Nanofibrillar cellulose wound dressing in skin graft donor site treatment

Tissue-engineered cellulose tubes for microvascular and lymphatic reconstruction: A translational and feasibility study

BACKGROUND

Lymphedema microsurgery is an emerging treatment modality, with dissimilar long-term outcomes. One of the main technical challenges in lymphatic microsurgery is the identification and availability of suitable donor vessels for anastomosis. Tissue engineering using biomaterials has demonstrated promise in addressing vessel quality issues in other fields, but its application in microsurgery is still limited.

METHODS

Decellularized cellulose tubes were developed and bioengineered by decellularizing stems of Taraxacum-Ruderalia. The microscopic structure, mechanical properties, and residual DNA content of the cellulose tubes were evaluated. Human and murine skin fibroblasts and dermal lymphatic endothelial cells were isolated and cultured for recellularization studies. Biocompatibility, proliferative capacity, and ex-vivo endothelialization of the cellulose tubes were assessed as potential interposition grafts. Finally, the engineered cellulose tubes were assessed as interposing xenografts for lymphovenous anastomoses (LVA) in an ex-vivo swine limb model.

RESULTS

The decellularized cellulose tubes exhibited a suitable microscopic structure, mechanical properties, and low residual DNA content. The tubes showed adequate biocompatibility, supported cell proliferation, and facilitated spontaneous ex-vivo endothelialization of lymphatic endothelial cells. In the swine limb model, LVA using the engineered cellulose tubes was successfully performed.

CONCLUSION

This translational study presents the use of decellularized cellulose tubes as an adjunct for micro and supermicrosurgical reconstruction. The developed tubes demonstrated favorable structural, mechanical, and biocompatible properties, making them a potential candidate for improving long-term outcomes in lymphedema surgical treatment. The next translational step would be trialing the obtained tubes in a microsurgical in-vivo model.

A state-of-the-art review on plant-derived cellulose-based green hydrogels and their multifunctional role in advanced biomedical applications

The most prevalent carbohydrate on Earth is cellulose, a polysaccharide composed of glucose units that may be found in diverse sources, such as cell walls of wood and plants and some bacterial and algal species. The inherent availability of this versatile material provides a natural pathway for exploring and identifying novel uses. This study comprehensively analyzes cellulose and its derivatives, exploring their structural and biochemical features and assessing their wide-ranging applications in tissue fabrication, surgical dressings, and pharmaceutical delivery systems. The use of diverse cellulose particles as fundamental components gives rise to materials with distinct microstructures and characteristics, fulfilling the requirements of various biological applications. Although cellulose boasts substantial potential across various sectors, its exploration has predominantly unfolded within industrial realms, leaving the biomedical domain somewhat overlooked in its initial stages. This investigation, therefore, endeavors to shed light on the contemporary strides made in synthesizing cellulose and its derivatives. These innovative techniques give rise to distinctive attributes, presenting a treasure trove of advantages for their compelling integration into the intricate tapestry of biomedical applications.

Analysis of bioprinting strategies for skin diseases and injuries through structural and temporal dynamics: historical perspectives, research hotspots, and emerging trends

This study endeavors to investigate the progression, research focal points, and budding trends in the realm of skin bioprinting over the past decade from a structural and temporal dynamics standpoint. Scholarly articles on skin bioprinting were obtained from WoSCC. A series of bibliometric tools comprising R software, CiteSpace, HistCite, and an alluvial generator were employed to discern historical characteristics, evolution of active topics, and upcoming tendencies in the area of skin bioprinting. Over the past decade, there has been a consistent rise in research interest in skin bioprinting, accompanied by an extensive array of meaningful scientific collaborations. Concurrently, diverse dynamic topics have emerged during various periods, as substantiated by an aggregate of 22 disciplines, 74 keywords, and 187 references demonstrating citation bursts. Four burgeoning research subfields were discerned through keyword clustering-namely, #3 'in situbioprinting', #6 'vascular', #7 'xanthan gum', and #8 'collagen hydrogels'. The keyword alluvial map reveals that Module 1, including 'transplantation' etc, has primarily dominated the research module over the previous decade, maintaining enduring relevance despite annual shifts in keyword focus. Additionally, we mapped out the top six key modules from 2023 being 'silk fibroin nanofiber', 'system', 'ionic liquid', 'mechanism', and 'foot ulcer'. Three recent research subdivisions were identified via timeline visualization of references, particularly Clusters #0 'wound healing', #4 'situ mineralization', and #5 '3D bioprinter'. Insights derived from bibliometric analyses illustrate present conditions and trends in skin bioprinting research, potentially aiding researchers in pinpointing central themes and pioneering novel investigative approaches in this field.

NIR-triggered bacterial cellulose-based wound dressings for multiple synergistic therapy of infected wound

Skin wounds are repaired by a complex series of events and overlapping phases in which bacterial infection and insufficient angiogenesis at the wound site delay the healing process. Thus, functional wound dressings with enhanced antibacterial activity and angiogenic capacity have attracted attention. Herein, bacterial cellulose (BC)-based dressings were successfully fabricated by functionalization with a polydopamine (PDA) coating and copper sulfide nanoparticles (CuS NPs). Under 808 nm laser illumination, the BC/PDA/CuS composite membranes exhibited outstanding adjustable photothermal and photodynamic activities as well as controlled Cu2+ release, endowing the composite membranes with synergetic antibacterial activity. Specially, a bactericidal efficiency of 99.7 % and 88.0 % for Staphylococcus aureus and Escherichia coli was achieved after treatment with BC/PDA/CuS5 sample under NIR irradiation (0.8 W/cm2, 10 min), respectively. Moreover, the BC/PDA/CuS5 composite membrane could enhance the angiogenesis due to the released Cu2+. In vivo experiments revealed that the BC/PDA/CuS5 composite membrane dressing could accelerate the wound closure process of the full-thickness skin defects with S. aureus by synergistically reducing inflammation, enhancing collagen deposition, and promoting vascularization under NIR irradiation. Additionally, the BC/PDA/CuS5 composite membrane exhibited high biocompatibility and biosafety. This work offers a new strategy to prepare multifunctional BC-based dressing for clinical wound healing.

Papain Covalent Immobilization in Bacterial Cellulose Films as a Wound Dressing

Ideally, the dressings used in the clinic have characteristics that help the wound closure process. Among several factors that affect the success of this healing process, there is debridement. It manages the wound bed components and the re-epithelialization process. Still, the property of debridement is not generally associated with dressings. Here, we show a chemically modified bacterial cellulose film conjugated to a proteolytic enzyme, papain, as a dressing with debridement properties. Bacterial cellulose films were reacted with a spacer derived from succinic acid and finally had this enzyme covalently immobilized in its structure by an amide bond. FT-IR and UV-vis showed bands typically of bioconjugated polymer. Enzymatic immobilization was very effective under the conditions applied with high yield (33% w/w), and these remained activated after the coupling reaction. The bacterial cellulose film with the enzyme papain attached to it was also very compatible with fibroblast cells, suggesting that it could be a promising wound dressing material for future research.

Mupirocin loaded core-shell pluronic-pectin-keratin nanofibers improve human keratinocytes behavior, angiogenic activity and wound healing

In the current study, a core-shell nanofibrous wound dressing based on Pluronic-F127 (F127) containing 2 wt% mupirocin (Mup) core and pectin (Pec)-keratin (Kr) shell was fabricated through coaxial electrospinning technique, and the blended nanofibers were also fabricated from the same materials. The fiber diameter and specific surface area of the blended nanofibers were about 101.56 nm and 20.16 m2/g, while for core-shell nanofibers they were about 97.32 nm and 25.26 m2/g, respectively. The resultant blended and core-shell nanofibers experienced a degradation of 27.65 % and 32.28 % during 7 days, respectively. The drug release profile of core-shell nanofibers revealed a sustained release of Mup over 7 days (87.66 %), while the blended F127-Pec-Kr-Mup nanofibers had a burst release within the first few hours (89.38 % up to 48 h) and a cumulative release of 91.36 % after 7 days. Due to the controlled release of Mup, the core-shell structure significantly improved the human keratinocytes behavior, angiogenic potential and wound healing in a rat model compared to the blended structure. In conclusion, the F127-Mup/Pec-Kr core-shell nanofibrous wound dressing appears to be a promising candidate for the prevention of infection, and can potentially accelerate the recovery and healing of chronic and ischemic wounds.

Preparation and Characterization of Softwood and Hardwood Nanofibril Hydrogels: Toward Wound Dressing Applications

Hydrogels of cellulose nanofibrils (CNFs) are promising wound dressing candidates due to their biocompatibility, high water absorption, and transparency. Herein, two different commercially available wood species, softwood and hardwood, were subjected to TEMPO-mediated oxidation to proceed with delignification and oxidation in a one-pot process, and thereafter, nanofibrils were isolated using a high-pressure microfluidizer. Furthermore, transparent nanofibril hydrogel networks were prepared by vacuum filtration. Nanofibril properties and network performance correlated with oxidation were investigated and compared with commercially available TEMPO-oxidized pulp nanofibrils and their networks. Softwood nanofibril hydrogel networks exhibited the best mechanical properties, and in vitro toxicological risk assessment showed no detrimental effect for any of the studied hydrogels on human fibroblast or keratinocyte cells. This study demonstrates a straightforward processing route for direct oxidation of different wood species to obtain nanofibril hydrogels for potential use as wound dressings, with softwood having the most potential.

Cellulosic Textiles-An Appealing Trend for Different Pharmaceutical Applications

Cellulose, the most abundant biopolymer in nature, is derived from various sources. The production of pharmaceutical textiles based on cellulose represents a growing sector. In medicated textiles, textile and pharmaceutical sciences are integrated to develop new healthcare approaches aiming to improve patient compliance. Through the possibility of cellulose functionalization, pharmaceutical textiles can broaden the applications of cellulose in the biomedical field. This narrative review aims to illustrate both the methods of extraction and preparation of cellulose fibers, with a particular focus on nanocellulose, and diverse pharmaceutical applications like tissue restoration and antimicrobial, antiviral, and wound healing applications. Additionally, the merging between fabricated cellulosic textiles with drugs, metal nanoparticles, and plant-derived and synthetic materials are also illustrated. Moreover, new emerging technologies and the use of smart medicated textiles (3D and 4D cellulosic textiles) are not far from those within the review scope. In each section, the review outlines some of the limitations in the use of cellulose textiles, indicating scientific research that provides significant contributions to overcome them. This review also points out the faced challenges and possible solutions in a trial to present an overview on all issues related to the use of cellulose for the production of pharmaceutical textiles.

Exploitation of lignocellulosic-based biomass biorefinery: A critical review of renewable bioresource, sustainability and economic views

Urbanization has driven the demand for fossil fuels, however, the overly exploited resource has caused severe damage on environmental pollution. Biorefining using abundant lignocellulosic biomass is an emerging strategy to replace traditional fossil fuels. Value-added lignin biomass reduces the waste pollution in the environment and provides a green path of conversion to obtain renewable resources. The technology is designed to produce biofuels, biomaterials and value-added products from lignocellulosic biomass. In the biorefinery process, the pretreatment step is required to reduce the recalcitrant structure of lignocellulose biomass and improve the enzymatic digestion. There is still a gap in the full and deep understanding of the biorefinery process including the pretreatment process, thus it is necessary to provide optimized and adapted biorefinery solutions to cope with the conversion process in different biorefineries to further provide efficiency in industrial applications. Current research progress on value-added applications of lignocellulosic biomass still stagnates at the biofuel phase, and there is a lack of comprehensive discussion of emerging potential applications. This review article explores the advantages, disadvantages and properties of pretreatment methods including physical, chemical, physico-chemical and biological pretreatment methods. Value-added bioproducts produced from lignocellulosic biomass were comprehensively evaluated in terms of encompassing biochemical products , cosmetics, pharmaceuticals, potent functional materials from cellulose and lignin, waste management alternatives, multifunctional carbon materials and eco-friendly products. This review article critically identifies research-related to sustainability of lignocellulosic biomass to promote the development of green chemistry and to facilitate the refinement of high-value, environmentally-friendly materials. In addition, to align commercialized practice of lignocellulosic biomass application towards the 21st century, this paper provides a comprehensive analysis of lignocellulosic biomass biorefining and the utilization of biorefinery green technologies is further analyzed as being considered sustainable, including having potential benefits in terms of environmental, economic and social impacts. This facilitates sustainability options for biorefinery processes by providing policy makers with intuitive evaluation and guidance.

A Polyelectrolyte Colloidal Brush Based on Cellulose: Perspectives for Future Applications

This feature article is devoted to the evaluation of different techniques for producing colloidal polyelectrolyte brushes (CPEBs) based on cellulose nanofibers modified with grafted polyacrylates. The paper also reviews the potential applications of these CPEBs in designing electrode materials and as reinforcing additives. Additionally, we discuss our own perspectives on investigating composites with CPEBs. Herein, polyacrylic acid (PAA) was grafted onto the surface of cellulose nanofibers (CNFs) employing a "grafting from" approach. The effect of the PAA shell on the morphological structure of a composite with polypyrrole (PPy) was investigated. The performance of as-obtained CNF-PAA/PPy as organic electrode material for supercapacitors was examined. Furthermore, this research highlights the ability of CNF-PAA filler to act as an additional crosslinker forming a physical sub-network due to the hydrogen bond interaction inside chemically crosslinked polyacrylamide (PAAm) hydrogels. The enhancement of the mechanical properties of the material with a concomitant decrease in its swelling ratio compared to a pristine PAAm hydrogel was observed. The findings were compared with the recent theoretical foundation pertaining to other similar materials.

The clinical outcomes of xenografts in the treatment of burn patients: a systematic review and meta-analysis

BACKGROUND

Although autografts are not feasible in patients with extensive burn wounds, allografts and xenografts can be used for temporary coverage. In this systematic review and meta-analysis, we compared the outcomes of xenografts and the standard treatment of burn wounds.

METHODS

International online databases were searched for English articles comparing xenografts with routine treatment in the burn patients. The random-effects model was used to estimate standardized mean differences (SMD) or odds ratios (OR) with a 95% confidence interval (CI).

RESULTS

From a total of 7144 records, 14 studies were included in our review after screening by title and abstracts followed by full-texts. No significant difference in hospital stays was found between the mammalian xenografts and control groups (SMD [95% CI] = - 0.18 [- 0.54-0.18]). The mean number of dressing changes was significantly lower in both mammalian xenografts compared to the controls (SMD [95% CI] = - 1.01 [- 1.61-- 0.41]) and fish xenografts compared to controls (SMD [95% CI] = - 6.16 [- 7.65-- 4.66]). In the fish xenografts, re-epithelialization time was significantly lower compared to controls (SMD [95% CI] = - 1.18 [- 2.23-- 0.14]).

CONCLUSIONS

Xenografts showed a significantly lower number of dressing changes and fish xenografts showed significant benefit in re-epithelialization compared to routine treatment. The beneficial results of xenografts suggest further research in the use of different types of xenografts in patients with extensive burn.

Willow Bark-Derived Material with Antibacterial and Antibiofilm Properties for Potential Wound Dressing Applications

Tree stems contain wood in addition to 10-20% bark, which remains one of the largest underutilized biomasses on earth. Unique macromolecules (like lignin, suberin, pectin, and tannin), extractives, and sclerenchyma fibers form the main part of the bark. Here, we perform detailed investigation of antibacterial and antibiofilm properties of bark-derived fiber bundles and discuss their potential application as wound dressing for treatment of infected chronic wounds. We show that the yarns containing at least 50% of willow bark fiber bundles significantly inhibit biofilm formation by wound-isolated Staphylococcus aureus strains. We then correlate antibacterial effects of the material to its chemical composition. Lignin plays the major role in antibacterial activity against planktonic bacteria [i.e., minimum inhibitory concentration (MIC) 1.25 mg/mL]. Acetone extract (unsaturated fatty acid-enriched) and tannin-like (dicarboxylic acid-enriched) substances inhibit both bacterial planktonic growth [MIC 1 and 3 mg/mL, respectively] and biofilm formation. The yarn lost its antibacterial activity once its surface lignin reached 20.1%, based on X-ray photoelectron spectroscopy. The proportion of fiber bundles at the fabricated yarn correlates positively with its surface lignin. Overall, this study paves the way to the use of bark-derived fiber bundles as a natural-based material for active (antibacterial and antibiofilm) wound dressings, upgrading this underappreciated bark residue from an energy source into high-value pharmaceutical use.

An Observational Study of Knowledge of First Aid for Burns among Parents in Indonesia

Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns and decrease the need for surgical intervention. Several studies outside of Indonesia demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. A period of data gathering from June to September 2022 was included the parents who have offspring aged between 18 and 12. This questionnaire was developed to achieve the objectives of this study and was based on others of a similar nature. A total of 102 participants were included in this study. In total, 102 parents (79.4% female [n = 81], 20.6% male [n = 21]) were questioned. Baseline knowledge was found to be poor overall; it was found that nearly 91% of parents did not know the first-aid procedures for treating pediatric burns. However, educational initiatives were effective in advancing this knowledge. When a child got burned, nearly 68% of parents knew to use cold running water, and about 70% knew to get help from a doctor. Cold running water being applied is an extremely positive sign, which can have the most beneficial effect on the healing of the injury. No other variables analyzed were shown to be statistically significant predictors of pre- or post-test scores (all P > 0.05). This study concluded that educational knowledge was effective to improve the parents' ability in performing first aid for burn care.

Current advances of nanocellulose application in biomedical field

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

2D foam film coating of antimicrobial lysozyme amyloid fibrils onto cellulose nanopapers

Amyloid fibrils made from inexpensive hen egg white lysozyme (HEWL) are bio-based, bio-degradable and bio-compatible colloids with broad-spectrum antimicrobial activity, making them an attractive alternative to existing small-molecule antibiotics. Their surface activity leads to the formation of 2D foam films within a loop, similar to soap films when blowing bubbles. The stability of the foam was optimized by screening concentration and pH, which also revealed that the HEWL amyloid foams were actually stabilized by unconverted peptides unable to undergo amyloid self-assembly rather than the fibrils themselves. The 2D foam film was successfully deposited on different substrates to produce a homogenous coating layer with a thickness of roughly 30 nm. This was thick enough to shield the negative charge of dry cellulose nanopaper substrates, leading to a positively charged HEWL amyloid coating. The coating exhibited a broad-spectrum antimicrobial effect based on the interactions with the negatively charged cell walls and membranes of clinically relevant pathogens (Staphylococcus aureus, Escherichia coli and Candida albicans). The coating method presented here offers an alternative to existing techniques, such as dip and spray coating, in particular when optimized for continuous production. Based on the facile preparation and broad spectrum antimicrobial performance, we anticipate that these biohybrid materials could potentially be used in the biomedical sector as wound dressings.

Development of an antibacterial and antioxidative nanofibrous membrane using curcumin-loaded halloysite nanotubes for smart wound healing: In vitro and in vivo studies

Endowing wound dressings with drug delivery capability is a suitable strategy to transfer medicinal compounds locally to damaged skin layers. These dressings are especially useful for accelerating the healing rate in the cases of long-term treatment, and adding more functionalities to the platform. In this study, a wound dressing composed of polyamide 6, hyaluronic acid, and curcumin-loaded halloysite nanotubes (PA6/HA/HNT@Cur) was designed and fabricated for wound healing applications. The physicochemical properties of this platform were investigated through Fourier-transform infrared spectroscopy and field-emission scanning electron microscopy. Moreover, wettability, tensile strength, swelling, and in vitro degradation were assessed. The HNT@Cur was incorporated in the fibers in three concentrations and 1 wt% was found as the optimum concentration yielding desirable structural and mechanical properties. The loading efficiency of Cur on HNT was calculated to be 43 ± 1.8%, and the release profiles and kinetics of nanocomposite were investigated at physiological and acidic pH. In vitro antibacterial and antioxidation studies showed that the PA6/HA/HNT@Cur mat had strong antibacterial and antioxidation activities against gram-positive and -negative pathogens and reactive oxygen species, respectively. Desirable cell compatibility of the mat was found through MTT assay against L292 cells up to 72 h. Finally, the efficacy of the designed wound dressing was evaluated in vivo; after 14 days, the results indicated that the wound size treated with the nanocomposite mat significantly decreased compared to the control sample. This study proposed a swift and straightforward method for developing materials that might be utilized as wound dressings in clinical settings.

An introductory review on advanced multifunctional materials

This review summarizes the applications of some of the advanced materials. It included the synthesis of several nanoparticles such as metal oxide nanoparticles (e.g., Fe₃O₄, ZnO, ZrOSO₄, MoO_3-x, CuO, AgFeO₂, Co₃O₄, CeO₂, SiO₂, and CuFeO₂); metal hydroxide nanosheets (e.g., Zn₅(OH)₈(NO₃)₂·2H₂O, Zn(OH)(NO₃)·H₂O, and Zn₅(OH)₈(NO₃)₂); metallic nanoparticles (Ag, Au, Pd, and Pt); carbon-based nanomaterials (graphene, graphene oxide (GO), graphitic carbon nitride (g-C₃N₄), and carbon dots (CDs)); biopolymers (cellulose, nanocellulose, TEMPO-oxidized cellulose nanofibers (TOCNFs), and chitosan); organic polymers (e.g. covalent-organic frameworks (COFs)); and hybrid materials (e.g. metal-organic frameworks (MOFs)). Most of these materials were applied in several fields such as environmental-based technologies (e.g., water remediation, air purification, gas storage), energy (production of hydrogen, dimethyl ether, solar cells, and supercapacitors), and biomedical sectors (sensing, biosensing, cancer therapy, and drug delivery). They can be used as efficient adsorbents and catalysts to remove emerging contaminants e.g., inorganic (i.e., heavy metals) and organic (e.g., dyes, antibiotics, pesticides, and oils in water via adsorption. They can be also used as catalysts for catalytic degradation reactions such as redox reactions of pollutants. They can be used as filters for air purification by capturing carbon dioxide (CO₂) and volatile organic compounds (VOCs). They can be used for hydrogen production via water splitting, alcohol oxidation, and hydrolysis of NaBH₄. Nanomedicine for some of these materials was also included being an effective agent as an antibacterial, nanocarrier for drug delivery, and probe for biosensing.

Super-Elastic Carbonized Mushroom Aerogel for Management of Uncontrolled Hemorrhage

Uncontrolled hemorrhage is still the most common cause of potentially preventable death after trauma in prehospital settings. However, there rarely are hemostatic materials that can achieve safely and efficiently rapid hemostasis simultaneously. Here, new carbonized cellulose-based aerogel hemostatic material is developed for the management of noncompressible torso hemorrhage, the most intractable issue of uncontrolled hemorrhage. The carbonized cellulose aerogel is derived from the Agaricus bisporus after a series of processing, including cutting, carbonization, purification, and freeze-drying. In vitro, the carbonized cellulose aerogels with porous structure show improved hydrophilicity, good blood absorption, and coagulation ability, rapid shape recoverable ability under wet conditions. And in vivo, the carbonized aerogels show effective hemostatic ability in both small and big animal serious hemorrhage models. The amount of blood loss and the hemostatic time of carbonized aerogels are all better than the positive control group. Moreover, the mechanism studies reveal that the good hemostatic ability of the carbonized cellulose aerogel is associated with high hemoglobin binding efficiency, red blood cell absorption, and platelets absorption and activation. Together, the carbonized aerogel developed in this study could be promising for the management of uncontrolled hemorrhage.

Safety and efficacy of autologous skin tissue cells grafting for facial sunken or flat scars

Importance

It is necessary to determine whether safety and efficacy of autologous skin tissue cells grafting for facial sunken or flat scars.

Objective

To identify autologous skin tissue cells grafting can reduce facial sunken or flat scars.

Design setting and participants

In this retrospective cross-sectional study, a total of 128 patients with scar (exclude pathological scar patients), who were receiving autologous skin tissue cells grafting therapy from January 1, 2016, to December 31, 2019.

Interventions

Autologous skin tissue cells grafting.

Main outcomes and measures

Changes in scar severity, color changes in the scar area, infection rate and patient satisfaction.

Results

A total of 128 patients with scar (89 females [69.5%]; mean [SD] age, 30.6 [13.12] years) received autologous skin tissue cells grafting therapy. SCAR (Scar Cosmesis Assessment and Rating), with scores ranging from 0 (best possible scar) to 15 (worst possible scar). After treatment 12 months, the mean [SD] of SCAR score went down from 9.85 [1.33] to 2.67 [1.21]. No infection was observed during treatment or recovery, and the main drawback after autologous skin tissue cells grafting is that the color recovery time is longer. The patient satisfaction 6 months after treatment was 85.2%, furthermore 12 months after treatment patient satisfaction was 94.7%.

Conclusions and relevance

In this study, autologous skin tissue cells grafting was safe and effective to treat facial scars. Therefore, autologous skin tissue cells grafting may be recommended as a reliable treatment for facial scar.

KR-12 Derivatives Endow Nanocellulose with Antibacterial and Anti-Inflammatory Properties: Role of Conjugation Chemistry

This work combines the wound-healing-related properties of the host defense peptide KR-12 with wood-derived cellulose nanofibrils (CNFs) to obtain bioactive materials, foreseen as a promising solution to treat chronic wounds. Amine coupling through carbodiimide chemistry, thiol-ene click chemistry, and Cu(I)-catalyzed azide-alkyne cycloaddition were investigated as methods to covalently immobilize KR-12 derivatives onto CNFs. The effects of different coupling chemistries on the bioactivity of the KR12-CNF conjugates were evaluated by assessing their antibacterial activities against Escherichia coli and Staphylococcus aureus. Potential cytotoxic effects and the capacity of the materials to modulate the inflammatory response of lipopolysaccharide (LPS)-stimulated RAW 245.6 macrophages were also investigated. The results show that KR-12 endowed CNFs with antibacterial activity against E. coli and exhibited anti-inflammatory properties and those conjugated by thiol-ene chemistry were the most bioactive. This finding is attributed to a favorable peptide conformation and accessibility (as shown by molecular dynamics simulations), driven by the selective chemistry and length of the linker in the conjugate. The results represent an advancement in the development of CNF-based materials for chronic wound care. This study provides new insights into the effect of the conjugation chemistry on the bioactivity of immobilized host defense peptides, which we believe to be of great value for the use of host defense peptides as therapeutic agents.

Self-Assembly of Nanocellulose Hydrogels Mimicking Bacterial Cellulose for Wound Dressing Applications

The self-assembly of nanocellulose in the form of cellulose nanofibers (CNFs) can be accomplished via hydrogen-bonding assistance into completely bio-based hydrogels. This study aimed to use the intrinsic properties of CNFs, such as their ability to form strong networks and high absorption capacity and exploit them in the sustainable development of effective wound dressing materials. First, TEMPO-oxidized CNFs were separated directly from wood (W-CNFs) and compared with CNFs separated from wood pulp (P-CNFs). Second, two approaches were evaluated for hydrogel self-assembly from W-CNFs, where water was removed from the suspensions via evaporation through suspension casting (SC) or vacuum-assisted filtration (VF). Third, the W-CNF-VF hydrogel was compared to commercial bacterial cellulose (BC). The study demonstrates that the self-assembly via VF of nanocellulose hydrogels from wood was the most promising material as wound dressing and displayed comparable properties to that of BC and strength to that of soft tissue.

Preparation of polyvinyl alcohol hydrogel containing chlorogenic acid microspheres and its evaluation for use in skin wound healing

Chlorogenic acid (CGA) is a phenolic compound widely found in plants. Several studies have shown that CGA possesses antioxidant, antibacterial, anti-inflammatory and wound healing properties. Because of their three-dimensional structure, good permeability, excellent biocompatibility and moisturizing properties, hydrogels are ideal candidates for wound dressing. The aim of the present study was to preparation and characterization of Polyvinyl alcohol (PVA) hydrogel containing CGA microspheres and evaluation its wound healing activity. The double-emulsion solvent evaporation technique was applied for preparing the CGA containing microspheres. The microspheres were characterized using scanning electron microscopy (SEM) and Fourier transformation infrared spectroscopy (FTIR) and subsequently incorporated in the structure of a PVA hydrogel. The effects of prepared hydrogel on NIH3T3 cell line viability were evaluated using MTT method and wound healing activity was investigated in full thickness wound model in rabbit. SEM images showed formation of homogenous CGA microspheres with diameters in the range of 1-2 μm, embedded in the porous structure of the hydrogel. Infra-red results indicated successful incorporation of CGA microspheres into PVA hydrogel. The NIH3T3 cell viability percentage in CGA 2.5% hydrogel treated group significantly (p < .05) increased after 24 h and 48 h comparing to control group. In vivo studies showed that CGA hydrogel significantly (p < .001) stimulated the rate of wounds closures. Histological studies revealed that administration of CGA hydrogel significantly increased epithelialization and production of collagen fibers compared to the control group. It can be concluded that the CGA microsphere loaded PVA hydrogel has the potential for wound healing.

Icy core-shell composite nanofibers with cooling, antibacterial and healing properties for outdoor burns

Burns are usually difficult to treat because their susceptibe to bacterial infections. When burns is accompanied by hyperthermia, the heat accumulated on the skin will causes extensive tissue damage. Most dressings focus on the treatment process, while ignoring the first-aid treatment to remove hyperthermia. To make matters worse, when outdoors, it is hard to find clean water to wash and cool the burned area. A dressing which can simultaneously realize first-time cooling and repairing treatment of the burned area can shorten treatment time, and is especially beneficial for outdoor use. In this study, a handheld coaxial electrospinning device is developed for preparing platelet-rich plasma @Polycaprolactone-epsilon polylysine (PRP@PCL/ε-PL) core-shell nanofibers. The nanofibers can be synchronously transformed into ice fibers during the spinning process, and directly deposited on the skin. The whole process is convenient to use outdoor. Via dual cooling mechanisms, first aid can take away the excessive heat in the burn area by nanofibers. These core-shell nanofibers also show its excellent antimicrobial and tissue regeneration-promoting properties. Therefore, it achieves first-time cooling and repair treatment of the burned area at the same time. Moreover, due to direct in-situ deposition of this handheld coaxial electrospinning, better antimicrobial properties, and faster healing performance are achieved. By using this integrated strategy that combines cooling, antibacterial and healing promotion, the burn recovery time is shortened from 21 days to 14 days.

The Effects of Zataria multiflora Cream on Split-Thickness Skin Graft Donor-Site Management: A Randomized, Blinded, Placebo-Controlled Study

Purpose: The wound healing process involves a complex series of biological events. Skin grafts have several uses as a reconstructive method. There are several dressings for the skin graft donor site, but the optimum dressing agents that provide all the requirements at the same time are unclear. This prospective, randomized, placebo-controlled clinical trial aimed to evaluate the therapeutic effect of Zataria multiflora cream in the wound healing process of partial-thickness skin graft donor sites and compared it with a placebo. Materials and Methods: This clinical trial study was performed on patients who underwent split-thickness skin grafts. Enrolled patients applied Z. multiflora cream and placebo controlled (petrolatum ointment) twice a day, from the day of intervention at the skin graft donor sites in two parts, separately. On 7, 14, 21, and 28 days after surgery, the wound healing process was evaluated, photographed, and scored according to the Bates-Jensen assessment tool. Evidence of infection was evaluated. The main agent and placebo were compared during the wound healing process. Results: Decreases in wound surface area and total score were significantly greater in the Z. multiflora group (p < 0.05). The wounds of 30% of patients in the second week and 90% of patients in the third week were completely epithelialized in the Z. multiflora group. These values were 3.3% and 36.7% for the control group, respectively, and so, the healing rate was ∼9-fold in the second week and 2.45-fold in the third week in the Z. multiflora group compared with the control group (p < 0.05). Conclusion: Wound healing and reepithelialization accelerated significantly in the first, second, third, and fourth week after intervention in the Z. multiflora treatment group, due to modulating the inflammatory phase and improving the proliferative phase. Clinical Trial Registration Number: IRCT20210624051695N1.

Modifications of cellulose-based biomaterials for biomedical applications

Cellulose is one of the most abundant organic compounds in nature and is available from diverse sources. Cellulose features tunable properties, making it a promising substrate for biomaterial development. In this review, we highlight advances in the physical processes and chemical modifications of cellulose that enhance its properties for use as a biomaterial. Three cellulosic products are discussed, including nanofibrillated, nanocrystalline, and bacterial cellulose, with a focus on how each may serve as a platform for the development of advanced cellulose-based biomaterials for Biomedical applications. In addition to associating mechanical and chemical properties of cellulosic materials to specific applications, a prospectus is offered for the future development of cellulose-based biomaterials for biomedicine.

Comparison of Long-Term Skin Quality and Scar Formation in Partial-Thickness Burn Wounds Treated with Suprathel® and epicitehydro® Wound Dressings

Background and Objectives: Scar formation after burn trauma has a significant impact on the quality of life of burn patients. Hypertrophic scars or keloids can be very distressing to patients due to potential pain, functional limitations, or hyper- or hypopigmentation. In a previous study comparing Suprathel® and the new and cheaper dressing epicitehydro®, we were able to show that pain reduction, exudation, and time until wound-healing of partial-thickness burn wounds were similar, without any documented infections. No study exists that objectively measures and compares skin and scar quality after treatment with Suprathel® and epicitehydro® at present. Materials and Methods: In this study, the scar quality of 20 patients who had been treated with Suprathel® and epicitehydro® was objectively assessed using the Cutometer®, Mexameter®, and Tewameter®, as well as subjectively with the Patient and Observer Scar Assessment Scale, 3, 6, and 12 months after burn injury. Results: In all performed measurements, no significant differences were detected in scar formation after treatment of partial-thickness burn wounds with the two dressings. Conclusions: Both the newer and less expensive wound-dressing epicitehydro® and the well-known wound-dressing Suprathel® resulted in stable wound closure and showed good cosmetic results in the follow-up examinations.

Sources, Chemical Functionalization, and Commercial Applications of Nanocellulose and Nanocellulose-Based Composites: A Review

Nanocellulose is the most abundant material extracted from plants, animals, and bacteria. Nanocellulose is a cellulosic material with nano-scale dimensions and exists in the form of cellulose nanocrystals (CNC), bacterial nanocellulose (BNC), and nano-fibrillated cellulose (NFC). Owing to its high surface area, non-toxic nature, good mechanical properties, low thermal expansion, and high biodegradability, it is obtaining high attraction in the fields of electronics, paper making, packaging, and filtration, as well as the biomedical industry. To obtain the full potential of nanocellulose, it is chemically modified to alter the surface, resulting in improved properties. This review covers the nanocellulose background, their extraction methods, and possible chemical treatments that can enhance the properties of nanocellulose and its composites, as well as their applications in various fields.

Toxicological Assessment of Cellulose Nanomaterials: Oral Exposure

Cellulose nanomaterials (CNMs) have emerged recently as an important group of sustainable bio-based nanomaterials (NMs) with potential applications in multiple sectors, including the food, food packaging, and biomedical fields. The widening of these applications leads to increased human oral exposure to these NMs and, potentially, to adverse health outcomes. Presently, the potential hazards regarding oral exposure to CNMs are insufficiently characterised. There is a need to understand and manage the potential adverse effects that might result from the ingestion of CNMs before products using CNMs reach commercialisation. This work reviews the potential applications of CNMs in the food and biomedical sectors along with the existing toxicological in vitro and in vivo studies, while also identifying current knowledge gaps. Relevant considerations when performing toxicological studies following oral exposure to CNMs are highlighted. An increasing number of studies have been published in the last years, overall showing that ingested CNMs are not toxic to the gastrointestinal tract (GIT), suggestive of the biocompatibility of the majority of the tested CNMs. However, in vitro and in vivo genotoxicity studies, as well as long-term carcinogenic or reproductive toxicity studies, are not yet available. These studies are needed to support a wider use of CNMs in applications that can lead to human oral ingestion, thereby promoting a safe and sustainable-by-design approach.

Nanocelluloses - Nanotoxicology, Safety Aspects and 3D Bioprinting

Nanocelluloses have good rheological properties that facilitate the extrusion of nanocellulose gels in micro-extrusion systems. It is considered a highly relevant characteristic that makes it possible to use nanocellulose as an ink component for 3D bioprinting purposes. The nanocelluloses assessed in this book chapter include wood nanocellulose (WNC), bacterial nanocellulose (BNC), and tunicate nanocellulose (TNC), which are often assumed to be non-toxic. Depending on various chemical and mechanical processes, both cellulose nanofibrils (CNF) and cellulose nanocrystals (CNC) can be obtained from the three mentioned nanocelluloses (WNC, BNC, and TNC). Pre/post-treatment processes (chemical and mechanical) cause modifications regarding surface chemistry and nano-morphology. Hence, it is essential to understand whether physicochemical properties may affect the toxicological profile of nanocelluloses. In this book chapter, we provide an overview of nanotoxicology and safety aspects associated with nanocelluloses. Relevant regulatory requirements are considered. We also discuss hazard assessment strategies based on tiered approaches for safety testing, which can be applied in the early stages of the innovation process. Ensuring the safe development of nanocellulose-based 3D bioprinting products will enable full market use of these sustainable resources throughout their life cycle.

Cellulose-Based Nanomaterials Advance Biomedicine: A Review

There are various biomaterials, but none fulfills all requirements. Cellulose biopolymers have advanced biomedicine to satisfy high market demand and circumvent many ecological concerns. This review aims to present an overview of cellulose knowledge and technical biomedical applications such as antibacterial agents, antifouling, wound healing, drug delivery, tissue engineering, and bone regeneration. It includes an extensive bibliography of recent research findings from fundamental and applied investigations. Cellulose-based materials are tailorable to obtain suitable chemical, mechanical, and physical properties required for biomedical applications. The chemical structure of cellulose allows modifications and simple conjugation with several materials, including nanoparticles, without tedious efforts. They render the applications cheap, biocompatible, biodegradable, and easy to shape and process.

Analysis of the In Vitro Toxicity of Nanocelluloses in Human Lung Cells as Compared to Multi-Walled Carbon Nanotubes

Cellulose micro/nanomaterials (CMNM), comprising cellulose microfibrils (CMF), nanofibrils (CNF), and nanocrystals (CNC), are being recognized as promising bio-nanomaterials due to their natural and renewable source, attractive properties, and potential for applications with industrial and economical value. Thus, it is crucial to investigate their potential toxicity before starting their production at a larger scale. The present study aimed at evaluating the cell internalization and in vitro cytotoxicity and genotoxicity of CMNM as compared to two multi-walled carbon nanotubes (MWCNT), NM-401 and NM-402, in A549 cells. The exposure to all studied NM, with the exception of CNC, resulted in evident cellular uptake, as analyzed by transmission electron microscopy. However, none of the CMNM induced cytotoxic effects, in contrast to the cytotoxicity observed for the MWCNT. Furthermore, no genotoxicity was observed for CNF, CNC, and NM-402 (cytokinesis-block micronucleus assay), while CMF and NM-401 were able to significantly raise micronucleus frequency. Only NM-402 was able to induce ROS formation, although it did not induce micronuclei. Thus, it is unlikely that the observed CMF and NM-401 genotoxicity is mediated by oxidative DNA damage. More studies targeting other genotoxicity endpoints and cellular and molecular events are underway to allow for a more comprehensive safety assessment of these nanocelluloses.

Genotoxicity of Three Micro/Nanocelluloses with Different Physicochemical Characteristics in MG-63 and V79 Cells

(1) Background: Nanocellulose is an innovative engineered nanomaterial with an enormous potential for use in a wide array of industrial and biomedical applications and with fast growing economic value. The expanding production of nanocellulose is leading to an increased human exposure, raising concerns about their potential health effects. This study was aimed at assessing the potential toxic and genotoxic effects of different nanocelluloses in two mammalian cell lines; (2) Methods: Two micro/nanocelluloses, produced with a TEMPO oxidation pre-treatment (CNFs) and an enzymatic pre-treatment (CMFs), and cellulose nanocrystals (CNCs) were tested in osteoblastic-like human cells (MG-63) and Chinese hamster lung fibroblasts (V79) using the MTT and clonogenic assays to analyse cytotoxicity, and the micronucleus assay to test genotoxicity; (3) Results: cytotoxicity was observed by the clonogenic assay in V79 cells, particularly for CNCs, but not by the MTT assay; CNF induced micronuclei in both cell lines and nucleoplasmic bridges in MG-63 cells; CMF and CNC induced micronuclei and nucleoplasmic bridges in MG-63 cells, but not in V79 cells; (4) Conclusions: All nanocelluloses revealed cytotoxicity and genotoxicity, although at different concentrations, that may be related to their physicochemical differences and availability for cell uptake, and to differences in the DNA damage response of the cell model.

New Insights of Scaffolds Based on Hydrogels in Tissue Engineering

In recent years, biomaterials development and characterization for new applications in regenerative medicine or controlled release represent one of the biggest challenges. Tissue engineering is one of the most intensively studied domain where hydrogels are considered optimum applications in the biomedical field. The delicate nature of hydrogels and their low mechanical strength limit their exploitation in tissue engineering. Hence, developing new, stronger, and more stable hydrogels with increased biocompatibility, is essential. However, both natural and synthetic polymers possess many limitations. Hydrogels based on natural polymers offer particularly high biocompatibility and biodegradability, low immunogenicity, excellent cytocompatibility, variable, and controllable solubility. At the same time, they have poor mechanical properties, high production costs, and low reproducibility. Synthetic polymers come to their aid through superior mechanical strength, high reproducibility, reduced costs, and the ability to regulate their composition to improve processes such as hydrolysis or biodegradation over variable periods. The development of hydrogels based on mixtures of synthetic and natural polymers can lead to the optimization of their properties to obtain ideal scaffolds. Also, incorporating different nanoparticles can improve the hydrogel’s stability and obtain several biological effects. In this regard, essential oils and drug molecules facilitate the desired biological effect or even produce a synergistic effect. This study’s main purpose is to establish the main properties needed to develop sustainable polymeric scaffolds. These scaffolds can be applied in tissue engineering to improve the tissue regeneration process without producing other side effects to the environment.

Nanocelluloses as skin biocompatible materials for skincare, cosmetics, and healthcare: Formulations, regulations, and emerging applications

Nowadays, skin biocompatible products are fast-growing markets for nanocelluloses with increasing number of patents published in last decade. This review highlights recent developments, market trends, safety assessments, and regulations for different nanocellulose types (i.e. nanoparticles, nanocrystals, nanofibers, nanoyarns, bacterial nanocellulose) used in skincare, cosmetics, and healthcare. The specific properties of nanocelluloses for skincare include high viscosity and shear thinning properties, surface functionality, dispersion stability, water-holding capacity, purity, and biocompatibility. Depending on their morphology (e.g. size, aspect ratio, geometry, porosity), nanocelluloses can be used as formulation modifiers, moisturizers, nanofillers, additives, membranes, and films. Nanocellulose composite particles were recently developed as carriers for bioactive compounds or UV-blockers and platforms for wound healing and skin sensors. As toxicological assessment depends on morphologies and intrinsic properties, stringent regulation is needed from the testing of efficient nanocellulose dosages. The challenges and perspectives for an industrial breakthrough are related to optimization of production and processing conditions.

Nanocellulose-Based Biomedical Scaffolds in Future Bioeconomy: A Techno-Legal Assessment of the State-of-the-Art

Nanocellulose is a broader term used for nano-scaled cellulosic crystal and/or fibrils of plant or animal origin. Where bacterial nanocellulose was immediately accepted in biomedicine due to its “cleaner” nature, the plant-based nanocellulose has seen several roadblocks. This manuscript assesses the technological aspects (chemistry of cellulose, nanocellulose producing methods, its purity, and biological properties including toxicity and suggested applications in final drug formulation) along with legal aspects in REACH (Registration, Evaluation, Authorization, and Restriction of Chemicals) regulation by the European Union, EMA (European Medicine Agency). The botanical biomass processing methods leading to the nanoscale impurity (lignin and others) on nanocellulose surface, along with surface modification with harsh acid treatments are found to be two major sources of “impurity” in botanical biomass derived nanocellulose. The status of nanocellulose under the light of REACH regulation along with EMA has been covered. The provided information can be directly used by material and biomedical scientists while developing new nanocellulose production strategies as well as formulation design for European markets.

The latest achievements in plant cellulose-based biomaterials for tissue engineering focusing on skin repair

The present work reviews recent developments in plant cellulose-based biomaterial design and applications, properties, characterizations, and synthesis for skin tissue engineering and wound healing. Cellulose-based biomaterials are promising materials for their remarkable adaptability with three-dimensional polymeric structure. They are capable of mimicking tissue properties, which plays a key role in tissue engineering. Besides, concerns for environmental issues have motivated scientists to move toward eco-friendly materials and natural polymer-based materials for applications in the tissue engineering field these days. Therefore, cellulose as an appropriate substitute for common polymers based on crude coal, animal, and human-derived biomolecules is greatly considered for various applications in biomedical fields. Generally, natural biomaterials lack good mechanical properties for skin tissue engineering. But using modified cellulose-based biopolymers tackles these restrictions and prevents immunogenic responses. Moreover, tissue engineering is a quick promoting field focusing on the generation of novel biomaterials with modified characteristics to improve scaffold function through physical, biochemical, and chemical tailoring. Also, nanocellulose with a broad range of applications, particularly in tissue engineering, advanced wound dressing, and as a material for coupling with drugs and sensorics, has been reviewed here. Moreover, the potential cytotoxicity and immunogenicity of cellulose-based biomaterials are addressed in this review.

The Effect of Inhalation Aromatherapy on Sedation Level, Analgesic Dosage, and Bispectral Index Values during Donor Site Dressing in Patients with Burns: A Randomized Clinical Trial

OBJECTIVE

To determine the effect of inhalation aromatherapy on sedation level, analgesic dosage, and bispectral index (BIS) values during donor site dressing in patients with burns.

METHODS

This trial was conducted on 62 patients with burns requiring donor site dressing who were admitted to the Burn Center of Imam Reza Hospital, Mashhad, Iran. In the intervention group, the patients inhaled damask rose 40% and lavender 10% essential oils during donor site dressing change, whereas in the control group, the site was dressed using routine protocol. Sedatives and analgesics were prescribed until the levels of brain activity achieved light sedation. The brain activity and sedation levels were measured before and after the donor site dressings using the BIS. Data were analyzed using the analysis of covariance and the two-way analysis of variance with repeated measures.

RESULTS

All 62 patients completed the study. The required doses of ketamine (P < .001), fentanyl (P = .003), morphine (P < .001), and propofol (P < .001) were significantly lower in the intervention group. The BIS was also significantly lower in the intervention group (P < .001). Heart rate decreased significantly during the aromatherapy, as well as after analgesic and sedative consumption (P < .001).

CONCLUSIONS

The inhalation of damask rose and lavender essential oils is an effective intervention to reduce the doses of sedative and analgesic drugs administered as well as BIS during donor site dressing change in patients with burns.

Challenges and recent trends with the development of hydrogel fiber for biomedical applications

Hydrogel is the most emblematic soft material which possesses significantly tunable and programmable characteristics. Polymer hydrogels possess significant advantages including, biocompatible, simple, reliable and low cost. Therefore, research on the development of hydrogel for biomedical applications has been grown intensely. However, hydrogel development is challenging and required significant effort before the application at an industrial scale. Therefore, the current work focused on evaluating recent trends and issues with hydrogel development for biomedical applications. In addition, the hydrogel's development methodology, physicochemical properties, and biomedical applications are evaluated and benchmarked against the reported literature. Later, biomedical applications of the nano-cellulose-based hydrogel are considered and critically discussed. Based on a detailed review, it has been found that the surface energy, intermolecular interactions, and interactions of hydrogel adhesion forces are major challenges that contribute to the development of hydrogel. In addition, compared to other hydrogels, nanocellulose hydrogels demonstrated higher potential for drug delivery, 3D cell culture, diagnostics, tissue engineering, tissue therapies and gene therapies. Overall, nanocellulose hydrogel has the potential for commercialization for different biomedical applications.

Electrospun Antibacterial Nanomaterials for Wound Dressings Applications

Chronic wounds are caused by bacterial infections and create major healthcare discomforts; to overcome this issue, wound dressings with antibacterial properties are to be utilized. The requirements of antibacterial wound dressings cannot be fulfilled by traditional wound dressing materials. Hence, to improve and accelerate the process of wound healing, an antibacterial wound dressing is to be designed. Electrospun nanofibers offer a promising solution to the management of wound healing, and numerous options are available to load antibacterial compounds onto the nanofiber webs. This review gives us an overview of some recent advances of electrospun antibacterial nanomaterials used in wound dressings. First, we provide a brief overview of the electrospinning process of nanofibers in wound healing and later discuss electrospun fibers that have incorporated various antimicrobial agents to be used in wound dressings. In addition, we highlight the latest research and patents related to electrospun nanofibers in wound dressing. This review also aims to concentrate on the importance of nanofibers for wound dressing applications and discuss functionalized antibacterial nanofibers in wound dressing.

Skin-like hydrogel devices for wearable sensing, soft robotics and beyond

Skin-like electronics are developing rapidly to realize a variety of applications such as wearable sensing and soft robotics. Hydrogels, as soft biomaterials, have been studied intensively for skin-like electronic utilities due to their unique features such as softness, wetness, biocompatibility and ionic sensing capability. These features could potentially blur the gap between soft biological systems and hard artificial machines. However, the development of skin-like hydrogel devices is still in its infancy and faces challenges including limited functionality, low ambient stability, poor surface adhesion, and relatively high power consumption (as ionic sensors). This review aims to summarize current development of skin-inspired hydrogel devices to address these challenges. We first conduct an overview of hydrogels and existing strategies to increase their toughness and conductivity. Next, we describe current approaches to leverage hydrogel devices with advanced merits including anti-dehydration, anti-freezing, and adhesion. Thereafter, we highlight state-of-the-art skin-like hydrogel devices for applications including wearable electronics, soft robotics, and energy harvesting. Finally, we conclude and outline the future trends.

VEGETABLE CELLULOSE NANOFIBER DRESSING AIDS IN THE HEALING PROCESS OF THIRD-DEGREE BURNS? STUDY ON RATS

BACKGROUND

The treatment of 3rd degree burns represents a major medical challenge. Pinus vegetable cellulose is a biomaterial with characteristic similar to bacterial cellulose.

AIM

To evaluate the safety of cellulose membrane (Pinus sp) in the treatment of 3rd burns in rats and to compare its effectiveness with the bacterial membrane already on the market.

METHOD

Thirty-three Wistar rats were beaten with a 3rd degree burn on back skin by applying water at 98º C for 30 s. Then, they were divided into three groups (n=11): group 1 - simple dressing with gauze; group 2 - dressing with bacterial cellulose membrane; and group 3 - dressing with vegetable cellulose membrane. The animals were maintained for 15 days to check the general clinical status, macroscopic aspect, contraction of the wounds and microscopic analysis for the degree of healing and collagenization.

RESULTS

They were clinically well during the experiment. During the removal of the dressing, there was bleeding in the wound of the control group, unlike the groups treated with cellulose membranes, which protected the bed from injury. The macroscopic evaluation showed a greater contraction of the wounds treated with the membranes in relation to the control. A microscopic analysis revealed that most of the wounds were in advanced healing degree with predominance of mature collagen in all groups.

CONCLUSION

Pinus sp cellulose membrane showed efficacy similar to that of the bacterial membrane in the treatment of 3rd degree burns.

Multifunctional Ginger Nanofiber Hydrogels with Tunable Absorption: The Potential for Advanced Wound Dressing Applications

In this study, ginger residue from juice production was evaluated as a raw material resource for preparation of nanofiber hydrogels with multifunctional properties for advanced wound dressing applications. Alkali treatment was applied to adjust the chemical composition of ginger fibers followed by TEMPO (2,2,6,6-tetramethylpiperidine-1-oxyl radical)-mediated oxidation prior to nanofiber isolation. The effect of alkali treatment on hydrogel properties assembled through vacuum filtration without addition of any chemical cross-linker was evaluated. An outstanding absorption ability of 6200% combined with excellent mechanical properties, tensile strength of 2.1 ± 0.2 MPa, elastic modulus of 15.3 ± 0.3 MPa, and elongation at break of 25.1%, was achieved without alkali treatment. Furthermore, the absorption capacity was tunable by applying alkali treatment at different concentrations and by adjusting the hydrogel grammage. Cytocompatibility evaluation of the hydrogels showed no significant effect on human fibroblast proliferation in vitro. Ginger essential oil was used to functionalize the hydrogels by providing antimicrobial activity, furthering their potential as a multifunctional wound dressing.