Thermosensitive nanofibers loaded with ciprofloxacin as antibacterial wound dressing materials

Smart theranostics for wound monitoring and therapy

To overcome the challenges of poor wound diagnosis and limited clinical efficacy of current wound management, wound dressing materials with the aim of monitoring various biomarkers vital to the wound healing process such as temperature, pH, glucose concentration, and reactive oxygen species (ROS) and improving the therapeutic outcomes have been developed. These innovative theranostic dressings are smartly engineered using stimuli-responsive biomaterials to monitor and regulate local microenvironments and deliver cargos to the wound sites in a timely and effective manner. This review provides an overview of recent advances in novel theranostics for wound monitoring and therapy as well as giving insights into the future treatment of wounds via smart design of theranostic materials.

Electrospun Gelatin Scaffolds with Incorporated Antibiotics for Skin Wound Healing

Recent advances in regenerative medicine provide encouraging strategies to produce artificial skin substitutes. Gelatin scaffolds are successfully used as wound-dressing materials due to their superior properties, such as biocompatibility and the ability to mimic the extracellular matrix of the surrounding environment. In this study, five gelatin combination solutions were prepared and successfully electrospun using an electrospinning technique. After careful screening, the optimal concentration of the most promising combination was selected for further investigation. The obtained scaffolds were crosslinked with 25% glutaraldehyde vapor and characterized by scanning electron microscopy, energy-dispersive X-ray spectroscopy, and Fourier-transform infrared spectroscopy. The incorporation of antibiotic agents such as ciprofloxacin hydrochloride and gentamicin sulfate into gelatin membranes improved the already existing antibacterial properties of antibiotic-free gelatin scaffolds against Pseudomonas aeruginosa and Staphylococcus aureus. Also, the outcomes from the in vivo model study revealed that skin regeneration was significantly accelerated with gelatin/ciprofloxacin scaffold treatment. Moreover, the gelatin nanofibers were found to strongly promote the neoangiogenic process in the in vivo chick embryo chorioallantoic membrane assay. Finally, the combination of gelatin's extracellular matrix and antibacterial agents in the scaffold suggests its potential for effective wound-healing treatments, emphasizing the importance of gelatin scaffolds in tissue engineering.

The comparison of contribution of GO and rGO produced by green synthesis to the properties of CMC-based wound dressing material

Herein, GO (graphene oxide) or rGO (reduced graphene oxide) which is produced by the green synthesis method using plant extract (Laurus nobilis) was incorporated into a polymeric structure consisting of carboxymethyl cellulose (CMC) and polyethylene glycol (PEG) to produce a wound dressing material with enhanced mechanical and electrical properties. The effect of GO and rGO on the wound dressing features of the produced materials was investigated and compared to each other. Conductivity tests demonstrated that rGO contributed more significantly to the electrical conductivity than GO. While rGO-CMC/PEG/CA reached 3.01 × 10-6 S.cm-1 as the conductivity value, that of GO-CMC/PEG/CA was determined as 0.85 × 10-6 S.cm-1. As for the mechanical tests, it was seen that rGO achieved the best results in terms of elastic modulus (588.62 N/mm2), tensile strength (94.95 MPa) and elongation at break (17.64 %) compared to GO reinforced and pure hydrogel. Curcumin and ascorbic acid were used for antibiotic-free wound treatment and their release kinetics were also modeled. The results showed that rGO reinforced hydrogel provided a more controlled release. All results assured that both the produced GO reinforced and especially rGO reinforced hydrogels could be utilized as modern wound dressing materials with suitable properties to achieve remarkable results for wound healing.

Intelligent electrospinning nanofibrous membranes for monitoring and promotion of the wound healing

The incidence of chronic wound healing is promoted by the growing trend of elderly population, obesity, and type II diabetes. Although numerous wound dressings have been studied over the years, it is still challenging for many wound dressings to perfectly adapt to the healing process due to the dynamic and complicated wound microenvironment. Aiming at an optimal reproduction of the physiological environment, multifunctional electrospinning nanofibrous membranes (ENMs) have emerged as a promising platform for the wound treatment owing to their resemblance to extracellular matrix (ECM), adjustable preparation processes, porousness, and good conformability to the wound site. Moreover, profiting from the booming development of human-machine interaction and artificial intelligence, a next generation of intelligent electrospinning nanofibrous membranes (iENMs) based wound dressing substrates that could realize the real-time monitoring of wound proceeding and individual-based wound therapy has evoked a surge of interest. In this regard, general wound-related biomarkers and process are overviewed firstly and representative iENMs stimuli-responsive materials are briefly summarized. Subsequently, the emergent applications of iENMs for the wound healing are highlighted. Finally, the opportunities and challenges for the development of next-generation iENMs as well as translating iENMs into clinical practice are evaluated.

Bringing innovative wound care polymer materials to the market: Challenges, developments, and new trends

The development of innovative products for treating acute and chronic wounds has become a significant topic in healthcare, resulting in numerous products and innovations over time. The growing number of patients with comorbidities and chronic diseases, which may significantly alter, delay, or inhibit normal wound healing, has introduced considerable new challenges into the wound management scenario. Researchers in academia have quickly identified promising solutions, and many advanced wound healing materials have recently been designed; however, their successful translation to the market remains highly complex and unlikely without the contribution of industry experts. This review article condenses the main aspects of wound healing applications that will serve as a practical guide for researchers working in academia and industry devoted to designing, evaluating, validating, and translating polymer wound care materials to the market. The article highlights the current challenges in wound management, describes the state-of-the-art products already on the market and trending polymer materials, describes the regulation pathways for approval, discusses current wound healing models, and offers a perspective on new technologies that could soon reach consumers. We envision that this comprehensive review will significantly contribute to highlighting the importance of networking and exchanges between academia and healthcare companies. Only through the joint of these two actors, where innovation, manufacturing, regulatory insights, and financial resources act in harmony, can wound care products be developed efficiently to reach patients quickly and affordably.

Catecholamines polymerization crosslinking for alginate-based burn wound dressings developed with ciprofloxacin and zinc oxide interactions

There is an increasing demand for stable and durable wound dressings to treat burn injuries and infections. Bioactive electrospun nanofibrous mats with antibacterial properties are promising for wound dressing usage. Electrospinning of biopolymers for wound dressing applications needs post-spinning crosslinking to prevent mat dissolution in moist wound environments. Here, we prepared durable wound dressing by using the Dopamine (DA) polymerization crosslinking in Alginate (ALG)/Polyvinyl alcohol (PVA) nanofibrous mats, which are developed by Ciprofloxacin (CIP) and Zinc oxide (ZO). The nanofibrous mats were investigated by FESEM, FTIR, mechanical strength, water contact angle, degradation, degree of swelling, and WVTR tests. The analyses demonstrate the nanofibrous mats with uniform and unbranched fibers, with a hydrophilic nature, which was porous, durable, and stable. Also, it showed the CIP and ZO addition enhanced their durability by crosslinking reinforcement. In addition, the drug release and antibacterial assays demonstrated the pH-sensitive release with more drug release at higher pH (bacterial invasion) and impressive antibacterial activity (up to 99 %). In the burn wound model in rats, the ALG/PVA/DA/CIP/ZO nanofibrous mats displayed excellent wound healing ability in wound closure and tissue regeneration. Also, complete re-epithelization and remodeling and highest collagen synthesis in histological assessment.

Mild Quantitative One Step Removal of Macrophages from Cocultures with Human Umbilical Vein Endothelial Cells Using Thermoresponsive Poly(Di(Ethylene Glycol)Methyl Ether Methacrylate) Brushes

The authors report on a mild, label-free, and fast method for the separation of human umbilical vein endothelial cells (HUVEC), which are relevant cells, whose use is not limited to studies of endothelial dysfunction, from cocultures with macrophages to afford HUVEC in ≈100% purity. Poly(di(ethylene glycol)methyl ether methacrylate) (PDEGMA) brushes with a dry thickness of (5 ± 1) nm afford the highly effective one-step separation by selective HUVEC detachment, which is based on the brushes' thermoresponsive behavior. Below the thermal transition at 32 °C the brushes swells and desorbs attached proteins, resulting in markedly decreased cell adhesion. Specifically, HUVEC and macrophages, which are differentiated from THP-1 monocytes, are seeded and attached to PDEGMA brushes at 37°C. After decreasing the temperature to 22°C, HUVEC shows a decrease in their cell area, while the macrophages are not markedly affected by the temperature change. After mild flushing with a cell culture medium, the HUVEC can be released from the surface and reseeded again with ≈100% purity on a new surface. With this selective cell separation and removal method, it is possible to separate and thereby purify HUVEC from macrophages without the use of any releasing reagent or expensive labels, such as antibodies.

Functionally multifaceted alginate/curdlan/agarose-based bilayer fibro-porous dressings for addressing full-thickness diabetic wounds

Full-thickness diabetic wounds are chronic injuries characterized by bleeding, excessive exude, and prolonged inflammation. Single-layer dressings fail to address their disturbed pathophysiology. Therefore, bilayer dressings with structural and compositional differences in each layer have gained attention. We hypothesized that natural polymer (alginate, curdlan, and agarose) based bilayer dressings with inherent healing properties could effectively resolve these issues. Hence, bilayer dressings were fabricated by electrospinning curdlan/agarose/ polyvinyl alcohol blend (top layer) on an alginate/agarose/polyvinyl alcohol-based lyophilized porous (bottom) layer. Ciprofloxacin was incorporated in both layers as a potential antibacterial drug. The bilayer dressing exhibited high swelling (~1300 %), biocompatibility (>90 % with NIH 3T3 and L929 mouse fibroblasts), and hemocompatibility (hemolysis <5 %). In vitro, scratch assay revealed a faster wound closure (~ 95-100 %) than control. Inhibition zone assay revealed antibacterial activity against Staphylococcus aureus and Escherichia coli. Real-time (in vitro) gene expression experiments performed using human THP-1 macrophages exhibited a significant increase in anti-inflammatory cytokines (4.51 fold in IL-10) and a decrease in pro-inflammatory cytokines (1.42 fold in IL-6) in comparison to lipopolysaccharide. Thus, fabricated dressings with high swelling, hemostatic, immunomodulatory, and antibacterial characteristics can serve as potential multifunctional and sustainable templates for healing full-thickness diabetic wounds.

Kick-Starting Wound Healing: A Review of Pro-Healing Drugs

Cutaneous wound healing consists of four stages: hemostasis, inflammation, proliferation/repair, and remodeling. While healthy wounds normally heal in four to six weeks, a variety of underlying medical conditions can impair the progression through the stages of wound healing, resulting in the development of chronic, non-healing wounds. Great progress has been made in developing wound dressings and improving surgical techniques, yet challenges remain in finding effective therapeutics that directly promote healing. This review examines the current understanding of the pro-healing effects of targeted pharmaceuticals, re-purposed drugs, natural products, and cell-based therapies on the various cell types present in normal and chronic wounds. Overall, despite several promising studies, there remains only one therapeutic approved by the United States Food and Drug Administration (FDA), Becaplermin, shown to significantly improve wound closure in the clinic. This highlights the need for new approaches aimed at understanding and targeting the underlying mechanisms impeding wound closure and moving the field from the management of chronic wounds towards resolving wounds.

Synthesis and Characterization of Antibacterial Chitosan Films with Ciprofloxacin in Acidic Conditions

This work presents the results of research on obtaining chitosan (CS) films containing on their surface ciprofloxacin (CIP). A unique structure was obtained that not only gives new properties to the films, but also changes the way of coverage and structure of the surface. The spectroscopic test showed that in the process of application of CIP on the surface of CS film, CIP was converted from its crystalline form to an amorphic one, hence improving its bioavailability. This improved its scope of microbiological effect. The research was carried out on the reduction of CIP concentration during the process of CIP adhesion to the surface of chitosan films. The antibacterial activity of the CS films with and without the drug was evaluated in relation to Escherichia coli and Staphylococcus aureus, as well as Candida albicans and Penicillium expansum. Changes in the morphology and roughness of membrane surfaces after the antibacterial molecule adhesion process were tested with atomic force microscopy (AFM) and scanning electron microscopy (SEM). Structural analysis of CS and its modifications were confirmed with Fourier-transform spectroscopy in the infrared by an attenuated total reflectance of IR radiation (FTIR-ATR) and solid-state nuclear magnetic resonance (NMR).

Resveratrol-loaded co-axial electrospun poly(ε-caprolactone)/chitosan/polyvinyl alcohol membranes for promotion of cells osteogenesis and bone regeneration

The guided bone regeneration (GBR) membranes currently used in clinics are usually compromised by their limited osteogenic induction potential. In this study, we fabricate a core-shell poly(ε-caprolactone)/chitosan/polyvinyl alcohol (PCL/CS/PVA) GBR membrane with different amount of resveratrol (RSV), endowing the PCL/CS/PVA GBR membrane with superior osteogenic induction ability, which was not attained by the regular GBR membrane. The prepared GBR membranes were characterized by scanning electron microscopy, transmission electron microscopy, and CCK-8 and live-dead staining assays, and their osteogenic induction ability was evaluated using Col-I immunofluorescence staining, micro-computed tomography, haematoxylin and eosin staining and immunohistochemical staining. Results of the in vitro release experiment confirmed that the membranes exhibited a continuous RSV release profile for 15 days. Furthermore, the cumulative releasing of RSV was increased from 39.68 ± 2.09 μg to 65.8 ± 2.91 μg with increasing contents of RSV from 0.1 % to 0.5 % (w/v) in the core layer of GBR membranes. In particular, the PCL/CS/PVA GBR membrane loading with 0.5 % RSV most efficiently release RSV in a sustained and controlled manner, which significantly induced osteogenic differentiation of pre-osteoblasts in vitro and bone regeneration in vivo. Based on the in vivo histological findings, newly formed bone tissues with 82.46 ± 9.86 % BV/TV and 0.70 ± 0.07gcm-3 BMD were generated in the defect sites treated by the GBR membrane loaded with 0.5 % RSV, which were the largest values among those for all three groups after 12 weeks of post implantation. Overall, the PCL/CS/PVA GBR membrane loaded with 0.5 % RSV has significant potential for bone regeneration.

Perspectives of nanofibrous wound dressings based on glucans and galactans - A review

Wound healing is a complex and dynamic process that needs an appropriate environment to overcome infection and inflammation to progress well. Wounds lead to morbidity, mortality, and a significant economic burden, often due to the non-availability of suitable treatments. Hence, this field has lured the attention of researchers and pharmaceutical industries for decades. As a result, the global wound care market is expected to be 27.8 billion USD by 2026 from 19.3 billion USD in 2021, at a compound annual growth rate (CAGR) of 7.6 %. Wound dressings have emerged as an effective treatment to maintain moisture, protect from pathogens, and impede wound healing. However, synthetic polymer-based dressings fail to comprehensively address optimal and quick regeneration requirements. Natural polymers like glucan and galactan-based carbohydrate dressings have received much attention due to their inherent biocompatibility, biodegradability, inexpensiveness, and natural abundance. Also, nanofibrous mesh supports better proliferation and migration of fibroblasts because of their large surface area and similarity to the extracellular matrix (ECM). Thus, nanostructured dressings derived from glucans and galactans (i.e., chitosan, agar/agarose, pullulan, curdlan, carrageenan, etc.) can overcome the limitations associated with traditional wound dressings. However, they require further development pertaining to the wireless determination of wound bed status and its clinical assessment. The present review intends to provide insight into such carbohydrate-based nanofibrous dressings and their prospects, along with some clinical case studies.

Biomaterials releasing drug responsively to promote wound healing via regulation of pathological microenvironment

Wound healing is characterized by complex, orchestrated, spatiotemporal dynamic processes. Recent findings demonstrated suitable local microenvironments were necessities for wound healing. Wound microenvironments include various biological, biochemical and physical factors, which are produced and regulated by endogenous biomediators, exogenous drugs, and external environment. Successful drug delivery to wound is complicated, and need to overcome the destroyed blood supply, persistent inflammation and enzymes, spatiotemporal requirements of special supplements, and easy deactivation of drugs. Triggered by various factors from wound microenvironment itself or external elements, stimuli-responsive biomaterials have tremendous advantages of precise drug delivery and release. Here, we discuss recent advances of stimuli-responsive biomaterials to regulate local microenvironments during wound healing, emphasizing on the design and application of different biomaterials which respond to wound biological/biochemical microenvironments (ROS, pH, enzymes, glucose and glutathione), physical microenvironments (mechanical force, temperature, light, ultrasound, magnetic and electric field), and the combination modes. Moreover, several novel promising drug carriers (microbiota, metal-organic frameworks and microneedles) are also discussed.

Fabrication and evaluation of agarose-curdlan blend derived multifunctional nanofibrous mats for diabetic wounds

Diabetic wounds with complex pathophysiology significantly burden the wound care industry and require novel management strategies. In the present study, we hypothesized that agarose-curdlan based nanofibrous dressings could be an effective biomaterial for addressing diabetic wounds due to their inherent healing properties. Hence, agarose/curdlan/polyvinyl alcohol based nanofibrous mats loaded with ciprofloxacin (0, 1, 3, and 5 wt%) were fabricated using an electrospinning technique with water and formic acid. In vitro evaluation revealed the average diameter of the fabricated nanofibers between 115 and 146 nm with high swelling (~450-500 %) properties. They exhibited enhanced mechanical strength (7.46 ± 0.80 MPa -7.79 ± 0.007 MPa) and significant biocompatibility (~90-98 %) with L929 and NIH 3T3 mouse fibroblasts. In vitro scratch assay showed higher proliferation and migration of fibroblasts (~90-100 % wound closure) compared to electrospun PVA and control. Significant antibacterial activity was observed against Escherichia coli and Staphylococcus aureus. In vitro real-time gene expression studies with human THP-1 cell line revealed a significant downregulation of pro-inflammatory cytokines (8.64 fold decrease for TNF-α) and upregulation of anti-inflammatory cytokines (6.83 fold increase for IL-10) compared to lipopolysaccharide. In brief, the results advocate agarose-curdlan mat as a potential multifunctional, bioactive, and eco-friendly dressing for healing diabetic wounds.

Antibacterial smart hydrogels: New hope for infectious wound management

Millions of people die annually due to uncured wound infections. Healthcare systems incur high costs to treat wound infections. Tt is predicted to become more challenging due to the rise of multidrug-resistant conditions. During the last decades, smart antibacterial hydrogels could attract attention as a promising solution, especially for skin wound infections. These antibacterial hydrogels are termed 'smart' due to their response to specific physical and chemical environmental stimuli. To deliver different drugs to particular sites in a controlled manner, various types of crosslinking strategies are used in the manufacturing process. Smart hydrogels are designed to provide antimicrobial agents to the infected sites or are built from polymers with inherent disinfectant properties. This paper aims to critically review recent pre-clinical and clinical advances in using smart hydrogels against skin wound infections and propose the next best thing for future trends. For this purpose, an introduction to skin wound healing and disease is presented and intelligent hydrogels responding to different stimuli are introduced. Finally, the most promising investigations are discussed in their related sections. These studies can pave the way for producing new biomaterials with clinical applications.

Plasma-Initiated Grafting of Bioactive Peptide onto Nano-CuO/Tencel Membrane

A bioactive peptide has been successfully grafted onto nano-CuO impregnated Tencel membranes by a simple and rapid method involving a series of textile processes, and an atmospheric argon plasma treatment that requires no additional solvent or emulsifier. Surface morphology shows an apparent change from smooth, slightly roughened, and stripped with increasing plasma treatment time. The FT-IR characteristic peaks confirm the presence of the CuO nanoparticle and peptide on the extremely hydrophilic Tencel membranes that exhibit a zero-degree contact angle. Prepared nano-CuO/Tencel membranes with 90 s plasma treatment time exhibit excellent antimicrobial activity against E. coli and S. aureus, and promote fibroblast cell viability with the assistance of a grafted bioactive peptide layer on the membrane surface.

Nanofiber Carriers of Therapeutic Load: Current Trends

The fast advancement in nanotechnology has prompted the improvement of numerous methods for the creation of various nanoscale composites of which nanofibers have gotten extensive consideration. Nanofibers are polymeric/composite fibers which have a nanoscale diameter. They vary in porous structure and have an extensive area. Material choice is of crucial importance for the assembly of nanofibers and their function as efficient drug and biomedicine carriers. A broad scope of active pharmaceutical ingredients can be incorporated within the nanofibers or bound to their surface. The ability to deliver small molecular drugs such as antibiotics or anticancer medications, proteins, peptides, cells, DNA and RNAs has led to the biomedical application in disease therapy and tissue engineering. Although nanofibers have shown incredible potential for drug and biomedicine applications, there are still difficulties which should be resolved before they can be utilized in clinical practice. This review intends to give an outline of the recent advances in nanofibers, contemplating the preparation methods, the therapeutic loading and release and the various therapeutic applications.

Combined Strategy of Wound Healing Using Thermo-Sensitive PNIPAAm Hydrogel and CS/PVA Membranes: Development and In-Vivo Evaluation

Past studies have shown that the hot spring effect can promote wound healing. Mild thermal stimulation and metal ions can promote angiogenesis. In this study, the hot spring effect was simulated by thermosensitive PNIPAAm hydrogel loaded with copper sulfide nanoparticles. Heat stimulation could be generated through near-infrared irradiation, and copper ions solution could be pulsed. On the other hand, the CS/PVA nanofiber membrane was attached to the bottom of the hydrogel to simulate the extracellular matrix structure, thus improving the wound healing ability. The CS/PVA nanofiber membrane was prepared by electrospinning, and the appropriate prescription and process parameters were determined. The nanofiber membrane has uniform pore size, good water absorption and permeability. The poor mechanical properties of PNIPAAm hydrogel were improved by adding inorganic clay. The temperature of the hydrogel loaded with CuS nanoparticles reached 40 °C under near-infrared light irradiation for 20 min, and the release rate of Cu²⁺ reached 26.89%. The wound-healing rate of the rats in the combined application group reached 79.17% at 13 days, demonstrating superior results over the other control groups. Histological analyses show improved inflammatory response at the healed wound area. These results indicate that this combined application approach represents a promising wound treatment strategy.

Poly(lactic acid)-Based Electrospun Fibrous Structures for Biomedical Applications

Poly(lactic acid)(PLA) is an aliphatic polyester that can be derived from natural and renewable resources. Owing to favorable features, such as biocompatibility, biodegradability, good thermal and mechanical performance, and processability, PLA has been considered as one of the most promising biopolymers for biomedical applications. Particularly, electrospun PLA nanofibers with distinguishing characteristics, such as similarity to the extracellular matrix, large specific surface area and high porosity with small pore size and tunable mechanical properties for diverse applications, have recently given rise to advanced spillovers in the medical area. A variety of PLA-based nanofibrous structures have been explored for biomedical purposes, such as wound dressing, drug delivery systems, and tissue engineering scaffolds. This review highlights the recent advances in electrospinning of PLA-based structures for biomedical applications. It also gives a comprehensive discussion about the promising approaches suggested for optimizing the electrospun PLA nanofibrous structures towards the design of specific medical devices with appropriate physical, mechanical and biological functions.

Optimizing the chitosan-PCL based membranes with random/aligned fiber structure for controlled ciprofloxacin delivery and wound healing

The aim of this study was to optimize the chitosan/polycaprolactone (CS/PCL) electrospun nanofibrous membrane with random/aligned fiber structures to provide a controlled release of ciprofloxacin (Cip) and guide skin fibroblasts arrangement. A series of Cip-encapsulated CS/PCL electrospun membranes were prepared by coaxial-electrospinning. The existence of Cip in core-shell structured fibers was confirmed by using SEM, TEM and FTIR characterizations. The in vitro drug-release profiles suggested that the Cip presented a sustained release for 15 days. Simultaneously, cyto-compatibility of the membranes decreased with the increasing amount of Cip from 2.0% to 5.0%. In particular, aligned CS/PCL membrane loading with 2.0% Cip exhibited a good balanced ability between cell proliferation and antibacterial effect (>99% against Escherichiacoli and Staphylococcus aureus), which significantly accelerated the wound healing process in vivo. These results suggested that the aligned CS/PCL membrane loading with 2.0% Cip exhibited great antibacterial property and biocompatibility, which possess promising applications potential for wound healing.

Fabrication of Nanofibers Based on Hydroxypropyl Starch/Polyurethane Loaded with the Biosynthesized Silver Nanoparticles for the Treatment of Pathogenic Microbes in Wounds

Fabrication of electrospun nanofibers based on the blending of modified natural polymer, hydroxyl propyl starch (HPS) as one of the most renewable resources, with synthetic polymers, such as polyurethane (PU) is of great potential for biomedical applications. The as-prepared nanofibers were used as antimicrobial sheets via blending with biosynthesized silver nanoparticles (AgNPs), which were prepared in a safe way with low cost using the extract of Nerium oleander leaves, which acted as a reducing and stabilizing agent as well. The biosynthesized AgNPs were fully characterized by various techniques (UV-vis, TEM, DLS, zeta potential and XRD). The obtained results from UV-vis depicted that the AgNPs appeared at a wavelength equal to 404 nm affirming the preparation of AgNPs when compared with the wavelength of extract (there are no observable peaks). The average particle size of the fabricated AgNPs that mediated with HPS exhibited a very small size (less than 5 nm) with excellent stability (more than -30 mv). In addition, the fabricated nanofibers were also fully characterized and the obtained data proved that the diameter of nanofibers was enlarged with increasing the concentration of AgNPs. Additionally, the findings illustrated that the pore sizes of electrospun sheets were in the range of 75 to 350 nm. The obtained results proved that the presence of HPS displayed a vital role in decreasing the contact angle of PU nanofibers and thus, increased the hydrophilicity of the net nanofibers. It is worthy to mention that the prepared nanofibers incorporated with AgNPs exhibited incredible antimicrobial activity against pathogenic microbes that actually presented in human wounds. Moreover, P. aeruginosa was the most sensitive species to the fabricated nanofibers compared to other tested ones. The minimal inhibitory concentrations (MICs) values of AgNPs-3@NFs against P. aeruginosa, and E. faecalis, were 250 and 500 mg/L within 15 min, respectively.

A collagen-based bi-layered composite dressing for accelerated wound healing

AIM OF THE STUDY

The aim of the study was to fabricate collagen-based composite dressings, evaluate the efficiency for wound healing and reveal the mechanism of promoting wound healing.

MATERIALS AND METHODS

An innovative bi-layered composite wound dressing was developed using two marine biomacromolecules (collagen and chitosan). Full-thickness skin defect model was performed to evaluate the wound healing activity in vivo. The levels of inflammatory cytokines including tumor necrosis factor alpha (TNF-α), interleukin (IL-1, IL-6, IL-8) and growth factors like transforming growth factor beta (TGF-β), vascular epidermal growth factor (VEGF) and basic fibroblast growth factor (bFGF) were quantified by ELISA assays. The total amount of collagen was quantified by hydroxyproline content. The proliferation and viability of fibroblast cells cultured on collagen sponges were determined by CCK-8 assay.

RESULTS

The results of wound closure and histopathological analysis indicated that non-crosslinked collagen-based bi-layered composite dressing stimulated wound healing, accelerated re-epithelialization and accomplished wound healing within a time span of 28 days. The results of levels of inflammatory cytokines and growth factors showed that collagen-based composite dressings could reduce the inflammatory response and upregulate growth factors levels to accelerate the wound healing. The results of hydroxyproline content and CCK-8 assay indicated that collagen-based composite dressings could also promote collagen synthesis and fibroblasts viability and proliferation.

CONCLUSION

The non-crosslinked collagen-based bi-layered composite dressing could be applied for an efficient and ideal wound dressing. Therefore, the findings provided the essential theoretical basis for the potential of collagen-based composite dressing applied in wound healing fields.

Wound Healing: From Passive to Smart Dressings

The universal increase in the number of patients with nonhealing skin wounds imposes a huge social and economic burden on the patients and healthcare systems. Although, the application of traditional wound dressings contributes to an effective wound healing outcome, yet, the complexity of the healing process remains a major health challenge. Recent advances in materials and fabrication technologies have led to the fabrication of dressings that provide proper conditions for effective wound healing. The 3D-printed wound dressings, biomolecule-loaded dressings, as well as smart and flexible bandages are among the recent alternatives that have been developed to accelerate wound healing. Additionally, the new generation of wound dressings contains a variety of microelectronic sensors for real-time monitoring of the wound environment and is able to apply required actions to support the healing progress. Moreover, advances in manufacturing flexible microelectronic sensors enable the development of the next generation of wound dressing substrates, known as electronic skin, for real-time monitoring of the whole physiochemical markers in the wound environment in a single platform. The current study reviews the importance of smart wound dressings as an emerging strategy for wound care management and highlights different types of smart dressings for promoting the wound healing process.

Preparation and Characterization of Electrospun Polylactic Acid (PLA) Fiber Loaded with Birch Bark Triterpene Extract for Wound Dressing

Drug-loaded electrospun fibers have attracted increasing attention as a promising wound dressing material due to their capability of preventing from infections and inflammation and maintaining an appropriate environment for wound healing. In this study, polylactic acid (PLA), which is widely used in wound management, was chosen as electrospinnable polymer. A triterpene extract (TE) from the outer bark of birch known for its anti-inflammatory, antiviral, antibacterial, and wound healing effects was chosen to produce TE-loaded PLA electrospun fibers for wound dressing. A binary solvent system of dichloromethane (DCM) and dimethyl sulfoxide (DMSO) was employed, and the ratio of the solvents was optimized for preparing smooth and uniform fibers. The morphology of TE-loaded PLA electrospun fibers was investigated by scanning electron microscopy (SEM). The entrapment of TE in PLA fibers was confirmed by confocal laser scanning microscopy (CLSM). Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) were used to analyze the solid state of TE in PLA fibers. The release behavior of TE was assayed by a shaking flask method for a period of 96 h. The results revealed that TE-loaded electrospun PLA microfibers could be reliably prepared and are promising future candidates in wound therapy.

Preparation and evaluation of an innovative antibacterial bi-layered composite dressing for skin wound healing

AIM OF THE STUDY

The aim of the current study was to develop collagen-based bi-layered composite dressings with antibacterial property and evaluate the efficiency for wound healing.

MATERIALS AND METHODS

A bi-layered composite wound dressing was fabricated using two marine biomacromolecules (collagen and chitosan or carboxymethyl chitosan). Non-crosslinked and N-Ethyl-N'-(3-dimethylaminopropyl) carbodiimide/N-Hydroxy succinimide (EDC/NHS) cross-linked collagen sponges fabricated by vacuum freeze-drying technology was used as the inner layer. The medical spun-laced nonwoven coated with chitosan and carboxymethyl chitosan was used as the outer layer. The antibacterial activities against E. coli and S. aureus were evaluated by the inhibition zone assay. Deep second-degree scald model was performed to evaluate the efficiency of bi-layered composite dressings for wound healing.

RESULTS

In view of comprehensive evaluation of appearance and in vitro antibacterial activity, medical spun-laced nonwoven coated with 3% of chitosan solution was chosen to be used as the optimized preparation conditions to produce the outer layer of composite dressing, which acted as a barrier against microorganisms and provided mechanical support. Furthermore, the results of wound closure and histopathological analysis indicated that EDC/NHS cross-linked collagen-based bi-layered composite dressing was superior to non-crosslinked and commercial products, which stimulated the wound healing process and accomplished deep second-degree scalded skin healing within a time span of 28 days.

CONCLUSION

The EDC/NHS cross-linked collagen-based bi-layered composite dressing had immense potential to be applied for an ideal wound dressing for more efficient and faster wound healing. Therefore, the findings provided the essential theoretical basis for great potential of collagen-based composite dressing used in wound healing applications.

Which Are the Main Surface Disinfection Approaches at the Time of SARS-CoV-2?

Among many guidelines issued by the World Health Organization to prevent contagion from novel coronavirus (SARS-CoV-2), disinfection of animate and inanimate surfaces has emerged as a key issue. One effective approach to prevent its propagation can be achieved by disinfecting air, skin, or surfaces. A thorough and rational application of an Environmental Protection Agent for disinfection of surfaces, as well as a good personal hygiene, including cleaning hands with appropriate products (e.g., 60–90% alcohol-based product) should minimize transmission of viral respiratory pathogens such as SARS-CoV-2. Critical issues, associated with the potential health hazard of chemical disinfectants and the ineffective duration of most of the treatments, have fostered the introduction of innovative and alternative disinfection approaches. The present review aims to provide an outline of methods currently used for inanimate surface disinfection with a look to the future and a focus on the development of innovative and effective disinfection approaches (e.g., metal nanoparticles, photocatalysis, self-cleaning, and self-disinfection) with particular focus on SARS-CoV-2. The research reviews are, usually, focused on a specific category of disinfection methods, and therefore they are limited. On the contrary, a panoramic review with a wider focus, as the one here proposed, can be an added value for operators in the sector and generally for the scientific community.

Fabrication of ciprofloxacin-loaded chitosan/polyethylene oxide/silica nanofibers for wound dressing application: In vitro and in vivo evaluations

Silica plays an effective role in collagen creation; hence, the degradation products of silica-based materials accelerate wound healing. In this regard, chitosan/polyethylene oxide/silica hybrid nanofibers were prepared by the combining the sol-gel method with electrospinning technique to accelerate the wound healing process. Ciprofloxacin, as an antibacterial drug, was then added to the electrospinning mixture. The nanofibers were characterized by SEM, EDX, X-ray mapping, TEM, TGA, FTIR, and XRD analysis. The degradation, swelling ratio, and release of ciprofloxacin were investigated in PBS. The prepared nanofiber could absorb water, maintain its morphological integrity during the degradation process, and gradually release ciprofloxacin. The nanofibers revealed an efficient antibacterial activity against Escherichia coli and Staphylococcus aureus. Cell viability assays showed that the nanofibers had no cytotoxicity against L929 mouse fibroblast and HFFF2 human foreskin fibroblast cell lines. The potential of the chitosan/polyethylene oxide/silica/ciprofloxacin nanofiber for healing full-thickness wound was assessed by applying the scaffold in the dorsal cutaneous wounds of the Balb/C mice. The white blood cell counts of the animals indicated the nanofiber-treated mice compared with the untreated ones had less infection and inflammation. According to the histopathologic data, the prepared nanofiber accelerated and enhanced tissue regeneration by increasing fibroblast cells and angiogenesis as well as decreasing the inflammation phase. The findings suggest that the prepared antibacterial scaffold with drug delivery properties could be an appropriate candidate for many medical and hygienic applications, especially as a bio-compatible and bio-degradable wound dressing.

An alginate-PHMB-AgNPs based wound dressing polyamide nanocomposite with improved antibacterial and hemostatic properties

Wound dressing should be impenetrable against microorganisms and it should keep the wound wet. Gauze and polyamide (PA) substrate were treated with various concentrations of AgNPs (25, 50, 75, and 100 ppm), PHMB (0.2, 0.4, 0.6, 0.8, and 1% w/v), and constant concentration of alginate (0.5% W/V) using a simple dipping method. Prepared samples were characterized by various techniques including Fourier transform infrared spectroscopy and scanning electron microscopy. The results indicated that the particles were successfully applied onto both substrates with an average diameter of particle size of 78 nm on gauze and 172 nm on the PA substrate surface (based on 50 nanoparticles). Antibacterial activity of the prepared nanocomposite against Staphylococcus aureus (gram-positive) bacteria on PA substrate and gauze were evaluated using the disc diffusion method. The results indicated that the prepared nanocomposites offer favorable antibacterial properties and bacteria would not grow in culture media. The water uptake capacity test of the treated samples was assessed and the data demonstrated that the water absorption rate significantly increases on both treated substrates (gauze and PA substrate) due to the presence of alginate polymer. Also, observing the results of the coagulation test showed that treated samples caused blood clots on the dressing. This is due to the presence of alginate polymer. The present work demonstrates that the prepared samples offer excellent antibacterial properties and good water uptake capacity that capable of being a potential candidate for wound dressings. Due to the results, the produced PA substrate could be an appropriate replacement for the cotton gauze as a wound dressing.

Current approaches and future prospects of nanofibers: a special focus on antimicrobial drug delivery

Antibacterial nanofibers have a great potential for effective treatment of infections. They act as drug reservoir systems that release higher quantities of antibacterial agents/drug in a controlled manner at infection sites and prevent drug resistance, while concomitantly decreasing the systemic toxicity. With this drug delivery system, it is also possible to achieve multiple drug entrapment and also simultaneous or sequential release kinetics at the site of action. Therefore, advances in antibacterial nanofibers as drug delivery systems were overviewed within this article. Recently published data on antibacterial drug delivery was also summarised to provide a view of the current state of art in this field. Although antibacterial use seems to be limited and one can ask that 'what is left to be discovered?'; recent update literatures in this field highlighted the use of nanofibers from very different perspectives. We believe that readers will be benefiting this review for enlightening of novel ideas.

Electrospinning for healthcare: recent advancements

This perspective explores recent developments and innovations in the electrospinning technique and their potential applications in biomedicine.

Electrospun Nanocomposites Containing Cellulose and Its Derivatives Modified with Specialized Biomolecules for an Enhanced Wound Healing

Wound healing requires careful, directed, and effective therapies to prevent infections and accelerate tissue regeneration. In light of these demands, active biomolecules with antibacterial properties and/or healing capacities have been functionalized onto nanostructured polymeric dressings and their synergistic effect examined. In this work, various antibiotics, nanoparticles, and natural extract-derived products that were used in association with electrospun nanocomposites containing cellulose, cellulose acetate and different types of nanocellulose (cellulose nanocrystals, cellulose nanofibrils, and bacterial cellulose) have been reviewed. Renewable, natural-origin compounds are gaining more relevance each day as potential alternatives to synthetic materials, since the former undesirable footprints in biomedicine, the environment, and the ecosystems are reaching concerning levels. Therefore, cellulose and its derivatives have been the object of numerous biomedical studies, in which their biocompatibility, biodegradability, and, most importantly, sustainability and abundance, have been determinant. A complete overview of the recently produced cellulose-containing nanofibrous meshes for wound healing applications was provided. Moreover, the current challenges that are faced by cellulose acetate- and nanocellulose-containing wound dressing formulations, processed by electrospinning, were also enumerated.

Chitosan-bacterial cellulose patch of ciprofloxacin for wound dressing: Preparation and characterization studies

Biopolymeric blends based on bacterial cellulose (BC) films modified with low molecular weight chitosan (Chi) were developed for controlled release of ciprofloxacin (Cip). Biophysical studies revealed a compatible and cooperative network between BC and Chi including deep structural changes in the BC matrix shown by spectroscopic and thermal analyses (SEM, roughness analysis, FTIR, XRD, TGA, mechanical properties and water vapor transmission rate). Incorporation of chitosan to BC matrix generated a thickening scaffold with high permeability to water vapor from 0.7 to 3.2 g mm/m² h. Cip loaded onto the BC-Chi film showed a hyperbolic release profile with a 30% decrease in antibiotic release mediated by the presence of Chi. BC-Chi blend films containing Cip tested against Pseudomonas aeruginosa and Staphylococcus aureus showed a synergic effect of chitosan on Cip antimicrobial activity. Besides, in vitro studies revealed the lack of cytotoxicity of BC-Chi-Cip films in human fibroblasts.

Does antibiotic use accelerate or retard cutaneous repair? A systematic review in animal models

BACKGROUND

The presence of infections is one of the main factors that leads to delays in healing or non-closure of cutaneous wounds. Although the goal of antibiotic use is to treat or prevent infection, there is currently no agreement on the effectiveness of these products.

AIM

The aim of this study was to evaluate the efficacy of antibiotic use during the healing process of skin wounds in animal models not intentionally infected, as well as to analyze the advances and limitations of the studies carried out in this field.

MAIN METHODS

This systematic review was performed according to the PRISMA guidelines, using a structured search on the MedLine (PubMed) and Scopus platforms to retrieve studies published until August 29, 2018, 13:35p.m. The studies included were limited to those that used excision or incision wound models and that were not intentionally infected. The data for the animal models, antibiotic used, and the main results of the studies were extracted, and compared where possible. Bias analysis and methodological quality assessments were examined through the SYRCLE's Risk of Bias tool.

KEY FINDINGS

Twenty-seven studies were selected. Overall, the effects of the antibiotic on the wound decreased inflammatory cell infiltration and promoted an increased number of fibroblasts, extracellular matrix constituents, re-epithelialization and tissue strength. A great deal of important information about the methodology was not presented, such as: the statistical analysis used, the animal model (sex and age), antibiotic dosage, blinding and randomization of the animals chosen.

SIGNIFICANCE

Based on the results found, we believe that antibiotic therapy can be considered a viable alternative for the treatment of cutaneous wounds. However, current evidence obtained from the methodological quality analysis points towards a high risk of bias. This is due to the incomplete characterization of the experimental design and treatment protocol, which compromises the reproducibility of the studies.

Electrospun Chitosan/Poly (Vinyl Alcohol)/Graphene Oxide Nanofibrous Membrane with Ciprofloxacin Antibiotic Drug for Potential WoundDressing Application

In this paper, nanofibrous membranes based on chitosan (CS), poly (vinyl alcohol) (PVA) and graphene oxide (GO) composites, loaded with antibiotic drugs, such as Ciprofloxacin (Cip) and Ciprofloxacin hydrochloride (CipHcl) were prepared via the electrospinning technique. The uniform and defect-free CS/PVA nanofibers were obtained and GO nanosheets, shaping spindle and spherical, were partially embedded into nanofibers. Besides, the antibiotic drugs were effectively loaded into the nanofibers and part of which were absorbed into GO nanosheets. Intriguingly, the release of the drug absorbed in GO nanosheets regulated the drug release profile trend, avoiding the "burst" release of drug at the release initial stage, and the addition of GO slightly improved the drug release ratio. Nanofibrous membranes showed the significantly enhanced antibacterial activity against Escherichia coli, Staphylococcus aureus and Bacillus subtilis after the addition of antibiotic drug. Moreover, the drug-loaded nanofibrous membranes exhibited excellent cytocompatibility with Melanoma cells, indicative to the great potential potential for applications in wound dressing.

The effect of collection substrate on electrospun ciprofloxacin-loaded poly(vinylpyrrolidone) and ethyl cellulose nanofibers as potential wound dressing materials

In this work, nanofibers based on hydrophilic poly(vinylpyrrolidone) (PVP) and hydrophobic ethyl cellulose (EC) were generated via electrospinning. A model antibiotic, ciprofloxacin (CIF), was also incorporated into the fibers. Fibers were collected on both a foil substrate and a commercial gauze, the latter in the interests of developing a smart fabric. Electron microscopy images revealed that the fibers collected on both foil and fabric were homogeneous and cylindrical. Infrared spectroscopy, X-ray diffraction and differential scanning calorimetry demonstrated that CIF was successfully loaded into the fibers and present in the amorphous physical form. In vitro drug release tests were conducted to simulate drug release from the formulations into a wound site, and as expected the hydrophilic fibers showed much faster release than their hydrophobic analogues. CIF was released through a combined mechanism of polymer erosion and drug diffusion, and the EC nanofibers displayed close to zero-order release over three days. Fibroblast cells are able to grow and proliferate on the fibers. Finally, inhibition zone assays revealed that the growth of both Gram positive and Gram negative bacteria could be effectively inhibited as a result of the presence of CIF in the fibers. There were no marked differences between the fibers collected on foil and on gauze, and electrospinning can be performed directly onto a gauze substrate to prepare a smart fabric.

Self-disinfecting surfaces and infection control

According to World Health Organization, every year in the European Union, 4 million patients acquire a healthcare associated infection. Even though some microorganisms represent no threat to healthy people, hospitals harbor different levels of immunocompetent individuals, namely patients receiving immunosuppressors, with previous infections, or those with extremes of age (young children and elderly), requiring the implementation of effective control measures. Public spaces have also been found an important source of infectious disease outbreaks due to poor or none infection control measures applied. In both places, surfaces play a major role on microorganisms' propagation, yet they are very often neglected, with very few guidelines about efficient cleaning measures and microbiological assessment available. To overcome surface contamination problems, new strategies are being designed to limit the microorganisms' ability to survive over surfaces and materials. Surface modification and/or functionalization to prevent contamination is a hot-topic of research and several different approaches have been developed lately. Surfaces with anti-adhesive properties, with incorporated antimicrobial substances or modified with biological active metals are some of the strategies recently proposed. This review intends to summarize the problems associated with contaminated surfaces and their importance on infection spreading, and to present some of the strategies developed to prevent this public health problem, namely some already being commercialized.