Development of antimicrobial and scar preventive chitosan hydrogel wound dressings

The scar-reducing effect of a novel chitosan gel: an in vivo study

OBJECTIVE

Scar tissue formation, as a normal part of wound healing, initiates in the proliferation phase, continues after the remodelling phase, and may cause an unpleasant appearance or disruption in normal functioning. This study investigated the effects of a topical gel on acute wound healing and reducing scars in a rat model.

METHOD

ChitoScar (ChitoTech Company, Iran), a commercial scar-reducing gel based on chitosan, was analysed for antibacterial and antiviral activity through a quantitative suspension test. Its cytotoxic effect was investigated, and then irritation and delayed-type hypersensitivity tests were carried out on rabbits through direct application of the gel. Furthermore, the effect of the chitosan-based gel on wound healing and scar tissue formation was studied in rats with an acute wound in two groups: the treatment group (topical application of the chitosan-based gel); and the control group (without treatment). Histopathological examination was carried out based on the inflammatory cells, collagen fibre, keratinocytes and fibroblasts.

RESULTS

Analysis revealed that the chitosan-based gel had no cytotoxicity and caused no erythema, oedema, local or other systemic adverse response. Wound healing occurred earlier in the treatment group, which was a result of a significant increase in re-epithelialisation, angiogenesis, fibroblast population and collagen fibre thickness (p<0.05). In the treatment group, wounds healed completely after 21 days and scars totally disappeared after 28 days, while in the control group, wound healing remained incomplete with distinct scar tissue.

CONCLUSION

The results demonstrated the positive effect of the chitosan-based gel on the duration and quality of the wound healing process, as well as minimising the scar tissue formation in this in vivo study.

Ziziphora clinopodioides extract-loaded chitosan/polyvinylpyrrolidone casting films for potential applications in wound dressings

Chitosan/polyvinylpyrrolidone composite films containing hydroalcoholic Ziziphora clinopodioides extract were developed and evaluated for their potential use as wound dressings. The physical and chemical properties of the films were extensively explored, including swelling capacity, mechanical properties, antimicrobial activity, and microstructural characteristics. The results showed that the addition of Ziziphora extract significantly increased the swelling capacity of the films by 561.24% to 1175% (p < 0.05). While tensile strength and Young's modulus were enhanced, elongation at the breaking point decreased with increasing volume percentages of Ziziphora extract. Variance analysis indicated no statistically significant effect on the tensile properties of the films with varying Ziziphora extract content (p < 0.05). Furthermore, films incorporated with Ziziphora extract demonstrated antimicrobial properties. Scanning electron microscopy (SEM) analysis revealed that samples lacking Ziziphora extract had a smooth surface, while those containing the extract displayed a rough texture that may potentially accelerate the wound healing process.

Antibacterial and Anti-Inflammatory Polysaccharide from Fructus Ligustri Lucidi Incorporated in PVA/Pectin Hydrogels Accelerate Wound Healing

In cutaneous wound healing, an overproduction of inflammatory chemokines and bacterial infections impedes the process. Hydrogels can maintain a physiologically moist microenvironment, absorb chemokines, prevent bacterial infection, inhibit bacterial reproduction, and facilitate wound healing at a wound site. The development of hydrogels provides a novel treatment strategy for the entire wound repair process. Here, a series of Fructus Ligustri Lucidi polysaccharide extracts loaded with polyvinyl alcohol (PVA) and pectin hydrogels were successfully fabricated through the freeze-thaw method. A hydrogel containing a 1% mixing weight ratio of FLL-E (named PVA-P-FLL-E1) demonstrated excellent physicochemical properties such as swellability, water retention, degradability, porosity, 00drug release, transparency, and adhesive strength. Notably, this hydrogel exhibited minimal cytotoxicity. Moreover, the crosslinked hydrogel, PVA-P-FLL-E1, displayed multifunctional attributes, including significant antibacterial properties, earlier re-epithelialization, production of few inflammatory cells, the formation of collagen fibers, deposition of collagen I, and faster remodeling of the ECM. Consequently, the PVA-P-FLL-E1 hydrogel stands out as a promising wound dressing due to its superior formulation and enhanced healing effects in wound care.

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

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

Progress in injectable hydrogels for the treatment of incompressible bleeding: an update

Uncontrollable haemorrhage from deep, noncompressible wounds remains a persistent and intractable challenge, accounting for a very high proportion of deaths in both war and disaster situations. Recently, injectable hydrogels have been increasingly studied as potential haemostatic materials, highlighting their enormous potential for the management of noncompressible haemorrhages. In this review, we summarize haemostatic mechanisms, commonly used clinical haemostatic methods, and the research progress on injectable haemostatic hydrogels. We emphasize the current status of injectable hydrogels as haemostatic materials, including their physical and chemical properties, design strategy, haemostatic mechanisms, and application in various types of wounds. We discuss the advantages and disadvantages of injectable hydrogels as haemostatic materials, as well as the opportunities and challenges involved. Finally, we propose cutting-edge research avenues to address these challenges and opportunities, including the combination of injectable hydrogels with advanced materials and innovative strategies to increase their biocompatibility and tune their degradation profile. Surface modifications for promoting cell adhesion and proliferation, as well as the delivery of growth factors or other biologics for optimal wound healing, are also suggested. We believe that this paper will inform researchers about the current status of the use of injectable haemostatic hydrogels for noncompressible haemorrhage and spark new ideas for those striving to propel this field forward.

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.

Borophosphate glasses as active agents for antimicrobial hydrogels

Herein we report the synthesis of transition-metal-free potassium borophosphate glasses and their application as bactericidal and bacteriostatic material. The antimicrobial activity was achieved through a simple change in the molar ratio of boron and phosphorus atoms, making borophosphate glass soluble in water. The glasses were analyzed by X-ray powder diffraction, Raman spectroscopy, laser-induced breakdown spectroscopy, and water absorption. The addition of a boron compound is required to obtain potassium-based phosphate glasses. Moreover, the change in the phosphorus and boron molar ratio (P/B), 2, 1 or 0.5 affects the glass solubilization in water, which increases with the phosphorus content. The glass materials were submitted to tests of biological activity against the bacteria Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. These water-soluble borophosphate glasses were employed in the development of hydrogel formulations using Carbopol®. Phosphorous-rich samples at a concentration of 15 % (w/w) in hydrogel showed better antimicrobial activity against S. aureus and E. coli, when compared to other samples, including commercial alcohol hand sanitizer gel, with an average size of the inhibition halo of 24.02±1.43 and 19.24±1.63mm, respectively.

The Influence of κ-Carrageenan-R-Phycoerythrin Hydrogel on In Vitro Wound Healing and Biological Function

Wound healing is widely recognized as a critical issue impacting the healthcare sector in numerous countries. The application of wound dressings multiple times in such instances can result in tissue damage, thereby increasing the complexity of wound healing. With the aim of tackling this necessity, in the present study, we have formulated a hydrogel using natural polysaccharide κ-carrageenan and phycobiliprotein R-phycoerythrin from Pyropia yezoensis. The formulated hydrogel κ-Carrageenan-R-Phycoerythrin (κ-CRG-R-PE) was analyzed for its antioxidant and antimicrobial activity. The wound healing potential of the κ-CRG-R-PE was evaluated in Hs27 cells by the wound scratch assay method. The hydrogel showed dose-dependent antioxidant activity and significant antimicrobial activity at 100 μg/mL concentration. κ-CRG-R-PE hydrogels promoted more rapid and complete wound closure than κ-Carrageenan (κ-CRG) hydrogel at 24 and 48 h. κ-CRG-R-PE hydrogels also filled the wound within 48 h of incubation, indicating that they positively affect fibroblast migration and wound healing.

Development of Cissus quadrangularis-Loaded POSS-Reinforced Chitosan-Based Bilayer Sponges for Wound Healing Applications: Drug Release and In Vitro Bioactivity

Nowadays, antibiotic-loaded biomaterials have been widely used in wound healing applications. However, the use of natural extracts has come into prominence as an alternative to these antimicrobial agents in the recent period. Among natural sources, Cissus quadrangularis (CQ) herbal extract is used for treatment of bone and skin diseases in ayurvedic medicine due to its antibacterial and anti-inflammatory effects. In this study, chitosan-based bilayer wound dressings were fabricated with electrospinning and freeze-drying techniques. CQ extract-loaded chitosan nanofibers were coated on chitosan/POSS nanocomposite sponges using an electrospinning method. The bilayer sponge is designed to treat exudate wounds while mimicking the layered structure of skin tissue. Bilayer wound dressings were investigated with regard to the morphology and physical and mechanical properties. In addition, CQ release from bilayer wound dressings and in vitro bioactivity studies were performed to determine the effect of POSS nanoparticles and CQ extract loading on NIH/3T3 and HS2 cells. The morphology of nanofibers was investigated with SEM analysis. Physical characteristics of bilayer wound dressings were determined with FT-IR analysis, swelling study, open porosity determination, and mechanical test. The antimicrobial activity of CQ extract released from bilayer sponges was investigated with a disc diffusion method. Bilayer wound dressings' in vitro bioactivity was examined using cytotoxicity determination, wound healing assay, proliferation, and the secretion of biomarkers for skin tissue regeneration. The nanofiber layer diameter was obtained in the range of 77.9-97.4 nm. The water vapor permeability of the bilayer dressing was obtained as 4021 to 4609 g/m2day, as it is in the ideal range for wound repair. The release of the CQ extract over 4 days reached 78-80% cumulative release. The release media were found to be antibacterial against Gram-negative and Gram-positive bacteria. In vitro studies showed that both CQ extract and POSS incorporation induced cell proliferation as well as wound healing activity and collagen deposition. As a result, CQ-loaded bilayer CHI-POSS nanocomposites were found as a potential candidate for wound healing applications.

Structural and biological engineering of 3D hydrogels for wound healing

Chronic wounds have become one of the most important issues for healthcare systems and are a leading cause of death worldwide. Wound dressings are necessary to facilitate wound treatment. Engineering wound dressings may substantially reduce healing time, reduce the risk of recurrent infections, and reduce the disability and costs associated. In the path of engineering of an ideal wound dressing, hydrogels have played a leading role. Hydrogels are 3D hydrophilic polymeric structures that can provide a protective barrier, mimic the native extracellular matrix (ECM), and provide a humid environment. Due to their advantages, hydrogels (with different architectural, physical, mechanical, and biological properties) have been extensively explored as wound dressing platforms. Here we describe recent studies on hydrogels for wound healing applications with a strong focus on the interplay between the fabrication method used and the architectural, mechanical, and biological performance achieved. Moreover, we review different categories of additives which can enhance wound regeneration using 3D hydrogel dressings. Hydrogel engineering for wound healing applications promises the generation of smart solutions to solve this pressing problem, enabling key functionalities such as bacterial growth inhibition, enhanced re-epithelialization, vascularization, improved recovery of the tissue functionality, and overall, accelerated and effective wound healing.

New insights into balancing wound healing and scarless skin repair

Scars caused by skin injuries after burns, wounds, abrasions and operations have serious physical and psychological effects on patients. In recent years, the research of scar free wound repair has been greatly expanded. However, understanding the complex mechanisms of wound healing, in which various cells, cytokines and mechanical force interact, is critical to developing a treatment that can achieve scarless wound healing. Therefore, this paper reviews the types of wounds, the mechanism of scar formation in the healing process, and the current research progress on the dual consideration of wound healing and scar prevention, and some strategies for the treatment of scar free wound repair.

Bioadhesive Gauze Embedded with Chitosan-Butein Bioconjugate: A Redox-Active pH Sensor Platform

With the ever-growing global wound care market, demand for robust redox-active healthcare material is obvious for the construction of wearable sensor platforms. Surface reactive functional group-rich material like chitosan holds huge potential for electrochemical biosensor application. Herein, a metal-free redox-active chitosan-butein (CSB) bioconjugate is processed into epidermal bioadhesive electrode material useful for pH sensors promising toward wound site analysis. A two-electrode system devised for conducting carbon-reinforced silver chloride paste and CSB-modified carbon/silver chloride matrix was used as a reference and working electrodes, respectively. Dimensions of working and reference electrodes (4 mm) were designed by 2D cutter plotter-assisted stenciling. The cross-sectional topology of the constructed adhesive CSB-sensor platform exhibits an average surface thickness of 183 ± 2 μm. Cyclic voltammetric analysis revealed the inherent 2e^-/2H⁺ transfer attributed to the catechol OH groups of graft polymerized CSB modified on adhesive gauze. As-fabricated modified electrode substrates exhibit distinguishable potential differences with respect to electrolytes of varied pH (between 5 to 9), promising for wound site analysis.

Polysaccharide-based hydrogels for drug delivery and wound management: a review

INTRODUCTION

Polysaccharide-based hydrogels (PBHs) offer several advantages over their synthetic counterparts. Their natural origin contributes to their nontoxicity, high biocompatibility, and in vivo biodegradability. Their properties can be tuned finely to obtain hydrogels with desired mechanical, structural, and chemical properties.

AREAS COVERED

Such versatile characteristics have potentiated the use of PBHs for the delivery of drugs, vaccines, protein and peptide therapeutics, genes, cells, probiotics, bacteriophages, and other therapeutic agents. Recent advances in hydrogel-based formulations such as nanogels, microgels, microneedles, hydrogel beads, nanocarrier-loaded hydrogels, and complexation hydrogels have enabled the precise delivery of a wide range of therapeutics. This review aims to give a holistic overview of hydrogels in the delivery of a variety of therapeutics through different routes.

EXPERT OPINION

PBHs have been used to enable the oral delivery of vaccines and other biologicals, thereby allowing self-administration of life-saving vaccines during public health emergencies. There is a lack of commercialized wound dressings for the treatment of chronic wounds. PBH-based wound dressings, especially those based on chitosan and loaded with actives and growth factors, have the potential to help in the long-term treatment of such wounds. Recent developments in the 3D printing of hydrogels can enable the quick and large-scale production of drug-loaded hydrogels.

Silver Nanoparticles and Its Mechanistic Insight for Chronic Wound Healing: Review on Recent Progress

Wounds are structural and functional disruptions of skin that occur because of trauma, surgery, acute illness, or chronic disease conditions. Chronic wounds are caused by a breakdown in the finely coordinated cascade of events that occurs during healing. Wound healing is a long process that split into at least three continuous and overlapping processes: an inflammatory response, a proliferative phase, and finally the tissue remodeling. Therefore, these processes are extensively studied to develop novel therapeutics in order to achieve maximum recovery with minimum scarring. Several growth hormones and cytokines secreted at the site of lesions tightly regulates the healing processes. The traditional approach for wound management has been represented by topical treatments. Metal nanoparticles (e.g., silver, gold and zinc) are increasingly being employed in dermatology due to their favorable effects on healing, as well as in treating and preventing secondary bacterial infections. In the current review, a brief introduction on traditional would healing approach is provided, followed by focus on the potential of wound dressing therapeutic techniques functionalized with Ag-NPs.

Bilayer Hydrogels for Wound Dressing and Tissue Engineering

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

Recent Advances in Hydrogel-Mediated Nitric Oxide Delivery Systems Targeted for Wound Healing Applications

Despite the noticeable evolution in wound treatment over the centuries, a functional material that promotes correct and swift wound healing is important, considering the relative weight of chronic wounds in healthcare. Difficult to heal in a fashionable time, chronic wounds are more prone to infections and complications thereof. Nitric oxide (NO) has been explored for wound healing applications due to its appealing properties, which in the wound healing context include vasodilation, angiogenesis promotion, cell proliferation, and antimicrobial activity. NO delivery is facilitated by molecules that release NO when prompted, whose stability is ensured using carriers. Hydrogels, popular materials for wound dressings, have been studied as scaffolds for NO storage and delivery, showing promising results such as enhanced wound healing, controlled and sustained NO release, and bactericidal properties. Systems reported so far regarding NO delivery by hydrogels are reviewed.

Preparation of norfloxacin-grafted chitosan antimicrobial sponge and its application in wound repair

Trauma is one of the most common health issues in humans, and bacterial infection of the wound may result in many complications. In this paper, using 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) as a coupling agent, chitosan (CS) was grafted with norfloxacin (NF), an antibacterial agent, to prepare a CS-NF sponge by freezing-induced phase separation. The CS-NF sponge was characterized by ultra violet-visible spectroscopy, Fourier transform infrared spectroscopy, and scanning electron microscopy. Its porosity and water absorption ratio were determined, the antimicrobial activity was evaluated by inhibition zone assay, and its wound repair effect was investigated in a full-thickness cutaneous excisional wound animal model. The results showed that NF was successfully grafted onto CS, and the obtained CS-NF sponge had both a high porosity and water absorption ratio. The CS-NF sponge displayed significant antimicrobial activities in the inhibition zone assay. In vivo the CS-NF sponge exhibited a strong wound healing effect, with a wound healing rate close to 100% by day 15. Therefore, the CS-NF sponge is a novel promising wound-healing dressing for clinical practice.

Fabrication of Biocompatible Electrospun Poly(ε-caprolactone)/Gelatin Nanofibers Loaded with Pinus radiata Bark Extracts for Wound Healing Applications

In this study, poly(ε-caprolactone) (PCL)/gelatin (GEL) electrospun nanofibers loaded with two different concentrations of Pinus radiata bark extracts (PEs) were fabricated via electrospinning for wound healing applications. The effects of incorporating PE into PCL/GEL electrospun nanofibers were investigated regarding their physicochemical properties and in vitro biocompatibility. All electrospun nanofibers showed smooth, uniform, and bead-free surfaces. Their functional groups were detected by ATR-FTIR spectroscopy, and their total phenol content was measured by a Folin-Ciocalteu assay. With PE addition, the electrospun nanofibers exhibited an increase in their wettability and degradation rates over time and a decrease in their tensile stress values from 20 ± 4 to 8 ± 2 MPa for PCL/GEL and PCL/GEL/0.36%PE samples, respectively. PE was also released from the fibrous mats in a rather controlled fashion. The PCL/GEL/0.18%PE and PCL/GEL/0.36%PE electrospun nanofibers inhibited bacterial activity at around 6 ± 0.1% and 23 ± 0.3% against E. coli and 14 ± 0.1% and 18 ± 0.2% against S. aureus after 24 h incubation, respectively. In vitro cell studies showed that PE-loaded electrospun nanofibers enhanced HaCaT cell growth, attachment, and proliferation, favoring cell migration towards the scratch area in the wound healing assay and allowing a complete wound closure after 72 h treatment. These findings suggested that PE-loaded electrospun nanofibers are promising materials for antibiotic-free dressings for wound healing applications.

Closing the Gap: Bridging Peripheral Sensory Nerve Defects with a Chitosan-Based Conduit a Randomized Prospective Clinical Trial

Introduction: If tensionless nerve coaptation is not possible, bridging the resulting peripheral nerve defect with an autologous nerve graft is still the current gold standard. The concept of conduits as an alternative with different materials and architectures, such as autologous vein conduits or bioartificial nerve conduits, could not replace the nerve graft until today. Chitosan, as a relatively new biomaterial, has recently demonstrated exceptional biocompatibility and material stability with neural lineage cells. The purpose of this prospective randomized clinical experiment was to determine the efficacy of chitosan-based nerve conduits in regenerating sensory nerves in the hand. Materials and methods: Forty-seven patients with peripheral nerve defects up to 26 mm distal to the carpal tunnel were randomized to receive either a chitosan conduit or an autologous nerve graft with the latter serving as the control group. Fifteen patients from the conduit group and seven patients from the control group were available for a 12-month follow-up examination. The primary outcome parameter was tactile gnosis measured with two-point discrimination. The secondary outcome parameters were Semmens Weinstein Monofilament Testing, self-assessed pain, and patient satisfaction. Results: Significant improvement (in static two-point discrimination) was observed six months after trauma (10.7 ± 1.2 mm; p < 0.05) for chitosan-based nerve conduits, but no further improvement was observed after 12 months of regeneration (10.9 ± 1.3 mm). After six months and twelve months, the autologous nerve graft demonstrated comparable results to the nerve conduit, with a static two-point discrimination of 11.0 ± 2.0 mm and 7.9 ± 1.1 mm. Semmes Weinstein Filament Testing in the nerve conduit group showed a continuous improvement over the regeneration period by reaching from 3.1 ± 0.3 after three months up to 3.7 ± 0.4 after twelve months. Autologous nerve grafts presented similar results: 3.3 ± 0.4 after three months and 3.7 ± 0.5 after twelve months. Patient satisfaction and self-reported pain levels were similar between the chitosan nerve conduit and nerve graft groups. One patient required revision surgery due to complications associated with the chitosan nerve tube. Conclusion: Chitosan-based nerve conduits are safe and suitable for bridging nerve lesions up to 26 mm in the hand. Tactile gnosis improved significantly during the early regeneration period, and functional outcomes were similar to those obtained with an autologous nerve graft. Thus, chitosan appears to be a sufficient substitute for autologous nerve grafts in the treatment of small nerve defects in the hand.

Antibiotics-Free Compounds for Chronic Wound Healing

The rapid rise in the health burden associated with chronic wounds is of great concern to policymakers, academia, and industry. This could be attributed to the devastating implications of this condition, and specifically, chronic wounds which have been linked to invasive microbial infections affecting patients' quality of life. Unfortunately, antibiotics are not always helpful due to their poor penetration of bacterial biofilms and the emergence of antimicrobial resistance. Hence, there is an urgent need to explore antibiotics-free compounds/formulations with proven or potential antimicrobial, anti-inflammatory, antioxidant, and wound healing efficacy. The mechanism of antibiotics-free compounds is thought to include the disruption of the bacteria cell structure, preventing cell division, membrane porins, motility, and the formation of a biofilm. Furthermore, some of these compounds foster tissue regeneration by modulating growth factor expression. In this review article, the focus is placed on a number of non-antibiotic compounds possessing some of the aforementioned pharmacological and physiological activities. Specific interest is given to Aloevera, curcumin, cinnamaldehyde, polyhexanide, retinoids, ascorbate, tocochromanols, and chitosan. These compounds (when alone or in formulation with other biologically active molecules) could be a dependable alternative in the management or prevention of chronic wounds.

Nanoengineered therapeutic scaffolds for burn wound management

BACKGROUND

Wound healing is a complex process, and selecting an appropriate treatment is crucial and varies from one wound to another. Among injuries, burn wounds are more challenging to treat. Different dressings and scaffolds come into play when skin is injured. These scaffolds provide the optimum environment for wound healing. With the advancements of nanoengineering, scaffolds have been engineered to improve wound healing with lower fatality rates.

OBJECTIVES

Nanoengineered systems have emerged as one of the promising candidates for burn wound management. This review paper aims to provide an in-depth understanding of burn wounds and the role of nanoengineering in burn wound management. The advantages of nanoengineered scaffolds, their properties, and their proven effectiveness have been discussed. Nanoparticles and nanofibers-based nanoengineered therapeutic scaffolds provide optimum protection, infection management, and accelerated wound healing due to their unique characteristics. These scaffolds increase cell attachment and proliferation for desired results.

RESULTS

The literature review suggested that the utilization of nanoengineered scaffolds has accelerated burn wound healing. Nanofibers provide better cell attachment and proliferation among different nanoengineered scaffolds due to their 3D structure mimics the body's extracellular matrix.

CONCLUSION

With the application of these advanced nanoengineered scaffolds, better burn wound management is possible due to sustained drug delivery, better cell attachment, and an infection-free environment.

Smart 3D Printed Hydrogel Skin Wound Bandages: A Review

Wounds are a major health concern affecting the lives of millions of people. Some wounds may pass a threshold diameter to become unrecoverable by themselves. These wounds become chronic and may even lead to mortality. Recently, 3D printing technology, in association with biocompatible hydrogels, has emerged as a promising platform for developing smart wound dressings, overcoming several challenges. 3D printed wound dressings can be loaded with a variety of items, such as antibiotics, antibacterial nanoparticles, and other drugs that can accelerate wound healing rate. 3D printing is computerized, allowing each level of the printed part to be fully controlled in situ to produce the dressings desired. In this review, recent developments in hydrogel-based wound dressings made using 3D printing are covered. The most common biosensors integrated with 3D printed hydrogels for wound dressing applications are comprehensively discussed. Fundamental challenges for 3D printing and future prospects are highlighted. Additionally, some related nanomaterial-based hydrogels are recommended for future consideration.

Novel Wound Dressing Based on Postbiotic/Chitosan Film Accelerates Cutaneous Wound Healing

Background: Wound healing is a complex and overlapping process involving immune cells, cytokines, and growth factors. Objectives: This study aimed to design and evaluate a novel wound dressing based on postbiotic/chitosan in accelerating wound healing. Methods: Lactobacillus reuteri PTCC1655 was cultured, and the cell-free supernatant (postbiotic) was obtained by medium centrifugation. The films were prepared using the solvent casting method and evaluated in terms of water absorption index, water vapor transmission rate, and antimicrobial properties. Forty-five male Wistar rats were subjected to a full-thickness excisional wound to assess the wound healing potential. The rats were randomly divided into ctrl-, chitosan, and postbiotic groups. The time-course histological and gene expression analysis was performed to compare the dressing efficacy. Results: The films showed proper water absorption and water vapor transmission rate and inhibited the pathogens commonly associated with wound infection. The postbiotic film improved wound healing by modulating the inflammatory phase, increasing collagen and elastin deposition, and enhancing angiogenesis based on the histological results. The gene expression assay showed that the postbiotic film accelerated wound healing by improving the expression of inflammatory mediators (IL-6 and TNF-α) and anti-inflammatory mediators (TGF-β and VEGF). Conclusions: The cell-free supernatant/chitosan/polyethylene glycol (CFS/CS/PEG) biodegradable film could be introduced as a novel dressing for cutaneous wound healing. This transparent film enhances cutaneous wound healing by modulating infiltrated immunity cells and expressing inflammatory/anti-inflammatory cytokines.

A 4arm-PEG macromolecule crosslinked chitosan hydrogels as antibacterial wound dressing

In order to develop better wound dressings, a novel chitosan hydrogel (Cn-Nm gel) was designed and fabricated by using aldehyde-4-arm polyethylene glycol (4r-PEG-CHO) to crosslink the chitosan dissolved in alkaline solution, amino-4-arm polyethylene glycol (4r-PEG-NH₂) was chosen as the additive simultaneously. The special dissolution technique and macromolecular crosslinking structure endows the Cn-Nm gels with better performance than that of gels prepared by acid dissolving method with micromolecule crosslinker. First, Cn-Nm gels own strong toughness with 500 kPa tensile strength and 1000% elongation, about 400% swelling ratio and fast water absorption rate. Second, about 300 kPa adhesive strength and strippability between the gels and skin is achieved. More importantly, Cn-Nm gels show nearly 100% antibacterial rate towards Escherichia coli and Staphylococcus aureus. Excellent biocompatibility is also proved by the mouse fibroblasts tests. All of the performance makes this developed chitosan-based gel be the potential candidate as a wound dressing.

Development and Evaluation of Hydrogel Wound Dressings Loaded with Herbal Extracts

The current study aimed to develop carbomer based hydrogel dressings, incorporating ethanolic extracts of Rosmarinus officinalis aerial parts, Achillea millefolium and Calendula officinalis flowers. The pharmaceutical properties of the obtained hydrogels, as well as their texture and antimicrobial activity, were further evaluated. Five wound dressing formulations based on carbopol were prepared. The addition of the ethanolic extracts to the formulation slightly lowered the pH of the hydrogels, as expected. The Rosmarinus officinalis aerial parts extract loaded hydrogel proved to be the firmest one. In terms of consistency and viscosity, the behavior of the five hydrogels was relatively similar. Based on the texture analysis, the texture of the hydrogels has been affected to some extent by the addition of the ethanolic extracts, decreasing their consistency, firmness, and adhesiveness. The hydrogel loaded with Rosmarinus officinalis aerial parts extract and the one incorporating the blend of extracts (mixture of the three above-mentioned extracts) proved to have a good antimicrobial activity. The studied hydrogel formulations could serve as a basis for the development of novel wound dressing materials, although more extended in vivo studies would be needed in order to support current results.

Near-Infrared Light-Controllable Multifunction Mesoporous Polydopamine Nanocomposites for Promoting Infected Wound Healing

The successful treatment of infected wounds requires strategies with effective antimicrobial, anti-inflammatory, and healing-promoting properties. Accordingly, the use of Cu²⁺ and tetracycline (TC), which can promote angiogenesis, re-epithelialization, and collagen deposition, also antibacterial activity, at the wound site, has shown application prospects in promoting infected wound repair. However, realizing controllable release to prolong action time and avoid potential toxicities is critical. Moreover, near-infrared light (NIR)-activated mesoporous polydopamine nanoparticles (MPDA NPs) reportedly exert anti-inflammatory effects by eliminating the reactive oxygen species generated during inflammatory responses. In this study, we assess whether Cu²⁺ and TC loaded in MPDA NPs can accelerate infected wound healing in mice. In particular, Cu²⁺ is chelated and immobilized on the surface of MPDA NPs, while a thermosensitive phase-change material (PCM; melting point: 39-40 °C), combined with antibiotics, was loaded into the MPDA NPs as a gatekeeper (PPMD@Cu/TC). Results show that PPMD@Cu/TC exhibits significant great photothermal properties with NIR irradiation, which induces the release of Cu²⁺, while inducing PCM melting and, subsequent, TC release. In combination with anti-inflammatory therapy, NIR-triggered Cu²⁺ and TC release enables the nanocomposite to eradicate bacterial wound infections and accelerate healing. Importantly, negligible damage to primary organs and satisfactory biocompatibility were observed in the murine model. Collectively, these findings highlight the therapeutic potential of this MPDA-based platform for controlling bacterial infection and accelerating wound healing.

Insightful Advancement and Opportunities for Microbial Bioplastic Production

Impetuous urbanization and population growth are driving increased demand for plastics to formulate impeccable industrial and biomedical commodities. The everlasting nature and excruciating waste management of petroleum-based plastics have catered to numerous challenges for the environment. However, just implementing various end-of-life management techniques for assimilation and recycling plastics is not a comprehensive remedy; instead, the extensive reliance on finite resources needs to be reduced for sustainable production and plastic product utilization. Microorganisms, such as bacteria and algae, are explored substantially for their bioplastic production repertoire, thus replacing fossil-based plastics sooner or later. Nevertheless, the utilization of pure microbial cultures has led to various operational and economical complications, opening the ventures for the usage of mixed microbial cultures (MMCs) consisting of bacteria and algae for sustainable production of bioplastic. The current review is primarily focuses on elaborating the bioplastic production capabilities of different bacterial and algal strains, followed by discussing the quintessence of MMCs. The present state-of-the-art of bioplastic, different types of bacterial bioplastic, microalgal biocomposites, operational factors influencing the quality and quantity of bioplastic precursors, embracing the potential of bacteria-algae consortia, and the current global status quo of bioplastic production has been summarized extensively.

The Expanded Role of Chitosan in Localized Antimicrobial Therapy

Chitosan is one of the most studied natural origin polymers for biomedical applications. This review focuses on the potential of chitosan in localized antimicrobial therapy to address the challenges of current rising antimicrobial resistance. Due to its mucoadhesiveness, chitosan offers the opportunity to prolong the formulation residence time at mucosal sites; its wound healing properties open possibilities to utilize chitosan as wound dressings with multitargeted activities and more. We provide an unbiased overview of the state-of-the-art chitosan-based delivery systems categorized by the administration site, addressing the site-related challenges and evaluating the representative formulations. Specifically, we offer an in-depth analysis of the current challenges of the chitosan-based novel delivery systems for skin and vaginal infections, including its formulations optimizations and limitations. A brief overview of chitosan's potential in treating ocular, buccal and dental, and nasal infections is included. We close the review with remarks on toxicity issues and remaining challenges and perspectives.

Construction of chitosan/Ag nanocomposite sponges and their properties

Chitosan/Ag nanocomposite sponges were prepared by soaking the chitosan hydrogels in AgNO₃ aqueous solution, which was heated at 80 °C to synthesize Ag nanoparticles (AgNPs) in the porous chitosan matrix and freeze-dried. The structure and properties of the nanocomposite sponges were characterized by FT-IR, X-ray diffraction (XRD), scanning electron microscopy (SEM), and compressive testing. In our findings, the pores of the chitosan hydrogel were used as a microreactor to synthesize AgNPs, which could distribute evenly on the chitosan matrix. The chitosan/Ag nanocomposite sponges exhibited good mechanical properties, suitable water vapor transmission and noncytotoxicity. Antibacterial test revealed their excellent antibacterial activity against Staphylococcus aureus and E. coli. The chitosan/Ag nanocomposite sponges would have great potential as wound dressings due to their good properties and facile industrialization.

Wound-aided semi-solid poly(vinyl alcohol) hydrogels incorporating essential oil-loaded chitosan nanoparticles

The potential of chitosan nanoparticles (CSNPs) loaded with essential oil (EO) incorporated into semi-solid PVA hydrogels for use in wound management was studied. Two types of essential oil were compared including clove essential oil (CEO) and turmeric essential oil (TEO). The EO-loaded CSNPs were prepared by a two-step method; oil-in-water (o/w) emulsification followed by ionic gelation using different ratios of chitosan:EO (i.e., 1:0.25, 1:0.50, 1:0.75, and 1:1.00 w/w). The increasing amount of EO caused more aggregate structure as observed from SEM images. The TEO-loaded CSNPs showed a higher extent of aggregation than the CEO-loaded CSNPs. The adhesiveness of the semi-solid PVA hydrogels containing TEO-loaded CSNPs was the highest. The use of EO-loaded CSNPs in the semi-solid PVA hydrogel helped to sustain and prolong the release rate of EO from the hydrogels as compared to just the EO alone. The studied semi-solid PVA hydrogels were non-toxic to both NCTC clone 929 and NHDF cells. Overall results suggested that these semi-solid hydrogels are good candidates for use in wound management.

Marine Polysaccharides for Wound Dressings Application: An Overview

Wound dressings have become a crucial treatment for wound healing due to their convenience, low cost, and prolonged wound management. As cutting-edge biomaterials, marine polysaccharides are divided from most marine organisms. It possesses various bioactivities, which allowing them to be processed into various forms of wound dressings. Therefore, a comprehensive understanding of the application of marine polysaccharides in wound dressings is particularly important for the studies of wound therapy. In this review, we first introduce the wound healing process and describe the characteristics of modern commonly used dressings. Then, the properties of various marine polysaccharides and their application in wound dressing development are outlined. Finally, strategies for developing and enhancing marine polysaccharide wound dressings are described, and an outlook of these dressings is given. The diverse bioactivities of marine polysaccharides including antibacterial, anti-inflammatory, haemostatic properties, etc., providing excellent wound management and accelerate wound healing. Meanwhile, these biomaterials have higher biocompatibility and biodegradability compared to synthetic ones. On the other hand, marine polysaccharides can be combined with copolymers and active substances to prepare various forms of dressings. Among them, emerging types of dressings such as nanofibers, smart hydrogels and injectable hydrogels are at the research frontier of their development. Therefore, marine polysaccharides are essential materials in wound dressings fabrication and have a promising future.

Functional Hydrogels as Wound Dressing to Enhance Wound Healing

Hydrogels, due to their excellent biochemical and mechnical property, have shown attractive advantages in the field of wound dressings. However, a comprehensive review of the functional hydrogel as a wound dressing is still lacking. This work first summarizes the skin wound healing process and relates evaluation parameters and then reviews the advanced functions of hydrogel dressings such as antimicrobial property, adhesion and hemostasis, anti-inflammatory and anti-oxidation, substance delivery, self-healing, stimulus response, conductivity, and the recently emerged wound monitoring feature, and the strategies adopted to achieve these functions are all classified and discussed. Furthermore, applications of hydrogel wound dressing for the treatment of different types of wounds such as incisional wound and the excisional wound are summarized. Chronic wounds are also mentioned, and the focus of attention on infected wounds, burn wounds, and diabetic wounds is discussed. Finally, the future directions of hydrogel wound dressings for wound healing are further proposed.

Antimicrobial Peptides: The Promising Therapeutics for Cutaneous Wound Healing

Chronic wound infections have caused an increasing number of deaths and economic burden, which necessitates wound treatment options. Hitherto, the development of functional wound dressings has achieved reasonable progress. Antibacterial agents, growth factors, and miRNAs are incorporated in different wound dressings to treat various types of wounds. As an effective antimicrobial agent and emerging wound healing therapeutic, antimicrobial peptides (AMPs) have attracted significant attention. The present study focuses on the application of AMPs in wound healing and discusses the types, properties and formulation strategies of AMPs used for wound healing. In addition, the clinical trial and the current status of studies on "antimicrobial peptides and wound healing" are elaborated through bibliometrics. Also, the challenges and opportunities for further development and utilization of AMP formulations in wound healing are discussed.

Chitosan Nanoparticles Functionalized Viscose Fabrics as Potentially Durable Antibacterial Medical Textiles

This research proposed two pretreatments of viscose fabrics: oxidation with 2,2,6,6-tetramethylpiperidine-1-oxy radical (TEMPO) and coating with TEMPO-oxidized cellulose nanofibrils (TOCN), to introduce functional groups (COOH and CHO) suitable for irreversible binding of chitosan nanoparticles without and with embedded zinc (NCS and NCS + Zn, respectively) and consequently achieving washing durable antibacterial properties of the chitosan nanoparticles functionalized fabrics. The characterizations of pretreated and chitosan nanoparticles functionalized fabrics were performed by FTIR and XPS spectroscopy, elemental analysis, inductively coupled plasma optical emission spectrometry, zeta potential measurements, scanning electron microscopy, determination of COOH and CHO groups content, and antimicrobial activity under dynamic contact conditions. Influence of pretreatments on NCS and NCS + Zn adsorption, chemical, electrokinetic, and antibacterial properties as well as morphology, and washing durability of NCS and NCS + Zn functionalized fabrics were studied and compared. Washing durability was evaluated through changes in the chitosan and zinc content, zeta potential, and antibacterial activity after 1, 3, and 5 washing cycles. Pretreatments improved washing durability of antibacterial properties of chitosan nanoparticles functionalized fabrics. The NCS and NCS + Zn functionalized pretreated fabrics preserved antibacterial activity against S. aureus after five washing cycles, while antibacterial activity against E. coli was preserved only after one washing cycle in the case NCS + Zn functionalized pretreated viscose fabrics.

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.

Biosynthesis and characterization of deuterated chitosan in filamentous fungus and yeast

Deuterated chitosan was produced from the filamentous fungus Rhizopus oryzae, cultivated with deuterated glucose in H₂O medium, without the need for conventional chemical deacetylation. After extraction and purification, the chemical composition and structure were determined by Fourier-transform infrared spectroscopy (FTIR), nuclear magnetic resonance (NMR), and small-angle neutron scattering (SANS). ¹³C NMR experiments provided additional information about the position of the deuterons in the glucoseamine backbone. The NMR spectra indicated that the deuterium incorporation at the non-exchangeable hydrogen positions of the aminoglucopyranosyl ring in the C3 - C5 positions was at least 60-80 %. However, the C2 position was deuterated at a much lower level (6%). Also, SANS showed that the structure of deuterated chitosan was very similar compared to the non-deuterated counterpart. The most abundant radii of the protiated and deuterated chitosan fibers were 54 Å and 60 Å, respectively, but there is a broader distribution of fiber radii in the protiated chitosan sample. The highly deuterated, soluble fungal chitosan described here can be used as a model material for studying chitosan-enzyme complexes for future neutron scattering studies. Because the physical behavior of non-deuterated fungal chitosan mimicked that of shrimp shell chitosan, the methods presented here represent a new approach to producing a high quality deuterated non-animal-derived aminopolysaccharide for studying the structure-function association of biocomposite materials in drug delivery, tissue engineering and other bioactive chitosan-based composites.

Polysaccharide-Based Aerogel Production for Biomedical Applications: A Comparative Review

A comparative analysis concerning bio-based gels production, to be used for tissue regeneration, has been performed in this review. These gels are generally applied as scaffolds in the biomedical field, thanks to their morphology, low cytotoxicity, and high biocompatibility. Focusing on the time interval 2015-2020, the production of 3D scaffolds of alginate, chitosan and agarose, for skin and bone regeneration, has mainly been investigated. Traditional techniques are critically reviewed to understand their limitations and how supercritical CO2-assisted processes could overcome these drawbacks. In particular, even if freeze-drying represents the most widespread drying technique used to produce polysaccharide-based cryogels, supercritical CO2-assisted drying effectively allows preservation of the nanoporous aerogel structure and removes the organic solvent used for gel preparation. These characteristics are essential for cell adhesion and proliferation.

Liposomes-in-chitosan hydrogel boosts potential of chlorhexidine in biofilm eradication in vitro

Successful treatment of skin infections requires eradication of biofilms found in up to 90 % of all chronic wounds, causing delayed healing and increased morbidity. We hypothesized that chitosan hydrogel boosts the activity of liposomally-associated membrane active antimicrobials (MAA) and could potentially improve bacterial and biofilm eradication. Therefore, liposomes (∼300 nm) bearing chlorhexidine (CHX; ∼50 μg/mg lipid) as a model MAA were incorporated into chitosan hydrogel. The novel CHX-liposomes-in-hydrogel formulation was optimized for skin therapy. It significantly inhibited the production of nitric oxide (NO) in lipopolysaccharide (LPS)-induced macrophage and almost completely reduced biofilm formation. Moreover, it reduced Staphylococcus aureus and Pseudomonas aeruginosa adherent bacterial cells in biofilm by 64.2-98.1 %. Chitosan hydrogel boosted the anti-inflammatory and antimicrobial properties of CHX.

Fibroblasts treated with macrophage conditioned medium results in phenotypic shifts and changes in collagen organization

In tissue regeneration, the goal is to regenerate tissue similar to what was damaged or missing while preventing fibrotic scarring, which may lead to decreased mechanical strength and dissimilar tissue characteristics compared to native tissue. We believe collagen orientation plays a critical role in wound contraction and scarring and that it is modulated by myofibroblasts. We used macrophage conditioned medium to simulate complex events that can influence the fibroblast phenotype during the wound healing process. In addition to examining the effect of macrophage phenotype on fibroblasts, we inhibited focal adhesion kinase (FAK), Rho-associated protein kinase (ROCK), and myosin II for fibroblasts cultured on both tissue culture plastic and methacrylated gellan gum to understand how different pathways and materials influence fibroblast responses. Collagen orientation, α-SMA expression, focal adhesion area, and cell migration were altered by inhibition of FAK, ROCK, or myosin II and macrophage phenotype, along with the substrate. An increase in either focal adhesion area or α-smooth muscle actin (α-SMA) expression correlated with an aligned collagen orientation. Gellan gum hydrogels upregulated α-SMA expression in ROCK inhibited conditioned media and downregulated the FAK area in FAK and ROCK inhibited conditioned media. Myosin II had no impact on the α-SMA expression on the substrate compared to coverslip except for M2 conditioned medium. Gellan gum hydrogel significantly increased cell migration under FAK and Myosin II mediated conditioned media and unconditioned media. Collectively, our study examined how macrophage phenotype influences fibroblast response, which would be beneficial in controlling scar tissue formation.

Design and Characterization of Elastic Artificial Skin Containing Adenosine-Loaded Solid Lipid Nanoparticles for Treating Wrinkles

Adenosine (AD), which is used for treating wrinkles, exhibits poor skin permeation. The aim of the present study was to develop a cross-linked silicone-based cellulose elastomer as an elastic artificial skin for the treatment of skin wrinkles, a biocompatible lipid-based nano-carrier for enhancing the skin permeation of AD, and a formulation consisting of the lipid-based carrier incorporated in the elastic artificial skin. AD-loaded solid lipid nanoparticles (SLNs) were prepared using a double-emulsion method. Particle characteristics and mechanical properties of SLNs and elastic artificial skin, respectively, were assessed. Skin permeation was evaluated using SkinEthic RHE tissue, a reconstructed human epidermis model. The mean particle size and zeta potential for SLNs ranged from 123.57 to 248.90 nm and -13.23 to -41.23 mV, respectively. The components of neither SLNs nor the elastic artificial skin were cytotoxic, according to cell- and tissue-viability assays and EU classification. SLNs and the elastic artificial skin exhibited sustained drug release for 48 h. The amount of AD released from SLNs and elastic artificial skin was approximately 10 times and 5 times higher, respectively, than that from AD solution. Therefore, elastic artificial skin incorporated with AD-loaded SLNs may serve as a promising topical delivery system for cosmeceutical treatment of skin wrinkles.