Antibiofouling Zwitterionic Gradational Membranes with Moisture Retention Capability and Sustained Antimicrobial Property for Chronic Wound Infection and Skin Regeneration

Designing a Naturally Inspired Conductive Copolymer to Engineer Wearable Bioadhesives for Sensing Applications

The design of adhesive and conductive soft hydrogels using biopolymers with tunable mechanical properties has received significant interest in the field of wearable sensors for detecting human motions. These hydrogels are primarily fabricated through the modification of biopolymers to introduce cross-linking sites, the conjugation of adhesive components, and the incorporation of conductive materials into the hydrogel network. The development of a multifunctional copolymer that integrates adhesive and conductive properties within a single polymer chain with suitable cross-linking sites eliminates the need for biopolymer modification and the addition of extra conductive and adhesive components. In this study, we synthesized a copolymer based on poly([2-(methacryloyloxy)ethyl] trimethylammonium chloride-co-dopamine methacrylamide) (p(METAC-DMA)) using a controlled radical polymerization, allowing for the efficient conjugation of both adhesive and conductive units within a single polymer chain. Subsequently, our multifunctional hydrogel named Gel-MD was fabricated by mixing the p(METAC-DMA) copolymer with non-modified gelatin in which cross-linking took place in an oxidative environment. We confirmed the biocompatibility of the Gel-MD hydrogel through in vitro studies using NIH 3T3 cells as well as in vivo subcutaneous implantation in rats. Furthermore, the Gel-MD hydrogel was effective and sensitive in detecting various human motions, making it a promising wearable sensor for health monitoring and diagnosis.

Silver nanoparticles loaded triple-layered cellulose-acetate based multifunctional dressing for wound healing

Chronic wounds present considerable challenges which delay their effective healing. Currently, there are several biomaterial-based wound dressings available for healing diverse wound types. However, most of commercial wound dressings are too expensive to be affordable to the patients belonging to the middle and lower socioeconomic strata of the society. Thus, in this investigation affordable triple layered nanofibrous bandages were fabricated using the layer-by-layer approach. Here, the topmost layer comprised of a hydrophilic poly vinyl alcohol layer, cross-linked with citric acid. The middle layer comprising of cellulose acetate was loaded with silver nanoparticles as an antibacterial agent, while the lowermost layer was fabricated using hydrophobic polycaprolactone. The triple-layered nanofibrous bandages having a nano-topography, exhibited a smooth, uniform and bead-free morphology, with the nanofiber diameter ranging between 200 and 300 nm. The nanofibers demonstrated excellent wettability, slow in vitro degradation, controlled release of nano‑silver and potent antibacterial activity against Gram-negative (E.coli) and Gram-positive (S. aureus) bacteria. The fabricated bandages had excellent mechanical strength upto 12.72 ± 0.790 M. Pa, which was suitable for biomedical and tissue engineering applications. The bandage demonstrated excellent in vitro hemocompatibility and biocompatibility. In vivo excisional wound contraction, along with H and E and Masson's Trichrome staining further confirmed the potential of the nanofibrous bandage for full-thickness wound healing. Pre-clinical investigations thus indicated the possibility of further evaluating the triple-layered nanofibrous dressing in clinical settings.

Preparation and characterization of a polyurethane-based sponge wound dressing with a superhydrophobic layer and an antimicrobial adherent hydrogel layer

Bacterial infection poses a significant impediment in wound healing, necessitating the development of dressings with intrinsic antimicrobial properties. In this study, a multilayered wound dressing (STPU@MTAI2/AM1) was reported, comprising a surface-superhydrophobic treated polyurethane (STPU) sponge scaffold coupled with an antimicrobial hydrogel. A superhydrophobic protective outer layer was established on the hydrophilic PU sponge through the application of fluorinated zinc oxide nanoparticles (F-ZnO NPs), thereby resistance to environmental contamination and bacterial invasion. The adhesive and antimicrobial inner layer was an attached hydrogel (MTAI2/AM1) synthesized through the copolymerization of N-[2-(methacryloyloxy)ethyl]-N, N, N-trimethylammonium iodide and acrylamide, exhibits potent adherence to dermal surfaces and broad-spectrum antimicrobial actions against resilient bacterial strains and biofilm formation. STPU@MTAI2/AM1 maintained breathability and flexibility, ensuring comfort and conformity to the wound site. Biocompatibility of the multilayered dressing was demonstrated through hemocompatibility and cytocompatibility studies. The multilayered wound dressing has demonstrated the ability to promote wound healing when addressing MRSA-infected wounds. The hydrogel layer demonstrates no secondary damage when peeled off compared to commercial polyurethane sponge dressing. The STPU@MTAI2/AM1-treated wounds were nearly completely healed by day 14, with an average wound area of 12.2 ± 4.3 %, significantly lower than other groups. Furthermore, the expression of CD31 was significantly higher in the STPU@MTAI2/AM1 group compared to other groups, promoting angiogenesis in the wound and thereby contributing to wound healing. Therefore, the prepared multilayered wound dressing presents a promising therapeutic candidate for the management of infected wounds. STATEMENT OF SIGNIFICANCE: Healing of chronic wounds requires avoidance of biofouling and bacterial infection. However developing a wound dressing which is both anti-biofouling and antimicrobial is a challenge. A multilayered wound dressing with multifunction was developed. Its outer layer was designed to be superhydrophobic and thus anti-biofouling, and its inner layer was broad-spectrum antimicrobial and could inhibit biofilm formation. The multilayered wound dressing with adhesive property could easily be removed from the wound surface preventing the cause of secondary damage. The multilayered wound dressing has demonstrated good abilities to promote MRSA-infected wound healing and presents a viable treatment for MRSA-infected wound.

Antimicrobial and Antiviral Nanofibers Halt Co-Infection Spread via Nuclease-Mimicry and Photocatalysis

The escalating spread of drug-resistant bacteria and viruses is a grave concern for global health. Nucleic acids dominate the drug-resistance and transmission of pathogenic microbes. Here, imidazolium-type poly(ionic liquid)/porphyrin (PIL-P) based electrospun nanofibrous membrane and its cerium (IV) ion complex (PIL-P-Ce) are developed. The obtained PIL-P-Ce membrane exhibits high and stable efficiency in eradicating various microorganisms (bacteria, fungi, and viruses) and decomposing microbial antibiotic resistance genes and viral nucleic acids under light. The nuclease-mimetic and photocatalytic mechanisms of the PIL-P-Ce are elucidated. Co-infection wound models in mice with methicillin-resistant S. aureus and hepatitis B virus demonstrate that PIL-P-Ce integrate the triple effects of cationic polymer, photocatalysis, and nuclease-mimetic activities. As revealed by proteomic analysis, PIL-P-Ce shows minimal phototoxicity to normal tissues. Hence, PIL-P-Ce has potential as a "green" wound dressing to curb the spread of drug-resistant bacteria and viruses in clinical settings.

Thermoresponsive in situ forming and self-healing double-network hydrogels as injectable dressings for silymarin/levofloxacin delivery for treatment of third-degree burn wounds

Our study aimed to introduce a novel double-cross-linked and thermoresponsive hydrogel with remarkable potential for accelerating third-degree burn wound healing. Burn injuries are recognized as challenging, critical wounds. Especially in third-degree burns, treatment is demanding due to extended wounds, irregular shapes, significant exudation, and intense pain during dressing changes. In this work, hydrogels made of zwitterionic chitosan and dialdehyde starch (ZCS and ZDAS) were created to deliver silymarine (SM) and levofloxacin (LEV). The hydrogels were effortlessly produced using dynamic Schiff base linkages and ionic interactions between ZCS and ZDAS at appropriate times. The pore uniformity, gel fraction, and commendable swelling properties can imply a suitable degree of Schiff base cross-link. The hydrogel demonstrated outstanding shape retention, and significant self-healing and flexibility abilities, enabling it to uphold its form even during bodily movements. After injecting biocompatible hydrogel on the wound, a notable acceleration in wound closure was observed on day 21 (98.1 ± 1.10 %) compared to the control group (75.1 ± 6.13 %), and histopathological analysis revealed a reduction of inflammation that can be linked to remarkable antioxidant and antibiotic properties. The results demonstrate the hydrogel's efficacy in promoting burn wound healing, making it a promising candidate for medical applications.

Multifunctional Nanoclay-Based Hemostatic Materials for Wound Healing: A Review

Bleeding to death accounts for around 30-40% of all trauma-related fatalities. Current hemostatic materials are mainly mono-functional or have insufficient hemostatic capacity. Nanoclay has been recently shown to accelerate hemostasis, improve wound healing, and provide the resulting multifunctional hemostatic materials antibacterial, anti-inflammatory, and healing-promoting due to its distinctive morphological structure and physicochemical properties. Herein, the chemical design and action mechanism of nanoclay-based hemostatic, antibacterial, and pro-wound healing materials in the context of wound healing are discussed. The physiological processes of hemostasis and wound healing to elucidate the significance of nanoclay for functional wound hemostatic dressing design are outlined. A summary of the features of various nanoclay and product types used in wound hemostatic dressings is provided. Nanoclay can be antimicrobial due to the slow release of metal ions and has an abundant surface charge allowing for high affinity for proteins and cells, which can activate the coagulation reaction or facilitate tissue repair. Nanoclay with a microporous structure can be used as drug carriers to create composites critical for inhibiting bacterial growth on wounds or promoting the regeneration of vascular, muscle, and skin tissues. Directions for further research and innovation of nanoclay-based multifunctional materials for hemostasis and tissue regeneration are explored.

Recent advances in the application of clay-containing hydrogels for hemostasis and wound healing

INTRODUCTION

Immediate control of bleeding and anti-infection play important roles in wound management. Multiple organ dysfunction syndrome and death may occur if persistent bleeding, hemodynamic instability, and hypoxemia are not addressed. The combination of clay and hydrogel provides a new outlet for wound hemostasis. In this review, the current research progress of hydrogel/clay composite hemostatic agents was reviewed.

AREAS COVERED

This paper summarizes the characteristics of several kinds of clay including kaolinite, montmorillonite, laponite, sepiolite, and palygorskite. The advantages and disadvantages of its application in hemostasis were also summarized. Future directions for the application of hydrogel/clay composite hemostatic agents are presented.

EXPERT OPINION

Clay can activate the endogenous hemostatic pathway by increasing blood cell concentration and promoting plasma absorption to accelerate the hemostasis. Clay is antimicrobial due to the slow release of metal ions and has a rich surface charge with a high affinity for proteins and cells to promote tissue repair. Hydrogels have some properties such as good biocompatibility, strong adhesion, high stretchability, and good self-healing. Despite promising advances, hydrogel/clay composite hemostasis remains a limitation. Therefore, more evidence is needed to further elucidate the risk factors and therapeutic effects of hydrogel/clay in hemostasis and wound healing.

Advanced function, design and application of skin substitutes for skin regeneration

The development of skin substitutes aims to replace, mimic, or improve the functions of human skin, regenerate damaged skin tissue, and replace or enhance skin function. This includes artificial skin, scaffolds or devices designed for treatment, imitation, or improvement of skin function in wounds and injuries. Therefore, tremendous efforts have been made to develop functional skin substitutes. However, there is still few reports systematically discuss the relationship between the advanced function and design requirements. In this paper, we review the classification, functions, and design requirements of artificial skin or skin substitutes. Different manufacturing strategies for skin substitutes such as hydrogels, 3D/4D printing, electrospinning, microfluidics are summarized. This review also introduces currently available skin substitutes in clinical trials and on the market and the related regulatory requirements. Finally, the prospects and challenges of skin substitutes in the field of tissue engineering are discussed.

An antibacterial nanoclay- and chitosan-based quad composite with controlled drug release for infected skin wound healing

Microbial infections of surgical sites and other wounds represent a major impediment for patients. Multifunctional low-cost dressings promoting tissue reparation while preventing infections are of great interest to medical professionals. Here, clay-based laponite nanodiscs (LAP) were loaded with the antibacterial drug kanamycin (KANA) before being embedded into a poly(lactic-co-glycolic acid) (PLGA) membrane and coated with the biopolymer chitosan (CS). Results indicated that these biocompatible materials combined the excellent capacity of LAP for controlled drug release with the mechanical robustness of PLGA and the antibacterial properties of CS as well as its hydrophilicity to form a composite highly suitable as an infection-preventing wound dressing. In vitro, PLGA/LAP/KANA/CS released drugs in a sustainable manner over 30 d, completely inhibited the growth of infectious bacteria, prompted the adhesion fibroblasts, and accelerated their proliferation 1.3 times. In vivo, the composite enabled the fast healing of infected full-thickness skin wounds with a 96.19 % contraction after 14 d. During the healing process, PLGA/LAP/KANA/CS stimulated re-epithelization, reduced inflammation, and promoted both angiogenesis and the formation of dense collagen fibers with an excellent final collagen volume ratio of 89.27 %. Thus, multifunctional PLGA/LAP/KANA/CS made of low-cost components demonstrated its potential for the treatment of infected skin wounds.

Phase Change Material-Embedded Multifunctional Janus Nanofiber Dressing with Directional Moisture Transport, Controlled Release of Anti-Inflammatory Drugs, and Synergistic Antibacterial Properties

Wound healing is a systematic and complex process that involves various intrinsic and extrinsic factors affecting different stages of wound repair. Therefore, multifunctional wound dressings that can modulate these factors to promote wound healing are in high demand. In this work, a multifunctional Janus electrospinning nanofiber dressing with antibacterial and anti-inflammatory properties, controlled release of drugs, and unidirectional water transport was prepared by depositing coaxial nanofibers on a hydrophilic poly(ε-caprolactone)@polydopamine-ε-polyl-lysine (PCL@PDA-ε-PL) nanofiber membrane. The coaxial nanofiber was loaded with the phase change material lauric acid (LA) in the shell layer and anti-inflammatory ibuprofen (IBU) in the core layer. Among them, LA with a melting point of 43 °C served as a phase change material to control the release of IBU. The phase transition of LA was induced by near-infrared (NIR) irradiation that triggered the photothermal properties of PDA. Moreover, the Janus nanofiber dressing exhibited synergistic antimicrobial properties for Escherichia coli and Staphylococcus aureus due to the photothermal properties of PDA and antibacterial ε-PL. The prepared Janus nanofiber dressing also exhibited anti-inflammatory activity and biocompatibility. In addition, the Janus nanofiber dressing had asymmetric wettability that enabled directional water transport, thereby draining excessive wound exudate. The water vapor transmission test indicated that the Janus nanofiber dressing had good air permeability. Finally, skin wound healing evaluation in rats confirmed its efficacy in promoting wound healing. Therefore, this strategy of designing and manufacturing a multifunctional Janus nanofiber dressing had great potential in wound healing applications.

TiB2-Derived Nanosheets Enhance the Tensile Strength and Controlled Drug Release of Biopolymeric Films Used in Wound Healing

Wound healing using an alginate-based biopolymeric film is one of the most preferred treatments. However, these films lack mechanical strength (elasticity and tensile strength), show higher initial burst release, and exhibit high vapor permeability. The present study reports the development of nanosheets derived from titanium diboride (10 nm) (NTB)-incorporated biopolymeric films (0.025, 0.05, and 0.1% w/v) using sodium alginate (SA) and carboxymethyl cellulose (CMC) to overcome the shortfalls. The surface properties of the film, nanosheet distribution within the film, and possible interactions with the film are explored by using scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), Fourier transform infrared (FTIR), and X-ray diffraction (XRD). These analyses confirm that nanosheets are uniformly distributed in the film and introduce unevenness on the film's surface. The tensile strength of the nanosheet-incorporated film (0.1% NTB film) using UTM is found to be 24.30 MPa (six times higher compared to the blank film), equivalent to human skin. The water vapor transmission rate of the film is also found to be in the desired range (i.e., 2000-2500 g/m2 day). The biocompatibility of the NTB film is confirmed by the MTT assay test using NIH/3T3 cells and HEK 293 cells. Furthermore, the scratch assay shows that the developed films promote cell migration and proliferation. The antibacterial activity of the film is also demonstrated using a model drug, tetracycline hydrochloride (TCl). Besides, the film exhibits the sustained release of TCl and follows the Korsmeyer-Peppas model for drug release. Overall, the 0.1% w/v NTB film is easy to fabricate, biocompatible and shows superior mechanical properties.

Biodegradable Polymers and Polymer Composites with Antibacterial Properties

Antibiotic resistance is one of the greatest threats to global health and food security today. It becomes increasingly difficult to treat infectious disorders because antibiotics, even the newest ones, are becoming less and less effective. One of the ways taken in the Global Plan of Action announced at the World Health Assembly in May 2015 is to ensure the prevention and treatment of infectious diseases. In order to do so, attempts are made to develop new antimicrobial therapeutics, including biomaterials with antibacterial activity, such as polycationic polymers, polypeptides, and polymeric systems, to provide non-antibiotic therapeutic agents, such as selected biologically active nanoparticles and chemical compounds. Another key issue is preventing food from contamination by developing antibacterial packaging materials, particularly based on degradable polymers and biocomposites. This review, in a cross-sectional way, describes the most significant research activities conducted in recent years in the field of the development of polymeric materials and polymer composites with antibacterial properties. We particularly focus on natural polymers, i.e., polysaccharides and polypeptides, which present a mechanism for combating many highly pathogenic microorganisms. We also attempt to use this knowledge to obtain synthetic polymers with similar antibacterial activity.

One-Pot Synthesis of Bioadhesive Double-Network Hydrogel Patch as Disposable Wound Dressing

Inventions of materials to achieve biocompatibility, bioadhesion, and easy manufacturing are the urgent demand for promoting wound healing in clinical treatment. Hyaluronic acid (HA) is probably the ideal candidate for current dressing materials due to its well-known biocompatibility. However, the unavoidable problem for HA dressings is their inherent low adhesiveness to wounds, which severely impairs their treatment efficacy, especially during body movement. Here, we report a one-pot facile fabrication of hybrid double-network polydopamine-HA (PDA-HA) hydrogel with significantly enhanced adhesiveness compared to the HA hydrogel. Besides the easy manufacturing and promoted effectiveness, the PDA-HA hydrogel could be vacuum-dried to form a patch, further benefitting from the convenience for storage and distribution. When applied on the wound, the PDA-HA patch quickly rehydrated by absorbing exudate and stuck tightly to the wound. The applied PDA-HA patches keep the wounds covered for more than 7 days against strenuous exercise. Thus, mouse full-thickness wounds treated with the PDA-HA patches exhibited increased healing rates, where epithelization was finished within 14 days. Moreover, the hydrogel dressing exhibited promoting effects on vascularization and cell proliferation/migration. Together with the easy manufacturing procedure, good adhesion/adaptation, and promotion of wound healing, the PDA-HA patch holds great potential for future clinical translation.

Mechanisms of magnesium oxide-incorporated electrospun membrane modulating inflammation and accelerating wound healing

Previously, we demonstrated that magnesium oxide (MgO)-incorporated electrospun membranes show powerful antibacterial activity and promote wound healing, but the underlying mechanisms have not been entirely understood. Herein, we investigated the relationship between structure and function of MgO-incorporated membranes and interrogated critical bioactive cues that contribute to accelerated wound healing and functional restoration. Our results show that MgO-incorporated membranes exhibit good flexibility and improved water vapor transmission rates (WVTRs) and sustained Mg²⁺ release in a simulated model of wounds. MgO-incorporated membranes modulate macrophage phenotype to downregulate inflammatory response, contributing to alleviated inflammation and creating a favorable microenvironment for wound healing. Specifically, MgO-incorporated membranes stimulate macrophages to shift to a pro-healing M2 phenotype and upregulate pro-healing cytokine of transforming growth factor-beta 1 (TGF-β1) and downregulate pro-inflammatory cytokines under lipopolysaccharide (LPS) challenge conditions. Together with increased TGF-β1 by macrophages, MgO-incorporated membranes significantly boost the proliferation of fibroblasts and upregulate collagen production, thus driving granulation tissue formation and wound closure. MgO-incorporated membranes promote angiogenesis by promoting tube formation and upregulating vascular endothelial growth factor (VEGF) production of endothelial cells. Rapid epithelialization of regenerated skin tissue is attributed to the balanced phenotype of keratinocytes between proliferative and terminally differentiated populations. In addition to coordinating keratinocyte phenotype, MgO-incorporated membranes reduce the expression of inflammatory cytokine interleukin 1-alpha (IL-1α) therefore promoting hair follicle regeneration. These data provide mechanisms of MgO-incorporated membranes that inhibit bacterial infection, alleviate inflammation, facilitate extracellular matrix production and epithelialization, and potentiate hair follicle regeneration.

Amphiphilic sodium alginate-polylysine hydrogel with high antibacterial efficiency in a wide pH range

Bacterial infection is a major pathological factor leading to persistent wounds. With the aging of population, wound infection has gradually become a global health-issue. The wound site environment is complicated, and the pH changes dynamically during healing. Therefore, there is an urgent need for new antibacterial materials that can adapt to a wide pH range. To achieve this goal, we developed a thymol-oligomeric tannic acid/amphiphilic sodium alginate-polylysine hydrogel film, which exhibited excellent antibacterial efficacy in the pH range from 4 to 9, achieving the highest achievable 99.993 % (4.2 log units) and 99.62 % (2.4 log units) against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli, respectively. The hydrogel films exhibited excellent cytocompatibility, suggesting that the materials are promising as a novel wound healing material without the concern of biosafety.

Membranes for the life sciences and their future roles in medicine

Since the global outbreak of COVID-19, membrane technology for clinical treatments, including extracorporeal membrane oxygenation (ECMO) and protective masks and clothing, has attracted intense research attention for its irreplaceable abilities. Membrane research and applications are now playing an increasingly important role in various fields of life science. In addition to intrinsic properties such as size sieving, dissolution and diffusion, membranes are often endowed with additional functions as cell scaffolds, catalysts or sensors to satisfy the specific requirements of different clinical applications. In this review, we will introduce and discuss state-of-the-art membranes and their respective functions in four typical areas of life science: artificial organs, tissue engineering, in vitro blood diagnosis and medical support. Emphasis will be given to the description of certain specific functions required of membranes in each field to provide guidance for the selection and fabrication of the membrane material. The advantages and disadvantages of these membranes have been compared to indicate further development directions for different clinical applications. Finally, we propose challenges and outlooks for future development.

Design and Fabrication of a Dual Protein-Based Trilayered Nanofibrous Scaffold for Efficient Wound Healing

Chronic wound healing is a major threat all over the world. There are currently a plethora of biomaterials-based wound dressings available for wound healing applications. In this study, a dual protein-based (silk fibroin and sericin) nanofibrous scaffold from a natural source (B.mori silkworm cocoons) with antibacterial and antioxidative properties for wound healing was investigated. An electrospun layer-by-layer silk protein-based nanofibrous scaffold was fabricated with a top layer of hydrophobic silk fibroin protein blended with polyvinyl alcohol (PVA), a middle layer of waste protein silk sericin loaded with silver(I) sulfadiazine as an antibacterial agent, and a bottom layer using silk fibroin blended with polycaprolactone (PCL). The trilayered nanofibrous scaffold with a smooth and bead-free morphology demonstrated excellent wettability, slow in vitro degradation, controlled drug release, and potent antibacterial and antioxidant properties. In vitro, the scaffold also demonstrated excellent hemocompatibility and biocompatibility. Furthermore, in vivo wound contraction, histological, and micro-CT investigations show complete wound healing and the formation of new skin tissue in a male Balb/c mouse model treated with the scaffold. The antioxidant properties of the sericin protein and SSD-based triple-layered nanofibrous scaffold protect the wound from bacterial infection and improve wound healing in a mouse model. The current study develops a dual protein-based nanofibrous scaffold with antibacterial and antioxidant properties as a promising wound dressing material.

Slippery 3-dimensional porous bioabsorbable membranes with anti-adhesion and bactericidal properties as substitute for vaseline gauze

Vaseline gauze is a common type of wound dressing that consist of absorbent gauze impregnated with white petrolatum. It has excellent anti-adhesive property which can reduce trauma during dressing changes. However, this kind of wound dressing doesn't have bacterial killing property. Thus, a new kind of wound dressing that has anti-adhesive and bactericidal properties is needed urgently. Creating slippery liquid-impregnated porous surfaces (SLIPS) that insensitive to the structure of porous solid are generally viewed as a new anti-adhesion strategy. To expand the potential utility of SLIPS as substitute for vaseline gauze, dual-functional slippery membranes with anti-adhesion and bactericidal properties by using triclosan, vegetable oils and polylactic acid (PLA) were prepared. It's demonstrated that the triclosan-loaded/vegetable oils-infused PLA membranes (T/V-PM) has good cytocompatibility in vitro. Notably, the T/V-PM can gradually release biocide molecule into surrounding aqueous media. Moreover, the T/V-PM can kill planktonic bacterial cells without loss of their antifouling property. The in vivo study revealed that the T/V-PM can prevent the secondary injuries during wound dressing changes. This simple and low-cost strategy can be applied to inhibit blood and bacterial adhesion, and prevent tissue adhesion at the wound site. It's confirmed that the T/V-PM have great potential as substitute for vaseline gauze.

Antibacterial biomaterials for skin wound dressing

Bacterial infection and the ever-increasing bacterial resistance have imposed severe threat to human health. And bacterial contamination could significantly menace the wound healing process. Considering the sophisticated wound healing process, novel strategies for skin tissue engineering are focused on the integration of bioactive ingredients, antibacterial agents included, into biomaterials with different morphologies to improve cell behaviors and promote wound healing. However, a comprehensive review on anti-bacterial wound dressing to enhance wound healing has not been reported. In this review, various antibacterial biomaterials as wound dressings will be discussed. Different kinds of antibacterial agents, including antibiotics, nanoparticles (metal and metallic oxides, light-induced antibacterial agents), cationic organic agents, and others, and their recent advances are summarized. Biomaterial selection and fabrication of biomaterials with different structures and forms, including films, hydrogel, electrospun nanofibers, sponge, foam and three-dimension (3D) printed scaffold for skin regeneration, are elaborated discussed. Current challenges and the future perspectives are presented in this multidisciplinary field. We envision that this review will provide a general insight to the elegant design and further refinement of wound dressing.

Synthesis of poly-tetrahydropyrimidine antibacterial polymers and research of their basic properties

Modern medicine has increasingly higher requirements for antibacterial materials. In order to overcome this challenge, we use alkynyl monomers, amino monomers, formaldehyde, and acetic acid as raw materials to synthesize...

Challenges and solutions in polymer drug delivery for bacterial biofilm treatment: A tissue-by-tissue account

To tackle the emerging antibiotic resistance crisis, novel antimicrobial approaches are urgently needed. Bacterial communities (biofilms) are a particular concern in this context. Biofilms are responsible for most human infections and are inherently less susceptible to antibiotic treatments. Biofilms have been linked with several challenging chronic diseases, including implant-associated osteomyelitis and chronic wounds. The specific local environments present in the infected tissues further contribute to the rise in antibiotic resistance by limiting the efficacy of systemic antibiotic therapies and reducing drug concentrations at the infection site, which can lead to reoccurring infections. To overcome the shortcomings of systemic drug delivery, encapsulation within polymeric carriers has been shown to enhance antimicrobial efficacy, permeation and retention at the infection site. In this Review, we present an overview of current strategies for antimicrobial encapsulation within polymeric carriers, comparing challenges and solutions on a tissue-by-tissue basis. We compare challenges and proposed drug delivery solutions from the perspective of the local environments for biofilms found in oral, wound, gastric, urinary tract, bone, pulmonary, vaginal, ocular and middle/inner ear tissues. We will also discuss future challenges and barriers to clinical translation for these therapeutics. The following Review demonstrates there is a significant imbalance between the research focus being placed on different tissue types, with some targets (oral and wound biofims) being extensively more studied than others (vaginal and otitis media biofilms and endocarditis). Furthermore, the importance of the local tissue environment when selecting target therapies is demonstrated, with some materials being optimal choices for certain sites of bacterial infection, while having limited applicability in others.

Fluorescent carbon dots with excellent moisture retention capability for moisturizing lipstick

Long-lasting moisture retention is a huge challenge to humectants, and effective methods or additives for promote these functions are limited, especially nano-additives. Carbon dots (CDs) have attracted increasing research interest due to its ultra-small size, excellent optical properties and low toxicity, etc. However, most of researches have been focused on the photoexcited CDs and its subsequent photophysical and chemical processes, such as photoluminescence, photodynamic, photothermal and photocatalytic behavior. The intrinsic chemo-physical properties of the pristine CDs are not fully explored. Here, we report an excellent moisture retention capability of a new carmine cochineal-derived CDs (Car-CDs) for the first time. The relationship between the structure of Car-CDs and its moisture retention capability is revealed. More interestingly, the effective applications of Car-CDs in moisturizing lipstick are demonstrated. This work expands the research and application of CDs into a broad, new area, potentially in skin care.

Eradication of Mature Bacterial Biofilms with Concurrent Improvement in Chronic Wound Healing Using Silver Nanoparticle Hydrogel Treatment

Biofilm-associated infections are a major cause of impaired wound healing. Despite the broad spectrum of anti-bacterial benefits provided by silver nanoparticles (AgNPs), these materials still cause controversy due to cytotoxicity and a lack of efficacy against mature biofilms. Herein, highly potent ultrasmall AgNPs were combined with a biocompatible hydrogel with integrated synergistic functionalities to facilitate elimination of clinically relevant mature biofilms in-vivo combined with improved wound healing capacity. The delivery platform showed a superior release mechanism, reflected by high biocompatibility, hemocompatibility, and extended antibacterial efficacy. In vivo studies using the S. aureus wound biofilm model showed that the AgNP hydrogel (200 µg/g) was highly effective in eliminating biofilm infection and promoting wound repair compared to the controls, including silver sulfadiazine (Ag SD). Treatment of infected wounds with the AgNP hydrogel resulted in faster wound closure (46% closure compared to 20% for Ag SD) and accelerated wound re-epithelization (60% for AgNP), as well as improved early collagen deposition. The AgNP hydrogel did not show any toxicity to tissue and/or organs. These findings suggest that the developed AgNP hydrogel has the potential to be a safe wound treatment capable of eliminating infection and providing a safe yet effective strategy for the treatment of infected wounds.

Fabrication of Bacterial Cellulose-Based Dressings for Promoting Infected Wound Healing

Bacterial cellulose (BC) holds several unique properties such as high water retention capability, flexibility, biocompatibility, and high absorption capacity. All these features make it a potential material for wound healing applications. However, it lacks antibacterial properties, which hampers its applications for infectious wound healings. This study reported BC-based dressings containing ε-polylysine (ε-PL), cross-linked by a biocompatible and mussel-inspired polydopamine (PDA) for promoting infectious wound healing. BC membranes were coated with PDA by a simple self-polymerization process, followed by treating with different contents of ε-PL. The resulted membranes showed strong antibacterial properties against tested bacteria by both in vitro and in vivo evaluations. The membranes also exhibited hemocompatibility and cytocompatibility by in vitro investigations. Moreover, the functionalized membranes promoted infected wound healing using Sprague-Dawley rats as a model animal. A complete wound healing was observed in the group treated with functionalized membranes, while wounds were still open for control and pure BC groups in the same duration. Histological investigations indicated that the thickness of newborn skin was greater and smoother in the groups treated with modified membranes in comparison to neat BC or control groups. These results revealed that the functionalized membranes have great potential as a dressing material for infected wounds in future clinical applications.

Application of Electrospinning in Antibacterial Field

In recent years, electrospun nanofibers have attracted extensive attention due to their large specific surface area, high porosity, and controllable shape. Among the many applications of electrospinning, electrospun nanofibers used in fields such as tissue engineering, food packaging, and air purification often require some antibacterial properties. This paper expounds the development potential of electrospinning in the antibacterial field from four aspects: fiber morphology, antibacterial materials, antibacterial mechanism, and application fields. The effects of fiber morphology and antibacterial materials on the antibacterial activity and characteristics are first presented, then followed by a discussion of the antibacterial mechanisms and influencing factors of these materials. Typical application examples of antibacterial nanofibers are presented, which show the good prospects of electrospinning in the antibacterial field.

Innovations in drug delivery for chronic wound healing

Wound healing is a varied and complex process designed to promptly restore standard skin structure, function, and appearance. To achieve this goal, different immune and biological systems participate in coordination through four separate steps, including homeostasis, inflammation, proliferation, and regeneration. Each step involves the function of other cells, cytokines, and growth factors. However, chronic ulcers, which are classified into three types of ulcers, namely vascular ulcers, diabetic ulcers, and pressure ulcers, cannot heal through the mentioned natural stages. It causes mental and physical problems for these people and, as a result, imposes high economic and social costs on society. In this regard, using a system that can accelerate the healing process of such chronic wounds, as an urgent need in the community, should be considered. Therefore, in this study, the innovations of drug delivery systems for the healing of chronic wounds using hydrogels, nanomaterial, and membranes are discussed and reviewed.

Curcumin-loaded sandwich-like nanofibrous membrane prepared by electrospinning technology as wound dressing for accelerate wound healing

Wound healing is a complicated process constituted of four successive physiological stages involving wound bleeding, inflammatory response, cell proliferation and tissue remodeling. During this period, bacteria can easily infect the wound. Therefore, we prepared a novel curcumin-loaded sandwich-like nanofibrous membrane (CSNM) using sequential electrospinning for the hemostasis, antibacterial and accelerate wound healing. The morphology of the nanofibrous membrane was analyzed by SEM. In addition, the water absorption capacity, water vapor transmission rate, water contact-angle, and in vitro drug release were all tested. Then in vitro and in vivo hemostatic experiments demonstrated that CSNM has a good hemostatic effect. Antioxidant effect was assessed by the DPPH radical scavenging method and CSNM presented a high antioxidant activity. Additionally, CSNM demonstrated excellent antibacterial activity by the disk diffusion method. Furthermore, the rat dorsal skin defects model revealed that the CSNM distinctly induced the granulation tissue grew, collagen deposition and epithelial tissue remodeling. Meanwhile, the results of the immunohistochemical staining showed that the CSNM can facilitate the expression of CD31 and TGF-β in the early stage of the wound, thereby accelerating wound healing. In general, this study proved that the multifunctional CSNM has great potential as wound dressing in wound healing.

Magnesium oxide-incorporated electrospun membranes inhibit bacterial infections and promote the healing process of infected wounds

Bacterial infections cause severe secondary damage to wounds and hinder wound healing processes. We prepared magnesium oxide (MgO) nanoparticle-incorporated nanofibrous membranes by electrospinning and investigated their potential for wound dressing and fighting bacterial infection. MgO-Incorporated membranes possessed good elasticity and flexibility similar to native skin tissue and were hydrophilic, ensuring comfortable contact with wound beds. The cytocompatibility of membranes was dependent on the amounts of incorporated MgO nanoparticles: lower amounts promoted while higher amounts suppressed the proliferation of fibroblasts, endothelial cells, and macrophages. The antibacterial capacity of membranes was proportional to the amounts of incorporated MgO nanoparticles and they inhibited more than 98% E. coli, 90% S. aureus, and 94% S. epidermidis. MgO nanoparticle-incorporated membranes effectively suppressed bacterial infection and significantly promoted the healing processes of infected full-thickness wounds in a rat model. Subcutaneous implantation demonstrated that the incorporation of MgO nanoparticles into electrospun membranes elevated their bioactivity as evidenced by considerable cell infiltration into their dense nanofiber configuration and enhanced the remodeling of implanted membranes. This study highlights the potential of MgO-incorporated electrospun membranes in preventing bacterial infections of wounds.

Antifouling Antioxidant Zwitterionic Dextran Hydrogels as Wound Dressing Materials with Excellent Healing Activities

Hydrogels as wound dressings have received great attention in recent years. It is highly important yet challenging to develop hydrogel dressings that are biocompatible and that can promote wound healing by lowering the risk of inflammatory responses. In this work, we designed and prepared zwitterionic dextran-based hydrogels using carboxybetaine dextran (CB-Dex) and sulfobetaine dextran (SB-Dex) as raw materials, respectively. The efficacy of CB-Dex and SB-Dex hydrogels in promoting wound recovery was evaluated using a mouse skin wound model. Results suggested that the zwitterionic dextran wound dressings showed a faster healing rate than natural dextran hydrogel and a commercial wound dressing (Duoderm film) due to their excellent protein resistance and capacity to scavenge free hydroxyl radicals. In addition, both CB-Dex and SB-Dex hydrogel wound dressings showed excellent cytocompatibility with NIH3T3 and L929 cells, as well as antibacterial adhesion against Staphylococcus aureus and Escherichia coli. Furthermore, both zwitterionic hydrogels demonstrated self-healing properties and can be stretched to adapt to irregular full-thickness wound beds. More importantly, they can be removed from the wound site painlessly by washing with normal saline. Overall, this work provided a new pathway to fabricate multifunctional polysaccharide hydrogels for wound treatment and pain relief when changing wound dressings.

Zwitterionized Nanofibrous Poly(vinylidene fluoride) Membranes for Improving the Healing of Diabetic Wounds

This work presents nanofibrous membranes made of poly(vinylidene fluoride) (PVDF) and poly(2-methacryloyloxyethyl phosphorylcholine-co-methacryloyloxyethyl butylurethane) (PMBU) for promoting the healing of acute and chronic wounds. Membranes were prepared by an electrospinning process, which led to matrixes with a pore size mimicking the extracellular matrix. PMBU greatly improves the hydration of membranes, resulting in very low biofouling by protein or bacteria and enhanced blood compatibility while the cell viability remains close to 100%. This set of properties exhibited by the suitable combination of physical structure and material composition led to applying the zwitterionic nanofibrous membranes as wound-dressing materials for acute and chronic wounds. The results demonstrated that the zwitterionic membrane could compete with commercial dressings in terms of wound-healing kinetics and could outperform them with regard to the quality of new tissue. Histological analyses suggested that inflammation was reduced while proliferative and maturation phases were accelerated, leading to homogeneous re-epithelialization. This study unveils another potential biomedical application of antifouling zwitterionic membranes.

Multifunction gelatin/chitosan composite microspheres with ROS-scavenging and antibacterial activities for improving the microenvironment of chronic wounds

Multifunction gelatin/chitosan composite microspheres with ROS-scavenging and antibacterial activities for chronic wound healing.

Multifunctional Synthetic Amphiphile for Niche Therapeutic Applications: Mitigation of MRSA Biofilms and Potential in Wound Healing

The relentless menace of implant- and skin wound-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA) biofilms demands the design of therapeutics that have an edge over conventional antibiotics. The present study reports the potential of pluri-active amphiphiles having a 12-carbon alkyl chain and a salicaldehyde head group (C1) or a napthaldehyde head group (C2) in mitigating wound site- and implant-associated MRSA biofilms and as a topical wound healing agent. The amphiphiles impeded S. aureus MRSA 100 biofilm formation on collagen both on extraneous addition and on impregnation into collagen and inflicted damage to MRSA cells embedded in collagen matrix infused with simulated wound fluid, with C1 being more potent than C2. Adhesion of the MRSA biofilm was hampered on C1-coated orthopedic stainless-steel wire, while eluates from C1-coated wires were non-toxic to HEK 293 cells, highlighting the prospect of C1 as an implant-associated antibacterial coating. Upon treatment with C1, expression of the adhesin fnbA gene was low in the MRSA biofilm and downregulated in non-adherent MRSA cells, while δ-toxin (hld) gene expression in the MRSA biofilm increased, implying that C1 hindered cell-cell adhesion and planktonic-biofilm transition and also reduced biofilm adhesion. Oral administration of C1 (300 and 1000 mg/kg) was non-toxic to BALB/c mice as evidenced in stable hematological parameters and normal histopathological features of vital organs. Topical application of C1 (50 and 100 mg/kg) on a skin excision wound in female BALB/c mice resulted in effective wound closure, fibrous tissue proliferation, and tissue reorganization. Confocal microscopy revealed that topical application of C1 in an ex vivo murine skin explant could alleviate invasion of skin by MRSA, while solution-based studies indicated subdued MRSA adhesion onto the skin explants. The pluri-active synthetic amphiphile C1 provides a framework for developing antibacterials that hold translational potential as a therapeutic for implant- and skin wound-associated MRSA infections.

Electrochemical sensing interfaces based on hierarchically architectured zwitterionic peptides for ultralow fouling detection of alpha fetoprotein in serum

Herein, an electrochemical sensing platform based on zwitterionic peptide with a hierarchical structure was constructed for ultralow fouling and highly sensitive protein quantification. Through the combination of CPPPPEKEKEKEK and CPPPPEKEKEK peptides, hierarchical antifouling peptide brushes were formed and exhibited excellent antifouling property, which can be further modified with alpha fetoprotein (AFP) aptamer to achieve highly sensitive detection of AFP. The hierarchical peptide brush-based sensor system achieved an AFP quantification range from 1.0 fg mL^-1 to 1.0 ng mL^-1, with a very low limit of detection as low as 0.59 fg mL^-1. In addition, due to the superior antifouling property of the newly designed hierarchical peptide brushes, the electrochemical biosensor supported the quantification of AFP in solutions with a high concentration of nonspecific proteins without sacrifice in sensitivity. It is worth noting that the constructed antifouling biosensor ensured quantitative recruitment of AFP in clinical serum samples with acceptable accuracy when compared with the commonly used method in the hospital. The strategy of constructing sensing interfaces based on designed hierarchical peptide brushes provided an effective way to develop biosensors with both excellent antifouling capability and high sensitivity.

Regulation of ERK1/2 and SMAD2/3 Pathways by Using Multi-Layered Electrospun PCL-Amnion Nanofibrous Membranes for the Prevention of Post-Surgical Tendon Adhesion

Background

Adhesion after tendon injury is a common complication in clinical practice. The lack of effective prevention mechanisms seriously affects the functional rehabilitation of patients. This research aimed to optimise the amniotic membrane and explain the mechanism of tendon–amniotic membrane by imitating the tendon sheath to construct a multilayer electrospun polycaprolactone (PCL) nanofibre membrane.

Materials and Methods

Fresh amnions were subjected to freezing and vacuum drying. The two surfaces of freeze-dried amnions were coated with PCL nanofibres by electrospinning, thereby forming a multilayer composite membrane and constructing a growth factor-sustained release system conforming to the tendon-healing cycle. The new materials were characterised, and the biological effects on tenocytes and fibroblasts were evaluated. The tendon injury model of New Zealand rabbits was constructed to observe the effects on tendon adhesion and healing.

Results

After freezing and vacuum drying, fresh amnions were found to effectively remove most of the cell components but retained the active components TGF-β1, bFGF, VEGF, and PDGF, as well as the fibrous reticular structure of the basement membrane. After coating with PCL nanofibres, a composite membrane mimicking the structure of the tendon sheath was constructed, thereby strengthening the tensile strength of the amnion. By up-regulating the phosphorylation of ERK1/2 and SMAD2/3, the adhesion and proliferation of tenocytes and fibroblasts were promoted, and collagen synthesis was enhanced. In the rabbit tendon repair model, the composite membrane effectively isolated the exogenous adhesion tissue and promoted endogenous tendon healing.

Conclusion

The composite membrane mimicking the structure of tendon sheath effectively isolated the exogenous adhesion tissue and achieved good tendon slip. By slowly releasing the growth factors TGF-β1, bFGF, VEGF and PDGF, the ERK1/2 and SMAD2/3 pathways were regulated. Consequently, endogenous tendon healing was promoted. This strategy can alternatively address the clinical problem of tendon adhesion.

Antibiotic Delivery Strategies to Treat Skin Infections When Innate Antimicrobial Defense Fails

The epidermal skin barrier protects the body from a host of daily challenges, providing protection against mechanical insults and the absorption of chemicals and xenobiotics. In addition to the physical barrier, the epidermis also presents an innate defense against microbial overgrowth. This is achieved through the presence of a diverse collection of microorganisms on the skin (the "microbiota") that maintain a delicate balance with the host and play a significant role in overall human health. When the skin is wounded, the local tissue with a compromised barrier can become colonized and ultimately infected if bacterial growth overcomes the host response. Wound infections present an immense burden in healthcare costs and decreased quality of life for patients, and treatment becomes increasingly important because of the negative impact that infection has on slowing the rate of wound healing. In this review, we discuss specific challenges of treating wound infections and the advances in drug delivery platforms and formulations that are under development to improve topical delivery of antimicrobial treatments.