Hydrogel wound dressings for bioactive treatment of acute and chronic wounds

Biomedical applications of functional hydrogels: Innovative developments, relevant clinical trials and advanced products

Functional hydrogels are used for numerous biomedical applications such as tissue engineering, wound dressings, lubricants, contact lenses and advanced drug delivery systems. Most of them are based on synthetic or natural polymers forming a three-dimensional network that contains aqueous media. Among synthetic polymers, poly(meth)acrylates, polyethyleneglycols, poly(vinylalcohols), poly(vinylpyrrolidones), PLGA and poly(urethanes) are of high relevance, whereas natural polymers are mainly polysaccharides such as hyaluronic acid, alginate or chitosan and proteins such as albumin, collagen or elastin. In contrast to most synthetic polymers, natural polymers are biodegradable. Both synthetic and natural polymers are often chemically modified in order to improve or induce favorable properties and functions like high mechanical strength, stiffness, elasticity, high porosity, adhesive properties, in situ gelling properties, high water binding capacity or drug release controlling properties. Within this review we provide an overview about the broad spectrum of biomedical applications of functional hydrogels, summarize innovative approaches, discuss the concept of relevant functional hydrogels that are in clinical trials and highlight advanced products as examples for successful developments.

Quaternary ammonium grafted chitosan hydrogel with enhanced antibacterial performance as tannin acid and deferoxamine carrier to promote diabetic wound healing

The delay of diabetic wound healing puts a huge burden on the society. The key factors hindering wound healing include bacterial infection, unresolved inflammation and poorly generated blood vessels. In this paper, glycidyl trimethyl ammonium chloride (GTA) was grafted to chitosan (CS) to obtain quaternary ammonium grafted chitosan (QCS) with enhanced antibacterial performance, and then cross-linked by dialdehyde terminated poly(ethylene oxide) (PEO DA) to construct QCS/PEO DA hydrogel with tissue adhesion, biodegradation and self-healing properties. The QCS/PEO DA hydrogel is loaded with tannin acid (TA) and deferoxamine (DFO) to enhance antioxidant property and angiogenesis. At the same time, the TA and DFO loaded TA@DFO/hydrogel preserved the biocompatibility and biodegradability of chitosan. Moreover, the multifunctional hydrogel behaved excellent hemostatic properties in mice model and significantly promoted the healing efficacy of diabetic wounds. Overall, the TA@DFO/hydrogel is promising anti-infection dressing material for diabetic wound healing.

Chitosan-based matrix as a carrier for bacteriophages

Wound healing is a dynamic and complex process where infection prevention is essential. Chitosan, thanks to its bactericidal activity against gram-positive and gram-negative bacteria, as well as anti-inflammatory and hemostatic properties, is an excellent candidate to design dressings for difficult-to-heal wound treatment. The great advantage of this biopolymer is its capacity to be chemically modified, which allows for the production of various functional forms, depending on the needs and subsequent use. Moreover, chitosan can be an excellent polymer matrix for bacteriophage (phage) packing as a novel alternative/supportive antibacterial therapy approach. This study is focused on the preparation and characteristics of chitosan-based material in the form of a film with the addition of Pseudomonas lytic phages (KTN4, KT28, and LUZ19), which would exhibit antibacterial activity as a potential dressing that accelerates the wound healing. We investigated the method of producing a polymer based on microcrystalline chitosan (MKCh) to serve as the matrix for phage deposition. We described some important parameters such as average molar mass, swelling capacity, surface morphology, phage release profile, and antibacterial activity tested in the Pseudomonas aeruginosa bacterial model. The chitosan polysaccharide turned out to interact with phage particles immobilizing them within a material matrix. Nevertheless, with the high hydrophilicity and swelling features of the prepared material, the external solution of bacterial culture was absorbed and phages went in direct contact with bacteria causing their lysis in the polymer matrix. KEY POINTS: • A novel chitosan-based matrix with the addition of active phages was prepared • Phage interactions with the chitosan matrix were determined as electrostatic • Phages in the matrix work through direct contact with the bacterial cells.

A novel biological antibacterial polyvinyl alcohol/polyionic liquid hydrogel for wound dressing

The release of antibiotics or anions by traditional bacteriostatic agents led to the development of bacterial drug resistance and environmental pollution. Ionic liquids (ILs) have become important choices for antibacterial agents because of their excellent physical, chemical and biological properties. In this paper, the bioactivities of 1-vinyl-3-butylimidazolium chloride ([VBIM]Cl, IL) and poly (1-vinyl-3-butylimidazolium chloride) (P[VBIM]Cl, PIL) were evaluated, and the potential antibacterial material was used to synthesize hydrogels. Using the colony formation assay and the Oxford cup method, antibacterial effect of IL and PIL were tested. Cell-Counting-Kit-8 (CCK-8) experiments were used to study the IC50 (half maximal inhibitory concentration) values of IL and showed 1.47 mg/mL, 0.35 mg/mL and 0.33 mg/mL at 24 h, 48 h and 72 h, respectively. The IC50 value of PIL were 12.15 μg/mL, 12.06 μg/mL and 11.76 μg/mL at 24 h, 48 h and 72 h, respectively. The PIL is further crosslinked with polyvinyl alcohol (PVA) to form a novel hydrogel through freeze-thaw cycles. The newly fabricated hydrogel exhibited a high water content, excellent water absorption properties and outstanding mechanical performance. Using the colony formation assay and the inhibition zone assay, the hydrogels exhibited favorable antibacterial effects (against E.coli and S.aureus) such that nearly 100% of the bacteria were killed in liquid medium while cultivating with H4 (synthesized by 0.5 g PIL and 1g PVA). In addition, the cytotoxicity of PIL was significantly reduced through hydrogen bond crosslinking. H4 showed the highest antibacterial activity and a good biocompatibility. The results indicated that the PVA&PIL hydrogels had great potential for wound dressing.

A multifunctional hydrogel dressing loaded with antibiotics for healing of infected wound

Wound bacterial infections can significantly delay the healing process and even lead to fetal sepsis. There is a need for multifunctional dressings that possess antibacterial property, tissue adhesive property, self-healing capability, and biocompatibility to effectively treat bacteria-infected wound. In this study, we report a dual dynamically crosslinked hydrogel, OHA-PBA/PVA/Gen, which incorporates the antibiotic gentamicin (Gen) as a dynamic crosslinker. The hydrogel is formed through the formation of Schiff base bonds between phenylboronic acid-grafted oxidized hyaluronic acid (OHA-PBA) and Gen, as well as boronic acid ester bonds between OHA-PBA and polyvinyl alcohol (PVA). This unique composition imparts tissue adhesiveness, injectability and self-healing property to the hydrogel. The hydrogel also exhibits pH-responsive antibiotic release behavior due to the acid-responsive dissociation of Schiff base bonds. As a result, it demonstrates strong antibacterial activity against both Gram-positive bacteria S. aureus and Gram-negative bacteria E. coli through contact killing and diffusion killing mechanisms. Importantly, the OHA-PBA/PVA/Gen hydrogel avoids incorporation of toxic small molecular crosslinking agents, and all the components of the hydrogel are biocompatible, ensuring its biosafety. In a S. aureus-infected wound mouse model, this hydrogel effectively eradicated bacteria and promoted angiogenesis, leading to significantly accelerated wound healing. These results highlight the potential of the dual dynamically crosslinking hydrogel OHA-PBA/PVA/Gen as a multifunctional wound dressing for the treatment of bacteria-infected wound.

A review of polysaccharide hydrogels as materials for skin repair and wound dressing: Construction, functionalization and challenges

Hydrogels can imitate the extracellular matrix, therefore facilitating the creation of an ideal healing environment for wounds. Consequently, they are popular as a material choice for wound dressings. Polysaccharides have been widely used in wound dressings due to their good biocompatibility and degradability. In this study, we first discuss skin and wound physiology before summarizing the methods for producing hydrogels from polysaccharides and their derivatized. These include not just normal polysaccharides like chitosan, cellulose, and alginate, but also Chinese medicinal polysaccharides with therapeutic properties. Then, strategies for causing hydrogel production from polysaccharides or their derivatives are briefly explained. Finally, the functions of hydrogel dressings are reviewed, including antibacterial, antioxidant, and adhesive properties, as well as the methods for achieving these properties. Furthermore, current issues and concerns are discussed, with the goal of providing fresh paths for the development of future wound dressings.

Hemp Protein Isolate-Based Natural Thermal-Reversible Hydrogel as a Novel Wound Dressing Material

Hydrogels, due to their excellent microstructure and mechanical strength, have become a novel biomaterial in wound dressing. However, plant proteins have never been considered because of their poor original gelling performances and insufficient rheological properties. Here, we reported the fabrication of a plant protein-based thermal-reversible gel using a reverse micelle-extracted hemp protein isolate (HPI). A systematic study was conducted to fully reveal their microstructure, rheological properties, and anti-inflammatory effect to lay a foundation for this newly developed plant protein hydrogel as a potential natural wound dressing. By modulating protein concentration (4% HPI) and temperature (85 °C), a thermal-reversible HPI gel appeared as a filament structure with the major molecular driving force of hydrophobic interactions and hydrogen bonds. By characterizing the rheological properties, lower gel strength and wider linear viscoelastic regime were determined in the thermal-reversible HPI gel compared with a thermal-irreversible HPI gel. Besides, large amplitude oscillatory shear data identified the thermal-reversible gel as a soft gel which demonstrated intracycle strain stiffening and shear thinning behavior. Moreover, the thermal-reversible HPI gel is nontoxic and has benefits in neutrophil growth with injectability and perfect wound coverage. This study opens a novel means to form a natural thermal-reversible hydrogel that can be a new material source for wound dressing.

Bionic sulfated glycosaminoglycan-based hydrogel inspired by snail mucus promotes diabetic chronic wound healing via regulating macrophage polarization

The treatment of diabetic foot ulcers remains a significant challenge, as their morbidity is increasing while current therapies are expensive and often ineffective. The dried mucus from the snail Achatina fulica promotes diabetic wound healing. Herein, to develop a more controllable and stable wound dressing for diabetic wound treatment, the AFG/StarPEG hydrogel mimicking snail mucus was prepared by covalently coupling of sulfated glycosaminoglycan from A. fulica (AFG) with star-shaped polyethylene glycol (StarPEG) amine. The AFG/StarPEG hydrogel reduced excessive inflammation in wound tissues by decreasing pro-inflammatory cytokines (IL-6, IL-1β, and TNF-α) and increasing anti-inflammatory cytokines (IL-4 and IL-10). Moreover, it promoted the polarization of macrophages to M2 anti-inflammatory type in diabetic wound. By improving transition of diabetic chronic wound from inflammatory phase to proliferative phase, it promoted angiogenesis, collagen deposition and re-epithelialization, and thus tissue regeneration for wound healing. This work provides a convenient and effective dressing for treating chronic diabetic wound.

A review: Current trends and future perspectives of bacterial nanocellulose-based wound dressings

Bacterial cellulose (BC) has gained significant attention as a base material for wound dressings due to its superior physical properties, biocompatibility, and non-toxicity. However, to produce wound dressings that actively facilitate wound healing, BC modification is essential. To provide a comprehensive analysis of the potential research developments and the trends in bacterial cellulose-based wound dressings (BCWD), this review focuses on the BCWD research conducted in the last decade. The review highlights the optimization of BC usage as a base material for active wound dressing, including the incorporation of miscellaneous materials and the enhancement of BC properties such as ultra-transparency, anti-leakage, stretchability/flexibility, adhesiveness, conductivity, injectability, pattern, and pH-sensor ability.

Biopolymer hydrogels and synergistic blends for tailored wound healing

Biopolymers have a transformative role in wound repair due to their biocompatibility, ability to stimulate collagen production, and controlled drug and growth factor delivery. This article delves into the biological parameters critical to wound healing emphasizing how combinations of hydrogels with reparative properties can be strategically designed to create matrices that stimulate targeted cellular responses at the wound site to facilitate tissue repair and recovery. Beyond a detailed examination of various biopolymer types and their functionalities in wound dressings acknowledging that the optimal choice depends on the specific wound type and application, this evaluation provides concepts for developing synergistic biopolymer blends to create next-generation dressings with enhanced efficiencies. Furthermore, the incorporation of therapeutic agents such as medications and wound healing accelerators into dressings to enhance their efficacy is examined. These agents often possess desirable properties such as antibacterial activity, antioxidant effects, and the ability to promote collagen synthesis and tissue regeneration. Finally, recent advancements in conductive hydrogels are explored, highlighting their capabilities in treatment and real-time wound monitoring. This comprehensive resource emphasizes the importance of optimizing ingredient efficiency besides assisting researchers in selecting suitable materials for personalized wound dressings, ultimately leading to more sophisticated and effective wound management strategies.

The impact of copper nanoparticles surfactant on the structural and biological properties of chitosan/sodium alginate wound dressings

Multifunctional wound dressings based on hydrogels are an efficacious and practicable strategy in therapeutic processes and accelerated chronic wound healing. Here, copper (Cu) nanoparticles were added to chitosan/sodium alginate (CS/SA) hydrogels to improve the antibacterial properties of the prepared wound dressings. Due to the super-hydrophobicity of Cu nanoparticles, polyethylene glycol (PEG) was used as a surfactant, and then added to the CS/SA-based hydrogels. The CS/SA/Cu hydrogels were synthesized with 0, 2, 3.5, and 5 wt% Cu nanoparticles. The structural and morphological properties in presence of PEG were evaluated using Fourier-transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), and field emission scanning electron microscopy (FESEM). The biodegradation and swelling properties of the hydrogels were investigated in phosphate buffer saline (PBS) at 37 °C for up to 30 days. Cell viability and adhesion, as well as antibacterial behavior, were investigated via MTT assay, FESEM, and disk diffusion method, respectively. The obtained results showed that PEG provided new intra- and intermolecular bonds that affected significantly the hydrogels' degradation and swelling ratio, which increased up to ~1200 %. Cell viability reached ~110 % and all samples showed remarkable antibacterial behavior when CS/SA/Cu containing 2 wt% was introduced. This study provided new insights regarding the use of PEG as a surfactant for Cu nanoparticles in CS/SA hydrogel wound dressing, ultimately affecting the chemical bonding and various properties of the prepared hydrogels.

Hydrogel foam dressings with angiogenic and immunomodulatory factors from mesenchymal stem cells

Stem cell therapy and skin substitutes address the stalled healing of chronic wounds in order to promote wound closure; however, the high cost and regulatory hurdles of these treatments limit patient access. A low-cost method to induce bioactive healing has the potential to substantially improve patient care and prevent wound-induced limb loss. A previous study reported that bioactive factors derived from apoptotic-like mesenchymal stem cells (MSCs) demonstrated anti-inflammatory and proangiogenic effects and improved ischemic muscle regeneration. In this work, these MSC-derived bioactive factors were loaded into a hydrogel foam to harness immunomodulatory and angiogenic properties from MSC components to facilitate chronic wound healing without the high cost and translational challenges of cell therapies. After incorporation of bioactive factors, the hydrogel foam retained high absorbency, moisture retention, and target water vapor transmission rate. High loading efficiency was confirmed and release studies indicated that over 90% of loaded factors were released within 24 h. Ethylene oxide sterilization and 4-week storage did not affect the bioactive factor release profile or physical properties of the hydrogel foam dressing. Bioactivity retention of the released factors was also confirmed for as-sterilized, 4°C-stored, and -20°C-stored bioactive hydrogel foams as determined by relevant gene expression levels in treated pro-inflammatory (M1) macrophages. These results support the use of the bioactive dressings as an off-the-shelf product. Overall, this work reports a new method to achieve a first-line wound dressing with the potential to reduce persistent inflammation and promote angiogenesis in chronic wounds.

Highly Compressible, Superabsorbent, and Biocompatible Hybrid Cryogel Constructs Comprising Functionalized Chitosan and St. John's Wort Extract

Biobased porous hydrogels enriched with phytocompounds-rich herbal extracts have aroused great interest in recent years, especially in healthcare. In this study, new macroporous hybrid cryogel constructs comprising thiourea-containing chitosan (CSTU) derivative and a Hypericum perforatum L. extract (HYPE), commonly known as St John's wort, were prepared by a facile one-pot ice-templating strategy. Benefiting from the strong interactions between the functional groups of the CSTU matrix and those of polyphenols in HYPE, the hybrid cryogels possess excellent liquid absorption capacity, mechanical resilience, antioxidant performance, and a broad spectrum of antibacterial activity simultaneously. Thus, owing to their design, the hybrid constructs exhibit an interconnected porous architecture with the ability to absorb over 33 and 136 times their dry weight, respectively, when contacted with a phosphate buffer solution (pH 7.4) and an acidic aqueous solution (pH 2). These cryogel constructs have extremely high compressive strengths ranging from 839 to 1045 kPa and withstand elevated strains of over 70% without developing fractures. Moreover, the water-swollen hybrid cryogels with the highest HYPE content revealed a complete and instant shape recovery after uniaxial compression. The incorporation of HYPE into CSTU cryogels enabled substantial improvement in scavenging reactive oxygen species and an expanded antibacterial spectrum toward multiple pathogens, including Gram-positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis), Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa), and fungi (Candida albicans). Cell viability experiments demonstrated the cytocompatibility of the 3D cryogel constructs, which did not induce changes in the fibroblast morphology. This work showcases a simple and effective strategy to immobilize HYPE extracts on CSTU 3D networks, allowing the development of novel multifunctional platforms with promising potential in hemostasis, wound dressing, and dermal regeneration scaffolds.

A novel strategy to construct hydrogels with anti-swelling and water-retention abilities by covalent surface modification

Hydrogels have been widely used in various fields due to their diverse properties and flexible preparation methods. However, limited by the open network structure, hydrogels inevitably lose water in air or absorb water in aqueous solution, resulting in the loss of intrinsic functions, which severely hinders their practical applications. To address this issue, a general strategy was developed by subsequently modifying the surface of hydrogels with branched polyethyleneimine (PEI) and (3-(methacryloxy)propyl)trimethoxysilane (MPS) to covalently construct a dense cross-linked siloxane layer on the hydrogel surface. As a proof of concept, poly(2-(dimethylamino)ethyl methacrylate)/sodium alginate (PDMAEMA/SA) hydrogels were chosen as the model hydrogels to verify the feasibility of this strategy. The hydrogels adsorbed PEI to form amino-rich surfaces through hydrogen bonding, followed by covalently grafting MPS through rapid and catalyst-free mutual chemical reactions between acrylates and amine groups, as well as the hydrolysis of MPS. After modification, robust hydrophobic surfaces were successfully fabricated on the hydrophilic hydrogels. The modified hydrogels exhibited extraordinary anti-swelling and water-retention abilities. As the most typical intrinsic properties of hydrogels, the conductivity and sensing performance were well preserved. The strategy reported here provides a new insight into the construction of hydrogels with anti-swelling and water-retention abilities.

Synergistic potential of gellan gum methacrylate and keratin hydrogel for visceral hemostasis and skin tissue regeneration

In recent years, the development of biodegradable hydrogels as an alternative over the traditional wound dressing has become increasingly significant. These specific hydrogels are able to offer suitable microenvironments to further aid the process of tissue or organ regeneration. However, application of biodegradable hydrogels in clinical medicine remains uncommon due to most biodegradable hydrogels struggle with achieving satisfactory adhesiveness property, high mechanical support and cell compatibility simultaneously. In order to overcome these constraints and enhance the applicability of biodegradable hydrogels, methods have been employed in this study. By reacting gellan gum with methacrylic anhydride and incorporating a biodegradable protein, keratin, we endowed the hydrogels with high pliability via photo-polymerization chain extension, thereby obtaining a biodegradable hydrogel with exceptional properties. Through a series of in vitro tests, GGMA/keratin hydrogels exhibited great cell compatibility via providing an appropriate environment for cell proliferation. Furthermore, this hydrogel not only exhibits extraordinary adhesive ability on visceral tissues but also extends to scenarios involving skin or organ damage, offering valuable assistance in wound healing. Our design provides a suitable platform for cell proliferation and tissue regeneration, which shows prospects for future medical research and clinical applications.

Promoting the healing of infected diabetic wound by nanozyme-containing hydrogel with anti-bacterial inflammation suppressing, ROS-scavenging and oxygen-generating properties

Bacterial infections already pose a significant threat to skin wounds, especially in diabetic patients who have difficulty healing wounds. However, wound or bacterial infections are known to produce excess reactive oxygen species (ROS), and hypoxia may further hinder wound healing and the development of chronic wounds. In this study, a multifunctional hydrogel for ROS scavenging and bacterial inhibition was developed by cross-linking polyvinyl alcohol (PVA) and sodium alginate (SA) with graphene oxide (GO) loaded with silver-platinum hybrid nanoparticles (GO@Ag-Pt). The PVA/SA hydrogel loaded with GO@Ag-Pt exhibited the ability to scavenge different types of ROS, generate O2, and kill a broad spectrum of bacteria in vitro. The silver-platinum hybrid nanoparticles significantly increased the antibacterial ability against Escherichia coli and Staphylococcus aureus compared with silver nanoparticles (AgNps). GO@Ag-Pt loaded hydrogel was effective in treating infections caused by S.aureus, thereby significantly promoting wound healing during the inflammatory phase. Hydrogel therapy significantly reduced the level of ROS and alleviated inflammation levels. Notably, our ROS-scavenging, antibacterial hydrogels can be used to effectively treat various types of wounds, including difficult-to-heal diabetic wounds with bacterial infections. Thus, this study proposes an effective strategy for various chronic wound healing based on ROS clearance and bacteriostatic hydrogels.

Molecular immunological mechanisms of impaired wound healing in diabetic foot ulcers (DFU), current therapeutic strategies and future directions

Diabetic foot ulcer (DFU) is a foremost cause of amputation in diabetic patients. Consequences of DFU include infections, decline in limb function, hospitalization, amputation, and in severe cases, death. Immune cells including macrophages, regulatory T cells, fibroblasts and other damage repair cells work in sync for effective healing and in establishment of a healthy skin barrier post-injury. Immune dysregulation during the healing of wounds can result in wound chronicity. Hyperglycemic conditions in diabetic patients influence the pathophysiology of wounds by disrupting the immune system as well as promoting neuropathy and ischemic conditions, making them difficult to heal. Chronic wound microenvironment is characterized by increased expression of matrix metalloproteinases, reactive oxygen species as well as pro-inflammatory cytokines, resulting in persistent inflammation and delayed healing. Novel treatment modalities including growth factor therapies, nano formulations, microRNA based treatments and skin grafting approaches have significantly augmented treatment efficiency, demonstrating creditable efficacy in clinical practices. Advancements in local treatments as well as invasive methodologies, for instance formulated wound dressings, stem cell applications and immunomodulatory therapies have been successful in targeting the complex pathophysiology of chronic wounds. This review focuses on elucidating the intricacies of emerging physical and non-physical therapeutic interventions, delving into the realm of advanced wound care and comprehensively summarizing efficacy of evidence-based therapies for DFU currently available.

A comprehensive exploration of hydrogel applications in multi-stage skin wound healing

Hydrogels, as an emerging biomaterial, have found extensive use in the healing of wounds due to their distinctive physicochemical structure and functional properties. Moreover, hydrogels can be made to match a range of therapeutic requirements for materials used in wound healing through specific functional modifications. This review provides a step-by-step explanation of the processes involved in cutaneous wound healing, including hemostasis, inflammation, proliferation, and reconstitution, along with an investigation of the factors that impact these processes. Furthermore, a thorough analysis is conducted on the various stages of the wound healing process at which functional hydrogels are implemented, including hemostasis, anti-infection measures, encouraging regeneration, scar reduction, and wound monitoring. Next, the latest progress of multifunctional hydrogels for wound healing and the methods to achieve these functions are discussed in depth and categorized for elucidation. Finally, perspectives and challenges associated with the clinical applications of multifunctional hydrogels are discussed.

Review of Malaysian medicinal plants with potential wound healing activity

Wound is defined as the damage to biological tissues including skin, mucous membranes and organ tissues. The acute wound heals in less than 4 weeks without complications, while a chronic wound takes longer than 6 weeks to heal. Wound healing occurs in 4 phases, namely, coagulation, inflammatory, proliferative and remodeling phases. Triclosan and benzalkonium chloride are commonly used as skin disinfectants in wound healing. However, they cause allergic contact dermatitis and antibiotic resistance. Medicinal plants are widely studied due to the limited availability of wound healing agents. The present review included six commonly available medicinal plants in Malaysia such as Aloe barbadensis Miller, Carica papaya Linn., Centella asiatica Linn., Cymbopogon nardus Linn., Ficus benghalensis Linn. and Hibiscus rosa sinensis Linn. Various search engines and databases were used to obtain the scientific findings, including Google Scholar, ScienceDirect, PubMed Central and Research Gate. The review discussed the possible mechanism of action of medicinal plants and their active constituents in the wound healing process. In addition, their application in nanotechnology and wound dressings was also discussed in detail.

Characterization of Electrospinning Chitosan Nanofibers Used for Wound Dressing

Wound dressings play a crucial role in promoting wound healing by providing a protective barrier against infections and facilitating tissue regeneration. Electrospun nanofibers have emerged as promising materials for wound dressing applications due to their high surface area, porosity, and resemblance to the extracellular matrix. In this study, chitosan, a biocompatible and biodegradable polymer, was electrospun into nanofibers for potential use in wound dressing. The chitosan nanofibers were characterized by using various analytical techniques to assess their morphology and biocompatibility. Scanning electron microscopy (SEM) revealed the formation of uniform and bead-free nanofibers with diameters ranging from tens to hundreds of nanometers. Structural analysis, including Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD), elucidated the chemical composition and crystalline structure of the nanofibers. Furthermore, in vitro studies evaluated the cytocompatibility of the chitosan nanofibers with human dermal fibroblasts, demonstrating cell viability and proliferation on the nanofibers. Additionally, antibacterial properties were assessed to evaluate the potential of chitosan nanofibers in preventing wound infections. Overall, the characterization results highlight the promising attributes of electrospun chitosan nanofibers as wound dressings, paving the way for further investigation and development in the field of advanced wound care. This study has been carried out for the first time in our region and has assessed the antibacterial properties of electrospun chitosan nanofiber material. The created mat has shown efficaciousness against bacteria that are both gram-positive and gram-negative.

Polymer-Based Wound Dressings Loaded with Essential Oil for the Treatment of Wounds: A Review

Wound healing can result in complex problems, and discovering an effective method to improve the healing process is essential. Polymeric biomaterials have structures similar to those identified in the extracellular matrix of the tissue to be regenerated and also avoid chronic inflammation, and immunological reactions. To obtain smart and effective dressings, bioactive agents, such as essential oils, are also used to promote a wide range of biological properties, which can accelerate the healing process. Therefore, we intend to explore advances in the potential for applying hybrid materials in wound healing. For this, fifty scientific articles dated from 2010 to 2023 were investigated using the Web of Science, Scopus, Science Direct, and PubMed databases. The principles of the healing process, use of polymers, type and properties of essential oils and processing techniques, and characteristics of dressings were identified. Thus, the plants Syzygium romanticum or Eugenia caryophyllata, Origanum vulgare, and Cinnamomum zeylanicum present prospects for application in clinical trials due to their proven effects on wound healing and reducing the incidence of inflammatory cells in the site of injury. The antimicrobial effect of essential oils is mainly due to polyphenols and terpenes such as eugenol, cinnamaldehyde, carvacrol, and thymol.

Gram-negative bacteria recognition and photodynamic elimination by Zn-DPA based sensitizers

The abuse and overuse of antibiotics let drug-resistant bacteria emerges. Antibacterial photodynamic therapy (APDT) has shown outstanding merits to eliminate the drug-resistant bacteria via cytotoxic reactive oxygen species produced by irradiating photosensitizer. However, most of photosensitizers are not effective for Gram-negative bacteria elimination. Herein conjugates of NBS, a photosensitizer, linked with one (NBS-DPA-Zn) or two (NBS-2DPA-Zn) equivalents of zinc-dipicolylamine (Zn-DPA) have been designed to achieve the functional recognition of different bacteria. Due to the cationic character of NBS and metal transfer channel effect of Zn-DPA, NBS-DPA-Zn exhibited the first regent to distinguish P. aeruginosa from other Gram-negative bacteria. Whereas NBS-2DPA-Zn showed broad-spectrum antibacterial effect because the two arm of double Zn-DPA enhanced interactions with anionic membranes of bacteria, led the bacteria aggregation and thus provided the efficacy of APDT to bacteria and corresponding biofilm. In combination with a hydrogel of Pluronic, NBS-2DPA-Zn@gel shows promising clinical application in mixed bacterial diabetic mouse model infection. This might propose a new method that can realize functional identification and elimination of bacteria through intelligent regulation of Zn-DPA, and shows excellent potential for antibacterial application.

Cryogel wound dressings based on natural polysaccharides perfectly adhere to irregular wounds for rapid haemostasis and easy disassembly

Skin injuries can have unexpected surfaces, leading to uneven wound surfaces and inadequate dressing contact with these irregular surfaces. This can decrease the dressing's haemostatic action and increase the healing period. This study recommends the use of sticky and flexible cryogel coverings to promote faster haemostasis and efficiently handle uneven skin wounds. Alginate cryogels have a fast haemostatic effect and shape flexibility due to their macroporous structure. The material demonstrates potent antibacterial characteristics and enhances skin adherence by adding grafted chitosan with gallic acid. In irregular defect wound models, cryogels can cling closely to uneven damage surfaces due to their amorphous nature. Furthermore, their macroporous structure allows for quick haemostasis by quickly absorbing blood and wound exudate. After giving the dressing a thorough rinse, its adhesive strength reduces and it is simple to remove without causing any damage to the wound. Cryogel demonstrated faster haemostasis than gauze in a wound model on a rat tail, indicating that it has considerable potential for use as a wound dressing in the biomedical area.

Antimicrobial Hydrogels Based on Cationic Curdlan Derivatives for Biomedical Applications

Hydrogels based on biocompatible polysaccharides with biological activity that can slowly release an active principle at the wound site represent promising alternatives to traditional wound dressing materials. In this respect, new hydrogels based on curdlan derivative with 2-hydroxypropyl dimethyl octyl ammonium groups (QCurd) and native curdlan (Curd) were obtained at room temperature by covalent cross-linking using a diepoxy cross-linking agent. The chemical structure of the QCurd/Curd hydrogels was investigated by Fourier transform infrared spectroscopy (FTIR) spectroscopy. Scanning electron microscopy (SEM) revealed well-defined regulated pores with an average diameter between 50 and 75 μm, and hydrophobic micro-domains of about 5 μm on the pore walls. The high swelling rate (21-24 gwater/ghydrogel) and low elastic modulus values (7-14 kPa) make them ideal for medical applications as wound dressings. To evaluate the possible use of the curdlan-based hydrogels as active dressings, the loading capacity and release kinetics of diclofenac, taken as a model drug, were studied under simulated physiological skin conditions. Several mathematical models have been applied to evaluate drug transport processes and to calculate the diffusion coefficients. The prepared QCurd/Curd hydrogels were found to have good antibacterial properties, showing a bacteriostatic effect after 48 h against S. aureus, MRSA, E. coli, and P. aeruginosa. The retarded drug delivery and antimicrobial properties of the new hydrogels support our hypothesis that they are candidates for the manufacture of wound dressings.

Self-Healing Guar Gum-Based Nanocomposite Hydrogel Promotes Infected Wound Healing through Photothermal Antibacterial Therapy

Preventing bacterial infections is a crucial aspect of wound healing. There is an urgent need for multifunctional biomaterials without antibiotics to promote wound healing. In this study, we fabricated a guar gum (GG)-based nanocomposite hydrogel, termed GBTF, which exhibited photothermal antibacterial therapy for infected wound healing. The GBTF hydrogel formed a cross-linked network through dynamic borate/diol interactions between GG and borax, thereby exhibiting simultaneously self-healing, adaptable, and injectable properties. Additionally, tannic acid (TA)/Fe3+ nanocomplexes (NCs) were incorporated into the hydrogel to confer photothermal antibacterial properties. Under the irradiation of an 808 nm near-infrared laser, the TA/Fe3+ NCs in the hydrogel could rapidly generate heat, leading to the disruption of bacterial cell membranes and subsequent bacterial eradication. Furthermore, the hydrogels exhibited good cytocompatibility and hemocompatibility, making them a precandidate for preclinical and clinical applications. Finally, they could significantly promote bacteria-infected wound healing by reducing bacterial viability, accelerating collagen deposition, and promoting epithelial remodeling. Therefore, the multifunctional GBTF hydrogel, which was composed entirely of natural substances including guar gum, borax, and polyphenol/ferric ion NCs, showed great potential for regenerating infected skin wounds in clinical applications.

Dissolvable Immunomodulatory Microneedles for Treatment of Skin Wounds

Sustained inflammation can halt or delay wound healing, and macrophages play a central role in wound healing. Inflammatory macrophages are responsible for the removal of pathogens, debris, and neutrophils, while anti-inflammatory macrophages stimulate various regenerative processes. Recombinant human Proteoglycan 4 (rhPRG4) is shown to modulate macrophage polarization and to prevent fibrosis and scarring in ear wound healing. Here, dissolvable microneedle arrays (MNAs) carrying rhPRG4 are engineered for the treatment of skin wounds. The in vitro experiments suggest that rhPRG4 modulates the inflammatory function of bone marrow-derived macrophages. Degradable and detachable microneedles are developed from gelatin methacryloyl (GelMA) attach to a dissolvable gelatin backing. The developed MNAs are able to deliver a high dose of rhPRG4 through the dissolution of the gelatin backing post-injury, while the GelMA microneedles sustain rhPRG4 bioavailability over the course of treatment. In vivo results in a murine model of full-thickness wounds with impaired healing confirm a decrease in inflammatory biomarkers such as TNF-α and IL-6, and an increase in angiogenesis and collagen deposition. Collectively, these results demonstrate rhPRG4-incorporating MNA is a promising platform in skin wound healing applications.

An Injectable, Self-Healing, Adhesive Multifunctional Hydrogel Promotes Bacteria-Infected Wound Healing

Bacterial infections have a serious impact on public health. It is urgent to develop antibacterial hydrogels with good biocompatibility to reduce the use of antibiotics. In this study, poly(lipoic acid-co-sodium lipoate)-phytic acid (P(LA-SL)-PA) hydrogels are prepared by a simple mixture of the natural small molecules lipoic acid (LA) and phytic acid (PA) in a mild and green reaction environment. The crosslinking network is constructed through the connection of covalent disulfide bonds as well as the hydrogen bonds, which endow the injectable and self-healing properties. The P(LA-SL)-PA hydrogels exhibit an adjustable compression modulus and adhesion. The in vitro agar plates assay indicates that the antibacterial rate of hydrogels against Escherichia coli and Staphylococcus aureus is close to 95%. In the rat-infected wound model, the P(LA-SL)-PA hydrogels adhere closely to the tissue and promote epithelialization and collagen deposition with a significant effect on wound healing. These results prove that the P(LA-SL)-PA hydrogels could act as effective wound dressings for promoting the healing of infected wounds.

Evaluating physiochemical characteristics of tragacanth gum-gelatin network hydrogels designed through graft copolymerization technique

The present work deals with the evaluation of the physiochemical and biomedical properties of hydrogels derived from copolymerization of tragacanth gum (TG) and gelatin for use in drug delivery (DD) applications. Copolymers were characterized by field emission-scanning electron micrographs (FE-SEM), electron dispersion X-ray analysis (EDAX), Fourier transform infrared spectroscopy (FTIR), 13C-nuclear magnetic resonance (NMR), thermo-gravimetric analysis (TGA), differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analysis. FE-SEM revealed heterogeneous morphology and XRD analysis demonstrated an amorphous nature with short range pattern of polymer chains within the copolymers. The release of the drug ofloxacin occurred through a non-Fickian diffusion mechanism and the release profile was best described by the Korsmeyer-Peppas kinetic model. The hydrogels exhibited blood compatibility and demonstrated a thrombogenicity value of 75.63 ± 1.98 % during polymer-blood interactions. Polymers revealed mucoadhesive character during polymer-mucous membrane interactions and required 119 ± 8.54 mN detachment forces to detach from the biological membrane. The copolymers illustrated the antioxidant properties as evidenced by 2, 2'-diphenylpicrylhydrazyl (DPPH) assay which demonstrated a 65.71 ± 3.68 % free radical inhibition. Swelling properties analysis demonstrated that by change in monomer and cross linker content during the reaction increased the crosslinking of the network. These results suggest that the pore size of network hydrogels could be controlled as per the requirement of DD systems. The copolymers were prepared at optimized reaction conditions using 14.54 × 10-1 molL-1 of acrylic acid monomer and 25.0 × 10-3 molL-1 of crosslinker NNMBA. The optimized hydrogels exhibited a crosslink density of 2.227 × 10-4 molcm-3 and a mesh size of 7.966 nm. Additionally, the molecular weight between two neighboring crosslinks in the hydrogels was determined to be 5332.209 gmol-1.The results indicated that the combination of protein-polysaccharide has led to the development of hydrogels suitable for potential applications in sustained drug delivery.

Preparation of carboxymethyl chitosan/double-formaldehyde cellulose based hydrogel loaded with ginger essential oil nanoemulsion for meat preservation

An antibacterial nano-hydrogel (ginger essential oil nanoemulsion hydrogel, GEONH) based on Schiff base reaction was prepared using double-formaldehyde micro fibrillated cellulose (DAMFC) and carboxymethyl chitosan (CMCS) loaded with ginger essential oil nanoemulsion (GEON). It was found that when the mass ratio of DAMFC/CMCS/GEON was 1/9/270, the gel time, the water absorbency, gel strength, and morphology were the best. The results of X-ray diffraction and FT-IR confirmed that the aldehyde group on the DAMFC molecular chain formed a stable chemical crosslinking with the amino group on the CMCS molecular chain, resulting in a change in the crystal structure. GEONH showed excellent bactericidal activity against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Simultaneously, the prepared GEONH decreased the total viable count, Malondialdehyde, and total sulfhydryl content and improved the taste in the storage of boiled salted duck. Therefore, GEONH film is a promising fresh-keeping packaging for storing meat products.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10068-023-01437-4.

Characterization, Biocompatibility and Antioxidant Activity of Hydrogels Containing Propolis Extract as an Alternative Treatment in Wound Healing

Hydrogels consist of a network of highly porous polymeric chains with the potential for use as a wound dressing. Propolis is a natural product with several biological properties including anti-inflammatory, antibacterial and antioxidant activities. This study was aimed at synthesizing and characterizing a polyacrylamide/methylcellulose hydrogel containing propolis as an active ingredient, to serve as a wound dressing alternative, for the treatment of skin lesions. The hydrogels were prepared using free radical polymerization, and were characterized using scanning electron microscopy, infrared spectroscopy, thermogravimetry, differential scanning calorimetry, swelling capacity, mechanical and rheological properties, UV-Vis spectroscopy, antioxidant activity by the DPPH, ABTS and FRAP assays and biocompatibility determined in Vero cells and J774 macrophages by the MTT assay. Hydrogels showed a porous and foliaceous structure with a well-defined network, a good ability to absorb water and aqueous solutions simulating body fluids as well as desirable mechanical properties and pseudoplastic behavior. In hydrogels containing 1.0 and 2.5% propolis, the contents of total polyphenols were 24.74 ± 1.71 mg GAE/g and 32.10 ± 1.01 mg GAE/g and those of total flavonoids 8.01 ± 0.99 mg QE/g and 13.81 ± 0.71 mg QE/g, respectively, in addition to good antioxidant activity determined with all three methods used. Therefore, hydrogels containing propolis extract, may serve as a promising alternative wound dressing for the treatment of skin lesions, due to their anti-oxidant properties, low cost and availability.

Skin-adhesive and self-healing diagnostic wound dressings for diabetic wound healing recording and electrophysiological signal monitoring

Performing efficient wound management is essential for infected diabetic wounds due to the complex pathology. Flexible electronics have been recognized as one of the promising solutions for wound management. Herein, a kind of skin-adhesive and self-healing flexible bioelectronic was developed, which could be employed as a diagnostic wound dressing to record diabetic wound healing and monitor electrophysiological signals of the patients. The flexible substrate of diagnostic wound dressings showed excellent tissue adhesive (to various substrates including biological samples), self-healing (fracture strength restores by 96%), and intrinsic antibacterial properties (antibacterial ratio >96% against multidrug-resistant bacteria). The diagnostic wound dressings could record the glucose level (1-30 mM), pH values (4-7), and body temperature (18.8-40.0 °C) around the infected diabetic wounds. Besides, the dressings could help optimize treatment strategies based on electrophysiological signals of patients monitored in real-time. This study contributes to developing flexible bioelectronics for the diagnosis and management of diabetic wounds.

Novel Photothermal Graphene-Based Hydrogels in Biomedical Applications

In the last decade, photothermal therapy (PTT) has attracted tremendous attention because it is non-invasive, shows high efficiency and antibacterial activity, and minimizes drug side effects. Previous studies demonstrated that PTT can effectively inhibit the growth of bacteria and promotes cell proliferation, accelerating wound healing and tissue regeneration. Among different NIR-responsive biomaterials, graphene-based hydrogels with photothermal properties are considered as the best candidates for biomedical applications, due to their excellent properties. This review summarizes the current advances in the development of innovative graphene-based hydrogels for PTT-based biomedical applications. Also, the information about photothermal properties and the potential applications of graphene-based hydrogels in biomedical therapies are provided. These findings provide a great potential for supporting their applications in photothermal biomedicine.

Advances in Hydrogel-Based Drug Delivery Systems

Hydrogels, with their distinctive three-dimensional networks of hydrophilic polymers, drive innovations across various biomedical applications. The ability of hydrogels to absorb and retain significant volumes of water, coupled with their structural integrity and responsiveness to environmental stimuli, renders them ideal for drug delivery, tissue engineering, and wound healing. This review delves into the classification of hydrogels based on cross-linking methods, providing insights into their synthesis, properties, and applications. We further discuss the recent advancements in hydrogel-based drug delivery systems, including oral, injectable, topical, and ocular approaches, highlighting their significance in enhancing therapeutic outcomes. Additionally, we address the challenges faced in the clinical translation of hydrogels and propose future directions for leveraging their potential in personalized medicine and regenerative healthcare solutions.

Progress in the Use of Hydrogels for Antioxidant Delivery in Skin Wounds

The skin is the largest organ of the body, and it acts as a protective barrier against external factors. Chronic wounds affect millions of people worldwide and are associated with significant morbidity and reduced quality of life. One of the main factors involved in delayed wound healing is oxidative injury, which is triggered by the overproduction of reactive oxygen species. Oxidative stress has been implicated in the pathogenesis of chronic wounds, where it is known to impair wound healing by causing damage to cellular components, delaying the inflammatory phase of healing, and inhibiting the formation of new blood vessels. Thereby, the treatment of chronic wounds requires a multidisciplinary approach that addresses the underlying causes of the wound, provides optimal wound care, and promotes wound healing. Among the promising approaches to taking care of chronic wounds, antioxidants are gaining interest since they offer multiple benefits related to skin health. Therefore, in this review, we will highlight the latest advances in the use of natural polymers with antioxidants to generate tissue regeneration microenvironments for skin wound healing.

A comprehensive review on the inherent and enhanced antifouling mechanisms of hydrogels and their applications

Biofouling remains a persistent challenge within the domains of biomedicine, tissue engineering, marine industry, and membrane separation processes. Multifunctional hydrogels have garnered substantial attention due to their complex three-dimensional architecture, hydrophilicity, biocompatibility, and flexibility. These hydrogels have shown notable advances across various engineering disciplines. The antifouling efficacy of hydrogels typically covers a range of strategies to mitigate or inhibit the adhesion of particulate matter, biological entities, or extraneous pollutants onto their external or internal surfaces. This review provides a comprehensive review of the antifouling properties and applications of hydrogels. We first focus on elucidating the fundamental principles for the inherent resistance of hydrogels to fouling. This is followed by a comprehensive investigation of the methods employed to enhance the antifouling properties enabled by the hydrogels' composition, network structure, conductivity, photothermal properties, release of reactive oxygen species (ROS), and incorporation of silicon and fluorine compounds. Additionally, we explore the emerging prospects of antifouling hydrogels to alleviate the severe challenges posed by surface contamination, membrane separation and wound dressings. The inclusion of detailed mechanistic insights and the judicious selection of antifouling hydrogels are geared toward identifying extant gaps that must be bridged to meet practical requisites while concurrently addressing long-term antifouling applications.

Exudate-Induced Gelatinizable Nanofiber Membrane with High Exudate Absorption and Super Bactericidal Capacity for Bacteria-Infected Wound Management

Invasion of bacteria and continuous oozing of exudate are significant causes of interference with the healing of infected wounds. Therefore, an exudate-induced gelatinizable and near-infrared (NIR)-responsive nanofiber membrane composed of polyvinyl alcohol (PVA), carboxymethyl chitosan (CMC), and Fe-doped phosphomolybdic acid (Fe-PMA) with exceptional exudate absorption capacity and potent bactericidal efficacy is developed and denoted as the PVA-FP-CMC membrane. After absorbing exudate, the fiber membrane can transform into a hydrogel membrane, forming coordination bonds between the Fe-PMA and CMC. The unique exudate-induced gelation process imparts the membrane with high exudate absorption and retention capability, and the formed hydrogel also traps the bacteria that thrive in the exudate. Moreover, it is discovered for the first time that the Fe-PMA exhibits an enhanced photothermal conversion capability and photocatalytic activity compared to the PMA. Therefore, the presence of Fe-PMA provides the membrane with a photothermal and photodynamic therapeutic effect for killing bacteria. The PVA-FP-CMC membrane is proven with a liquid absorption ratio of 520.7%, a light-heat conversion efficiency of 41.9%, high-level generation of hydroxyl radical (•OH) and singlet oxygen (1O2), and a bacterial killing ratio of 100% for S. aureus and 99.6% for E. coli. The treatment of infected wounds on the backs of rats further confirms the promotion of wound healing by the PVA-FP-CMC membrane with NIR irradiation. Overall, this novel functional dressing for the synergistic management of bacteria-infected wounds presents a promising therapeutic strategy for tissue repair and regeneration.

Bacteria-responsive programmed self-activating antibacterial hydrogel to remodel regeneration microenvironment for infected wound healing

There is still an urgent need to develop hydrogels with intelligent antibacterial ability to achieve on-demand treatment of infected wounds and accelerate wound healing by improving the regeneration microenvironment. We proposed a strategy of hydrogel wound dressing with bacteria-responsive self-activating antibacterial property and multiple nanozyme activities to remodel the regeneration microenvironment in order to significantly promote infected wound healing. Specifically, pH-responsive H2O2 self-supplying composite nanozyme (MSCO) and pH/enzyme-sensitive bacteria-responsive triblock micelles encapsulated with lactate oxidase (PPEL) were prepared and encapsulated in hydrogels composed of L-arginine-modified chitosan (CA) and phenylboronic acid-modified oxidized dextran (ODP) to form a cascade bacteria-responsive self-activating antibacterial composite hydrogel platform. The hydrogels respond to multifactorial changes of the bacterial metabolic microenvironment to achieve on-demand antibacterial and biofilm eradication through transformation of bacterial metabolites, and chemodynamic therapy enhanced by nanozyme activity in conjunction with self-driven nitric oxide (NO) release. The composite hydrogel showed 'self-diagnostic' treatment for changes in the wound microenvironment. Through self-activating antibacterial therapy in the infection stage to self-adaptive oxidative stress relief and angiogenesis in the post-infection stage, it promotes wound closure, accelerates wound collagen deposition and angiogenesis, and completely improves the microenvironment of infected wound regeneration, which provides a new method for the design of intelligent wound dressings.

A review of the current state of natural biomaterials in wound healing applications

Skin, the largest biological organ, consists of three main parts: the epidermis, dermis, and subcutaneous tissue. Wounds are abnormal wounds in various forms, such as lacerations, burns, chronic wounds, diabetic wounds, acute wounds, and fractures. The wound healing process is dynamic, complex, and lengthy in four stages involving cells, macrophages, and growth factors. Wound dressing refers to a substance that covers the surface of a wound to prevent infection and secondary damage. Biomaterials applied in wound management have advanced significantly. Natural biomaterials are increasingly used due to their advantages including biomimicry of ECM, convenient accessibility, and involvement in native wound healing. However, there are still limitations such as low mechanical properties and expensive extraction methods. Therefore, their combination with synthetic biomaterials and/or adding bioactive agents has become an option for researchers in this field. In the present study, the stages of natural wound healing and the effect of biomaterials on its direction, type, and level will be investigated. Then, different types of polysaccharides and proteins were selected as desirable natural biomaterials, polymers as synthetic biomaterials with variable and suitable properties, and bioactive agents as effective additives. In the following, the structure of selected biomaterials, their extraction and production methods, their participation in wound healing, and quality control techniques of biomaterials-based wound dressings will be discussed.

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.

MgO@polydopamine Nanoparticle-Loaded Photothermal Microneedle Patches Combined with Chitosan Gel Dressings for the Treatment of Infectious Wounds

As for wound drug delivery, microneedles (MNs) have attracted wide attention. However, while effective at increasing the depth of drug delivery, traditional MNs often have limited drug loads and have difficulty penetrating scabs on wounds. Herein, we develop a drug delivery system combining MgO@polydopamine (MgO@PDA) nanoparticle-loaded photothermal MN patches and chitosan (CS) gel to inhibit the formation of scabs and deliver sufficient drugs into deep tissue. When inserted into the wound, the MN system can keep the wound bed moist and weakly acidic to inhibit the formation of scabs and accelerate wound closure. The released MgO@PDA nanoparticles from both the tips and the backing layer, which immensely increase the drug load, continuously release Mg2+ in the moist, weakly acidic wound bed, promoting tissue migration and the formation of microvessels. MgO@PDA nanoparticles show excellent antibacterial activity under near-infrared irradiation synergized with the CS gel, and the PDA coating can also overcome the adverse effects of oxidative stress. Through in vitro and in vivo experiments, the MN system showed remarkable antibacterial, antioxidant, anti-inflammatory, and pro-angiogenic effects, indicating its potential in the treatment of infectious wounds.

Multifunctional Therapeutic Nanodiamond Hydrogels for Infected-Wound Healing and Cancer Therapy

Wound infection and tumor recurrence are the two main threats to cancer patients after surgery. Although researchers have developed new treatment systems to address the two significant challenges simultaneously, the potential side effects of the heavy-metal-ion-based treatment systems still severely limit their widespread application in therapy. In addition, the wounds from tumor removal compared with general operative wounds are more complex. The tumor wounds mainly exhibit more hemorrhage, larger trauma area, greater vulnerability to bacterial infection, and residual tumor cells. Therefore, a multifunctional treatment platform is urgently needed to integrate rapid hemostasis, sterilization, wound healing promotion, and antitumor functions. In this work, nanodiamonds (NDs), a material that has been well proven to have excellent biocompatibility, are added into a solution of acrylic-grafted chitosan (CEC) and oxidized hyaluronic acid (OHA) to construct a multifunctional treatment platform (CEC-OHA-NDs). The hydrogels exhibit rapid hemostasis, a wound-healing-promoting effect, excellent self-healing, and injectable abilities. Moreover, CEC-OHA-NDs can effectively eliminate bacteria and inhibit tumor proliferation by the warm photothermal effect of NDs under tissue-penetrable near-infrared laser irradiation (NIR) without cytotoxicity. Consequently, we adopt a simple and convenient strategy to construct a multifunctional treatment platform using carbon-based nanomaterials with excellent biocompatibility to promote the healing of infected wounds and to inhibit tumor cell proliferation simultaneously.

Tissue engineering applications of recombinant human collagen: a review of recent progress

With the rapid development of synthetic biology, recombinant human collagen has emerged as a cutting-edge biological material globally. Its innovative applications in the fields of material science and medicine have opened new horizons in biomedical research. Recombinant human collagen stands out as a highly promising biomaterial, playing a pivotal role in crucial areas such as wound healing, stroma regeneration, and orthopedics. However, realizing its full potential by efficiently delivering it for optimal therapeutic outcomes remains a formidable challenge. This review provides a comprehensive overview of the applications of recombinant human collagen in biomedical systems, focusing on resolving this crucial issue. Additionally, it encompasses the exploration of 3D printing technologies incorporating recombinant collagen to address some urgent clinical challenges in regenerative repair in the future. The primary aim of this review also is to spotlight the advancements in the realm of biomaterials utilizing recombinant collagen, with the intention of fostering additional innovation and making significant contributions to the enhancement of regenerative biomaterials, therapeutic methodologies, and overall patient outcomes.

Functional electrospun nanofibers: fabrication, properties, and applications in wound-healing process

Electrostatic spinning as a technique for producing nanoscale fibers has recently attracted increasing attention due to its simplicity, versatility, and loadability. Nanofibers prepared by electrostatic spinning have been widely studied, especially in biomedical applications, because of their high specific surface area, high porosity, easy size control, and easy surface functionalization. Wound healing is a highly complex and dynamic process that is a crucial step in the body's healing process to recover from tissue injury or other forms of damage. Single-component nanofibers are more or less limited in terms of structural properties and do not fully satisfy various needs of the materials. This review aims to provide an in-depth analysis of the literature on the use of electrostatically spun nanofibers to promote wound healing, to overview the infinite possibilities for researchers to tap into their biomedical applications through functional composite modification of nanofibers for advanced and multifunctional materials, and to propose directions and perspectives for future research.

Novel Injectable, Self-Healing, Long-Effective Bacteriostatic, and Healed-Promoting Hydrogel Wound Dressing and Controlled Drug Delivery Mechanisms

Multivalent ion cross-linking has been used to form hydrogels between sodium alginate (SA) and hyaluronic acid (HA) in previous studies. However, more stable and robust covalent cross-linking is rarely reported. Herein, we present a facile approach to fabricate a SA and HA hydrogel for wound dressings with injectable, good biocompatibility, and high ductility. HA was first reacted with ethylenediamine to graft an amino group. Then, it was cross-linked with oxidized SA with dialdehyde to form hydrogel networks. The dressing can effectively promote cell migration and wound healing. To increase the antibacterial property of the dressing, we successfully loaded tetracycline hydrochloride into the hydrogel as a model drug. The drug can be released slowly in the alkaline environment of chronic wounds, and the hydrogel releases drugs again in the more acidic environment with wound healing, achieving a long-term antibacterial effect. In addition, one-dimensional partial differential equations based on Fickian diffusion with time-varying diffusion coefficients and hydrogel thicknesses were used to model the entire complex drug release process and to predict drug release.

Multifunctional photothermally responsive hydrogel as an effective whole-process management platform to accelerate chronic diabetic wound healing

The management of chronic diabetic wounds is a complex issue that requires wound repair, regulation of inflammatory levels, and intervention to prevent bacterial infection. To address this issue, we developed a multifunctional photothermally responsive hydrogel (PAG-CuS) as an effective platform for managing the entire wound-healing process, including promoting wound healing, providing anti-inflammatory therapy, and performing photothermal sterilization. Constructed through copolymerization of acrylic acid (AA), methacrylic anhydride-modified gelatin (GelMA), and lipoic acid sodium (LAS) coated copper sulfide nanoparticles (CuS@LAS), PAG-CuS possessed a porous three-dimensional structure that promoted cell adhesion and had a substantial water-holding capacity. Additionally, the internal CuS@LAS not only conferred photothermal antibacterial properties to the hydrogel but also served as physical cross-linking agents, thus enhancing its mechanical strength. Under the NIR-induced photothermal effect, the porous hydrogel liberates CuS@LAS, and later CuS@LAS expels LAS via micelle deassembly to eliminate intracellular ROS. This results in the down-regulation of MMP-9 expression, promoting ECM production and facilitating wound healing. Meanwhile, the release of Cu2+ from PAG-CuS could enhance CD31 expression in endothelial cells, promoting microvessel formation, which is crucial for wound healing. In the diabetic wound model of GK rats, the PAG-CuS hydrogel reduced ROS levels, increased microvessel count, improved epithelialization, and enhanced wound healing. Therefore, this versatile photothermal hydrogel has the potential to be applied in sterilization, scavenging free radicals, and promoting angiogenesis, making it an effective and comprehensive solution to manage the challenges of diabetic wounds. STATEMENT OF SIGNIFICANCE: Assessment of functional recovery and timely adjustment of treatment strategy is critical in the management of chronic diabetic wounds. In this work, we prepared PAG-CuS composite hydrogels by integrating in situ reduction, chemical crosslinking, and nanoenhancement techniques. The near-infrared light-induced photothermal effect of PAG-CuS gel rapidly kills bacteria at the lesion site, and the generated heat simultaneously promotes the multilevel release of LAS from the gel, which could regulate the levels of ROS and MMP-9 to promote extracellular matrix formation. In addition, the Cu2+ released from the gel can promote the formation of blood vessels to improve blood oxygenation. Therefore, this project proposes a synergistic solution to realize the whole process of management to accelerate chronic diabetic wound healing.

Rapid Preparation of Highly Stretchable and Fast Self-Repairing Antibacterial Hydrogels for Promoting Hemostasis and Wound Healing

Hydrogel dressings have emerged as a vital resource in wound management, offering several advantages over conventional wound dressing materials. Their inherent biocompatibility, ability to replicate the native extracellular matrix, and capacity to provide an ideal environment for cell survival make them particularly valuable. Nevertheless, the mechanical properties of many hydrogel dressings are an area that warrants improvement, as it currently constrains their application range. This limitation is especially evident when skin wounds are addressed in highly active or easily scratched areas. In this study, we present the development of a highly stretchable self-repairing hydrogel by cross-linking poly(vinyl alcohol) (PVA) through dynamic boron ester bonds, coupled with the hydrogen bonding of carboxymethyl cellulose sodium (CMC) via an efficient one-pot method without adding any catalyst. This innovative PVA/CMC hydrogel exhibited remarkable antibacterial properties achieved through the incorporation of bergamot oil, which was dispersed in a β-cyclodextrin solution. The hydrogel's elongation at the point of rupture reached an impressive 1910%, and it was capable of rapid self-healing in just 3 min upon bonding. Additionally, the hydrogel demonstrated excellent hemostatic properties, effectively mitigating blood loss and exudation. In vivo wound models have shown that PVA/CMC significantly expedites wound healing by reducing bacterial infections, inflammatory responses, and blood loss and by promoting collagen deposition. In summary, this research provides crucial insights into its potential as an advanced wound dressing material, particularly well-suited for addressing wounds in places with frequent activities or easy scratches.

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

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

Hydrogels and Wound Healing: Current and Future Prospects

The care and rehabilitation of acute and chronic wounds have a significant social and economic impact on patients and global health. This burden is primarily due to the adverse effects of infections, prolonged recovery, and the associated treatment costs. Chronic wounds can be treated with a variety of approaches, which include surgery, negative pressure wound therapy, wound dressings, and hyperbaric oxygen therapy. However, each of these strategies has an array of limitations. The existing dry wound dressings lack functionality in promoting wound healing and exacerbating pain by adhering to the wound. Hydrogels, which are commonly polymer-based and swell in water, have been proposed as potential remedies due to their ability to provide a moist environment that facilitates wound healing. Their unique composition enables them to absorb wound exudates, exhibit shape adaptability, and be modified to incorporate active compounds such as growth factors and antibacterial compounds. This review provides an updated discussion of the leading natural and synthetic hydrogels utilized in wound healing, details the latest advancements in hydrogel technology, and explores alternate approaches in this field. Search engines Scopus, PubMed, Science Direct, and Web of Science were utilized to review the advances in hydrogel applications over the last fifteen years.

Current Advances in Wound Healing and Regenerative Medicine

Treating chronic wounds is a common and costly challenge worldwide. More advanced treatments are needed to improve wound healing and prevent severe complications such as infection and amputation. Like other medical fields, there have been advances in new technologies promoting wound healing potential. Regenerative medicine as a new method has aroused hope in treating chronic wounds. The technology improving wound healing includes using customizable matrices based on synthetic and natural polymers, different types of autologous and allogeneic cells at different differentiation phases, small molecules, peptides, and proteins as a growth factor, RNA interference, and gene therapy. In the last decade, various types of wound dressings have been designed. Emerging dressings include a variety of interactive/ bioactive dressings and tissue-engineering skin options. However, there is still no suitable and effective dressing to treat all chronic wounds. This article reviews different wounds and common treatments, advanced technologies and wound dressings, the advanced wound care market, and some interactive/bioactive wound dressings in the market.

Multifunctional biomaterial hydrogel loaded with antler blood peptide effectively promotes wound repair

Diabetes is an epidemic in contemporary society, which seriously affects people's health. Therefore, it is imperative to develop a multifunctional wound dressing that can expedite the healing of diabetic wounds. In this study, quaternized oxidized sodium alginate (QOSA) and carboxymethyl chitosan (CMCS) formed hydrogel through Schiff base reaction, and the composite hydrogel was prepared by adding the antioxidant activity of deer antler blood polypeptide (D). The hydrogel exhibits favorable attributes, including a high swelling ratio, biocompatibility, and noteworthy antioxidant, antibacterial, and hemostatic properties. Finally, it was used to evaluate its effectiveness in repairing diabetic wounds. Upon evaluation, this hydrogel can effectively promote diabetic wound healing. It facilitates cell proliferation at the wound site, mitigates inflammatory responses, and enhances the expression of growth factors at the wound site. This suggests that this hydrogel holds significant promise as an ideal candidate for advanced wound dressings.