Development of Graphene Oxide Composite Aerogel with Proanthocyanidins with Hemostatic Properties As a Delivery System

Enhanced specific surface area and mechanical property of silk nanofibers aerogel for potential hemostasis applications

Biopolymer aerogel is a new type of material with potential applications in the biomedical field. Silk fibroin is of particular interest as a raw material with good biocompatibility and degradable. However, the low mechanical strength and small specific surface area of silk fibroin aerogels limit its further development. Herein, a fast water absorption, highly specific surface area and mechanically strong of aerogels were prepared using low crystal silk fibroin nanofibers (SNF), sol-gel process, solvent exchange and supercritical carbon dioxide (CO2) drying method. The resulting Aero-Sc displayed highly specific surface area (251 m2/g), porosity (97.6 %) and water absorption capacity (1200 %). Furthermore, with rapid water absorption and stronger erythrocyte adhesion, the Aero-Sc showed highly effective hemostasis in vitro. In vivo, animal experiments on rat liver hemorrhage model confirmed that SNF aerogels have a less blood loss (312 ± 29 mg) and faster hemostatic time (92 ± 13 s) than commercially gelatin sponge (p < 0.05). The unique properties of silk fibroin nanofibers aerogel developed in this study has great potential to be a safe and effective hemostatic medical device.

Recent Advances in Topical Hemostatic Materials

Untimely or improper treatment of traumatic bleeding may cause secondary injuries and even death. The traditional hemostatic modes can no longer meet requirements of coping with complicated bleeding emergencies. With scientific and technological advancements, a variety of topical hemostatic materials have been investigated involving inorganic, biological, polysaccharide, and carbon-based hemostatic materials. These materials have their respective merits and defects. In this work, the application and mechanism of the major hemostatic materials, especially some hemostatic nanomaterials with excellent adhesion, good biocompatibility, low toxicity, and high adsorption capacity, are summarized. In the future, it is the prospect to develop multifunctional hemostatic materials with hemostasis and antibacterial and anti-inflammatory properties for promoting wound healing.

Double cross-linked graphene oxide hydrogel for promoting healing of diabetic ulcers

This study explores the synthesis and characterization of a novel double cross-linked hydrogel composed of polyvinyl alcohol (PVA), sodium alginate (SA), graphene oxide (GO), and glutathione (GSH), henceforth referred to as PVA/SA/GO/GSH. This innovative hydrogel system incorporates two distinct types of cross-linking networks and is meticulously engineered to exhibit sensitivity to high glucose and/or reactive oxygen species (ROS) environments. A sequential approach was adopted in the hydrogel formation. The initial phase involved the absorption of GSH onto GO, which was subsequently functionalized with boric acid and polyethylene glycol derivatives via a bio-orthogonal click reaction. This stage constituted the formation of the first chemically cross-linked network. Subsequently, freeze-thaw cycles were utilized to induce a secondary cross-linking process involving PVA and SA, thereby forming the second physically cross-linked network. The resultant PVA/SA/GO/GSH hydrogel retained the advantageous hydrogel properties such as superior water retention capacity and elasticity, and additionally exhibited the ability to responsively release GSH under changes in glucose concentration and/or ROS levels. This feature finds particular relevance in the therapeutic management of diabetic ulcers. Preliminary in vitro evaluation affirmed the hydrogel's biocompatibility and its potential to promote cell migration, inhibit apoptosis, and exhibit antibacterial properties. Further in vivo studies demonstrated that the PVA/SA/GO/GSH hydrogel could facilitate the healing of diabetic ulcer sites by mitigating oxidative stress and regulating glucose levels. Thus, the developed PVA/SA/GO/GSH hydrogel emerges as a promising candidate for diabetic ulcer treatment, owing to its specific bio-responsive traits and therapeutic efficacy.

Gelatin-decorated Graphene oxide: A nanocarrier for delivering pH-responsive drug for improving therapeutic efficacy against atherosclerotic plaque

The progressive inflammatory disease atherosclerosis promotes myocardial infarction, stroke, and heart attack. Anti-inflammatory drugs treat severe atherosclerosis. They are inadequate bioavailability and cause adverse effects at higher doses. A new nanomaterial coupled pH-apperceptive drug delivery system for atherosclerotic plaque is outlined here. We have synthesized a Graphene Oxide-Gelatin-Atorvastatin (GO-Gel-ATR) nanodrug characterized by spectroscopic and imaging techniques. The encapsulation efficiency of GO-Gel-ATR (79.2%) in the loading process is observed to be better than GO-ATR (66.8%). The internal milieu of the plaque cells has a pH of 6.8. The GO-Gel-ATR displays sustained and cumulative release profile at pH 6.8 compared to ATR and GO-ATR. Our proposed nanocomposite demonstrated high cytocompatibility up to 100μg/mL in foam cells induced by Oxidized-Low Density Lipoprotein (Ox-LDL) and Lipopolysaccharides (LPS) compared to normal macrophages for 24 and 48 h. The uptake efficacy of the nanodrugs is shown to be enhanced in foam cells compared to normal macrophage. Oil red O staining of foam cells with and without drugs confirmed therapeutic efficacy. Foam cells treated with nanocomposite had more lipids efflux than ATR. The finding of the in-vitro study reveals that the GO-Gel-ATR nanocomposite carriers have the potential to deliver anti-atherosclerotic drugs effectively and inhibit atherosclerotic plaque progression.

Bioinspired Zn-MOF doped radial porous chitosan-based sponge with antibacterial and antioxidant properties for rapid hemostasis and wound healing

Herein, a novel bioinspired radial porous zinc-based metal-organic framework (Zn-MOF) doped sodium alginate/chitosan derivatives/pullulan-based SA/PSCS/Pul/Zn-MOF (SPCP/Zn) composites sponge with excellent antioxidant and antibacterial properties was fabricated by the ice-templating method. Boric acid (BA) and Ca2+, which were respectively used as hydrogen- and ionic- bonding cross-linkers, provided strong mechanical properties for sponge matrix composed of SA, PSCS, and Pul. The obtained SPCP/Zn sponge exhibited uniform porous morphology, proper hydrophilicity, and admirable biocompatibility. In addition, the SPCP/Zn sponge achieved a sustained release of Zn2+ and gallic acid, which displayed powerful antibacterial and antioxidant activities. Importantly, the SPCP/Zn sponge exhibited shorter rapid hemostasis (20.4 ± 2.9 s) and lower blood loss (19.8 ± 4.3 mg). The SPCP/Zn sponge also showed faster wound closure ratio for the rat full-thickness skin defect model. It was revealed that SPCP/Zn sponge could significantly accelerate and enhance wound healing through downregulating inflammatory cytokines (TNF-α, IL-6) and increasing the expression of growth factors (VEGF). Due to its excellent properties, the SPCP/Zn sponge may have promising potential in wound healing applications.

Graphene-Based Aerogels for Biomedical Application

Aerogels are three-dimensional solid networks with incredibly low densities, high porosity, and large specific surface areas. These aerogels have both nanoscale and macroscopic interior structures. Combined with graphene, the aerogels show improved mechanical strength, electrical conductivity, surface area, and adsorption capacity, making them ideal for various biomedical applications. The graphene aerogel has a high drug-loading capacity due to its large surface area, and the porous structure enables controlled drug release over time. The presence of graphene makes it a suitable material for wound dressings, blood coagulation, and bilirubin adsorption. Additionally, graphene's conductivity can help in the electrical stimulation of cells for improved tissue regeneration, and it is also appropriate for biosensors. In this review, we discuss the preparation and advantages of graphene-based aerogels in wound dressings, drug delivery systems, bone regeneration, and biosensors.

Multifunctional Chitosan Scaffold Platforms Loaded with Natural Polyphenolic Extracts for Wound Dressing Applications

Chitosan (CS)-based scaffolds loaded with Pinus radiata extract bark (PE) and grape seed extract (GSE) were successfully developed for wound dressing applications. The effects of incorporating GSE and PE in CS scaffolds were investigated in relation to their physicochemical and biological properties. All scaffolds exhibited porous structures with the ability to absorb more than 70 times their weight when contacted with blood and phosphate buffer solution. The incorporation of GSE and PE into the CS scaffolds increased their blood absorption ability and degradation rates over time. All scaffolds showed a clotting ability above 95%, with their surfaces being favorable for red blood cell attachment. Both GSE and PE were released from the CS scaffolds in a sustained manner. Scaffolds loaded with GSE and PE inhibited the bacterial activity of S. aureus and E. coli by 40% and 44% after 24 h testing. In vitro cell viability studies demonstrated that all scaffolds were nontoxic to HaCaT cells. Importantly, the addition of GSE and PE further increased cell viability compared to that of the CS scaffold. This study provides a new synthesis method to immobilize GSE and PE on CS scaffolds, enabling the formation of novel material platforms with a high potential for wound dressing applications.

Sea Cucumber-Inspired Aerogel for Ultrafast Hemostasis of Open Fracture

The symptomatic management of hemorrhagic shock complicated by open fractures is a great challenge, because it is also complicated by complex wound bleeding, bacterial infection, and bone defects. Inspired by the water absorption and cross-sectional microstructure of sea cucumbers, in this study, a new sea cucumber-like aerogel (GCG) is proposed. Its aligned porous structure and composition can stop bleeding rapidly and effectively with a blood clotting index of 3.73 ± 1.8%. More importantly, the data of in vivo hemostasis test in an amputating rat tail hemostatic model (15.69 ± 2.45 s, 26.95 ± 8.43 mg) and liver puncture bleeding model (23.77 ± 2.68 s, 36.22 ± 16.92 mg) also indicate the excellent hemostatic performance of GCG. In addition, GCG also shows a significant inhibitory effect on S. aureus and E. coli, which can prevent the occurrence of postoperative osteomyelitis. Not only that, after filling in the bone defect, it is shown that this GCG aerogel completely degrades eight weeks after surgery and induces new bone ingrowth, achieving functional regeneration after hemostasis of an open fracture defect. Generally, because of its combination of hemostatic, antibacterial, and osteogenic activities, this new aerogel is a promising option for open fractures treatment.

Aerogel-Based Biomaterials for Biomedical Applications: From Fabrication Methods to Disease-Targeting Applications

Aerogel-based biomaterials are increasingly being considered for biomedical applications due to their unique properties such as high porosity, hierarchical porous network, and large specific pore surface area. Depending on the pore size of the aerogel, biological effects such as cell adhesion, fluid absorption, oxygen permeability, and metabolite exchange can be altered. Based on the diverse potential of aerogels in biomedical applications, this paper provides a comprehensive review of fabrication processes including sol-gel, aging, drying, and self-assembly along with the materials that can be used to form aerogels. In addition to the technology utilizing aerogel itself, it also provides insight into the applicability of aerogel based on additive manufacturing technology. To this end, how microfluidic-based technologies and 3D printing can be combined with aerogel-based materials for biomedical applications is discussed. Furthermore, previously reported examples of aerogels for regenerative medicine and biomedical applications are thoroughly reviewed. A wide range of applications with aerogels including wound healing, drug delivery, tissue engineering, and diagnostics are demonstrated. Finally, the prospects for aerogel-based biomedical applications are presented. The understanding of the fabrication, modification, and applicability of aerogels through this study is expected to shed light on the biomedical utilization of aerogels.

Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis

The development of materials that effectively stop bleeding and prevent wound adhesion is essential in both military and medical fields. However, traditional hemostasis methods, such as cautery, tourniquets, and gauze, have limitations. In recent years, new nanomaterials have gained popularity in medical and health fields due to their unique microstructural advantages. Compared to traditional materials, nanomaterials offer better adhesion, versatility, and improved bioavailability of traditional medicines. Nanomaterials also possess advantages such as a high degree and stability, self-degradation, fewer side effects, and improved wound healing, which make them ideal for the development of new hemostatic materials. Our review provides an overview of the currently used hemostatic strategies and materials, followed by a review of the cutting-edge nanomaterials for hemostasis, including nanoparticles and nanocomposite hydrogels. The paper also briefly describes the challenges faced by the application of nanomaterials for hemostasis and the prospects for their future development.

Chitosan-based hemostatic sponges as new generation hemostatic materials for uncontrolled bleeding emergency: Modification, composition, and applications

The choice of hemostatic technique is a curial concern for surgery and as first-aid treatment in combat. To treat uncontrolled bleeding in complex wound environments, chitosan-based hemostatic sponges have attracted significant attention in recent years because of the excellent biocompatibility, degradability, hemostasis and antibacterial properties of chitosan and their unique sponge-like morphology for high fluid absorption rate and priority aggregation of blood cells/platelets to achieve rapid hemostasis. In this review, we provide a historical perspective on the use of chitosan hemostatic sponges as the new generation of hemostatic materials for uncontrolled bleeding emergencies in complex wounds. We summarize the modification of chitosan, review the current status of preparation protocols of chitosan sponges based on various composite systems, and highlight the recent achievements on the detailed breakdown of the existing chitosan sponges to present the relationship between their composition, physical properties, and hemostatic capacity. Finally, the future opportunities and challenges of chitosan hemostatic sponges are also proposed.

Vacuum sealing drainage system combined with an antibacterial jackfruit aerogel wound dressing and 3D printed fixation device for infections of skin soft tissue injuries

Injuries and infections of skin and soft tissue are commonly encountered in primary health care and are challenging to manage. Vacuum sealing drainage (VSD) is generally used in clinical treatment, but current commercial methods of VSD have some disadvantages, such as easy blockage, nonantibacterial effects, and inconvenient curved surfaces. Herein, we report a functional zinc oxide/jackfruit aerogel (ZnO/JFA) composite material that is ultralight, superabsorbent and antibacterial as a new antibacterial VSD wound dressing. The JFA is carbonized from fresh jackfruit, and the JFA exhibits superhydrophilicity and superabsorbability. The water absorption rate of JFA was up to 1209.39%, and the SBF absorption rate was up to 1384.22%. The water absorption rate of ZnO/JFA was up to 494.47%, and the SBF absorption rate was up to 473.71%. The JFA and ZnO/JFA possess a pipeline structure, which is beneficial for absorbing wound exudates. In addition, surface modification of nanosized ZnO and its effects on antibacterial properties and biocompatibility were performed. When the concentration of ZnO/JFA was 3.125 mg/mL, the survival rate of human fibroblast cells was close to 80%, while the antibacterial rates against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were up to 99.06%, 75.28% and 93.58%, respectively. Moreover, a 3D printed assisted device was introduced to make the ZnO/JFA wound dressing more attached to the bottom of the wound on a curved surface. An integrated device was formed under the printing mold, and then animal experiments were conducted in vivo. The results showed that a healing rate of almost 100% for infected skin wounds was obtained with this novel VSD device after 14 days, compared to only 79.65% without the VSD device. This novel VSD with a negative pressure suction dressing is beneficial for healing infectious wounds.

Carbon-based nanostructures for cancer therapy and drug delivery applications

Synthesis, design, characterization, and application of carbon-based nanostructures (CBNSs) as drug carriers have attracted a great deal of interest over the past half of the century because of their promising chemical, thermal, physical, optical, mechanical, and electrical properties and their structural diversity. CBNSs are well-known in drug delivery applications due to their unique features such as easy cellular uptake, high drug loading ability, and thermal ablation. CBNSs, including carbon nanotubes, fullerenes, nanodiamond, graphene, and carbon quantum dots have been quite broadly examined for drug delivery systems. This review not only summarizes the most recent studies on developing carbon-based nanostructures for drug delivery (e.g. delivery carrier, cancer therapy and bioimaging), but also tries to deal with the challenges and opportunities resulting from the expansion in use of these materials in the realm of drug delivery. This class of nanomaterials requires advanced techniques for synthesis and surface modifications, yet a lot of critical questions such as their toxicity, biodistribution, pharmacokinetics, and fate of CBNSs in biological systems must be answered.

Biocompatible Carboxymethyl Chitosan/GO-Based Sponge to Improve the Efficiency of Hemostasis and Wound Healing

Sponges with highly absorptive properties have been widely used in emergency hemostasis. Graphene oxide (GO) has been extensively investigated in biomedical applications and is a promising candidate for hemostatic sponges. However, GO has been demonstrated to have adverse effects on the human body. To overcome this problem, a hemostatic sponge based on modified GO and carboxymethyl chitosan (CMCS) is successfully prepared, which has excellent water absorption ability and mechanical strength. Importantly, hemostasis assays showed that the composite sponge exhibited high hemostatic efficiency, and the possible hemostatic mechanism is also discussed in this study. Moreover, the results of in vitro antibacterial tests reveal that the composite sponge also presents strong antimicrobial effects against Staphylococcus aureus and Escherichia coli. Significantly, the composited sponge used as hemostatic dressing can effectively promote cell proliferation, achieving a wound closure rate of 95% on day 12. Such a graphene-based sponge with multiple advantageous features would hold broad prospects in the hemostatic field.

The Effect on Hemostasis of Gelatin-Graphene Oxide Aerogels Loaded with Grape Skin Proanthocyanidins: In Vitro and In Vivo Evaluation

Using in vitro and in vivo models, this study investigated the hemostatic potential to control bleeding of both unloaded gelatin-graphene oxide aerogels and the same loaded with proanthocyanidins (PAs) from Vitis vinifera grape skin extract. Our results showed that the physicochemical and mechanical properties of the aerogels were not affected by PA inclusion. In vitro studies showed that PA-loaded aerogels increased the surface charge, blood absorption capacity and cell viability compared to unloaded ones. These results are relevant for hemostasis, since a greater accumulation of blood cells on the aerogel surface favors aerogel–blood cell interactions. Although PAs alone were not able to promote hemostasis through extrinsic and intrinsic pathways, their incorporation into aerogels did not affect the in vitro hemostatic activity of these composites. In vivo studies demonstrated that both aerogels had significantly increased hemostatic performance compared to SpongostanTM and gauze sponge, and no noticeable effects of PA alone on the in vivo hemostatic performance of aerogels were observed; this may have been related to its poor diffusion from the aerogel matrix. Thus, PAs have a positive effect on hemostasis when incorporated into aerogels, although further studies should be conducted to elucidate the role of this extract in the different stages of hemostasis.

Novel and effective hemostats based on graphene oxide-polymer aerogels: In vitro and in vivo evaluation

In this study, graphene oxide (GO)-based aerogels cross-linked with chitosan (CS), gelatin (GEL), and polyvinyl alcohol (PVA) were characterized and their hemostatic efficiencies both in vitro and in vivo were investigated and compared to commercial materials (ChitoGauze®XR and Spongostan™). All aerogels exhibited highly porous structures and a negative surface charge density favorable to their interaction with blood cells. The in vitro studies showed that all aerogels coagulated >60 % of the blood contained in their structures after 240 s of the whole-blood clotting assay, the GO-CS aerogel being the one with the highest blood clotting. All aerogels showed high hemocompatibility, with hemolytic rates <5 %, indicating their use as biomaterials. Among them, the GO-GEL aerogel exhibited the lowest hemolytic activity, due possibly to its high GEL content compared to the GO amount. According to their blood clotting activity, aerogels did not promote coagulation through extrinsic and intrinsic pathways. However, their surfaces are suitable for accelerating hemostasis by promoting alternative routes. All aerogels adhered platelets and gathered RBCs on their surfaces, and in addition the GO-CS aerogel surface also promoted the formation of filamentous fibrin networks adhered on its structure. Furthermore, in vivo evaluations revealed that all aerogels significantly shortened the hemostatic times and reduced the blood loss amounts compared both to the Spongostan™ and ChitoGauze®XR commercial materials and to the gauze sponge (control group). The hemostatic performance in vitro and in vivo of these aerogels suggests that they could be used as hemostats for controlling profuse bleedings.

Fabrication of Biocompatible Electrospun Poly(ε-caprolactone)/Gelatin Nanofibers Loaded with Pinus radiata Bark Extracts for Wound Healing Applications

In this study, poly(ε-caprolactone) (PCL)/gelatin (GEL) electrospun nanofibers loaded with two different concentrations of Pinus radiata bark extracts (PEs) were fabricated via electrospinning for wound healing applications. The effects of incorporating PE into PCL/GEL electrospun nanofibers were investigated regarding their physicochemical properties and in vitro biocompatibility. All electrospun nanofibers showed smooth, uniform, and bead-free surfaces. Their functional groups were detected by ATR-FTIR spectroscopy, and their total phenol content was measured by a Folin-Ciocalteu assay. With PE addition, the electrospun nanofibers exhibited an increase in their wettability and degradation rates over time and a decrease in their tensile stress values from 20 ± 4 to 8 ± 2 MPa for PCL/GEL and PCL/GEL/0.36%PE samples, respectively. PE was also released from the fibrous mats in a rather controlled fashion. The PCL/GEL/0.18%PE and PCL/GEL/0.36%PE electrospun nanofibers inhibited bacterial activity at around 6 ± 0.1% and 23 ± 0.3% against E. coli and 14 ± 0.1% and 18 ± 0.2% against S. aureus after 24 h incubation, respectively. In vitro cell studies showed that PE-loaded electrospun nanofibers enhanced HaCaT cell growth, attachment, and proliferation, favoring cell migration towards the scratch area in the wound healing assay and allowing a complete wound closure after 72 h treatment. These findings suggested that PE-loaded electrospun nanofibers are promising materials for antibiotic-free dressings for wound healing applications.

Berberine coated biocomposite hemostatic film based alginate as absorbable biomaterial for wound healing

In wound treatment, severe bleeding and infection are always primary challenges. Therefore, it is highly desired to develop novel dressing with both hemostatic and antibacterial capability. Herein, a series of biocomposite hemostatic films (BHFs) based alginate/chitosan/collagen-berberine have been prepared and well characterized for further biofunctional study. We have demonstrated that the hemostatic and antibacterial activities were significantly enhanced by calcium/berberine dual-crosslinking system in the film. Through the synergistic effects, BHF-6B exhibited a shorter in vivo clotting and wound healing time than that of commercial dressing in rat tail amputation and full-thickness skin defect models. Additionally, BHF-6B showed excellent bacteriostatic activity with long-term effects. Moreover, hemolysis and cytotoxicity tests in vitro illustrated the prominent biocompatibility of the composite films. Notably, BHF-6B could be degraded quickly and completely in vivo. Overall, the present work indicated that the functionalized BHF-6B has great potential as an absorbable biomaterial for wound treatment.

Graphene-based Nanomaterials in Fighting the Most Challenging Viruses and Immunogenic Disorders

Viral diseases have long been among the biggest challenges for healthcare systems around the world. The recent Coronavirus Disease 2019 (COVID-19) pandemic is an example of how complicated the situation can get if we are not prepared to combat a viral outbreak in time, which brings up the need for quick and affordable biosensing platforms and vast knowledge of potential antiviral effects and drug/gene delivery opportunities. The same challenges have also existed for nonviral immunogenic disorders. Nanomedicine is considered a novel candidate for effectively overcoming these worldwide challenges. Among the versatile nanomaterials commonly used in biomedical applications, graphene has recently earned much attention thanks to its special and inspiring physicochemical properties, such as its large surface area, efficient thermal/electrical properties, carbon-based chemical purity with controllable biocompatibility, easy functionalization, capability of single-molecule detection, anticancer characteristics, 3D template feature in tissue engineering, and, in particular, antibacterial/antiviral activities. In this Review, the most important and challenging viruses of our era, such as human immunodeficiency virus, Ebola, SARS-CoV-2, norovirus, and hepatitis virus, and immunogenic disorders, such as asthma, Alzheimer's disease, and Parkinson's disease, in which graphene-based nanomaterials can effectively take part in the prevention, detection, treatment, medication, and health effect issues, have been covered and discussed.

Hemostatic materials in wound care

Blood plays an essential role in the human body. Hemorrhage is a critical cause of both military and civilian casualties. The human body has its own hemostatic mechanism that involves complex processes and has limited capacity. However, in emergency situations such as battlefields and hospitals, when the hemostatic mechanism of the human body itself cannot stop bleeding effectively, hemostatic materials are needed for saving lives. In this review, the hemostatic mechanisms and performance of the most commonly used hemostatic materials, (including fibrin, collagen, zeolite, gelatin, alginate, chitosan, cellulose and cyanoacrylate) and the commercial wound dressings based on these materials, will be discussed. These materials may have limitations, such as poor tissue adhesion, risk of infection and exothermic reactions, that may lessen their hemostatic efficacy and cause secondary injuries. High-performance hemostatic materials, therefore, have been designed and developed to improve hemostatic efficiency in clinical use. In this review, hemostatic materials with advanced performances, such as antibacterial capacity, superhydrophobicity/superhydrophilicity, superelasticity, high porosity and/or biomimicry, will be introduced. Future prospects of hemostatic materials will also be discussed in this review.

Improved hemocompatibility for gelatin-graphene oxide composite aerogels reinforced with proanthocyanidins for wound dressing applications

Aerogels based on gelatin and graphene oxide (GO) were synthesized by microwave-assisted reactions, incorporating grape skin extracts -high in proanthocyanidins (PAs)- to develop a hemostatic device with improved properties. The effects of incorporating PAs into the aerogels were investigated in relation to their physicochemical properties, absorption ability, clotting activity and cytotoxicity in human dermal fibroblast (HDF) cells. The aerogels presented highly resistant porous structures, capable of absorbing more than 50 times their weight when in contact with a phosphate saline solution (PBS) and fresh human blood. Interestingly, the addition of PAs increased the negative surface charges and the blood absorption ability of the aerogels, which may make them suitable for hemostasis. The incorporation of 5% and 10% (w/w) of extracts into the aerogels increased the total coagulated blood content by 36.6% and 24.5% compared with gelatin-GO aerogel, respectively. These improvements in the hemostatic properties of the aerogels were greater with the inclusion of 5% (w/w) of grape skin extracts into the aerogels. The aerogels were also able to adhere red blood cells onto their surfaces, which could favor the formation of stable fibrin networks to promote hemostasis. Their clotting activity suggested the activation of alternative routes based on complement coagulation systems. Finally, the aerogels were non-toxic for HDF cells and the PAs were successfully released from their matrices. Thus, gelatin-GO aerogels reinforced with PAs are promising as topical phytodrug delivery systems, with great potential for wound healing processes.

Bioaerogels: Promising Nanostructured Materials in Fluid Management, Healing and Regeneration of Wounds

Wounds affect one's quality of life and should be managed on a patient-specific approach, based on the particular healing phase and wound condition. During wound healing, exudate is produced as a natural response towards healing. However, excessive production can be detrimental, representing a challenge for wound management. The design and development of new healing devices and therapeutics with improved performance is a constant demand from the healthcare services. Aerogels can combine high porosity and low density with the adequate fluid interaction and drug loading capacity, to establish hemostasis and promote the healing and regeneration of exudative and chronic wounds. Bio-based aerogels, i.e., those produced from natural polymers, are particularly attractive since they encompass their intrinsic chemical properties and the physical features of their nanostructure. In this work, the emerging research on aerogels for wound treatment is reviewed for the first time. The current scenario and the opportunities provided by aerogels in the form of films, membranes and particles are identified to face current unmet demands in fluid managing and wound healing and regeneration.

Advances on Graphene-Based Nanomaterials and Mesenchymal Stem Cell-Derived Exosomes Applied in Cutaneous Wound Healing

Graphene is a new type of carbon nanomaterial discovered after fullerene and carbon nanotube. Due to the excellent biological properties such as biocompatibility, cell proliferation stimulating, and antibacterial properties, graphene and its derivatives have become emerging candidates for the development of novel cutaneous wound dressings and composite scaffolds. On the other hand, pre-clinical research on exosomes derived from mesenchymal stem cells (MSC-Exos) has been intensified for cell-free treatment in wound healing and cutaneous regeneration, via ameliorating the damaged microenvironment of the wound site. Here, we provide a comprehensive understanding of the latest studies and observations on the various effects of graphene-based nanomaterials (GBNs) and MSC-Exos during the cutaneous wound repair process, as well as the putative mechanisms thereof. In addition, we propose the possible forward directions of GBNs and MSC-Exos applications, expecting to promote the clinical transformation.

Aerogels in drug delivery: From design to application

Aerogels are the lightest processed solid materials on Earth and with the largest empty volume fraction in their structure. Composition versatility, modularity, and feasibility of industrial scale manufacturing are behind the fast emergence of aerogels in the drug delivery field. Compared to other 3D materials, the high porosity (interconnected mesopores) and high specific surface area of aerogels may allow faster loading of small-molecule drugs, less constrained access to inner regions of the matrix, and more efficient interactions of the biological milieu with the polymer matrix. Processing in supercritical CO₂ medium for both aerogel production (drying) and drug loading (impregnation) has remarkable advantages such as absence of an oxidizing environment, clean manufacture, and easiness for the scale-up under good manufacturing practices. The aerogel solid skeleton dictates the chemical affinity to the different drugs, which in turn determines the loading efficiency and the release pattern. Aerogels can be used to increase the solubility of BCS Class II and IV drugs because the drug can be deposited in amorphous state onto the large surface area of the skeleton, which facilitates a rapid contact with the body fluids, dissolution, and release. Conversely, tuning the aerogel structure by functionalization with drug-binding moieties or stimuli-responsive components, application of coatings and incorporation of drug-loaded aerogels into other matrices may enable site-specific, stimuli-responsive, or prolonged drug release. The present review deals with last decade advances in aerogels for drug delivery. An special focus is paid first on the loading efficiency of active ingredients and release kinetics under biorelevant conditions. Subsequent sections deal with aerogels intended to address specific therapeutic demands. In addition to oral delivery, the physical properties of the aerogels appear to be very advantageous for mucosal administration routes, such as pulmonary, nasal, or transdermal. A specific section devoted to recent achievements in gene therapy and theranostics is also included. In the last section, scale up strategies and life cycle assessment are comprehensively addressed.

Synthesis and characterization of graphene oxide chitosan aerogels reinforced with flavan-3-ols as hemostatic agents

The natural mechanisms of the body cannot control massive hemorrhaging, resulting in a requirement for hemostatic intervention. In this study, Graphene oxide and Chitosan aerogels reinforced with grape seed (SD) and skin (SK) extracts were developed for use as hemostatic agents by evaluating the influence of pH on their synthesis, and the amount of grape extract added on the physical and chemical properties of the aerogels. The material was evaluated by FTIR, XRD, Raman spectroscopy, DLS, uniaxial compression tests and SEM. The capacity of the aerogels to absorb water, PBS and blood, as well as their coagulation capacity, were determined. In addition, the release profile for grape extracts in PBS and the material's cytotoxicity were determined. The aerogels that were synthesized under basic conditions and loaded with grape extracts were more rigid and negatively charged, and they presented smaller pores than the un-loaded acidic aerogels. For all aerogels, the hemoglobin absorption was greater than 90 % in the first 30 s. A higher density of adsorbed blood cells was observed on aerogels loaded with a higher amount of grape extract. The maximum release of extract from the aerogels occurred for those loaded with SK extracts at a basic pH; the aerogels that were prepared under acidic conditions dissolved in the media. Aerogels loaded with SK extracts under alkaline conditions were not cytotoxic toward human dermal fibroblasts and exhibited cell viabilities above 90 %. These findings suggest that these aerogels have the potential for use as hemostatic agents in wound management.

Preparation of a Three-Dimensional Porous Graphene Oxide-Kaolinite-Poly(vinyl alcohol) Composite for Efficient Adsorption and Removal of Ciprofloxacin

Because of the widespread presence of antibiotics in water, soil, and other environments, they pose great potential risks to the environment, threatening human and animal health. In this study, graphene oxide-kaolinite homogeneous dispersion was prepared by simple liquid phase exfoliation. The three-dimensional (3D) porous graphene oxide-kaolinite-poly(vinyl alcohol) composites were prepared by the cross-linking of poly(vinyl alcohol) and the formation of ice crystals during the freezing-drying process. Three influencing factors [adsorbent dosage, ciprofloxacin (CIP) initial concentration, and time] of CIP adsorption and removal were systematically analyzed by the response surface method. The order of significance for response values (CIP removal rate) was adsorbent dosage > CIP initial concentration > time. The 3D porous material showed good adsorption capacity of CIP, the theoretical maximum adsorption capacity was 408.16 mg/g, and it had good recyclability. By Fourier transform infrared (FTIR) and X-ray photoelectron spectroscopy analysis, it was found the composite adsorbs CIP by hydrogen bonding and π-π interaction. In conclusion, the graphene oxide-kaolinite-poly(vinyl alcohol) porous composite is a good candidate for efficient antibiotic wastewater treatment.

Engineering of Aerogel-Based Biomaterials for Biomedical Applications

Biomaterials with porous structure and high surface area attract growing interest in biomedical research and applications. Aerogel-based biomaterials, as highly porous materials that are made from different sources of macromolecules, inorganic materials, and composites, mimic the structures of the biological extracellular matrix (ECM), which is a three-dimensional network of natural macromolecules (e.g., collagen and glycoproteins), and provide structural support and exert biochemical effects to surrounding cells in tissues. In recent years, the higher requirements on biomaterials significantly promote the design and development of aerogel-based biomaterials with high biocompatibility and biological activity. These biomaterials with multilevel hierarchical structures display excellent biological functions by promoting cell adhesion, proliferation, and differentiation, which are critical for biomedical applications. This review highlights and discusses the recent progress in the preparation of aerogel-based biomaterials and their biomedical applications, including wound healing, bone regeneration, and drug delivery. Moreover, the current review provides different strategies for modulating the biological performance of aerogel-based biomaterials and further sheds light on the current status of these materials in biomedical research.

N-acetyl cysteine-loaded graphene oxide-collagen hybrid membrane for scarless wound healing

Wound dressings composed of natural polymers, such as type I collagen, possess good biocompatibility, water holding capacity, air permeability, and degradability, and can be used in wound repair. However, due to the persistent oxidative stress in the wound area, the migration and proliferation of fibroblasts might be suppressed, leading to poor healing. Thus, collagen-containing scaffolds are not suitable for accelerated wound healing. Antioxidant N-acetyl cysteine (NAC) is known to reduce the reactive oxygen species (ROS) and has been widely used in the clinic. Theoretically, the carboxyl group of NAC allows loading of graphene oxide (GO) for sustained release and may also enhance the mechanical properties of the collagen scaffold, making it a better wound-dressing material. Herein, we demonstrated an innovative approach for a potential skin-regenerating hybrid membrane using GO incorporated with collagen I and NAC (N-Col-GO) capable of continuously releasing antioxidant NAC. Methods: The mechanical stability, water holding capacity, and biocompatibility of the N-Col-GO hybrid membrane were measured in vitro. A 20 mm rat full-skin defect model was created to evaluate the repair efficiency of the N-Col-GO hybrid membrane. The vascularization and scar-related genes in the wound area were also examined. Results: Compared to the Col only scaffold, N-Col-GO hybrid membrane exhibited a better mechanical property, stronger water retention capacity, and slower NAC release ability, which likely promote fibroblast migration and proliferation. Treatment with the N-Col-GO hybrid membrane in the rat wound model showed complete healing 14 days after application which was 22% faster than the control group. HE and Masson staining confirmed faster collagen deposition and better epithelization, while CD31 staining revealed a noticeable increase of vascularization. Furthermore, Rt-PCR demonstrated decreased mRNA expression of profibrotic and overexpression of anti-fibrotic factors indicative of the anti-scar effect. Conclusion: These findings suggest that N-Col-GO drug release hybrid membrane serves as a better platform for scarless skin regeneration.

N-alkylated chitosan/graphene oxide porous sponge for rapid and effective hemostasis in emergency situations

N-alkylated chitosan (AC) sponges and graphene oxide (GO) sponges are promising candidates for emergency hemostat. However, AC sponges have weak mechanical strength and GO sponges may induce toxicity. To overcome these problems, a series of AC/GO composite spongs (ACGS) were prepared with various ratios (GO/AC, 0%, 5%, 10%, and 20%) using a dilute solution freeze phase separation and drying process. The sponges exhibit excellent absorption capacity, mechanical stability, and biocompatibility. In serial in vitro clotting tests, the higher the ratio of GO, the better the coagulation efficiency. ACGS with 20% ratio of GO (ACGS20) has shorter hemostatic time than Celox in a rabbit femoral injury test. Moreover, ACGS20 can accelerate erythrocyte and platelet adhesion. CD62p and intracellular Ca²⁺ measurements show that ACGS20 can promote the release of intracellular Ca²⁺ and stimulate platelet activation. These results suggest that ACGS20 is a good candidate composition for a safe and efficacious hemostatic dressing.

Preparation and evaluation of Bletilla striata polysaccharide/graphene oxide composite hemostatic sponge

Uncontrolled bleeding is an important cause of military and civilian casualties. GO has received more attention in the field of hemostasis. However, pure GO has various limitation in application due to its potential thrombosis, hemolytic and cytotoxicity. Herein, we present a simple, rapid and low-cost method to combine GO and natural polysaccharides by hydrogen bonding to prepare a new material Bletilla striata polysaccharide/graphene oxide composite sponge (BGCS). The BGCS was successfully synthesized and characterized by SEM, IR, RAMAN, XRD and Zeta potential analyzer analysis. The BGCS exhibited favorable biocompatibility. Besides, the porosity of BGCS was higher than 90% and showed good water absorption capacity. The results of whole blood coagulation evaluation showed that the BGCS can promote blood coagulation within 30 s without anticoagulant, showing excellent hemostatic effect. Further coagulation mechanism studies indicated that the surface of the BGCS possessed a high charge (-27.3 ± 0.9 mV) and showed strong platelet stimulation, the BGCS can also induce red blood cell aggregation, accelerate fibrin formation and accelerate blood coagulation. Therefore, the BGCS can stop bleeding within 50 s in rat-tail amputation models. The BGCS provides a new perspective for the safe application of GO in the field of trauma hemostasis.

Polydopamine reinforced hemostasis of a graphene oxide sponge via enhanced platelet stimulation

Graphene oxide (GO) is a promising hemostatic material because of its platelet stimulatory activity. However, our previous studies on cross-linked graphene sponges demonstrated that those sponges lost the GO function of platelet stimulation due to the pristine GO was reduced under the harsh reaction conditions. Accordingly, a mild cross-linking strategy is expected to preserve the oxygen-containing groups to further increase the hemostatic performance of the sponges. Here, we present a polydopamine (PDA) cross-linked GO sponge (DCGO) by using mild and facile wet chemistry. The obtained DCGO possessed a high surface charge (-31.3 ± 0.3 mV) and showed strong platelet stimulation. Moreover, this method strengthened the mechanical properties of the DCGO, which supported 350 times its own weight without deformation, thus ensuring its absorbability. For the synergy of platelet stimulation and physical absorption, DCGO achieved outstanding hemostatic performance. Bleeding stopped within 105 ± 15 s, which was 165 s faster than that of the un-cross-linked GO aerogel and 96 s faster than that of the cross-linked graphene sponge (CGS). The DCGO combines the advantages of both PDA and GO, thus supplying a new material and method for the field of trauma hemostasis.

Chitosan/rectorite nanocomposite with injectable functionality for skin hemostasis

Maltose-like chitosan/rectorite nanocomposites could promote blood coagulation and reduce the release of clay particles to avoid in vitro secondary thrombosis.