In vivo models for assesment of wound healing potential: A systematic review

45S5 Bioactive Glass-Ointment Positively Effects on Wound Healing in Rats by Regulating TNFα, Il-10, VEGF, and TGFβ

AIM

This study aimed to investigate the effects of 45S5 bioactive glass-ointment (BG) on cutaneous wound healing in rats at the molecular, biochemical, and histopathological levels.

MATERIALS AND METHODS

Thirty-two rats were divided into four groups (n = 8): Control, Sham, BG, and DEX (Dexpanthenol). While no wound treatment was applied to the CONTROL, a wound model was created in the Sham, and no treatment was applied. A wound model was created for other groups, and BG and DEX were applied locally for 21 days. During the 21-day experiment period, feed and water consumption and weight changes were observed. Wound areas were calculated on days 0, 3, 7, 4, and 21. Following treatment, the rats were euthanized and tissues from the wound area and blood samples were collected. While the expression levels of tumor necrosis factor-alpha (TNFα), Interleukin 6 (IL6), Interleukin 10 (IL10), transforming growth factor-beta (TGFβ), and vascular endothelial growth factor (VEGF) genes were determined by qPCR, the levels of TNFα, IL6, and IL10 proteins were measured by ELISA.

RESULTS

It was observed that the BG group showed anti-inflammatory activity by suppressing TNFα levels and stimulating IL-10. In addition, it was determined that BG increased fibroblast activity and vascularization.

CONCLUSION

Current findings showed that topical application of BG has anti-inflammatory effects, while also accelerating healing by increasing vascularity and making positive contributions to tissue healing.

The Potential of Composite Cements for Wound Healing in Rats

Recent developments in biomaterials have resulted in the creation of cement composites with potential wound treatment properties, even though they are currently mainly employed for bone regeneration. Their ability to improve skin restoration after surgery is worth noting. The main purpose of this research is to evaluate the ability of composite cement to promote wound healing in a rat experimental model. Full-thickness 5 mm skin defects were created, and the biomaterials were applied as wound dressings. The hybrid light-cured cement composites possess an organic matrix (Bis-GMA, TEGDMA, UDMA, and HEMA) and an inorganic phase (bioglasses, silica, and hydroxyapatite). The organic phase also contains γ-methacryloxypropyl-trimethoxysilane, which is produced by distributing bioactive silanized inorganic filler particles. The repair of the defect is assessed using a selection of macroscopic and microscopic protocols, including wound closure rate, histopathological analysis, cytotoxicity, and biocompatibility. Both composites exerted a favorable influence on cells, although the C1 product demonstrated a more extensive healing mechanism. Histological examination of the kidney and liver tissues revealed no evidence of toxicity. There were no notable negative outcomes in the treated groups, demonstrating the biocompatibility and efficacy of these bioproducts. By day 15, the skin of both groups had healed completely. This research introduces a pioneering strategy by utilizing composite cements, traditionally used in dentistry, in the context of skin wound healing.

A critical overview of challenging roles of medicinal plants in improvement of wound healing technology

PURPOSE

Chronic diseases often hinder the natural healing process, making wound infections a prevalent clinical concern. In severe cases, complications can arise, potentially leading to fatal outcomes. While allopathic treatments offer numerous options for wound repair and management, the enduring popularity of herbal medications may be attributed to their perceived minimal side effects. Hence, this review aims to investigate the potential of herbal remedies in efficiently treating wounds, presenting a promising alternative for consideration.

METHODS

A literature search was done including research, reviews, systematic literature review, meta-analysis, and clinical trials considered. Search engines such as Pubmed, Google Scholar, and Scopus were used while retrieving data. Keywords like Wound healing 'Wound healing and herbal combinations', 'Herbal wound dressing', Nanotechnology and Wound dressing were used.

RESULT

This review provides valuable insights into the role of natural products and technology-based formulations in the treatment of wound infections. It evaluates the use of herbal remedies as an effective approach. Various active principles from herbs, categorized as flavonoids, glycosides, saponins, and phenolic compounds, have shown effectiveness in promoting wound closure. A multitude of herbal remedies have demonstrated significant efficacy in wound management, offering an additional avenue for care. The review encompasses a total of 72 studies, involving 127 distinct herbs (excluding any common herbs shared between studies), primarily belonging to the families Asteraceae, Fabaceae, and Apiaceae. In research, rat models were predominantly utilized to assess wound healing activities. Furthermore, advancements in herbal-based formulations using nanotechnology-based wound dressing materials, such as nanofibers, nanoemulsions, nanofiber mats, polymeric fibers, and hydrogel-based microneedles, are underway. These innovations aim to enhance targeted drug delivery and expedite recovery. Several clinical-based experimental studies have already been documented, evaluating the efficacy of various natural products for wound care and management. This signifies a promising direction in the field of wound treatment.

CONCLUSION

In recent years, scientists have increasingly utilized evidence-based medicine and advanced scientific techniques to validate the efficacy of herbal medicines and delve into the underlying mechanisms of their actions. However, there remains a critical need for further research to thoroughly understand how isolated chemicals extracted from herbs contribute to the healing process of intricate wounds, which may have life-threatening consequences. This ongoing research endeavor holds great promise in not only advancing our understanding but also in the development of innovative formulations that expedite the recovery process.

Rodent models of dermatological disorders

To assess the possible beneficial effects of drugs and drug candidates, different dermatological disease models are available in rodents. These models are able to mimic one or more characteristic features of the disorders, but not completely recapitulate the pathogenesis of the human skin diseases. Therefore, to improve the technology many new models have been developed both by genetic engineering and by chemical or physical induction. Currently the in vivo rodent models provide the physiologically most relevant approach to produce the pathology related to the majority of dermatological diseases. In this short review some widely used animal techniques (psoriasis, allergic contact dermatitis, atopic dermatitis, wound healing, melanoma and non-melanoma type skin cancers and UV erythema) are shown which are currently applied in pharmacological, pharmacokinetic, pharmaceutical and dermatological research. First the main points of the human pathomechanism are shown and afterwards the rodent models are briefly discussed. Finally critical evaluation is provided by the authors. However, according to the 3R rule the number of experimental animals is strongly suggested to be reduced, therefore the advanced in vitro and ex vivo techniques become more and more important contrary to in vivo preclinical methods also in dermatological research. As it is described in the outlook section, although the 2D/3D in vitro and skin on-a-chip techniques are promising and have many advantages they are not able to completely substitute the animal models in their vascular, immunological, secretory and neural complexity.

Indole-3-carbinol loaded-nanocapsules modulated inflammatory and oxidative damages and increase skin wound healing in rats

This study evaluated the effects of topically applied hydrogels (HG) containing nanoencapsulated indol-3-carbinol (I3C) and its free form in a rat model of skin wounds. Formulations were topically applied twice a day for five days to the wounds. On days 1, 3, and 6, the wound area was measured to verify the % of regression. On the sixth day, the animals were euthanized for the analysis of the inflammatory and oxidative profile in wounds. The nanocapsules (NC) exhibited physicochemical characteristics compatible with this kind of suspension. After five hours of exposure to ultraviolet C, more than 78% of I3C content in the suspensions was still observed. The NC-I3C did not modify the physicochemical characteristics of HG when compared to the HG base. In the in vivo study, an increase in the size of the wound was observed on the 3rd experimental day, which was lower in the treated groups (mainly in HG-NC-I3C) compared to the control. On the 6th day, HG-I3C, HG-NC-B, and HG-NC-I3C showed lower regression of the wound compared to the control. Additionally, HG-NC-I3C exhibited an anti-inflammatory effect (as observed by decreased levels of interleukin-1B and myeloperoxidase), reduced oxidative damage (by decreased reactive species, lipid peroxidation, and protein carbonylation levels), and increased antioxidant defense (by improved catalase activity and vitamin C levels) compared to the control. The current study showed more satisfactory results in the HG-NC-I3C group than in the free form of I3C in decreasing acute inflammation and oxidative damage in wounds.

Efficacy of nano encapsulated herbal extracts in the treatment of induced wounds in animal models: a systematic review protocol

BACKGROUND

Wounds inflict pain and affect human health causing high expenditure on treatment and management. Herbal crude extracts are used in traditional medicine as a treatment for wounds and other illnesses. However, the progress in the use of plants has been deterred due to their poor solubility and poor bioavailability requiring administration at high doses. It has been established that nanoencapsulation of herbal products in nanocarriers (size 1 nm to 100 nm) such as nanofibers, nanoparticles, nanospheres, and nanoliposomes greatly improves their efficacy. Due to their small and large surface area, nanocarriers are more biologically active, improve bioavailability, protect the drug from deterioration, and release it to the targeted site in a sustainable manner.

AIM

The review aims to collate and appraise evidence on the efficacy of nano encapsulated herbal extracts in the treatment of induced wounds in animal models.

METHODS

The review will be protocol-driven and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols (PRISMA-P) and protocol guidelines for systematic review and meta-analysis for animal intervention studies. The final review will be conducted and reported with reference to PRISMA 2020 statement. Studies will be searched in Pub Med, ProQuest, Web of Science, Medline Ovid, EMBASE, and Google Scholar. The PRISMA flow criteria will be followed in screening the articles for inclusion. Data extraction form will be designed in Excel spreadsheet 2013 and data extracted based on the primary and secondary outcomes. Risk of bias assessment will be done using SYRCLE's risk of bias tool for animal studies. Data analysis will be done using narrative and quantitative synthesis.

EXPECTED RESULTS

We hope to make meaningful comparisons between the effectiveness of the herb-loaded nanomaterials and other interventions (controls) in the selected studies, based on the primary and secondary outcome measures. We expect that these findings to inform clinical practice on whether preclinical studies show enough quality evidence on the efficacy and safety of herbal-loaded nanomaterials that can be translated into clinical trials and further research.

SYSTEMIC REVIEW REGISTRATION

PROSPERO 330330. The protocol was submitted on the 11th of May 2022.

Wound Healing Potential of Couroupita guianensis Aubl. Fruit Pulp Investigated on Excision Wound Model

Wound care management aims at stimulating and improving healing process without scar formation. Although various plants have been reported to possess wound healing properties in tribal and folklore medicines, there is a lack of scientific data to validate the claim. In this aspect, it becomes inevitable to prove the efficacy of naturally derived products at pharmacological levels. Couroupita guianensis as a whole plant has been reported to exhibit wound healing activity. The leaves and fruit of this plant have been utilized in folkloric medicine to cure skin diseases and infections for many years. However, to the best of our knowledge, no scientific studies have been conducted to verify the wound healing properties of C. guianensis fruit pulp. Therefore, the present study seeks to investigate the wound healing potential of C. guianensis fruit pulp using an excision wound model in Wistar albino male rats. This study indicated that the ointment prepared from crude ethanolic extract of C. guianensis fruit pulp facilitated wound contraction that were evidenced by a greater reduction in the wound area and epithelialization period and increased hydroxyproline content. The experimental groups treated with low and mid dose of C. guianensis ethanol extract (CGEE) ointments had shown a wound closure of 80.27% and 89.11% respectively within 15 days, which is comparable to the standard betadine ointment which showed 91.44% healing in the treated groups. Further, the extract influenced the expression of genes VEGF and TGF-β on post wounding days that clearly explained the strong correlation between these genes and wound healing in the experimental rats. The animals treated with 10% CGEE ointment showed a significant upregulation of both VEGF and TGF-β as compared with other test and standard groups. These findings provide credence to the conventional application of this plant in the healing of wounds and other dermatological conditions, and may represent a therapeutic strategy for the treatment of wounds.

Nanosilver-functionalized polysaccharides as a platform for wound dressing

Polysaccharides that are naturally sourced have enormous promise as wound dressings, due to their wider availability and reasonable cost and good biocompatibility. Furthermore, nanosilver extensively applied in wound treatment is attributed to its broad spectrum of antimicrobial effects and lesser drug resistance. Consequently, wound dressings in corporating nanosilver have attracted wide-scale interest in wound healing, and nanosilver-functionalized polysaccharide-based wound dressings present an affordable option for healing of chronic wounds. This review encompasses preparation methods, classification, and antibacterial performances of nanosilver wound dressings. The prospective research arenas of nanosilver-based wound polysaccharide dressings are also elaborated. The review attempts to include a summary of the most recent advancements in silver nanotechnology as well as guidance for the investigation of nanosilver-functionalized polysaccharide-based wound dressings.

Wound healing efficacy of rhamnolipid-coated zinc oxide nanoparticle along with its in vivo antibacterial efficacy against Staphylococcus aureus

Rhamnolipids are microbial metabolites with antibacterial efficacies, which can be further boosted through the application of nanobiotechnology. In this study, the efficacy of rhamnolipid-coated zinc oxide nanoparticles (ZnRL) has been studied for their wound healing efficacy as well as in vivo antibacterial efficacy. Thus, this study evaluates the efficacy of ZnRL to heal an excised infected wound, which was compared with the healing efficacy of rhamnolipid and clindamycin. The study revealed that rhamnolipid-coated zinc oxide nanoparticles possess promising wound healing efficacy with prominent antibacterial activity in the rat model. Prominent wound healing in a Staphylococcus aureus infected excised wound was observed on the 5th day of the treatment when the wound site was treated with 100 μl of 0.5 mg/ml of ZnRL. This concentration of ZnRL was found to exhibit efficient antibacterial activity against the pathogen, thereby decreasing the amount of pathogen in the wound site. ZnRL exhibited efficient wound contraction, thereby decreasing the size of the wound prominently in 5 days. Histological study revealed efficient tissue remodelling in ZnRL-treated skin which resulted in rapid formation of the epidermis and recruitment of various dermal cells within the 5th day of treatment. The study also revealed the non-cytotoxic effect of the nanoparticles in fibroblast cell line L929 and the non-haemolytic effect against blood cells, indicating its potential in pharmaceuticals.

The industrially important genus Kaempferia: An ethnopharmacological review

Kaempferia, a genus of the family Zingiberaceae, is widely distributed with more than 50 species which are mostly found throughout Southeast Asia. These plants have important ethnobotanical significance as many species are used in Ayurvedic and other traditional medicine preparations. This genus has received a lot of scholarly attention recently as a result of the numerous health advantages it possesses. In this review, we have compiled the scientific information regarding the relevance, distribution, industrial applications, phytochemistry, ethnopharmacology, tissue culture and conservation initiative of the Kaempferia genus along with the commercial realities and limitations of the research as well as missing industrial linkages followed by an exploration of some of the likely future promising clinical potential. The current review provides a richer and deeper understanding of Kaempferia, which can be applied in areas like phytopharmacology, molecular research, and industrial biology. The knowledge from this study can be further implemented for the establishment of new conservation strategies.

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.

Investigation on wound healing effect of Mediterranean medicinal plants and some related phenolic compounds: A review

ETHNOPHARMACOLOGICAL RELEVANCE

The human skin constitutes a biological barrier against external stress and wounds can reduce the role of its physiological structure. In medical sciences, wounds are considered a major problem that requires urgent intervention. For centuries, medicinal plants have been used in the Mediterranean countries for many purposes and against wounds.

AIM OF THIS REVIEW

Provides an outlook on the Mediterranean medicinal plants used in wound healing. Furthermore, the wound healing effect of polyphenolic compounds and their chemical structures are also summarized. Moreover, we discussed the wound healing process, the structure of the skin, and the current therapies in wound healing.

MATERIALS AND METHODS

The search was performed in several databases such as ScienceDirect, PubMed, Google Scholar, Scopus, and Web of Science. The following Keywords were used individually and/or in combination: the Mediterranean, wound healing, medicinal plants, phenolic compounds, composition, flavonoid, tannin.

RESULTS

The wound healing process is distinguished by four phases, which are respectively, hemostasis, inflammation, proliferation, and remodeling. The Mediterranean medicinal plants are widely used in the treatment of wounds. The finding showed that eighty-nine species belonging to forty families were evaluated for their wound-healing effect in this area. The Asteraceae family was the most reported family with 12 species followed by Lamiaceae (11 species). Tunisia, Egypt, Morocco, and Algeria were the countries where these plants are frequently used in wound healing. In addition to medicinal plants, results showed that nineteen phenolic compounds from different classes are used in wound treatment. Tyrosol, hydroxytyrosol, curcumin, luteolin, chrysin, rutin, kaempferol, quercetin, icariin, morin, epigallocatechin gallate, taxifolin, silymarin, hesperidin, naringin, isoliquiritin, puerarin, genistein, and daidzein were the main compounds that showed wound-healing effect.

CONCLUSION

In conclusion, medicinal plants and polyphenolic compounds provide therapeutic evidence in wound healing and for the development of new drugs in this field.

Wound-Healing and Antibacterial Activity of the Quercetin-4-Formyl Phenyl Boronic Acid Complex against Bacterial Pathogens of Diabetic Foot Ulcer

Complications of diabetic foot can be prevented using a naturally occurring, efficient, and newly synthesized antimicrobial agent. The purpose of the study was to improve wound healing and antibacterial effects of quercetin and its esterified complex with 4-formyl phenyl boronic acid (4FPBA-Q) compared with phenytoin. The formation of the 4FPBA-Q complex was confirmed by thin-layer chromatography (TLC), Fourier transform infrared (FTIR) spectroscopy, and mass spectrometry (MS). The prepared 4FPBA-Q complex was used against Gram-positive bacteria along with Gram-negative bacteria, and more than 2-fold decrease in minimum inhibitory concentrations (MIC) was observed compared to pure quercetin. Scanning electron microscopic images of Pseudomonas aeruginosa and Staphylococcus aureus showed their complete destruction after incubation with the 4FPBA-Q complex even after 3 h. Interestingly, wound-healing properties of the 4FPBA-Q complex in infected diabetic rats increased from 64 to 99% as compared to phenytoin, which were increased from those of noninfected diabetic rats. Furthermore, histopathological evaluations showed significantly enhanced wound healing, re-epithelialization, fibroblasts, and angiogenesis in wounds of diabetic rats after 10 days. Conclusively, reduction in the primary irritation index (PDII) and improved antibacterial and wound-healing properties render the 4FPBA-Q complex ideal for diabetic foot ulcer treatment.

Age-Defying and Photoprotective Potential of Geranium/Calendula Essential Oil Encapsulated Vesicular Cream on Biochemical Parameters against UVB Radiation Induced Skin Aging in Rat

UVB irradiation promotes the production of reactive oxygen species, which can lead to an increase in oxidative stress in the cell and the generation of toxic components, resulting in photoaging. Essential oils (EOs) are well-known in the cosmetics sector for their beneficial effects, as they have a wide range of biological activities. Considering this fact, the current study investigates the photoprotective potential of geranium essential oil (GEO)/calendula essential oil (CEO) encapsulated vesicular cream on the biochemical parameters of the skin of albino rats exposed to UVB radiation. After 30 days of treatment with cream formulations and UVB irradiation, the skin tissue was assayed for several biochemical parameters and histopathology analysis. The results of biochemical study revealed that, in comparison to non-vesicular creams, vesicular cream formulations were able to protect the endogenous skin natural antioxidant system by maintaining superoxide dismutase, catalase, total protein, ascorbic acid, and hydroxyproline levels and by decreasing malondialdehyde levels in the skin after UVB exposure. Changes in various cellular structures along with the change in the epidermis and dermis of the skin after UVB exposure in the treated group were observed by a histopathology of skin tissue and compared to the non-treated group, which revealed the skin damaging effect of UVB radiation and the protective effect of vesicular creams. The results suggest that the GEO/CEO-encapsulated vesicular creams have the potential to protect the skin against harmful UVB radiation by maintaining the natural antioxidant defence mechanism of the skin. In conclusion, this research presents novel herbal cosmetic formulations with improved antioxidant capacity and photoprotective potential that may help to slow down the skin aging process.

Plant-based Natural Products for Wound Healing: A Critical Review

Wound healing is an intricate process consisting of four overlapping phases, namely hemostasis, inflammation, proliferation, and remodelling. Effective treatment of wounds depends upon the interaction of appropriate cell types, cell surface receptors, and the extracellular matrix with the therapeutic agents. Several approaches currently used for treating wounds, such as advanced wound dressing, growth factor therapy, stem cell therapy, and gene therapy, are not very effective and lead to impaired healing. Further, repeated use of antibiotics to treat open wounds leads to multi- drug resistance. Today there is considerable interest in plant-based drugs as they are believed to be safe, inexpensive, and more suitable for chronic wounds. For example, a large number of plant- based extracts and their bioactive compounds have been investigated for wound healing. In recent years the structural and mechanistic diversity of natural products have become central players in the search for newer therapeutic agents. In the present review, a thorough critical survey of the traditionally used plant-based drugs used worldwide for wound healing with special reference to the natural products/bioactive compounds isolated and screened is presented. It is hoped that this review will attract the attention of the research community involved in newer drug design and development for wound healing.

In-silico Screening of Phytoconstituents on Wound Healing Targets-Approaches and Current Status

Over recent years, there has been tremendous research focused on the effective utilization of natural products in wound management. Natural or herbal products contain several phytoconstituents that may act on various stages in wound healing and thereby provide a multi-targeted approach especially in the treatment of chronic wounds. Currently, attempts have been made to screen the phytoconstituents present in herbs on various targets involved in wound healing. This review includes a systematic evaluation of scientific reports by various groups of researchers on the herbals evaluated for wound management, their phytochemical profiling, pre-clinical studies, and molecular modeling studies. Various wound targets discussed include Interleukin-1, Interleukin-6, Tumor necrosis factor-α (TNF-α), Thymosin beta-4 (Tβ-4) that regulate the early inflammatory stage and the novel T cell immune response cDNA 7(TIRC7) that regulates angiogenesis. Also, neuropeptides P and Y act on the inflammatory, migratory, and proliferation phases, and growth factors like vascular endothelial growth factor family (VEGF) and placental growth factor family (PGF) are involved in angiogenesis, while the role of Fibroblast growth factor in tissue remodeling is discussed. As many of the natural products include polyherbal systems, this approach can help in the judicious selection of a combination of herbs that will act on multiple targets in the wound healing process and provide a multi-factorial approach in wound management.

Acrylate-endcapped urethane-based hydrogels: An in vivo study on wound healing potential

Improving wound healing by developing innovative dressing materials has been an important focus over the past few years in the biomedical field. In this regard, the current study focuses on developing new dressings based on acrylate-endcapped urethane-based polymers (AUPs). The materials have been processed into films and electrospun mats. Exudate uptake capacity, mechanical properties and fiber morphology were evaluated herein. The results showed superior uptake capacity of both films and mats when compared to Aquacel®Ag, Exufiber® and Help®. Addition of a high molar mass poly(ethylene glycol) to the AUP polymers benefits both the film and electrospun dressings in terms of flexibility and elongation. An in vivo study was conducted to assess the wound healing properties of these dressings on an acute wound model induced to rats. A macroscopic evaluation indicated that wound contraction and wound fraction percentages were improved significantly in case of the AUP-materials when compared to both the positive (Aquacel®Ag) and negative (Exufiber® and Help®) controls. A histopathological assay, to underline the changes noticed on a macroscopical level, was also performed. The data obtained proved that the developed dressings are beneficial towards tissue regeneration and accelerated wound healing. These findings offer a practical yet adequate strategy for the fabrication of acrylate-endcapped urethane-based materials for wound healing applications.

Skin wounds, the healing process, and hydrogel-based wound dressings: a short review

Skin wounds are damage to the epithelial layer and the integrity of living tissue. The healing mechanism is dynamic and complex, and often treatments with wound dressings help in tissue regeneration, reducing the risk of infections. Polymeric hydrogels become good candidates for wet curing process. These materials prevent dehydration of the tissue and avoid discomfort to the patient when changing the dressing. In this short review, we demonstrate the importance of the healing process, the types of skin wounds, and the hydrogels that are potentially attractive as wound dressings.

Microfluidic and Lab-on-a-Chip Systems for Cutaneous Wound Healing Studies

Cutaneous wound healing is a complex, multi-stage process involving direct and indirect cell communication events with the aim of efficiently restoring the barrier function of the skin. One key aspect in cutaneous wound healing is associated with cell movement and migration into the physically, chemically, and biologically injured area, resulting in wound closure. Understanding the conditions under which cell migration is impaired and elucidating the cellular and molecular mechanisms that improve healing dynamics are therefore crucial in devising novel therapeutic strategies to elevate patient suffering, reduce scaring, and eliminate chronic wounds. Following the global trend towards the automation, miniaturization, and integration of cell-based assays into microphysiological systems, conventional wound healing assays such as the scratch assay and cell exclusion assay have recently been translated and improved using microfluidics and lab-on-a-chip technologies. These miniaturized cell analysis systems allow for precise spatial and temporal control over a range of dynamic microenvironmental factors including shear stress, biochemical and oxygen gradients to create more reliable in vitro models that resemble the in vivo microenvironment of a wound more closely on a molecular, cellular, and tissue level. The current review provides (a) an overview on the main molecular and cellular processes that take place during wound healing, (b) a brief introduction into conventional in vitro wound healing assays, and (c) a perspective on future cutaneous and vascular wound healing research using microfluidic technology.

The Impact of Composites with Silicate-Based Glasses and Gold Nanoparticles on Skin Wound Regeneration

The silver content of the skin regeneration ointments can influence its regeneration process but in the meantime, it can take the benefit of the antibacterial properties of silver by avoiding the bacterial infection of an open wound. In the current study, the skin healing and regeneration capacity of bioactive glass with spherical gold nanocages (BGAuIND) in the Vaseline ointments were evaluated in vivo comparing the bioactive glass (BG)-Vaseline and bioactive glass with spherical gold (BGAuSP)-Vaseline ointments. Spherical gold nanocages are stabilized with silver and as a consequence the BGAuIND exhibits great antibacterial activity. Histological examination of the cutaneous tissue performed on day 8 indicates a more advanced regeneration process in rats treated with BGAuSP-Vaseline. The histopathological examination also confirms the results obtained after 11 days post-intervention, when the skin is completely regenerated at rats treated with BGAuSP-Vaseline compared with the others groups where the healing was incomplete. This result is also confirmed by the macroscopic images of the evolution of wounds healing. As expected, the silver content influences the wound healing process but after two weeks, for all of the post-interventional trials from the groups of rats, the skin healing was completely.

Curcumin-loaded, alginate-gelatin composite fibers for wound healing applications

The wound healing process is characterized by varied biological and molecular cascades including inflammation, tissue proliferation, and remodeling phase. To augment and maintain these cascades, an all-natural matrix system is proposed. Biocompatible biopolymers, sodium alginate and gelatin, were employed to prepare microfibers via extrusion-gelation into a physical crosslinking solution. Curcumin, an anti-inflammatory, anti-oxidant and wound healing agent, was loaded into the fibers as a natural bioactive compound. Curcumin-loaded composite microfibers and blank microfibers were fabricated using biopolymers such as sodium alginate and gelatin. The formulation batches were coded as A1G9-A10G0 according to the varied concentrations of sodium alginate and gelatin. The molecular transitions within the composite microfibers were characterized using FTIR and were further corroborated using molecular mechanics analysis. In mechanical properties tensile strength and elongation-at-break (extensibility) were ranging between 1.08 ± 0.01 to 3.53 ± 0.41 N/mm² and 3.89 ± 0.18 to 0.61 ± 0.03%. The morphological analysis confirmed the formation and fabrication of the microfibers. In addition, physical evaluation including matrix degradation and entrapment efficiency was performed to give a comparative account of various formulations. The water uptake capacity of the blank and curcumin-loaded composite fibers was found to be in the range of 30.77 ± 2.17 to 100.00 ± 5.99 and 22.34 ± 1.11 to 56.34 ± 4.68, respectively. Composite microfibers presented a cumulative release of 85% in 72 h, confirming the prolonged release potential of the composite fibers. The drug release followed an anomalous (non-Fickian) release behavior asserting the role of degradation and diffusion. In an in vivo full-thickness cutaneous wound model, the composite microfibers provided higher degree of contraction 96.89 ± 3.76% as compared to the marketed formulation (Vicco turmeric cream). In conclusion, this all-natural, alginate-gelatin-curcumin composite has the potential to be explored as a cost-effective wound healing platform.

Nanotechnology-Based Medical Devices for the Treatment of Chronic Skin Lesions: From Research to the Clinic

Chronic wounds, such as pressure ulcers, diabetic ulcers, venous ulcers and arterial insufficiency ulcers, are lesions that fail to proceed through the normal healing process within a period of 12 weeks. The treatment of skin chronic wounds still represents a great challenge. Wound medical devices (MDs) range from conventional and advanced dressings, up to skin grafts, but none of these are generally recognized as a gold standard. Based on recent developments, this paper reviews nanotechnology-based medical devices intended as skin substitutes. In particular, nanofibrous scaffolds are promising platforms for wound healing, especially due to their similarity to the extracellular matrix (ECM) and their capability to promote cell adhesion and proliferation, and to restore skin integrity, when grafted into the wound site. Nanotechnology-based scaffolds are emphasized here. The discussion will be focused on the definition of critical quality attributes (chemical and physical characterization, stability, particle size, surface properties, release of nanoparticles from MDs, sterility and apyrogenicity), the preclinical evaluation (biocompatibility testing, alternative in vitro tests for irritation and sensitization, wound healing test and animal wound models), the clinical evaluation and the CE (European Conformity) marking of nanotechnology-based MDs.

Microphysiological systems for the modeling of wound healing and evaluation of pro-healing therapies

Wound healing is a multivariate process involving the coordinated response of numerous proteins and cell types. Accordingly, biomedical research has seen an increased adoption of the use of in vitro wound healing assays with complexity beyond that offered by traditional well-plate constructs. These microphysiological systems (MPS) seek to recapitulate one or more physiological features of the in vivo microenvironment, while retaining the analytical capacity of more reductionist assays. Design efforts to achieve relevant wound healing physiology include the use of dynamic perfusion over static culture, the incorporation of multiple cell types, the arrangement of cells in three dimensions, the addition of biomechanically and biochemically relevant hydrogels, and combinations thereof. This review provides a brief overview of the wound healing process and in vivo assays, and we critically review the current state of MPS and supporting technologies for modelling and studying wound healing. We distinguish between MPS that seek to inform a particular phase of wound healing, and constructs that have the potential to inform multiple phases of wound healing. This distinction is a product of whether analysis of a particular process is prioritized, or a particular physiology is prioritized, during design. Material selection is emphasized throughout, and relevant fabrication techniques discussed.

A topical ointment formulation containing leaves' powder of Lawsonia inermis accelerate excision wound healing in Wistar rats

AIM

Lawsonia inermis (LI), a naturally grown or cultivated shrub in Northeast of Africa and India, has been traditionally used as a strong remedy for several injuries. However, few studies have reported its use as a cicatrizing agent. The aim of this study was to evaluate the effect of daily application of an ointment prepared with LI leaves' powder on wound healing in Wistar rats.

MATERIALS AND METHODS

Twenty female Wistar rats were used in this study. Excisional wound model was realized by removing skin from the dorsal part of the neck of each animal. Wounds have been then treated by a daily application of LI ointment prepared by mixing leaves' powder to petroleum jelly in test group and by simple application of petroleum jelly in control group. Evaluation of wound healing activity was then based on calculating the percentage of wound contraction, period of epithelialization, and wound index every 3 days for a period of 24 days, then, a histological study of the healed excised wound was performed.

RESULTS

Treatment with LI has shown excellent wound healing activity, since it has increased percent of wound contraction, and reduced period of epithelialization and wound index as compared to control (p<0.05). These results have been supported by the histological findings that revealed better epithelialization, dermal differentiation, collagen fiber orientation, and angiogenesis in LI treated rats compared to control (p<0.05).

CONCLUSION

We can conclude that LI leaves' can be used as a potential wound healing agent.

Ethnobotany, ecology, pharmacology, and chemistry of Anredera cordifolia (Basellaceae): a review

Abstract The potential of a plant with medicinal and nutritional properties, Anredera cordifolia, is reviewed. Its common names include “Bertalha” and “folha gorda” and it is popularly used for wound healing and against fungal infections and other types of infection. Its pharmacological properties have been widely investigated and acknowledged, especially with regard to its antibacterial activity, which improves the healing of wounds infected by Staphylococcus aureus, and to its antifungal activity against Candida albicans. It is an unconventional food plant, with leaves and aerial tubers used as food prepared in varied ways. It is also considered an invasive plant in several countries and thus classified as a weed. Its characteristics of a Brazilian native plant, with proven medicinal properties and unconventional use as food, underlie our study on its ecology and botanical classification, as well as the pharmacological assays and screening of chemical constituents.

Spongy wound dressing of pectin/carboxymethyl tamarind seed polysaccharide loaded with moxifloxacin beads for effective wound heal

An attempt was made to formulate moxifloxacin loaded alginate beads incorporated into spongy wound dressing to heal chronic wounds as well as to reduce frequency of painful dressing change. Moxifloxacin loaded beads (sodium alginate:pectin, 1:1) were prepared by ionic gelation method, with entrapment efficiency 94.52%, crushing strength 25.30 N and drug release 90.52%. Beads were further incorporated into wound dressing, made of pectin and carboxymethyl tamarind seed polysaccharide (CMTSP). Spongy wound dressing was obtained by freeze drying technology, which showed good folding endurance, high wound fluid absorption and good crushing strength. Drug release was found to be 85.09%. Dressing made of CMTSP:pectin (1.5:2) showed good water vapour transmission and antibacterial activity. Porous nature of dressing absorbed exudates of wound. Excision wound model in rats revealed wound healing within 17 days: groups I (control), II (moxifloxacin beads loaded wound dressing), III (moxifloxacin beads), IV (pectin film) and V (sodium alginate film) showed 65.28, 99.09, 86.90, 66.84 and 64.30% wound closure, respectively. To conclude, moxifloxacin beads loaded spongy wound dressing has good healing and wound closing potential compared to pectin film and moxifloxacin beads. Thus, the formulation is novel for biomedical application which reduced the frequency of painful dressing change.

Skin wound regeneration with bioactive glass-gold nanoparticles ointment

The bioactive glasses can lead to the promotion of growth of granulation tissue, while the gold nanoparticles (AuNPs) can induce the acceleration of wound healing including tissue regeneration, connective tissue formation, and angiogenesis. The aim of this study was to evaluate the impact of using the bioactive glass (BG) and BG-AuNPs composites on skin wound healing in experimental rat models for 14 days. Sol-gel derived BGs and BG-AuNPs composites mixed with Vaseline at 6, 12 and 18 wt% were used to evaluate the repair response of the skin. During the process of healing, granulomatous reaction was observed in the wound treated with 12 and 18 wt% BG-Vaseline ointments. Furthermore, a strong vascular proliferation and complete wound regeneration were found in 18%BG-AuNPs-Vaseline treated groups. The results derived from the performed investigations revealed that the 18% BG-AuNPs-Vaseline ointment is a promising candidate for wound healing applications.

Effect of collagenase ointment versus moist exposed burn ointment on healing of full-thickness burns in mice by removing of necrotic tissue

The presence of necrotic tissue is one of the major problems that affect healing of burn wounds. The present study was designed to find the effectiveness of collagenase versus moist exposed burn ointment (MEBO) on removal of necrotic tissue of burns. Twenty mice randomly assigned and divided into four groups. For Group 1, burn wounds were treated with collagenase ointment only, Group 2 burn wounds were treated with MEBO, Group 3 burn wounds were treated with white vaseline alone, and Group 4 burn wounds were considered as control and left without treatment. In each group, the time of treatment was considered. The results indicated that the removal time of necrotic tissue and healing process was better in the case of using collagenase than using MEBO for treatment of burns.