Gelatin-based films containing clinoptilolite-Ag for application as wound dressing

Fundamental properties and sustainable applications of the natural zeolite clinoptilolite

This review explores a set of sustainable applications of clinoptilolite, a natural zeolite abundant around the world in different localities. Thanks to its physico-chemical properties this material is extremely versatile for several applications, ranging from environmental catalysis and CO2 removal to industrial and agricultural wastewater purification, aquaculture, animal feeding, and food industry but also medical applications and energy storage systems. Due to the presence of cations in its framework, it is possible to tune the material's features making it suitable for adsorbing specific compounds. Thus, this review aims to provide insight into developing new technologies based on the use of this material that is sustainable, not harmful for humans and animals, naturally abundant, and above all cost-effective. Furthermore, it is intended to promote the use of natural materials in various areas with a view to sustainability and to reduce as far as possible the use of chemicals or other materials whose synthesis process can have a polluting effect on the environment.

Bismuth Oxide Composite-Based Agricultural Waste for Wound Dressing Applications

The purpose of this study was to enhance the antimicrobial activity of bagasse paper by coating the paper with bismuth oxide (Bi2O3) and using it to accelerate the process of wound healing. Paper sheets were prepared from sugarcane waste (bagasse). First, the paper sheets were coated with different Bi2O3 concentrations to improve the antimicrobial activity of the paper. After that, the paper sheets were allowed to dry in an oven at 50 °C for 3 h. Then, in vitro antimicrobial activity was evaluated against different microbial species, including Gram-negative bacteria (i.e., Klebsiella pneumonia, Escherichia coli) and Gram-positive bacteria (i.e., Staphylococcus aureus, Streptococcus pyogenes). The obtained results showed that the paper coated with 25% and 100% Bi2O3 had activity against all models of bacteria; however, the paper coated with 100% Bi2O3 composite had the strongest inhibitory effect. Then, bagasse paper was coated with 100% Bi2O3 and different antibiotics, to investigate their wound-healing potency in a wounded rat model for 14 days. Moreover, the paper coated with 100% Bi2O3 inhibited the cellular migration in vitro. Conclusively, coating paper with Bi2O3 enhances the wound-healing potential when applied to wounds. This impact could be ascribed to Bi2O3's broad antibacterial activity, which reduced infection and accelerated the healing process.

Polymer-Based Wound Dressings Loaded with Ginsenoside Rg3

The skin, the largest organ in the human body, mainly plays a protective role. Once damaged, it can lead to acute or chronic wounds. Wound healing involves a series of complex physiological processes that require ideal wound dressings to promote it. The current wound dressings have characteristics such as high porosity and moderate water vapor permeability, but they are limited in antibacterial properties and cannot protect wounds from microbial infections, which can delay wound healing. In addition, several dressings contain antibiotics, which may have bad impacts on patients. Natural active substances have good biocompatibility; for example, ginsenoside Rg3 has anti-inflammatory, antibacterial, antioxidant, and other biological activities, which can effectively promote wound healing. Some researchers have developed various polymer wound dressings loaded with ginsenoside Rg3 that have good biocompatibility and can effectively promote wound healing and reduce scar formation. This article will focus on the application and mechanism of ginsenoside Rg3-loaded dressings in wounds.

Agaricus blazei Murill polysaccharides/alginate/poly(vinyl alcohol) blend as dressings for wound healing

Macromolecules with antioxidant properties such as polysaccharides from Agaricus blazei Murill mushroom (PAbs) are an excellent option for manufacturing wound dressings. Based on this, this study aimed to analyze preparation, physicochemical characterization, and assessment of the potential wound-healing activity of films based on sodium alginate and polyvinyl alcohol loaded with PAbs. PAbs did not significantly alter the cell viability of human neutrophils in a concentration range of 1-100 μg mL^-1. The Infrared Spectroscopy (FTIR) indicates that the components present in the films (PAbs/Sodium Alginate (SA)/Polyvinyl Alcohol (PVA)) present an increase in hydrogen bonds due to the increase of hydroxyls present in the components. Thermogravimetry (TGA), Differential Scanning Calorimetry (DSC) and X-ray Diffraction (XRD) characterizations indicate a good miscibility between the components where PAbs increasing the amorphous characteristics of the films and that the addition of SA increased the mobility of the chains PVA polymers. The addition of PAbs to films significantly improves properties such as mechanical, thickness, and water vapor permeation. The morphological study evidenced good miscibility between the polymers. The wound healing evaluation indicated that F100 film presented better results from the fourth day onward compared to the other groups. It favored the formation of a thicker dermis (476.8 ± 18.99 μm), with greater collagen deposition and a significant reduction in malondialdehyde and nitrite/nitrate, markers of oxidative stress. These results indicate that PAbs is a candidate for wound dressing.

Natural Polymer-Based Thin Film Strategies for Skin Regeneration in Lieu of Regenerative Dentistry

Wound healing (WH) is a complex and dynamic process that comprises of a series of molecular and cellular events that occur after tissue injury. The injuries of the maxillofacial and oral region caused by trauma or surgery result in undesirable WH such as delayed wound closure and formation of scar tissue. Skin tissue engineering (TE)/regeneration is an emerging approach toward faster, superior, and more effective resolution of clinically significant wounds effectively. A multitude of TE principles approaches are being put to action for the fabrication of hydrogels, electrospun sheets, 3D scaffolds, and thin films that can be used as wound dressings materials, sutures, or skin substitutes. Thin films are advantageous over other materials owing to their flexibility, ability to provide a barrier against external contamination, easy gaseous exchange, and easy monitoring of wounds. This review focuses on wound-dressing films and their significance and discusses various fabrication techniques. In addition, we explore various natural biopolymers that can be used for fabrication of skin TE materials. Impact Statement In this review article, critical evaluations of natural polymers used in skin regeneration were discussed. Further, the fabrication technology of the 2D and 3D material in wound healing were discussed.

Tannic acid-based dual-network homogeneous hydrogel with antimicrobial and pro-healing properties for infected wound healing

The clinical treatment of infected skin injuries caused by exogenous bacteria faces great challenges. Conventional therapeutic approaches are difficult to achieve synergistic effects of infection control and induction of skin regeneration. In this study, a novel tannic acid-based physically cross-linked double network hydrogel (PDH gel) was prepared on demand by covalent cross-linking of tannic acid (TA) with polyvinyl alcohol (PVA) and chelating ligand of TA with Fe³⁺. The homogeneity of the hydrogel was achieved by the action of glycol dispersant. With the anti-inflammatory and antioxidant properties of Fe³⁺ and TA, this hydrogel exhibited excellent antibacterial properties by achieving 99.69% and 99.36% bacterial inhibition against E.coli and S. aureus, respectively. Moreover, the PDH gel exhibits good biocompatibility, stretchability (up to 200%) and skin-friendliness. After 14 days of PDH-1 gel implantation in a rat model infected by S. aureus, the wound healing rate was as high as 95.21%. PDH gel-1 showed more granulation tissue, more pronounced blood vessels, higher collagen fiber density and good collagen deposition, and its recovery effect was better than that of PSH gel and PDH gel-2 in vivo. Hence, this study provides a novel avenue for the design of future clinical infected wound healing dressings.

Quarternized chitosan/quercetin/polyacrylamide semi-interpenetrating network hydrogel with recoverability, toughness and antibacterial properties for wound healing

Antibiotic abuse has posed enormous burdens on patients and healthcare systems. Hence, the design and development of non-antibiotic wound dressings to meet clinical demand are urgently desired. However, there remains one of the impediments to hydrogel wound dressings that integrated with good recoverability, toughness, and excellent antibacterial properties. Herein, a series of semi-interpenetrating network (semi-IPN) hydrogels with exceptional mechanical performance and remarkable antibacterial activity based on quaternized chitosan (QCS) and polyacrylamide (PAM) were developed using a one-pot method. Additionally, the antibacterial activity of semi-IPN hydrogel against S. aureus and E. coli was enhanced by integrating it with quercetin (QT). The semi-IPN hydrogels also exhibited high recoverability and toughness, outstanding liquid absorbability (the swelling ratio reached 565 ± 12 %), and a satisfying water vapor transmission rate. Moreover, the semi-IPN hydrogels presented ideal hemocompatibility and cytocompatibility. These high-elastic hydrogels are promising candidates for potential applications in wound dressing, tissue repair, chronic wound care, as well as other biomedical fields.

In Vitro and In Vivo Characterization Methods for Evaluation of Modern Wound Dressings

Chronic wound management represents a major challenge in the healthcare sector owing to its delayed wound-healing process progression and huge financial burden. In this regard, wound dressings provide an appropriate platform for facilitating wound healing for several decades. However, adherent traditional wound dressings do not provide effective wound healing for highly exudating chronic wounds and need the development of newer and innovative wound dressings to facilitate accelerated wound healing. In addition, these dressings need frequent changing, resulting in more pain and discomfort. In order to overcome these issues, a wide range of affordable and innovative modern wound dressings have been developed and explored recently to accelerate and improve the wound healing process. However, a comprehensive understanding of various in vitro and in vivo characterization methods being utilized for the evaluation of different modern wound dressings is lacking. In this context, an overview of modern dressings and their complete in vitro and in vivo characterization methods for wound healing assessment is provided in this review. Herein, various emerging modern wound dressings with advantages and challenges have also been reviewed. Furthermore, different in vitro wound healing assays and in vivo wound models being utilized for the evaluation of wound healing progression and wound healing rate using wound dressings are discussed in detail. Finally, a summary of modern wound dressings with challenges and the future outlook is highlighted.

Silver Nanoparticles and Its Mechanistic Insight for Chronic Wound Healing: Review on Recent Progress

Wounds are structural and functional disruptions of skin that occur because of trauma, surgery, acute illness, or chronic disease conditions. Chronic wounds are caused by a breakdown in the finely coordinated cascade of events that occurs during healing. Wound healing is a long process that split into at least three continuous and overlapping processes: an inflammatory response, a proliferative phase, and finally the tissue remodeling. Therefore, these processes are extensively studied to develop novel therapeutics in order to achieve maximum recovery with minimum scarring. Several growth hormones and cytokines secreted at the site of lesions tightly regulates the healing processes. The traditional approach for wound management has been represented by topical treatments. Metal nanoparticles (e.g., silver, gold and zinc) are increasingly being employed in dermatology due to their favorable effects on healing, as well as in treating and preventing secondary bacterial infections. In the current review, a brief introduction on traditional would healing approach is provided, followed by focus on the potential of wound dressing therapeutic techniques functionalized with Ag-NPs.

Dissolvable wound dressing loaded with silver nanoparticles together with ampicillin and ciprofloxacin

Aim: The current study is focused on the development of water-soluble wound dressings, which are potential dressings for the treatment of burn wounds. Materials & methods: Sodium alginate-based dissolvable wound dressings were prepared and loaded with silver nanoparticles and various antibiotics (ampicillin and ciprofloxacin) followed by characterization and in vitro antibacterial studies. Results & conclusions: The prepared sodium alginate-based dissolvable wound dressing exhibited good porosity, water uptake and moisture content, promising antibacterial activity, high absorption capacity of simulated wound exudates, excellent water vapor transmission rate in the range of 2000 to 5000 g/m² day^-1, sustained drug-release profiles and water solubility. The wound dressings were active against Proteus mirabilis, Staphylococcus aureus, Proteus vulgaris, Escherichia coli and Klebsiella aeruginosa strains of bacteria. The results obtained revealed the wound dressing as potential wound dressings for burn wounds and sensitive skin.

Efficiency of Multifunctional Antibacterial Hydrogels for Chronic Wound Healing in Diabetes: A Comprehensive Review

Diabetic chronic wounds or amputation, which are complications of diabetes mellitus (DM), are a cause of great suffering for diabetics. In addition to the lack of oxygen, elevated reactive oxygen species (ROS) and reduced vascularization, microbial invasion is also a critical factor that induces non-healing chronic diabetic wounds, ie, wounds still remaining in the stage of inflammation, after which the wound tissue begins to age and becomes necrotic. To clear up the infection, alleviate the inflammation in the wound and prevent necrosis, many kinds of hydrogel have been fabricated to eliminate infections with pathogens. The unique properties of hydrogels make them ideally suited to wound dressings because they provide a moist environment for wound healing and act as a barrier against bacteria. This review article will mainly cover the recent developments and innovations of antibacterial hydrogels for diabetic chronic wound healing.

Arabinoxylan-Carboxymethylcellulose Composite Films for Antibiotic Delivery to Infected Wounds

Modern dressings should provide for local delivery of antibiotics and protect the wound from bacterial infection, dehydration and environmental factors to achieve optimal healing. The local delivery of antibiotics can reduce adverse effects and resistance challenges. In this study, we fabricated film dressings composed of arabinoxylan (AX) from Plantago ovata seed husks and carboxymethylcellulose (CMC) by a solvent cast method for the delivery of the antibiotic amikacin (AMK). To determine the suitability of the prepared AX-CMC composite films as wound dressings and drug delivery materials, their physical, chemical, mechanical, morphological, thermal, pharmaceutical, antimicrobial, cytocompatible, and drug delivery properties were investigated. The results demonstrated that the dressings were suitable for delivering the drug at the wound site in a sustained manner and keeping the environment moist for rapid healing. The AMK-loaded AX-CMC films exhibited controlled release of AMK, excellent antibacterial activity, and cytocompatibility. Thus, the AX-CMC composite films appear to be promising bioactive dressing materials for the prevention of wound infections.

Biodegradable gelatin-based films with nisin and EDTA that inhibit Escherichia coli

In this study, we developed gelatin-based films for active packaging with the ability to inhibit E. coli. We created these novel biodegradable gelatin-based films with a nisin-EDTA mix. FT-IR, TGA, and SEM analysis showed that nisin interacted with the gelatin by modifying its thermal stability and morphology. The use of nisin (2,500 IU/mL) with concentrations of Na-EDTA (1.052 M stock solution) distributed in the polymer matrix generated a significant decrease in the growth of E. coli when compared to the control. In freshly made films (t0), the growth of E. coli ATCC 25922 was reduced by approximately 3 logarithmic cycles. Two weeks after the films were made, a reduction in antimicrobial activity was observed in approximately 1, 1 and 3 logarithmic cycles of the films with 5%, 10% and 20% of the compound (nisin/Na-EDTA) distributed in the polymer matrix, respectively. This evidences an antimicrobial effect over time. Also, biodegradation tests showed that the films were completely degraded after 10 days. With all these results, an active and biodegradable packaging was successfully obtained to be potentially applied in perishable foods. These biodegradable, gelatin-based films are a versatile active packaging option. Further research on the barrier properties of these films is needed.

Chitosan crosslinking with a vanillin isomer toward self-healing hydrogels with antifungal activity

The purpose of the study was to develop new antimicrobial hydrogels from natural resources that may promote wound healing and prevent bacterial skin infection. The new hydrogels were synthesized by crosslinking chitosan with a vanillin isomer, 5-methoxysalicylaldehyde, by a friendly and easy method. To characterize these hydrogels, their structural and morphological properties were explored by FTIR, ¹H NMR, SEM, POM, and TGA. In view of the targeted application, swelling behavior, biodegradability, antimicrobial activity and biocompatibility were investigated in vitro. Structural and morphological studies confirmed the formation of new hydrogels via the imination reaction concomitant with the supramolecular organization. The hydrogels were highly porous with the average pore diameter around 80 μm, and a swelling rate controlled by the crosslinking density and medium pH. The hydrogels showed a progressive weight loss in the presence of lysozyme up to 35%, during 21 days of testing. They proved non-cytotoxic effect on Normal Human Dermal Fibroblasts using MTS test and powerful antifungal activity against Candida Albicans, as determined by disk diffusion assay. All these properties indicate the new hydrogels as a promising option for the treatment of various skin lesions.

An Up-to-Date Review of Biomaterials Application in Wound Management

Whether they are caused by trauma, illness, or surgery, wounds may occur throughout anyone's life. Some injuries' complexity and healing difficulty pose important challenges in the medical field, demanding novel approaches in wound management. A highly researched possibility is applying biomaterials in various forms, ranging from thin protective films, foams, and hydrogels to scaffolds and textiles enriched with drugs and nanoparticles. The synergy of biocompatibility and cell proliferative effects of these materials is reflected in a more rapid wound healing rate and improved structural and functional properties of the newly grown tissue. This paper aims to present the biomaterial dressings and scaffolds suitable for wound management application, reviewing the most recent studies in the field.

Coaxially electrospun 5-fluorouracil-loaded PLGA/PVP fibrous membrane for skin tumor treatment

As a biocompatible and biodegradable polymer, poly(lactide-co-glycolide) (PLGA) has been widely used as a carrier to achieve controlled drug delivery in various forms. Focusing on skin tumor treatment, herein 5-fluorouracil (5-FU) was embedded into the core of coaxially electrospun PLGA fibers to get a drug-loaded core-shell fibrous membrane. In the coaxial electrospinning, poly(vinylpyrrolidone) was applied in the inner flow to facilitate the formation of the core-shell structured fibers. The morphology and micro-structure of the fibers were characterized by scanning electron microscope and transmission electron microscope. The influences of the molecular weights and chemical compositions of PLGA copolymers on the release behaviors were studied. The cytotoxicity of the fibers was characterized by cell proliferation and living-dead cell staining experiments. The results showed that faster release rates would be obtained if the copolymers were of lower molecular weights and higher fraction of glycidyl unit. All the prepared 5-FU loaded fibrous membranes were non-cytotoxic, suggesting their potential applications in skin tumor treatment.

Microwave Enabled Physically Cross Linked Sodium Alginate and Pectin Film and Their Application in Combination with Modified Chitosan-Curcumin Nanoparticles. A Novel Strategy for 2nd Degree Burns Wound Healing in Animals

This study reports microwave assisted physically cross-linked sodium alginate and pectin film and their testing in combination with modified chitosan-curcumin nanoparticles for skin tissue regeneration following 2nd degree burn wound. Film was formulated by solution casting method and physically cross-linked using microwave irradiation at frequency of 2450 MHz, power 750 Watt for different time intervals for optimization. The optimized formulation was analyzed for various physiochemical attributes. Afterwards, the optimized film and optimized modified chitosan-curcumin nanoparticles were tested in combination for skin regeneration potential following burn wound in vivo and skin samples extracted and tested for different attributes. The results indicated that the optimized film formulation (5 min microwave treatment) physicochemical attributes significantly enhanced addressing the properties required of a wound healing platform. The vibrational analysis indicated that the optimized film experienced significant rigidification of hydrophilic domains while the hydrophobic domains underwent significant fluidization which also resulted in significant increase in the transition temperatures and system enthalpies of both polymer moieties with microwave treatment. The combined film and nanoparticles application significantly increased protein content in the wounds which were evident from higher absorbance ratios of amide-I and amide-II (2.15 ± 0.001), significantly higher melting transition temperature and enthalpy (∆T = 167.2 ± 15.4 °C, ∆H = 510.7 ± 20.1 J/g) and higher tensile strength (14.65 ± 0.8 MPa) with significantly enhanced percent re-epithelization (99.9934 ± 2.56) in comparison to other treatments. The combined application of film and nanoparticles may prove to be a new novel treatment strategy for 2nd degree burn wound healing.

Influence of replacing oregano essential oil by ground oregano leaves on chitosan/alginate-based dressings properties

Biopolymers, as chitosan and alginate, have gained prominence in the biomedical area, mainly for application in wound dressings, as partial replacements for synthetic polymers. The present work aimed to compare the influence of the antimicrobial agent incorporation form on the properties of films prepared by casting. The chitosan/alginate-based films were manufactured containing oregano essential oil (OEO) or ground oregano leaves (OR). The OEO was chosen due to its excellent pharmacological properties, and the substitution by OR can represent an advantageous alternative for minimizing the final cost of the product, by removing the oil extraction step. The films, with different amounts of OEO and OR, were characterized in terms of their morphological, physicochemical, mechanical and antimicrobial properties. The films had properties according to desirable for wound dressing application: water vapor flux less than 35 g m^-2 h^-1, moderate liquid absorption capacity, and similar mechanical properties to human skin. All developed films showed antimicrobial activity against the bacteria Escherichia coli and Staphylococcus aureus. Formulations containing OEO presented the largest inhibition zones, although OR showed high potential for the proposed use. These results suggest that films developed, with both OEO and ground oregano leaves, are promising for use as dressings.

Antibiotic-Loaded Psyllium Husk Hemicellulose and Gelatin-Based Polymeric Films for Wound Dressing Application

Wound infections are one of the major reasons for the delay in the healing of chronic wounds and can be overcome by developing effective wound dressings capable of absorbing exudate, providing local antibiotic release, and improving patient comfort. Arabinoxylan (AX) is a major hemicellulose present in psyllium seed husk (PSH) and exhibits promising characteristics for developing film dressings. Herein, AX-gelatin (GL) films were prepared by blending AX, gelatin (GL), glycerol, and gentamicin (antibiotic). Initially, the optimal quantities of AX, GL, and glycerol for preparing transparent, bubble-free, smooth, and foldable AX-GL films were found. Physiochemical, thermal, morphological, drug release, and antibacterial characteristics of the AX-GL films were evaluated to investigate their suitability as wound dressings. The findings suggested that the mechanical, water vapor transmission, morphological, and expansion characteristics of the optimized AX-GL films were within the required range for wound dressing. The results of Fourier-transform infrared (FTIR) analyses suggested chemical compatibility among the ingredients of the films. In in vitro drug release and antibacterial activity experiments, gentamicin (GM)-loaded AX-GL films released approximately 89% of the GM in 24 h and exhibited better antibacterial activity than standard GM solution. These results suggest that AX-GL films could serve as a promising dressing to protect against wound infections.

Polymer-Based Materials Loaded with Curcumin for Wound Healing Applications

Some of the currently used wound dressings have interesting features such as excellent porosity, good water-absorbing capacity, moderate water vapor transmission rate, high drug loading efficiency, and good capability to provide a moist environment, but they are limited in terms of antimicrobial properties. Their inability to protect the wound from microbial invasion results in wound exposure to microbial infections, resulting in a delayed wound healing process. Furthermore, some wound dressings are loaded with synthetic antibiotics that can cause adverse side effects on the patients. Natural-based compounds exhibit unique features such as good biocompatibility, reduced toxicity, etc. Curcumin, one such natural-based compound, has demonstrated several biological activities such as anticancer, antibacterial and antioxidant properties. Its good antibacterial and antioxidant activity make it beneficial for the treatment of wounds. Several researchers have developed different types of polymer-based wound dressings which were loaded with curcumin. These wound dressings displayed excellent features such as good biocompatibility, induction of skin regeneration, accelerated wound healing processes and excellent antioxidant and antibacterial activity. This review will be focused on the in vitro and in vivo therapeutic outcomes of wound dressings loaded with curcumin.

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

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