A natural polymer based bioadhesive with self-healing behavior and improved antibacterial properties

Tunable and fast-cured hyaluronic acid hydrogel inspired on catechol architecture for enhanced adhesion property

Hyaluronic acid-based hydrogels have been broadly used in medical applications due to their remarkable properties such as biocompatibility, biodegradability, super hydroscopicity, non-immunogenic effect, etc. However, the inherent weak and hydrophilic polysaccharide structure of pure hyaluronic acid (HA) hydrogels has limited their potential use in muco-adhesiveness, wound dressing, and 3D printing. In this research, we developed in-situ forming of catechol-modified HA hydrogels with improved mechanical properties involving blue-light curing crosslinking reaction. The effect of catechol structure on the physicochemical properties of HA hydrogels was evaluated by varying the content (0-40 %). The as-synthesized hydrogel demonstrated rapid prototyping, excellent wetting adhesiveness, and good biocompatibility. Furthermore, an optimized hydrogel precursor solution was used as a blue light-cured bio-ink with high efficiency and good precision and successfully prototyped a microstructure that mimicked the human hepatic lobule by using DLP 3D printing method. This catechol-modified HA hydrogel with tunable physicochemical and rapid prototyping properties has excellent potential in biomedical engineering.

Natural Underwater Bioadhesive Offering Cohesion Modulation via Hydrogen Bond Disruptor: A Highly Injectable and in Vivo Stable Remedy for Gastric Ulcer Resolution

Injectable bioadhesives are attractive for managing gastric ulcers through minimally invasive procedures. However, the formidable challenge is to develop bioadhesives that exhibit high injectability, rapidly adhere to lesion tissues with fast gelation, provide reliable protection in the harsh gastric environment, and simultaneously ensure stringent standards of biocompatibility. Here, a natural bioadhesive with tunable cohesion is developed based on the facile and controllable gelation between silk fibroin and tannic acid. By incorporating a hydrogen bond disruptor (urea or guanidine hydrochloride), the inherent network within the bioadhesive is disturbed, inducing a transition to a fluidic state for smooth injection (injection force <5 N). Upon injection, the fluidic bioadhesive thoroughly wets tissues, while the rapid diffusion of the disruptor triggers instantaneous in situ gelation. This orchestrated process fosters the formed bioadhesive with durable wet tissue affinity and mechanical properties that harmonize with gastric tissues, thereby bestowing long-lasting protection for ulcer healing, as evidenced through in vitro and in vivo verification. Moreover, it can be conveniently stored (≥3 m) postdehydration. This work presents a promising strategy for designing highly injectable bioadhesives utilizing natural feedstocks, avoiding any safety risks associated with synthetic materials or nonphysiological gelation conditions, and offering the potential for minimally invasive application.

Shape-fixing hydrogel promotes scarless healing of wounds under tension

The healing of a wound under tension (hereafter, "tension wound") often coincides with the development of hypertrophic scars in clinical settings. Currently, compress bandages offer a potential alternative for the healing of tension wounds; however, their application in surgery is limited due to their prefabricated patch form. To overcome this, a tension-shielding hydrogel system was designed using photocurable catechol-grafted hyaluronic acid and tannic-acid silver nanoparticles (hereafter, "HTA system"). The hydrogel exhibited tension-shielding capacity, reducing wound tension via shape-fixation and ultimately reducing scar formation. The HTA hydrogel exhibited superior photothermal antibacterial efficacy, self-healing properties, and effective dissipation of energy, thereby promoting tissue regeneration. The hydrogel significantly inhibited the mechanotransduction pathway, thus preventing Engrailed-1 activation and reducing the fibrotic response. The HTA hydrogel system, therefore, provides a treatment strategy for tension wounds, burn wounds and other wounds that are prone to form hypertrophic scars via creating a tension-free local environment. STATEMENT OF SIGNIFICANCE: In our study, we presented a wound-dressing hydrogel system (HTA) that exhibit shape-fixing capacity in tension wound model. Here, we designed and modified a tension regulator, applied it to mice, and furthermore, established a tension wound model in mice with adjustable tension. Outcomes showed that the HTA hydrogel system can effectively form a shape-fixed environment on tension wounds and dynamic wounds, thus promoting scarless healing. Additionally, HTA performs injectability, rapid crosslinking, biocompatibility, wet adhesion, hemostasis and photothermal antibacterial properties. We believe this research has various potential clinical applications, including scarless-healing in tension wounds, treatment of acute bleeding, treatment of infected wounds, and even internal organ repair.

Silk-based wearable devices for health monitoring and medical treatment

Previous works have focused on enhancing the tensile properties, mechanical flexibility, biocompatibility, and biodegradability of wearable devices for real-time and continuous health management. Silk proteins, including silk fibroin (SF) and sericin, show great advantages in wearable devices due to their natural biodegradability, excellent biocompatibility, and low fabrication cost. Moreover, these silk proteins possess great potential for functionalization and are being explored as promising candidates for multifunctional wearable devices with sensory capabilities and therapeutic purposes. This review introduces current advancements in silk-based constituents used in the assembly of wearable sensors and adhesives for detecting essential physiological indicators, including metabolites in body fluids, body temperature, electrocardiogram (ECG), electromyogram (EMG), pulse, and respiration. SF and sericin play vital roles in addressing issues related to discomfort reduction, signal fidelity improvement, as well as facilitating medical treatment. These developments signify a transition from hospital-centered healthcare toward individual-centered health monitoring and on-demand therapeutic interventions.

Silk fibroin-based dressings with antibacterial and anti-inflammatory properties

Silk fibroin is a fibrillar protein obtained from arthropods such as mulberry and non-mulberry silkworms. Silk fibroin has been used as a dressing in wound treatment for its physical, chemical, mechanical, and biological properties. This systematic review analyzed studies from PubMed, Web of Science, and Scopus databases to identify the molecules preferred for functionalizing silk fibroin-based dressings and to describe their mechanisms of exhibiting anti-inflammatory and antibacterial properties. The analysis of the selected articles allowed us to classify the dressings into different conformations, such as membranes, films, hydrogels, sponges, and bioadhesives. The incorporation of various molecules, including antibiotics, natural products, peptides, nanocomposites, nanoparticles, secondary metabolites, growth factors, and cytokines, has allowed the development of dressings that promote wound healing with antibacterial and immunomodulatory properties. In addition, silk fibroin-based dressings have been established to have the potential to regenerate wounds such as venous ulcers, arterial ulcers, diabetic foot, third-degree burns, and neoplastic ulcers. Evaluation of the efficacy of silk fibroin-based dressings in tissue engineering is an area of great activity that has shown significant advances in recent years.

A Drop-By-Drop Self-Assembled All-Natural Hydrogel as a Desensitizer for Rapid and Enduring Management of Dentin Hypersensitivity

Dentin hypersensitivity (DH) is a prevalent dental condition arising from the exposure of dentin tubules (DTs), leading to discomfort upon external stimuli. However, achieving swift and profound occlusion of these exposed DTs for immediate and enduring relief remains challenging due to the intricate dentin structure and oral environment. Herein, a pioneering and facile drop-by-drop strategy involving an in situ generated natural supramolecular hydrogel formed by self-assembling silk fibroin (SF) and tannic acid (TA) within the narrow DT space is proposed. When SF and TA aqueous solutions are applied successively to exposed dentin, they penetrate deeply within DTs and coassemble into compact gels, robustly adhering to DT walls. This yields a rapid and compact occlusion effect with an unprecedented depth exceeding 250 µm, maintaining stable occlusion efficacy even under rigorous in vitro and in vivo erosion and friction conditions for no less than 21 days. Furthermore, the biocompatibility and effective occlusion properties are verified through cell studies in simulated oral settings and an in vivo rabbit model. This study, for the first time, demonstrates the translational potential of hydrogel-based desensitizers in treating DH with prompt action, superior occlusion depth and enduring treatment benefits, holding promise as clinical-friendly restorative solutions for delicate-structured biosystems.

Natural Extracts for Antibacterial Applications

Bacteria-induced epidemics and infectious diseases are seriously threatening the health of people around the world. In addition, antibiotic therapy has been inducing increasingly more serious bacterial resistance, which makes it urgent to develop new treatment strategies to combat bacteria, including multidrug-resistant bacteria. Natural extracts displaying antibacterial activity and good biocompatibility have attracted much attention due to greater concerns about the safety of synthetic chemicals and emerging drug resistance. These antibacterial components can be isolated and utilized as antimicrobials, as well as transformed, combined, or wrapped with other substances by using modern assistive technologies to fight bacteria synergistically. This review summarizes recent advances in natural extracts from three kinds of sources-plants, animals, and microorganisms-for antibacterial applications. This work discusses the corresponding antibacterial mechanisms and the future development of natural extracts in antibacterial fields.

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.

Bioadhesive Technology Platforms

Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.

Bioadhesives with Antimicrobial Properties

Bioadhesives with antimicrobial properties enable easier and safer treatment of wounds as compared to the traditional methods such as suturing and stapling. Composed of natural or synthetic polymers, these bioadhesives seal wounds and facilitate healing while preventing infections through the activity of locally released antimicrobial drugs, nanocomponents, or inherently antimicrobial polers. Although many different materials and strategies are employed to develop antimicrobial bioadhesives, the design of these biomaterials necessitates a prudent approach as achieving all the required properties including optimal adhesive and cohesive properties, biocompatibility, and antimicrobial activity can be challenging. Designing antimicrobial bioadhesives with tunable physical, chemical, and biological properties will shed light on the path for future advancement of bioadhesives with antimicrobial properties. In this review, the requirements and commonly used strategies for developing bioadhesives with antimicrobial properties are discussed. In particular, different methods for their synthesis and their experimental and clinical applications on a variety of organs are reviewed. Advances in the design of bioadhesives with antimicrobial properties will pave the way for a better management of wounds to increase positive clinical outcomes.

Encapsulation of Sericin-Decorated Efficient Agents in Silk Hydrogels for Wound Dressings

Excessive oxidative stress, bacterial infections, and inflammation are the primary factors impeding the healing of skin wounds. Bioactive hydrogels are commonly employed in the treatment of skin injuries. However, the limited solubility of many drugs and active agents in water significantly hampers their effectiveness in hydrogel dressings. In this research, prior to incorporation into the silk fibroin (SF) hydrogel matrix, two active agents curcumin and silver nanoparticles (Ag NPs) were decorated by silk sericin to improve their dispersibility and stability in water. The resultant SF/Ag/C hydrogels combined the biological safety and nontoxicity of SF, the antioxidant and anti-inflammatory efficacy of curcumin, and the antibacterial effect of Ag NPs. These properties effectively enhanced wound repair by reducing bacterial infections, mitigating oxidative stress, suppressing the expression of pro-inflammatory factors, and promoting angiogenesis. This study presented a straightforward approach for constructing bioactive hydrogels for the promotion of the wound healing process.

Evolution of nanostructured skin patches towards multifunctional wearable platforms for biomedical applications

Recent advances in the field of skin patches have promoted the development of wearable and implantable bioelectronics for long-term, continuous healthcare management and targeted therapy. However, the design of electronic skin (e-skin) patches with stretchable components is still challenging and requires an in-depth understanding of the skin-attachable substrate layer, functional biomaterials and advanced self-powered electronics. In this comprehensive review, we present the evolution of skin patches from functional nanostructured materials to multi-functional and stimuli-responsive patches towards flexible substrates and emerging biomaterials for e-skin patches, including the material selection, structure design and promising applications. Stretchable sensors and self-powered e-skin patches are also discussed, ranging from electrical stimulation for clinical procedures to continuous health monitoring and integrated systems for comprehensive healthcare management. Moreover, an integrated energy harvester with bioelectronics enables the fabrication of self-powered electronic skin patches, which can effectively solve the energy supply and overcome the drawbacks induced by bulky battery-driven devices. However, to realize the full potential offered by these advancements, several challenges must be addressed for next-generation e-skin patches. Finally, future opportunities and positive outlooks are presented on the future directions of bioelectronics. It is believed that innovative material design, structure engineering, and in-depth study of fundamental principles can foster the rapid evolution of electronic skin patches, and eventually enable self-powered close-looped bioelectronic systems to benefit mankind.

Smart Bandaid Integrated with Fully Textile OECT for Uric Acid Real-Time Monitoring in Wound Exudate

Hard-to-heal wounds (i.e., severe and/or chronic) are typically associated with particular pathologies or afflictions such as diabetes, immunodeficiencies, compression traumas in bedridden people, skin grafts, or third-degree burns. In this situation, it is critical to constantly monitor the healing stages and the overall wound conditions to allow for better-targeted therapies and faster patient recovery. At the moment, this operation is performed by removing the bandages and visually inspecting the wound, putting the patient at risk of infection and disturbing the healing stages. Recently, new devices have been developed to address these issues by monitoring important biomarkers related to the wound health status, such as pH, moisture, etc. In this contribution, we present a novel textile chemical sensor exploiting an organic electrochemical transistor (OECT) configuration based on poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) for uric acid (UA)-selective monitoring in wound exudate. The combination of special medical-grade textile materials provides a passive sampling system that enables the real-time and non-invasive analysis of wound fluid: UA was detected as a benchmark analyte to monitor the health status of wounds since it represents a relevant biomarker associated with infections or necrotization processes in human tissues. The sensors proved to reliably and reversibly detect UA concentration in synthetic wound exudate in the biologically relevant range of 220-750 μM, operating in flow conditions for better mimicking the real wound bed. This forerunner device paves the way for smart bandages integrated with real-time monitoring OECT-based sensors for wound-healing evaluation.

An antibacterial and self-healing hydrogel from aldehyde-carrageenan for wound healing applications

This study aimed to develop and characterize a novel antibacterial, self-healing hydrogel made from aldehyde-carrageenan. Thus, carrageenan (CA) was first oxidized using different amounts of sodium periodate (NaIO₄), and the highest concentration of aldehyde was obtained when the ratio of NaIO₄ to CA was 1.5:1. Using dopamine (PDA) and zinc ions (Zn²⁺), various hydrogels were synthesized from oxidized carrageenan (O-CA). The effects of dopamine and zinc ions on the properties of O-CA hydrogel were examined. According to Fourier Transform Infrared Spectroscopy (FTIR) studies, the hydrogel's components are linked by Schiff bases, hydrogen bonds, and ion complexes. The rheological tests confirmed that hydrogels were elastic gels, not viscous sol, and were able to recover rapidly. Adding zinc to the hydrogel reduced weight loss (38 %) and provided extra antibacterial properties, particularly against E. coli. In addition, collagen secretion and cell attachment to Zn-containing hydrogels were significantly increased, and fibroblast viability reached 118 %. Overall, a hybrid O-CA/PDA/Zn hydrogel has excellent potential for wound healing applications.

Smart bioadhesives for wound healing and closure

The high demand for rapid wound healing has spurred the development of multifunctional and smart bioadhesives with strong bioadhesion, antibacterial effect, real-time sensing, wireless communication, and on-demand treatment capabilities. Bioadhesives with bio-inspired structures and chemicals have shown unprecedented adhesion strengths, as well as tunable optical, electrical, and bio-dissolvable properties. Accelerated wound healing has been achieved via directly released antibacterial and growth factors, material or drug-induced host immune responses, and delivery of curative cells. Most recently, the integration of biosensing and treatment modules with wireless units in a closed-loop system yielded smart bioadhesives, allowing real-time sensing of the physiological conditions (e.g., pH, temperature, uric acid, glucose, and cytokine) with iterative feedback for drastically enhanced, stage-specific wound healing by triggering drug delivery and treatment to avoid infection or prolonged inflammation. Despite rapid advances in the burgeoning field, challenges still exist in the design and fabrication of integrated systems, particularly for chronic wounds, presenting significant opportunities for the future development of next-generation smart materials and systems.

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Rational material engineering of bioadhesives with optimized mechanical and curative properties.

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Incorporation of biosensing allows real-time and precise evaluation of the healing stage.

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Closed-loop, smart bioadhesives that integrate wireless sensing and treatment hold great potential for chronic wound healing.

Natural Small Biological Molecule Based Supramolecular Bioadhesives with Innate Photothermal Antibacterial Capability for Nonpressing Hemostasis and Effective Wound Healing

Bioadhesives with immediate wound closure, efficient hemostasis, and antibacterial properties that can well integrate with tissue are urgently needed in wound management. Natural small biological molecule based bioadhesives hold great promise for manipulating wound healing by taking advantage of integrated functionalities, synthetic simplification, and accuracy, cost efficiency and biosafety. Herein, a natural small biological molecule based bioadhesive, composed of natural small biological molecules (α-lipoic acid and tannic acid) and a small amount of ferric chloride, was prepared via an extremely simple and green route for wound management. In this system, covalent and noncovalent interactions between each component resulted in the self-healing supramolecular bioadhesive. It possessed appropriate wet-tissue adhesion, efficient nonpressing hemostasis and free radical scavenging abilities. More importantly, the interaction between tannic acid and Fe³⁺ endowed the bioadhesive with innate and steady photothermal activity, which showed excellent photothermal bactericidal activity to both E. coli and S. aureus. The bioadhesive promoted wound healing for linear and circular wounds in vivo, especially for infectious wounds under near-infrared (NIR) irradiation. This bioadhesive will have promising value as a safe and effective antimicrobial adhesive for infectious wound management.

Design strategies for adhesive hydrogels with natural antibacterial agents as wound dressings: Status and trends

The wound healing process is usually susceptible to different bacterial infections due to the complex physiological environment, which significantly impairs wound healing. The topical application of antibiotics is not desirable for wound healing because the excessive use of antibiotics might cause bacteria to develop resistance and even the production of super bacteria, posing significant harm to human well-being. Wound dressings based on adhesive, biocompatible, and multi-functional hydrogels with natural antibacterial agents have been widely recognized as effective wound treatments. Hydrogels, which are three-dimensional (3D) polymer networks cross-linked through physical interactions or covalent bonds, are promising for topical antibacterial applications because of their excellent adhesion, antibacterial properties, and biocompatibility. To further improve the healing performance of hydrogels, various modification methods have been developed with superior biocompatibility, antibacterial activity, mechanical properties, and wound repair capabilities. This review summarizes hundreds of typical studies on various ingredients, preparation methods, antibacterial mechanisms, and internal antibacterial factors to understand adhesive hydrogels with natural antibacterial agents for wound dressings. Additionally, we provide prospects for adhesive and antibacterial hydrogels in biomedical applications and clinical research.

Biomineralization-Inspired Intermediate Precursor for the Controllable Gelation of Polyphenol-Macromolecule Hydrogels

Hydrogels composed of polyphenols and various macromolecules have been widely reported to have the advantage of facile preparation, mainly through the formation of hydrogen bonds. However, the traditional preparation method involves the direct mixing of polyphenols and macromolecules, which generally occurs too quickly and uncontrollably, and results in poor homogeneity, injectability, and shape designability. Here, inspired by the intermediate precursor during biomineralization, to facilitate transformation in a controllable way, we propose a novel and universal internal gelation method that creates an intermediate precursor by controlling the pH value to manipulate the elimination and generation of hydrogen bonds between a polyphenol and macromolecules. The precursor strategy greatly improves the homogeneity, injectability, and shape designability of the hydrogel while also achieving a controllable gelation process, and the gelation time can be accurately adjusted. The hydrogels prepared with this method exhibited superior capability to seal leaks, provided complete wound coverage, and showed the potential to be a shape-designable wearable strain sensor. Our study opens up a new way to construct and apply polyphenol-macromolecule hydrogels in a more controllable manner.

Mussel-Inspired Hydrogels for Fluoride Delivery and Caries Prevention

Fluoride agents hold promise for the repair and prevention of caries lesions, but their interaction with enamel is often hampered and diminished because of the dynamic wet environment in the oral cavity, which affects the efficacy of fluoride delivery and limits treatment success. We herein developed a mussel-inspired wet adhesive fluoride system (denoted TS@NaF) fabricated by the self-assembly of tannic acid (TA), silk fibroin (SF), and sodium fluoride (NaF). TS@NaF demonstrated remarkable biological stability and biocompatibility, showed reliable wet adhesion, released fluoride ions (F−) topically, and induced significant deposition of calcium fluoride (CaF2) onto enamel in vitro. Furthermore, TS@NaF provided an anticaries effect in vitro and induced a detectable increase in enamel mineral density. Advanced fluoride-releasing bioadhesives are therefore promising candidates for caries prevention and highlight the great potential of mussel-inspired dental materials in clinical applications.

Recent Advances in the Development and Antimicrobial Applications of Metal-Phenolic Networks

Due to the abuse of antibiotics and the emergence of multidrug resistant microorganisms, medical devices, and related biomaterials are at high risk of microbial infection during use, placing a heavy burden on patients and healthcare systems. Metal-phenolic networks (MPNs), an emerging organic-inorganic hybrid network system developed gradually in recent years, have exhibited excellent multifunctional properties such as anti-inflammatory, antioxidant, and antibacterial properties by making use of the coordination between phenolic ligands and metal ions. Further, MPNs have received widespread attention in antimicrobial infections due to their facile synthesis process, excellent biocompatibility, and excellent antimicrobial properties brought about by polyphenols and metal ions. In this review, different categories of biomaterials based on MPNs (nanoparticles, coatings, capsules, hydrogels) and their fabrication strategies are summarized, and recent research advances in their antimicrobial applications in biomedical fields (e.g., skin repair, bone regeneration, medical devices, etc.) are highlighted.

Tannic acid: a versatile polyphenol for design of biomedical hydrogels

Tannic acid (TA), a natural polyphenol, is a hydrolysable amphiphilic tannin derivative of gallic acid with several galloyl groups in its structure. Tannic acid interacts with various organic, inorganic, hydrophilic, and hydrophobic materials such as proteins and polysaccharides via hydrogen bonding, electrostatic, coordinative bonding, and hydrophobic interactions. Tannic acid has been studied for various biomedical applications as a natural crosslinker with anti-inflammatory, antibacterial, and anticancer activities. In this review, we focus on TA-based hydrogels for biomaterials engineering to help biomaterials scientists and engineers better realize TA's potential in the design and fabrication of novel hydrogel biomaterials. The interactions of TA with various natural or synthetic compounds are deliberated, discussing parameters that affect TA-material interactions thus providing a fundamental set of criteria for utilizing TA in hydrogels for tissue healing and regeneration. The review also discusses the merits and demerits of using TA in developing hydrogels either through direct incorporation in the hydrogel formulation or indirectly via immersing the final product in a TA solution. In general, TA is a natural bioactive molecule with diverse potential for engineering biomedical hydrogels.

A Review of Recent Advances in Natural Polymer-Based Scaffolds for Musculoskeletal Tissue Engineering

The musculoskeletal (MS) system consists of bone, cartilage, tendon, ligament, and skeletal muscle, which forms the basic framework of the human body. This system plays a vital role in appropriate body functions, including movement, the protection of internal organs, support, hematopoiesis, and postural stability. Therefore, it is understandable that the damage or loss of MS tissues significantly reduces the quality of life and limits mobility. Tissue engineering and its applications in the healthcare industry have been rapidly growing over the past few decades. Tissue engineering has made significant contributions toward developing new therapeutic strategies for the treatment of MS defects and relevant disease. Among various biomaterials used for tissue engineering, natural polymers offer superior properties that promote optimal cell interaction and desired biological function. Natural polymers have similarity with the native ECM, including enzymatic degradation, bio-resorb and non-toxic degradation products, ability to conjugate with various agents, and high chemical versatility, biocompatibility, and bioactivity that promote optimal cell interaction and desired biological functions. This review summarizes recent advances in applying natural-based scaffolds for musculoskeletal tissue engineering.

Advancements in Skin Delivery of Natural Bioactive Products for Wound Management: A Brief Review of Two Decades

Application of modern delivery techniques to natural bioactive products improves their permeability, bioavailability, and therapeutic efficacy. Many natural products have desirable biological properties applicable to wound healing but are limited by their inability to cross the stratum corneum to access the wound. Over the past two decades, modern systems such as microneedles, lipid-based vesicles, hydrogels, composite dressings, and responsive formulations have been applied to natural products such as curcumin or aloe vera to improve their delivery and efficacy. This article reviews which natural products and techniques have been formulated together in the past two decades and the success of these applications for wound healing. Many cultures prefer natural-product-based traditional therapies which are often cheaper and more available than their synthetic counterparts. Improving natural products’ effect can provide novel wound-healing therapies for those who trust traditional compounds over synthetic drugs to reduce medical inequalities.

Adhesive Materials Inspired by Barnacle Underwater Adhesion: Biological Principles and Biomimetic Designs

Wet adhesion technology has potential applications in various fields, especially in the biomedical field, yet it has not been completely mastered by humans. Many aquatic organisms (e.g., mussels, sandcastle worms, and barnacles) have evolved into wet adhesion specialists with excellent underwater adhesion abilities, and mimicking their adhesion principles to engineer artificial adhesive materials offers an important avenue to address the wet adhesion issue. The crustacean barnacle secretes a proteinaceous adhesive called barnacle cement, with which they firmly attach their bodies to almost any substrate underwater. Owing to the unique chemical composition, structural property, and adhesion mechanism, barnacle cement has attracted widespread research interest as a novel model for designing biomimetic adhesive materials, with significant progress being made. To further boost the development of barnacle cement–inspired adhesive materials (BCIAMs), it is necessary to systematically summarize their design strategies and research advances. However, no relevant reviews have been published yet. In this context, we presented a systematic review for the first time. First, we introduced the underwater adhesion principles of natural barnacle cement, which lay the basis for the design of BCIAMs. Subsequently, we classified the BCIAMs into three major categories according to the different design strategies and summarized their research advances in great detail. Finally, we discussed the research challenge and future trends of this field. We believe that this review can not only improve our understanding of the molecular mechanism of barnacle underwater adhesion but also accelerate the development of barnacle-inspired wet adhesion technology.

A silk fibroin based bioadhesive with synergistic photothermal-reinforced antibacterial activity

Bioadhesives have gained considerable popularity for application in wound closure. However, applying bioadhesives incurs risks associated with bacterial infection during wound healing. Hence, in this study, a silk fibroin based bioadhesive was constructed via employing natural macromolecule, silk fibroin (SF), to spontaneously coassemble with natural plant polyphenol, tannic acid (TA), and iron oxide nanoparticles (Fe₃O₄ NPs). In the system, the natural macromolecule SF plays a key role in fabricating the macromolecular network matrix due to the change of the secondary structure of SF (from random coil to β-sheet) under the trigger of TA. Importantly, the strong hydrogen bonding interactions between SF and TA, and the coordination bonds between TA and Fe₃O₄ NPs endow the bioadhesive with high extensibility, self-healing properties, and considerable wet adhesion. Meanwhile, the synergy between the inherent photothermal properties of Fe₃O₄ NPs and TA/Fe³⁺ complexes under near-infrared (NIR) radiation enables the bioadhesive superior photothermal-reinforced antibacterial activity. The multifunctional natural macromolecule bioadhesive is a potential candidate in clinical wound management for improved outcomes, especially in infected wounds.

The solvent effect modulates the formation of homogeneous polyphenol composite hydrogels with improved transparency and mechanical strength for antibacterial delayed sternal closure films

The usage of delayed sternal closure films after thoracotomy surgery helps doctors deal with emergency conveniently. There is a growing demand to develop suturable, antibacterial and transparent films for delayed sternal closure. Although polyphenol incorporated hydrogels provide good suture ability, they lose transparency because of the heterogeneous distribution of polyphenols during the post-immersion process. Here, a solvent exchange method is proposed to fabricate homogeneous polyphenol composite hydrogels in a bottom-up manner, which utilizes the distinct solvent effect of DMSO and H₂O to modulate the association and disassociation between polyphenols and the polymer backbones on demand. DMSO first provides a protective environment to turn off the intermolecular interactions and allows tannic acid (TA) to be dispersed into the polymer network PEG-lysozyme (PEG-LZM) homogeneously. The following water rehydration turns on the intermolecular interactions between titanic acid and PEG-lysozymes, and results in a homogeneous titanic acid toughened composite hydrogel (PEG-LZM-TA (DH)), which has an improved transparency and mechanical properties than those of the materials prepared by the post-immersion method. In addition, the TA integration provides antibacterial function to the hydrogels. We establish a rabbit delayed sternal closure model to demonstrate that PEG-LZM-TA (DH) films can be sutured to temporarily close the thoracic cavity of rabbits, provide a transparent window to inspect the wound at any time, and control the bacterial contamination efficiently. We further explore the solvent exchange method to other polyphenols and polymeric hydrogel composites. The results suggest that the solvent exchange method provides generic opportunities to fabricate homogeneous polyphenol strengthened hydrogel systems with high performance.

Metal Phenolic Nanodressing of Porous Polymer Scaffolds for Enhanced Bone Regeneration via Interfacial Gating Growth Factor Release and Stem Cell Differentiation

Porous polymer scaffolds are essential materials for tissue engineering because they can be easily processed to deliver stem cells or bioactive factors. However, scaffolds made of synthetic polymers normally lack a bioactive cell-material interface and undergo a burst release of growth factors, which may hinder their further application in tissue engineering. In this paper, a metal-phenolic network (MPN) was interfacially constructed on the pore surface of a porous poly(dl-lactide) (PPLA) scaffold. Based on the molecular gating property of the MPN supramolecular structure, the PPLA@MPN scaffold achieved the sustained release of the loaded molecules. In addition, the MPN coating provided a bioactive interface, thus encouraging the migration and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). The PPLA@MPN scaffolds exhibited enhanced bone regeneration in a rat femoral defect model in vivo compared to PPLA, which is ascribed to the combined effect of sustained bone morphogenetic protein-2 (BMP-2) release and the osteogenic ability of MPN. This nanodressing technique provides a viable and straightforward strategy for enhancing the performance of porous polymer scaffolds in bone tissue engineering.

Emerging Biopolymer-Based Bioadhesives

Bioadhesives have been widely used in healthcare and biomedical applications due to their ease-of-operation for wound closure and repair compared to conventional suturing and stapling. However, several challenges remain for developing ideal bioadhesives, such as unsatisfied mechanical properties, non-tunable biodegradability, and limited biological functions. Considering these concerns, naturally derived biopolymers have been considered good candidates for making bioadhesives owing to their ready availability, facile modification, tunable mechanical properties, and desired biocompatibility and biodegradability. Over the past several years, remarkable progress has been made on biopolymer-based adhesives, covering topics from novel materials designs and advanced processing to clinical translation. The developed bioadhesives have been applied for diverse applications, including tissue adhesion, hemostasis, antimicrobial, wound repair/tissue regeneration, and skin-interfaced bioelectronics. Here in this comprehensive review, recent progress on biopolymer-based bioadhesives is summarized with focuses on clinical translations and multifunctional bioadhesives. Furthermore, challenges and opportunities such as weak adhesion strength at the hydrated state, mechanical mismatch with tissues, and unfavorable immune responses are discussed with an aim to facilitate the future development of high-performance biopolymer-based bioadhesives.

A multifunctional green antibacterial rapid hemostasis composite wound dressing for wound healing

Rapid hemostasis and antibacterial properties are essential for novel wound dressings to promote wound healing. In particular, timely and rapid hemostasis could be of benefit to reduce the mortality caused by excessive bleeding loss. Herein, we present a novel strategy of combining electrospinning technology with post-modification technology to prepare a multifunctional wound dressing, cellulose diacetate-based composite wound dressing (CDCE), with rapid hemostasis and antibacterial activity. It is interesting that the CDCE wound dressing had superhydrophilicity, high water absorption, and strong absorbing capacity, which could eliminate the exudate around the wound in a timely manner and further promote rapid hemostasis. Additionally, its excellent antibacterial properties could inhibit severe infection in the wound and accelerate wound healing. Based on these advantages, the novel CDCE wound dressing could promote wound contraction and further accelerate wound healing compared with the common traditional wound dressing gauze. Taken together, the multifunctional CDCE wound dressing has high potential for clinical application in the future.

Mussel-inspired self-assembly engineered implant coatings for synergistic anti-infection and osteogenesis acceleration

Implant associated infections (IAI) and poor osseointegration are the two major causes for titanium implant failure, leading to subsequent financial burden and physical sufferings. Therefore, advanced implants with excellent anti-infection and osseointegration performance are needed. In this work, mussel-inspired tannic acid (TA) mediated layer-by-layer (LbL) self-assembly was used for fabricating bonded polyethylene glycol (PEG) and 8DSS (8 repeating units of aspartate-serine-serine) coatings (Ti/8DSS/PEG) on the surface of titanium implants. The coating is designed to simultaneously reduce bacterial adhesion through the super-hydrophilic effect of PEG and promote osseointegration through the effective biomineralization of 8DSS. The obtained Ti/8DSS/PEG implant exhibits superior anti-biofouling capabilities (anti-protein adhesion and anti-bacterial adhesion against S. aureus and E. coli) and excellent biocompatibility. Meanwhile, the Ti/8DSS/PEG implant accelerates osteoblast differentiation and presents significantly better osteogenic ability than bare titanium implants in vivo. This mussel-inspired TA mediated LbL self-assembly method is expected to provide a multifunctional and robust platform for surface engineering in bone repair.

Injectable Hydrogel Based on Modified Gelatin and Sodium Alginate for Soft-Tissue Adhesive

To assist or replace the traditional suture techniques for wound closure, soft-tissue adhesives with excellent adhesion strength and favorable biocompatibility are of great significance in biomedical applications. In this study, an injectable hydrogel tissue adhesive containing adipic acid dihydrazide–modified gelatin (Gel-ADH) and oxidized sodium alginate (OSA) was developed. It was found that this tissue adhesive possessed a uniform structure, appropriate swelling ratio, good injectability, and excellent hemocompatibility and cytocompatibility. The adhesion capacity of the developed adhesive with optimized component and concentration was stronger than that of the commercial adhesive Porcine Fibrin Sealant Kit. All these results suggested that the developed hydrogel was a promising candidate for a soft-tissue adhesive.

Rational engineering and applications of functional bioadhesives in biomedical engineering

For the past decades, several bioadhesives have been developed to replace conventional wound closure medical tools such as sutures, staples, and clips. The bioadhesives are easy to use and can minimize tissue damage. They are designed to provide strong adhesion with stable mechanical support on tissue surfaces. However, this monofunctionality of the bioadhesives hinders their practical applications. In particular, a bioadhesive can lose its intended function under harsh tissue environments or delay tissue regeneration during wound healing. Based on several natural and synthetic biomaterials, functional bioadhesives have been developed to overcome the aforementioned limitations. The functional bioadhesives are designed to have specific characteristics such as antimicrobial, cell infiltrative, stimuli-responsive, electrically conductive, and self-healing to ensure stability under harsh tissue conditions, facilitate tissue regeneration, and effectively monitor biosignals. Herein, we thoroughly review the functional bioadhesives from their fundamental background to recent progress with their practical applications for the enhancement of tissue healing and effective biosignal sensing. Furthermore, the future perspectives on the applications of functional bioadhesives and current challenges in their commercialization are also discussed.

Self-Healing, Self-Adhesive Silk Fibroin Conductive Hydrogel as a Flexible Strain Sensor

Flexible and wearable hydrogel strain sensors have attracted tremendous attention for applications in human motion and physiological signal monitoring. However, it is still a great challenge to develop a hydrogel strain sensor with certain mechanical properties and tensile deformation capabilities, which can be in conformal contact with the target organ and also have self-healing properties, self-adhesive capability, biocompatibility, antibacterial properties, high strain sensitivity, and stable electrical performance. In this paper, an ionic conductive hydrogel (named PBST) is rationally designed by proportionally mixing polyvinyl alcohol (PVA), borax, silk fibroin (SF), and tannic acid (TA). SF can not only be a reinforcement to introduce an energy dissipation mechanism into the dynamically cross-linked hydrogel network to stabilize the non-Newtonian behavior of PVA and borax but it can also act as a cross-linking agent to combine with TA to reduce the dissociation of TA on the hydrogel network, improving the mechanical properties and viscoelasticity of the hydrogel. The combination of SF and TA can improve the self-healing ability of the hydrogel and realize the adjustable viscoelasticity of the hydrogel without sacrificing other properties. The obtained hydrogel has excellent stretchability (strain > 1000%) and shows good conformal contact with human skin. When the hydrogel is damaged by external strain, it can rapidly self-repair (mechanical and electrical properties) without external stimuli. It shows adhesiveness and repeatable adhesiveness to different materials (steel, wood, PTFE, glass, iron, and cotton fabric) and biological tissues (pigskin) and is easy to peel off without residue. The obtained PBST conductive hydrogel also has a wide strain-sensing range (>650%) and reliable stability. The hydrogel adhered to the skin surface can monitor large strain movements such as in finger joints, wrist joints, knee joints, and so on and detect swallowing, smiling, facial bulging and calming, and other micro-deformation behaviors. It can also distinguish physical signals such as light smile, big laugh, fast and slow breathing, and deep and shallow breathing. Therefore, the PBST conductive hydrogel material with multiple synergistic functions has great potential as a flexible wearable strain sensor. The PBST hydrogel has antibacterial properties and good biocompatibility at the same time, which provides a safety guarantee for it as a flexible wearable strain sensor. This work is expected to provide a new way for people to develop ideal wearable strain sensors.

Bioinspired self-degradable hydrogels towards wound sealing

Inspired by the autolysis of shaggy mane, we developed a self-degradable hydrogel as a medical adhesive for skin wounds. The rapid gelation and self-degradation of the hydrogel were achieved via the Michael addition and subsequent hydrolysis of the addition product. In vivo experiments further showed that the hydrogel adhesive was efficiently applied for skin wound repair.

A review of the properties and applications of bioadhesive hydrogels

Due to their outstanding properties, bioadhesive hydrogels have been extensively studied by researchers in recent years.

Hyperbranched polymer with dynamic thiol-aldehyde crosslinking and its application as a self-healable bioadhesive

Bioadhesives crosslinked with dynamic bonds exhibit shear-thinning, self-healing, and on-demand detachment properties, but generally show a weak bonding performance due to their poor bulk strength. Obtaining a strong bioadhesive with reversible crosslinking remains a challenge. To address this issue, herein we engineered a dynamic thiol-aldehyde crosslinked solvent-free adhesive based on hyperbranched polymer. The adhesive was obtained by directly mixing a liquid hyperbranched polymer with thiol end groups (HBPTE) and benzaldehyde-terminated polyethylene glycol (PEGCHO) without any additional catalyst or solvent. The solvent-free strategy yielded a dense crosslinking structure with many aldehyde groups, so this HBPTE-PEGCHO adhesive can strongly bond to tissue and various non-biological substrates. In addition, the HBPTE-PEGCHO adhesive has self-healing and thermo-reversible bonding properties due to the dynamic thiol-aldehyde crosslinking matrix. In vivo wound healing experiments show that this HBPTE-PEGCHO adhesive is tissue-benign, suggesting it can be applied in clinical practice. Combining the hyperbranched polymer-based solvent-free strategy and dynamic thiol-aldehyde crosslinking chemistry provides a simple but effective way to engineer a multifunctional bioadhesive with the desired bonding performance.