Guanidine hydrochloride embedded polyurethanes as antimicrobial and absorptive wound dressing membranes with promising cytocompatibility

Precise healing of oral and maxillofacial wounds: tissue engineering strategies and their associated mechanisms

Precise healing of wounds in the oral and maxillofacial regions is usually achieved by targeting the entire healing process. The rich blood circulation in the oral and maxillofacial regions promotes the rapid healing of wounds through the action of various growth factors. Correspondingly, their tissue engineering can aid in preventing wound infections, accelerate angiogenesis, and enhance the proliferation and migration of tissue cells during wound healing. Recent years, have witnessed an increase in the number of researchers focusing on tissue engineering, particularly for precise wound healing. In this context, hydrogels, which possess a soft viscoelastic nature and demonstrate exceptional biocompatibility and biodegradability, have emerged as the current research hotspot. Additionally, nanofibers, films, and foam sponges have been explored as some of the most viable materials for wound healing, with noted advantages and drawbacks. Accordingly, future research is highly likely to explore the application of these materials harboring enhanced mechanical properties, reduced susceptibility to external mechanical disturbances, and commendable water absorption and non-expansion attributes, for superior wound healing.

Solvent-free synthesis of biostable segmented polyurethane shape memory polymers for biomedical applications

Biostable shape memory polymers that remain stable in physiological conditions are beneficial for user-defined shape recovery in response to a specific stimulus. For potential commercialization and biocompatibility considerations, biomaterial synthesis must be simple and scalable. Hence, a library of biostable and cytocompatible shape memory polymers with tunable thermomechanical properties based on hard segment content was synthesized using a solvent-free method. Polymer surface chemistry, thermomechanical and shape memory properties, and biostability were assessed. We also investigated the effects of processing methods on thermomechanical and shape memory properties. All polymers showed high glass transition temperatures (>50 °C), which indicates that their temporary shape could be preserved after implantation. Polymers also demonstrate high shape fixity (73-80%) and shape recovery (93-95%). Minimal mass loss (<5%) was observed in accelerated oxidative (20% H2O2) and hydrolytic (0.1 M NaOH) media. Additionally, minimal shape recovery (∼0%) occurred in programmed samples with higher hard segment content that were stored in degradation media. After 40 days of storage in media, programmed samples recovered their primary shapes upon heating to temperatures above their transition temperature. Annealing to above the polymer melting point and solvent casting of polymers improved shape memory and thermal properties. To enable their potential use as biomaterial scaffolds, fiber formation of synthesized polyurethanes was compared with those of samples synthesized using a previously reported solvent-based method. The new method provided polymers that can form fibrous scaffolds with improved mechanical and shape memory properties, which is attributed to the higher molecular weight and crystalline content of polymers synthesized using the new, solvent-free approach. These biostable segmented polyurethanes could be coupled with a range of components that respond to specific stimuli, such as enzymes, magnetic field, pH, or light, to enable a specific shape change response, which could be coupled with drug and/or bioactive material delivery in future work.

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

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

Multilayered 3-D nanofibrous scaffold with chondroitin sulfate sustained release as dermal substitute

Electrospun nanofibers for skin tissue engineering applications face two main challenges. The low thickness of electrospun mats is the main reason for their weak load-bearing performance at clinical applications and limited cell penetration due to their small pore sizes. We have developed multi-layered nanofibrous 3D (M3DN) scaffolds comprising gelatin, polyvinyl alcohol, and chondroitin sulfate (CS) by an electrospinning method and attaching three electrospun layers via ethanol to cause interface fibers to come in contact with each other. Prepared M3DN scaffolds revealed a sustained CS release profile. The improved mechanical performance, stable release of CS, and penetration capability of the cells and blood vessels through the spaces between layers in the prepared multi-layered nanofibrous scaffolds demonstrate their potential applications in response to the increasing demand for replacement of damaged dermis. The results of animal studies on the dorsal skin of Rat with full-thickness wounds have shown that the reconstruction of full-thickness skin lesions is significantly higher for M3DN scaffolds than a control group (treated with sterile gauze). The amount of epithelization, collagen arrangement, and inflammatory cells (acute and chronic) has been investigated, and their associated results demonstrated that M3DN scaffolds have great potential for full-thickness wound restoration.

Polyurethane Foam Incorporated with Nanosized Copper-Based Metal-Organic Framework: Its Antibacterial Properties and Biocompatibility

Polyurethane foams (PUFs) have attracted attention as biomaterials because of their low adhesion to the wound area and suitability as biodegradable or bioactive materials. The composition of the building blocks for PUFs can be controlled with additives, which provide excellent anti-drug resistance and biocompatibility. Herein, nanosized Cu-BTC (copper(II)-benzene-1,3,5-tricarboxylate) was incorporated into a PUF via the crosslinking reaction of castor oil and chitosan with toluene-2,4-diisocyanate, to enhance therapeutic efficiency through the modification of the surface of PUF. The physical and thermal properties of the nanosized Cu-BTC-incorporated PUF (PUF@Cu-BTC), e.g., swelling ratio, phase transition, thermal gravity loss, and cell morphology, were compared with those of the control PUF. The bactericidal activities of PUF@Cu-BTC and control PUF were evaluated against Pseudomonas aeruginosa, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus. PUF@Cu-BTC exhibited selective and significant antibacterial activity toward the tested bacteria and lower cytotoxicity for mouse embryonic fibroblasts compared with the control PUF at a dose of 2 mg mL-1. The Cu(II) ions release test showed that PUF@Cu-BTC was stable in phosphate buffered saline (PBS) for 24 h. The selective bactericidal activity and low cytotoxicity of PUF@Cu-BTC ensure it is a candidate for therapeutic applications for the drug delivery, treatment of skin disease, and wound healing.

Polyurethane-Nanolignin Composite Foam Coated with Propolis as a Platform for Wound Dressing: Synthesis and Characterization

This piece of research explores porous nanocomposite polyurethane (PU) foam synthesis, containing nanolignin (NL), coated with natural antimicrobial propolis for wound dressing. PU foam was synthesized using polyethylene glycol, glycerol, NL, and 1, 6-diisocyanato-hexane (NCO/OH ratio: 1.2) and water as blowing agent. The resultant foam was immersed in ethanolic extract of propolis (EEP). PU, NL-PU, and PU-NL/EEP foams were characterized from mechanical, morphological, and chemical perspectives. NL Incorporation into PU increased mechanical strength, while EEP coating showed lower strength than PU-NL/EEP. Morphological investigations confirmed an open-celled structure with a pore diameter of 150-200 μm, a density of nearly 0.2 g/cm3,, and porosity greater than 85%, which led to significantly high water absorption (267% for PU-NL/EEP). The hydrophilic nature of foams, measured by the contact angle, proved to be increased by NL addition and EEP coating. PU and PU-NL did not show important antibacterial features, while EEP coating resulted in a significant antibacterial efficiency. All foams revealed high biocompatibility toward L929 fibroblasts, with the highest cell viability and cell attachment for PU-NL/EEP. In vivo wound healing using Wistar rats' full-thickness skin wound model confirmed that PU-NL/EEP exhibited an essentially higher wound healing efficacy compared with other foams. Hence, PU-NL/EEP foam could be a promising wound dressing candidate.

Biocompatibility studies of polyurethane electrospun membranes based on arginine as chain extender

Electrospun polymers are an example of multi-functional biomaterials that improve the material-cellular interaction and aimed at enhancing wound healing. The main objective of this work is to fabricate electrospun polyurethane membranes using arginine as chain extender (PUUR) in order to test the fibroblasts affinity and adhesion on the material and the polymer toxicity. Polyurethane membranes were prepared in two steps: (i) the polyurethane synthesis, and ii) the electrospinning process. The membranes were characterized by scanning electron microscopy (SEM), Fourier transforms infrared spectroscopy, gel permeation chromatography, and differential scanning calorimetry techniques. The evaluation of PUUR as a scaffolding biomaterial for growing and developing of cells on the material was realized by LIVE/DEAD staining. The results show that the fluorescent surface area of human fibroblasts (hFB), was greater in control dense membranes made from Tecoflex than in electrospun and dense PUUR. From SEM analysis, the electrospun membranes show relatively uniform attachment of cells with a well-spread shape, while Tecoflex dense membranes show a non-proliferating round shape, which is attributed to the fiber's structure in electrospun membranes. The cell morphology and the cell attachment assay results reveal the well spreading of hFB cells on the surface of electrospun PUUR membranes which indicates a good response related to cell adhesion.

Functional-modified polyurethanes for rendering surfaces antimicrobial: An overview

Antimicrobial surfaces and coatings are rapidly emerging as primary components in functional modification of materials and play an important role in addressing the problems associated with biofouling and microbial infection. Polyurethane (PU) consisting of alternating soft and hard segments has been one of the most important coating materials that have been widely applied in many fields due to its versatile properties. This review attempts to provide insight into the recent advances in antimicrobial polyurethane coatings or surfaces. According to different classes of antimicrobial components along with their antimicrobial mechanism, the synthesis pathways are presented systematically herein to afford polyurethane with antimicrobial properties. Also, the challenges and opportunities of antimicrobial PU coatings and surfaces are also discussed. This review will be beneficial to the exploitation and the further studies of antimicrobial polyurethane materials for a variety of applications.

In vitro and in vivo evaluation of antibacterial activity of polyhexamethylene guanidine (PHMG)-loaded TiO2 nanotubes

Artificial joint replacement is an effective surgical method for treating end-stage degenerative joint diseases, but peripheral bacterial infection of prosthesis can compromise the effect of the surgery. Herein, antibacterial effects of titanium dioxide nanotubes (TNTs) coated with polyhexamethylene guanidine (PHMG) were examined via in vitro and in vivo experiments. TNTs with a pore diameter 46.4 ± 5.9 nm and length of 300-500 nm for the slice and 650-800 nm for the rod were fabricated by anodization. Then, 3.46 ± 0.40 mg and 1.27 ± 0.28 mg of PHMG were coated onto the TNT slice and rod, respectively. In vitro studies of the release of PHMG showed that the antibacterial agent was released in two stages: initial burst release and relatively slow release. In vitro and in vivo antibacterial studies showed that the PHMG-loaded TNTs (PHMG-TNTs) had excellent antibacterial abilities to prevent bacterial infections. Clinical pathological analysis of rabbit femurs indicated that the implanted PHMG-TNTs had no apparent pathological changes. Real-time quantitative reverse transcription polymerase chain reaction analysis of the femur tissues around the implants showed that the expression of osteogenic-related genes, including runt-related transcription factor 2, osteocalcin, alkaline phosphatase, bone sialoprotein, bone morphogenetic protein 2 and vascular endothelial growth factor A, was significantly upregulated in the PHMG-TNT implanted group as compared to the other groups. Overall, these findings provide a promising approach for the fabrication of antibacterial and bone biocompatible titanium-based implants in orthopedics.

Development of a Chitosan-Vaseline Gauze Dressing with Wound-Healing Properties in Murine Models

Wound dressings are always needed after skin injury; however, most of the dressings still leave room for improvement. Here, we would like to develop an effective dressing with the ability to improve wound healing. A chitosan-Vaseline gauze (CVG) dressing was developed by coating the chitosan mixture and Vaseline on sterile gauze with subsequent drying. Infrared spectroscopy and electron microscopy were used to investigate the miscibility and structure of the dressing. The cytotoxicity and antibacterial nature were evaluated in vitro. The studies of water retention rate, wound healing, and tissue compatibility were carried out over a period of 14 days on full-thickness skin wounds of male Sprague-Dawley rats. It was observed that the CVG dressing demonstrated functional structure by miscibility, non-cytotoxicity, and good antibacterial effects against both Gram-positive and Gram-negative bacteria. The water retention rate incresased up to 25% after applying CVG for 3 hours. Besides, CVG treatment increased angiogenesis and improved microvascular density in wounds. The wounds treated with CVG showed size deduction with new collagen aggregations similar to those in the normal dermis. All the aforementioned results suggest that CVG dressing could be a promising candidate for wound treatment.

Nanocomposite foams based on flexible biobased thermoplastic polyurethane and ZnO nanoparticles as potential wound dressing materials

In the present study biobased and soft thermoplastic polyurethane (TPU), obtained by polymerization from fatty acids, was used to produce TPU/ZnO nanocomposite foams by thermally induced phase separation method (TIPS). The produced foams were characterized and evaluated regarding their potential uses as wound dressing materials. The structure and morphology of the prepared flexible polymer foams with different content of ZnO nanofiller (1, 2, 5 and 10 wt% related to the polymer) were studied by Fourier transform infrared spectroscopy (FTIR) and Scanning electron microscopy (SEM). Highly porous nanocomposite structure made of interconnected pores with dimensions between 10 and 60 μm was created allowing water vapor transmission rate (WVTR) up to 8.9 mg/cm²·h. The TPU/ZnO foams, tested for their ability to support cells and their growth, showed highest cell proliferation for TPU nanocomposite foams with 2 and 5 wt% ZnO. Overall, the nanocomposite foams displayed a low cytotoxic potential (varied proportionally to the ZnO content) and good biocompatibility. All tested nanocomposite foams were found to be significantly active against biofilms formed by different Gram-positive (Enterococcus faecalis and Staphylococcus aureus) and Gram-negative (Escherichia coli and Pseudomonas aeruginosa) bacteria. Based on their behaviors, flexible TPU/ZnO nanocomposite foams can be considered for biomedical applications such as potential active wound dressing.

Antimicrobial wound dressings with high mechanical conformability prepared through thiol-yne click photopolymerization reaction

Radical mediated photochemical thiol-yne click polymerization of thiol-terminated polyurethane prepolymers, with poly(ethylene glycol) soft segment at two different molecular weights, a propargyl terminated urethane crosslinker and silver salt was utilized to prepare versatile wound dressings containing well-dispersed Ag° nanoparticles produced via in situ reduction of Ag⁺ ions. The dressings with optimized chemical structure showed desirable fluid handling capacity (up to 4.84 g/10 cm² d^-1) to provide moist environment over damaged tissue. They were permeable to oxygen and carbon dioxide, therefore, the processes related to tissue regeneration of wound bed could be continued without problem. Their appropriate tensile strength (up to 3.87 MPa) and suitable conformability (less than 0.1% permanent set) enabled protection of damaged skin tissue from external physical forces during the healing process, even for wounds present at organs with a high degree of freedom. The proper cytocompatibility of the prepared dressings and their ability to support growth and proliferation of fibroblast cells as determined by wound scratch healing assay showed the potential utility of the dressings to motivate wound healing progression by migration of cells to the damaged area. In addition, these dressings with in situ formed silver nanoparticles exhibited promising antimicrobial activity against different bacterial and fungal strains, and consequently could encourage wound healing process by prevention from infection in the wound site.

Facile Fabrication of Sandwich Structural Membrane With a Hydrogel Nanofibrous Mat as Inner Layer for Wound Dressing Application

A common problem existing in wound dressing is to integrate the properties of against water erosion while maintaining a high water-uptake capacity. To tackle this issue, we imbedded one layer of hydrogel nanofibrous mat into two hydrophobic nanofibrous mats, thereafter, the sandwich structural membrane (SSM) was obtained. Particularly, SSM is composed of three individual nanofibrous layers which were fabricated through sequential electrospinning technology, including two polyurethane/antibacterial agent layers, and one middle gelatin/rutin layer. The obtained SSM is characterized in terms of morphology, component, mechanical, and functional performance. In addition to the satisfactory antibacterial activity against Staphylococcus aureus and Escherichia coli, and antioxidant property upon scavenging DPPH free radicals, the obtained SSM also shows a desirable thermally regulated water vapor transmission rate. More importantly, such SSM can be mechanically stable and keep its intact morphology without appearance damage while showing a high water-absorption ratio. Therefore, the prepared sandwich structural membrane with hydrogel nanofibrous mat as inner layer can be expected as a novel wound dressing.

Interactions of Biocidal Polyhexamethylene Guanidine Hydrochloride and Its Analogs with POPC Model Membranes

The bacterial membrane-targeted polyhexamethylene guanidine hydrochloride (PHGH) and its novel analog polyoctamethylene guanidine hydrochloride (POGH) had excellent antimicrobial activities against antibiotics-resistant bacteria. However, the biocompatibility aspects of PHGH and POGH on the phospholipid membrane of the eukaryotic cell have not yet been considered. Four chemically synthesized cationic oligoguanidine polymers containing alkyl group with different carbon chain lengths, including PHGH, POGH, and their two analogs, were used to determine their interactions with zwitterionic 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) phospholipids vesicles mimicking the eukaryotic cell membrane. Characterization was conducted by using bactericidal dynamics, hemolysis testing, calcein dye leakage, and isothermal titration calorimetry. Results showed that the gradually lengthened alkyl carbon chain of four oligoguanidine polymers increased the biocidal activity of the polymer, accompanied with the increased hemolytic activity, calcein dye leakage rate and the increased absolute value of the exothermic effect of polymer-POPC membrane interaction. The thermodynamic curve of the polymer-POPC membrane interaction exhibited a very weak exothermic effect and a poorly unsaturated titration curve, which indicated that four guanidine polymers had weak affinity for zwitterionic POPC vesicles. Generally, PHGH of four guanidine polymers had high biocidal activity and relatively high biocompatibility. This study emphasized that appropriate amphiphilicity balanced by the alkyl chain length, and the positive charge is important factor for the biocompatibility of cationic antimicrobial guanidine polymer. Both PHGH and POGH exhibited destructive power to phospholipid membrane of eukaryotic cell, which should be considered in their industry applications.

Polyurethane/siloxane membranes containing graphene oxide nanoplatelets as antimicrobial wound dressings: in vitro and in vivo evaluations

Preserving wounds from bacterial and fungal infections and retaining optimum moist environment over damaged tissue are major challenges in wound care management. Application of wound dressings with antimicrobial activity and appropriate wound exudates handling ability is of particular significance for promoting wound healing. To this end, preparation and evaluation of novel wound dres1sings made from polyurethane/siloxane network containing graphene oxide (GO) nanoplatelets are described. The particular sol-gel hydrolysis/condensation procedure applied for the preparation of dressings leads to an appropriate distribution of GO nanoplatelets in the dressing membranes. The crosslinked siloxane domains and the presence of GO nanoplatelets within polymeric chains offered necessary mechanical strength for dressings. Meanwhile, a combination of hydrophilic and hydrophobic moieties in dressing backbone enabled suitable wound exudate management. Therefore, both of physical protection from external forces and preservation of moist environment over wound were attained by using the designed dressings. Widespread antimicrobial activity against gram-positive, gram-negative and fungal strains was recorded for the dressing with the optimum amount of GO, meanwhile, very good cytocompatibility against fibroblast cells was noted for these dressings. In vivo assay of the GO containing dressing on rat animal model reveals that the dressing can promote wound healing by complete re-epithelization, enhanced vascularization and collagen deposition on healed tissue.

Development of contact-killing non-leaching antimicrobial guanidyl-functionalized polymers via click chemistry

A new contact-killing and non-leaching antimicrobial polymer was prepared by a robust, efficient and orthogonal click-chemistry.

pH-Modulating Poly(ethylene glycol)/Alginate Hydrogel Dressings for the Treatment of Chronic Wounds

The development of chronic wounds has been frequently associated with alkaline pH values. The application of pH-modulating wound dressings can, therefore, be a promising treatment option to promote normal wound healing. This study reports on the development and characterization of acidic hydrogel dressings based on interpenetrating poly(ethylene glycol) diacrylate/acrylic acid/alginate networks. The incorporation of ionizable carboxylic acid groups results in high liquid uptake up to 500%. The combination of two separate polymer networks significantly improves the tensile and compressive stability. In a 2D cell migration assay, the application of hydrogels (0% to 1.5% acrylic acid) results in complete "wound" closure; hydrogels with 0.25% acrylic acid significantly increase the cell migration velocity to 19.8 ± 1.9 µm h^-1 . The most promising formulation (hydrogels with 0.25% acrylic acid) is tested on 3D human skin constructs, increasing keratinocyte ingrowth into the wound by 164%.

Thermoresponsive polyurethane/siloxane membrane for wound dressing and cell sheet transplantation: In-vitro and in-vivo studies

Polyurethane/siloxane based wound dressing for transferring fibroblast cell sheet to wounded skin and ability to provide an optimum condition for cellular activity at damaged tissue was prepared in this research. The dressing was made thermoresponsive, via the introduction of a poly(N-isopropyl acrylamide) copolymer into the backbone of dressing. The ability of membrane for adhesion, growth, and proliferation of fibroblast cells was improved via surface modification with gelatin. The optimized dressing exhibited appropriate tensile strength (4.5MPa) and elongation at break (80%) to protect wound against physical forces. Due to controlled equilibrium water absorption of about 89% and water vapor transmission rate of 2040g/m(2)day, the dressing could maintain the favorable moist environment over moderate to high exuding wounds. The grown cell sheet on dressing membrane could easily roll up from the surface just with lowering the temperature. The in vivo study of the wound dressed with cell loaded membrane confirmed the accelerated healing and production of tissue with complete re-epithelization, enhanced vascularization, and increased collagen deposition on the damaged area.

A novel biodegradable polyurethane based on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) and poly(ethylene glycol) as promising biomaterials with the improvement of mechanical properties and hemocompatibility

A novel biodegradable PHBV-based polyurethane was designed and synthesized by using PHBV, MDI and PEG.