Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing

Advances of antimicrobial dressings loaded with antimicrobial agents in infected wounds

Wound healing is a complex process that is critical for maintaining the barrier function of the skin. However, when a large quantity of microorganisms invade damaged skin for an extended period, they can cause local and systemic inflammatory responses. If left untreated, this condition may lead to chronic infected wounds. Infected wounds significantly escalate wound management costs worldwide and impose a substantial burden on patients and healthcare systems. Recent clinical trial results suggest that the utilization of effective antimicrobial wound dressing could represent the simplest and most cost-effective strategy for treating infected wounds, but there has hitherto been no comprehensive evaluation reported on the efficacy of antimicrobial wound dressings in promoting wound healing. Therefore, this review aims to systematically summarize the various types of antimicrobial wound dressings and the current research on antimicrobial agents, thereby providing new insights for the innovative treatment of infected wounds.

Non-isocyanate polyurethane-co-polyglycolic acid electrospun nanofiber membrane wound dressing with high biocompatibility, hemostasis, and prevention of chronic wound formation

The prevention of chronic wound formation has already been a primary subject in wound management, particularly for deep wounds. The electrospun nanofiber membranes hold tremendous potential in the prevention of chronic wounds due to their micro/nano pore structures. Currently, many natural and synthetic materials have been utilized in the fabrication of nanofiber membranes. However, striking a balance between the structural stability and the biocompatibility remains challenging. It is necessary not only to ensure the long-term durability of nanofiber membranes but also to enhance their biocompatibility for alleviating patients' suffering. In this study, we reported a nanofiber membrane dressing with excellent biocompatibility and mechanical properties, which is potential for the treatment of deep wounds. The basal material chosen for the preparation of the nanofiber membrane was a co-polyester (NI-LPGD5) synthesized by non-isocyanate polyurethane (NIPU) and polyglycolic acid with a dihydroxy structure (LPGD-synthesized from glycolic acid and neopentyl glycol). Moreover, curcumin was also added as a bioactive substance to enhance the pro-healing effect of dressings. The physicochemical properties of the prepared nanofiber membranes were characterized through various physicochemical tools. Our results demonstrated that the NI-LPGD5 co-polymer can be electrospun into smooth fibers. Meanwhile, curcumin-loaded nanofiber membranes (Cur/NI-LPGD5) also exhibited a favorable microscopic morphology. The fabricated membranes exhibited suitable mechanical properties, outstanding hygroscopic-swelling rate and water vapor transmittance. Besides, in vitro cell culturing, the cells on the NI-LPGD5 membrane maintained their maximum viability. The potential of in vivo wound healing was further demonstrated through animal experiments. The experimental results showed that the nanofiber membranes effectively prevented chronic wounds from forming and promoted granulation tissue growth without replacing the dressing throughout the healing process. We also found that these nanofiber membranes could effectively promote the expression of related biomarkers to accelerate wound healing, particularly the Cur/NI-LPGD5 membrane. In conclusion, the fabricated membranes possess suitable physicochemical properties and promising bioactivity. As a result, it effectively prevented the formation of chronic wounds and demonstrated significant potential in reducing the frequency of dressing changes.

The Uniform Distribution of Hydroxyapatite in a Polyurethane Foam-Based Scaffold (PU/HAp) to Enhance Bone Repair in a Calvarial Defect Model

Polyurethane (PU) is a promising material for addressing challenges in bone grafting. This study was designed to enhance the bone grafting capabilities of PU by integrating hydroxyapatite (HAp), which is known for its osteoconductive and osteoinductive potential. Moreover, a uniform distribution of HAp in the porous structure of PU increased the effectiveness of bone grafts. PEG/APTES-modified scaffolds were prepared through self-foaming reactions. A uniform pore structure was generated during the spontaneous foaming reaction, and HAp was uniformly distributed in the PU structure (PU15HAp and PU30HAp) during foaming. Compared with the PU scaffolds, the HAp-modified PU scaffolds exhibited significantly greater protein absorption. Importantly, the effect of the HAp-modified PU scaffold on bone repair was tested in a rat calvarial defect model. The microstructure of the newly formed bone was analyzed with microcomputed tomography (μ-CT). Bone regeneration at the defect site was significantly greater in the HAp-modified PU scaffold group than in the PU group. This innovative HAp-modified PU scaffold improves current bone graft materials, providing a promising avenue for improved bone regeneration.

An injectable hydrogel dressing for controlled release of hydrogen sulfide pleiotropically mediates the wound microenvironment

The healing of scalded wounds faces many challenges such as chronic inflammation, oxidative stress, wound infection, and difficulties in vascular and nerve regeneration. Treating a single problem cannot effectively coordinate the complex regenerative microenvironment of scalded wounds, limiting the healing and functional recovery of the skin. Therefore, there is a need to develop a multi-effect treatment plan that can adaptively address the issues at each stage of wound healing. In this study, we propose a scheme for on-demand release of hydrogen sulfide (H2S) based on the concentration of reactive oxygen species (ROS) in the wound microenvironment. This is achieved by encapsulating peroxythiocarbamate (PTCM) in the ROS-responsive polymer poly(ethylene glycol)-poly(L-methionine) (PMet) to form nanoparticles, which are loaded into a thermosensitive injectable hydrogel, F127-poly(L-aspartic acid-N-hydroxysuccinimide) (F127-P(Asp-NHS)), to create a scald dressing. The H2S released by the hydrogel dressing on demand regulates the wound microenvironment by alleviating infection, reducing oxidative stress, and remodeling inflammation, thereby accelerating the healing of full-thickness scalded wounds. This hydrogel dressing for the adaptive release of H2S has great potential in addressing complex scalded wounds associated with infection and chronic inflammation.

Green Electrospun Poly(vinyl alcohol)/Gelatin-Based Nanofibrous Membrane by Incorporating 45S5 Bioglass Nanoparticles and Urea for Wound Dressing Applications: Characterization and In Vitro and In Vivo Evaluations

This study reports the fabrication and characterization of poly(vinyl alcohol) (PVA) and gelatin (Gel)-based nanofiber membranes cross-linked with citric acid (CA) by a green electrospinning method in which nano 45S5 bioglass (BG) and urea were incorporated. Various combinations of PVA, gelatin, and BG were prepared, and nanofiber membranes with average fiber diameters between 238 and 595 nm were fabricated. Morphological, chemical, and mechanical properties, porosity, swelling, water retention, and water vapor transmission rate of the fabricated membranes were evaluated. PVA:Gel (90:10), 15% CA, and 3% BG were determined as the optimum blend for nanofiber membrane fabrication via electrospinning. The membrane obtained using this blend was further functionalized with 10% w/w polymer urea coating by the electrospray method following the cross-linking. In vitro biocompatibility tests revealed that the fabricated membranes were all biocompatible except for the one that functionalized with urea. In vivo macroscopic and histopathological analysis results of PVA/Gel/BG and PVA/Gel/BG/Urea treated wounds indicated increased collagenization and vascularization and had an anti-inflammatory effect. Furthermore, careful examination of the in vivo macroscopic results of the PVA/Gel/BG/Urea membrane indicated its potential to decrease uneven scar formation. In conclusion, developed PVA/Gel/BG and PVA/Gel/BG/Urea electrospun membranes with multifunctional and biomimetic features may have the potential to be used as beneficial wound dressings.

A 3D-Printed Cuttlefish Bone Elastomeric Sponge Rapidly Controlling Noncompressible Hemorrhage

Developing a self-expanding hemostatic sponge with high blood absorption and rapid shape recovery for noncompressible hemorrhage remains a challenge. In this study, a 3D-printed cuttlefish bone elastomeric sponge (CBES) is fabricated, which combined ordered channels and porous structures, presented tunable mechanical strength, and shape memory potentials. The incorporation of cuttlefish bone powder (CBp) plays key roles in concentrating blood components, promoting aggregation of red blood cells and platelets, and activating platelets, which makes CBES show enhanced hemostatic performance compared with commercial gelatin sponges in vivo. Moreover, CBES promotes more histiocytic infiltration and neovascularization in the early stage of degradation than gelatin sponges, which is conducive to the regeneration and repair of injured tissue. To conclude, CBp loaded 3D-printed elastomeric sponges can promote coagulation, present the potential to guide tissue healing, and broaden the hemostatic application of traditional Chinese medicine.

Generation of a photothermally responsive antimicrobial, bioadhesive gelatin methacryloyl (GelMA) based hydrogel through 3D printing for infectious wound healing

Recently, photothermal nanomaterials has attracted enormous interests owing to their enhanced therapeutic effects and less adverse effects in the treatment of infectious diseases. Herein, this work presents a photothermally responsive antimicrobial, bioadhesive hydrogel through three dimensions (3D) printing technology for treatment the wound infection. The hydrogel is based on a visible-light-activated naturally derived polymer (GelMA), GelMA grafted with dopamine (GelMA-DA) and the polydopamine coated reduced graphene oxide (rGO@PDA), which can provide the multifunctional such as photothermal antibacterial, antioxidant, conductivity, adhesion and hemostasis performance to accelerate wound healing. The developed hydrogel shown the excellent adhesion capability to adhere the in vitro physiological tissues and glass surface. Moreover, the fabricated hydrogel also exhibited excellent cytocompatibility to L929 cells which is a vital biofunction for efficiently promoting cell proliferation and migration in vitro. The hydrogel also showed remarkable photothermally responsive antimicrobial capability against two strains (99.3 % antibacterial ratio for E. coli and 98.6 % antibacterial ratio for S. aureus). Furthermore, it could support the wound repair and regeneration of S. aureus infected full-thickness wound defects in rats. Overall, the 3D printed hydrogel could be used as a photothermal platform for the development of more effective therapies against the infected wound.

Surface modification strategies for improved hemocompatibility of polymeric materials: a comprehensive review

Polymeric biomaterials are a widely used class of materials due to their versatile properties. However, as with all other types of materials used for biomaterials, polymers also have to interact with blood. When blood comes into contact with any foreign body, it initiates a cascade which leads to platelet activation and blood coagulation. The implant surface also has to encounter a thromboinflammatory response which makes the implant integrity vulnerable, this leads to blood coagulation on the implant and obstructs it from performing its function. Hence, the surface plays a pivotal role in the design and application of biomaterials. In particular, the surface properties of biomaterials are responsible for biocompatibility with biological systems and hemocompatibility. This review provides a report on recent advances in the field of surface modification approaches for improved hemocompatibility. We focus on the surface properties of polysaccharides, proteins, and synthetic polymers. The blood coagulation cascade has been discussed and blood - material surface interactions have also been explained. The interactions of blood proteins and cells with polymeric material surfaces have been discussed. Moreover, the benefits as well as drawbacks of blood coagulation on the implant surface for wound healing purposes have also been studied. Surface modifications implemented by other researchers to enhance as well as prevent blood coagulation have also been analyzed.

Antimicrobial Nonisocyanate Polyurethane Foam Derived from Lignin for Wound Healing

Medical dressings, as a cover for wounds, can replace damaged skin in the wound healing process to play a temporary barrier role, avoid or control wound infection, and provide a favorable environment for wound healing. Therefore, there is an urgent need for medical antimicrobial dressings for the treatment of chronic wounds. Although traditional polyurethane foam has been widely used in medical dressings, conventional polyurethane foams are primarily prepared using nonbiocompatible isocyanate-based compounds, which are potentially hazardous for both operators and applications in the medical field. Here, we propose nonisocyanate polyurethane foams naturally derived from lignin by enzymatic lignin alkylation, cyclic carbonation modification, and polymerization with diamine and the addition of a blowing agent. Silver nanoparticle solution was added during foaming to confer antimicrobial properties. This lignin-based nonisocyanate polyurethane/silver composite foam (named NIPU foam-silver) using a green synthesis method has good mechanical properties, which can be used to manufacture polyurethane/silver foams, and thermal and antimicrobial properties. Notably, NIPU foam-Ag showed more than 95% bactericidal efficacy against both Escherichia coli and Staphylococcus aureus within 4 h. Evaluation of in vitro wounds in mice showed that this antimicrobial composite foam rapidly promotes wound healing and repairs damaged tissue. This suggests that this biobased biodegradable antimicrobial foam has significant scope for clinical applications in wound management.

In situ photo-crosslinkable hyaluronic acid-based hydrogel embedded with GHK peptide nanofibers for bioactive wound healing

A versatile hydrogel was developed for enhancing bioactive wound healing by introducing the amphiphilic GHK peptide (GHK-C16) into a photo-crosslinkable tyramine-modified hyaluronic acid (HA-Ty). GHK-C16 self-assembled into GHK nanofibers (GHK NF) in HA-Ty solution, which underwent in situ gelation after the wound area was filled with precursor solution. Blue light irradiation (460-490 nm), with riboflavin phosphate as a photoinitiator, was used to trigger crosslinking, which enhanced the stability of the highly degradable hyaluronic acid and enabled sustained release of the nanostructured GHK derivatives. The hydrogels provided a microenvironment that promoted the proliferation of dermal fibroblasts and the activation of cytokines, leading to reduced inflammation and increased collagen expression during wound healing. The complexation of Cu2+ into GHK nanofibers resulted in superior wound healing capabilities compared with non-lipidated GHK peptide with a comparable level of growth factor (EGF). Additionally, nanostructured Cu-GHK improved angiogenesis through vascular endothelial growth factor (VEGF) activation, which exerted a synergistic therapeutic effect. Furthermore, in vivo wound healing experiments revealed that the Cu-GHK NF/HA-Ty hydrogel accelerated wound healing through densely packed remodeled collagen in the dermis and promoting the growth of denser fibroblasts. HA-Ty hydrogels incorporating GHK NF also possessed improved mechanical properties and a faster wound healing rate, making them suitable for advanced bioactive wound healing applications. STATEMENT OF SIGNIFICANCE: By combining photo-crosslinkable tyramine-modified hyaluronic acid with self-assembled Cu-GHK-C16 peptide nanofibers (Cu-GHK NF), the Cu-GHK NF/HA-Ty hydrogel offers remarkable advantages over conventional non-structured Cu-GHK for wound healing. It enhances cell proliferation, migration, and collagen remodeling-critical factors in tissue regeneration. The incorporation of GHK nanofibers complexed with copper ions imparts potent anti-inflammatory effects, promoting cytokine activation and angiogenesis during wound healing. The Cu-GHK NF/hydrogel's unique properties, including in situ photo-crosslinking, ensure high customization and potency in tissue regeneration, providing a cost-effective alternative to growth factors. In vivo experiments further validate its efficacy, demonstrating significant wound closure, collagen remodeling, and increased fibroblast density. Overall, the Cu-GHK NF/HA-Ty hydrogel represents an advanced therapeutic option for wound healing applications.

Asymmetric fabrication and in vivo evaluation of the wound healing potency of electrospun biomimetic nanofibrous scaffolds based on collagen crosslinked modified-chitosan and graphene oxide quantum dot nanocomposites

Asymmetric scaffolds were developed through electrospinning by utilizing biocompatible materials for effective wound healing applications. First of all, the chitosan surface was modified with decanoyl chloride and crosslinked with collagen to synthesize collagen crosslinked modified-chitosan (CG-cross-CS-g-Dc). Then, the asymmetric scaffolds were fabricated through electrospinning, where the top layer was a monoaxial nanofiber of the PCL/graphene oxide quantum dot (GOQD) nanocomposite and the bottom layer was a coaxial nanofiber having PCL in the core and the CG-cross-CS-g-Dc/GOQD nanocomposite in the shell layer. The formation of monoaxial (∼130 ± 50 nm) and coaxial (∼320 ± 40 nm) nanofibers was confirmed by transmission electron microscopy (TEM). The presence of GOQDs contributed to antioxidant and antimicrobial efficacy. These scaffolds showed substantial antibacterial activity against the common wound pathogens Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The scaffolds exhibited excellent cytocompatibility (MTT assay) and anti-inflammatory behaviour as analysed via the cytokine assay and biochemical analysis. The in vivo wound healing potential of the nanofibrous scaffolds was assessed with full-thickness excisional wounds in a rat model. The scaffolds accelerated the re-epithelialization as well as the collagen deposition, thereby facilitating the wound healing process in a very short span of time (10 days). Both in vitro and in vivo analyses thus provide a compelling argument for the use of these scaffolds as therapeutic biomaterials and their suitability for application in rapid wound regeneration and repair.

HE@PCL/PCE Gel-Nanofiber Dressing with Robust Self-Adhesion toward High Wound-Healing Rate via Microfluidic Electrospinning Technology

Hydrogels have attracted increasing attention in the biomedical field due to their similarity in structure and composition to natural extracellular matrices. However, they have been greatly limited by their low mechanical strength and self-adhesion for further application. Here, a gel-nanofiber material is designed for wound healing, which synergistically combines the benefits of hydrogels and nanofibers and can overcome the bottleneck of poor mechanical strength and self-adhesion in hydrogels and inadequate healing environment created by nanofibers. First, a nanofiber scaffold composed of polycaprolactone/poly(citric acid)-ε-lysine (PCL/PCE) nanofibers is fabricated via a new strategy of microfluidic electrospinning, which could provide a base for hyaluronic acid-polylysine (HE) gel growth on nanofibers. The prepared HE@PCL/PCE gel-nanofiber possesses high tensile strength (24.15 ± 1.67 MPa), excellent air permeability (656 m3/m2 h kPa), outstanding self-adhesion property, and positive hydrophilicity. More importantly, the prepared gel-nanofiber dressing shows good cytocompatibility and antibacterial properties, achieving a high wound-healing rate (92.48%) and 4.685 mm granulation growth thickness within 12 days. This material may open a promising avenue for accelerating wound healing and tissue regeneration, providing potential applications in clinical medicine.

Rapid hemostatic antibacterial self-gelling powder based on methacryloylsulfonyl betaine and quaternized carboxymethyl chitosan

Hemostatic powders can be used for deep wounds and wounds with irregular shapes that are frequently inaccessible to traditional hemostatic dressings like hemostatic gauze, sponges, and foams. In this study, sulfobetaine methacrylate (SBMA) and quaternized carboxymethyl chitosan (QCCS) were combined to create an antibacterial hemostatic hydrogel through photopolymerization under green LED irradiation, which was then changed into PSBMA/QCCS powder. PSBMA/QCCS powder could quickly form hydrogel with strong wet adhesion. The internal structure, water absorption capacity, and adhesion properties of the powder were evaluated. The coagulation ability, antimicrobial properties, and biocompatibility of the powder were also characterized. The PSBMA/QCCS powder could aggregate blood cells and platelets to enhance hemostasis. Meanwhile, PSBMA/QCCS powder also showed effective antibacterial ability against both gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). In summary, PSBMA/QCCS powder is a promising hemostatic agent with the characteristics of quick hemostasis, tough wet adhesion, satisfactory biocompatibility, considerable antibacterial effect, and adaptability to any irregularly shaped wounds.

Bimetallic hydrogels based on chitosan and carrageenan as promising materials for biological applications

In this study, novel crosslinked hydrogels based on chitosan (CS) and carrageenan (CRG) loaded with silver and/or copper nanoparticles (Ag/CuNPs) were prepared through a freeze-drying (thawing) process to be applied in biological applications comprising wound dressing. These hydrogels showed porous interconnected structures. The influence of the used nanoparticles (NPs) on the antibacterial properties of the CS/CRG hydrogels was explored. Antimicrobial results revealed that both CS/CRG/CuNPs, CS/CRG/AgNPs, and CS/CRG/Ag-CuNPs exhibited promising antibacterial and antifungal activity against Escherichia coli, Pseudomonas aeruginosa, Streptococcus mutans, Staphylococcus aureus, Bacillus subtilis, and Candida albicans. Moreover, CS/CRG/AgNPs, CS/CRG/CuNPs, and CS/CRG/Ag-CuNPs hydrogels showed potential antioxidant activity to be 57%, 78%, and 89%, respectively. Furthermore, cytotoxicity results against Vero normal cell line confirmed that all designed hydrogels are safe upon usage. The bimetallic CS/CRG hydrogels showed notably enhanced antibacterial properties among the as-prepared hydrogels allowing them to be a successful material upon being employed in wound dressing applications.

Polyurethane-based nanofibrous mat containing porphyrin with photosensitivity and bactericidal properties can promote cutaneous tissue healing in rats

The regeneration of cutaneous tissue is one of the most challenging issues in human regenerative medicine. To date, several studies have been done to promote cutaneous tissue healing with minimum side effects. The healing potential of polyurethane (PU)/Poly (caprolactone)-poly (ethylene glycol)-poly (caprolactone) (PCEC)/chitosan (CS) (PCS) nanofibrous mat with cationic photosensitizer meso tetrakis (N-methyl pyridinium-4-yl) porphyrin tetratosylate salt (TMP) was examined. The CS tripolyphosphate nanoparticles (CSNPs) were prepared and loaded by TMP to provide an efficient drug release system (TMPNPs) for delivery of TMP to promote wound healing. In in vitro setting, parameters such as bactericidal effects, cytocompatibility, and hemolytic effects were examined. The healing potential of prepared nanofibrous mats was investigated in a rat model of full-thickness cutaneous injury. PCS/TMP/TMPNPs nanofibers can efficiently release porphyrin in the aqueous phase. The addition of TMPNPs and CS to the PU backbone increased the hydrophilicity, degradation, and reduced mechanical properties. The culture of human fetal foreskin fibroblasts (HFFF2) on PCS/TMP/TMPNPs scaffold led to an increased survival rate and morphological adaptation analyzed by MTT and SEM images. Irradiation with a red laser (635 nm, 3 J/cm2) for the 30 s reduced viability of S. aureus and E. Coli bacteria plated on PCS/TMP and PCS/TMP/TMPNPs nanofibrous mats compared to PU/PCEC (PC) and PU/PCEC/CS (PCS) groups, indicating prominent antibacterial effects of PCS/TMP and PCS/TMP/TMPNPs nanofibrous (p < 0.05). Data indicated that PCS/TMP/TMPNPs mat enhanced healing of the full-thickness excisional wound in a rat model by the reduction of inflammatory response and fibrotic changes compared to the PC, and PCS groups (p < 0.05). Immunofluorescence imaging indicated that levels of Desmoglein were increased in rats that received PCS/TMP/TMPNPs compared to the other groups. It is found that a PU-based nanofibrous mat is an appropriate scaffold to accelerate the healing of injured skin.

A Multifunctional Polyethylene Glycol/Triethoxysilane-Modified Polyurethane Foam Dressing with High Absorbency and Antiadhesion Properties Promotes Diabetic Wound Healing

The delayed healing of chronic wounds, such as diabetic foot ulcers (DFUs), is a clinical problem. Few dressings can promote wound healing by satisfying the demands of chronic wound exudate management and tissue granulation. Therefore, the aim of this study was to prepare a high-absorption polyurethane (PU) foam dressing modified by polyethylene glycol (PEG) and triethoxysilane (APTES) to promote wound healing. PEG-modified (PUE) and PEG/APTES-modified (PUESi) dressings were prepared by self-foaming reactions. Gauze and PolyMem were used as controls. Next, Fourier transform-infrared spectroscopy, thermomechanical analyses, scanning electron microscopy and tensile strength, water absorption, anti-protein absorption, surface dryness and biocompatibility tests were performed for in vitro characterization. Wound healing effects were further investigated in nondiabetic (non-DM) and diabetes mellitus (DM) rat models. The PUE and PUESi groups exhibited better physicochemical properties than the gauze and PolyMem groups. Moreover, PUESi dressing showed better anti-adhesion properties and absorption capacity with deformation. Furthermore, the PUESi dressing shortened the inflammatory phase and enhanced collagen deposition in both the non-DM and DM animal models. To conclude, the PUESi dressing not only was fabricated with a simple and effective strategy but also enhanced wound healing via micronegative-pressure generation by its high absorption compacity with deformation.

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.

Considerations for an ideal post-surgical wound dressing aligned with antimicrobial stewardship objectives: a scoping review

OBJECTIVE

Most surgical wounds heal by primary or secondary intention. Surgical wounds can present specific and unique challenges including wound dehiscence and surgical site infection (SSI), either of which can increase risk of morbidity and mortality. The use of antimicrobials to treat infection in these wounds is prevalent, but there is now an imperative to align treatment with reducing antimicrobial resistance and antimicrobial stewardship (AMS). The aim of this review was to explore the published evidence identifying general considerations/criteria for an ideal post-surgical wound dressing in terms of overcoming potential wound healing challenges (including infection) while supporting AMS objectives.

METHOD

A scoping review examining evidence published from 1954-2021, conducted by two authors acting independently. Results were synthesised narratively and have been reported in line with PRISMA Extension for Scoping Reviews.

RESULTS

A total of 819 articles were initially identified and subsequently filtered to 178 for inclusion in the assessment. The search highlighted six key outcomes of interest associated with post-surgical wound dressings: wound infection; wound healing; physical attributes related to comfort, conformability and flexibility; fluid handling (e.g., blood and exudate); pain; and skin damage.

CONCLUSION

There are several challenges that can be overcome when treating a post-surgical wound with a dressing, not least the prevention and treatment of SSIs. However, it is imperative that the use of antimicrobial wound dressings is aligned with AMS programmes and alternatives to active antimicrobials investigated.

A bacteriostatic hemostatic dressing prepared from l-glutamine-modified chitosan, tannic acid-modified gelatin and oxidized dextran

In this study, porous hemostatic sponges (CGS1, CGS2 and CGS3) with proper absorption (38-43×) and air permeability (2214 g/m²·day) were prepared from l-glutamine-modified chitosan (CG), tannic acid-modified gelatin (GTA), and oxidized dextran (ODEX) by Schiff base crosslinking reaction. Among them, CGS2 was proved to have high porosity (88.98 %), durable water retention (>6 h), strong antibacterial activity, proper mechanical quality, and suitable tissue adhesion. In addition, CGS2 had good biocompatibility, mainly manifested in low hemolysis rate (<0.4 %), low cytotoxicity (relative cell activity>90 %), and good biodegradability in vitro. The hemostatic time and blood loss in CGS2 group were much lower than those in commercial gelatin sponge group in three animal injury models. Moreover, the activated partial thromboplastin time (APTT) and the prothrombin time (PT) results indicated that CGS2 promoted coagulation by activating the endogenous coagulation pathway. These results suggested that CGS2 had great potential for rapid hemostasis and avoidance of wound infection.

Preparation of nanocomposite membranes loaded with taxifolin liposome and its mechanism of wound healing in diabetic mice

In this study, a new wound dressing was developed to speed up the healing process of diabetic wounds. First of all, taxifolin liposome (TL) was manufactured in this study. Then, taxifolin (TAX) and TL were mixed with polyvinyl alcohol (PVA) and chitosan (CS) by electrostatic spinning to prepare nanocomposite membranes. Finally, the mechanism of nanocomposite membranes to accelerate diabetic wound healing was investigated. The diameter of TL-loaded polyvinyl alcohol/chitosan nanocomposite membranes (PVA/CS/TL) was 429.43 ± 78.07 nm. The results of in vitro experiments demonstrated that the PVA/CS/TL had better water absorption, water vapor transmission rate (WVTR), porosity, hydrophilicity, mechanical properties, slow-release, antioxidant capacity, and antibacterial properties. The results of in vivo experiments demonstrated that the wound healing rate of mice treated with PVA/CS/TL for eighteen days was 98.39 ± 0.34 %. Histopathological staining, immunohistochemical staining, and western blot experiments also demonstrated that PVA/CS/TL could promote wound healing in diabetic mice by inhibiting the activation of inhibitor kappa B alpha (IκBα)/nuclear factor-kappa B (NF-κB) signaling pathway and related pro-inflammatory factors to increase the expression of CD31 and VEGF in skin tissues. These results suggested that PVA/CS/TL could be a potential candidate for wound dressing to promote chronic skin wound healing.

Insights into the Role of Natural Polysaccharide-Based Hydrogel Wound Dressings in Biomedical Applications

Acute skin damage caused by burns or cuts occurs frequently in people's daily lives. Such wounds are difficult to heal normally and have persistent inflammation. Wound dressings not only improve the speed of wound healing, but also protect and cover the wound well. Hydrogels have the characteristics of good flexibility, high water content, and good biocompatibility, and are widely used in biomedicine and other fields. Common hydrogels are mainly natural hydrogels and synthetic hydrogels. Hydrogels cross-linked using different raw materials and different methods have different performance characteristics. Natural hydrogels prepared using polysaccharides are simple to obtain and have good biocompatibility, but are inferior to synthetic hydrogels in terms of mechanical properties and stability, and a single polysaccharide hydrogel cannot meet the component requirements for wound healing. Therefore, functional composite hydrogels with high mechanical properties, high biocompatibility, and high antibacterial properties are the current research hotspots. In this review, several common polysaccharides for hydrogel synthesis and the synthesis methods of polysaccharide hydrogels are introduced, and functional composite hydrogel dressings from recent years are classified. It is hoped that this can provide useful references for relevant research in this field.

Production of Mesoglycan/PCL Based Composites through Supercritical Impregnation

The development of targeted therapies for wound repair is knowing a growing interest due to the increasing aging of the population and the incidence of chronic pathologies, mainly pressure ulcers. Among molecules recruiting cell populations and promoting the formation of new vital tissue, sodium mesoglycan (MSG) has been proven to be effective in wound healing. In this work, MSG impregnation of polymer matrices has been attempted by a supercritical carbon dioxide-based process. Polymeric matrices are composed of polycaprolactone blends, where water-soluble polymers, polyethylene glycol, polyvinyl pyrrolidone, gelatin, and thermoplastic starch, have been employed to modulate the MSG release, making the devices potentially suitable for topical administrations. Two different techniques have been used to obtain the films: the first one is compression molding, producing compact and continuous structures, and the second one is electrospinning, producing membrane-like designs. A higher amount of MSG can be loaded into the polymeric matrix in the membrane-like structures since, in these films, the impregnation process is faster than in the case of compression molded films, where the carbon dioxide has firstly diffused and then released the active molecule. The type of water-soluble polymer influences the drug release rate: the blend polycaprolactone-gelatin gives a prolonged release potentially suitable for topical administration.

Insights into the Design of Polyurethane Dressings Suitable for the Stages of Skin Wound-Healing: A Systematic Review

Dressings made with polyurethanes have been found to exhibit good and varied biological properties that make them good candidates for this application. However, as has been seen, the wound-healing process is complex, which includes four different stages. So far, the design and evaluation of polyurethane for wound dressing has focused on achieving good properties (mechanical, physicochemical, and biological), but each of them separates from the others or even directed at only one of the stages of skin wound-healing. Therefore, the aim of this systematic review is to explore the applications of polyurethanes in wound dressings and to determine whether could be designed to cover more than one stage of skin wound-healing. The PRISMA guidelines were followed. The current research in this field does not consider each stage separately, and the design of polyurethane dressings is focused on covering all the stages of wound healing with a single material but is necessary to replace polyurethanes in short periods of time. Additionally, little emphasis is placed on the hemostasis stage and further characterization of polyurethanes is still needed to correlate mechanical and physicochemical properties with biological properties at each stage of the wound-healing. Current research demonstrates an effort to characterize the materials physiochemically and mechanically, but in terms of their biological properties, most of the literature is based on the performance of histological tests of explants morphologically probing the compromised tissues, which give an indication of the potential use of polyurethanes in the generation of wound-healing dressings.

Tiny tots for a big-league in wound repair: Tools for tissue regeneration by nanotechniques of today

Overall, chronic injuries place considerable burden on patients and health systems. The skin injuries are exposed to inflammatory bacteria and hinder the healing process. The skin being the biggest tissue of the whole body ensures protection against microbial invasion, dehydration, and against chemical, thermal, bright radiations and mechanical agents. When injured, the skin loses its defensive purpose and the attack of bacterial types arises with the loss of protein, water, and electrolytes. Improved wound closure therapy helps to restore normal skin function by managing wounds with the help of a suitable skin replacement. According to the type of wound and its healing ability, an appropriate skin replacement system must be identified. Nanofibrous layers because of their permeable structure, their large superficial reach and their similarity with the local extracellular network serve as cutaneous substitution for dealing with deep and superficial injuries. By a diminished microbial load without infestation, scab formation and infiltration of defense cells in the initial phase, acute injuries are usually characterized. Here recovery is related with epithelialization, angiogenesis and relocation of fibroblasts. The wound becomes obstinate when microbial biofilms are developed while the immune system does not manage to eliminate the infection. Increased inflammatory process, lower deep tissue oxygenation, fibrin cuffs, fibroblastic senescence, altered angiogenesis, stalled re-epithelialization and chronic infection have been visualized. Conventional wound mending treatments for the most part falling flat to supply a great clinical result, either basically like wound epithelialization and regulation of fluid loss or practically like histological highlights that decide versatility, strength, affectability, etc. Conventional wound therapies commonly fail to offer a better medical output, like wound epithelialization and regulation of fluid reduction or physiologically like cellular features that determine durability, sensitivity, elasticity, etc. Nanotechnology may be a dependable investigation space for wound-healing treatments through their versatile physicochemical properties. Advancing nano platforms with novel solutions for curing chronicdiabetic wounds are discussed in detail that can guide further research in this sector.

Engineered Hemostatic Biomaterials for Sealing Wounds

Hemostatic biomaterials show great promise in wound control for the treatment of uncontrolled bleeding associated with damaged tissues, traumatic wounds, and surgical incisions. A surge of interest has been directed at boosting hemostatic properties of bioactive materials via mechanisms triggering the coagulation cascade. A wide variety of biocompatible and biodegradable materials has been applied to the design of hemostatic platforms for rapid blood coagulation. Recent trends in the design of hemostatic agents emphasize chemical conjugation of charged moieties to biomacromolecules, physical incorporation of blood-coagulating agents in biomaterials systems, and superabsorbing materials in either dry (foams) or wet (hydrogel) states. In addition, tough bioadhesives are emerging for efficient and physical sealing of incisions. In this Review, we highlight the biomacromolecular design approaches adopted to develop hemostatic bioactive materials. We discuss the mechanistic pathways of hemostasis along with the current standard experimental procedures for characterization of the hemostasis efficacy. Finally, we discuss the potential for clinical translation of hemostatic technologies, future trends, and research opportunities for the development of next-generation surgical materials with hemostatic properties for wound management.

Structure-Dependent Nontraditional Intrinsic Fluorescence of Aliphatic Hyperbranched Polyureas

The nontraditional intrinsic fluorescence (NTIF) of polymers containing heteroatoms has gained considerable attention due to its promising applications in label-free bioimaging. Aliphatic hyperbranched polyureas (aBPUs), which have recently shown great promise in the field of nanomedicine, bear controllable urea groups distributed on the branch points and thus are potential candidate luminogens. However, their NTIF properties and how their structures influence the NTIF properties have not been illustrated yet. Here, we addressed these issues by synthesizing a series of aBPUs with different degrees of branching (DBs) or different modifications. aBPUs exhibited an obvious NTIF phenomenon and with the increase of DBs, the NTIF enhanced as well. Chemical modifications either at the branching ends or in the interior of aBPUs could affect the NTIF performances, which were highly dependent on the types of modification. Disruption of the intra-/intermolecular hydrogen-bonding interactions decreased the NTIF. In addition, poly(ethylene glycol) (PEG)-modified aBPUs could self-assemble into nanospheres, and the formation of nanoassembly led to 89% enhancement on NTIF compared with the homogeneous solution of aBPUs-PEG in dimethylformamide (DMF). Finally, aBPUs-PEG nanoassembly demonstrated a capability in realizing label-free material imaging in vitro. These results shed light on the rational design of the polymer structures to achieve desired fluorescence with unconventional luminophores.

Monitoring cardiovascular disease severity using near-infrared mechanoluminescent materials as a built-in indicator

Artificial vascular grafts (AVGs) are widely used to treat cardiovascular diseases (CVDs). But none of the reported AVGs can also monitor the CVD severity. Because CVDs affect the blood pressure, we proposed to employ a force-sensing material that emits near-infrared (NIR) light upon force loading, a NIR mechanoluminescent (ML) material (CaZnOS:Nd³⁺), as an indicator in AVGs to tackle this challenge. Specifically, we used a polydimethylsiloxane AVG modified with this ML material, termed ML-AVG, to achieve the rapid and convenient monitoring of two CVD models (vascular occlusion and hypertension) in real time. The NIR ML material showed good blood and tissue compatibility without causing an inflammatory response. By implanting the ML-AVGs into the common carotid artery (CCA) of rats, we observed the NIR ML signals emitted from the AVGs by a thermal camera, a NIR spectrometer, and a NIR camera. The NIR ML signal was linearly correlated with the degree of vascular opening (in the vascular occlusion model) or the degree of hypertension (in the hypertension model). Our work suggests that NIR ML materials can monitor the severity of diseases with force or pressure as biomarkers.

Antimicrobial Lignin-Based Polyurethane/Ag Composite Foams for Improving Wound Healing

Antimicrobial materials are an urgent need for modern wound care in the clinic. Although traditional polyurethane foams have proven to be clinically valuable for wound treatment, their petroleum-originated preparation and bioinert nature have restricted their efficacy in biomedical applications. Here, we propose a simple one-step foaming method to prepare lignin-based polyurethane foams (LPUFs) in which fully biobased polyether polyols partially replace traditional petroleum-based raw materials. The trace amount of phenolic hydroxyl groups (about 4 mmol) in liquefied lignin acts as a direct reducing agent and capping agent to silver ions (less than 0.3 mmol), in situ forming silver nanoparticles (Ag NPs) within the LPUF skeleton. This newly proposed lignin polyurethane/Ag composite foam (named as Ag NP-LPUF) shows improved mechanical, thermal, and antibacterial properties. It is worth mentioning that the Ag NP-LPUF exhibits more than 99% antibacterial rate against Escherichia coli within 1 h and Staphylococcus aureus within 4 h. Evaluations in mice indicate that the antimicrobial composite foams can effectively promote wound healing of full-thickness skin defects. As a proof of concept, this antibacterial and biodegradable foam exhibits significant potential for clinical translation in wound care dressings.

Virtual Reality-Based Analysis of Pressure Ulcer Care Information Related to Medical Equipment for the Prevention of Pressure Ulcer Skin Foam Dressings in the Elderly

As the standard of life has increased with the advancement of the time, there has been an increasing stress on healthcare with the aging diet, and pressure sores occur in elderly hospitalized subjects. Of course, the emergence of related medical devices, especially auxiliary foam dressings, is constantly improving. Pressure ulcers are extremely harmful to the elderly. The use of virtual reality technology to simulate the treatment of foam excipients is to test the role of medical devices in virtual reality. In particular, the use of foam dressings in the management of pressure deposits is the most relevant study for this paper, which reviews the relevant literature and conducts a thematic study on patients in a specific urban hospital. The relevant materials were designed, the experiments were designed, and the relevant research data were obtained. Studies show that virtual reality-based preventive medical devices can improve the efficiency of pressure ulcer treatment in hospitals by about 12%. Pressure ulcers have different incidences among people of different ages. The probability is much higher than that of adolescents. Foam dressing is very effective in preventing pressure ulcers. The probability of pressure ulcers after using foam dressing is about 35% lower than that when it is not used.

Hemostatic dressings based on poly(vinyl formal) sponges

The development of novel hemostatic agents is related to the fact that severe blood loss due to hemorrhage continues to be the leading cause of preventable death of patients with military trauma and the second leading cause of death of civilian patients with injuries. Herein we assessed the hemostatic properties of porous sponges based on biocompatible hydrophilic polymer, poly(vinyl formal) (PVF), which meets the main requirements for the development of hemostatic materials. A series of composite hemostatic materials based on PVF sponges with different porosities and fillers were synthesized by acetalization of poly(vinyl alcohol) with formaldehyde. Nano-sized aminopropyl silica, micro-sized calcium carbonate, and chitosan hydrogel were used to modify PVF matrixes. The physicochemical properties (pore size, elemental composition, functional groups, hydrophilicity, and acetalization degree) of the synthesized composite sponges were studied by gravimetrical analysis, optical microscopy, scanning electron microscopy combined with energy dispersive x-ray spectroscopy, infrared spectroscopy, and nuclear magnetic resonance. Hemostatic properties of the materials were assessed using a model of parenchymal bleeding from the liver of white male Wistar rat with a gauze bandage as a control. All investigated PVF-based porous sponges showed high hemostatic activity: upon the application of PVF-samples the bleeding decreased within 3 min by 68.4-94.4% (р < 0.001). The bleeding time upon the application of PVF-based composites decreased by 78.3-90.4% (p < 0.001) compared to the application of well-known commercial product Celox™.

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.

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

AIM OF THE STUDY

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Hyaluronic Acid/Collagen Nanofiber Tubular Scaffolds Support Endothelial Cell Proliferation, Phenotypic Shape and Endothelialization

In this study, we designed and synthetized artificial vascular scaffolds based on nanofibers of collagen functionalized with hyaluronic acid (HA) in order to direct the phenotypic shape, proliferation, and complete endothelization of mouse primary aortic endothelial cells (PAECs). Layered tubular HA/collagen nanofibers were prepared using electrospinning and crosslinking process. The obtained scaffold is composed of a thin inner layer and a thick outer layer that structurally mimic the layer the intima and media layers of the native blood vessels, respectively. Compared with the pure tubular collagen nanofibers, the surface of HA functionalized collagen nanofibers has higher anisotropic wettability and mechanical flexibility. HA/collagen nanofibers can significantly promote the elongation, proliferation and phenotypic shape expression of PAECs. In vitro co-culture of mouse PAECs and their corresponding smooth muscle cells (SMCs) showed that the luminal endothelialization governs the biophysical integrity of the newly formed extracellular matrix (e.g., collagen and elastin fibers) and structural remodeling of SMCs. Furthermore, in vitro hemocompatibility assays indicated that HA/collagen nanofibers have no detectable degree of hemolysis and coagulation, suggesting their promise as engineered vascular implants.

Antimicrobial Peptides: The Promising Therapeutics for Cutaneous Wound Healing

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

Cellulose fibers-reinforced self-expanding porous composite with multiple hemostatic efficacy and shape adaptability for uncontrollable massive hemorrhage treatment

Uncontrollable hemorrhage leads to high mortality and thus effective bleeding control becomes increasingly important in the military field and civilian trauma arena. However, current hemostats not only present limitation when treating major bleeding, but also have various side effects. Here we report a self-expanding porous composites (CMCP) based on novel carboxymethyl cellulose (CMC) fibers and acetalized polyvinyl alcohol (PVA) for lethal hemorrhage control. The CMC fibers with uniform fibrous structure, high liquid absorption and procoagulant ability, are evenly interspersed inside the composite matrix. The obtained composites possess unique fiber-porous network, excellent absorption capacity, fast liquid-triggered self-expanding ability and robust fatigue resistance, and their physicochemical performance can be fine-tuned through varying the CMC content. In vitro tests show that the porous composite exhibits strong blood clotting ability, high adhesion to blood cells and protein, and the ability to activate platelet and the coagulation system. In vivo hemostatic evaluation further confirms that the CMCP presents high hemostatic efficacy and multiple hemostatic effects in swine femoral artery major hemorrhage model. Additionally, the CMCP will not fall off from the injury site, and is also easy to surgically remove from the wound cavity after the hemostasis. Importantly, results of CT tomography and 3D reconstruction indicate that CMCP can achieve shape adaptation to the surrounding tissues and the wound cavities with different depths and shapes, to accelerate hemostasis while protecting wound tissue and preventing infection.

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.

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

AIM OF THE STUDY

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Combination of Nitric Oxide Release and Surface Texture for Mitigating the Foreign Body Response

The tissue response to polyurethane (PU)-coated implants employing active and/or passive FBR mitigation techniques was evaluated over a 28 day study in a diabetic swine model. Active FBR mitigation was achieved through the sustained release of nitric oxide (NO) from a mesoporous silica nanoparticle-doped PU coating. Passive FBR mitigation was achieved through the application of a foam- or fiber-based topcoat. These topcoats were designed to possess topographical features known to promote tissue integration with foam-coated implants having pore sizes of approximately 50 μm and fiber-coated implants consisting of fiber diameters of less than 1 μm. Nitric oxide-release profiles were minimally impacted by the presence of either topcoat. Inflammatory cell density and collagen density at the implant-tissue interface were assessed at 7, 14, 21, and 28 days following implantation. Nitric oxide-releasing implants had significantly lower inflammatory cell density and collagen density than non-NO-releasing controls. The presence of a topcoat did not significantly impact inflammatory cell density, though top-coated textured implants resulted in significantly lower collagen density, irrespective of NO release. Overall, coatings that combine NO release with surface texture demonstrated the greatest potential for tissue-based biomedical device applications.

Biobased polyurethanes for biomedical applications

Polyurethanes (PUs) are a major family of polymers displaying a wide spectrum of physico-chemical, mechanical and structural properties for a large range of fields. They have shown suitable for biomedical applications and are used in this domain since decades. The current variety of biomass available has extended the diversity of starting materials for the elaboration of new biobased macromolecular architectures, allowing the development of biobased PUs with advanced properties such as controlled biotic and abiotic degradation. In this frame, new tunable biomedical devices have been successfully designed. PU structures with precise tissue biomimicking can be obtained and are adequate for adhesion, proliferation and differentiation of many cell's types. Moreover, new smart shape-memory PUs with adjustable shape-recovery properties have demonstrated promising results for biomedical applications such as wound healing. The fossil-based starting materials substitution for biomedical implants is slowly improving, nonetheless better renewable contents need to be achieved for most PUs to obtain biobased certifications. After a presentation of some PU generalities and an understanding of a biomaterial structure-biocompatibility relationship, recent developments of biobased PUs for non-implantable devices as well as short- and long-term implants are described in detail in this review and compared to more conventional PU structures.

Blood-clotting model and simulation analysis of polyvinyl alcohol-chitosan composite hemostatic materials

The blood-clotting performance and characteristics of hemostatic materials are critical for their development and actual application. Based on the theory of porous media and characteristics of a non-Newtonian fluid, this study proposed an adsorption factor to characterize the porosity generation and blood coagulation process of hemostatic materials. On this basis, we constructed a physical model of blood coagulation in a porous medium integrated with the power-law fluid model to study the proposed poly(vinyl alcohol)-chitosan (PVA-CS) composite hemostatic material. Moreover, we simulated the dynamic blood flow process and blood coagulation process in the PVA-CS hemostatic material by introducing the physical model. The simulation results show that the blood begins to coagulate, which affects the porosity and permeability of the blood-containing area, resulting in changing the porosity after blood flowed into the hemostatic material. The porosity, permeability, and blood flow rate will approach zero until the generated blood coagulation entirely blocked the porous medium. Besides, simulation can provide the pressure and velocity distribution varying in the coagulation process of hemostatic materials. The temperature will also influence the hemostatic performance of the PVA-CS material. In all, the proposed simulation method enabled the coagulation mechanism of PVA-CS to be revealed from the perspective of blood flow in porous media combined with the adsorption factor.

Cryogenically printed flexible chitosan/bioglass scaffolds with stable and hierarchical porous structures for wound healing

Wound healing is a dynamic and well-orchestrated process that can be promoted by creating an optimal environment with wound dressing. An ideal wound dressing material should possess a suitable matrix, structure and bioactive components, functioning synergistically to accelerate wound healing. Wound dressings that allow reproducibility and customizability are highly desirable in clinical practice. In this study, using chitosan (CS) as the matrix and bioglass (BG) as the biological component, a spatially designed dressing scaffold was fabricated from a home-made cryogenic printing system. The micro- and macro-structures of the scaffold were highly controllable and reproducible. The printed scaffold exhibited interconnected and hierarchical pore structures, as well as good flexibility and water absorption capacity, and these properties were not affected by the content of BG. Nevertheless, when the content of BGs exceeded 20% that of CS, the tension strength and elongation rate reduced, but in vitro antibacterial, cell proliferation and migration performance were enhanced. In vivo examinations revealed that the composite scaffold significantly promoted wound healing process, with the group having 30% bioglass showing better wound closure, neovascularization and collagen deposition than other groups. These results indicate that the 3D printed CS/BG composite scaffold is a promising dressing material that accelerates wound healing.

Bactericidal and antifouling electrospun PVA nanofibers modified with a quaternary ammonium salt and zwitterionic sulfopropylbetaine

Bacterial adhesion and colonization on material surfaces have attracted great attention due to their potential threat to human health. Combining bactericidal and antifouling functions has been confirmed as an optimal strategy to prevent microbial infection. In this work, biodegradable electrospun polyvinyl alcohol (PVA) nanofibers were chosen due to its high specific area and abundant reactive hydroxyl groups. A quaternary ammonium salt (IQAS) and zwitterionic sulfopropylbetaine (ISB), both containing isocyanate (NCO) groups, were chemically bonded to the PVA nanofiber surface via a coupling reaction between the OH groups of the PVA nanofibers and the NCO groups of IQAS or ISB. The results indicated that the antimicrobial rates of PVA nanofibers modified by IQAS (0.5%) reached 99.9% against both gram-positive Staphylococcus aureus (S. aureus, ATCC 6538) and gram-negative Escherichia coli (E. coli, ATCC 25922). Additionally, the live/dead staining and cytotoxicity test indicated that the dual functional IQAS/ISB/PVA nanofibers exhibited excellent bactericidal and antifouling activities with low cytotoxicity. This work may provide practical guidelines to fabricate bactericidal and antifouling materials for healthcare applications, including but not limited to wound dressings, textile, food packaging and air filtration.

Tissue-engineered PLLA/gelatine nanofibrous scaffold promoting the phenotypic expression of epithelial and smooth muscle cells for urethral reconstruction

The repair and regeneration of tissues using tissue-engineered scaffolds represent the ultimate goal of regenerative medicine. Despite rapid developments in the field, urethral tissue engineering methods are still insufficient to replicate natural urethral tissue because the bioactivity of existing scaffolds is inefficient, especially for large tissue defects, which require large tissue-engineered scaffolds. Here, we describe the efficiency of gelatine-functionalized, tubular nanofibrous scaffolds of poly(l-lactic acid) (PLLA) in regulating the phenotypic expression of epithelial cells (ECs) and smooth muscle cells (SMCs) for urethral reconstruction. Flexible PLLA/gelatine tubular nanofibrous scaffolds with hierarchical architecture were fabricated by electrospinning. The PLLA/gelatine nanofibrous scaffold exhibited enhanced hydrophilicity and significantly promoted the adhesion, oriented elongation, and proliferation of New Zealand rabbit autologous ECs and SMCs simultaneously. Compared with pure PLLA nanofibrous scaffold, PLLA/gelatine nanofibrous scaffolds upregulated the expression of keratin (AE1/AE3) in ECs and actin (α-SMA) in SMCs as well as the synthesis of elastin. Three months of in vivo scaffold replacement of New Zealand rabbit urethras indicated that a tubular cellularized PLLA/gelatine nanofibrous scaffold maintained urethral patency and facilitated oriented SMC remodeling, lumen epithelialization, and angiogenesis. Our observations showed the synergistic effects of nano-morphology and biochemical clues in the design of biomimetic scaffolds, which can effectively promote urethral regeneration.