Bioactive nano yarns as surgical sutures for wound healing

Melt-extruded biocompatible surgical sutures loaded with microspheres designed for wound healing

Sutures are commonly used in surgical procedures and have immense potential for direct drug delivery into the wound site. However, incorporating active pharmaceutical ingredients into the sutures has always been challenging as their mechanical strength deteriorates. This study proposes a new method to produce microspheres-embedded surgical sutures that offer adequate mechanical properties for effective wound healing applications. The study used curcumin, a bioactive compound found in turmeric, as a model drug due to its anti-inflammatory, antioxidant, and anti-bacterial properties, which make it an ideal candidate for a surgical suture drug delivery system. Curcumin-loaded microspheres were produced using the emulsion solvent evaporation method with polyvinyl alcohol (PVA) as the aqueous phase. The microspheres' particle sizes, drug loading (DL) capacity, and encapsulation efficiency (EE) were investigated. Microspheres were melt-extruded with polycaprolactone and polyethylene glycol via a 3D bioplotter, followed by a drawing process to optimise the mechanical strength. The sutures' thermal, physiochemical, and mechanical properties were investigated, and the drug delivery and biocompatibility were evaluated. The results showed that increasing the aqueous phase concentration resulted in smaller particle sizes and improved DL capacity and EE. However, if PVA was used at 3% w/v or below, it prevented aggregate formation after lyophilisation, and the average particle size was found to be 34.32 ± 12.82 μm. The sutures produced with the addition of microspheres had a diameter of 0.38 ± 0.02 mm, a smooth surface, minimal tissue drag, and proper tensile strength. Furthermore, due to the encapsulated drug-polymer structure, the sutures exhibited a prolonged and sustained drug release of up to 14 d. Microsphere-loaded sutures demonstrated non-toxicity and accelerated wound healing in thein vitrostudies. We anticipate that the microsphere-loaded sutures will serve as an excellent biomedical device for facilitating wound healing.

Design and construction of poly (L-lactic-acid) nanofibrous yarns and threads with controllable structure and performances

The design and development of electrospun nanofibrous yarns (ENYs) have attracted intensive attentions in the fields of biomedical textiles and tissue engineering, but the inferior fiber arrangement structure, low yarn eveness, and poor tensile properties of currently-obtained ENYs has been troubled for a long time. In this study, a series of innovative strategies which combined a modified electrospinning method with some traditional textile processes like hot stretching, twisting, and plying, were designed and implemented to generate poly (L-lactic-acid) (PLLA) ENYs with adjustable morphology, structure, and tensile properties. PLLA ENYs made from bead-free and uniform PLLA nanofibers were fabricated by our modified electrospinning method, but the as-spun PLLA ENYs exhibited relatively lower fiber alignment degree and tensile properties. A hot stretching technique was explored to process the primary PLLA ENYs to improve the fiber alignment and crystallinity, resulting in a 779.7% increasement for ultimate stress and a 470.4% enhancement for Young's modulus, respectively. Then, the twisting post-treatment was applied to process as-stretched PLLA ENYs, and the tensile performances of as-twisted ENYs was found to present a trend of first increasing and then decreasing with the increasing of twisting degree. Finally, the PLLA threads made from different numbers of as-stretched PLLA ENYs were also manufactured with a traditional plying process, demonstrating the feasibility of further improving the yarn diameter and tensile properties. In all, this study reported a simple and cost-effective technique roadmap which could generate high performance PLLA nanofiber-constructed yarns or threads with controllable structures like highly aligned fiber orientation, twisted structure, and plied structure.

A Review on the Progress in Core-Spun Yarns (CSYs) Based Textile TENGs for Real-Time Energy Generation, Capture and Sensing

This review is a critical analysis of the current state-of-the-art in core spun yarn textile triboelectric nanogenerators (CSY-T-TENGs) for self-powered smart sensing applications. The rapid expansion of wireless communication, flexible conductive materials, and wearable electronics over the last ten years is now demanding autonomous energy, which has created a new research space in the field of wearable T-TENGs. Current research is exploring T-TENGs made from CSYs as stable and reliable energy harvesters and sensing devices for modern wearable IoT platforms. CSY-TENGs are emerging as an important technology due to its simple structure, low cost, and excellent performance in converting mechanical energy into electrical energy and due to its sensing ability. This paper provides a critical review on current progress, it analyzes the unique advantages of CSYs T-TENGs over conventional T-TENGs, it describes fabrication techniques and discusses the materials used along with their properties and electrical performance characteristics, and it highlights the recent advancements in their integration with self-excitation circuits, charge storage devices and IoT-enabled smart sensing applications, such as environmental and health monitoring. In the conclusion, it discusses the challenges and future directions of CSYs T-TENGs and it provides a future road map for optimization, upscaling, and commercialization of the technology.

Electrospun Nanofiber Membranes with Various Structures for Wound Dressing

Electrospun nanofiber membranes (NFMs) have high porosity and a large specific surface area, which provide a suitable environment for the complex and dynamic wound healing process and a large number of sites for carrying wound healing factors. Further, the design of the nanofiber structure can imitate the structure of the human dermis, similar to the natural extracellular matrix, which better promotes the hemostasis, anti-inflammatory and healing of wounds. Therefore, it has been widely studied in the field of wound dressing. This review article overviews the development of electrospinning technology and the application of electrospun nanofibers in wound dressings. It begins with an introduction to the history, working principles, and transformation of electrospinning, with a focus on the selection of electrospun nanofiber materials, incorporation of functional therapeutic factors, and structural design of nanofibers and nanofiber membranes. Moreover, the wide application of electrospun NFMs containing therapeutic factors in wound healing is classified based on their special functions, such as hemostasis, antibacterial and cell proliferation promotion. This article also highlights the structural design of electrospun nanofibers in wound dressing, including porous structures, bead structures, core-shell structures, ordered structures, and multilayer nanofiber membrane structures. Finally, their advantages and limitations are discussed, and the challenges faced in their application for wound dressings are analyzed to promote further research in this field.

Curcumin-based nanoformulations alleviate wounds and related disorders: A comprehensive review

Despite numerous advantages, curcumin's (CUR) low solubility and low bioavailability limit its employment as a free drug. CUR-incorporated nanoformulation enhances the bioavailability and angiogenesis, collagen deposition, fibroblast proliferation, reepithelization, collagen synthesis, neovascularization, and granulation tissue formation in different wounds. Designing nanoformulations with controlled-release properties ensure the presence of CUR in the defective area during treatment. Different nanoformulations encompassing nanofibers, nanoparticles (NPs), nanospray, nanoemulsion, nanosuspension, nanoliposome, nanovesicle, and nanomicelle were described in the present study comprehensively. Moreover, for some other systems which contain nano-CUR or CUR nanoformulations, including some nanofibers, films, composites, scaffolds, gel, and hydrogels seems the CUR-loaded NPs incorporation has better control of the sustained release, and thereby, the presence of CUR until the final stages of wound healing is more possible. Incorporating CUR-loaded chitosan NPs into nanofiber increased the release time, while 80% of CUR was released during 240 h (10 days). Therefore, this system can guarantee the presence of CUR during the entire healing period. Furthermore, porous structures such as sponges, aerogels, some hydrogels, and scaffolds disclosed promising performance. These architectures with interconnected pores can mimic the native extracellular matrix, thereby facilitating attachment and infiltration of cells at the wound site, besides maintaining a free flow of nutrients and oxygen within the three-dimensional structure essential for rapid and proper wound healing, as well as enhancing mechanical strength.

Production of Modified Composite Nanofiber Yarns with Functional Particles

The study focused on the production of modified composite nanofiber yarns with fine functional particles. A device that incorporates fine functional particles into a nanofiber yarn wrapper was specially developed, which ensures the continuous production of modified yarn. It was demonstrated during the study that the specially designed equipment could be used effectively for incorporating fine functional particles into the nanofiber packaging, thus creating a unique yarn with high application potential. The use of particles with dimensions of just tens of micrometers results in the uneven flow of particles inside the chamber and the uneven supply of particles to the composite yarn. The study also determined that the number of particles incorporated into the composite yarn is affected by the particle concentration and the variation of the vortex velocity ratios in the chamber. During testing, it was also found that the nanofiber sheet of the composite yarn improves the mechanical properties of the produced yarn. In addition, the study included the semi-industrial production of a composite filter candle, which can be used for the treatment of fluids, especially air and water.

Applications of Electrospun Drug-Eluting Nanofibers in Wound Healing: Current and Future Perspectives

Wounds are a consequence of disruption in the structure, integrity, or function of the skin or tissue. Once a wound is formed following mechanical or chemical damage, the process of wound healing is initiated, which involves a series of chemical signaling and cellular mechanisms that lead to regeneration and/or repair. Disruption in the healing process may result in complications; therefore, interventions to accelerate wound healing are essential. In addition to mechanical support provided by sutures and traditional wound dressings, therapeutic agents play a major role in accelerating wound healing. The medicines known to improve the rate and extent of wound healing include antibacterial, anti-inflammatory, and proliferation enhancing agents. Nonetheless, the development of these agents into eluting nanofibers presents the possibility of fabricating wound dressings and sutures that provide mechanical support with the added advantage of local delivery of therapeutic agents to the site of injury. Herein, the process of wound healing, complications of wound healing, and current practices in wound healing acceleration are highlighted. Furthermore, the potential role of drug-eluting nanofibers in wound management is discussed, and lastly, the economic implications of wounds as well as future perspectives in applying fiber electrospinning in the design of wound dressings and sutures are considered and reported.

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.

State-of-the-art review of advanced electrospun nanofiber yarn-based textiles for biomedical applications

The pandemic of the coronavirus disease 2019 (COVID-19) has made biotextiles, including face masks and protective clothing, quite familiar in our daily lives. Biotextiles are one broad category of textile products that are beyond our imagination. Currently, biotextiles have been routinely utilized in various biomedical fields, like daily protection, wound healing, tissue regeneration, drug delivery, and sensing, to improve the health and medical conditions of individuals. However, these biotextiles are commonly manufactured with fibers with diameters on the micrometer scale (> 10 μm). Recently, nanofibrous materials have aroused extensive attention in the fields of fiber science and textile engineering because the fibers with nanoscale diameters exhibited obviously superior performances, such as size and surface/interface effects as well as optical, electrical, mechanical, and biological properties, compared to microfibers. A combination of innovative electrospinning techniques and traditional textile-forming strategies opens a new window for the generation of nanofibrous biotextiles to renew and update traditional microfibrous biotextiles. In the last two decades, the conventional electrospinning device has been widely modified to generate nanofiber yarns (NYs) with the fiber diameters less than 1000 nm. The electrospun NYs can be further employed as the primary processing unit for manufacturing a new generation of nano-textiles using various textile-forming strategies. In this review, starting from the basic information of conventional electrospinning techniques, we summarize the innovative electrospinning strategies for NY fabrication and critically discuss their advantages and limitations. This review further covers the progress in the construction of electrospun NY-based nanotextiles and their recent applications in biomedical fields, mainly including surgical sutures, various scaffolds and implants for tissue engineering, smart wearable bioelectronics, and their current and potential applications in the COVID-19 pandemic. At the end, this review highlights and identifies the future needs and opportunities of electrospun NYs and NY-based nanotextiles for clinical use.

Electrospun Medical Sutures for Wound Healing: A Review

With the increasing demand for wound healing around the world, the level of medical equipment is also increasing, but sutures are still the preferred medical equipment for medical personnel to solve wound closures. Compared with the traditional sutures, the nanofiber sutures produced by combining the preparation technology of drug-eluting sutures have greatly improved both mechanical properties and biological properties. Electrospinning technology has attracted more attention as one of the most convenient and simple methods for preparing functional nanofibers and the related sutures. This review firstly discusses the structural classification of sutures and the performance analysis affecting the manufacture and use of sutures, followed by the discussion and classification of electrospinning technology, and then summarizes the relevant research on absorbable and non-absorbable sutures. Finally, several common polymers and biologically active substances used in creating sutures are concluded, the related applications of sutures are discussed, and the future prospects of electrospinning sutures are suggested.

Continuous Microfiber Wire Mandrel-Less Biofabrication for Soft Tissue Engineering Applications

Suture materials are the most common bioimplants in surgical and clinical practice, playing a crucial role in wound healing and tendon and ligament repair. Despite the assortment available on the market, sutures are still affected by significant disadvantages, including failure in mimicking the mechanical properties of the tissue, excessive fibrosis, and inflammation. This study introduces a mandrel-less electrodeposition apparatus to fabricate continuous microfiber wires of indefinite length. The mandrel-less biofabrication produces wires, potentially used as medical fibers, with different microfiber bundles, that imitate the hierarchical organization of native tissues, and tailored mechanical properties. Microfiber wire morphology and mechanical properties are characterized by scanning electron microscopy, digital image processing, and uniaxial tensile test. Wires are tested in vitro on monocyte/macrophage stimulation and in vivo on a rat surgical wound model. The wires produced by mandrel-less deposition show an increased M2 macrophage phenotype in vitro. The in vivo assessment demonstrates that microfiber wires, compared to the medical fibers currently used, reduce pro-inflammatory macrophage response and preserve their mechanical properties after 30 days of use. These results make this microfiber wire an ideal candidate as a suture material for soft tissue surgery, suggesting a crucial role of microarchitecture in more favorable host response.

Synthesis and in vitro evaluation of natural drug loaded polymeric films for cardiovascular applications

Drug eluting stents (DES) can efficiently reduce the atherosclerosis and restenosis issues of coronary artery as compared to bare metal stents due to the presence of pharmaceutically active agent on their surface. Nevertheless, the arising safety concerns of DES such as delayed healing and late in stent restenosis and thrombus, has stirred the research efforts to improve the outcomes of the DES. In this connection, attention is being shifted from the use of synthetic drug to natural drug for DES. In the present work, natural compound loaded polymeric films were synthesized and their antioxidant and anticoagulation capabilities were assessed through in vitro testing. The potential of the drug loaded polymeric films to curb the production of free radicals was evaluated by carrying out antioxidant activity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The in vitro platelet adhesion was investigated through static platelet adhesion test while effect of synthesized films on intrinsic coagulation pathway was investigated through activated partially thromboplastin time (APTT). Moreover, to further evaluate the blood compatibility of the developed drug loaded films, in vitro hemolytic and anti-thrombolytic assays were carried out. The obtained results indicated that, incorporating herbal compounds such as ginger, magnolol and curcumin, in polymeric matrix (PVA) has significantly improved the blood compatibility of the polymeric films. Hence, it can be concluded that the synthesized drug loaded polymeric films have the potential capability to be used as a potential coating material for coating biomedical implants with good anticoagulation and antioxidant property to cater the cardiovascular issues such as atherosclerosis, restenosis and thrombus formation.

Electrospun strong, bioactive, and bioabsorbable silk fibroin/poly (L-lactic-acid) nanoyarns for constructing advanced nanotextile tissue scaffolds

Bio-textiles have aroused attractive attentions in tissue engineering and regenerative medicine, and developing robust, bio-absorbable, and extracellular matrix (ECM) fibril-mimicking nanofibrous textiles is urgently required for the renewal of existing microfibrous textile-based scaffolds and grafts. In this study, an integrated electrospinning system consisting of one nanoyarn-forming unit and one hot stretching unit is reported to fabricate silk fibroin (SF)/poly (L-lactic-acid) (PLLA) nanofibrous yarns (nanoyarns). The hot stretching process is demonstrated to significantly improve the fiber alignment, crystallinity, and mechanical properties of SF/PLLA nanoyarns, compared to the unstretched controls. For instance, the fiber alignment degree of hot stretched 50/50 SF/PLLA nanoyarn has increased by 25%, and the failure strength has increased by 246.5%, compared with the corresponding un-stretched control. Increasing the SF/PLLA mass ratio is found to significantly decrease the crystallinity and mechanical properties, but notably increase the degradation rate and surface hydrophilicity of SF/PLLA nanoyarns. Different SF/PLLA nanoyarns are further meticulously interwoven with warp and weft directions to obtain several nanofibrous woven textiles. The results from in vitro cell characterization and in vivo subcutaneous implantation show that increasing the SF/PLLA mass ratio significantly improves the biological properties and effectively reduces the inflammatory response of nanoyarn-constructed textiles. Overall, this study demonstrates that our SF/PLLA nanoyarns with controllable physical, mechanical and biological performances are fantastic candidates for the designing and development of advanced nanoarchitectured textile tissue scaffolds.

Biopolymers for Surgical Applications

Biopolymers have gained significant attention as a class of polymer materials with a wide range of applications, especially in the medical and pharmaceutical field. Due to particular characteristics, such as biocompatibility, biodegradability, non-toxicity, and functionality, they have become promising candidates for various surgical applications, including as bioadhesives, sealants, wound dressings, sutures, drug carriers, coating materials, etc. Recent research shows that further modification of biopolymers by advanced techniques can improve their functionality i.e., antibacterial activity, cell viability, drug-releasing capability, good wet adhesion performance, and good mechanical properties. This mini review aims to provide a brief report on the type of biopolymers and recent developments regarding their use in various surgical applications.

Preliminary Results on Heparin-Modified Double-Layered PCL and PLA-Based Scaffolds for Tissue Engineering of Small Blood Vessels

Low-diameter blood vessels are challenging to replace with more traditional synthetic vascular grafts. Therefore, the obvious choice is to try to regenerate small veins and arteries through tissue-engineering approaches. However, the layered structure of native vessels and blood compatibility issues make this a very challenging task. The aim of this study is to create double-layered tubular scaffolds with enhanced anticoagulant properties for the tissue engineering of small blood vessels. The scaffolds were made of a polycaprolactone-based porous outer layer and a polylactide-based electrospun inner layer modified with heparin. The combination of thermally induced phase separation and electrospinning resulted in asymmetric scaffolds with improved mechanical properties. The release assay confirmed that heparin is released from the scaffolds. Additionally, anticoagulant activity was shown through APTT (activated partial thromboplastin time) assay. Interestingly, the endothelial cell culture test revealed that after 14 days of culture, HAECs (human aortic endothelial cell lines) tended to organize in chain-like structures, typical for early stages of vascular formation. In the longer culture, HAEC viability was higher for the heparin-modified scaffolds. The proposed scaffold design and composition have great potential for application in tissue engineering of small blood vessels.

Development of novel hyaluronic acid/human-like collagen bio-composite membranes: A facile "surface modification-assembly" approach

The merits of hyaluronic acid (HA) as a representative biological carbohydrate polymers especially in bioactivity and tailorability makes it ideal building block for the engineering of tissue engineering scaffolds. HA-based bio-composites integrate the characteristics of multi-component materials, possessing versatility and further improving the therapeutic efficacy. Human like collagen (HLC), which is hydrophilic, biomimetic, and bio-safe, with human tissue-derived collagen biofunction, has attracted extensive attention worldwide. Herein, we developed a novel method for HA/HLC bio-composite membranes preparation, comprising one-step surface modification-assembly process by which the HLC self-assembles are simultaneously loaded on the oxidized-modified HA (oxi-HA) from the surface/interface micro-scale. Comprehensive material characterizations and in vitro/in vivo biostudies proved that the HLC/oxi-HA composite membranes exhibited significantly enhanced biological activity, hemostatic performances, and wound healing properties compared to that of the pristine HA. The results of this study highlight the great potential of the prepared biomimetic HLC/oxi-HA bio-composites as a new generation of multifunctional HA-based wound-healing materials.