Insights into the Design of Polyurethane Dressings Suitable for the Stages of Skin Wound-Healing: A Systematic Review

Dressings made with polyurethanes have been found to exhibit good and varied biological properties that make them good candidates for this application. However, as has been seen, the wound-healing process is complex, which includes four different stages. So far, the design and evaluation of polyurethane for wound dressing has focused on achieving good properties (mechanical, physicochemical, and biological), but each of them separates from the others or even directed at only one of the stages of skin wound-healing. Therefore, the aim of this systematic review is to explore the applications of polyurethanes in wound dressings and to determine whether could be designed to cover more than one stage of skin wound-healing. The PRISMA guidelines were followed. The current research in this field does not consider each stage separately, and the design of polyurethane dressings is focused on covering all the stages of wound healing with a single material but is necessary to replace polyurethanes in short periods of time. Additionally, little emphasis is placed on the hemostasis stage and further characterization of polyurethanes is still needed to correlate mechanical and physicochemical properties with biological properties at each stage of the wound-healing. Current research demonstrates an effort to characterize the materials physiochemically and mechanically, but in terms of their biological properties, most of the literature is based on the performance of histological tests of explants morphologically probing the compromised tissues, which give an indication of the potential use of polyurethanes in the generation of wound-healing dressings.

Development of chitosan/poly (vinyl alcohol)/graphene oxide loaded with vanadium doped titanium dioxide patch for visible light driven antibacterial activity and accelerated wound healing application

Wound healing is a multi-stage process that is dynamic, interactive, and complicated. However, many nanomaterials are employed to expedite wound healing by demonstrating antibacterial activity or boosting cell proliferation. But only one phase is focused during the wound healing process. As a result, there is a need for optimum wound dressing materials that promotes different wound healing cascades with ideal properties. Herein, Graphene Oxide loaded with vanadium (V) doped titanium dioxide (TiO₂) blended with chitosan, and polyvinyl alcohol (CS/PVA/GO/TiO₂-V) patch was developed for wound healing. XRD, FTIR and FE-SEM analyses were carried out to study the morphology and structural property of the patch. The fabricated patch has a high surface porosity, excellent moisture vapor transfer rate, appropriate swelling behaviour, and oxygen permeability, which results in an excellent moist environment for wound breathing and effective management of wound exudates. The antibacterial test showed significant antibacterial efficacy against wound infections in the presence of light when compared to dark. In-vitro analysis such as hemocompatibility, cytotoxicity, cell adhesion, and scratch assay show the predicted potential wound healing application with high biocompatibility. These results suggest that CS/PVA/GO/TiO₂-V patch provides a microenvironment favourable to cells' growth and differentiation and positively modulates full-thickness wounds' healing.

Tuning the properties of carboxymethylchitosan-based porous membranes for potential application as wound dressing

Wound repair is a complex process that calls for strategies to allow a rapid and effective regeneration of injured skin, which has stimulated the research of advanced wound dressings. Herein, highly porous membranes of N,O-carboxymethylchitosan (CMCh), and poly (vinyl alcohol) (PVA) were successfully prepared via a green and facile freeze-drying method of blend solutions containing CMCh/PVA at weight ratio 25/75. Membranes composed only by CMCh were also prepared and genipin was used for crosslinking. Different contents of TiO₂ nanoparticles were incorporated to both type of membranes, which were characterized in terms of morphology, porosity (Φ), swelling capacity (S.C.), mechanical properties, susceptibility to lysozyme degradation and in vitro cytotoxicity toward human fibroblast (HDFn) and keratinocytes (HaCaT) cells. Larger apparent pores were observed in the surface of the genipin-crosslinked CMCh membrane, which resulted in higher porosity (Φ ≈ 76%) and swelling capacity (S.C. ≈ 1720%) as compared to CMCh/PVA membrane (Φ ≈ 68%; S.C. ≈ 1660%). The porosity of both types of membranes decreased upon the addition of TiO₂ nanoparticles while swelling capacity increased. Due to their high porosity and swelling capacity, adequate mechanical properties, controlled degradability, and cytocompatibility, such carboxymethylchitosan-based membranes are potentially useful as wound dressings.

Novel Poly(vinyl alcohol)/Chitosan/Modified Graphene Oxide Biocomposite for Wound Dressing Application

Rapid absorption of wound exudate and prevention of wound infection are prerequisites for wound dressing to accelerate wound healing. In this study, a novel kind of promising wound dressing is developed by incorporating polyhexamethylene guanidine (PHMG)-modified graphene oxide (mGO) into the poly(vinyl alcohol)/chitosan (PVA/CS) matrix, conferring the dressing the required mechanical properties, higher water vapor transmission rate (WVTR), less swelling time, improved antibacterial activity, and more cell proliferation compared to the PVA/CS film crosslinked by genipin. In vivo experiments indicate that the PVA/CS/mGO composite film can accelerate wound healing via enhancement of the re-epithelialization. PVA/CS/mGO composite film with 0.5 wt% mGO sheets displays the best wound healing properties, as manifested by the 50% higher antibacterial rate compared to GO and the wound healing rate of the mouse using this dressing is about 41% faster than the control group and 31% faster than the pure PVA/CS dressing. The underlying mechanism of the accelerated wound healing properties may be a result of the improved antibacterial ability to eradicate pathogenic bacteria on the wound area and maintain an appropriate moist aseptic wound healing environment to accelerate re-epithelialization. These findings suggest that this novel composite PVA/CS/mGO film may have promising applications in wound dressing.

Janus N,N-dimethylformamide as a solvent for a gradient porous wound dressing of poly(vinylidene fluoride) and as a reducer for in situ nano-silver production: anti-permeation, antibacterial and antifouling activities against multi-drug-resistant bacteria both in vitro and in vivo

The requirements for anti-permeation, anti-infection and antifouling when treating a malicious wound bed raise new challenges for wound dressing. The present study used N,N-dimethylformamide to treat poly(vinylidene fluoride) (PVDF) in order to obtain a dressing impregnated with in situ generated nano-silver particles (NS) via an immersion phase inversion method. Scanning electron microscopy (SEM) images showed that the film was characterized by a two-layer asymmetric structure with different pore sizes (top layer: ∼0.4 μm; bottom layer: ∼1.8 μm). The moisture permeability test indicated that the film had an optimal water vapor transmission rate (WVTR: ∼2500 g m-2 per day). TEM images revealed the successful formation of spherical NS, and Fourier-transform infrared spectroscopy (FTIR) demonstrated the integration of PVDF and NS (i.e., PVDF/NS). Correspondingly, the water contact angle measurements confirmed increased membrane surface hydrophobicity after NS integration. The inductively coupled plasma (ICP) spectrometry showed that the PVDF/NS displayed a continuous and safe release of silver ions. Moreover, in vitro experiments indicated that PVDF/NS films possessed satisfactory anti-permeation, antibacterial and antifouling activities against A. baumannii and E. coli bacteria, while they exhibited no obvious cytotoxicity toward mammalian HaCaT cells. Finally, the in vivo results showed that the nanoporous top layer of film could serve as a physical barrier to prevent bacterial penetration, whereas the microporous bottom layer could efficiently prevent bacterial infection caused by biofouling, leading to fast re-epithelialization via the enhancement of keratinocyte proliferation. Collectively, the results show that the PVDF/NS25 film has a promising application in wound treatment, especially for wounds infected by multi-drug-resistant bacteria such as A. baumannii.

Polydimethylsiloxane incorporated with reduced graphene oxide (rGO) sheets for wound dressing application: Preparation and characterization

Toward fabricating a novel multifunctional wound dressing material, we incorporated a series of contents of reduced graphene oxide (rGO) sheets into polydimethylsiloxane (PDMS) matrix to prepare the rGO-PDMS composite membrane and be used for wound dressing. The pore structure, dispersion of rGO, physical properties, water vapor transmission rate (WVTR), cytotoxicity and antibacterial activity were studied. Finally, the effect of the rGO-PDMS composite membrane on wound healing was investigated on a murine full-thickness skin wound model. The rGO-PDMS composite membrane exhibited bionic performance (ordered pore structure and suitable WVTR), improved mechanical properties, good compatibility and effective antibacterial activity. In vivo experiment indicated that the rGO-PDMS composite membrane could accelerate wound healing via enhancement of the re-epithelialization and granulation tissue formation. These findings suggest that rGO doping PDMS uniquely resulted in a multifunctional material for potential use in wound dressing.