Rational design and latest advances of polysaccharide-based hydrogels for wound healing

A macromolecular cross-linked alginate aerogel with excellent concentrating effect for rapid hemostasis

Alginate-based materials present promising potential for emergency hemostasis due to their excellent properties, such as procoagulant capability, biocompatibility, low immunogenicity, and cost-effectiveness. However, the inherent deficiencies in water solubility and mechanical strength pose a threat to hemostatic efficiency. Here, we innovatively developed a macromolecular cross-linked alginate aerogel based on norbornene- and thiol-functionalized alginates through a combined thiol-ene cross-linking/freeze-drying process. The resulting aerogel features an interconnected macroporous structure with remarkable water-uptake capacity (approximately 9000 % in weight ratio), contributing to efficient blood absorption, while the enhanced mechanical strength of the aerogel ensures stability and durability during the hemostatic process. Comprehensive hemostasis-relevant assays demonstrated that the aerogel possessed outstanding coagulation capability, which is attributed to the synergistic impacts on concentrating effect, platelet enrichment, and intrinsic coagulation pathway. Upon application to in vivo uncontrolled hemorrhage models of tail amputation and hepatic injury, the aerogel demonstrated significantly superior performance compared to commercial alginate hemostatic agent, yielding reductions in clotting time and blood loss of up to 80 % and 85 %, respectively. Collectively, our work illustrated that the alginate porous aerogel overcomes the deficiencies of alginate materials while exhibiting exceptional performance in hemorrhage, rendering it an appealing candidate for rapid hemostasis.

O-carboxymethyl chitosan in biomedicine: A review

O-carboxymethyl chitosan (O-CMC) is a chitosan derivative produced through the substitution of hydroxyl (-OH) functional groups in glucosamine units with carboxymethyl (-CH2COOH) substituents, effectively addressing the inherent solubility issues of chitosan in aqueous solutions. O-CMC has garnered significant interest due to its enhanced solubility, elevated viscosity, minimal toxicity, and advantageous biocompatibility properties. Furthermore, O-CMC demonstrates antibacterial, antifungal, and antioxidant characteristics, rendering it a promising candidate for various biomedical uses such as wound healing, tissue engineering, anti-tumor therapies, biosensors, and bioimaging. Additionally, O-CMC is well-suited for the fabrication of nanoparticles, hydrogels, films, microcapsules, and tablets, offering opportunities for effective drug delivery systems. This review outlines the distinctive features of O-CMC, offers analyses of advancements and future potential based on current research, examines significant obstacles for clinical implementation, and foresees its ongoing significant impacts in the realm of biomedicine.

Near-Infrared Responsive Nanocomposite Hydrogel Dressing with Anti-Inflammation and Pro-Angiogenesis for Wound Healing

Anti-inflammatory and angiogenesis are two important factors in wound healing. Wound dressings with anti-inflammation and vascularization are essential to address complex interventions, expensive treatments, and uncontrolled release mechanisms. Based on the above considerations, we designed a near-infrared (NIR)-responsive hydrogel dressing, which is composed of mPDA-DFO@LA nanoparticles (mPDA: dopamine hydrochloride nanoparticles, DFO: deferoxamine, LA: lauric acid), valsartan (abbreviated as Va), and dopamine-hyaluronic acid hydrogel. The hydrogel dressing demonstrated injectability, bioadhesive, and photothermal properties. The results indicated the obtained dressing by releasing Va can appropriately regulate macrophage phenotype transformation from M1 to M2, resulting in an anti-inflammatory environment. In addition, DFO encapsulated by LA can be sustainably released into the wound site by NIR irradiation, which further prevents excessive neovascularization. Notably, the results in vivo indicated the mPDA-DFO@LA/Va hydrogel dressing significantly enhanced wound recovery, achieving a healing rate of up to 96% after 11 days of treatment. Therefore, this NIR-responsive hydrogel dressing with anti-inflammation, vascularization, and on-demand programmed drug release will be a promising wound dressing for wound infection.

Genipin crosslinked quaternary ammonium chitosan hydrogels for wound dressings

Bacterial infection can lead to various complications, such as inflammations on surrounding tissues, which can prolong wound healing and thus represent a significant clinical and public healthcare problem. Herein, a report on the fabrication of a novel genipin/quaternized chitosan (CS) hydrogel for wound dressing is presented. The hydrogel was prepared by mixing quaternized CS and genipin under 35 °C bath. The hydrogels showed porous structure (250-500 μm) and mechanical properties (3000-6000 Pa). In addition, the hydrogels displayed self-healing ability and adhesion performance on different substrates. Genipin crosslinked quaternized CS hydrogels showed antibacterial activities againstE. coliandS. aureus. The CCK-8 and fluorescent images confirmed the cytocompatibility of hydrogels by seeding with NIH-3T3 cells. The present study showed that the prepared hydrogel has the potential to be used as wound dressing.

Antibacterial polylysine-containing hydrogels for hemostatic and wound healing applications: preparation methods, current advances and future perspectives

The treatment of various types of wounds such as dermal wounds, multidrug resistant bacteria-infected wounds, and chronic diabetic wounds is one of the critical challenges facing healthcare systems. Delayed wound healing can impose a remarkable burden on patients and health care professionals. In this case, given their unique three-dimensional porous structure, biocompatibility, high hydrophilicity, capability to provide a moist environment while absorbing wound exudate, permeability to both gas and oxygen, and tunable mechanical properties, hydrogels with antibacterial function are one of the most promising candidates for wound healing applications. Polylysine is a cationic polymer with the advantages of inherent antibacterial properties, biodegradability, and biocompatibility. Therefore, its utilization to engineer antibacterial hydrogels for accelerating wound healing is of great interest. In this review, we initially discuss polylysine properties, and then focus on the most recent advances in polylysine-containing hydrogels (since 2016) prepared using various chemical and physical crosslinking methods for hemostasis and wound healing applications. Finally, the challenges and future directions in the engineering of these antibacterial hydrogels for wound healing are discussed.

Iron(III) cross-linked hydrogels based on Alteromonas macleodii Mo 169 exopolysaccharide

Recently, polysaccharide-based hydrogels crosslinked with the trivalent iron cation have attracted interest due to their remarkable properties that include high mechanical stability, stimuli-responsiveness, and enhanced absorptivity. In this study, a Fe3+ crosslinked hydrogel was prepared using the biocompatible extracellular polysaccharide (EPS) secreted by the marine bacterium Alteromonas macleodii Mo169. Hydrogels with mechanical strengths (G') ranging from 0.3 kPa to 44.5 kPa were obtained as a result of the combination of different Fe3+ (0.05-9.95 g L-1) and EPS (0.3-1.7 %) concentrations. All the hydrogels had a water content above 98 %. Three different hydrogels, named HA, HB, and HC, were chosen for further characterization. With strength values (G') of 3.2, 28.9, and 44.5 kPa, respectively, these hydrogels might meet the strength requirements for several specific applications. Their mechanical resistance increased as higher Fe3+ and polymer concentrations were used in their preparation (the compressive hardness increased from 8.7 to 192.1 kPa for hydrogel HA and HC, respectively). In addition, a tighter mesh was noticed for HC, which was correlated to its lower swelling ratio value compared to HA and HB. Overall, this preliminary study highlighted the potential of these hydrogels for tissue engineering, drug delivery, or wound healing applications.

Novel Sprayable Antioxidative Dressing Based on Fullerene and Curdlan for Accelerating Chronic Wound Healing

The effective treatment of chronic wounds represents a critical global medical challenge demanding urgent attention. Persistent inflammation, driven by an excess of reactive oxygen radicals, sets in motion a detrimental cycle leading to chronic wounds and impeding the natural healing process. This study develops a sprayable wound dressing by covalently grafting amino fullerene to carboxymethylated curdlan (CMC-C). This novel dressing exhibits excellent biocompatibility, antioxidant, and reactive oxygen species scavenging properties. Furthermore, it demonstrates a targeted affinity for HEK-a cells, efficiently reducing the inflammatory response while promoting cell proliferation and migration in vitro. Moreover, the animal experiment investigations reveal that CMC-C significantly accelerates chronic wounds healing by regulating the inflammatory process, promoting collagen deposition, and improving vascularization. These results demonstrate the potential of the sprayable dressing (CMC-C) in curing the healing of chronic wounds through the modulation of the inflammatory microenvironment. Overall, the sprayable hydrogel dressing based on water-soluble derivative of fullerene and curdlan emerges as a potential approach for clinical applications in the treatment of chronic wounds.

Renewable Electroconductive Hydrogels for Accelerated Diabetic Wound Healing and Motion Monitoring

Diabetic foot ulcers (DFUs), a prevalent complication of diabetes mellitus, may result in an amputation. Natural and renewable hydrogels are desirable materials for DFU dressings due to their outstanding biosafety and degradability. However, most hydrogels are usually only used for wound repair and cannot be employed to monitor motion because of their inherent poor mechanical properties and electrical conductivity. Given that proper wound stretching is beneficial for wound healing, the development of natural hydrogel patches integrated with wound repair properties and motion monitoring was expected to achieve efficient and accurate wound healing. Here, we designed a dual-network (chitosan and sodium alginate) hydrogel embedded with lignin-Ag and quercetin-melanin nanoparticles to achieve efficient wound healing and motion monitoring. The double network formed by the covalent bond and electrostatic interaction confers the hydrogel with superior mechanical properties. Instead of the usual chemical reagents, genipin extracted from Gardenia was used as a cross-linking agent for the hydrogel and consequently improved its biosafety. Furthermore, the incorporation of lignin-Ag nanoparticles greatly enhanced the mechanical strength, antibacterial efficacy, and conductivity of the hydrogel. The electrical conductivity of hydrogels gives them the capability of motion monitoring. The motion sensing mechanism is that stretching of the hydrogel induced by motion changes the conductivity of the hydrogel, thus converting the motion into an electrical signal. Meanwhile, quercetin-melanin nanoparticles confer exceptional adhesion, antioxidant, and anti-inflammatory properties to the hydrogels. The system ultimately achieved excellent wound repair and motion monitoring performance and was expected to be used for stretch-assisted safe and accurate wound repair in the future.

Multifunctional Cu2Se/F127 Hydrogel with SOD-Like Enzyme Activity for Efficient Wound Healing

Free radicals are secreted following skin damage and cause oxidative stress and inflammatory reactions that increase the difficulty of wound healing. In this study, copper-based nanozyme Cu2Se nanosheets (NSs) are synthesized by an anion-exchange strategy and apply to wounds with F127 hydrogels to investigate the healing effect of this nanozyme composite hydrogels on wounds. Cu2Se NSs have a large number of catalytically active centers, are simple to synthesize, require few reaction conditions and have a short synthesis cycle. In vitro experiments have shown that Cu2Se NSs possess superoxide dismutase (SOD)-like activity and nitrogen radical scavenging activity and promote angiogenesis and fibroblast migration. The doping of Cu2Se NSs into the F127 hydrogel does not have a significantly affect on the properties of the hydrogel. This hybridized hydrogel not only adapts to the irregular and complex morphology of acute wounds but also prolongs the duration of nanozyme action on the wound, thus promoting wound healing. Transcriptomic analysis further reveals the potential therapeutic mechanism of the Cu2Se/F127 hydrogel in promoting acute wound healing. Animal experiments have shown that the Cu2Se/F127 hydrogel has good biosafety. The Cu2Se/F127 hydrogel provides an innovative idea for the development of hydrogel dressings for the treatment of acute wounds.

Multifunctional antibacterial hydrogels for chronic wound management

Chronic wounds have gradually evolved into a global health challenge, comprising long-term non-healing wounds, local tissue necrosis, and even amputation in severe cases. Accordingly, chronic wounds place a considerable psychological and economic burden on patients and society. Chronic wounds have multifaceted pathogenesis involving excessive inflammation, insufficient angiogenesis, and elevated reactive oxygen species levels, with bacterial infection playing a crucial role. Hydrogels, renowned for their excellent biocompatibility, moisture retention, swelling properties, and oxygen permeability, have emerged as promising wound repair dressings. However, hydrogels with singular functions fall short of addressing the complex requirements associated with chronic wound healing. Hence, current research emphasises the development of multifunctional antibacterial hydrogels. This article reviews chronic wound characteristics and the properties and classification of antibacterial hydrogels, as well as their potential application in chronic wound management.

Collagen/gelatin and polysaccharide complexes enhance gastric retention and mucoadhesive properties

This article has focused on collagen-gelatin, the gelation process, as well as blend interaction between collagen/gelatin with various polysaccharides to boost mucoadhesion and gastric retention. The interaction between mucoadhesive materials and mucin layers is of significant interest in the development of drug delivery systems and biomedical applications for effective targeting and prolonged time in the gastrointestinal tract. This paper reviews the current advancement and mucoadhesive properties of collagen/gelatin and different polysaccharide complexes concerning the mucin layer and interactions are briefly highlighted. Collagen/gelatin and polysaccharide blends biocompatible and biodegradable, the complex biomolecules have shown encouraging mucoadhesive properties due to their cationic nature and ability to form hydrogen bonds with mucin glycoproteins. The mucoadhesion mechanism was attributed to the electrostatic interactions between the positively charged amino (NH2) groups of blend biopolymers and the negatively charged sialic acid residues present in mucin glycoprotein. At the end of this article, the encouraging prospect of collagen/polysaccharide complex and mucin glycoprotein is highlighted.

Evaluation of drug release efficiency and antibacterial property of a pH-responsive dextran-based silver nanocomposite hydrogel

The bioavailability of curcumin (CUR), a highly lipophilic and commonly used anticancer drug, is mainly affected by its poor solubility in aqueous environment and quick metabolism. These challenges can be met by employing delivery systems. Nanocomposite materials have been used as delivery systems to enhance the solubility and dissolution rate of the drug. This study aims to develop dextran-graft-poly(4-acryloylmorpholine) silver nanocomposite using a microwave-assisted method to evaluate its drug-release efficiency and antimicrobial activity. The materials were characterized by FT-IR, FE-SEM, EDS, XRD, HR-TEM, TGA, and BET techniques. Drug loading and release efficiency were evaluated using CUR as the model drug. The swelling and drug release studies were conducted in buffer solutions of pH 1.2 and 7.4. Staphylococcus aureus and Escherichia coli were employed to evaluate the antibacterial activity. The cytotoxicity was assessed by MTT assay against the breast MCF-10. Higher swelling and drug release were observed at pH 1.2 than 7.4. Nanocomposite hydrogel exhibited antibacterial activity against the tested bacterial strains. Cytotoxicity study proved the safety of the developed matrix. The results suggest the developed nanocomposite hydrogel to be a promising polymer matrix for the sustained release of CUR for cancer treatment that requires infectious control.

Bacterial cellulose-based hydrogel with regulated rehydration and enhanced antibacterial activity for wound healing

Bacterial cellulose (BC) hydrogels are promising medical biomaterials that have been widely used for tissue repair, wound healing and cartilage engineering. However, the high water content of BC hydrogels increases the difficulty of storage and transportation. Moreover, they will lose their original hydrogel structure after dehydration, which severely limits their practical applications. Introducing the bio-based polyelectrolytes is expected to solve this problem. Here, we modified BC and combined it with quaternized chitosan (QCS) via a chemical reaction to obtain a dehydrated dialdehyde bacterial cellulose/quaternized chitosan (DBC/QCS) hydrogel with repeated swelling behavior and good antibacterial properties. The hydrogel can recover the initial state on the macro scale with a swelling ratio over 1000 % and possesses excellent antimicrobial properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) with a killing rate of 80.8 % and 81.3 %, respectively. In addition, the hydrogel has excellent biocompatibility, which is conducive to the stretching of L929 cells. After 14 d of in vivo wound modeling in rats, it was found that the hydrogel loaded with pirfenidone (PFD) could promote collagen deposition and accelerate wound healing with scar prevention. This rehydratable hydrogel can be stored and transported under dry conditions, which is promising for practical applications.

Natural polyphenolic antibacterial bio-adhesives for infected wound healing

Bio-adhesives used clinically, commonly have the ability to fill surgical voids and support wound healing, but which are devoid of antibacterial activity, and thus, could not meet the particular needs of the infected wound site. Herein, a series of natural polyphenolic antibacterial bio-adhesives were prepared via simple mixing and heating of polyphenols and acid anhydrides without any solvent or catalyst. Upon the acid anhydride ring opening and acylation reactions, various natural polyphenolic bio-adhesives could adhere to various substrates (i.e., tissue, wood, glass, rubber, paper, plastic, and metal) based on multi-interactions. Moreover, these bio-adhesives showed excellent antibacterial and anti-infection activity, rapid hemostatic performance and appropriate biodegradability, which could be widely used in promoting bacterial infection wound healing and hot burn infection wound repair. This work could provide a new strategy for strong adhesives using naturally occurring molecules, and provide a method for the preparation of novel multifunctional wound dressings for infected wound healing.

Nanoarchitectonics of Bimetallic Cu-/Co-Doped Nitrogen-Carbon Nanozyme-Functionalized Hydrogel with NIR-Responsive Phototherapy for Synergistic Mitigation of Drug-Resistant Bacterial Infections

Superbug infections and transmission have become major challenges in the contemporary medical field. The development of novel antibacterial strategies to efficiently treat bacterial infections and conquer the problem of antimicrobial resistance (AMR) is extremely important. In this paper, a bimetallic CuCo-doped nitrogen-carbon nanozyme-functionalized hydrogel (CuCo/NC-HG) has been successfully constructed. It exhibits photoresponsive-enhanced enzymatic effects under near-infrared (NIR) irradiation (808 nm) with strong peroxidase (POD)-like and oxidase (OXD)-like activities. Upon NIR irradiation, CuCo/NC-HG possesses photodynamic activity for producing singlet oxygen(1O2), and it also has a high photothermal conversion effect, which not only facilitates the elimination of bacteria but also improves the efficiency of reactive oxygen species (ROS) production and accelerates the consumption of GSH. CuCo/NC-HG shows a lower hemolytic rate and better cytocompatibility than CuCo/NC and possesses a positive charge and macroporous skeleton for restricting negatively charged bacteria in the range of ROS destruction, strengthening the antibacterial efficiency. Comparatively, CuCo/NC and CuCo/NC-HG have stronger bactericidal ability against methicillin-resistant Staphylococcus aureus (MRSA) and ampicillin-resistant Escherichia coli (AmprE. coli) through destroying the cell membranes with a negligible occurrence of AMR. More importantly, CuCo/NC-HG plus NIR irradiation can exhibit satisfactory bactericidal performance in the absence of H2O2, avoiding the toxicity from high-concentration H2O2. In vivo evaluation has been conducted using a mouse wound infection model and histological analyses, and the results show that CuCo/NC-HG upon NIR irradiation can efficiently suppress bacterial infections and promote wound healing, without causing inflammation and tissue adhesions.

Using bacterial cellulose to bridge covalent and physical crosslinks in hydrogels for fabricating multimodal sensors

Network optimization is vital for the polysaccharide based hydrogels with multiple crosslinks. In this study, we developed a 'two-step' strategy to activate synergistic effect of chemical and physical crosslinks using a poly (vinyl alcohol) (PVA)/bacterial cellulose (BC) hydrogel as a template. The BC nanofibers, on the one hand, acted as nucleating agents, participating in the crystallization of PVA, and on the other hand, were also involved in the formation of boronic ester bond, anchored with the PVA chains via chemical bonding. Therefore, the existence of BC nanofibers, as 'bridge', linked the crystalline regions and amorphous parts of PVA together, associating the two characteristic crosslinks, which was conducive to load transfer. The mechanical properties of resultant hydrogels, including the tensile elongation and strength, as well as fracture toughness, were significantly improved. Moreover, the dually cross-linked hydrogels possessed ionic conductivity, which was sensitive to the tensile deformation and environmental temperature. This study clarifies a unique role of BC nanofibers in hydrogels, and proposes an effective approach to construct multiple networks in the nanocellulose reinforced PVA hydrogels.

Rapid innervation and physiological epidermal regeneration by bioengineered dermis implanted in mouse

Tissue-engineered skin substitutes are promising tools to cover large and deep skin defects. However, the lack of a synergic and fast regeneration of the vascular network, nerves, and skin appendages limits complete skin healing and impairs functional recovery. It has been highlighted that an ideal skin substitute should mimic the structure of the native tissue to enhance clinical effectiveness. Here, we produced a pre-vascularized dermis (PVD) comprised of fibroblasts embedded in their own extracellular matrix (ECM) and a capillary-like network. Upon implantation in a mouse full-thickness skin defect model, we observed a very early innervation of the graft in 2 weeks. In addition, mouse capillaries and complete epithelialization were detectable as early as 1 week after implantation and, skin appendages developed in 2 weeks. These anatomical features underlie the interaction with the skin nerves, thus providing a further cue for reinnervation guidance. Further, the graft displays mechanical properties, collagen density, and assembly features very similar to the host tissue. Taken together our data show that the pre-existing ECM components of the PVD, physiologically organized and assembled similarly to the native tissue, support a rapid regeneration of dermal tissue. Therefore, our results suggest a promising potential for PVD in skin regeneration.

A dual network cross-linked hydrogel with multifunctional Bletilla striata polysaccharide/gelatin/tea polyphenol for wound healing promotion

Wound healing is a dynamic and complex biological process, and traditional biological excipients cannot meet the needs of the wound healing process, and there is an urgent need for a biological dressing with multifunctionality and the ability to participate in all stages of wound healing. This study developed tea polyphenol (TP) incorporated multifunctional hydrogel based on oxidized Bletilla striata polysaccharide (OBSP) and adipic acid dihydrazide modified gelatin (Gel-ADH) with antimicrobial, antioxidant hemostatic, and anti-inflammatory properties to promote wound healing. The composite OBSP, Gel-ADH, TP (OBGTP) hydrogels prepared by double crosslinking between OBSP, TP and Gel-ADH via Schiff base bonding and hydrogen bonding had good rheological and swelling properties. The introduction of TP provided the composite hydrogel with excellent antioxidant antibacterial activities against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coil). In the rat liver hemorrhage model and skin injury model, the OBGTP composite hydrogel had significant (p < 0.001) hemostatic ability, and had the ability to accelerate collagen deposition, reduce the expression of inflammatory factors, and promote rapid wound healing. In addition, OBGTP hydrogels had adhesive properties and good biocompatibility. In conclusion, OBGTP multifunctional composite hydrogels have great potential for wound healing applications.

Advancements in Regenerative Hydrogels in Skin Wound Treatment: A Comprehensive Review

This state-of-the-art review explores the emerging field of regenerative hydrogels and their profound impact on the treatment of skin wounds. Regenerative hydrogels, composed mainly of water-absorbing polymers, have garnered attention in wound healing, particularly for skin wounds. Their unique properties make them well suited for tissue regeneration. Notable benefits include excellent water retention, creating a crucially moist wound environment for optimal healing, and facilitating cell migration, and proliferation. Biocompatibility is a key feature, minimizing adverse reactions and promoting the natural healing process. Acting as a supportive scaffold for cell growth, hydrogels mimic the extracellular matrix, aiding the attachment and proliferation of cells like fibroblasts and keratinocytes. Engineered for controlled drug release, hydrogels enhance wound healing by promoting angiogenesis, reducing inflammation, and preventing infection. The demonstrated acceleration of the wound healing process, particularly beneficial for chronic or impaired healing wounds, adds to their appeal. Easy application and conformity to various wound shapes make hydrogels practical, including in irregular or challenging areas. Scar minimization through tissue regeneration is crucial, especially in cosmetic and functional regions. Hydrogels contribute to pain management by creating a protective barrier, reducing friction, and fostering a soothing environment. Some hydrogels, with inherent antimicrobial properties, aid in infection prevention, which is a crucial aspect of successful wound healing. Their flexibility and ability to conform to wound contours ensure optimal tissue contact, enhancing overall treatment effectiveness. In summary, regenerative hydrogels present a promising approach for improving skin wound healing outcomes across diverse clinical scenarios. This review provides a comprehensive analysis of the benefits, mechanisms, and challenges associated with the use of regenerative hydrogels in the treatment of skin wounds. In this review, the authors likely delve into the application of rational design principles to enhance the efficacy and performance of hydrogels in promoting wound healing. Through an exploration of various methodologies and approaches, this paper is poised to highlight how these principles have been instrumental in refining the design of hydrogels, potentially revolutionizing their therapeutic potential in addressing skin wounds. By synthesizing current knowledge and highlighting potential avenues for future research, this review aims to contribute to the advancement of regenerative medicine and ultimately improve clinical outcomes for patients with skin wounds.

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.

Cryogel wound dressings based on natural polysaccharides perfectly adhere to irregular wounds for rapid haemostasis and easy disassembly

Skin injuries can have unexpected surfaces, leading to uneven wound surfaces and inadequate dressing contact with these irregular surfaces. This can decrease the dressing's haemostatic action and increase the healing period. This study recommends the use of sticky and flexible cryogel coverings to promote faster haemostasis and efficiently handle uneven skin wounds. Alginate cryogels have a fast haemostatic effect and shape flexibility due to their macroporous structure. The material demonstrates potent antibacterial characteristics and enhances skin adherence by adding grafted chitosan with gallic acid. In irregular defect wound models, cryogels can cling closely to uneven damage surfaces due to their amorphous nature. Furthermore, their macroporous structure allows for quick haemostasis by quickly absorbing blood and wound exudate. After giving the dressing a thorough rinse, its adhesive strength reduces and it is simple to remove without causing any damage to the wound. Cryogel demonstrated faster haemostasis than gauze in a wound model on a rat tail, indicating that it has considerable potential for use as a wound dressing in the biomedical area.

CO2-Mediated Alkali-Neutralization Curdlan Hydrogels for Potential Wound Healing Application

Physical hydrogels of natural polysaccharides are considered as ideal candidates for wound dressing due to their natural biological activity and no harmful cross-linking agents. However, it remains a challenge to fabricate such hydrogel dressings in a facile and low-cost way. Herein, we reported an easy and cost-effective method to construct CO2-mediated alkali-neutralization Curdlan (CR) hydrogels without using an external cross-linking agent. Two types of hydrogels (denoted as CR-NaOH and CR-Na3PO4, respectively) were fabricated by dissolving CR powders in a NaOH or Na3PO4 aqueous solution, followed by keeping the CR alkaline solutions in air. The obtained pure CR hydrogels possessed a tunable porous structure with walls containing different forms of nanofibrils. These hydrogels exhibited much higher gel strength by comparison with the gels prepared by conventional heating treatment. They were flexible, stretchable, twistable, and conformable to arbitrarily curved skins. Moreover, they exhibited ideal swellability, proper degradability, and water vapor transmission rate, and their physicochemical properties were closely related to CR concentration in the alkaline solution. These two hydrogels also supported the growth of L929 cells. Importantly, studies on wound healing revealed that both 3CR-NaOH and 3CR-Na3PO4 hydrogels were capable of accelerating the wound healing process through recruiting more macrophages/fibroblasts, inducing more collagen deposition and neovascularization (α-SMA and CD31) without carrying any exogenous bioactive components. In conclusion, the present work not only reported promising materials for application in wound therapy but also offered a facile and safe manufacturing procedure for generating pure CR physical hydrogels with better performance.

Bifunctional lignocellulose nanofiber hydrogel possessing intriguing pH-responsiveness and self-healing capability towards wound healing applications

Lignocellulose nanofibers (LCNF) obtained from agricultural waste are potential candidates for enhancing composite materials because of their excellent mechanical properties, abundant groups and high biocompatibility. However, the application of LCNF has received limited attention to date from researchers in the healthcare field. Herein, based on the bifunctional group (carboxyl and aldehyde groups) modified LCNF (DCLCNF) and chitosan (CS), we developed a multifunctional bio-based hydrogel (CS-DCLCNF). The addition of lignin-containing DCLCNF strengthened the internal crosslinking and the intermolecular interaction of hydrogels, and the presence of lignin and carboxyl groups increased the mechanical strength of the hydrogel and the adsorption of aromatic drugs. Results revealed that the hydrogels exhibited self-healing, injectable, and high swelling rates. The hydrogels had favorable mechanical strength (G'max of ~16.60 kPa), and the maximum compressive stress was 24 kPa. Moreover, the entire tetracycline hydrochloride (TH) release process was slow and pH-responsive, because of the rich noncovalent and π-π interactions between DCLCNF and TH. The hydrogels also exhibited excellent biocompatibility and antibacterial properties. Notably, the wound healing experiment showed that the hydrogels were beneficial in accelerating wounds healing, which could heal completely in 13 days. Therefore, CS-DCLCNF hydrogels may have promising applications in drug delivery for wound healing.

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.

Exploring polysaccharide-based bio-adhesive topical film as a potential platform for wound dressing application: A review

Wound dressings act as a physical barrier between the wound site and the external environment, preventing additional harm; choosing suitable wound dressings is essential for the healing process. Polysaccharide biopolymers have demonstrated encouraging findings and therapeutic prospects in recent decades about wound therapy. Additionally, polysaccharides have bioactive qualities like anti-inflammatory, antibacterial, and antioxidant capabilities that can help the process of healing. Due to their excellent tissue adhesion, swelling, water absorption, bactericidal, and immune-regulating properties, polysaccharide-based bio-adhesive films have recently been investigated as intriguing alternatives in wound management. These films also mimic the structure of the skin and stimulate the regeneration of the skin. This review presented several design standards and functions of suitable bio-adhesive films for the healing of wounds. Additionally, the most recent developments in the use of bio-adhesive films as wound dressings based on polysaccharides, including hyaluronic acid, chondroitin sulfate, dextran, alginate, chitosan, cellulose, konjac glucomannan, gellan gum, xanthan gum, pectin, guar gum, heparin, arabinogalactans, carrageen, and tragacanth gum, are thoroughly discussed. Lastly, to create a road map for the function of polysaccharide-based bio-adhesive films in advanced wound care, their clinical performances and future challenges in making bio-adhesive films by three-dimensional bioprinting are summarized.

Metallic-Polyphenolic Nanoparticles Reinforced Cationic Guar Gum Hydrogel for Effectively Treating Burn Wound

The development of injectable hydrogel dressings which are long-term moisturizing, easy-to-apply, and effectively inhibiting infection and inflammatory is essential to promote burn wound repairing. Herein, an injectable hydrogel with moisturizing, antibacterial, and anti-inflammation abilities via multiple reversible interactions between cation guar gum (CG) and metallic-polyphenolic nanoparticles (PA-ZnII NPs) is developed. Specifically, PA-ZnII NPs is formed by synergistic complexation of protocatechualdehyde (PA) and zinc ion (Zn2+ ), provides CGPZ hydrogel with plentiful reversible interactions to inhibit the loss of moist. By interacting with PA-ZnII NPs, the CGPZ hydrogel can provide enhanced moisturization for more than 3 days. Moreover, the CGPZ hydrogel can maintain good adhesion for a period of time with injection and self-healing capabilities due to reversible interactions between CG and PA-ZnII NPs. In addition, CGPZ hydrogel exhibits outstanding broad spectrum antibacterial performance, as its killing efficiency against Escherichia coli and Staphylococcus aureus is all greater than 99.99%. Importantly, compared with commercial dressing, the CGPZ hydrogel can promote wound healing faster by inhibiting tissue damage from dysregulated inflammation and accelerating neovascularization. It is believed that the moisturizing CGPZ hydrogel with antibacterial and anti-inflammation performance can serve as a promising dressing for the effective treatment of burn wound.

Emerging horizons and prospects of polysaccharide-constructed gels in the realm of wound healing

Polysaccharides, with the abundant availability, biodegradability, and inherent safety, offer a vast array of promising applications. Leveraging the remarkable attributes of polysaccharides, biomimetic and multifunctional hydrogels have emerged as a compelling avenue for efficacious wound dressing. The gels emulate the innate extracellular biomatrix as well as foster cellular proliferation. The distinctive structural compositions and profusion of functional groups within polysaccharides confer excellent physical/chemical traits as well as distinct restorative involvements. Gels crafted from polysaccharide matrixes serve as a robust defense against bacterial threats, effectively shielding wounds from harm. This comprehensive review delves into wound physiology, accentuating the significance of numerous polysaccharide-based gels in the wound healing context. The discourse encompasses an exploration of polysaccharide hydrogels tailored for diverse wound types, along with an examination of various therapeutic agents encapsulated within hydrogels to facilitate wound repair, incorporating recent patent developments. Within the scope of this manuscript, the perspective of these captivating gels for promoting optimal healing of wounds is vividly depicted. Nevertheless, the pursuit of knowledge remains ongoing, as further research is warranted to bioengineer progressive polysaccharide gels imbued with adaptable features. Such endeavors hold the promise of unlocking substantial potential within the realm of wound healing, propelling us toward multifaceted and sophisticated solutions.

Towards superior biopolymer gels by enabling interpenetrating network structures: A review on types, applications, and gelation strategies

Gels derived from single networks of natural polymers (biopolymers) typically exhibit limited physical properties and thus have seen constrained applications in areas like food and medicine. In contrast, gels founded on a synergy of multiple biopolymers, specifically polysaccharides and proteins, with intricate interpenetrating polymer network (IPN) structures, represent a promising avenue for the creation of novel gel materials with significantly enhanced properties and combined advantages. This review begins with the scrutiny of newly devised IPN gels formed through a medley of polysaccharides and/or proteins, alongside an introduction of their practical applications in the realm of food, medicine, and environmentally friendly solutions. Finally, based on the fact that the IPN gelation process and mechanism are driven by different inducing factors entwined with a diverse amalgamation of polysaccharides and proteins, our survey underscores the potency of physical, chemical, and enzymatic triggers in orchestrating the construction of crosslinked networks within these biomacromolecules. In these mixed systems, each specific inducer aligns with distinct polysaccharides and proteins, culminating in the generation of semi-IPN or fully-IPN gels through the intricate interpenetration between single networks and polymer chains or between two networks, respectively. The resultant IPN gels stand as paragons of excellence, characterized by their homogeneity, dense network structures, superior textural properties (e.g., hardness, elasticity, adhesion, cohesion, and chewability), outstanding water-holding capacity, and heightened thermal stability, along with guaranteed biosafety (e.g., nontoxicity and biocompatibility) and biodegradability. Therefore, a judicious selection of polymer combinations allows for the development of IPN gels with customized functional properties, adept at meeting precise application requirements.

Porous Collagen Sponge Loaded with Large Efficacy-Potentiated Exosome-Mimicking Nanovesicles for Diabetic Skin Wound Healing

Diabetic skin wounds are difficult to heal quickly due to insufficient angiogenesis and prolonged inflammation, which is an urgent clinical problem. To address this clinical problem, it becomes imperative to develop a dressing that can promote revascularization and reduce inflammation during diabetic skin healing. Herein, a multifunctional collagen dressing (CTM) was constructed by loading large efficacy-potentiated exosome-mimicking nanovesicles (L-Meseomes) into a porous collagen sponge with transglutaminase (TGase). L-Meseomes were constructed in previous research with the function of promoting cell proliferation, migration, and angiogenesis and inhibiting inflammation. CTM has a three-dimensional porous network structure with good biocompatibility, swelling properties, and degradability and could release L-Meseome slowly. In vitro experiments showed that CTM could promote the proliferation of fibroblasts and the polarization of macrophages to the anti-inflammatory phenotype. For in vivo experiments, on the 21st day after surgery, the wound healing rates of the control and CTM were 83.026 ± 4.17% and 93.12 ± 2.16%, respectively; the epidermal maturation and dermal differentiation scores in CTM were approximately four times that of the control group, and the skin epidermal thickness of the CTM group was approximately 20 μm, which was closest to that of normal rats. CTM could significantly improve wound healing in diabetic rats by promoting anti-inflammation, angiogenesis, epidermal recovery, and dermal collagen deposition. In summary, the multifunctional collagen dressing CTM could significantly promote the healing of diabetic skin wounds, which provides a new strategy for diabetic wound healing in the clinic.

Gellan gum-dopamine mediated in situ synthesis of silver nanoparticles and development of nano/micro-composite injectable hydrogel with antimicrobial activity

Infected skin wounds represent a serious health threat due to the long healing process and the risk of colonization by multi-drug-resistant bacteria. Silver nanoparticles (AgNPs) have shown broad-spectrum antimicrobial activity. This study introduces a novel approach to address the challenge of infected skin wounds by employing gellan gum-dopamine (GG-DA) as a dual-functional agent, serving both as a reducing and capping agent, for the in situ green synthesis of silver nanoparticles. Unlike previous methods, this work utilizes a spray-drying technique to convert the dispersion of GG-DA and AgNPs into microparticles, resulting in nano-into-micro systems (AgNPs@MPs). The microparticles, with an average size of approximately 3 μm, embed AgNPs with a 13 nm average diameter. Furthermore, the study explores the antibacterial efficacy of these AgNPs@MPs directly and in combination with other materials against gram-positive and gram-negative bacteria. The versatility of the antimicrobial material is showcased by incorporating the microparticles into injectable hydrogels. These hydrogels, based on oxidized Xanthan Gum (XGox) and a hyperbranched synthetic polymer (HB10K-G5-alanine), are designed with injectability and self-healing properties through Shiff base formation. The resulting nano-into-micro-into-macro hybrid hydrogel emerges as a promising biomedical solution, highlighting the multifaceted potential of this innovative approach in wound care and infection management.

The Recent Progress of the Cellulose-Based Antibacterial Hydrogel

Cellulose-based antibacterial hydrogel has good biocompatibility, antibacterial performance, biodegradability, and other characteristics. It can be very compatible with human tissues and degradation, while its good water absorption and moisturizing properties can effectively absorb wound exudates, keep the wound moist, and promote wound healing. In this paper, the structural properties, and physical and chemical cross-linking preparation methods of cellulose-based antibacterial hydrogels were discussed in detail, and the application of cellulose-based hydrogels in the antibacterial field was deeply studied. In general, cellulose-based antibacterial hydrogels, as a new type of biomaterial, have shown good potential in antimicrobial properties and have been widely used. However, there are still some challenges, such as optimizing the preparation process and performance parameters, improving the antibacterial and physical properties, broadening the application range, and evaluating safety. However, with the deepening of research and technological progress, it is believed that cellulose-based antibacterial hydrogels will be applied and developed in more fields in the future.

Polysaccharide Composite Alginate-Pectin Hydrogels as a Basis for Developing Wound Healing Materials

This article presents materials that highlight the bioengineering potential of polymeric systems of natural origin based on biodegradable polysaccharides, with applications in creating modern products for localized wound healing. Exploring the unique biological and physicochemical properties of polysaccharides offers a promising avenue for the atraumatic, controlled restoration of damaged tissues in extensive wounds. The study focused on alginate, pectin, and a hydrogel composed of their mixture in a 1:1 ratio. Atomic force microscopy data revealed that the two-component gel exhibits greater cohesion and is characterized by the presence of filament-like elements. The dynamic light scattering method indicated that this structural change results in a reduction in the damping of acoustic modes in the gel mixture compared to the component gels. Raman spectroscopy research on these gels revealed the emergence of new bonds between the components' molecules, contributing to the observed effects. The biocompatibility of the gels was evaluated using dental pulp stem cells, demonstrating that all the gels exhibit biocompatibility.

Stimuli-responsive polysaccharide-based smart hydrogels for diabetic wound healing: Design aspects, preparation methods and regulatory perspectives

Diabetes adversely affects wound-healing responses, leading to the development of chronic infected wounds. Such wound microenvironment is characterized by hyperglycaemia, hyperinflammation, hypoxia, variable pH, upregulation of matrix metalloproteinases, oxidative stress, and bacterial colonization. These pathological conditions pose challenges for the effective wound healing. Therefore, there is a paradigm shift in diabetic wound care management wherein abnormal pathological conditions of the wound microenvironment is used as a trigger for controlling the drug release or to improve properties of wound dressings. Hydrogels composed of natural polysaccharides showed tremendous potential as wound dressings as well as stimuli-responsive materials due to their unique properties such as biocompatibility, biodegradability, hydrophilicity, porosity, stimuli-responsiveness etc. Hence, polysaccharide-based hydrogels have emerged as advanced healthcare materials for diabetic wounds. In this review, we presented important aspects for the design of hydrogel-based wound dressings with an emphasis on biocompatibility, biodegradability, entrapment of therapeutic agents, moisturizing ability, swelling, and mechanical properties. Further, various crosslinking methods that enable desirable properties and stimuli responsiveness to the hydrogels have been mentioned. Subsequently, state-of-the-art developments in mono- and multi- stimuli-responsive hydrogels have been presented along with the case studies. Finally regulatory perspectives, challenges for the clinical translation and future prospects have been discussed.

Supramolecular hydrogels for wound repair and hemostasis

The unique network characteristics and stimuli responsiveness of supramolecular hydrogels have rendered them highly advantageous in the field of wound dressings, showcasing unprecedented potential. However, there are few reports on a comprehensive review of supramolecular hydrogel dressings for wound repair and hemostasis. This review first introduces the major cross-linking methods for supramolecular hydrogels, which includes hydrogen bonding, electrostatic interactions, hydrophobic interactions, host-guest interactions, metal ligand coordination and some other interactions. Then, we review the advanced materials reported in recent years and then summarize the basic principles of each cross-linking method. Next, we classify the network structures of supramolecular hydrogels before outlining their forming process and propose their potential future directions. Furthermore, we also discuss the raw materials, structural design principles, and material characteristics used to achieve the advanced functions of supramolecular hydrogels, such as antibacterial function, tissue adhesion, substance delivery, anti-inflammatory and antioxidant functions, cell behavior regulation, angiogenesis promotion, hemostasis and other innovative functions in recent years. Finally, the existing problems as well as future development directions of the cross-linking strategy, network design, and functions in wound repair and hemostasis of supramolecular hydrogels are discussed. This review is proposed to stimulate further exploration of supramolecular hydrogels on wound repair and hemostasis by researchers in the future.

Chitosan-based supramolecular aerogel with "skeletal structure" constructed in natural deep eutectic solvents for medical dressings

Bacterial infection of wounds remains one of the major clinical challenges, calling for the urgent development of novel multifunctional biological dressings. In this study, we developed a chitosan-based supramolecular aerogel NADES/PVA/CS, constructed by hydrogen bonding between chitosan, a natural deep eutectic solvents and polyvinyl alcohol, as a novel wound dressing against bacterial infections. The effect of polyvinyl alcohol content and its incorporation within chitosan-based supramolecular aerogels were investigated. The results of antibacterial test and MTT assay showed that it has obvious inhibitory effect on Staphylococcus aureus and Escherichia coli, showing excellent biocompatibility and effectively promotes wound healing. The microstructure of chitosan-based supramolecular aerogel showed that by adjusting the addition amount of polyvinyl alcohol, it could exhibit a perfect skeleton-type 3D network structure, which also made it possess smaller density and larger porosity and exhibit excellent water absorption property, contributing to the wetting of wound surface. More importantly, chitosan-based supramolecular aerogel is an environment-friendly biomaterial, which has been verified by degradability experiment. In a word, these unique advantages provide a broad prospect for the medical application of chitosan-based supramolecular aerogel NADES/PVA/CS, and provide a new strategy for the construction of green polysaccharide medical materials.

Fabrication and characterization of an antibacterial chitosan-coated allantoin-loaded NaCMC/SA skin scaffold for wound healing applications

The field of tissue engineering has recently emerged as one of the most promising approaches to address the limitations of conventional tissue replacements for severe injuries. This study introduces a chitosan-coated porous skin scaffold based on sodium carboxymethyl cellulose (NaCMC) and sodium alginate (SA) hydrogels, incorporating allantoin (AL) as an antibacterial agent. The NaCMC/SA hydrogel was cross-linked with epichlorohydrin (ECH) and freeze-dried to obtain a three-dimensional porous structure. The coated and non-coated scaffolds underwent comprehensive evaluation and characterization through various in-vitro analyses, including SEM imaging, swelling, degradation, and mechanical assessments. Furthermore, the scaffolds were studied regarding their allantoin (AL) release profiles, antibacterial properties, cell viability, and cell adhesion. The in-vitro analyses revealed that adding a chitosan (CS) coating and allantoin (AL) to the NaCMC/SA hydrogel significantly improved the scaffolds' antibacterial properties and cell viability. It was observed that the NaCMC:SA ratio and ECH concentration influenced the swelling capacity, biodegradation, drug release profile, and mechanical properties of the scaffolds. Samples with higher NaCMC content exhibited enhanced swelling capacity, more controlled allantoin (AL) release, and improved mechanical strength. Furthermore, the in-vivo results demonstrated that the proposed skin scaffold exhibited satisfactory biocompatibility and supported cell viability during wound healing in Wistar rats, highlighting its potential for clinical applications.

Protein/polysaccharide-based hydrogels loaded probiotic-mediated therapeutic systems: A review

The natural characteristics of protein/polysaccharide-based hydrogels, as a potential drug delivery platform, have attracted extensive attention. Probiotics have attracted renewed interest in drug research because of their beneficial effects on host health. The idea of using probiotics loaded on protein/polysaccharide-based hydrogels as potential drugs to treat different diseases has been put forward and shows great prospects. Based on this, in this review, we highlight the design strategy of hydrogels loaded probiotic-mediated therapy systems and review the potential diseases that have been proved to be treatable in the laboratory, including promoting wound healing and improving intestinal health and vaginal health, and discuss the challenges existing in the current design.

Alginate/hyaluronic acid-based systems as a new generation of wound dressings: A review

Skin is the largest organ of the human body, which acts as a protective barrier against pathogens. Therefore, a lot of research has been carried out on wound care and healing. Creating an ideal environment for wound healing and optimizing the local and systemic conditions of the patient play critical roles in successful wound care. Many products have been developed for improving the wound environment and providing a protected and moist area for fast healing. However, there is still high demand for new systems with high efficiency. The first generation of wound dressings merely covered the wound, while the subsequent/last generations covered it and aided in healing it in different ways. In modern wound dressings, the kind of used materials and their complexity play a crucial role in the healing process. These new systems support wound healing by lowering inflammation, exudate, slough, and bacteria. This study addresses a review of alginate/hyaluronic acid-based wound dressings developed so far as well as binary and ternary systems and their role in wound healing. Our review corroborates that these systems can open up a new horizon for wounds that do not respond to usual treatments and have a long curing period.

Dual-Cross-Linked Chitosan-Based Antibacterial Hydrogels with Tough and Adhesive Properties for Wound Dressing

Biocompatible chitosan-based hydrogels have attracted extensive attention in wound dressing due to their human skin-like tissue characteristics. However, it is a crucial challenge to fabricate chitosan-based hydrogels with versatile properties, including flexibility, stretchability, adhesivity, and antibacterial activity. In this work, a kind of chitosan-based hydrogels with integrated functionalities are facilely prepared by solution polymerization of acrylamide (AAm) and sodium p-styrene sulfonate (SS) in the presence of quaternized carboxymethyl chitosan (QCMCS). Due to the dual cross-linking between QCMCS and P(AAm-co-SS), the optimized QCMCS/P(AAm-co-SS) hydrogel exhibits tough mechanical properties (0.767 MPa tensile stress and 1100% fracture strain) and moderate tissue adhesion (11.4 kPa). Moreover, biological evaluation in vitro illustrated that as-prepared hydrogel possesses satisfactory biocompatibility, hemocompatibility, and excellent antibacterial ability (against S. aureus and E. coli are 98.8% and 97.3%, respectively). Then, the hydrogels are tested in a rat model for bacterial infection incision in vivo, and the results show that they can significantly accelerate epidermal regeneration and wound closure. This is due to their ability to reduce the inflammatory response, promote the formation of collagen deposition and granulation tissue. The proposed chitosan-based antibacterial hydrogels have the potential to be a highly effective wound dressing in clinical wound healing.

In-situ wound healing by SDF-1-mimic peptide-loaded click crosslinked hyaluronic acid scaffold

Endogenous stem cell-based in-situ tissue regeneration has recently gained considerable attention. In this study, we investigated the potential of a chemokine, SDF-1-mimic peptide (SMP), to promote endogenous stem cell-based in-situ wound healing. Our approach involved the development of a click crosslinked hyaluronic acid scaffold loaded with SMP (Cx-HA + SMP) to release SMP in a wound site. The Cx-HA scaffold maintained its structural integrity throughout the wound healing process and also captured endogenous stem cells. Gradual SMP release from the Cx-HA + SMP scaffold established a concentration gradient at the wound site. In animal wound experiments, Cx-HA + SMP exhibited faster wound contraction compared to Cx-HA + SDF-1. Additionally, Cx-HA + SMP resulted in approximately 1.2-1.6 times higher collagen formation compared to Cx-HA + SDF-1. SMP released from the Cx-HA + SMP scaffold promoted endogenous stem cell migration to the wound site 1.5 times more effectively than Cx-HA + SDF-1. Moreover, compared to Cx-HA + SDF-1, Cx-HA + SMP exhibited higher expression of CXCR4 and CD31, as well as the positive markers CD29 and CD44 for endogenous stem cells. The endogenous stem cells that migrated through Cx-HA + SMP regenerated into wound skin with minimal scar granule formation, similar to the normal tissue. In conclusion, SMP peptide offers greater convenience, while efficiently attracting migrating endogenous stem cells compared to the SDF protein. Our findings suggest that Cx-HA + SMP scaffolds hold promise as a strategy to enhance endogenous stem cell-based in-situ wound healing.

3D printed drug loaded nanomaterials for wound healing applications

Wounds are a stern healthcare concern in the growth of chronic disease conditions as they can increase healthcare costs and complicate internal and external health. Advancements in the current and newer management systems for wound healing should be in place to counter the health burden of wounds. Researchers discovered that two-dimensional (2D) media lacks appropriate real-life detection of cellular matter as these have highly complicated and diverse structures, compositions, and interactions. Hence, innovation towards three-dimensional (3D) media is called to conquer the high-level assessment and characterization in vivo using new technologies. The application of modern wound dressings prepared from a degenerated natural tissue, biodegradable biopolymer, synthetic polymer, or a composite of these materials in wound healing is currently an area of innovation in tissue regeneration medicine. Moreover, the integration of 3D printing and nanomaterial science is a promising approach with the potential for individualized, flexible, and precise technology for wound care approaches. This review encompasses the outcomes of various investigations on recent advances in 3D-printed drug-loaded natural, synthetic, and composite nanomaterials for wound healing. The challenges associated with their fabrication, clinical application progress, and future perspectives are also addressed.

Multifunctional and theranostic hydrogels for wound healing acceleration: An emphasis on diabetic-related chronic wounds

Hydrogels represent intricate three-dimensional polymeric structures, renowned for their compatibility with living systems and their ability to naturally degrade. These networks stand as promising and viable foundations for a range of biomedical uses. The practical feasibility of employing hydrogels in clinical trials has been well-demonstrated. Among the prevalent biomedical uses of hydrogels, a significant application arises in the context of wound healing. This intricate progression involves distinct phases of inflammation, proliferation, and remodeling, often triggered by trauma, skin injuries, and various diseases. Metabolic conditions like diabetes have the potential to give rise to persistent wounds, leading to delayed healing processes. This current review consolidates a collection of experiments focused on the utilization of hydrogels to expedite the recovery of wounds. Hydrogels have the capacity to improve the inflammatory conditions at the wound site, and they achieve this by diminishing levels of reactive oxygen species (ROS), thereby exhibiting antioxidant effects. Hydrogels have the potential to enhance the growth of fibroblasts and keratinocytes at the wound site. They also possess the capability to inhibit both Gram-positive and Gram-negative bacteria, effectively managing wounds infected by drug-resistant bacteria. Hydrogels can trigger angiogenesis and neovascularization processes, while also promoting the M2 polarization of macrophages, which in turn mitigates inflammation at the wound site. Intelligent and versatile hydrogels, encompassing features such as pH sensitivity, reactivity to reactive oxygen species (ROS), and responsiveness to light and temperature, have proven advantageous in expediting wound healing. Furthermore, hydrogels synthesized using environmentally friendly methods, characterized by high levels of biocompatibility and biodegradability, hold the potential for enhancing the wound healing process. Hydrogels can facilitate the controlled discharge of bioactive substances. More recently, there has been progress in the creation of conductive hydrogels, which, when subjected to electrical stimulation, contribute to the enhancement of wound healing. Diabetes mellitus, a metabolic disorder, leads to a slowdown in the wound healing process, often resulting in the formation of persistent wounds. Hydrogels have the capability to expedite the healing of diabetic wounds, facilitating the transition from the inflammatory phase to the proliferative stage. The current review sheds light on the biological functionalities of hydrogels, encompassing their role in modulating diverse mechanisms and cell types, including inflammation, oxidative stress, macrophages, and bacteriology. Additionally, this review emphasizes the significance of smart hydrogels with responsiveness to external stimuli, as well as conductive hydrogels for promoting wound healing. Lastly, the discussion delves into the advancement of environmentally friendly hydrogels with high biocompatibility, aimed at accelerating the wound healing process.

Dynamic Microenvironment-Adaptable Hydrogel with Photothermal Performance and ROS Scavenging for Management of Diabetic Ulcer

Persistent bacterial infections and excessive oxidative stress prevent the healing of diabetic ulcers, leading to an increased disability rate. Current treatments fail to kill bacteria while simultaneously relieving oxidative stress. Herein, a dynamic microenvironment-adaptable hydrogel (BP@CAu) with photothermal performance and reactive oxygen species scavenging is presented for diabetic ulcer healing. This hydrogel prepared using a dynamic borate-ester could respond to acidity in the infection microenvironment for a controllable drug release. An excellent photothermal conversion effect was integrated in the hydrogel, which exhibited strong antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa. The hydrogel attenuated intracellular oxidative stress and inflammation and promoted cell migration. In a full-thickness skin defect model of diabetic rats, the BP@CAu hydrogel contributed to the fastest wound closure, with ideal reepithelialization, granulation tissue formation, and regeneration of blood vessels. Further mechanistic studies revealed that the hydrogel relieved oxidative stress and downregulated the expression of inflammatory cytokines, resulting in dramatic therapeutic effects on diabetic wounds. Therefore, this study provides a synergistic therapeutic strategy for efficient photothermal performance and reactive oxygen species scavenging in diabetic ulcers.

Hydrogel Membranes from Chitosan-Fish Gelatin-Glycerol for Biomedical Applications: Chondroitin Sulfate Incorporation Effect in Membrane Properties

Chondroitin sulfate (ChS), chitosan (Chi), and fish gelatin (FG), which are byproducts of a fish-treatment small enterprise, were incorporated with glycerol (Gly) to obtain dense hydrogel membranes with reduced brittleness, candidates for dressing in wound healing applications. The mechanical properties of all samples were studied via Dynamic Mechanical Analysis (DMA) and tensile tests while their internal structure was characterized using Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR) and X-ray Diffraction (XRD) instruments. Their surface morphology was analyzed by ThermoGravimetric Analysis (TGA) method, while their water permeability was estimated via Water Vapor Transmission Rate (WVTR) measurements. Wettability and degradation rate measurements were also carried out. Characterization results indicated that secondary interactions between the natural polymers and the plasticizer create the hydrogel membranes. The samples were amorphous due to the high concentration of plasticizer and the amorphous nature of the natural polymers. The integration of ChS led to decreased decomposition temperature in comparison with the glycerol-free sample, and all the materials had dense structures. Finally, the in vitro endothelial cell attachment studies indicate that the hydrogel membranes successfully support the attachment and survival of primary on the hydrogel membranes and could be appropriate for external application in wound healing applications as dressings.

Polysaccharide-Based Nanogels to Overcome Mucus, Skin, Cornea, and Blood-Brain Barriers: A Review

Nanocarriers have been extensively developed in the biomedical field to enhance the treatment of various diseases. However, to effectively deliver therapeutic agents to desired target tissues and enhance their pharmacological activity, these nanocarriers must overcome biological barriers, such as mucus gel, skin, cornea, and blood-brain barriers. Polysaccharides possess qualities such as excellent biocompatibility, biodegradability, unique biological properties, and good accessibility, making them ideal materials for constructing drug delivery carriers. Nanogels, as a novel drug delivery platform, consist of three-dimensional polymer networks at the nanoscale, offering a promising strategy for encapsulating different pharmaceutical agents, prolonging retention time, and enhancing penetration. These attractive properties offer great potential for the utilization of polysaccharide-based nanogels as drug delivery systems to overcome biological barriers. Hence, this review discusses the properties of various barriers and the associated constraints, followed by summarizing the most recent development of polysaccharide-based nanogels in drug delivery to overcome biological barriers. It is expected to provide inspiration and motivation for better design and development of polysaccharide-based drug delivery systems to enhance bioavailability and efficacy while minimizing side effects.

An additive-free multifunctional β-glucan-peptide hydrogel participates in the whole process of bacterial-infected wound healing

Bacterial infections and excessive inflammation can impede the healing of wounds. Hydrogels have emerged as a promising approach for dressing bacterial-infected injuries. However, some antibacterial hydrogels are complex, costly, and even require assistance with other instruments such as light, making them unsuitable for routine outdoor injuries. Here, we developed an in-situ generating hydrogel via hybridizing oxidized β-D-glucan with antimicrobial peptide C8G2 through the Schiff base reaction. This hydrogel is easily accessible and actively contributes to the whole healing process of bacterial-infected wounds, demonstrating remarkable antibacterial activity and biological compatibility. The pH-sensitive reversible imine bond enables the hydrogel to self-heal and sustainably release the antibacterial peptide, thereby improving its bioavailability and reducing toxicity. Meanwhile, the immunoregulating β-D-glucan inhibits the release of inflammatory factors while promoting the release of anti-inflammatory factors. In methicillin-resistant Staphylococcus aureus (MRSA)-infected full-thickness skin wound models, the hybrid hydrogel showed superior antibacterial and anti-inflammatory activity, enhanced the M2 macrophage polarization, expedited wound closure, and regenerated epidermis tissue. These features make this hydrogel an appealing wound dressing for treating multi-drug-resistant bacteria-infected wounds.

Enhanced Mechanical Properties of PVA Hydrogel by Low-Temperature Segment Self-Assembly vs. Freeze-Thaw Cycles

The rapid and effective fabrication of polyvinyl alcohol (PVA) hydrogels with good mechanical properties is of great significance yet remains a huge challenge. The preparation of PVA hydrogels via the conventional cyclic freeze-thaw method is intricate and time-intensive. In this study, a pioneering approach involving the utilization of low-temperature continuous freezing is introduced to produce a novel PVA-ethylene glycol (EG) gel. Fourier transform infrared (FTIR) spectroscopy, X-ray diffractometry (XRD) and scanning electron microscopy (SEM) confirm that with the assistance of EG, PVA molecular chains can self-assemble to generate an abundance of microcrystalline domains at low temperatures, thus improving the mechanical properties of PVA-EG gel. Remarkably, when the mass ratio of H2O/EG is 4:6, the gel's maximum tensile strength can reach 2.5 MPa, which is much higher than that of PVA gels prepared via the freeze-thaw method. The preparation process of PVA-EG gel is simple, and its properties are excellent, which will promote the wide application of PVA tough gel in many fields.

Polysaccharide based transdermal patches for chronic wound healing: Recent advances and clinical perspective

Polysaccharides form a major class of natural polymers with diverse applications in biomedical science and tissue engineering. One of the key thrust areas for polysaccharide materials is skin tissue engineering and regeneration, whose market is estimated to reach around 31 billion USD globally by 2030, with a compounded annual growth rate of 10.46 %. Out of this, chronic wound healing and management is a major concern, especially for underdeveloped and developing nations, mainly due to poor access to medical interventions for such societies. Polysaccharide materials have shown promising results and clinical potential in recent decades with regard to chronic wound healing. Their low cost, ease of fabrication, biodegradability, and ability to form hydrogels make them ideal candidates for managing and healing such difficult-to-heal wounds. The present review presents a summary of the recently explored polysaccharide-based transdermal patches for managing and healing chronic wounds. Their efficacy and potency of healing both as active and passive wound dressings are evaluated in several in-vitro and in-vivo models. Finally, their clinical performances and future challenges are summarized to draw a road map towards their role in advanced wound care.

Tissue Regeneration with Gelatine/Polysaccharide Derived Hydrogel Scaffolds: From Formulation to In Vivo Efficacy

Combinations of different biomaterials with certain formulations may lead to improved properties and have significant potential for use in tissue regeneration applications. However, previously reported studies comparing biomaterials often suffered from inconsistent processing methods or inadequate comprehensive application research, hindering a comprehension of their efficacy in tissue engineering. This report explores the significance of screening the combination of gelatine with polysaccharide materials, specifically hyaluronic acid (HA) and carboxymethyl cellulose (CMC), using the same crosslinking method used for tissue regeneration. Hydrogel scaffolds (Gel/HA and Gel/CMC) at various concentrations were developed and characterized to assess their physiochemical properties. The results demonstrated that the hydrogels exhibited desirable mechanical properties, appropriate swelling behaviour, suitable porosity, and excellent cytocompatibility. In particular, the Gel1HA1 and Gel1CMC1 hydrogels showed remarkable cellular proliferation and aggregation. Further, we performed animal studies and explored the tissue regeneration effects of the Gel1HA1 and Gel1CMC1 hydrogels. Both hydrogels exhibited an accelerated wound closure rate and promoted vessel formation in a rodent full-thickness skin excisional model. Additionally, the subcutaneous implantation model demonstrated the induction of angiogenesis and collagen deposition within the implanted hydrogel samples. Overall, the hydrogels developed in this study demonstrated promising potential for use in the regeneration of soft tissue defects and this study emphasizes the significance of screening biomaterial combinations and formulations for tissue regeneration applications.

An extracellular matrix-inspired self-healing composite hydrogel for enhanced platelet-rich plasma-mediated chronic diabetic wound treatment

Diabetes is generally accompanied by difficult-to-heal wounds, which often lead to permanent disability and even death of patients. Because of the abundance of a variety of growth factors, platelet rich plasma (PRP) has been proven to have great clinical potential for diabetic wound treatment. However, how to suppress the explosive release of its active components while realizing adaptability to different wounds remains important for PRP therapy. Here, an injectable, self-healing, and non-specific tissue-adhesive hydrogel formed by oxidized chondroitin sulfate and carboxymethyl chitosan was designed as an encapsulation and delivery platform for PRP. With a dynamic cross-linking structural design, the hydrogel can meet the clinical demands of irregular wounds with controllable gelation and viscoelasticity. Inhibition of PRP enzymolysis as well as sustained release of its growth factors is realized with the hydrogel, enhancing cell proliferation and migration in vitro. Notably, greatly accelerated healing of full thickness wounds of diabetic skins is enabled by promoting the formation of granulation tissues, collagen deposition and angiogenesis as well as reducing inflammation in vivo. This self-healing and extracellular matrix-mimicking hydrogel provides powerful assistance to PRP therapy, enabling its promising applications for the repair and regeneration of diabetic wounds.