Natural composite dressings based on collagen, gelatin and plant bioactive compounds for wound healing: A review

Advancements in wound management: integrating nanotechnology and smart materials for enhanced therapeutic interventions

Wound management spans various techniques and materials tailored to address acute and chronic non-healing wounds, with the primary objective of achieving successful wound closure. Chronic wounds pose additional challenges, often necessitating dressings to prepare the wound bed for subsequent surgical procedures like skin grafting. Ideal dressing materials should not only expedite wound healing but also mitigate protein, electrolyte, and fluid loss while minimizing pain and infection risk. Nanotechnology has emerged as a transformative tool in wound care, revolutionizing the landscape of biomedical dressings. Its application offers remarkable efficacy in accelerating wound healing and combating bacterial infections, representing a significant advancement in wound care practices. Integration of nanotechnology into dressings has resulted in enhanced properties, including improved mechanical strength and controlled drug release, facilitating tailored therapeutic interventions. This review article comprehensively explores recent breakthroughs in wound healing therapies, with a focus on innovative medical dressings such as nano-enzymes. Additionally, the utilization of smart materials, like hydrogels and electroactive polymers, in wound dressings offers dynamic functionalities to promote tissue regeneration. Emerging concepts such as bio-fabrication, microfluidic systems, bio-responsive scaffolds, and personalized therapeutics show promise in expediting wound healing and minimizing scarring. Through an in-depth exploration of these advancements, this review aims to catalyze a paradigm shift in wound care strategies, promoting a patient-centric approach to therapeutic interventions.

Sustained-release, antibacterial, adhesive gelatin composite hydrogel with AgNPs double-capped with curdlan derivatives

In this work, carboxymethylated curdlan (CMCD) was utilized as a capping and stabilizing agent for the green synthesis of silver nanoparticles. Subsequently, quaternized curdlan (QCD) was introduced as the second capping layer through electrostatic attraction, leading to the preparation of double-capped silver nanoparticles (AgNPs@CQ). The successful synthesis of silver nanoparticles was characterized using UV-vis, FTIR, XRD, TEM, and DLS. AgNPs@CQ were incorporated into gelatin and a AgNPs@CQ/Gel composite hydrogel was obtained. The incorporation of AgNPs@CQ imparts excellent antibacterial properties to the composite hydrogel, thereby enhancing its antimicrobial efficacy. The presence of double-capping layers significantly retards the release rate of silver, contributing to prolonged antimicrobial activity. The MTT and live/dead fluorescence staining results demonstrate that the gelatin hydrogel incorporating double-capped AgNPs exhibits enhanced cell viability compared to the one incorporating single-capped AgNPs. Additionally, the composite hydrogel exhibits remarkable mechanical strength and adhesive performance. The AgNPs@CQ/Gel composite hydrogel demonstrates a cost-effective and facile preparation, showing significant potential in the field of dressings.

Collagen as the extracellular matrix biomaterials in the arena of medical sciences

Collagen is a multipurpose material that has several applications in the health care, dental care, and pharmaceutical industries. Crosslinked compacted solids or lattice-like gels can be made from collagen. Biocompatibility, biodegradability, and wound-healing properties make collagen a popular scaffold material for cardiovascular, dentistry, and bone tissue engineering. Due to its essential role in the control of several of these processes, collagen has been employed as a wound-healing adjunct. It forms a major component of the extracellular matrix and regulates wound healing in its fibrillar or soluble forms. Collagen supports cardiovascular and other soft tissues. Oral wounds have been dressed with resorbable forms of collagen for closure of graft and extraction sites, and to aid healing. This present review is concentrated on the use of collagen in bone regeneration, wound healing, cardiovascular tissue engineering, and dentistry.

The interplay of skin architecture and cellular dynamics in wound healing: Insights and innovations in care strategies

Wound healing involves complex interactions among skin layers: the epidermis, which epithelializes to cover wounds; the dermis, which supports granulation tissue and collagen production; and the hypodermis, which protects overall skin structure. Key factors include neutrophils, activated by platelet degranulation and cytokines, and fibroblasts, which aid in collagen production during proliferation. The healing process encompasses inflammation, proliferation, and remodeling, with angiogenesis, fibroplasia, and re-epithelialization crucial for wound closure. Angiogenesis is characterized by the creation of collateral veins, the proliferation of endothelial cells, and the recruitment of perivascular cells. Collagen is produced by fibroblasts in granulation tissue, aiding in the contraction of wounds. The immunological response is impacted by T cells and cytokines. External topical application of various formulations and dressings expedites healing and controls microbial contamination. Polymeric materials, both natural and synthetic, and advanced dressings enhance healing by providing biodegradability, biocompatibility, and infection control, thus addressing tissue regeneration challenges. Numerous dressings promote healing, including films, hydrocolloids, hydrogels, foams, alginates, and tissue-engineered substitutes. Wound dressings are treated with growth factors, particularly PDGF, and antibacterial drugs to prevent infection. The challenges of tissue regeneration and infection control are evolving along with the field of wound care.

Anti-Inflammatory and Wound Healing Properties of Different Honey Varieties from Romania and Correlations to Their Composition

The complex composition of honey plays a crucial role in wound healing, exhibiting varying effects at different stages of the healing process. This study investigated seven honey varieties sourced from different regions of Romania using in vitro experimental models developed in macrophage-like, fibroblast, and keratinocyte cell lines to explore the mechanisms by which honey promoted the healing process. This study assessed the impact of honey on inflammatory cytokine production in macrophage-like cells, cell proliferation and collagen synthesis in fibroblasts, and cell proliferation and migration in keratinocytes. Additionally, correlation analysis was conducted to examine the relationship between honey composition and its biological properties. Honey varieties presented both anti- and pro-inflammatory effects. Moreover, they displayed dose-dependent pro-proliferative effects, stimulating collagen synthesis and cell migration, thereby enhancing the re-epithelialization process. The Pearson coefficient analysis indicated a strong positive correlation between biological activities and phenolic content. Additionally, there was a medium positive correlation with the ascorbic acid content and a medium negative correlation with the glucose content in the different honey varieties. Romanian honey varieties rich in phenolics showed potential in modulating inflammation, proliferation, collagen synthesis, and cell migration, suggesting their suitability for further evaluation and development of innovative dressings for skin tissue regeneration.

Bioinspired Wearable Hydrogel Composite with Sustained Drug-Release for Wound Healing and Naked-Eye Visual Early Warning of Wound Dehiscence

Wound healing is critical to the structural and functional restoration of damaged tissue. However, effective wound closure and healing are always great challenges in regenerative engineering. This study provided bioinspired wearable hydrogel composites with drug-releasing hydrogel and nonclose-packed photonic crystals (NPCs) for wound therapy and naked-eye visual early warning of wound dehiscence. Molecular dynamics models and drug-releasing results illustrated the sustained drug release of ibuprofen, and the mechanical properties of the drug-releasing hydrogel were optimized with 1410% tensile strain by introducing fish collagen; their biocompatibility and adhesion were also improved. The structural color of the NPCs blue-shifted from 630 to 500 nm with 15.0% strain, and the original color was customized with poly(methyl methacrylate) (PMMA) concentration and acrylamide content. Compared with the gauze and the traditional hydrogels, the composite provided a moist environment and an effectively closed wound; the debridement and released drug avoided inflammation, and the rat wound was healed 40.5% on the third day and essentially 100% on the 14th day. The work provided a novel strategy for wound healing and naked-eye visual early warning when a wound deforms, which is expected to promote the synergistic development of clinical treatment and visualized early warning.

Advances and perspectives in use of semisolid formulations for photodynamic methods

Although nearly 30 years have passed since the introduction of the first clinically approved photosensitizer for photodynamic therapy, progress in developing new pharmaceutical formulations remains unsatisfactory. This review highlights that despite years of research, many recurring challenges and issues remain unresolved. The paper includes an analysis of selected essential studies involving aminolevulinic acid and its derivatives, as well as other photosensitizers with potential for development as medical products. Among various possible vehicles, special attention is given to gelatin, alginates, poly(ethylene oxide), polyacrylic acid, and chitosan. The focus is particularly on infectious and cancerous diseases. Key aspects of developing new semi-solid drug forms should prioritize the creation of easily manufacturable and biocompatible preparations for clinical use. At the same time, new formulations should preserve the primary function of photosensitizers, which is the generation of reactive oxygen species capable of destroying pathogenic cells or tumors. Additionally, the use of adjuvant properties of carriers, which can enhance the effectiveness of macrocycles, is emphasized, especially in chitosan-based antibacterial formulations. Current research indicates that many promising dyes and macrocyclic compounds with high potential as photosensitizers in photodynamic therapy remain unexplored in formulation and development work. This review outlines potential new and previously explored pathways for advancing photosensitizers as active pharmaceutical ingredients (APIs).

Antibacterial, Anti-Inflammatory, and Antioxidant Cotton-Based Wound Dressing Coated with Chitosan/Cyclodextrin-Quercetin Inclusion Complex Nanofibers

Quercetin, recognized for its antioxidant, anti-inflammatory, and antibacterial properties, faces limited biomedical application due to its low solubility. Cotton, a preferred wound dressing material over synthetic ones, lacks inherent antibacterial and wound-healing attributes and can benefit from quercetin features. This study explores the potential of overcoming these challenges through the inclusion complexation of quercetin with cyclodextrins (CDs) and the development of a nanofibrous coating on a cotton nonwoven textile. Hydroxypropyl-beta-cyclodextrin (HP-β-CD) and hydroxypropyl-gamma-cyclodextrin (HP-γ-CD) formed inclusion complexes of quercetin, with chitosan added to enhance antibacterial properties. Phase solubility results showed that inclusion complexation can enhance quercetin solubility up to 20 times, with HP-γ-CD forming a more stable inclusion complexation compared with HP-β-CD. Electrospinning of the nanofibers from HP-β-CD/Quercetin and HP-γ-CD/Quercetin aqueous solutions without the use of a polymeric matrix yielded a uniform, smooth fiber morphology. The structural and thermal analyses of the HP-β-CD/Quercetin and HP-γ-CD/Quercetin nanofibers confirmed the presence of inclusion complexes between quercetin and each of the CDs (HP-β-CD and HP-γ-CD). Moreover, HP-β-CD/Quercetin and HP-γ-CD/Quercetin nanofibers showed a near-complete loading efficiency of quercetin and followed a fast-releasing profile of quercetin. Both HP-β-CD/Quercetin and HP-γ-CD/Quercetin nanofibers showed significantly higher antioxidant activity compared to pristine quercetin. The HP-β-CD/Quercetin and HP-γ-CD/Quercetin nanofibers also showed antibacterial activity, and with the addition of chitosan in the HP-γ-CD/Quercetin system, the Chitosan/HP-γ-CD/Quercetin nanofibers completely eliminated the investigated bacteria species. The nanofibers were nontoxic and well-tolerated by cells, and exploiting the quercetin and chitosan anti-inflammatory activities resulted in the downregulation of IL-6 and NO secretion in both immune as well as regenerative cells. Overall, CD inclusion complexation markedly enhances quercetin solubility, resulting in a biofunctional antioxidant, antibacterial, and anti-inflammatory wound dressing through a nanofibrous coating on cotton textiles.

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.

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.

An Injectable Living Hydrogel with Embedded Probiotics as a Novel Strategy for Combating Multifaceted Pathogen Wound Infections

Wound infections pose a significant challenge in healthcare, and traditional antibiotic treatments often result in the development of resistant pathogens. Addressing this gap, ProGel is introduced, a living hydrogel created by entrapping probiotic Lactobacillus plantarum as a therapeutic component within a gelatin matrix. With a double-syringe system, ProGel can be easily mixed and applied, conforming swiftly to any wound shape and forming hydrogel in situ. It also demonstrates robust mechanical and self-healing properties owing to the Schiff-base bonds. ProGel sustains more than 80% viability of the entrapped L. plantarum while restricting their escape from the hydrogel. After a week of storage, more than 70% viability of the entrapped L. plantarum is preserved. Importantly, ProGel exhibits broad-spectrum antimicrobial efficacy against pathogens commonly associated with wound infections, i.e., Pseudomonas aeruginosa (7Log reduction), Staphylococcus aureus (3-7Log reduction), and Candida albicans (40-70% reduction). Moreover, its cytocompatibility is affirmed through coculture with human dermal fibroblasts. The effectiveness of ProGel is further highlighted in more clinically relevant tests on human skin wound models infected with P. aeruginosa and S. aureus, where it successfully prevents the biofilm formation of these pathogens. This study showcases an injectable living hydrogel system for the management of complex wound infections.

Scaffold-Mediated Drug Delivery for Enhanced Wound Healing: A Review

Wound healing is a complex physiological process involving coordinated cellular and molecular events aimed at restoring tissue integrity. Acute wounds typically progress through the sequential phases of hemostasis, inflammation, proliferation, and remodeling, while chronic wounds, such as venous leg ulcers and diabetic foot ulcers, often exhibit prolonged inflammation and impaired healing. Traditional wound dressings, while widely used, have limitations such poor moisture retention and biocompatibility. To address these challenges and improve patient outcomes, scaffold-mediated delivery systems have emerged as innovative approaches. They offer advantages in creating a conducive environment for wound healing by facilitating controlled and localized drug delivery. The manuscript explores scaffold-mediated delivery systems for wound healing applications, detailing the use of natural and synthetic polymers in scaffold fabrication. Additionally, various fabrication techniques are discussed for their potential in creating scaffolds with controlled drug release kinetics. Through a synthesis of experimental findings and current literature, this manuscript elucidates the promising potential of scaffold-mediated drug delivery in improving therapeutic outcomes and advancing wound care practices.

Rutin-loaded zein gel as a green biocompatible formulation for wound healing application

Wound healing is a challenging clinical problem and efficient wound management is essential to prevent infection. This is best done by utilizing biocompatible materials in order to complete the healing in a rapid manner, with functional and esthetic outcomes. In this context, the zein protein fulfills the criteria of the ideal wound dressing which include non-toxicity and non-inflammatory stimulation. Zein gels containing rutin were prepared without any chemical refinement or addition of gelling agents in order to obtain a natural formulation characterized by antioxidant and anti-inflammatory properties to be proposed for the treatment of burns and sores. In vitro scratch assay showed that the proposed gel formulations promoted cell migration and a rapid gap closure within 24 h (~90 %). In addition, the in vivo activities of rutin-loaded zein gel showed a greater therapeutic efficacy in Wistar rats, with a decrease of the wound area of about 90 % at day 10 with respect to the free form of the bioactive and to DuoDERM®. The evaluation of various markers (TNF-α, IL-1β, IL-6, IL-10) confirmed the anti-inflammatory effect of the proposed formulation. The results illustrate the feasibility of exploiting the peculiar features of rutin-loaded zein gels for wound-healing purposes.

Research progress of photo-crosslink hydrogels in ophthalmology: A comprehensive review focus on the applications

Hydrogel presents a three-dimensional polymer network with high water content. Over the past decade, hydrogel has developed from static material to intelligent material with controllable response. Various stimuli are involved in the formation of hydrogel network, among which photo-stimulation has attracted wide attention due to the advantages of controllable conditions, which has a good application prospect in the treatment of ophthalmic diseases. This paper reviews the application of photo-crosslink hydrogels in ophthalmology, focusing on the types of photo-crosslink hydrogels and their applications in ophthalmology, including drug delivery, tissue engineering and 3D printing. In addition, the limitations and future prospects of photo-crosslink hydrogels are also provided.

Fabrication of a Triple-Layer Bionic Vascular Scaffold via Hybrid Electrospinning

Tissue engineering aims to develop bionic scaffolds as alternatives to autologous vascular grafts due to their limited availability. This study introduces a novel wet-electrospinning fabrication technique to create small-diameter, uniformly aligned tubular scaffolds. By combining this innovative method with conventional electrospinning, a bionic tri-layer scaffold that mimics the zonal structure of vascular tissues is produced. The inner and outer layers consist of PCL/Gelatin and PCL/PLGA fibers, respectively, while the middle layer is crafted using PCL through Wet Vertical Magnetic Rod Electrospinning (WVMRE). The scaffold's morphology is analyzed using Scanning Electron Microscopy (SEM) to confirm its bionic structure. The mechanical properties, degradation profile, wettability, and biocompatibility of the scaffold are also characterized. To enhance hemocompatibility, the scaffold is crosslinked with heparin. The results demonstrate sufficient mechanical properties, good wettability of the inner layer, proper degradability of the inner and middle layers, and overall good biocompatibility. In conclusion, this study successfully develops a small-diameter tri-layer tubular scaffold that meets the required specifications.

Multifunctional hydrogel dressing based on fish gelatin/oxidized hyaluronate for promoting diabetic wound healing

Non-healing chronic diabetic wound treatment remains an unsolved healthcare challenge and still threatens patients' lives. Recently, hydrogel dressings based on natural biomaterials have been widely investigated to accelerate the healing of diabetic wounds. In this study, we introduce a bioactive hydrogel based on fish gelatin (FG) as a candidate for diabetic wound treatments, which is a recently emerged substitute for mammalian derived gelatin. The composite hydrogel simply fabricated with FG and oxidized hyaluronate (OHy) through Schiff base reaction could successfully accelerate wound healing due to their adequate mechanical stability and self-healing ability. In vitro studies showed that the fabricated hydrogels exhibited cytocompatibility and could reduce pro-inflammatory cytokine expression such as NO, IL-1β, TNF-α, and PGE2 in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. In addition, the production of reactive oxygen species (ROS), a key marker of free radicals producing oxidative stress, was also reduced by fabricated hydrogels. Furthermore, in vivo experiments demonstrated that the hydrogel could promote wound closure, re-epithelialization, collagen deposition, and protein expression of CD31, CD206, and Arg1 in diabetic mice models. Our study highlights the advanced potential of FG as a promising alternative material and indicates that FOHI can be successfully used for diabetic wound healing applications.

Collagen/gelatin and polysaccharide complexes enhance gastric retention and mucoadhesive properties

This article has focused on collagen-gelatin, the gelation process, as well as blend interaction between collagen/gelatin with various polysaccharides to boost mucoadhesion and gastric retention. The interaction between mucoadhesive materials and mucin layers is of significant interest in the development of drug delivery systems and biomedical applications for effective targeting and prolonged time in the gastrointestinal tract. This paper reviews the current advancement and mucoadhesive properties of collagen/gelatin and different polysaccharide complexes concerning the mucin layer and interactions are briefly highlighted. Collagen/gelatin and polysaccharide blends biocompatible and biodegradable, the complex biomolecules have shown encouraging mucoadhesive properties due to their cationic nature and ability to form hydrogen bonds with mucin glycoproteins. The mucoadhesion mechanism was attributed to the electrostatic interactions between the positively charged amino (NH2) groups of blend biopolymers and the negatively charged sialic acid residues present in mucin glycoprotein. At the end of this article, the encouraging prospect of collagen/polysaccharide complex and mucin glycoprotein is highlighted.

Advancements in 3D-printable polysaccharides, proteins, and synthetic polymers for wound dressing and skin scaffolding - A review

This review investigates the most recent advances in personalized 3D-printed wound dressings and skin scaffolding. Skin is the largest and most vulnerable organ in the human body. The human body has natural mechanisms to restore damaged skin through several overlapping stages. However, the natural wound healing process can be rendered insufficient due to severe wounds or disturbances in the healing process. Wound dressings are crucial in providing a protective barrier against the external environment, accelerating healing. Although used for many years, conventional wound dressings are neither tailored to individual circumstances nor specific to wound conditions. To address the shortcomings of conventional dressings, skin scaffolding can be used for skin regeneration and wound healing. This review thoroughly investigates polysaccharides (e.g., chitosan, Hyaluronic acid (HA)), proteins (e.g., collagen, silk), synthetic polymers (e.g., Polycaprolactone (PCL), Poly lactide-co-glycolic acid (PLGA), Polylactic acid (PLA)), as well as nanocomposites (e.g., silver nano particles and clay materials) for wound healing applications and successfully 3D printed wound dressings. It discusses the importance of combining various biomaterials to enhance their beneficial characteristics and mitigate their drawbacks. Different 3D printing fabrication techniques used in developing personalized wound dressings are reviewed, highlighting the advantages and limitations of each method. This paper emphasizes the exceptional versatility of 3D printing techniques in advancing wound healing treatments. Finally, the review provides recommendations and future directions for further research in wound dressings.

Extracellular Matrix-Bioinspired Anisotropic Topographical Cues of Electrospun Nanofibers: A Strategy of Wound Healing through Macrophage Polarization

The skin serves as the body's outermost barrier and is the largest organ, providing protection not only to the body but also to various internal organs. Owing to continuous exposure to various external factors, it is susceptible to damage that can range from simple to severe, including serious types of wounds such as burns or chronic wounds. Macrophages play a crucial role in the entire wound-healing process and contribute significantly to skin regeneration. Initially, M1 macrophages infiltrate to phagocytose bacteria, debris, and dead cells in fresh wounds. As tissue repair is activated, M2 macrophages are promoted, reducing inflammation and facilitating restoration of the dermis and epidermis to regenerate the tissue. This suggests that extracellular matrix (ECM) promotes cell adhesion, proliferation, migrationand macrophage polarization. Among the numerous strategies, electrospinning is a versatile technique for obtaining ECM-mimicking structures with anisotropic and isotropic topologies of micro/nanofibers. Various electrospun biomaterials influence macrophage polarization based on their isotropic or anisotropic topologies. Moreover, these fibers possess a high surface-area-to-volume ratio, promoting the effective exchange of vital nutrients and oxygen, which are crucial for cell viability and tissue regeneration. Micro/nanofibers with diverse physical and chemical properties can be tailored to polarize macrophages toward skin regeneration and wound healing, depending on specific requirements. This review describes the significance of micro/nanostructures for activating macrophages and promoting wound healing.

Electrospun nanofibers synthesized from polymers incorporated with bioactive compounds for wound healing

The development of innovative wound dressing materials is crucial for effective wound care. It's an active area of research driven by a better understanding of chronic wound pathogenesis. Addressing wound care properly is a clinical challenge, but there is a growing demand for advancements in this field. The synergy of medicinal plants and nanotechnology offers a promising approach to expedite the healing process for both acute and chronic wounds by facilitating the appropriate progression through various healing phases. Metal nanoparticles play an increasingly pivotal role in promoting efficient wound healing and preventing secondary bacterial infections. Their small size and high surface area facilitate enhanced biological interaction and penetration at the wound site. Specifically designed for topical drug delivery, these nanoparticles enable the sustained release of therapeutic molecules, such as growth factors and antibiotics. This targeted approach ensures optimal cell-to-cell interactions, proliferation, and vascularization, fostering effective and controlled wound healing. Nanoscale scaffolds have significant attention due to their attractive properties, including delivery capacity, high porosity and high surface area. They mimic the Extracellular matrix (ECM) and hence biocompatible. In response to the alarming rise of antibiotic-resistant, biohybrid nanofibrous wound dressings are gradually replacing conventional antibiotic delivery systems. This emerging class of wound dressings comprises biopolymeric nanofibers with inherent antibacterial properties, nature-derived compounds, and biofunctional agents. Nanotechnology, diminutive nanomaterials, nanoscaffolds, nanofibers, and biomaterials are harnessed for targeted drug delivery aimed at wound healing. This review article discusses the effects of nanofibrous scaffolds loaded with nanoparticles on wound healing, including biological (in vivo and in vitro) and mechanical outcomes.

Chitosan and neem gum-based polyelectrolyte complex for design of allantoin loaded biocomposite film: In-vitro, ex-vivo, and in-vivo characterization

Presently, the preference for chitosan (CS) and gum polysaccharides in biomedical applications including drug delivery and wound healing has been extensively documented. Despite this, the demerits of CS and gum polysaccharides such as poor mechanical properties, degradation rate, swelling, etc., limit their applications for designing biocomposite films for drug delivery. Therefore, the anticipated work aims to design a CS and neem gum polysaccharides (NGP) polyelectrolyte complex-based allantoin (AT)-loaded (CS/NGP-AT) biocomposite film for improved wound healing. In brief, CS, NGP, and CS/NGP-AT-based biocomposite films were prepared using the solvent-casting method, and in-vitro, ex-vivo, and in-vivo characterizations were performed to assess the performance of these biocomposite films compared to their counterparts. In this, diffractogram and thermogram analysis assured the conversion of crystalline AT into an amorphous form. The optimized CS/NGP/AT-3 formulation exhibited controlled water absorption, appropriate water uptake capacity, good water retention ability, excellent water vapor transmission rate, controlled degradation rate, enhanced mechanical properties, cell and blood biocompatibility, etc. Furthermore, it offered improved antimicrobial, anti-inflammatory, and antioxidant potential. The optimized film provided a modified release (88.3 ± 0.3 %) of AT from the film for up to 48 h. Wound healing experiments on rats and their histopathology studies confirmed a significantly higher rate of wound recovery within 14 days compared to the control and CS/NGP film, attributable to the combined effects of CS, NGP, and AT. In conclusion, the fabricated CS/NGP-based biocomposite film presents promising prospects as an excellent candidate for wound healing applications.

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

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

A dual network cross-linked hydrogel with multifunctional Bletilla striata polysaccharide/gelatin/tea polyphenol for wound healing promotion

Wound healing is a dynamic and complex biological process, and traditional biological excipients cannot meet the needs of the wound healing process, and there is an urgent need for a biological dressing with multifunctionality and the ability to participate in all stages of wound healing. This study developed tea polyphenol (TP) incorporated multifunctional hydrogel based on oxidized Bletilla striata polysaccharide (OBSP) and adipic acid dihydrazide modified gelatin (Gel-ADH) with antimicrobial, antioxidant hemostatic, and anti-inflammatory properties to promote wound healing. The composite OBSP, Gel-ADH, TP (OBGTP) hydrogels prepared by double crosslinking between OBSP, TP and Gel-ADH via Schiff base bonding and hydrogen bonding had good rheological and swelling properties. The introduction of TP provided the composite hydrogel with excellent antioxidant antibacterial activities against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coil). In the rat liver hemorrhage model and skin injury model, the OBGTP composite hydrogel had significant (p < 0.001) hemostatic ability, and had the ability to accelerate collagen deposition, reduce the expression of inflammatory factors, and promote rapid wound healing. In addition, OBGTP hydrogels had adhesive properties and good biocompatibility. In conclusion, OBGTP multifunctional composite hydrogels have great potential for wound healing applications.

Emulgel based on fish skin collagen-microalgae-silver increased neovascularization and re-epithelialization of full thickness burn in rats

Deep skin burn represents a global morbidity and mortality problem, and the limitation of topical treatment agents has motivated research to development new formulations capable of preventing infections and accelerating healing. The aim of this work was to develop and characterize an emulgel based on collagen (COL) and gelatin (GEL) extracted from fish skin associated with Chlorella vulgaris extract (CE) and silver nitrate (AgNO3). COL and GEL were characterized by physicochemical and thermal analyses; and CE by electrophoresis and its antioxidant capacity. Three emulgels formulations were developed: COL (0.5%) + GEL (2.5%) (E1), COL+GEL+CE (1%) (E2), and COL+GEL+CE + AgNO3 (0.1%) (E3). All formulations were characterized by physicochemical, rheology assays, and preclinical analyses: cytotoxicity (in vitro) and healing potential using a burn model in rats. COL and GEL showed typical physicochemical characteristics, and CE presented 1.3 mg/mL of proteins and antioxidant activity of 76%. Emulgels presented a coherent physicochemical profile and pseudoplastic behavior. Preclinical analysis showed concentration-dependent cytotoxicity against fibroblast and keratinocytes. In addition, all emulgels induced similar percentages of wound contraction and complete wound closure in 28 days. The histopathological analysis showed higher scores for polymorphonuclear cells to E1 and greater neovascularization and re-epithelialization to E3. Then, E3 formulation has potential to improve burn healing, although its use in a clinical setting requires further studies.

Novel electro-spun fabrication of blended polymeric nanofibrous wound closure materials loaded with catechin to improve wound healing potential and microbial inhibition for the care of diabetic wound

Diabetic wound infections caused by the multiplication of infectious pathogens and their antibiotic resistance. Wound infection evident by bacterial colonization and other factors, such as the virulence and host immune factors. In this context, we need discover appropriate treatment and effective antibiotics for wound infection control. Considering this, we synthesized catechin-loaded polyvinyl alcohol/Chitosan (PVA/CS) based nanofiber for multifunctional wound healing. The physicochemical and biological properties of fabricated nanofiber, were systematically evaluated by various spectroscopy and microscopy techniques. The CA@PVA/CS nanofiber exhibited a high level of antibacterial and antioxidant effects. The nanofibers showed effective control in gram-positive and negative wound infectious bacterial multiplication at the lowest concentration. Based on the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cell viability study CA@PVA/CS nanofiber shows excellent biocompatibility against L929 cells. In wound, scratch assay results revealed that the CA@PVA/CS treated group shows enhanced cell migration and cell proliferation within 48 h. The synthesis of antioxidant, antibacterial, and biocompatible nanofiber exposes their potential for effective wound healing. Current research hypothesized catechin loaded PVA/CS nanofiber could be a multifunctional and low-cost material for diabetic wound care application. Fabricated nanofiber would be improved skin tissue regeneration and public health hygiene.

Film dressings from Thai mango seed kernel extracts versus nanocrystalline silver dressings in antibacterial properties

Introduction: The extract from the Mango Seed Kernel (MSK) has been documented to exhibit antibacterial activity against Gram-positive and Gram-negative bacteria, including Staphylococcus aureus and Pseudomonas aeruginosa. This suggests that biomaterials containing MSK extract could be a viable alternative to conventional wound treatments, such as nanocrystalline silver dressings. Despite this potential, there is a notable gap in the literature regarding comparing the antibacterial effectiveness of MSK film dressings with nanocrystalline silver dressings. This study aimed to develop film dressings containing MSK extract and evaluate their antibacterial properties compared to nanocrystalline silver dressings. Additionally, the study aimed to assess other vital physical properties of these dressings critical for effective wound care. Materials and methods: We prepared MSK film dressings from two cultivars of mango from Thailand, 'Chokanan' and 'Namdokmai'. The inhibition-zone method was employed to determine the antibacterial property. The morphology and chemical characterization of the prepared MSK film dressings were examined with scanning electron microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR), respectively. The absorption of pseudo-wound exudate and water vapor transmission rate (WVTR) of film dressings were evaluated. Results: The results showed that 40% of MSKC film dressing had the highest inhibition zone (20.00 ± 0.00 mm against S. aureus and 17.00 ± 1.00 mm against P. aeruginosa) and 20%, 30%, and 40% of MSKC and MSKN film dressings had inhibition zones similar to nanocrystalline silver dressing for both S. aureus and P. aeruginosa (p > 0.05). In addition, all concentrations of the MSK film dressings had low absorption capacity, and Chokanan MSK (MSKC) film dressings had a higher WVTR than Namdokmai MSK (MSKN) film dressings. Conclusion: 20%, 30%, and 40% of MSK film dressing is nearly as effective as nanocrystalline silver dressing. Therefore, it has the potential to be an alternative antibacterial dressing and is suitable for wounds with low exudate levels.

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.

Core-shell nanofibers containing L-arginine stimulates angiogenesis and full thickness dermal wound repair

Despite the advances in medicine, wound healing is still challenging and piques the interest of biomedical engineers to design effective wound dressings using natural and artificial polymers. In present study, coaxial electrospinning was employed to fabricate core-shell nanofiber-based wound dressing, with core composed of polyacrylamide (PAAm) and shell comprising 0.5 % solution of L-Arginine (L-Arg) in aloe vera and keratin (AloKr). Aloe vera and keratin were added as natural polymers to promote angiogenesis, reduce inflammation, and provide antibacterial activity, whereas PAAm in core was used to improve the tensile properties of the wound dressing. Moreover, L-Arg was incorporated in shell to promote angiogenesis and collagen synthesis. The fiber diameter of PAAm/(AloKr/L-Arg) core-shell fibers was (93.33 ± 35.11 nm) with finer and straighter fibers and higher water holding capacity due to increased surface area to volume ratio. In terms of tensile properties, the PAAm/(AloKr/L-Arg) core-shell nanofibers with tensile strength and elastic modulus of 2.84 ± 0.27 MPa and 62.15 ± 5.32 MPa, respectively, showed the best mechanical performance compared to other nanofibers tested. Furthermore, PAAm/(AloKr/L-Arg) exhibited the highest L-Arg release (87.62 ± 3.02 %) and viability of L929 cells in vitro compared to other groups. In addition, the highest rate of in vivo full thickness wound healing was observed in PAAm/(AloKr/L-Arg) group compared to other groups. It significantly enhanced the angiogenesis, neovascularization, and cell proliferation. The prepared PAAm/(AloKr/L-Arg) core-shell nanofibrous dressing could be promising for full-thickness wound healing.

Double-Network Hydrogel with Strengthened Mechanical Property for Controllable Release of Antibacterial Peptide

Developing double-network (DN) hydrogels with high mechanical properties and antibacterial efficacy to combat multidrug-resistant bacterial infections and serve as scaffolds for cell culture still remains an ongoing challenge. In this study, an ion-responsive antibacterial peptide (AMP) (C16-WIIIKKK, termed as IK7) was synergistically combined with a photoresponsive gelatin methacryloyl (GelMA) polymer to fabricate a biocompatible DN hydrogel. The GelMA-IK7 DN hydrogel showed enhanced mechanical properties in contrast to the individual IK7 and GelMA hydrogels and demonstrated substantial antibacterial efficacy. Further investigations revealed that the DN hydrogel effectively inhibited bacterial growth by the controlled and sustained release of the IK7 peptide. In addition, the formation of the DN hydrogel was also found to protect AMP IK7 from rapid degradation by proteinase K. Our findings suggested that the developed GelMA-IK7 DN hydrogel holds great potential for next-generation antibacterial hydrogels for three-dimensional cell culture and tissue regeneration.

Functionalization of cotton nonwoven with cyclodextrin/lawsone inclusion complex nanofibrous coating for antibacterial wound dressing

Functionalizing cotton to induce biological activity is a viable approach for developing wound dressing. This study explores the development of cotton-based wound dressing through coating with biologically active nanofibers. Bioactive compounds like lawsone offer dual benefits of wound healing and infection prevention, however, their limited solubility and viability hinder their applications. To address this, Hydroxypropyl-beta-cyclodextrin (HP-β-CD) and Hydroxypropyl-gamma-cyclodextrin (HP-γ-CD) were employed. Inclusion complexations of CD/lawsone were achieved at 2:1 and 4:1 M ratios, followed by the fabrication of CD/lawsone nanofibrous systems via electrospinning. Phase solubility studies indicated a twofold increase in lawsone water-solubility with HP-β-CD. Electrospinning yielded smooth and uniform nanofibers with an average diameter of ∼300-700 nm. The results showed that while specific crystalline peaks of lawsone are apparent in the samples with a 2:1 M ratio, they disappeared in 4:1, indicating complete complexation. The nanofibers exhibited ∼100 % loading efficiency of lawsone and its rapid release upon dissolution. Notably, antibacterial assays demonstrated the complete elimination of Escherichia coli and Staphylococcus aureus colonies. The CD/lawsone nanofibers also showed suitable antioxidant activity ranging from 50 % to 70 %. This integrated approach effectively enhances lawsone's solubility through CD complexation and offers promise for bilayer cotton-based wound dressings.

Development of a Sprayable Hydrogel-Based Wound Dressing: An In Vitro Model

Hydrogel-based dressings can effectively heal wounds by providing multiple functions, such as antibacterial, anti-inflammatory, and preangiogenic bioactivities. The ability to spray the dressing is important for the rapid and effective coverage of the wound surface. In this study, we developed a sprayable hydrogel-based wound dressing using naturally derived materials: hyaluronic acid and gelatin. We introduced methacrylate groups (HAMA and GelMA) to these materials to enable controllable photocrosslinking and form a stable hydrogel on the wound surface. To achieve sprayability, we evaluated the concentration of GelMA within a range of 5-15% (w/v) and then incorporated 1% (w/v) HAMA. Additionally, we incorporated calcium peroxide into the hydrogel at concentrations ranging from 0 to 12 mg/mL to provide self-oxygenation and antibacterial properties. The results showed that the composite hydrogels were sprayable and could provide oxygen for up to two weeks. The released oxygen relieved metabolic stress in fibroblasts and reduced cell death under hypoxia in in vitro culture. Furthermore, calcium peroxide added antibacterial properties to the wound dressing. In conclusion, the developed sprayable hydrogel dressing has the potential to be advantageous for wound healing due to its practical and conformable application, as well as its self-oxygenating and antibacterial functions.

Gelatin/carboxymethyl chitosan/aloe juice hydrogels with skin-like endurance and quick recovery: Preparation, characterization, and properties

Gelatin-based hydrogels have gained considerable attention due to their resemblance to the extracellular matrix and hydrophilic three-dimensional network structure. Apart from providing an air-permeable and moist environment, these hydrogels optimize the inflammatory microenvironment of the wounds. These properties make gelatin-based hydrogels highly competitive in the field of wound dressings. In this study, a series of composite hydrogels were prepared using gelatin (Gel) and carboxymethyl chitosan (CMCh) as primary materials, glutaraldehyde as a crosslinker, and aloe vera juice as an anti-inflammatory component. The properties of the hydrogel, including its rheological properties, microscopic structures, mechanical properties, swelling ratios, thermal stability, antibacterial properties, and biocompatibility, were investigated. The results demonstrate that the gelatin-based hydrogels exhibit good elasticity and rapid self-healing ability. The hydrogels exhibited slight shear behavior, which is advantageous for skin care applications. Furthermore, the inclusion of aloe vera juice into the hydrogel resulted in a dense structure, improved mechanical properties and enhanced swelling ratio. The Gel/CMCh/Aloe hydrogels tolerate a compressive strength similar to that of human skin. Moreover, the hydrogels displayed excellent cytocompatibility with HFF-1 cells, and exhibited antibacterial activity against E. coli and S. aureus. Lomefloxacin was used as a model drug to study the releasing behavior of the Gel/CMCh/aloe hydrogels. The results showed that the drug was released rapidly at the initial stage, and could continue to be released for 12 h, the maximum releasing rate exceeded 20 %. These findings suggest that the gelatin-based hydrogels hold great promise as effective wound dressings.

Recent research advances on polysaccharide-, peptide-, and protein-based hemostatic materials: A review

Hemorrhage is a potentially life-threatening emergency that can occur at any time or place. Whether traumatic, congenital, surgical, disease-related, or drug-induced, bleeding can lead to severe complications or death. Therefore, the development of efficient hemostatic materials is critical. However, the results and prognosis demonstrated by clinical means of hemostasis do not reach expectations. With the development of technology, novel hemostatic materials have been developed from polysaccharides (chitosan, hyaluronic acid, alginate, cellulose, cyclodextrins, starch, dextran, and carrageenan), peptides (self-assembling peptides), and proteins (silk fibroin, collagen, gelatin, keratin, and thrombin). These new materials exhibit high hemostatic efficacy due to the enhancement or interaction of various hemostatic mechanisms. The main forms include adhesives, sealants, bandages, hemostatic powders, and hemostatic sponges. This article introduces the clotting process and principles of hemostatic methods and reviews the research on polysaccharide-, peptide-, and protein-based hemostatic materials in the last five years. The design ideas and hemostatic principles of polysaccharide-, peptide-, and protein-based hemostatic materials are mainly introduced. Finally, we summarize material designs, advantages, disadvantages, and challenges regarding hemostatic materials.

Biomedical and ecosafety assessment of marine fish collagen capped silver nanoparticles

In the rapidly evolving landscape of silver nanoparticles (Ag NPs) synthesis, the focus has predominantly been on plant-derived sources, leaving the realm of biological or animal origins relatively uncharted. Breaking new ground, our study introduces a pioneering approach: the creation of Ag NPs using marine fish collagen, termed ClAg NPs, and offers a comprehensive exploration of their diverse attributes. To begin, we meticulously characterized ClAg NPs, revealing their spherical morphology, strong crystalline structure, and average diameter of 5 to 100 nm. These NPs showed potent antibacterial activity, notably against S. aureus (gram-positive), surpassing their efficacy against S. typhi (gram-negative). Additionally, ClAg NPs effectively hindered the growth of MRSA biofilms at 500 μg/mL. Impressively, they demonstrated substantial antioxidant capabilities, out performing standard gallic acid. Although higher concentrations of ClAg NPs induced hemolysis (41.804 %), lower concentrations remained non hemolytic. Further evaluations delved into the safety and potential applications of ClAg NPs. In vitro cytotoxicity studies on HEK 293 and HeLa cells revealed dose-dependent toxicity, with IC50 of 75.28 μg/mL and 79.13 μg/mL, respectively. Furthermore, ClAg NPs affected seed germination, root, and shoot lengths in Mung plants, underscoring their relevance in agriculture. Lastly, zebrafish embryo toxicity assays revealed notable effects, particularly at 500 μg/mL, on embryo morphology and survival rates at 96 hpf. In conclusion, our study pioneers the synthesis and multifaceted evaluation of ClAg NPs, offering promise for their use as versatile nano therapeutics in the medical field and as high-value collagen-based nanobiomaterial with minimal environmental impact.

Surface modification strategies for improved hemocompatibility of polymeric materials: a comprehensive review

Polymeric biomaterials are a widely used class of materials due to their versatile properties. However, as with all other types of materials used for biomaterials, polymers also have to interact with blood. When blood comes into contact with any foreign body, it initiates a cascade which leads to platelet activation and blood coagulation. The implant surface also has to encounter a thromboinflammatory response which makes the implant integrity vulnerable, this leads to blood coagulation on the implant and obstructs it from performing its function. Hence, the surface plays a pivotal role in the design and application of biomaterials. In particular, the surface properties of biomaterials are responsible for biocompatibility with biological systems and hemocompatibility. This review provides a report on recent advances in the field of surface modification approaches for improved hemocompatibility. We focus on the surface properties of polysaccharides, proteins, and synthetic polymers. The blood coagulation cascade has been discussed and blood - material surface interactions have also been explained. The interactions of blood proteins and cells with polymeric material surfaces have been discussed. Moreover, the benefits as well as drawbacks of blood coagulation on the implant surface for wound healing purposes have also been studied. Surface modifications implemented by other researchers to enhance as well as prevent blood coagulation have also been analyzed.

Hydrolyzed Collagen Powder Dressing Improves Wound Inflammation, Perfusion, and Breaking Strength of Repaired Tissue

Objective: Hydrolyzed collagen-based matrices are widely used as wound care dressings. Information on the mechanism of action of such dressings is scanty. The objective of this study was to test the effect of a specific hydrolyzed collagen powder (HCP), which is extensively used for wound care management in the United States. Approach: The effects of HCP on resolution of wound inflammation, perfusion, closure, and breaking strength of the repaired skin were studied in an experimental murine model. Results: In early (day 7) inflammatory phase of wound macrophages, HCP treatment boosted phagocytosis and efferocytosis of wound-site macrophages. In these cells, inducible reactive oxygen species were also higher on day (d) 7. HCP treatment potentiated the expression of anti-inflammatory interleukin (IL)-10 cytokine and proangiogenic vascular endothelial growth factor (VEGF) production. Excisional wounds dressed with HCP showed complete closure on day 21, while the control wounds remained open. HCP treatment also demonstrated improved quality of wound healing as marked by the improved breaking strength of the closed wound tissue/repaired skin. Innovation: These data represent first evidence on the mechanism of action of clinically used HCP. Conclusion: HCP dressing favorably influenced both wound inflammation and vascularization. Improved breaking strength of HCP-treated repaired skin lays the rationale for future studies testing the hypothesis that HCP-treated closed wounds would show fewer recurrences.

Polymer-Based Functional Materials Loaded with Metal-Based Nanoparticles as Potential Scaffolds for the Management of Infected Wounds

Wound infection due to bacterial invasion at the wound site is one of the primary challenges associated with delayed wound healing. Microorganisms tend to form biofilms that protect them from harm, leading to their multidrug resistance. The alarming increase in antibiotic resistance poses a threat to wound healing. Hence, the urgent need for novel wound dressing materials capable of managing bacterial infection is crucial for expediting wound recovery. There is considerable interest in polymeric wound dressings embedded with bioactive substances, such as metal-based nanoparticles, as potential solutions for treating microbially infected wounds. Metal-based nanoparticles have been widely used for the management of infected wounds due to their broad antimicrobial efficacy. This review focuses on polymer-based and bioactive wound dressings loaded with metal-based nanoparticles like silver, gold, magnesium oxide, or zinc oxide. When compared, zinc oxide-loaded dressings exhibited higher antibacterial activity against Gram-positive strains and silver nanoparticle-loaded dressings against gram-negative strains. However, wound dressings infused with both nanoparticles displayed a synergistic effect against both strains of bacteria. Furthermore, these dressings displayed antibiofilm activity and the generation of reactive oxygen species while accelerating wound closure both in vitro and in vivo.

Cellulose Acetate-Based Wound Dressings Loaded with Bioactive Agents: Potential Scaffolds for Wound Dressing and Skin Regeneration

Wound healing and skin regeneration are major challenges in chronic wounds. Among the types of wound dressing products currently available in the market, each wound dressing material is designed for a specific wound type. Some of these products suffer from various shortcomings, such as poor antibacterial efficacy and mechanical performance, inability to provide a moist environment, poor permeability to oxygen and capability to induce cell migration and proliferation during the wound healing process. Hydrogels and nanofibers are widely reported wound dressings that have demonstrated promising capability to overcome these shortcomings. Cellulose acetate is a semisynthetic polymer that has attracted great attention in the fabrication of hydrogels and nanofibers. Loading bioactive agents such as antibiotics, essential oils, metallic nanoparticles, plant extracts, and honey into cellulose acetate-based nanofibers and hydrogels enhanced their biological effects, including antibacterial, antioxidant, and wound healing. This review reports cellulose acetate-based hydrogels and nanofibers loaded with bioactive agents for wound dressing and skin regeneration.

Body temperature-induced adhesive hyaluronate/gelatin-based hybrid hydrogel dressing for promoting skin regeneration

Skin wound management faces significant clinical challenges, including continuous bacterial infection and inflammation. Therefore, developing removable hydrogel dressings with intrinsic multifunctional properties is highly desirable. In this study, a body temperature-induced adhesive and removable hydrogel was designed to treat skin defect wounds. The HA/Gel-R-Ag hybrid gel was prepared by incorporating a silver ion-crosslinked sulfhydryl hyaluronate/gelatin-based polymeric gel network into a supramolecular rhein gel network, thereby significantly enhancing its mechanical properties. Temperature-responsive gelatin chains give the hybrid gel reversible tissue adhesiveness and detachment, thus avoiding secondary injury to wounds when changing the hydrogels. The hybrid gel exhibited excellent bactericidal ability owing to the antibacterial capacity of the silver ions and rhein. Moreover, both HA and rhein endowed the hybrid gel with immunoregulatory effects by promoting macrophage polarization from pro-inflammatory M1 phenotype to anti-inflammatory M2 phenotype. In a full-thickness skin defect mouse mode, this porous, degradable, and biocompatible HA/Gel-R-Ag hybrid gel boosted skin regeneration by inhibiting inflammation and promoting collagen deposition and angiogenesis. It is thus a simple method for widening the application range of mechanically weak rhein gels and providing a promising wound dressing material with multiple intrinsic functions for treating skin wounds.

Fabrication and characterization of new levan@CBD biocomposite sponges as potential materials in natural, non-toxic wound dressing applications

Wound healing is a complex process; therefore, new dressings are frequently required to facilitate it. In this study, porous bacterial levan-based sponges containing cannabis oil (Lev@CBDs) were prepared and fully characterized. The sponges exhibited a suitable swelling ratio, proper water vapor transmission rate, sufficient thermal stability, desired mechanical properties, and good antioxidant and anti-inflammatory properties. The obtained Lev@CBD materials were evaluated in terms of their interaction with proteins, human serum albumin and fibrinogen, of which fibrinogen revealed the highest binding effect. Moreover, the obtained biomaterials exhibited antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa, as well as being non-hemolytic material as indicated by hemolysis tests. Furthermore, the sponges were non-toxic and compatible with L929 mouse fibroblasts and HDF cells. Most significantly, the levan sponge with the highest content of cannabis oil, in comparison to others, retained its non-hemolytic, anti-inflammatory, and antimicrobial properties after prolonged storage in a climate chamber at a constant temperature and relative humidity. The designed sponges have conclusively proven their beneficial physicochemical properties and, at the preliminary stage, biocompatibility as well, and therefore can be considered a promising material for wound dressings in future in vivo applications.

Development of an In Situ Photo-Crosslinking Antimicrobial Collagen Hydrogel for the Treatment of Infected Wounds

Antimicrobial hydrogels have received considerable attention in the treatment of bacteria-infected wounds. Herein, we develop a neutral, soluble collagen via modification with maleic anhydride, serving as a hydrogel precursor. Maleic anhydride-modified collagen (ColME) could form a gel after exposure to UV light and be loaded with the antimicrobial agents, nisin and levofloxacin, to acquire antimicrobial ability. The ColME hydrogel containing nisin and levofloxacin had good cytocompatibility and effectively killed pathogenic bacterial strains, such as Escherichia coli and Staphylococcus aureus. The antimicrobial ColME hydrogels effectively supported the healing of a full-thickness skin wound infected with S. aureus in a mouse model. Our results demonstrate the potential of antimicrobial hydrogels as effective wound dressings via in situ photogelation for the healing of infected wounds.

Biomimetic Antibacterial Gelatin Hydrogels with Multifunctional Properties for Biomedical Applications

A facile novel approach of introducing dopamine and [2-(methacryloyloxy) ethyl] dimethyl-(3-sulfopropyl) ammonium hydroxide via dopamine-triggered in situ synthesis into gelatin hydrogels in the presence of ZnSO4 is presented in this study. Remarkably, the resulting hydrogels showed 99.99 and 100% antibacterial efficiency against Gram-positive and Gram-negative bacteria, respectively, making them the highest performing surfaces in their class. Furthermore, the hydrogels showed adhesive properties, self-healing ability, antifreeze properties, electrical conductivity, fatigue resistance, and mechanical stability from -100 to 80 °C. The added multifunctional performance overcomes several disadvantages of gelatin-based hydrogels such as poor mechanical properties and limited thermostability. Overall, the newly developed hydrogels show significant potential for numerous biomedical applications, such as wearable monitoring sensors and antibacterial coatings.

Dual cross-linked gellan gum/gelatin-based multifunctional nanocomposite hydrogel scaffold for full-thickness wound healing

Biological macromolecules are excellent materials for wound dressing owing to their similar structure to the extracellular matrix and adjustable physicochemical properties. This research focuses on fabricating biological macromolecule-based hydrogel with desirable antibacterial, antioxidant, controlled drug release, cytocompatibility, and wound healing properties. Herein, different concentrations of nanoceria (NC) and flurbiprofen (FLU) drug-loaded gellan gum/gelatin (GG/Ge) based dual crosslinked (Ionic and EDC/NHS coupling) hydrogels were engineered. All fabricated hydrogels were hydrophilic, biodegradable, good strength, porous, antioxidant, hemocompatible and cytocompatible. Among all, hydrogel loaded with 500 μg/ml NC (GG/Ge/NC@FLU) exhibited desirable antioxidant, antibacterial (killed Staphylococcus aureus and Escherichia coli within 12 h), hemocompatible, cytocompatible, supports oxidative-stressed L929 cell growth and acted as a controlled release matrix for FLU, following Fickian diffusion, Peppas Sahlin and Korsmeyer-Peppas drug release models. Furthermore, nanocomposite hydrogel (GG/Ge/NC@FLU)-treated wounds of rats on day 14 demonstrated significantly higher collagen synthesis, nearly 100 % wound contractions, and efficiently decreased the expression of TNF-α and IL-1 while increasing the production of IL-10 and TNF-ß3, indicating antiinflammatory activity, and effectively reduced the expression of VEGF gene indicating effective angiogenesis than all other controls. In conclusion, the fabricated multifunctional GG/Ge/NC@FLU nanocomposite hydrogel shows promising potential for effectively treating full-thickness wound healing in a rat model.

Vascular endothelial growth factor a modified mRNA engineered cellular electrospun membrane complexes promotes mouse skin wound repair

Artificial skin substitutes are one of the most promising areas of wound healing research; however, graft survival largely depends on how the treatment is performed. Early angiogenesis is essential for wound healing and graft survival and vascular endothelial growth factor A (VEGFA) is an important cytokine that stimulates angiogenesis. Here, we first investigated the effects of different ratios of collagen (BC) and gelatin blended with poly (l-lactide-co-caprolactone) (PLCL) on nanofibrous membranes. The Young's modulus and cell proliferation were significantly higher in the 50% BC group than that in all other groups. Then, cellular electrospun membrane complexes (CEMC) were successfully constructed from nanoscaffolds and fibroblasts extracted from human foreskin and engineered with controlled autocrine VEGFA by transfecting VEGFA modified mRNA (modRNA). Engineered CEMC significantly promoted wound healing in vivo and contributed to stable vascular network formation in the grafted area, thereby increasing the survival rate of the engineered skin. This study provides a potential solution for wound healing while establishing the value of different RNA modification methods for various engineered skins in the future, thereby advancing engineered skin development.

Current advances of nanocellulose application in biomedical field

Nanocellulose (NC) is a natural fiber that can be extracted in fibrils or crystals form from different natural sources, including plants, bacteria, and algae. In recent years, nanocellulose has emerged as a sustainable biomaterial for various medicinal applications including drug delivery systems, wound healing, tissue engineering, and antimicrobial treatment due to its biocompatibility, low cytotoxicity, and exceptional water holding capacity for cell immobilization. Many antimicrobial products can be produced due to the chemical functionality of nanocellulose, such disposable antibacterial smart masks for healthcare use. This article discusses comprehensively three types of nanocellulose: cellulose nanocrystals (CNC), cellulose nanofibrils (CNF), and bacterial nanocellulose (BNC) in view of their structural and functional properties, extraction methods, and the distinctive biomedical applications based on the recently published work. On top of that, the biosafety profile and the future perspectives of nanocellulose-based biomaterials have been further discussed in this review.

Current status and progress in research on dressing management for diabetic foot ulcer

Diabetic foot ulcer (DFU) is a major complication of diabetes and is associated with a high risk of lower limb amputation and mortality. During their lifetime, 19%-34% of patients with diabetes can develop DFU. It is estimated that 61% of DFU become infected and 15% of those with DFU require amputation. Furthermore, developing a DFU increases the risk of mortality by 50%-68% at 5 years, higher than some cancers. Current standard management of DFU includes surgical debridement, the use of topical dressings and wound decompression, vascular assessment, and glycemic control. Among these methods, local treatment with dressings builds a protective physical barrier, maintains a moist environment, and drains the exudate from DFU wounds. This review summarizes the development, pathophysiology, and healing mechanisms of DFU. The latest research progress and the main application of dressings in laboratory and clinical stage are also summarized. The dressings discussed in this review include traditional dressings (gauze, oil yarn, traditional Chinese medicine, and others), basic dressings (hydrogel, hydrocolloid, sponge, foam, film agents, and others), bacteriostatic dressings, composite dressings (collagen, nanomaterials, chitosan dressings, and others), bioactive dressings (scaffold dressings with stem cells, decellularized wound matrix, autologous platelet enrichment plasma, and others), and dressings that use modern technology (3D bioprinting, photothermal effects, bioelectric dressings, microneedle dressings, smart bandages, orthopedic prosthetics and regenerative medicine). The dressing management challenges and limitations are also summarized. The purpose of this review is to help readers understand the pathogenesis and healing mechanism of DFU, help physicians select dressings correctly, provide an updated overview of the potential of biomaterials and devices and their application in DFU management, and provide ideas for further exploration and development of dressings. Proper use of dressings can promote DFU healing, reduce the cost of treating DFU, and reduce patient pain.

Recent Advances in Biodegradable and Biocompatible Synthetic Polymers Used in Skin Wound Healing

The treatment of skin wounds caused by trauma and pathophysiological disorders has been a growing healthcare challenge, posing a great economic burden worldwide. The use of appropriate wound dressings can help to facilitate the repair and healing rate of defective skin. Natural polymer biomaterials such as collagen and hyaluronic acid with excellent biocompatibility have been shown to promote wound healing and the restoration of skin. However, the low mechanical properties and fast degradation rate have limited their applications. Skin wound dressings based on biodegradable and biocompatible synthetic polymers can not only overcome the shortcomings of natural polymer biomaterials but also possess favorable properties for applications in the treatment of skin wounds. Herein, we listed several biodegradable and biocompatible synthetic polymers used as wound dressing materials, such as PVA, PCL, PLA, PLGA, PU, and PEO/PEG, focusing on their composition, fabrication techniques, and functions promoting wound healing. Additionally, the future development prospects of synthetic biodegradable polymer-based wound dressings are put forward. Our review aims to provide new insights for the further development of wound dressings using synthetic biodegradable polymers.

Bio-based polymers containing traditional medicinal fillers for wound healing applications - An evaluation of neoteric development and future perspectives

In recent years, health-care providers have seen more patients with difficult-to-treat wounds and burns. The biopolymer-based wound dressing protects the wounded area while assisting in the recovery of dermal and epithelial tissues throughout the healing process. The overall number of patients with chronic lesions has been expanding due to developing society, over weight, and cardiovascular illness. For the treatment of chronic wounds, there is an increasing demand for the development of ideal wound dressing materials with excellent properties such as antibacterial activity, biocompatibility, free radical scavenging capacity, non-adherent property, hydrophilicity, and so on. Nevertheless, owing to the above mention properties, natural polymers are being used for several key functions of biomedicine like narcotic distribution systems, tissue manufacturing, bandages, and so on. Accordingly, the significance of these bio-based polymers interfered with healing functions that lead to informing and inspiring youth and scientist researchers worldwide to grab with these far-reaching areas of medicine and biology. The review highlights the physiochemical properties of natural polymers, the biological evaluation of various materials as wound dressings, their synthesis and mechanical properties, clinical status, challenges, and future perspectives.

Agar/gelatin hydro-film containing EGF and Aloe vera for effective wound healing

In the current study, we produced a hydro-film dressing for the treatment of chronic wounds. The hydro-film structure was composed of gelatin cross-linked with citric acid, agar and Aloe vera extract (AV); additionally epidermal growth factor (EGF) was loaded to promote wound healing. Due to the excellent hydrogel-forming ability of gelatin, the obtained hydro-film was able to swell 884 ± 36% of its dry weight, which could help controlling wound moisture. To improve gelatin mechanical properties, polymer chains were cross-linked with citric acid and agar, reaching an ultimate tensile strength that was in the highest range of human skin. In addition, it showed a slow degradation profile that resulted in a remaining weight of 28 ± 8% at day 28. Regarding, biological activity, the addition of AV and citric acid provided the ability to reduce human macrophage activation, which could help reverse the permanent inflammatory state of chronic wounds. Moreover, loaded EGF, together with the structural AV of the hydro-film, promoted human keratinocyte and fibroblast migration, respectively. Furthermore, the hydro-films presented excellent fibroblast adhesiveness, so they could be useful as provisional matrices for cell migration. Accordingly, these hydro-films showed suitable physicochemical characteristics and biological activity for chronic wound healing applications.

Sugarcane Bagasse-Derived Cellulose Nanocrystal/Polyvinyl Alcohol/Gum Tragacanth Composite Film Incorporated with Betel Leaf Extract as a Versatile Biomaterial for Wound Dressing

In this study, nanocomposite film was fabricated using cellulose nanocrystals (CNCs) as nanofiller in a polymer matrix of polyvinyl alcohol (PVA) and gum tragacanth (GT) via solution casting. CNCs were extracted from sugarcane bagasse using a steam explosion technique followed by acid hydrolysis. Initial analysis of CNCs by transmission electron microscopy (TEM) showed nanosized particles of 104 nm in length and 7 nm in width. Physical and chemical characteristics of neat PVA, PVA/GT, and PVA/GT/CNC films with varying concentrations of CNCs (from 2% to 10%) were analyzed by the scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectrometry, mechanical test, and swelling test. The SEM analysis showed cluster formation of CNCs in the polymer matrix at high concentration. The developed films were transparent. FTIR spectrometry analysis confirmed the chemical functional groups of the various components in the film. The presence of GT and CNCs in the polymer matrix improved the characteristics of films as evident in the prolonged stability for 7 days and increased mechanical properties. The highest elastic modulus of 1526.11 ± 31.86 MPa and tensile strength of 80.39 MPa were recorded in PVA/GT/CNC2 film. The swelling ability, however, decreased from 260% to 230%. Cytotoxicity analysis of the PVA/GT/CNC film showed that it is nontoxic to mouse fibroblast cells L929 with 95% cell viability. Films loaded with betel leaf extract exhibited excellent antibacterial activities against Staphylococcus aureus DMST 8840 and Pseudomonas aeruginosa TISTR 781 with 28.20 ± 0.84 mm and 23.60 ± 0.55 mm inhibition zones, respectively. These results demonstrate that PVA/GT/CNC loaded with the betel leaf extract could act as promising and versatile wound dressings to protect the wound surface from infection and dehydration.