorrhaging. In vivo wound healing experiments confirmed the hemostatic and wound healing efficacy of the OKGM/PL/E hydrogel, highlighting its potential as a valuable hemostatic dressing.

Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances

Hemorrhage is a detrimental event present in traumatic injury, surgery, and disorders of bleeding that can become life-threatening if not properly managed. Moreover, uncontrolled bleeding can complicate surgical interventions, altering the outcome of surgical procedures. Therefore, to reduce the risk of complications and decrease the risk of morbidity and mortality associated with hemorrhage, it is necessary to use an effective hemostatic agent that ensures the immediate control of bleeding. In recent years, there have been increasingly rapid advances in developing a novel generation of biomaterials with hemostatic properties. Nowadays, a wide array of topical hemostatic agents is available, including chitosan-based biomaterials that have shown outstanding properties such as antibacterial, antifungal, hemostatic, and analgesic activity in addition to their biocompatibility, biodegradability, and wound-healing effects. This review provides an analysis of chitosan-based hemostatic biomaterials and discusses the progress made in their performance, mechanism of action, efficacy, cost, and safety in recent years.

How to Promote Skin Repair? In-Depth Look at Pharmaceutical and Cosmetic Strategies

Skin repair encompasses epidermal barrier repair and wound healing which involves multiple cellular and molecular stages. Therefore, many skin repair strategies have been proposed. In order to characterize the usage frequency of skin repair ingredients in cosmetics, medicines, and medical devices, commercialized in Portuguese pharmacies and parapharmacies, a comprehensive analysis of the products' composition was performed. A total of 120 cosmetic products, collected from national pharmacies online platforms, 21 topical medicines, and 46 medical devices, collected from INFARMED database, were included in the study, revealing the top 10 most used skin repair ingredients in these categories. A critical review regarding the effectiveness of the top ingredients was performed and an in-depth analysis focused on the top three skin repair ingredients pursued. Results demonstrated that top three most used cosmetic ingredients were metal salts and oxides (78.3%), vitamin E and its derivatives (54.2%), and Centella asiatica (L.) Urb. extract and actives (35.8%). Regarding medicines, metal salts and oxides were also the most used (47.4%) followed by vitamin B5 and derivatives (23.8%), and vitamin A and derivatives (26.3%). Silicones and derivatives were the most common skin repair ingredients in medical devices (33%), followed by petrolatum and derivatives (22%) and alginate (15%). This work provides an overview of the most used skin repair ingredients, highlighting their different mechanisms of action, aiming to provide an up-to-date tool to support health professionals' decisions.

Incorporation of mixed-dimensional palygorskite clay into chitosan/polyvinylpyrrolidone nanocomposite films for enhancing hemostatic activity

Clay mineral-based hemostatic materials have attracted much attention in recent years, but it is scarce to report the hemostatic nanocomposite films containing natural mixed-dimensional clay composed of natural one-dimensional and two-dimensional clay minerals. In this study, the high-performance hemostatic nanocomposite films were facilely prepared by incorporating the natural mixed-dimensional palygorskite clay leached by oxalic acid (O-MDPal) into chitosan/polyvinylpyrrolidone (CS/PVP) matrix. By contrast, the obtained nanocomposite films exhibited the higher tensile strength (27.92 MPa), lower water contact angel (75.40°), better degradation, thermal stability and biocompatibility after incorporation of 20 wt% of O-MDPal, suggesting that O-MDPal contributed to enhancing the mechanical performance and water holding capacity of the CS/PVP nanocomposite films. Compared with the medical gauze and CS/PVP matrix groups, the nanocomposite films also indicated excellent hemostatic performance evaluated by blood loss and hemostasis time indexes based on the mouse tail amputation model, which might be ascribed to the enriched hemostatic functional sites, and hydrophilic surface, robust physical barrier role of nanocomposite films. Therefore, the nanocomposite film exhibited a promising practical application in wound healing.

Hemostatic effect and safety evaluation of the absorbable macroporous polysaccharides composite hemostatic material prepared by a green fabrication approach

Carboxymethyl chitosan is widely used in the medical field such as wound healing and other medical fields. We previously fabricated the absorbable macroporous polysaccharides composite hemostatics (AMPCs) mainly composed of carboxymethyl chitosan which possess excellent hemostatic effect. To further elucidate the impact of CMCTs on the hemostatic effect and biosafety of AMPCs, carboxymethyl chitosan with different properties were used to prepare AMPCs. By comparing the physical and chemical properties, AMPCs performed high water absorption ability, especially Group 1 (swelling ratio reached 5792%), which facilitated the rapid formation of blood clots. It was confirmed by blood clotting index (BCI) and blood coagulation tests in vitro that Group 1 showed a slightly higher coagulation capacity than groups 2 and 3, which may be due to the positive charge on the surface of the cations in the salts attaches to the negative charge on the surface of the red blood cells, an electrostatic neutralization reaction occurs. The biosafety was a preliminary evaluation by implanted AMPCs into the back of Sprague-Dawley rats and the tissue was harvested after feeding for 28 days. The AMPCs exhibited good biosafety for whole blood and major organs during the degradation in vivo: during the degradation of AMPCs, excluding changes in some serum indicators, no tissue necrosis or inflammatory cell infiltration was observed in these organs, either by gross observation or histological analysis. These findings demonstrate that expecting to develop a highly functional and safe hemostatic agent based on Group 1 for rapid hemostasis applications in emergencies.

Characterization and Analysis of Chitosan-Gelatin Composite-Based Biomaterial Effectivity as Local Hemostatic Agent: A Systematic Review

Chitosan and gelatin were the most widely used natural materials in pharmaceutical and medical fields, especially as local hemostatic agents, independently or as a composite material with the addition of other active substances. Chitosan and gelatin have excellent properties in biocompatibility, biodegradability, non-toxicity and water absorption capacity. The objective of this review was to analyze the characteristics of chitosan-gelatin (CG) composite-based biomaterial and its effectivity as a local hemostatic agent. We used PRISMA guidelines and the PICO framework to compile this review. The findings demonstrated that the CG composite-based biomaterial had excellent physical, chemical, mechanical properties and local hemostatic agent activity by adding other active substances such as oxidized fibers (OF), silica nanoparticles (SiNPs), calcium (Ca) and biphasic calcium phosphate (BCP) or by setting the CG composite proportion ratio.

Insights into the Role of Biopolymer-Based Xerogels in Biomedical Applications

Xerogels are advanced, functional, porous materials consisting of ambient, dried, cross-linked polymeric networks. They possess characteristics such as high porosity, great surface area, and an affordable preparation route; they can be prepared from several organic and inorganic precursors for numerous applications. Owing to their desired properties, these materials were found to be suitable for several medical and biomedical applications; the high drug-loading capacity of xerogels and their ability to maintain sustained drug release make them highly desirable for drug delivery applications. As biopolymers and chemical-free materials, they have been also utilized in tissue engineering and regenerative medicine due to their high biocompatibility, non-immunogenicity, and non-cytotoxicity. Biopolymers have the ability to interact, cross-link, and/or trap several active agents, such as antibiotic or natural antimicrobial substances, which is useful in wound dressing and healing applications, and they can also be used to trap antibodies, enzymes, and cells for biosensing and monitoring applications. This review presents, for the first time, an introduction to biopolymeric xerogels, their fabrication approach, and their properties. We present the biological properties that make these materials suitable for many biomedical applications and discuss the most recent works regarding their applications, including drug delivery, wound healing and dressing, tissue scaffolding, and biosensing.

Chitosan films and scaffolds for regenerative medicine applications: A review

Over the last years, chitosan has demonstrated unparalleled characteristics for regenerative medicine applications. Beside excellent antimicrobial and wound healing properties, this polysaccharide biopolymer offers favorable characteristics such as biocompatibility, biodegradability, and film and fiber-forming capabilities. Having plentiful active amine groups, chitosan can be also readily modified to provide auxiliary features for growing demands in regenerative medicine, which is constantly confronted with new problems, necessitating the creation of biocompatible, immunogenic and biodegradable film/scaffold composites. A new look at the chitosan composites structure/activity/application tradeoff is the primary focus of the current review, which can help researchers to detect the bottlenecks and overcome the shortcomings that arose from this intersection. In the current review, the most recent advances in chitosan films and scaffolds in terms of preparation techniques and modifying methods for improving their functional properties, in three major biomedical fields i.e., tissue engineering, wound healing, and drug delivery are surveyed and discussed.

Silica/Protein and Silica/Polysaccharide Interactions and Their Contributions to the Functional Properties of Derived Hybrid Wound Dressing Hydrogels

Multifunctional and biocompatible hydrogels are on the focus of wound healing treatments. Protein and polysaccharides silica hybrids are interesting wound dressing alternatives. The objective of this review is to answer questions such as why silica for wound dressings reinforcement? What are the roles and contributions of silane precursors and silica on the functional properties of hydrogel wound dressings? The effects of tailoring the porous, morphological, and chemical characteristics of synthetic silicas on the bioactivity of hybrid wound dressings hydrogels are explored in the first part of the review. This is followed by a commented review of the mechanisms of silica/protein and silica/polysaccharide interactions and their impact on the barrier, scaffold, and delivery matrix functions of the derived hydrogels. Such information has important consequences for wound healing and paves the way to multidisciplinary researches on the production, processing, and biomedical application of this kind of hybrid materials.

Construction of multifunctional porcine acellular dermal matrix hydrogel blended with vancomycin for hemorrhage control, antibacterial action, and tissue repair in infected trauma wounds

Prevention of bacterial infection and reduction of hemorrhage, the primary challenges posed by trauma before hospitalization, are essential steps in prolonging the patient's life until they have been transported to a trauma center. Extracellular matrix (ECM) hydrogel is a promising biocompatible material for accelerating wound closure. However, due to the lack of antibacterial properties, this hydrogel is difficult to be applied to acute contaminated wounds. This study formulates an injectable dermal extracellular matrix hydrogel (porcine acellular dermal matrix (ADM)) as a scaffold for skin defect repair. The hydrogel combines vancomycin, an antimicrobial agent for inducing hemostasis, expediting antimicrobial activity, and promoting tissue repair. The hydrogel possesses a porous structure beneficial for the adsorption of vancomycin. The antimicrobial agent can be timely released from the hydrogel within an hour, which is less than the time taken by bacteria to infest an injury, with a cumulative release rate of approximately 80%, and thus enables a relatively fast bactericidal effect. The cytotoxicity investigation demonstrates the biocompatibility of the ADM hydrogel. Dynamic coagulation experiments reveal accelerated blood coagulation by the hydrogel. In vivo antibacterial and hemostatic experiments on a rat model indicate the healing of infected tissue and effective control of hemorrhaging by the hydrogel. Therefore, the vancomycin-loaded ADM hydrogel will be a viable biomaterial for controlling hemorrhage and preventing bacterial infections in trauma patients.