Preparation of chitosan-collagen-alginate composite dressing and its promoting effects on wound healing

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.

The Efficacy of Ozonated Olive Oil in Crown Lengthening Procedures for Anterior Teeth: A Case Report

Ensuring the health of the gums and supporting structures (periodontium) is crucial during dental restoration procedures to achieve optimal function and appearance of the teeth. Understanding the anatomy, the impact of restorative materials, and their interaction with the periodontium is essential for successful treatment outcomes. Crown lengthening is a surgical procedure that involves the removal of gingiva and bone tissue to expose more of the tooth structure, thereby increasing the visible portion of the tooth (clinical crown height). To protect the wound from mechanical trauma and stability of the surgical site during the healing process, periodontal dressing can be applied after surgery. Ozone therapy has demonstrated its effectiveness in promoting the healing of various types of wounds, including chronic and difficult-to-heal wounds, as an antibacterial agent and in modulating the immune system. Thus, this study aimed to compare, evaluate, and assess the use of periodontal dressing with that of ozonated olive oil after the crown lengthening procedure.

Fabrication and Biomedical Application of Alginate Composite Hydrogels in Bone Tissue Engineering: A Review

Nowadays, as a result of the frequent occurrence of accidental injuries and traumas such as bone damage, the number of people causing bone injuries or fractures is increasing around the world. The design and fabrication of ideal bone tissue engineering (BTE) materials have become a research hotspot in the scientific community, and thus provide a novel path for the treatment of bone diseases. Among the materials used to construct scaffolds in BTE, including metals, bioceramics, bioglasses, biomacromolecules, synthetic organic polymers, etc., natural biopolymers have more advantages against them because they can interact with cells well, causing natural polymers to be widely studied and applied in the field of BTE. In particular, alginate has the advantages of excellent biocompatibility, good biodegradability, non-immunogenicity, non-toxicity, wide sources, low price, and easy gelation, enabling itself to be widely used as a biomaterial. However, pure alginate hydrogel as a BTE scaffold material still has many shortcomings, such as insufficient mechanical properties, easy disintegration of materials in physiological environments, and lack of cell-specific recognition sites, which severely limits its clinical application in BTE. In order to overcome the defects of single alginate hydrogels, researchers prepared alginate composite hydrogels by adding one or more materials to the alginate matrix in a certain proportion to improve their bioapplicability. For this reason, this review will introduce in detail the methods for constructing alginate composite hydrogels, including alginate/polymer composite hydrogels, alginate/bioprotein or polypeptide composite hydrogels, alginate/bioceramic composite hydrogels, alginate/bioceramic composite hydrogels, and alginate/nanoclay composite hydrogels, as well as their biological application trends in BTE scaffold materials, and look forward to their future research direction. These alginate composite hydrogel scaffolds exhibit both unexceptionable mechanical and biochemical properties, which exhibit their high application value in bone tissue repair and regeneration, thus providing a theoretical basis for the development and sustainable application of alginate-based functional biomedical materials.

Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies

Diabetic foot ulcer (DFU) is one of the most costly and serious complications of diabetes. Treatment of DFU is usually challenging and new approaches are required to improve the therapeutic efficiencies. This review aims to update new and upcoming adjunctive therapies with noninvasive characterization for DFU, focusing on bioactive dressings, bioengineered tissues, mesenchymal stem cell (MSC) based therapy, platelet and cytokine-based therapy, topical oxygen therapy, and some repurposed drugs such as hypoglycemic agents, blood pressure medications, phenytoin, vitamins, and magnesium. Although the mentioned therapies may contribute to the improvement of DFU to a certain extent, most of the evidence come from clinical trials with small sample size and inconsistent selections of DFU patients. Further studies with high design quality and adequate sample sizes are necessitated. In addition, no single approach would completely correct the complex pathogenesis of DFU. Reasonable selection and combination of these techniques should be considered.

How the combination of alginate and chitosan can fabricate a hydrogel with favorable properties for wound healing

Wound management has always been a significant concern, particularly for men, and the search for effective wound dressings has led to the emergence of hydrogels as a promising solution. In recent years, hydrogels, with their unique properties, have gained considerable importance in wound management. Among the various types of hydrogels, those incorporating chitosan and alginate, two distinct chemical materials, have shown potential in accelerating wound healing. This review aims to discuss the desirable characteristics of an effective wound dressing, explore the alginate/chitosan-based hydrogels developed by different researchers, and analyze their effects on wound healing through in vitro and in vivo assessments. In vitro tests encompass a wide range of evaluations, including swelling capacity, degradation rate, porosity, Fourier Transform Infrared Spectroscopy, X-ray diffraction analysis, moisture vapor transmission rate, release studies, mechanical properties, microscopic observation, antibacterial properties, compatibility assessment, cell adhesion investigation, blood clotting capability, cell migration analysis, water contact angle determination, and structural stability. Furthermore, in vivo assessments encompass the examination of wound closure rate, modulation of gene expression, as well as histopathological and immunohistochemical studies.

Poly (vinyl alcohol)/sodium alginate/carboxymethyl chitosan multifunctional hydrogel loading HKUST-1 nanoenzymes for diabetic wound healing

Bacterial infection, hyperinflammation and hypoxia, which can lead to amputation in severe cases, are frequently observed in diabetic wounds, and this has been a critical issue facing the repair of chronic skin injuries. In this study, a copper-based MOF (TAX@HKUST-1) highly loaded with taxifolin (TAX) with a drug loading of 41.94 ± 2.60 % was prepared. In addition, it has excellent catalase activity, and by constructing an oxygen-releasing hydrogel (PTH) system with calcium peroxide (CaO2), it can be used as a nano-enzyme to promote the generation of oxygen from hydrogen peroxide (H2O2) to provide sufficient oxygen to the wound, and at the same time, solve the problem of the oxidative stress damage caused by excess H2O2 to the cells during the oxygen-releasing process. On the other hand, TAX and HKUST-1 in PTH synergistically promoted antimicrobial and anti-oxidative stress properties, and the bacterial inhibition rate against Staphylococcus aureus and Escherichia coli reached 90 %. In vivo experiments have shown that PTH hydrogel is able to treat diabetic skin repair by inhibiting the expression of inflammation-related proteins and promoting epidermal neogenesis, angiogenesis and collagen deposition.

3D-Printed Alginate/Pectin-Based Patches Loaded with Olive Leaf Extracts for Wound Healing Applications: Development, Characterization and In Vitro Evaluation of Biological Properties

Traditional wound dressings may lack suitability for diverse wound types and individual patient requirements. In this context, this study aimed to innovate wound care by developing a 3D-printed patch using alginate and pectin and incorporating Olive Leaf Extract (OLE) as an active ingredient. Different polymer-to-plasticizer ratios were systematically examined to formulate a printable ink with optimal viscosity. The resultant film, enriched with OLE, exhibited a substantial polyphenolic content of 13.15 ± 0.41 mg CAE/g, showcasing significant antioxidant and anti-inflammatory properties. Notably, the film demonstrated potent scavenging abilities against DPPH, ABTS, and NO radicals, with IC50 values of 0.66 ± 0.07, 0.47 ± 0.04, and 2.02 ± 0.14 mg/mL, respectively. In vitro release and diffusion studies were carried out and the release profiles revealed an almost complete release of polyphenols from the patch within 48 h. Additionally, the fabricated film exhibited the capacity to enhance cell motility and accelerate wound healing, evidenced by increased collagen I expression in BJ fibroblast cells. Structural assessments affirmed the ability of the patch to absorb exudates and maintain the optimal moisture balance, while biocompatibility studies underscored its suitability for biomedical applications. These compelling findings endorse the potential application of the developed film in advanced wound care, with the prospect of tailoring patches to individual patient needs.

Hemostatic and antibacterial calcium-copper zeolite gauze for infected wound healing

The design and development of wound dressings with excellent procoagulant and antibacterial activity to achieve high wound healing effectiveness are highly desirable in clinical applications. In this work, we develop a calcium-copper zeolite gauze (CaCu-ZG) by a two-step process involving calcium and copper ion exchange in a zeolite gauze. The CaCu-ZG exhibits remarkable procoagulant and antibacterial abilities, as well as good biocompatibility. Compared with the medical gauze, the blood clotting time of CaCu-ZG significantly decreases and the antibacterial activity increases in both in vivo and in vitro experiments. The remarkable ability of wound healing has been verified using a mouse dorsal skin-infected wound model, demonstrating its great potential for wound treatment in clinical applications.

Recent progress in polysaccharide and polypeptide based modern moisture-retentive wound dressings

Wounds were considered as defects in the tissues of the human skin and wound healing is said to be a tedious process as there are possibilities of infection or inflammation due to microorganisms. Modern moisture-retentive wound dressing (MMRWD) is opening a new window toward wound therapy. It comprises different types of wound dressing that has classified based on their functionality. Selective polysaccharide-polypeptide fiber composite materials such as hydrogels, hydrocolloids, hydro fibers, transparent-film dressing, and alginate dressing are discussed in this review as a type of MMRWD. The highlight of this polysaccharide and polypeptide based MMRWD is that it supports and enhances the healing of different types of wounds by moisture absorption thus preventing infection. This study has given enlightenment on the application of selected polysaccharide and polypeptide based MMRWD that enhances wound healing actions still it has been observed that the composite wound healing dressing is more effective than the single one. The nano-sized materials (synthetic nano drugs and phyto drugs) were found to increase the efficiency of healing action while coated in the wound dressing material. Future research is required to find out more possibilities of the different composite types of wound dressing in the healing action.

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

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

Physicochemical properties and cell proliferation and adhesive bioactivity of collagen-hyaluronate composite gradient membrane

Membrane materials were widely used in guided tissue regeneration (GTR) to prevent fibroblast invasion and form a confined area for preferentially growing of osteoblast. A novel collagen-hyaluronate composite gradient membrane was prepared by Tilapia (Oreochromis mossambicus) skin collagen and sodium hyaluronate for potential GTR applications and their bioactivities were investigated by cellular viability. SEM results indicated the membrane showed a dense outer and a porous inner surface for effectively guiding the growth of bone tissue. Physicochemical and biosafety experiments showed the tensile strength of membrane was 466.57 ± 44.31 KPa and contact angle was 74.11°, and the membrane showed perfect biocompatibility and cytocompatibility as well, which met the requirements of GTR material. Cell morphology revealed that the membrane could facilitate the adherence and proliferation of fibroblast and osteoblast. The results of qRT-PCR and ELISA demonstrated that the membrane could effectively activate TGF-β/Smad pathway in fibroblast, and promote the expressions of TGF-β1, FN1 and VEGF. Remarkably, RUNX2 was stimulated in BMP2 pathway by the membrane to regulate osteoblast differentiation. In summary, the collagen-hyaluronate composite gradient membrane not only fulfills the prerequisites for use as a GTR material but also demonstrates substantial potential for practical applications in the field.

Bioinspired Collagen/Hyaluronic Acid/Fibrin-Based Hydrogels for Soft Tissue Engineering: Design, Synthesis, and In Vitro Characterization

A major challenge for future drug development comprises finding alternative models for drug screening. The use of animal models in research is highly controversial, with an ongoing debate on their ethical acceptability. Also, animal models are often poorly predictive of therapeutic outcomes due to the differences between animal and human physiological environments. In this study, we aimed to develop a biomimetic hydrogel that replicates the composition of skin for potential use in in vitro modeling within tissue engineering. The hydrogel was fabricated through the crosslinking of collagen type I, hyaluronic acid, four-arm PEG succinimidyl glutarate (4S-StarPEG), and fibrinogen. Various ratios of these components were systematically optimized to achieve a well-interconnected porosity and desirable rheological properties. To evaluate the hydrogel's cytocompatibility, fibroblasts were embedded within the matrix. The resulting hydrogel exhibited promising properties as a scaffold, also facilitating the growth of and proliferation of the cells. This biomimetic hydrogel holds great potential for tissue engineering applications, particularly in skin regeneration and cancer research. The study used melanoma spheroids fabricated using the 96-round bottom well plate method as a potential application. The results demonstrate that the developed hydrogels allowed the maintenance of spheroid integrity and viability, meaning it has a promising use as a three-dimensional in vitro model of melanoma for both tissue engineering and drug screening applications.

Preparation of Enzyme-Soluble Swim Bladder Collagen from Sea Eel (Muraenesox cinereus) and Evaluation Its Wound Healing Capacity

In the present research, the enzyme-facilitated collagen from sea eel (Muraenesox cinereus) swim bladder was isolated, and the collagen characteristics were analyzed. Then, the collagen sponge was prepared and its potential mechanism in promoting skin wound healing in mice was further investigated. Collagen was obtained from the swim bladder of sea eels employing the pepsin extraction technique. Single-factor experiments served as the basis for the response surface method (RSM) to optimize pepsin concentration, solid-liquid ratio, and hydrolysis period. With a pepsin concentration of 2067 U/g, a solid-liquid ratio of 1:83 g/mL, and a hydrolysis period of 10 h, collagen extraction achieved a yield of 93.76%. The physicochemical analysis revealed that the extracted collagen belonged to type I collagen, and the collagen sponge displayed a fibrous structure under electron microscopy. Furthermore, in comparison to the control group, mice treated with collagen sponge dressing exhibited elevated activities of superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (T-AOC), and glutathione peroxidase (GSH-Px), and decreased levels of malondialdehyde (MDA), interleukin (IL)-1β, interleukin (IL)-6, and tumor necrosis factor (TNF)-α. The collagen sponge dressing effectively alleviated inflammation in the wound area, facilitating efficient repair and rapid healing of the skin tissue. During the initial phase of wound healing, the group treated with collagen sponge dressing exhibited an enhancement in the expressions of cluster of differentiation (CD)31, epidermal growth factor (EGF), transforming growth factor (TGF)-β1, and type I collagen, leading to an accelerated rate of wound healing. In addition, this collagen sponge dressing could also downregulate the expressions of CD31, EGF, and type I collagen to prevent scar formation in the later stage. Moreover, this collagen treatment minimized oxidative damage and inflammation during skin wound healing and facilitated blood vessel formation in the wound. Consequently, it exhibits significant potential as an ideal material for the development of a skin wound dressing.

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

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

Alginate: Microbial production, functionalization, and biomedical applications

Alginates are natural polysaccharides widely participating in food, pharmaceutical, and environmental applications due to their excellent gelling capacity. Their excellent biocompatibility and biodegradability further extend their application to biomedical fields. The low consistency in molecular weight and composition of algae-based alginates may limit their performance in advanced biomedical applications. It makes microbial alginate production more attractive due to its potential for customizing alginate molecules with stable characteristics. Production costs remain the primary factor limiting the commercialization of microbial alginates. However, carbon-rich wastes from sugar, dairy, and biodiesel industries may serve as potential substitutes for pure sugars for microbial alginate production to reduce substrate costs. Fermentation parameter control and genetic engineering strategies may further improve the production efficiency and customize the molecular composition of microbial alginates. To meet the specific needs of biomedical applications, alginates may need functionalization, such as functional group modifications and crosslinking treatments, to achieve enhanced mechanical properties and biochemical activities. The development of alginate-based composites incorporated with other polysaccharides, gelatin, and bioactive factors can integrate the advantages of each component to meet multiple requirements in wound healing, drug delivery, and tissue engineering applications. This review provided a comprehensive insight into the sustainable production of high-value microbial alginates. It also discussed recent advances in alginate modification strategies and alginate-based composites for representative biomedical applications.

A bio-polymeric scaffold incorporated with p-Coumaric acid enhances diabetic wound healing by modulating MMP-9 and TGF-β3 expression

Diabetic wounds lead to severe health complications as the tissue regeneration process fails predominantly due to prolonged inflammation, reactive oxygen species generation, and imbalance in collagen turnover. Modern wound dressings that can aid in wound management thus improving the public healthcare system, is the present need. This study aims to fabricate an effective wound dressing using plant polyphenol to treat chronic wounds as polyphenols possess excellent wound-healing ability. The collagen scaffold enriched with the polyphenol, p-Coumaric acid, was fabricated by freeze-drying method (Col-OxP3-Ca) and examined for its wound-healing ability by in vitro and in vivo analyses. Col-OxP3-Ca scaffold exhibited 85% antioxidant activity, biocompatibility in fibroblast cells, enhanced cell proliferation and migration rate. The diabetic excision wound treated with Col-OxP3-Ca scaffold healed within 21 days and a well-developed epidermis, blood vessels, hair follicle formation, fewer inflammatory cells and collagen deposition was observed in histological analysis. The immunohistochemical results depicted the enhanced expression of TGF-β3 and lessened expression of the MMP-9 in Col-OxP3-Ca scaffold treatment group. p-Coumaric acid shortened the inflammatory stage, enhanced angiogenesis, tissue regeneration and balanced collagen turnover during healing. From this, we can accomplish that the Col-OxP3-Ca wound dressing could be an outstanding alternative to treat chronic wounds.

A review on polysaccharides mediated electrospun nanofibers for diabetic wound healing: Their current status with regulatory perspective

The current treatment strategies for diabetic wound care provide only moderate degree of effectiveness; hence new and improved therapeutic techniques are in great demand. Diabetic wound healing is a complex physiological process that involves synchronisation of various biological events such as haemostasis, inflammation, and remodelling. Nanomaterials like polymeric nanofibers (NFs) offer a promising approach for the treatment of diabetic wounds and have emerged as viable options for wound management. Electrospinning is a powerful and cost-effective method to fabricate versatile NFs with a wide array of raw materials for different biological applications. The electrospun NFs have unique advantages in the development of wound dressings due to their high specific surface area and porosity. The electrospun NFs possess a unique porous structure and biological function similar to the natural extracellular matrix (ECM), and are known to accelerate wound healing. Compared to traditional dressings, the electrospun NFs are more effective in healing wounds owing to their distinct characteristics, good surface functionalisation, better biocompatibility and biodegradability. This review provides a comprehensive overview of the electrospinning procedure and its operating principle, with special emphasis on the role of electrospun NFs in the treatment of diabetic wounds. This review discusses the present techniques applied in the fabrication of NF dressings, and highlights the future prospects of electrospun NFs in medicinal applications.

Cell-based wound dressing: Bilayered PCL/gelatin nanofibers-alginate/collagen hydrogel scaffold loaded with mesenchymal stem cells

Wound dressing is applied to promote the healing process, wound protection, and additionally regeneration of injured skin. In this study, a bilayer scaffold composed of a hydrogel and nanofibers was fabricated to improve the regeneration of injured skin. To this end, polycaprolactone/gelatin (PCL/Gel) nanofibers were electrospun directly on the prepared collagen/alginate (Col/Alg) hydrogel. The bilayer scaffold was characterized by scanning electron microscopy (SEM), Fourier transform infrared (FTIR), mechanical properties, and swelling/degradation time. Cytotoxicity assays were evaluated using MTT assay. Then, the nanofiber and bilayer scaffolds were seeded with Adipose-derived stem cells (ADSCs). ADSCs were isolated from rat adipose tissue and analyzed using flow cytometry, in advance. Full-thickness wounds on the backs of rats were dressed with ADSCs-seeded bilayer scaffolds and nanofibers. Histopathological evaluations were performed after 14 and 21 days using H&E (hematoxylin and eosin) staining. The results indicated that re-epithelialization, angiogenesis, and collagen remodeling were enhanced in ADSCs-seeded bilayer scaffolds and nanofibers in comparison with the control group. In conclusion, the best re-epithelialization, collagen organization, neovascularization, and low presence of inflammation in the wound area were observed in the ADSCs-seeded bilayer scaffolds.

Antibacterial, wet adhesive, and healing-promoting nanosheets for the treatment of oral ulcers

The severe pain caused by oral ulcers seriously affects food intake and speech, bringing great inconvenience in daily life. Drug-loaded patches are mostly used to treat oral mucosal diseases such as oral ulcers and oral lichen planus, but their effects are limited because of the influences of saliva and muscle movement. To enhance the adhesion of drug-loaded patches used in the oral cavity, we designed antimicrobial peptides (AMPs)-modified polycaprolactone (PCL)-collagen nanosheets (APCNs). The internal layer is a bioactive and antibacterial collagen layer modified with antimicrobial peptides. The backing layer is a hydrophobic PCL layer with good mechanical strength that can reduce external influences. We have characterized and tested the APCNs. First, the APCNs exhibited continuous and strong adhesion to irregular buccal mucosa surfaces under wet conditions and external force action. Antibacterial experiments showed that the APCNs had high antibacterial activity against both Gram-positive bacteria and Gram-negative bacteria. Moreover, the APCNs showed good biocompatibility and promoted the adhesion of fibroblasts in vitro. Furthermore, APCNs treatment accelerated ulcer healing in a Sprague Dawley rat oral ulcer model. Our study developed antibacterial, wet-adhesive, and healing-promoting PCL-collagen nanosheets and demonstrated that these nanosheets could be promising adhesive therapeutic agents for the treatment of oral mucosal ulcers.

Effects of sericin and egg white on the inflammation of damaged skin in mice

Sericin and egg white (EW) have shown the ability to promote wound healing. However, there have been insufficient studies regarding the effects of sericin and EW mixtures on wound healing. This study aimed to investigate the effects of a hybrid sericin and EW solution on wound repair and inflammation-related indicators in mouse skin. In this work, sericin with a low molecular weight was first mixed with homogeneous EW to prepare a hybrid wound dressing. Histology evaluation, the expression of C-reactive protein (CRP) and inflammatory cytokines in mice were tested to determine the effects of this dressing on skin injuries in mice. The results showed that sericin and the hybrid solution of sericin and EW effectively promoted wound healing in mouse skin. The wound recovery rates of mice 12 days after treatment with a medium dose of sericin (0.2 g ml^-1) and the same dosage of sericin with added EW were 1.32 and 1.65 times that of mice treated with phosphate buffer saline as a control, respectively. In addition, the mixture solution was more effective in wound healing than sericin alone. Sericin with EW significantly reduced the expression of CRP and inflammatory cytokines in mice during wound healing. A sericin and EW hybrid solution can effectively shorten the time needed for wound healing and reduce inflammation-related indicators in mice, making it a promising candidate for wound dressing.

Microwave-Treated Physically Cross-Linked Sodium Alginate and Sodium Carboxymethyl Cellulose Blend Polymer Film for Open Incision Wound Healing in Diabetic Animals-A Novel Perspective for Skin Tissue Regeneration Application

This study aimed at developing the microwave-treated, physically cross-linked polymer blend film, optimizing the microwave treatment time, and testing for physicochemical attributes and wound healing potential in diabetic animals. Microwave-treated and untreated films were prepared by the solution casting method and characterized for various attributes required by a wound healing platform. The optimized formulation was tested for skin regeneration potential in the diabetes-induced open-incision animal model. The results indicated that the optimized polymer film formulation (MB-3) has significantly enhanced physicochemical properties such as high moisture adsorption (154.6 ± 4.23%), decreased the water vapor transmission rate (WVTR) value of (53.0 ± 2.8 g/m²/h) and water vapor permeability (WVP) value (1.74 ± 0.08 g mm/h/m²), delayed erosion (18.69 ± 4.74%), high water uptake, smooth and homogenous surface morphology, higher tensile strength (56.84 ± 1.19 MPa), and increased glass transition temperature and enthalpy (through polymer hydrophilic functional groups depicting efficient cross-linking). The in vivo data on day 16 of post-wounding indicated that the wound healing occurred faster with significantly increased percent re-epithelialization and enhanced collagen deposition with optimized MB-3 film application compared with the untreated group. The study concluded that the microwave-treated polymer blend films have sufficiently enhanced physical properties, making them an effective candidate for ameliorating the diabetic wound healing process and hastening skin tissue regeneration.

Chitosan Nanocomposites as Wound Healing Materials: Advances in Processing Techniques and Mechanical Properties

This review discusses the increasing potential of chitosan nanocomposites as viable materials capable of targeting these debilitating factors. This review focuses on various techniques used to process chitosan nanocomposites and their mechanical properties. Chitosan nanocomposites are regarded as highly effective antimicrobials for the treatment of chronic wounds. Chitosan nanocomposites, such as chitosan/polyethylene and oxide/silica/ciprofloxacin, demonstrate efficient antibacterial activity and exhibit no cytotoxicity against Human Foreskin Fibroblast Cell Lines (HFF2). Other studies have also showcased the capacity of chitosan nanocomposites to accelerate and improve tissue regeneration through increment in the number of fibroblast cells and angiogenesis and reduction of the inflammation phase. The layer-by-layer technique has benefits, ensuring its suitability in preparing chitosan nanocomposites for drug delivery and wound dressing applications. While the co-precipitation route requires a cross-linker to achieve stability during processing, the solution-casting route can produce stable chitosan nanocomposites without a cross-linker. By using the solution casting method, fillers such as multi-walled carbon nanotubes (MWCNTs) and halloysite nanotubes (HTs) can be uniformly distributed in the chitosan, leading to improved mechanical properties. The antibacterial effects can be achieved with the introduction of AgNPs or ZnO. With the increasing understanding of the biological mechanisms that control these diseases, there is an influx in the introduction of novel materials into the mainstream wound care market.

Effect of composite biodegradable biomaterials on wound healing in diabetes

The repair of diabetic wounds has always been a job that doctors could not tackle quickly in plastic surgery. To solve this problem, it has become an important direction to use biocompatible biodegradable biomaterials as scaffolds or dressing loaded with a variety of active substances or cells, to construct a wound repair system integrating materials, cells, and growth factors. In terms of wound healing, composite biodegradable biomaterials show strong biocompatibility and the ability to promote wound healing. This review describes the multifaceted integration of biomaterials with drugs, stem cells, and active agents. In wounds, stem cells and their secreted exosomes regulate immune responses and inflammation. They promote angiogenesis, accelerate skin cell proliferation and re-epithelialization, and regulate collagen remodeling that inhibits scar hyperplasia. In the process of continuous combination with new materials, a series of materials that can be well matched with active ingredients such as cells or drugs are derived for precise delivery and controlled release of drugs. The ultimate goal of material development is clinical transformation. At present, the types of materials for clinical application are still relatively single, and the bottleneck is that the functions of emerging materials have not yet reached a stable and effective degree. The development of biomaterials that can be further translated into clinical practice will become the focus of research.

Progress of Polysaccharide-Contained Polyurethanes for Biomedical Applications

Polyurethane (PU) has been widely examined and used for biomedical applications, such as catheters, blood oxygenators, stents, cardiac valves, drug delivery carriers, dialysis devices, wound dressings, adhesives, pacemaker, tissue engineering, and coatings for breast implants due to its mechanical flexibility, high tear strength, biocompatibility, and tailorable foams although bio-acceptability, biodegradability and controlled drug delivery to achieve the desired properties should be considered. Especially, during the last decade, the development of bio-based PUs has raised public awareness because of the concern with global plastic waste for creating more environmentally friended materials. Therefore, it is desirable to discuss polysaccharide (PS)-contained PU for the wound dressing and bone tissue engineering among bio-based PUs because PS has several advantages, such as biocompatibility, reproducibility from the natural resources, degradability, ease of incorporation of bioactive agents, ease of availability and cost-effectiveness, and structural feature of chemical modification to meet the desired needs to overcome the disadvantages of PU itself by containing the PS into the PU.

Antibacterial and Angiogenic Poly(ionic liquid) Hydrogels

Wounds, particularly under low-hydration conditions, require more time to repair successfully. Therefore, there is an urgent need to develop wound dressings that can accelerate wound healing. Hydrogels, which can maintain a moist environment around the wound and allow gas to pass through the material, act as antibacterial hydrogels as dressings and have great application value in the treatment of wounds. In addition, wound dressings (hydrogels) containing antibacterial capacity have lasting antibacterial effects and reduce damage to cells. In this work, we firstly synthesized two antibacterial agents: imidazolium poly(ionic liquids) containing sulfhydryl (Imidazole-SH) and ε-Poly(lysine) containing SH (EPL-SH). Then, lysine as a cross-linking agent, by “thiol-ene” click reaction, was mixed with Deferoxamine (DFO) to prepare the antibacterial hydrogels. The in vitro assays showed that the hydrogels could effectively kill Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). In addition, it also could reduce the inflammatory response produced by Lipopolysaccharide (LPS). More importantly, according to the transwell and angiogenesis assays, DFO-incorporated hydrogels promoted the migration and vascular repair of human umbilical vein endothelial cells (HUVECs). All the results revealed that the hydrogels provided new strategies for wound dressings.

Inter-donor variability of extracellular matrix production in long-term cultures of human fibroblasts

Several tissue engineering approaches are based on the ability of mesenchymal cells to endogenously synthesize an extracellular matrix (ECM) in vitro, which can be seen as a form of biomaterial. Accordingly, the inter-donor variability of cell-assembled extracellular matrix (CAM) production is a key parameter to understand in order to progress towards clinical applications, especially for autologous strategies. In this study, CAMs were produced, under good manufacturing process conditions, from skin fibroblasts of 21 patients as part of a clinical trial to evaluate a tissue-engineered vascular graft. The inter-donor variability of CAM strength, thickness, hydroxyproline, and glycosaminoglycan was substantial (coefficient of variability of 33%, 19%, 24%, and 19%, respectively), but a significant correlation was observed between all four properties (Pearson r: 0.43 to 0.70; p-value ≤ 0.05). A CAM matrisome analysis, performed by mass spectrometry, revealed the presence of 70 ECM-related proteins. Our study shows that the relative abundance of 16 proteins (15 non-collagenous) correlated with CAM thickness. These proteins also correlated with CAM hydroxyproline content, as well as 21 other proteins that included fibrillar collagens and non-collagenous proteins. However, data demonstrated that only the relative abundance of type I collagen subunit alpha-1 was correlated to CAM strength. This study is the most extensive evaluation of CAM inter-donor variability to date and will help tissue engineers working with this type of biomaterial to design strategies that take into account this variability, especially for autologous tissue manufacturing.

Several tissue engineering approaches are based on the ability of mesenchymal cells to endogenously synthesize an extracellular matrix (ECM) in vitro, which can be seen as a form of biomaterial.

Potential Wound Healing Effect of Gel Based on Chicha Gum, Chitosan, and Mauritia flexuosa Oil

Wounds are considered a clinically critical issue, and effective treatment will decrease complications, prevent chronic wound formation, and allow rapid healing. The development of products based on naturally occurring materials is an efficient approach to wound healing. Natural polysaccharides can mimic the extracellular matrix and promote cell growth, thus making them attractive for wound healing. In this context, the aim of this work was to produce a gel based on chicha gum, chitosan, and Mauritia flexuosa oil (CGCHO) for wound treatment. TG and DTG analyzed the thermal behavior of the materials, and SEM investigated the surface roughness. The percentages of total phenolic compounds, flavonoids, and antioxidants were determined, presenting a value of 81.811 ± 7.257 µmol gallic acid/g Mauritia flexuosa oil, 57.915 ± 0.305 µmol quercetin/g Mauritia flexuosa oil, and 0.379 mg/mL, respectively. The anti-inflammatory was determined, presenting a value of 10.35 ± 1.46% chicha gum, 16.86 ± 1.00% Mauritia flexuosa oil, 10.17 ± 1.05% CGCHO, and 15.53 ± 0.65% chitosan, respectively. The materials were tested against Gram-negative (Klebsiella pneumoniae) and Gram-positive (Staphylococcus aureus) bacteria and a fungus (Candida albicans). The CGCHO formulation showed better antimicrobial activity against Gram-positive bacteria. In addition, an in vivo wound healing study was also performed. After 21 days of treatment, the epidermal re-epithelialization process was observed. CGCHO showed good thermal stability and roughness that can help in cell growth and promote the tissue healing process. In addition to the good results observed for the antimicrobial, antioxidant, anti-inflammatory activities and providing wound healing, they provided the necessary support for the healing process, thus representing a new approach to the wound healing process.

Bacteria-engineered porous sponge for hemostasis and vascularization

Background

Hemostasis and repair are two essential processes in wound healing, yet early hemostasis and following vascularization are challenging to address in an integrated manner.

Results

In this study, we constructed a hemostatic sponge OBNC-DFO by fermentation of Komagataeibacterxylinus combined with TEMPO oxidation to obtain oxidized bacterial nanocellulose (OBNC). Then angiogenetic drug desferrioxamine (DFO) was grafted through an amide bond, and it promoted clot formation and activated coagulation reaction by rapid blood absorption due to the high total pore area (approximately 42.429 m2/g measured by BET). The further release of DFO stimulated the secretion of HIF-1α and the reconstruction of blood flow, thus achieving rapid hemostasis and vascularization in damaged tissue. This new hemostatic sponge can absorb water at a rate of approximate 1.70 g/s, rapidly enhancing clot formation in the early stage of hemostasis. In vitro and in vivo coagulation experiments (in rat tail amputation model and liver trauma model) demonstrated superior pro-coagulation effects of OBNC and OBNC-DFO to clinically used collagen hemostatic sponges (COL). They promoted aggregation and activation of red blood cells and platelets with shorter whole blood clotting time, more robust activation of endogenous coagulation pathways and less blood loss. In vitro cellular assays showed that OBNC-DFO prevailed over OBNC by promoting the proliferation of human umbilical vein endothelial cells (HUVECs). In addition, the release of DFO enhanced the secretion of HIF-1α, further strengthening vascularization in damaged skin. In the rat skin injury model, 28 days after being treated with OBNC-DFO, skin appendages (e.g., hair follicles) became more intact, indicating the achievement of structural and functional regeneration of the skin.

Conclusion

This hemostatic and vascularization-promoting oxidized bacterial nanocellulose hemostatic sponge, which rapidly activates coagulation pathways and enables skin regeneration, is a highly promising hemostatic and pro-regenerative repair biomaterial.

Graphical Abstract

Immuno-modulatory biomaterials as anti-inflammatory therapeutics

Biocompatible and biodegradable biomaterials are used extensively in regenerative medicine and serve as a tool for tissue replacement, as a platform for regeneration of injured tissue, and as a vehicle for delivery of drugs. One of the key factors that must be addressed in developing successful biomaterial-based therapeutics is inflammation. Whilst inflammation is initially essential for wound healing; bringing about clearance of debris and infection, prolonged inflammation can result in delayed wound healing, rejection of the biomaterial, further tissue damage and increased scarring and fibrosis. In this context, the choice of biomaterial must be considered carefully to minimise further induction of inflammation. Here we address the ability of the biomaterials themselves to modulate inflammatory responses and outline how the physico-chemical properties of the materials impact on their pro and anti-inflammatory properties (Fig. 1).

Chitosan Membrane Containing Copaiba Oil (Copaifera spp.) for Skin Wound Treatment

The interaction of copaiba oil in the polymer matrix of chitosan can produce a favorable synergistic effect and potentiate properties. Indeed, the bioactive principles present in copaiba oil have anti-inflammatory and healing action. In the present work, chitosan membranes containing different contents of copaiba oil copaíba (0.1, 0.5, 1.0 and 5.0% (v/v)) were for the first time investigated. The membranes were developed by the casting method and analyzed for their morphology, degree of intumescence, moisture content, contact angle, Scanning Electron Microscope, and X-ray diffractometry. These chitosan/copaiba oil porous membranes disclosed fluid absorption capacity, hydrophilic surface, and moisture. In addition, the results showed that chitosan membranes with the addition of 1.0% (v/v) of copaiba oil presented oil drops with larger diameters, around 123.78 μm. The highest fluid absorption indexes were observed in chitosan membranes containing 0.1 and 0.5% (v/v) of copaiba oil. In addition, the copaiba oil modified the crystalline structure of chitosan. Such characteristics are expected to favor wound treatment. However, biological studies are necessary for the safe use of chitosan/copaiba oil membrane as a biomaterial.

Glibenclamide Nanocrystal-Loaded Bioactive Polymeric Scaffolds for Skin Regeneration: In Vitro Characterization and Preclinical Evaluation

Skin restoration following full-thickness injury poses significant clinical challenges including inflammation and scarring. Medicated scaffolds formulated from natural bioactive polymers present an attractive platform for promoting wound healing. Glibenclamide was formulated in collagen/chitosan composite scaffolds to fulfill this aim. Glibenclamide was forged into nanocrystals with optimized colloidal properties (particle size of 352.2 nm, and polydispersity index of 0.29) using Kolliphor as a stabilizer to allow loading into the hydrophilic polymeric matrix. Scaffolds were prepared by the freeze drying method using different total polymer contents (3-6%) and collagen/chitosan ratios (0.25-2). A total polymer content of 3% at a collagen/chitosan ratio of 2:1 (SCGL3-2) was selected based on the results of in vitro characterization including the swelling index (1095.21), porosity (94.08%), mechanical strength, rate of degradation and in vitro drug release. SCGL3-2 was shown to be hemocompatible based on the results of protein binding, blood clotting and percentage hemolysis assays. In vitro cell culture studies on HSF cells demonstrated the biocompatibility of nanocrystals and SCGL3-2. In vivo studies on a rat model of a full-thickness wound presented rapid closure with enhanced histological and immunohistochemical parameters, revealing the success of the scaffold in reducing inflammation and promoting wound healing without scar formation. Hence, SCGL3-2 could be considered a potential dermal substitute for skin regeneration.

Biomaterials for Soft Tissue Repair and Regeneration: A Focus on Italian Research in the Field

Tissue repair and regeneration is an interdisciplinary field focusing on developing bioactive substitutes aimed at restoring pristine functions of damaged, diseased tissues. Biomaterials, intended as those materials compatible with living tissues after in vivo administration, play a pivotal role in this area and they have been successfully studied and developed for several years. Namely, the researches focus on improving bio-inert biomaterials that well integrate in living tissues with no or minimal tissue response, or bioactive materials that influence biological response, stimulating new tissue re-growth. This review aims to gather and introduce, in the context of Italian scientific community, cutting-edge advancements in biomaterial science applied to tissue repair and regeneration. After introducing tissue repair and regeneration, the review focuses on biodegradable and biocompatible biomaterials such as collagen, polysaccharides, silk proteins, polyesters and their derivatives, characterized by the most promising outputs in biomedical science. Attention is pointed out also to those biomaterials exerting peculiar activities, e.g., antibacterial. The regulatory frame applied to pre-clinical and early clinical studies is also outlined by distinguishing between Advanced Therapy Medicinal Products and Medical Devices.

Three Polymers from the Sea: Unique Structures, Directional Modifications, and Medical Applications

With the increase of wounds and body damage, the clinical demand for antibacterial, hemostatic, and repairable biomaterials is increasing. Various types of biomedical materials have become research hotspots. Of these, and among materials derived from marine organisms, the research and application of alginate, chitosan, and collagen are the most common. Chitosan is mainly used as a hemostatic material in clinical applications, but due to problems such as the poor mechanical strength of a single component, the general antibacterial ability, and fast degradation speed research into the extraction process and modification mainly focuses on the improvement of the above-mentioned ability. Similarly, the research and modification of sodium alginate, used as a material for hemostasis and the repair of wounds, is mainly focused on the improvement of cell adhesion, hydrophilicity, degradation speed, mechanical properties, etc.; therefore, there are fewer marine biological collagen products. The research mainly focuses on immunogenicity removal and mechanical performance improvement. This article summarizes the source, molecular structure, and characteristics of alginate, chitosan, and collagen from marine organisms; and introduces the biological safety, clinical efficacy, and mechanism of action of these materials, as well as their extraction processes and material properties. Their modification and other issues are also discussed, and their potential clinical applications are examined.

Chitosan/Hyaluronic acid/Alginate and an assorted polymers loaded with honey, plant, and marine compounds for progressive wound healing-Know-how

Biomaterials are being extensively used in regenerative medicine including tissue engineering applications, as these enhance tissue development, repair, and help in the process of angiogenesis. Wound healing is a crucial biological process of regeneration of ruptured tissue after getting injury to the skin and other soft tissue in humans and animals. Besides, the accumulation of microbial biofilms around the wound surface can increase the risk and physically obstruct the wound healing activity, and may even lead to amputation. Hence, in both acute and chronic wounds, prominent biomaterials are required for wound healing along with antimicrobial agents. This review comprehensively addresses the antimicrobial and wound healing effects of chitosan, chitin, cellulose acetate, hyaluronic acid, pullulan, bacterial cellulose, fibrin, alginate, etc. based wound dressing biomaterials fabricated with natural resources such as honey, plant bioactive compounds, and marine-based polymers. Due to their excellent biocompatibility and biodegradability, bioactive compounds derived from honey, plants, and marine resources are commonly used in biomedical and tissue engineering applications. Different types of polymer-based biomaterials including hydrogel, film, scaffold, nanofiber, and sponge dressings fabricated with bioactive agents including honey, curcumin, tannin, quercetin, andrographolide, gelatin, carrageenan, etc., can exhibit significant wound healing process in, diabetic wounds, diabetic ulcers, and burns, and help in cartilage repair along with good biocompatibility and antimicrobial effects. Among the reviewed biomaterials, carbohydrate polymers such as chitosan-based biomaterials are prominent and widely used for wound healing applications followed by hyaluronic acid and alginate-based biomaterials loaded with honey, plant, and marine compounds. This review first provides an overview of the vast natural resources used to formulate different biomaterials for the treatment of antimicrobial, acute, and chronic wound healing processes.

Bioaerogels: Promising Nanostructured Materials in Fluid Management, Healing and Regeneration of Wounds

Wounds affect one's quality of life and should be managed on a patient-specific approach, based on the particular healing phase and wound condition. During wound healing, exudate is produced as a natural response towards healing. However, excessive production can be detrimental, representing a challenge for wound management. The design and development of new healing devices and therapeutics with improved performance is a constant demand from the healthcare services. Aerogels can combine high porosity and low density with the adequate fluid interaction and drug loading capacity, to establish hemostasis and promote the healing and regeneration of exudative and chronic wounds. Bio-based aerogels, i.e., those produced from natural polymers, are particularly attractive since they encompass their intrinsic chemical properties and the physical features of their nanostructure. In this work, the emerging research on aerogels for wound treatment is reviewed for the first time. The current scenario and the opportunities provided by aerogels in the form of films, membranes and particles are identified to face current unmet demands in fluid managing and wound healing and regeneration.

Collagen-Alginate Composite Hydrogel: Application in Tissue Engineering and Biomedical Sciences

Alginate (ALG), a polysaccharide derived from brown seaweed, has been extensively investigated as a biomaterial not only in tissue engineering but also for numerous biomedical sciences owing to its wide availability, good compatibility, weak cytotoxicity, low cost, and ease of gelation. Nevertheless, alginate lacks cell-binding sites, limiting long-term cell survival and viability in 3D culture. Collagen (Col), a major component protein found in the extracellular matrix (ECM), exhibits excellent biocompatibility and weak immunogenicity. Furthermore, collagen contains cell-binding motifs, which facilitate cell attachment, interaction, and spreading, consequently maintaining cell viability and promoting cell proliferation. Recently, there has been a growing body of investigations into collagen-based hydrogel trying to overcome the poor mechanical properties of collagen. In particular, collagen-alginate composite (CAC) hydrogel has attracted much attention due to its excellent biocompatibility, gelling under mild conditions, low cytotoxicity, controllable mechanic properties, wider availability as well as ease of incorporation of other biomaterials and bioactive agents. This review aims to provide an overview of the properties of alginate and collagen. Moreover, the application of CAC hydrogel in tissue engineering and biomedical sciences is also discussed.

γ-PGA hydrogel loaded with cell-free fat extract promotes the healing of diabetic wounds

Diabetic wounds are one complication of persistent hyperglycemia and lead to neuropathy and vascular lesions in patients. The promotion of angiogenesis plays an important role in wound healing. Cell-free fat extract (Ceffe) is a cell-free fraction isolated from adipose that is enriched with a range of growth factors, the combination of which can synergistically induce angiogenesis. In this study, we prepared a wound dressing by loading Ceffe with the γ-PGA hydrogel (Ceffe-γ-PGA) to promote the healing of wounds in diabetic mice. The viscosity of Ceffe-γ-PGA was 9.2 pa s, and the water retention rate after 6 hours reached 50%. The slow-release effect of the Ceffe-γ-PGA hydrogel was investigated in vitro in PBS, and the cumulative release rate was 97% after 6 days. Water retention and viscosity analyses revealed that Ceffe-γ-PGA provided a moist environment for the wound surface. The therapeutic effect of the Ceffe-γ-PGA hydrogel on wound healing was studied in vivo in type-II diabetic male db/db mice. After 17 days of wound treatment, the wound area ratio of the Ceffe-γ-PGA group was reduced to 2% of the original, and the capillary density of the Ceffe-γ-PGA group reached 33 mm-2 and was 19 mm-2 higher than that of the untreated group. The cell proliferation rate in the Ceffe-γ-PGA group was 37% higher than that in the untreated group. These results support the use of this system as a promising therapeutic strategy for wound healing in patients with diabetes.

Effect and Repair Mechanism of Nano Ag Sponge Dressing Combined with Gelatin-Bletilla Striata Gum/Salvia Miltiorrhiza on Refractory Orthopedic Wounds

OBJECTIVE

To explore the effect and mechanism of the sponge dressing on the healing of refractory orthopedic wound, and the gelatin-Bletilla striata gum/Salvia miltiorrhiza nano Ag (GBS-Ag) sponge dressing was prepared.

METHODS

GBS-Ag sponge dressing was prepared by the freeze-drying method. Twenty male SD rats were randomly divided into the control group (Ctrl group) and GBS-Ag group, with 10 rats in each group, and the rats in the two groups were established a model of back wound infection. The Ctrl group was treated with gauze, while the GBS-Ag group was treated with GBS-Ag sponge dressing. Wound healing rate, blood immune indexes, Ag content in each organ, morphological changes of wound, and expression of transforming growth factor-β1 (TGF-β1) in wound transformation were detected in the two groups of rats.

RESULTS

The mechanical properties of GBS-Ag sponge dressing were all in line with the standard, and it had good killing effect on the conventional strain after being incubated for 24 hours. Compared with the Ctrl group, the healing rate and lymphocyte percentage in the GBS-Ag group were significantly increased on day 4 and day 10 (P < 0.05), while the total number of white blood cells and the percentage of neutrophils were significantly decreased (P < 0.05). Compared with Ctrl group, the Ag content in liver, spleen, and kidney of rats in the GBS-Ag group was significantly increased (P < 0.05). The histological results showed that the Ctrl group lacked collagen fibers in the dermis, and the angiogenesis was not rich, accompanied by a large number of inflammatory cell infiltration. The epidermal repair of rats in the GBS-Ag group was complete and partially keratinized, the dermis was rich in collagen fibers, with elastic fibers and new blood vessels, inflammatory cells were rare, and new hair follicles and thick-walled blood vessels were also observed. The expression of TGF-β1 protein in the wounds of rats in the GBS-Ag group was higher than that of the Ctrl group.

CONCLUSION

GBS-Ag sponge dressing had multiple effects of sterilization and promoting wound healing, and its mechanism may be related to promoting the TGF-β1 protein expression.

Influence of replacing oregano essential oil by ground oregano leaves on chitosan/alginate-based dressings properties

Biopolymers, as chitosan and alginate, have gained prominence in the biomedical area, mainly for application in wound dressings, as partial replacements for synthetic polymers. The present work aimed to compare the influence of the antimicrobial agent incorporation form on the properties of films prepared by casting. The chitosan/alginate-based films were manufactured containing oregano essential oil (OEO) or ground oregano leaves (OR). The OEO was chosen due to its excellent pharmacological properties, and the substitution by OR can represent an advantageous alternative for minimizing the final cost of the product, by removing the oil extraction step. The films, with different amounts of OEO and OR, were characterized in terms of their morphological, physicochemical, mechanical and antimicrobial properties. The films had properties according to desirable for wound dressing application: water vapor flux less than 35 g m^-2 h^-1, moderate liquid absorption capacity, and similar mechanical properties to human skin. All developed films showed antimicrobial activity against the bacteria Escherichia coli and Staphylococcus aureus. Formulations containing OEO presented the largest inhibition zones, although OR showed high potential for the proposed use. These results suggest that films developed, with both OEO and ground oregano leaves, are promising for use as dressings.

Collagen Peptides Derived from Sipunculus nudus Accelerate Wound Healing

Marine collagen peptides have high potential in promoting skin wound healing. This study aimed to investigate wound healing activity of collagen peptides derived from Sipunculus nudus (SNCP). The effects of SNCP on promoting healing were studied through a whole cortex wound model in mice. Results showed that SNCP consisted of peptides with a molecular weight less than 5 kDa accounted for 81.95%, rich in Gly and Arg. SNCP possessed outstanding capacity to induce human umbilical vein endothelial cells (HUVEC), human immortalized keratinocytes (HaCaT) and human skin fibroblasts (HSF) cells proliferation and migration in vitro. In vivo, SNCP could markedly improve the healing rate and shorten the scab removal time, possessing a scar-free healing effect. Compared with the negative control group, the expression level of tumor necrosis factor-α, interleukin-1β and transforming growth factor-β1 (TGF-β1) in the SNCP group was significantly down-regulated at 7 days post-wounding (p < 0.01). Moreover, the mRNA level of mothers against decapentaplegic homolog 7 (Smad7) in SNCP group was up-regulated (p < 0.01); in contrast, type II TGF-β receptors, collagen I and α-smooth muscle actin were significantly down-regulated at 28 days (p < 0.01). These results indicate that SNCP possessed excellent activity of accelerating wound healing and inhibiting scar formation, and its mechanism was closely related to reducing inflammation, improving collagen deposition and recombination and blockade of the TGF-β/Smads signal pathway. Therefore, SNCP may have promising clinical applications in skin wound repair and scar inhibition.

Collagen based electrospun materials for skin wounds treatment

Materials used for wound care have evolved from simple covers to functional wound dressings with bioactive properties. Electrospun nanofibers show great similarity to the natural fibrillar structure of skin extracellular matrix (ECM); therefore, by mimic, the morphology of ECM, nanofibers show high potential for facilitating the healing of skin injuries. Besides morphology, scaffold composition is another important parameter in the production of bioactive wound dressings. Collagen type I is the main structural protein of skin ECM is biocompatible, biodegradable, and its extraction from animal sources is relatively simple. The fabrication of electrospun wound dressings based on collagen and its blends have been studied for skin tissue engineering applications. This review focus on the new advances of collagen electrospun materials for skin wound treatment. It summarizes the recent research on pristine collagen, collagen blends, and collagen surface modifications on nanofibers mats. Finally, the strategies for three-dimensional nanofibers production will also be discussed.

Next-generation surgical meshes for drug delivery and tissue engineering applications: materials, design and emerging manufacturing technologies

Abstract

Surgical meshes have been employed in the management of a variety of pathological conditions including hernia, pelvic floor dysfunctions, periodontal guided bone regeneration, wound healing and more recently for breast plastic surgery after mastectomy. These common pathologies affect a wide portion of the worldwide population; therefore, an effective and enhanced treatment is crucial to ameliorate patients’ living conditions both from medical and aesthetic points of view. At present, non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia, pelvic floor dysfunctions and guided bone regeneration, with polypropylene and poly tetrafluoroethylene being the most common. Biological prostheses, such as surgical grafts, have been employed mainly for breast plastic surgery and wound healing applications. Despite the advantages of mesh implants to the treatment of these conditions, there are still many drawbacks, mainly related to the arising of a huge number of post-operative complications, among which infections are the most common. Developing a mesh that could appropriately integrate with the native tissue, promote its healing and constructive remodelling, is the key aim of ongoing research in the area of surgical mesh implants. To this end, the adoption of new biomaterials including absorbable and natural polymers, the use of drugs and advanced manufacturing technologies, such as 3D printing and electrospinning, are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical practice. The aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes, the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations.

Graphic abstract

Enhanced full-thickness wound healing via Sophora gibbosa extract delivery based on a chitosan/gelatin dressing incorporating microemulsion

There are many synthetic drugs in literature have been utilized in healing of the wounds although the natural product specially antioxidants can offer similar if not better biological activity in that regard. Genus Sophora is well known to contain flavonoids and phenolic compounds which have antioxidant and inflammatory effects. So, the aim of the current study was to develop and evaluate chitosan/gelatin based Sophora gibbosa extract-loaded microemulsion as wound dressing. Sophora gibbosa extract (SGE) contained 16 major compounds which have reasonable antioxidant activity. The developed microemulsion showed that Tween 80 produced significant (p < 0.05) lower particle size than Pluronic F127 at the same SGE concentration whereas high concentration of extract results in large particle size. Thermodynamic stability studies showed that using higher concentration of the extract produced less stable formulations. The selected formulation was impregnated in the dressing base (chitosan/gelatin; 2:1 w/w ratio) which exhibited more water absorption. In vivo evaluation revealed that the dressing displayed superior wound repair compared to the control in terms histological examination and determination of alpha smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA). Thus, SGE-loaded microemulsion-impregnated gelatin/chitosan could be a potential candidate for the wound healing.

Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial

OBJECTIVE

Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU.

METHOD

This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up.

RESULTS

A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively).

CONCLUSION

The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.