Wound dressings: principles and practice

Development of a tobramycin-loaded calcium alginate microsphere/chitosan composite sponge with antibacterial effects as a wound dressing

Traditional dressings exhibit several disadvantages, as they frequently lead to bacterial infections, cause severe tissue adhesion and perform a relatively single function. Therefore, in this study, a composite sponge dressing with antibacterial properties and excellent physicochemical properties was developed. Six groups of tobramycin-loaded calcium alginate microspheres were prepared by changing the amount of tobramycin added, and the optimal group was selected. Then, seven groups of tobramycin-loaded calcium alginate microsphere/chitosan composite sponges were fabricated via a solvent blending process and a freeze-drying method. The surface morphology, physicochemical properties,in vitrodegradation properties,in vitrodrug release properties, antibacterial properties and cytotoxicity of the composite sponges were examined. Group 3.0 contained the best microspheres with the largest drug loading capacity, good swelling performance and cumulative drug release rate, obvious and sustained antibacterial activity, and good cytocompatibility. The tobramycin-loaded calcium alginate microsphere/chitosan composite sponges exhibited three-dimensional porous structures, and their porosity, swelling rate, water absorption and water retention rates and water vapor transmission rate met the standards needed for an ideal dressing. The comprehensive performance of the sponge was best when 20 mg of drug-loaded microspheres was added (i.e. group 20). The cumulative drug release rate of the sponge was 29.67 ± 4.14% at 7 d, the diameters of the inhibition zones against the three bacteria were greater than 15 mm, and L929 cell proliferation was promoted. These results demonstrated that the tobramycin-loaded calcium alginate microsphere/chitosan composite sponge with 20 mg of tobramycin-loaded microspheres shows promise as a dressing for infected wounds.

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

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

Antioxidant, antimicrobial and healing properties of an extract from coffee pulp for the development of a phytocosmetic

Consumer demand for natural, chemical-free products has grown. Food industry residues, like coffee pulp, rich in caffeine, chlorogenic acid and phenolic compounds, offer potential for pharmaceutical and cosmetic applications due to their antioxidant, anti-inflammatory, and antibacterial properties. Therefore, the objective of this work was to develop a phytocosmetic only with natural products containing coffee pulp extract as active pharmaceutical ingredient with antioxidant, antimicrobial and healing activity. Eight samples from Coffea arabica and Coffea canephora Pierre were analyzed for caffeine, chlorogenic acid, phenolic compounds, tannins, flavonoids, cytotoxicity, antibacterial activity, and healing potential. The Robusta IAC-extract had the greatest prominence with 192.92 μg/mL of chlorogenic acid, 58.98 ± 2.88 mg GAE/g sample in the FRAP test, 79.53 ± 5.61 mg GAE/g sample in the test of total phenolics, was not cytotoxic, and MIC 3 mg/mL against Staphylococcus aureus. This extract was incorporated into a stable formulation and preferred by 88% of volunteers. At last, a scratch assay exhibited the formulation promoted cell migration after 24 h, therefore, increased scratch retraction. In this way, it was possible to develop a phytocosmetic with the coffee pulp that showed desirable antioxidant, antimicrobial and healing properties.

Biogenic Vaterite Calcium Carbonate-Silver/Poly(Vinyl Alcohol) Film for Wound Dressing

Vaterite, a spherical polymorph of CaCO3, shows potential as a carrier for the stable and controlled release of silver nanoparticles (AgNPs), preventing their aggregation or loss of efficacy during application. Furthermore, the embedding of CaCO3-Ag in a poly(vinyl alcohol) (PVA) matrix helps effectively encapsulate and protect the CaCO3-Ag microspheres and provides mechanical stability for better contact with the wound surface. This article focuses on the fabrication of an antimicrobial and biocompatible absorbent film embedded with precipitated biogenic vaterite CaCO3-Ag microspheres. The impact of vaterite CaCO3-Ag on the physical, chemical, nanomechanical, biocompatibility, and antimicrobial properties of the PVA films was investigated. The morphology study revealed a bilayer film structure with an inactive and active surface containing homogeneously distributed vaterite CaCO3-Ag. The X-ray photoelectron spectroscopy (XPS) analysis of the spin-orbit splitting in the Ag 3d5/2 and Ag 3d3/2 peaks indicated the presence of both metallic and ionic states of silver in vaterite CaCO3-Ag prior to its incorporation into the PVA polymer matrix. However, upon embedding in the PVA matrix, a subsequent transformation to solely ionic states was observed. The nanomechanical properties of PVA improved, and the reduced modulus and hardness increased to 14.62 ± 5.23 and 0.64 ± 0.29 GPa, respectively. The films demonstrate a significant activity toward Gram-negative Escherichia coli bacteria. The release of AgNPs was studied in both open and closed systems at pH 6, mimicking the pH environment of the wound, and it demonstrated a dependency on the type of capping agent used for synthesis and loading of AgNPs. The results further revealed the biocompatibility of the prepared films with human dermal fibroblast cells at a concentration of ≤5 mg/mL, making them applicable and functional for wound dressing applications.

The nutritional composition of six plant species after irrigation with treated wastewater and possible hazards by heavy metal accumulation

A field experiment was conducted investigating the possibility of using treated wastewater (TWW) on sites affected by water scarcity in summer, waterlogging during the wet season, and salinity. A corresponding pot experiment was conducted comparable to the field experiment in Kalaât Landelous. The same plant species (Atriplex nummularia Lindl., Eucalyptus gomphocephala DC., Acacia cyanophylla Lindl., Casuarina glauca Sieber ex Spreng., Cupressus sempervirens L., and Pinus halepensis Mill.) were grown with the same treatments. While, in the field the plants, elemental composition cannot be linked to inputs by TWW, this was studied under controlled conditions. Additionally, a control was established lower in salinity receiving tap water. The effect of TWW irrigation on macro- and microelement uptake by the six plant species was studied. The treatments were high soil salinity under drained saline (DS) conditions, high salinity under waterlogged saline (WS), and a drained non-saline control (DNS: EC = 3.0 dS/m, pH = 8.4). TWW application under DS treatment increased Na, Cl, Ca, Mg, N, P, and K in most plant tissues compared to the control. TWW application in WS treatment resulted in an increase in heavy metals. Cu and Zn showed the highest bioaccumulation factor (BAF). The BAF in different plant tissues followed the order: Cu > Zn > Mn > Cd > Ni > Co > Pb. The plants accumulated significant amounts of metals in their roots.

Polylactic Acid-Based Biomaterials in Wound Healing: A Systematic Review

OBJECTIVE

To examine (1) the effectiveness of polylactic acid (PLA)-based biomaterials in wound healing, (2) their effects on wound infection prevention, and (3) their safety compared with existing biomaterials.

DATA SOURCES

Data sources included PubMed, MEDLINE, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CNKI (China National Knowledge Infrastructure), WEIPU, and WANFANG databases.

STUDY SELECTION

Investigators included 14 studies discussing the effects of PLA-based biomaterials in cutaneous wound healing published from 2000 to 2021.

DATA EXTRACTION

Authors extracted the following information from the selected studies: general information, study type, type of wound, PLA-based biomaterials and techniques, study period, outcome measures, and results.

DATA SYNTHESIS

Polylactic acid-based biomaterials may promote wound healing through wound area repair, collagen deposition, angiogenesis, and cell activities, which are related to the good biocompatibility, biodegradability, and moisture management properties of PLA. A proper product structure may also help. Both the native PLA materials and PLA blends seem to be antibacterial, although more evidence is needed for the native PLA products. Because there was no severe adverse event or obvious cytotoxicity observed in the included studies, PLA-based biomaterials are likely safe.

CONCLUSIONS

Polylactic acid-based biomaterials may be good wound dressing materials, although more evidence is needed to support their broader application in wound care.

Formulation and Optimal Design of Dioscorea bulbifera and Honey-Loaded Gantrez®/Xyloglucan Hydrogel as Wound Healing Patches

Hydrogel patches are some of the most effective dressings for wound healing. In this study, the Gantrez^® S-97 (Gan)/xyloglucan (XG) hydrogel patches were formulated by using a full central composite design (CCD). The optimized hydrogel patches consisted of 17.78% w/w of Gan and 0.1% w/w of XG. Honey and D. bulbifera extract were loaded in the Gan/XG hydrogel patches. The physical properties of the hydrogel patches, including water content, water absorption, rate of water vapor transmission, and mechanical properties, were examined. The D. bulbifera extract/honey-loaded patch exhibited a higher value of water absorption, tensile strength, and elongation than the honey-loaded patch and the unloaded patch, respectively. The biological activities of the patches were also investigated. All hydrogel patches protected wounds from external bacterial infection. The D. bulbifera extract/honey-loaded patch exhibited stronger antioxidant activity than the honey-loaded patch and the unloaded patch. Besides, all the hydrogel patches with concentrations of 0.5-2.5 mg/mL showed that they were nontoxic to fibroblast cells. The combination of D. bulbifera extract and honey in the patch affected fibroblast proliferation. In addition, all Gan/XG hydrogel patches significantly induced recovery of the scratch area. Therefore, the Gan/XG hydrogel patches could be candidates as wound dressings.

Polylysine for skin regeneration: A review of recent advances and future perspectives

There have been several attempts to find promising biomaterials for skin regeneration, among which polylysine (a homopolypeptide) has shown benefits in the regeneration and treatment of skin disorders. This class of biomaterials has shown exceptional abilities due to their macromolecular structure. Polylysine-based biomaterials can be used as tissue engineering scaffolds for skin regeneration, and as drug carriers or even gene delivery vectors for the treatment of skin diseases. In addition, polylysine can play a preservative role in extending the lifetime of skin tissue by minimizing the appearance of photodamaged skin. Research on polylysine is growing today, opening new scenarios that expand the potential of these biomaterials from traditional treatments to a new era of tissue regeneration. This review aims to address the basic concepts, recent trends, and prospects of polylysine-based biomaterials for skin regeneration. Undoubtedly, this class of biomaterials needs further evaluations and explorations, and many critical questions have yet to be answered.

A Review of Recent Advances in Flexible Wearable Sensors for Wound Detection Based on Optical and Electrical Sensing

Chronic wounds that are difficult to heal can cause persistent physical pain and significant medical costs for millions of patients each year. However, traditional wound care methods based on passive bandages cannot accurately assess the wound and may cause secondary damage during frequent replacement. With advances in materials science and smart sensing technology, flexible wearable sensors for wound condition assessment have been developed that can accurately detect physiological markers in wounds and provide the necessary information for treatment decisions. The sensors can implement the sensing of biochemical markers and physical parameters that can reflect the infection and healing process of the wound, as well as transmit vital physiological information to the mobile device through optical or electrical signals. Most reviews focused on the applicability of flexible composites in the wound environment or drug delivery devices. This paper summarizes typical biochemical markers and physical parameters in wounds and their physiological significance, reviews recent advances in flexible wearable sensors for wound detection based on optical and electrical sensing principles in the last 5 years, and discusses the challenges faced and future development. This paper provides a comprehensive overview for researchers in the development of flexible wearable sensors for wound detection.

Improvement of the Wound-Healing Process by Curcumin-Loaded Chitosan/Collagen Blend Electrospun Nanofibers: In Vitro and In Vivo Studies

Chronic wounds have become a major health problem worldwide. Curcumin (Cur), with strong anti-inflammatory and anti-infective properties, is introduced as a unique molecule for wound dressing applications. In the present study, Cur-loaded chitosan/poly(ethylene oxide)/collagen (Cho/PEO/Col) nanofibers were developed for wound dressing applications by the blend-electrospinning process. Structural, mechanical, and biological properties of nanofibers were evaluated using SEM, FTIR, tensile testing, in vitro release study, Alamar blue cytotoxicity assay, and in vivo study in a rat model. According to the results, Cur was successfully released up to 3 days without any significant cytotoxicity of the above hybrid to human dermal fibroblasts. In vivo studies on full-thickness wounds in the rat model indicated significant improvement in the mean wound area closure by applying Cur-loaded Cho/PEO/Col nanofibers. The electrospun Cho/PEO/Col nanofibers loaded with Cur could be considered as a promising type of wound dressing in the wound-healing process.

Procoagulant and Antimicrobial Effects of Chitosan in Wound Healing

Chitosan, a polysaccharide derived from chitin, has excellent wound healing properties, including intrinsic antimicrobial and hemostatic activities. This study investigated the effectiveness of chitosan dressing and compared it with that of regular gauze dressing in controlling clinically surgical bleeding wounds and profiled the community structure of the microbiota affected by these treatments. The dressings were evaluated based on biocompatibility, blood coagulation factors in rat, as well as antimicrobial and procoagulant activities, and the microbial phylogenetic profile in patients with abdominal surgical wounds. The chitosan dressing exhibited a uniformly fibrous morphology with a large surface area and good biocompatibility. Compared to regular gauze dressing, the chitosan dressing accelerated platelet aggregation, indicated by the lower ratio of prothrombin time and activated partial thromboplastin time, and had outstanding blood absorption ability. Adenosine triphosphate assay results revealed that the chitosan dressing inhibited bacterial growth up to 8 d post-surgery. Moreover, 16S rRNA-based sequencing revealed that the chitosan dressing effectively protected the wound from microbial infection and promoted the growth of probiotic microbes, thereby improving skin immunity and promoting wound healing. Our findings suggest that chitosan dressing is an effective antimicrobial and procoagulant and promotes wound repair by providing a suitable environment for beneficial microbiota.

Silver-containing polysaccharide-based tricomponent antibacterial fibres for wound care applications

OBJECTIVE

Polysaccharide-based biomaterials are extensively used in wound care healing due to their unique liquid absorption, gelling properties and biocompatibility properties. They play an important role in controlling infections of highly exuding hard-to-heal wounds. The main objective of this study was to develop silver-containing polysaccharide-based tricomponent antibacterial fibres for use in these complex wounds.

METHOD

The fibres were developed by coating silver-containing alginate and psyllium fibres with hydrolysed chitosan. Dope solution containing alginate, psyllium and silver carbonate was extruded into a coagulation bath containing calcium chloride and hydrolysed chitosan. The developed fibres were tested for liquid absorption, swelling and antibacterial properties against a control fibre (of alginate and psyllium).

RESULTS

The developed fibres showed comparatively better liquid absorption, gelling and antibacterial properties than the control fibres.

CONCLUSION

The study concluded that developed fibres could be a preferred choice for application on hard-to-heal wounds with high levels of exudate, to support infection control and faster healing.

Graphene oxide-cellulose nanocomposite accelerates skin wound healing

The usage of materials with the potential to accelerate wound healing is a great benefit for patients and health care systems. This study evaluated the impact of using graphene oxide (GO)-cellulose nanocomposite on skin wound healing via in vitro and in vivo investigations. The nanomaterial was synthesized and characterized. Cytocompatibility performance of the GO-cellulose was investigated through in vitro testing based on MTT and live/dead assays by EA.hy926 human endothelial cells (ECs). Additionally, the effect of GO-cellulose on induced wound scratch model using EA.hy926 ECs was investigated. Finally, the therapeutic effect of GO-cellulose was evaluated in vivo after the creation of two full-thickness wounds in the dorsum of rats (8 mm diameter). These wounds were randomly placed into two groups, the control group (10 wounds) and the GO-cellulose group (10 wounds), and monitored for gross and histopathological changes at 7 and 21 days after wound induction. MTT and Live/Dead assays showed excellent GO-cellulose cytocompatibility, whereas no difference in ECs viability was observed after culturing using conditioned media. GO-cellulose nanocomposite enhanced cell migration in the in vitro wound scratch assay. As compared to the control group, the GO-cellulose nanocomposite group's wound healing process was promoted in the in vivo rat skin wounds. Interestingly, wound re-epithelization and neovascularization were significantly accelerated in the GO-cellulose-treated rats. Furthermore, thick granulation tissue formation and intense collagen deposition were found in the GO-cellulose group. These findings showed that GO-cellulose has a promoting effect on skin wound healing, suggesting its promising and potential application in tissue regeneration.

Classification and Production of Polymeric Foams among the Systems for Wound Treatment

This work represents an overview on types of wounds according to their definition, classification and dressing treatments. Natural and synthetic polymeric wound dressings types have been analyzed, providing a historical overview, from ancient to modern times. Currently, there is a wide choice of materials for the treatment of wounds, such as hydrocolloids, polyurethane and alginate patches, wafers, hydrogels and semi-permeable film dressings. These systems are often loaded with drugs such as antibiotics for the simultaneous delivery of drugs to prevent or cure infections caused by the exposition of blood vessel to open air. Among the presented techniques, a focus on foams has been provided, describing the most diffused branded products and their chemical, physical, biological and mechanical properties. Conventional and high-pressure methods for the production of foams for wound dressing are also analyzed in this work, with a proposed comparison in terms of process steps, efficiency and removal of solvent residue. Case studies, in vivo tests and models have been reported to identify the real applications of the produced foams.

Hybrid 3D Printing of Advanced Hydrogel-Based Wound Dressings with Tailorable Properties

Despite the extensive utilization of polysaccharide hydrogels in regenerative medicine, current fabrication methods fail to produce mechanically stable scaffolds using only hydrogels. The recently developed hybrid extrusion-based bioprinting process promises to resolve these current issues by facilitating the simultaneous printing of stiff thermoplastic polymers and softer hydrogels at different temperatures. Using layer-by-layer deposition, mechanically advantageous scaffolds can be produced by integrating the softer hydrogel matrix into a stiffer synthetic framework. This work demonstrates the fabrication of hybrid hydrogel-thermoplastic polymer scaffolds with tunable structural and chemical properties for applications in tissue engineering and regenerative medicine. Through an alternating deposition of polycaprolactone and alginate/carboxymethylcellulose gel strands, scaffolds with the desired architecture (e.g., filament thickness, pore size, macro-/microporosity), and rheological characteristics (e.g., swelling capacity, degradation rate, and wettability) were prepared. The hybrid fabrication approach allows the fine-tuning of wettability (approx. 50–75°), swelling (approx. 0–20× increased mass), degradability (approx. 2–30+ days), and mechanical strength (approx. 0.2–11 MPa) in the range between pure hydrogels and pure thermoplastic polymers, while providing a gradient of surface properties and good biocompatibility. The controlled degradability and permeability of the hydrogel component may also enable controlled drug delivery. Our work shows that the novel hybrid hydrogel-thermoplastic scaffolds with adjustable characteristics have immense potential for tissue engineering and can serve as templates for developing novel wound dressings.

Effect of the Degree of Acetylation of Chitin Nonwoven Fabrics for Promoting Wound Healing

Chitin and chitosan have been extensively used as wound dressings because of their special functions to promote wound healing. However, there was little focus on the effects of the degree of acetylation (DA) on wound healing. In this work, the regenerated chitin nonwoven fabrics with DA values of 90, 71, 60, and 42% were prepared, and the morphology and physical performances of the fabrics were characterized. Moreover, the effects of DA of the chitin nonwoven fabrics on wound recovery were studied with a full-thickness skin defect model in rats. In vitro experiments indicated that the chitin nonwoven fabrics exhibited good biocompatibility and blood compatibility and a low blood-clotting index (BCI). In vivo experiments revealed that the chitin nonwoven fabrics could accelerate wound healing more effectively than gauze by promoting re-epithelialization and collagen deposition as well as by stimulating neovascularization. The results of the wound healing process showed that DA of the chitin nonwoven fabrics had a profound effect on promoting wound healing. Notably, the regenerated chitin nonwoven fabrics with 71% DA significantly improved the wound healing compared to the commercial wound dressing Algoplaque film. Therefore, the regenerated chitin nonwoven fabrics are promising candidates for wound healing.

Lignin-Incorporated Nanogel Serving As an Antioxidant Biomaterial for Wound Healing

Oxidative phosphorylation is an important biological process in the body to produce energy, during which oxygen free radicals are generated as byproduct. Excessive oxygen free radicals cause cell death and reduce the rate of tissue regeneration and healing in a wound. Lignin is a natural antioxidant derived from plants, but its biomedical application is restricted because of the uncertain biocompatibility. In this work, we developed a lignin-incorporated nanogel and explored its application for wound healing. Lignin was extracted from coconut husks and determined to have strong antioxidant activity (IC₅₀ = 25.7 ppm). Various amounts of lignin were incorporated into thermoresponsive nanogels, which were produced from polyurethane copolymers of polyethylene glycol (PEG), polypropylene glycol (PPG), and polydimethylsiloxane (PDMS). It was shown that the addition of lignin had minimal effects on the gelation and rheological properties of the nanogel but slightly increased the critical micelle concentration (CMC) of poly(PEG/PPG/PDMS urethane) copolymer from 3.38 × 10^-4 g mL^-1 to 4.61 × 10^-4 g mL^-1. The lignin-incorporated nanogels did not display detectable cytotoxicity. The lignin-incorporated nanogel possessed antioxidant activity, as it reduced the active oxygen level, protecting the LO2 cells from apoptosis caused by oxidative stress. More importantly, in vivo studies demonstrated that the lignin-incorporated nanogels accelerated the healing of burn wounds in mice as proved by the increased expression of Ki67, one marker of cell proliferation. The present work demonstrates that lignin-incorporated nanogel could serve as an antioxidant wound-dressing material and facilitate the wound healing.

The sorptivity and durability of gelling fibre dressings tested in a simulated sacral pressure ulcer system

Wound‐dressing performances are affected by exudate viscosity, resistance to flow because of gravity, and bodyweight loads, the level of which is related to the body position. Here, we focussed on two dressing properties: (a) Sorptivity—the ability of dressings to transfer exudate away from the wound bed by capillary action—and (b) Durability—the capacity of dressings to maintain their integrity over time and during their removal. Both properties are critically important for avoiding further tissue damage but require the development of new laboratory tests for their measurement. A computer‐controlled phantom of an exuding sacral pressure ulcer has therefore been developed and used to compare the performances of Exufiber (Mölnlycke Health Care) vs an alternative market‐leading dressing. Sorptivity was determined using weight tests, and durability was measured through tensile tests of the used dressings. For a supine configuration, the Exufiber dressing demonstrated ~three times higher sorptivity and better durability, withstanding ~five times greater strain energy than the other product before failure occurred. This work paves the way for quantitative, standardised testing of dressings in all aspects of exudate management. The reported tests are further suitable for testing dressing combinations or how dressings interact with negative pressure wound therapy.

Textile-integrated polymer optical fibers for healthcare and medical applications

With ever growing interest in far-reaching solutions for pervasive healthcare and medicine, polymer optical fibers have been rendered into textile forms. Having both fiber-optic functionalities and traditional fabric-like comfort, textile-integrated polymer optical fibers have been advocated to remove the technical barriers for long-term uninterrupted health monitoring and treatment. In this context, this paper spotlights and reviews the recently developed textile-integrated polymer optical fibers in conjunction with fabrication techniques, applications in long-term continuous health monitoring and treatment, and future perspectives in the vision of mobile health (mHealth), as well as the introductory basics of polymer optical fibers. It is designed to serve as a topical guidepost for scientists and engineers on this highly interdisciplinary and rapidly growing topic.

Preparation and Properties of Microcrystalline Cellulose/Fish Gelatin Composite Film

As a natural macromolecule-based biomaterial, fish gelatin is used in medical materials for its low pathogen infection risk. However, because of poor mechanical properties, its application has been limited. In this study, microcrystalline cellulose-reinforced fish gelatin (FG/MCC) composite films were prepared with a biological cross-linking agent (genipin) under ultrasonic treatment. SEM micrographs showed that the smooth microstructure of FG film became increasingly disordered with the addition of MCC. The infrared spectrum analysis (FTIR) demonstrated the existence of hydrogen bond interaction between MCC and FG. Compared with the pure FG film, the tensile strength (TS) and modulus of elasticity (MOE) of composite films with MCC were improved, and the elongation at break (EAB) and swelling ratios (SR) were decreased. Ultrasonic treatment could further improve TS, MOE, and SR. When the composite film was prepared with 15% MCC and treated with ultrasound, the TS and MOE increased by 115% and 227%, respectively, while the EAB decreased by 35% and the SR decreased by 4% in comparison with pure FG films. Thermo-gravimetric analysis (TGA) showed that the FG/MCC composite films were stable below 100 °C. The above results indicate that the FG/MCC films have optimistic application prospects in the biomedical field.

Chemical Modification of Bacterial Cellulose for the Development of an Antibacterial Wound Dressing

Bacterial cellulose is a bacterially derived polymer with great potential for application in wound healing due to its innate properties such as high biocompatibility and biodegradability. In addition to this, it is naturally biosynthesized by bacteria as a hydrogel, which makes it an optimal substrate for the treatment of dry wounds, where additional moisture is required to facilitate the healing process. However, this polymer lacks antibacterial properties. As bacterial infections are becoming increasingly common and difficult to treat due to antimicrobial resistance, it is of crucial importance to develop strategies for the modification of cellulose to ensure protection against bacterial contamination. In this study, a green-chemistry approach was proposed for the functionalization of cellulose to introduce antibacterial functional groups. Two different active agents, namely glycidyl trimethylammonium chloride and glycidyl hexadecyl ether, were used for the covalent derivatization of the hydroxyl groups of glucose through a heterogeneous reaction in basic aqueous conditions. The modified material was chemically and mechanically characterized by solid-state techniques and rheological measurements. A biological assessment was then carried out both using bacterial cells and human keratinocytes. It was observed that the functionalization performed induced a reduction of approximately half of the bacterial population within 24 h of direct contact with Staphylococcus aureus subsp. aureus Rosenbach 6538PTM and Escherichia coli (Migula) Castellani and Chalmers ATCC® 8739TM (respectively, a reduction of 53% and 43% in the cell number was registered for the two strains). In parallel, cytotoxicity studies performed on keratinocytes (HaCaT cell line) showed cell viability in the range of 90 to 100% for up to 6 days of direct contact with both unmodified and modified samples. The morphology of the cells was also visually evaluated, and no significant difference was noted as compared to the control. Finally, the in vitro scratch assay evidenced good wound closure rates in the presence of the samples, with complete coverage of the scratched area after 5 days for both the modified cellulose and the positive control (i.e., keratinocytes growth medium). Overall, the modified hydrogel showed promising features, confirming its potential as an alternative substrate to develop a sustainable, antibacterial and biocompatible wound dressing.

Scaffolds for Wound Healing Applications

In order to overcome the shortcomings related to unspecific and partially efficient conventional wound dressings, impressive efforts are oriented in the development and evaluation of new and effective platforms for wound healing applications. In situ formed wound dressings provide several advantages, including proper adaptability for wound bed microstructure and architecture, facile application, patient compliance and enhanced therapeutic effects. Natural or synthetic, composite or hybrid biomaterials represent suitable candidates for accelerated wound healing, by providing proper air and water vapor permeability, structure for macro- and microcirculation, support for cellular migration and proliferation, protection against microbial invasion and external contamination. Besides being the most promising choice for wound care applications, polymeric biomaterials (either from natural or synthetic sources) may exhibit intrinsic wound healing properties. Several nanotechnology-derived biomaterials proved great potential for wound healing applications, including micro- and nanoparticulate systems, fibrous scaffolds, and hydrogels. The present paper comprises the most recent data on modern and performant strategies for effective wound healing.

Fabrication and evaluation of gelatin/hyaluronic acid/chondroitin sulfate/asiatic acid based biopolymeric scaffold for the treatment of second-degree burn wounds - Wistar rat model study

An extracellular matrix (ECM) mimicking architecture was introduced with gelatin glycosaminoglycans like hyaluronic acid and chondroitin sulfate and a triterpenoid using asiatic acid, possessing biodegradable and biocompatible properties that mark the functionality for the treatment of second-degree burn wounds. In the present work, a foam-based scaffold was fabricated and sterilized with gamma radiation at a 2.5 Mrad dose. The scaffolds were further characterized for morphology, swelling, degradation behaviour, release of bioactive components, ATR-FTIR, mechanical, thermal properties and compared with control. In vitro cytocompatibility of the developed scaffold was studied with L929 mouse fibroblast cells and human mesenchymal stem cells based on deoxyribonucleic acid and lactate dehydrogenase assay. Additionally, the developed scaffold was evaluated for its biocompatibility on the Wistar rat to assess any toxicity induced to the animal based on blood biochemistry and histopathology analysis. Finally, we assessed the efficacy of developed foam scaffolds on the second-degree burn wound-induced Wistar rat with a scaffold alone and a scaffold seeded with human bone-marrow-derived mesenchymal stem cells in a wound healing study for 28 d. The wound contraction assay, histopathology, immunohistochemistry analysis and pro-healing marker quantification using hexosamine, hydroxyproline, and pro-inflammatory markers like TNF-α and MMP-2 were carried out and compared with the commercially available wound dressing. The results revealed that foam-based ECM mimic was cytocompatible, biocompatible and biodegradable in 18 ± 3 d in in vivo conditions and the scaffold fostered the process of healing of second-degree burns within 28 d of treatment. The obtained result proved that the scaffold has a potential for clinical settings in second-degree burn wound treatment.

Nanomaterials for Wound Dressings: An Up-to-Date Overview

As wound healing continues to be a challenge for the medical field, wound management has become an essential factor for healthcare systems. Nanotechnology is a domain that could provide different new approaches concerning regenerative medicine. It is worth mentioning the importance of nanoparticles, which, when embedded in biomaterials, can induce specific properties that make them of interest in applications as materials for wound dressings. In the last years, nano research has taken steps to develop molecular engineering strategies for different self-assembling biocompatible nanoparticles. It is well-known that nanomaterials can improve burn treatment and also the delayed wound healing process. In this review, the first-line of bioactive nanomaterials-based dressing categories frequently applied in clinical practice, including semi-permeable films, semipermeable foam dressings, hydrogel dressings, hydrocolloid dressings, alginate dressings, non-adherent contact layer dressings, and multilayer dressings will be discussed. Additionally, this review will highlight the lack of high-quality evidence and the necessity for future advanced trials because current wound healing therapies generally fail to provide an excellent clinical outcome, either structurally or functionally. The use of nanomaterials in wound management represents a unique tool that can be specifically designed to closely reflect the underlying physiological processes in tissue repair.

Seal bites at sub-Antarctic Marion Island: Incidence, outcomes and treatment recommendations

Seal biologists at Marion Island (Southern Ocean) are in frequent contact with seals. During research activities, biologists may be bitten by seals, yet no standardised protocol for treating such bites is in place. Information on 22 seal bite cases at Marion Island was collected. Treatment of these bites varied, reflecting a need for standardised protocols for the treatment of bites. Recommendations for the in-field treatment of bites are presented. Five of the 22 cases had some symptoms which resembled ‘seal finger’ – a zoonotic infection, usually of the hands, that is contracted after a person comes into contact with tissues of seals or is bitten by one. However, in four of these cases, symptoms subsided within 4 days without antibiotic treatment; in the fifth case antibiotics were administered and symptoms subsided in 4 days. There is little evidence of the occurrence of seal finger at Marion Island, but this deserves further investigation.

A Novel Multilayer Composite Membrane for Wound Healing in Mice Skin Defect Model

To develop a wound dressing material that conforms to the healing process, we prepared a multilayer composite (MC) membrane consisting of an antibacterial layer (ABL), a reinforcement layer (RFL), and a healing promotion layer (HPL). Biocompatible zein/ethyl cellulose (zein/EC) electrospun nanofibrous membranes with in situ loaded antibacterial photosensitizer protoporphyrin (PPIX) and healing promotion material vaccarin (Vac) were, respectively, chosen as the ABL on the surface and the HPL on the bottom, between which nonwoven incorporated bacterial cellulose (BC/PETN) as the HPL was intercalated to enhance the mechanical property. Photodynamic antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa was confirmed by the enlarged inhibition zones; meanwhile, satisfactory biocompatibility of the HPL was verified by scanning electronic microscopy (SEM) of L929 cells cultured on its surface. The potential effects on wound healing in a mice skin defect model of the MC membranes were also evaluated. The animal experiments demonstrated that the wound healing rate in the MC group was significantly increased compared with that in the control group (p < 0.05). Histopathological observation revealed an alleviated inflammatory response, accompanied with vascular proliferation in the MC group. The MC membranes significantly promoted wound healing by creating an antibacterial environment and promoting angiogenesis. Taken together, this MC membrane may act as a promising wound dressing for skin wound healing.

Design Considerations for Hydrogel Wound Dressings: Strategic and Molecular Advances

Wound dressings are traditionally used to protect a wound and to facilitate healing. Currently, their function is expanding. There is an urgent need for new smart products that not only act as a protective barrier but also actively support the wound healing process. Hydrogel dressings are an example of such innovative products and typically facilitate wound healing by providing a hospitable and moist environment in which cells can thrive, while the wound can still breathe and exudate can be drained. These dressings also tend to be less painful or have a soothing effect and allow for additional drug delivery. In this review, various strategic and molecular design considerations are discussed that are relevant for developing a hydrogel into a wound dressing product. These considerations vary from material choice to ease of use and determine the dressing's final properties, application potential, and benefits for the patient. The focus of this review lies on identifying and explaining key aspects of hydrogel wound dressings and their relevance in the different phases of wound repair. Molecular targets of wound healing are discussed that are relevant when tailoring hydrogels toward specific wound healing scenarios. In addition, the potential of hydrogels is reviewed as medicine advances from a repair-based wound healing approach toward a regenerative-based one. Hydrogels can play a key role in the transition toward personal wound care and facilitating regenerative medicine strategies by acting as a scaffold for (stem) cells and carrier/source of bioactive molecules and/or drugs. Impact statement Improved wound healing will lead to a better quality of life around the globe. It can be expected that this coincides with a reduction in health care spending, as the duration of treatment decreases. To achieve this, new and modern wound care products are desired that both facilitate healing and improve comfort and outcome for the patient. It is proposed that hydrogel wound dressings can play a pivotal role in improving wound care, and to that end, this review aims to summarize the various design considerations that can be made to optimize hydrogels for the purpose of a wound dressing.

Carboxymethyl-kappa-carrageenan: A study of biocompatibility, antioxidant and antibacterial activities

Chemical modification of polysaccharides is an important route to enhance, develop or change polysaccharide properties. In this study, carboxymethylation of kappa-carrageenan (KC) with monochloroacetic acid was performed to achieve different degrees of substitution (DS) of carboxymethyl-kappa-carrageenan (CMKC). The degree of substitution ranged from 0.8 to 1.6 and was calculated from the ¹H NMR spectra. The chemical structure of the CMKCs was further characterized by FT-IR, and ¹³C NMR. FT-IR confirmed the carboxymethylation. Carboxymethylation increased viscosity of KC in water and decreased viscosity of KC in synthetic human sweat. Tests with human adipose derived stem cells showed higher viability and lower cytotoxicity for CMKCs when compared to KC. CMKCs showed no hemolytic activity to human red blood cells. CMKCs have increased antioxidant activity compared to KC. In antibacterial assays, CMKCs with DS of 0.8, 1.0 and 1.2 exhibited growth inhibition against Staphylococcus aureus, Bacillus cereus, Escherichia coli and Pseudomonas aeruginosa. CMKC with DS ranging from 1.0 to 1.2 are good candidate biomaterials for cell-contacting applications.

Accelerating healing of excisional wound with alginate hydrogel containing naringenin in rat model

Wounds have always been considered as one of the most common physical damages. Therefore, various researches have been conducted to find an appropriate method to improve wound healing process. Among various materials, since hydrogels have appropriate properties for wound healing, they are widely used for this purpose. In this study, to develop a potential wound dressing, different concentrations of naringenin (0%, 1%, 10% and 20%) were incorporated in alginate hydrogel followed by evaluating its characters such as morphology, swelling properties, weight loss, antibacterial activity, releasing profile of the naringenin, hemo-, and cytocompatibility. Finally, to evaluate the effect of developed hydrogels on wound healing, the full-thickness dermal wound model in rat was used. Our results provided that the prepared hydrogels have appropriate porosity (86.7 ± 5.3%) with the interconnected pores. Moreover, weight loss assessment confirmed that fabricated hydrogels have suitable biodegradability (about 89% after 14 days). MTT assay also revealed the positive effect of hydrogels on cell viabilities, and they have no toxicity effect on cells. In vivo study indicated that the prepared hydrogels had better wound closure than the gauze-treated wound (the control), and alginate/20% naringenin group had the best wound closure among other groups. All in all, this study concluded that alginate/naringenin hydrogel has positive effect on wound healing process, and it can be used to treat skin injuries in the clinic. Graphical abstract.

Polysaccharide-Based Formulations for Healing of Skin-Related Wound Infections: Lessons from Animal Models and Clinical Trials

Skin injuries constitute a gateway for pathogenic bacteria that can be either part of tissue microbiota or acquired from the environmental. These microorganisms (such as Acinetobacter baumannii, Enterococcus faecalis,Pseudomonas aeruginosa, and Staphylococcus aureus) produce virulence factors that impair tissue integrity and sustain the inflammatory phase leading for establishment of chronic wounds. The high levels of antimicrobial resistance have limited the therapeutic arsenal for combatting skin infections. Thus, the treatment of non-healing chronic wounds is a huge challenge for health services worldwide, imposing great socio-economic damage to the affected individuals. This scenario has encouraged the use of natural polymers, such as polysaccharide, in order to develop new formulations (membranes, nanoparticles, hydrogels, scaffolds) to be applied in the treatment of skin infections. In this non-exhaustive review, we discuss the applications of polysaccharide-based formulations in the healing of infected wounds in animal models and clinical trials. The formulations discussed in this review were prepared using alginate, cellulose, chitosan, and hyaluronic acid. In addition to have healing actions per se, these polysaccharide formulations can act as transdermal drug delivery systems, controlling the release of active ingredients (such as antimicrobial and healing agents). The papers show that these polysaccharides-based formulations are efficient in controlling infection and improve the healing, even in chronic infected wounds. These data should positively impact the design of new dressings to treat skin infections.

Chitosan-calcium alginate dressing promotes wound healing: A preliminary study

Dressings are necessary during the process of wound healing. Since the early 1980s, several types of wound dressings have been produced, but they cannot always take into account some effects include antibacterial effect, wound healing promotion, and other properties. In this study, we would like to develop an effective dressing with the above properties, especially accelerating wound healing effect. A chitosan-calcium alginate dressing (CCAD) was developed by coating mixture of chitosan with high-low molecular weight on calcium alginate dressing (CAD). We investigated the structural characteristics of CCAD with Fourier-transform infrared spectroscopy (FTIR) and electron microscopy. The cytotoxicity and antibacterial property were evaluated in vitro using CCK-8 and inhibition zone method. Moisture retention was tested on the skin of Sprague-Dawley (SD) rats, and wound healing studies were performed on a full-thickness skin wound model in SD rats. CCAD showed good moisturizing and antibacterial properties with no cytotoxicity. CCAD could inhibit inflammation by decreasing IL-6, and it could also promote angiogenesis by increasing VEGF, resulting in better wound healing than CAD. CCAD is a better choice in wound care due to its antibacterial property, biocompatibility, moisture retention, healing promotion, and non-cytotoxicity characteristics.

Chitosan as a Wound Dressing Starting Material: Antimicrobial Properties and Mode of Action

Fighting bacterial resistance is one of the concerns in modern days, as antibiotics remain the main resource of bacterial control. Data shows that for every antibiotic developed, there is a microorganism that becomes resistant to it. Natural polymers, as the source of antibacterial agents, offer a new way to fight bacterial infection. The advantage over conventional synthetic antibiotics is that natural antimicrobial agents are biocompatible, non-toxic, and inexpensive. Chitosan is one of the natural polymers that represent a very promising source for the development of antimicrobial agents. In addition, chitosan is biodegradable, non-toxic, and most importantly, promotes wound healing, features that makes it suitable as a starting material for wound dressings. This paper reviews the antimicrobial properties of chitosan and describes the mechanisms of action toward microbial cells as well as the interactions with mammalian cells in terms of wound healing process. Finally, the applications of chitosan as a wound-dressing material are discussed along with the current status of chitosan-based wound dressings existing on the market.

Combination of the Silver-Ethylene Interaction and 3D Printing To Develop Antibacterial Superporous Hydrogels for Wound Management

Due to insufficient biomedical functions of hydrogels for wound management, the exploitation of available methods to expand the biomedical functions of hydrogels always becomes the cutting-edge research. Here, we report on the use of the silver-ethylene interaction and 3D printing technique to develop the antibacterial superporous polyacrylamide (PAM)/hydroxypropyl methylcellulose (HPMC) hydrogel dressings. Experiments demonstrated that the silver-ethylene interaction played significant roles in mediating the formation, dispersion, and cross-linking of silver nanoparticles (AgNPs) in the hydrogel matrix as well as the cross-linking of the PAM networks. At the same time, such organometallic complexes also controlled the release of AgNPs to balance the cytocompatibility and antibacterial activity of the AgNP-cross-linked hydrogels. On the other hand, the use of 3D printed templates and HPMC as the pore-making materials demonstrated could tailor hydrogels into 91.4% porosity and the formed pores into open channels, endowing hydrogels with rapid water uptake rate and 14 times dead-weight of uptake capacity. Furthermore, experiments showed that the regular large pores arisen from 3D printed templates could buffer the swelling of superporous hydrogel dressings, thus decreasing the detachment risk of dressings from wounds. In vivo experiments demonstrated that the AgNP-cross-linked superporous hydrogel dressings could promote the healing of the infected wounds and restrain scar tissue formation.

Progress in the Development of Chitosan-Based Biomaterials for Tissue Engineering and Regenerative Medicine

Over the last few decades, chitosan has become a good candidate for tissue engineering applications. Derived from chitin, chitosan is a unique natural polysaccharide with outstanding properties in line with excellent biodegradability, biocompatibility, and antimicrobial activity. Due to the presence of free amine groups in its backbone chain, chitosan could be further chemically modified to possess additional functional properties useful for the development of different biomaterials in regenerative medicine. In the current review, we will highlight the progress made in the development of chitosan-containing bioscaffolds, such as gels, sponges, films, and fibers, and their possible applications in tissue repair and regeneration, as well as the use of chitosan as a component for drug delivery applications.

Fabrication and Characterization of Low Methoxyl Pectin/Gelatin/Carboxymethyl Cellulose Absorbent Hydrogel Film for Wound Dressing Applications

In this study, hydrogel films composed of low methoxyl pectin (LMP), gelatin, and carboxymethyl cellulose (CMC) were fabricated. Glycerin was used as a plasticizer while glutaraldehyde (Glu) and calcium chloride (CaCl₂) were used as crosslinking agents in film preparation. Hydrogel films were morphologically characterized and evaluated for mechanical properties. In addition, the investigations for fluid uptake ability, water retention capacity, water vapor transmission rate, and integrity value of the invented films were performed. The results showed that F-Glu-Ca-G30 film demonstrated superior properties when compared to other prepared films. It demonstrated a high percentage of elongation at break (32.80%), fluid uptake ability (88.45% at 2 h), water retention capacity (81.70% at 2 h), water vapor transmission rate (1889 g/m²/day), and integrity value (86.42%). F-Glu-Ca-G30 film was subsequently selected for 10% w/w povidone iodine (PI) loading and tested for anti-Staphylococcus aureus activity using an agar diffusion assay. Notably, F-Glu-Ca-G30-PI film demonstrated a dramatic ability to inhibit microbial growth, when compared to both a blank film and iodine solution control. Our LMP/gelatin/CMC hydrogel film promises to be an effective dressing material with high fluid absorption capacity, fluid holding ability, and water vapor transmission rate. Incorporation of antibiotics such as povidone iodine into the films conferred its antimicrobial property thereby highlighting its potential dermatological use. However, further clinical studies of the application of this hydrogel film as wound dressing material is recommended.

Evaluation of Hemostatic Behavior of Micro and Nano Gelatin/Silica Hybrid in Severe Bleeding

Background:

The pH variation of the injury site is an important factor in the failure of styptic and its structural damage. In this study, the behaviour of a gelatin-silica hybrid in severe bleeding was evaluated under different pH values. On the other hand, the effect of the hybrid particle size, which is one of the key physical properties of the hybrid, has been studied in rapid control of haemostasis. </P><P> Method: The hybrid haemostatic behaviour varied drastically by changing the particle size, so that the hybrid containing SiO2 with the average particle size of about 1 micro-meter (Hyb Gel-MSiO2) demonstrated very poor ability in platelet adhesion in neutral pH, about 24%. Also, the aPTT was not shorter than the normal time, whereas reduction of the particle size beyond a certain limit (with nanometer SiO2 for Hyb Gel-NSiO2) led to both increasing platelet adhesion to 32% and very considerable reduction of aPTT. </P><P> Results: Alignment of all results showed that the particle size reduction improves the haemostatic behaviour of the hybrid toward its best performance by controlling excessive bleeding. By changing the pH for a certain particle size, structural integrity, and thereby the hybrid haemostatic behaviour changed dramatically. Therefore, the nano-hybrid showed the most blood absorption (around 470%) in natural pH and acceded to a coherent structure. The results demonstrated that in alkaline or acidic environment, the hybrid haemostatic behaviour was limited. Based on the results of this study, it was found that changes in the hybrid behaviour in acidic pH were much more drastic than in alkaline pH, and also the hybrid with the optimum particle size (Hyb Gel-NSiO2) can maintain the structural integrity with rapid haemostasis (<3 seconds). </P><P> Conclusion: Based on the objective that the pH at the injury site change to the alkaline side, the resulting hybrid has an excellent ability to control excessive bleeding and can be proposed for further in vivo studies as a novel styptic.</P>

Chitosan based-asymmetric membranes for wound healing: A review

The wound healing process involves highly complex and dynamic events that allow the re-establishment of skin's structural integrity. To further improve or to overcome the drawbacks associated with this process, researchers have been focused on the development of new therapeutics. Among them, asymmetric membranes are currently one of the most promising approaches to be used in wound healing due to its structural similarities with the epidermal and dermal layers of the native skin. The outer layer of asymmetric membranes provides a barrier that protects the wound from external damages (e.g. microorganisms and chemical agents), whereas the interior porous layer acts as template for supporting cell adhesion, migration and proliferation. Among the different materials used to produce these distinct layers, the chitosan arises as one of the preeminent materials due to its inherent biocompatibility, antibacterial, hemostatic, and healing properties. Therefore, in this review, it is provided an overview of the different chitosan-based asymmetric membranes developed for wound dressing applications. Further, the chitosan modifications to enhance its bioactivity as well as the asymmetric membranes general properties and production techniques are also described.

Three-Dimensionally Printed Silk-Sericin-Based Hydrogel Scaffold: A Promising Visualized Dressing Material for Real-Time Monitoring of Wounds

A wound dressing which can be convenient for real-time monitoring of wounds is particularly attractive and user-friendly. In this study, a nature-originated silk-sericin-based (SS-based) transparent hydrogel scaffold was prepared and evaluated for the visualization of wound care. The scaffold was fabricated from a hybrid interpenetrating-network (IPN) hydrogel composed of SS and methacrylic-anhydride-modified gelatin (GelMA) by 3D printing. The scaffold transformed into a highly transparent hydrogel upon swelling in PBS, and thus, anything underneath could be easily read. The scaffold had a high degree of swelling and presented a regularly macroporous structure with pores around 400 μm × 400 μm, which can help maintain the moist and apinoid environment for wound healing. Meanwhile, the scaffolds were conducive to adhesion and proliferation of L929 cells. A coculture of HaCaT and HSF cells on the scaffold showed centralized proliferation of the two cells in distributed layers, respectively, denoting a promising comfortable environment for re-epithelialization. Moreover, in vivo studies demonstrated that the scaffold showed no excessive inflammatory reaction. In short, this work presented an SS-based transparent hydrogel scaffold with steerable physical properties and excellent biocompatibility through 3D printing, pioneering promising applications in the visualization of wound care and drug delivery.

Natural actives for wound healing: A review

Nature has been a source of medicinal treatments for thousands of years, with the use of plants as prototypes for drug development and for the extraction of active compounds. Skin injuries occur regularly in everyday life, and the human skin has the ability to promote repair spontaneously under healthy conditions. However, some intrinsic and external factors may interfere with skins' natural ability, leading to nonhealing lesions and chronic wounds, which directly affect health and quality of life. Thus, attention should be given to this health problem, using an appropriated management when necessary. In this scenario, phytotherapy may be an option for cutaneous wound treatment, although further high-quality studies are needed to firmly establish the clinical efficacy of plants. This article reviews traditionally used natural actives for wound healing, highlighting their characteristics and mode of action.