Biomedical materials for wound dressing: recent advances and applications

Optically pH-Sensing in smart wound dressings towards real-time monitoring of wound states: A review

BACKGROUND

Over the recent years, the investigations on wound dressings have been undergoing significant evolution, and now smart dressings with the function of the real-time monitoring of the wound states have been recognized as one of the most advanced treatment modalities. Among a variety of wound-related biomarkers, pH represents a promising candidate for in situ supervising the wound healing status. In this regard, a variety of optically pH sensing agents have been widely incorporated into different types of wound dressings.

RESULTS

Herein, we first presented an overview of the advanced wound dressings, especially those commonly used in wound pH sensing. Then, a comprehensive summary of the optical pH sensing agents that could be incorporated into the wound dressings for detecting the pH alteration on the wound bed was described in detail. These materials were classified into colorimetric dyes (i.e., synthetic and plant-based dyes) and fluorescent probes (i.e., small-molecular fluorescein and fluorescent nanomaterials). Each type of pH sensing agent was fully discussed with advantages and limitations for monitoring the wound pH alteration, as well as typical examples of practical applications. To well interpret messages produced by the color-coding dressings, the approaches for defining and communicating color were also summarized, and a proof-of-concept, the smartphone-based remote supervision was particularly highlighted.

SIGNIFICANCE

This review provides a comprehensive overview of the utilization of optically pH sensing in advanced wound dressings for the real-time monitoring of the wound states. It was expected to be an informative source for the exploitation of novel diagnostic dressings for wound management, and also a reference the for application of these materials in the biosensing of other physiological or pathological fluids.

A dual-modified glucomannan polysaccharide selectively sequesters growth factors for skin tissue repair

Artificial dermal matrixes (ADMs) are valuable clinical options for treating large soft tissue defects, but their suboptimal bioactivities compared with the real tissue limit their therapeutic potential. For example, glycosaminoglycan (GAG) polysaccharides in the native skin vitally and differentially regulate endogenous growth factors (GFs) to maintain tissue homeostasis. However, the GAG used in the current ADMs has often lost such delicate regulation. Here, we developed a novel polysaccharide-based ADM that can promote skin tissue repair through selective modulation of specific pro-healing GFs. First, we prepared a plant-derived backbone of glucomannan (named BSP) - representing the two dominant monosaccharide components in the human body - in mass and homogenic quality. Then, we modified this backbone with sulfate and acetyl groups in a controlled manner to yield an optimized BSP derivative (SMAL-BSP) as a main composition to generate a new ADM. In vitro, SMAL-BSP enabled the ADM to selectively sequester pro-angiogenic GFs of VEGF-A and FGF-2 in situ for stimulating endothelial cell growth. Moreover, the addition of the acetyl group induced macrophages to secrete nitric oxide (NO) with antibacterial activities. Further in vivo tests in a rat model of full-thickness skin wounds indicated that SMAL-BSP ADM could sequester GFs in situ to promote angiogenesis and thus tissue regeneration, with superior effects than conventional chondroitin sulfate-based ADM, while showing no adverse effects often associated with animal-derived products. Our study represents a novel strategy for ADM design, targeting selective GF sequestration towards optimal skin tissue regeneration.

Mechanically robust, mouldable, dynamically crosslinked hydrogel flap with multiple functionalities for accelerated deep skin wound healing

Deep cutaneous wounds, which are difficult to heal and specifically occur on dynamic body surfaces, remain a substantial healthcare challenge in clinical practice because of multiple underlying factors, including excessive reactive oxygen species, potential bacterial infection, and extensive degradation of the extracellular matrix (ECM) which further leads to the progressive deterioration of the wound microenvironment. Any available individual wound therapy, such as antibiotic-loaded cotton gauze, cannot address all these issues. Engineering an advanced multifunctional wound dressing is the current need to promote the overall healing process of such wounds. Here, we report a multifunctional hydrogel flap primarily composed of biodegradable polymers gelatin (G) and poly-methyl vinyl ether-alt-maleic acid (MA) as the base material. The hydrogel physically incorporates tannic acid (TA) and vancomycin (V), for added functionality. The resulting hydrogel flap, gelatin- poly-methyl vinyl ether-alt-maleic acid-tannic acid-vancomycin (G-MA-TA-V/E-N), is formed through a chemical crosslinking process using EDC (E) and NHS (N). Thus, the hydrogel flap reveals multiple ideal properties that support its ease of application, including stretchability, porous microstructure (honey-comb structure), mouldability, and adhesiveness to multiple surfaces, including wet biological surfaces. The in vitro studies demonstrated strong antioxidant, antibacterial, and absorption properties essential for accelerated wound-healing applications. In vivo studies further reveal accelerated wound contraction and enhanced healing kinetics, promoting re-epithelialization, angiogenesis, and formation of apocrine glands. These findings underscore the efficacy and cost-effectiveness of fabricated hydrogel flaps as viable therapeutic options for treating deep skin wounds and make it worthwhile to integrate them with medical devices for tissue adhesion.

The preparation of methacrylated oxidized konjac glucomannan hydrogel system and its treatment for diabetic wounds

The management of diabetic wounds has become an important task for the public health system. Hydrogels are highly anticipated as modern wound dressings for the treatment of diabetic wounds, hence we have prepared a MOK-Gel using methacrylated oxidized konjac glucomannan (MOK) crosslinked with acrylamide (AM). On this basis, we have incorporated drugs such as UiO-66 loaded with sodium ferulate (SF) and deferoxamine (DFO) to develop the hydrogel wound dressing DUS@MOK-Gel (a hydrogel composed of methacrylated oxidized konjac glucomannan, loaded with DFO and UiO-66 loaded with sodium ferulate). It not only has excellent physical properties, including swelling capacity, moisture retention, and water vapor permeability; but also possesses bioactivity functions such as antioxidant, anti-inflammatory, macrophage polarization regulation, promotion of anti-inflammatory factor release, and angiogenesis to accelerate the healing of diabetic wounds. Therefore, DUS@MOK-Gel has great development prospects and market value in the field of diabetic wound treatment.

Bioactive hemostatic materials: a new strategy for promoting wound healing and tissue regeneration

Wound healing remains a critical global healthcare challenge, with an annual treatment cost exceeding $50 billion worldwide. Over the past decade, significant advances in wound care have focused on developing sophisticated biomaterials that promote tissue regeneration and prevent complications. Despite these developments, there remains a crucial need for multifunctional wound healing materials that can effectively address the complex, multiphase nature of wound repair while being cost effective and easily applicable in various clinical settings. This review systematically analyzes the latest developments in wound healing materials, examining their chemical composition, structural design, and therapeutic mechanisms. We comprehensively evaluate various bioactive components, including natural polymers, synthetic matrices, and hybrid composites, along with their different forms, such as hydrogels, powders, and smart dressings. Special attention is given to emerging strategies in material design that integrate multiple therapeutic functions, including sustained drug delivery, infection prevention, and tissue regeneration promotion. The insights provided in this review illuminate the path toward next-generation wound healing materials, highlighting opportunities for developing more effective therapeutic solutions that can significantly improve patient outcomes and reduce healthcare burden.

Biodegradable Poly(d,l-lactide-co-ε-caprolactone) Electrospun Scaffolds Outperform Antifibrotic-Loaded Meshes in an in Vivo Tissue Regeneration Model

Wound healing is a complex and dynamic process of replacing missing cellular structures and tissue layers. Clinical practice includes the application of a sterile bandage to promote healing and to restrain infection, like the commercial nonbiodegradable meshes. However, while inert, nontoxic, and nonimmunogenic, they can cause calcification, fibrosis, and inflammation, potentially hindering the healing process in the long term. To address this challenge and enhance wound healing, we developed a totally biodegradable electrospun poly(d,l-lactide-co-ε-caprolactone) (PDLLCL) drug delivery system that incorporates two already FDA-approved antifibrotics, pirfenidone (PIRF) and triamcinolone acetonide (TA). The PDLLCL meshes, fabricated via electrospinning, exhibited homogeneity and complete degradation after 120 days, consistent with the wound healing process. In vitro, functional analysis on RAW 264.7 macrophages revealed no cytotoxicity and an immunomodulatory effect of PIRF and TA compared with the positive control (lipopolysaccharides, LPS) and the PDLLCL meshes alone. Lastly, subcutaneous in vivo assessment on a rabbit model, following the ISO 10993-6 standard, showed that our tailored made PDLLCL meshes were able to lower both irritation and fibrosis indexes from 2 weeks to 4 weeks of implantation, highlighting the beneficial effect of biodegradable polymers. However, we saw no significant positive effect on the incorporation of antifibrotics in vivo for irritation and fibrosis indexes. This underscores the potential of PDLLCL meshes as a possible alternative for wound healing, reducing the use of intermittent antifibrotic agents during the healing process.

Development of hyaluronic acid-based hydrogels for chronic diabetic wound healing: A review

This research delves into the advancements in chronic skin wound treatment, with a particular focus on diabetic foot ulcers, utilizing hyaluronic acid (HA)-based hydrogels. Hyaluronic acid, an integral component of the skin's extracellular matrix, plays a crucial role in process such as inflammation, angiogenesis, and tissue regeneration. Due to their three-dimensional network structure, biocompatibility, hydrophilicity, and gas exchange capabilities, HA-based hydrogels are considered highly suitable for promoting wound healing. Nonetheless, pure HA hydrogels exhibit limitations including insufficient mechanical strength and rapid release of encapsulated substances. To address these limitations, the incorporation of bioactive materials such as chitosan and collagen was investigated. This combination not only optimized mechanical strength and degradation rates but also enhanced antibacterial and anti-inflammatory properties. Furthermore, responsive hydrogel dressings were developed to adapt to the specific characteristics of the diabetic wound microenvironment, enabling on-demand drug release. These advancements present new perspectives for the treatment of diabetic foot ulcers.

Advancement of Nanomaterials- and Biomaterials-Based Technologies for Wound Healing and Tissue Regenerative Applications

Patients and healthcare systems face significant social and financial challenges due to the increasing number of individuals with chronic external and internal wounds that fail to heal. The complexity of the healing process remains a serious health concern, despite the effectiveness of conventional wound dressings in promoting healing. Recent advancements in materials science and fabrication techniques have led to the development of innovative dressings that enhance wound healing. To further expedite the healing process, novel approaches such as nanoparticles, 3D-printed wound dressings, and biomolecule-infused dressings have emerged, along with cell-based methods. Additionally, gene therapy technologies are being harnessed to generate stem cell derivatives that are more functional, selective, and responsive than their natural counterparts. This review highlights the significant potential of biomaterials, nanoparticles, 3D bioprinting, and gene- and cell-based therapies in wound healing. However, it also underscores the necessity for further research to address the existing challenges and integrate these strategies into standard clinical practice.

Assessing the efficacy of polyvinyl alcohol/chitosan nanofibrous mat loaded with myrtle essential oil/gum Arabic in wound healing

Nowadays, extensive research has been conducted on electrospun nanofibers for wound dressing applications. Considering the growing concern over bacterial resistance to common antibiotics, investigating the potential of natural essential oils with antibacterial properties could prove to be beneficial in addressing this issue. In response to the challenges posed by impaired wound healing, we have designed a novel electrospun polyvinyl alcohol/chitosan nanofiber embedded with myrtle essential oil and gum Arabic dispersion (PVA/CS/MT-GA). The morphology and molecular structure of the prepared nanofibers were evaluated by scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) analysis. The synthesized PVA/CS/MT-GA composite demonstrated a remarkable swelling capacity of 744% and exhibited acceptable mechanical strength. Additionally, the water vapor transmission rate (WVTR) of these nanofibers was obtained as 2497 g.m-2.day-1, which falls within the ideal range for wound dressings. The antimicrobial test results revealed that PVA/CS/MT-GA nanofibers exhibited notable antibacterial properties when tested against Escherichia coli and Staphylococcus aureus. The release profile of MT from MT-containing nanofibers exhibited a burst release mechanism in PVA/CS/MT-GA nanofibers, which can be beneficial in applications that require an immediate therapeutic effect. Furthermore, nanofibers as wound dressings in the full-thickness wound model of Wistar rats demonstrated a remarkable capacity to care for damaged tissue and promote faster healing times. Collectively, the results obtained in this study suggest that the developed nanofiber holds great promise as a potential candidate for wound dressing applications.

Double cross-linked cellulose hydrogel-supported Fe species for efficient wound healing

Traditional dressings often lack adequate skin structure support, which can lead to secondary damage, poor hemostasis, and an increased risk of inflammation due to wound adhesion. In this work, cellulose hydrogels were prepared by physical/chemical double cross-linking via a 'sol-gel' strategy and further loaded with Fe to obtain a three-dimensional (3D) porous cellulose/Fe composite hydrogel (cellulose/Fe gel). The obtained cellulose/Fe gel featured a 3D porous nanofiber structure, excellent water absorption/moisture retention performance, and good mechanical stability. Moreover, it could effectively remove reactive oxygen species (ROS) and inhibit cellular oxidative stress, demonstrating potential anti-inflammatory effects. When applied to wound repair in rats, cellulose/Fe gel, with excellent cell compatibility, effectively stimulated the formation of new blood vessels and significantly reduced the level of inflammatory factors, promoting wound healing. This work provides a new approach for cellulose-based hydrogel wound dressings.

Nanoparticle-Enhanced Collagen Hydrogels for Chronic Wound Management

Chronic wound infections present a persistent medical challenge; however, advancements in wound dressings and antimicrobial nanomaterials offer promising solutions for improving healing outcomes. This study introduces a hydrothermal synthesis approach for producing zinc oxide (ZnO) and copper oxide (CuO) nanoparticles, subsequently incorporated into PLGA microspheres and embedded within collagen hydrogels. The nanoparticles' physicochemical properties were characterized using X-ray diffraction (XRD) to confirm crystalline structure, scanning electron microscopy (SEM) for surface morphology, and Fourier-transform infrared spectroscopy (FT-IR) to verify functional groups and successful hydrogel integration. The hydrogels were tested for antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans, which are key pathogens in chronic wounds. Biocompatibility was assessed using the human HaCat keratinocyte cell line. Both ZnO- and CuO-loaded hydrogels exhibited broad-spectrum antimicrobial efficacy. Cytocompatibility tests demonstrated that both ZnO- and CuO-loaded hydrogels sustain cell viability and proliferation, highlighting their biocompatibility and suitability for chronic wound healing applications, with superior biological performance of ZnO-loaded hydrogels. Furthermore, the distinct antimicrobial profiles of ZnO and CuO hydrogels suggest their tailored use based on wound microbial composition, with CuO hydrogels excelling in antibacterial applications and ZnO hydrogels showing potential for antifungal treatments. These results underscore the potential of nanoparticle-based collagen hydrogels as innovative therapeutic tools for managing chronic wounds.

Decellularized Persian walnut leaf (Juglans regia) as a potential wound dressing scaffold: an experimental study

Introduction

Wound dressings often fall short of providing the multifunctional capabilities required for optimal wound healing, such as promoting cell migration, proliferation, and tissue regeneration. Decellularization of plant tissues has gained attention as a potential source of biomaterials for tissue engineering applications due to their favorable characteristics, including pre-existing vascular networks, interconnected porous structure, efficient water transport and retention, high surface area, and a diverse range of mechanical properties.

Methods

This study investigates the feasibility of using decellularized walnut leaves (DWL) as a novel scaffold for wound dressing in a mice model of excisional wounds. The decellularization and bleaching processes were carried out using various chemical agents. DNA and protein quantification and hematoxylin and eosin staining were performed to reveal the successful removal of cells in DWL. Scanning electron microscopy (SEM) was used to indicate that the normal structure of walnut leaves was preserved after chemical decellularization. Chemical characterization was conducted using Fourier-transform infrared (FTIR) and Raman spectroscopy to show the remaining bioactive molecules and components in the structure of DWL.

Results

Comparing tensile strength and surface roughness parameters, surface wettability, swelling, and porosity properties of native and DWL indicated no statistical differences between them. SEM analysis demonstrated that human mesenchymal stem cells excellently attach and proliferate on the DWL. Additionally, the biocompatibility and potential of DWL scaffolds to accelerate wound closure and enhance histopathological scores, collagen deposition, and epithelial thickness were observed in a mice model of excisional wounds.

Discussion

In conclusion, DWL shows promising potential for application as a skin wound dressing due to its biocompatibility, ability to promote cell attachment and proliferation, and efficacy in accelerating wound healing.

Atopic dermatitis: a comprehensive updated review of this intriguing disease with futuristic insights

Atopic dermatitis (AD) is a paradigmatic prevalent, long-lasting, and inflammatory skin condition with a diverse range of clinical manifestations. The etiology and clinical symptoms of AD are influenced by complex pathophysiological processes, which involve a strong genetic component, epidermal dysfunction, and immunological dysregulation, and a strong influence of other physiological and environmental factors. The FDA has approved targeted and well-tolerated immunomodulators including biologics like dupilumab and crisaborole, and small molecules such as baricitinib, as novel therapies for AD. They effectively treat AD but are too expensive for most patients. The review provides an update on the state of knowledge of AD pathogenesis, discusses the available diagnostic and scoring indices, and provides a scientific foundation for treatment methods for AD. This review also presents data on clinical efficacy of innovative treatments' considering recent guidelines, emphasizing the newest medications and ongoing trials. Finally, the new implication of artificial intelligence (AI) in AD management is explored, where AI can speed up diagnosis and therapy. The PubMed, Google Scholar, and ScienceDirect databases were used for this review.

The Printed Path to Healing: Advancing Wound Dressings through Additive Manufacturing

Wound care challenges healthcare systems worldwide as traditional dressings often fall short in addressing the diverse and complex nature of wound healing. Given conventional treatments limitations, innovative alternatives are urgent. Additive manufacturing (AM) has emerged as a distinct and transformative approach for developing advanced wound dressings, offering unprecedented functionality and customization. Besides exploring the AM processes state-of-the-art, this review comprehensively examines the application of AM to produce cellular-compatible and bioactive, therapeutic agent delivery, patient-centric, and responsive dressings. This review distinguishes itself from the published literature by covering a variety of wound types and by summarizing important data, including used materials, process/technology, printing parameters, and findings from in vitro, ex vivo, and in vivo studies. The prospects of AM in enhancing wound healing outcomes are also analyzed in a translational and cost-effective manner.

A customized postoperative wound management model tailored to the healing dynamics of the upper lip: a retrospective cohort study

BACKGROUND

Clinical observations suggest that upper lip injuries often exhibit prolonged healing and reduced healing efficacy. The unique anatomical and physiological characteristics of the lips make them particularly susceptible to infection and delayed recovery, posing significant challenges for postoperative management. The aim of this research, grounded in the anatomical and physiological subtleties of the upper lip, was to contrast the wound management outcomes between patients treated with a conventional wound management approach and those treated with a customized wound management model. Additionally, it aimed to explore the efficacy of a dynamic model in the assessment and treatment of upper lip wounds.

METHOD

It is a retrospective cohort study. Patients with maxillofacial injuries who attended the Emergency Department of West China Hospital of Stomatology of Sichuan University were selected for retrospective analysis. Between February and August 2023, 89 out of 783 patients with maxillofacial injuries who had upper lip injuries formed the control group. From February to August 2024, 84 patients with upper lip injuries, selected from 643 patients with maxillofacial injuries, constituted the experimental group. The control group applied the traditional wound management method, while the experimental group implemented the customized wound management model, which involved optimizing the team, devising a wound-healing model, improving dressings, innovating in both the timing and method of dressing changes, and providing customized care for complex wounds. The outcomes of upper lip wound management between the two groups were compared, including the wound infection rate, the Vancouver Scar Scale (VSS) score 30 days after surgery, and patients' satisfaction. Data analysis was conducted using SPSS 23.0 software.

RESULTS

There were no statistically significant differences in the demographic variables between the two groups (P > 0.05). The upper lip infection rates were 18% (16 out of 89) in the control group and 1.2% (1 out of 84) in the experimental group, respectively. Notably, the incidence of wound complications and wound infection rates differed significantly between the control and experimental groups, with the experimental group showing lower figures for both (P < 0.001). Compared to the control group, the experimental group had a lower VSS score and a higher patients' satisfaction score, with these differences being statistically significant (P < 0.001).

CONCLUSION

The customized wound management model demonstrated superior clinical efficacy in treating upper lip injuries. Patients gain advantages from a customized postoperative wound management model designed according to the upper lip healing kinetics. By aligning postoperative care with the unique healing kinetics of the upper lip, this approach significantly reduces infection rates and enhances patient satisfaction. These findings advocate for wider adoption of this personalized wound management model in the clinical treatment of upper lip injuries.

TRIAL REGISTRATION

Clinical Trial Registration No. ChiCTR2300079287, Registration Date 29 December 2023.

Therapeutic potential of Brazilian green propolis and oregano (Origanum vulgare) extracts in collagen hydrogel for pressure ulcer repair: an experimental study in an animal model

This study investigated the effects of incorporating Brazilian green propolis ethanolic extract and oregano (Origanum vulgare) methanolic extract into type I collagen hydrogel to enhance pressure ulcer healing in mice. Forty-four mice were divided into four groups: untreated control, plain collagen hydrogel, collagen hydrogel with 1% green propolis extract, and collagen hydrogel with 1% oregano extract. Pressure ulcers were induced on their dorsal skin, followed by a 14-day assessment of wound area, contraction, re-epithelialization, dermal collagen density, and levels of reactive oxygen species and nitrite. Results showed significant tissue repair promotion by both propolis and oregano extracts, with oregano exhibiting superior wound contraction. These hydrogels also facilitated skin layer reorganisation and reduced reactive oxygen species and nitrite production. Collagen hydrogels containing these extracts show promising therapeutic potential for pressure ulcer treatment.

Antibacterial and biodegradable PLA-based nanofibers loaded with natural phenolic monoterpenes for sustainable biomedical or food application

Antibacterial biodegradable PLA-based nanofibers loaded with phenolic monoterpenes - thymol, eugenol, carvacrol, and cinnamaldehyde, were prepared by electrospinning. The effect of bioactive molecule on the surface, thermal, morphological, and biological properties has been investigated about the potential pharmaceutical and food processing applications. Fiber diameters ranged from 320 nm for PLA fibrous mat up to 480 nm for PLA membrane with 6 % thymol. All the prepared active nanofibers exhibited hydrophobic surfaces with a slightly decreasing contact angle after the incorporation of phenols. Antimicrobial testing proved a strong efficiency against Escherichia coli and Staphylococcus aureus, depending on the specific type and content of the bioactive compound. A significant biofilm formation reduction of bioactive PLA nanofibers was revealed against tested microorganisms. Modification of PLA fibers with active molecules did not significantly affect the biodegradation kinetics in comparison to PLA samples with their absence. This study demonstrates the high potential of newly developed PLA-based/phenol nanofibrous membranes for use as antibacterial and antifouling systems applicable in wound dressings and food packaging.

Advanced biomaterials in pressure ulcer prevention and care: from basic research to clinical practice

Pressure ulcers are a common and serious medical condition. Conventional treatment methods often fall short in addressing the complexities of prevention and care. This paper provides a comprehensive review of recent advancements in advanced biomaterials for pressure ulcer management, emphasizing their potential to overcome these limitations. The study highlights the roles of biomaterials in enhancing wound healing, preventing infections, and accelerating recovery. Specific focus is placed on the innovation and application of multi-functional composite materials, intelligent systems, and personalized solutions. Future research should prioritize interdisciplinary collaboration to facilitate the clinical translation of these materials, providing more effective and tailored treatment approaches. These advancements aim to improve the quality of life and health outcomes for patients by offering more reliable, efficient, and patient-specific therapeutic options.

Advances in regenerative medicine-based approaches for skin regeneration and rejuvenation

Significant progress has been made in regenerative medicine for skin repair and rejuvenation. This review examines core technologies including stem cell therapy, bioengineered skin substitutes, platelet-rich plasma (PRP), exosome-based therapies, and gene editing techniques like CRISPR. These methods hold promise for treating a range of conditions, from chronic wounds and burns to age-related skin changes and genetic disorders. Challenges remain in optimizing these therapies for broader accessibility and ensuring long-term safety and efficacy.

Screening of an antimicrobial peptide-TWPAL and its application in hydrogels for wound healing

Open wounds are one of the concerns of modern medicine. Early on, before the wound has closed, bacteria can easily enter, leading to bacterial infections. Excipients with antimicrobial effects can greatly facilitate the wound healing process. In this work, we screened and synthesized the antimicrobial peptide Thr-Trp-Pro-Gla-Leu (TWPAL), which has good bacteriostatic effect as well as drug resistance. And by loading it into a hyaluronic acid/gelatin hydrogel, we developed an antimicrobial hydrogel (TWPAL-gel), and by analyzing the results of animal experiments, it was found that this treatment has obvious efficacy in the treatment of animal wound infections, which provides a strong experimental basis for the clinical treatment and an important reference value for the further research on the treatment of diseases. Therefore, a new antimicrobial peptide TWPAL and a hydrogel based on this peptide were developed in this study to provide a comfortable and sterile recovery environment for wound healing, which can be an ideal choice for the treatment of open wounds.

Tissue-Adhesive and Antibacterial Hydrogel Promotes MDR Bacteria-Infected Diabetic Wound Healing via Disrupting Bacterial Biofilm, Scavenging ROS and Promoting Angiogenesis

Effective treatment of diabetic wounds remains challenging because of multidrug-resistant (MDR) bacterial infections, excessive oxidative stress, and impaired angiogenesis. In this study, a tissue-adhesive and antibacterial hydrogel incorporating MXene and deferoxamine (DFO)-loaded microspheres is developed for the treatment of MDR bacteria-infected diabetic wounds. The hydrogel is built based on covalent crosslinking between ε-poly(L-lysine) and o-phthalaldehyde-terminated four-arm poly(ethylene glycol). The hydrogel exhibited excellent mechanical properties, tissue adhesion strength, biocompatibility, and biodegradability. Under near-infrared (NIR) irradiation, the MXene converted light into heat and elevated the local temperature rapidly, enabling the rapid disintegration of MDR bacterial biofilms. Simultaneously, the hydrogel exerted inherent antibacterial activity, persistently killing planktonic bacteria, and effectively controlling wound infections. The encapsulated DFO is then released from the hydrogel in a sustained and controlled manner, and promoted angiogenesis during diabetic wound healing. Additionally, MXenes can scavenge excessive reactive oxygen species and alleviate wound inflammation. In the methicillin-resistant Staphylococcus aureus-infected diabetic wound model in mice, the composite hydrogel along with NIR irradiation efficiently reduced the infectious bacteria, and accelerated the wound healing by promoting angiogenesis and alleviating inflammation. This composite hydrogel has great clinical potential for the treatment of diabetic wounds, particularly in challenging healing environments involving motion and infection.

Advancements in Wound Dressing Materials: Highlighting Recent Progress in Hydrogels, Foams, and Antimicrobial Dressings

Recent advancements in wound dressing materials have significantly improved acute and chronic wound management by addressing challenges such as infection control, moisture balance, and enhanced healing. Important progress has been made, especially with hydrogels, foams, and antimicrobial materials for creating optimized dressings. Hydrogels are known for maintaining optimal moisture levels, while foam dressings are excellent exudate absorbents. Meanwhile, antimicrobial dressing incorporates various antimicrobial agents to reduce infection risks. These dressing options reduce wound healing time while focusing on customized patient needs. Therefore, this review highlights the newest research materials and prototypes for wound healing applications, emphasizing their particular benefits and clinical importance. Innovations such as stimuli-responsive hydrogels and hybrid bioengineered composites are discussed in relation to their enhanced properties, including responsiveness to pH, temperature, glucose, or enzymes and drug delivery precision. Moreover, ongoing clinical trials have been included, demonstrating the potential of emerging solutions to be soon translated from the laboratory to clinical settings. By discussing interdisciplinary approaches that integrate advanced materials, nanotechnology, and biological insights, this work provides a contemporary framework for patient-centric, efficient wound care strategies.

Antibacterial nonwoven materials in medicine and healthcare

Bacterial infection has always been a severe challenge for mankind. The use of antibacterial nonwoven materials provides a lot of convenience in daily life and clinical practice grammar revision, it has become an important solution to avoid bacterial infection in clinical and daily life. This review systematically examines the spin bonding, melt blown, hydroneedling and electrospinning methods of nonwoven fabrication materials, and summarizes the antibacterial nonwoven materials fabrication methods. Finally, the review discusses the applications of antibacterial nonwoven materials for medical protection, external medical and healthcare, external circulation medical care implantable medical and healthcare and intelligent protection and detection. This comprehensive overview aims to provide valuable insights for the advancement of antibacterial nonwoven materials in the domain of medicine and health care. In the future, antibacterial nonwoven materials are expected to evolve towards biodegradability, composite materials, functionalization, minimally invasive techniques, diversification, and intelligence, thereby holding immense potential in healthcare.

Sodium alginate hydrogel loaded with Capparis spinosa L. extract for antimicrobial and antioxidant wound dressing applications

Novel composite hydrogels composed of Capparis spinosa L. extract (CSL) and sodium alginate (SA) were developed for biomedical applications using calcium chloride (CaCl₂) as a nontoxic ionic crosslinker. The swelling degree, antioxidant activity, water retention, and biocompatibility of the CSL/SA composite hydrogels were thoroughly analyzed, along with their antibacterial properties. Scanning electron microscopy (SEM) results indicated that the CSL/SA composite hydrogels exhibited a three-dimensional porous structure with uniform pore distribution. Fourier transform infrared spectroscopy (FTIR) results suggested that CSL was successfully incorporated into composite hydrogels. When the CSL concentration reached 9 %, the swelling degree attained 765.89 ± 21.36 %. Furthermore, the addition of CSL enhanced the oxidation resistance of the composite hydrogels. Agar disk diffusion assessments confirmed that the CSL/SA composite hydrogels exhibited significant antibacterial effects against E. coli and S. aureus. Cytotoxicity studies demonstrated that the composite hydrogels effectively accelerated cell proliferation. Therefore, these hydrogels show promising potential for application as wound dressings.

A review on multifunctional calcium alginate fibers for full-time and multipurposed wound treatment: From fundamentals to advanced applications

Recent progress in wound healing has highlighted the need for more effective treatment strategies capable of addressing the complex biological and physiological challenges of wound repair. Traditional wound dressings often fail to address the complex and evolving needs of chronic, acute, and burn wounds, particularly in terms of promoting healing, preventing infection, and supporting tissue regeneration. In response to these challenges, calcium alginate fibers (CAFs) have emerged as promising materials, characterized by their exceptional structural properties and diverse biological functions, offering significant commercial potential for the development of advanced wound dressings and therapeutic solutions. Here, a brief review of the CAFs for promoting wound healing is presented, with specific discussions of the fundamental characteristics of CAFs and its feasibility to be applied for adjusting physiological and pathological processes involved in wound healing. Then, a comprehensive and in-depth depiction of emerging representative fabrication techniques for generating CAFs is categorized and reviewed. Moreover, emerging applications benefits from the CAFs are reviewed, highlighting the multifunctional roles and benefits of CAFs in facilitating wound repair. Finally, the challenges and perspectives for further advancing CAFs toward a more powerful and versatile therapeutic strategy are discussed, particularly regarding new opportunities in biomedical research and clinical applications.

The effect of nanoceria on the alginate-gum arabic crosslinking mechanism and in vitro behavior as a wound dressing

Medical practice has proven that chronic wounds can be treated successfully if the dressing is chosen according to the healing phase of the wound. Correct intervention from the hemostasis and inflammatory phase can prevent oxidative stress and ensure optimal conditions for healing. It is important to design a new wound dressing that does not cause additional injury, has an antioxidant effect, removes dead cells, and promotes wound healing. Considering that the traditional dressings are not moisture-retentive, we proposed an alginate-gum arabic polymeric matrix enhanced with cerium oxide nanoparticles. The cryogels were prepared by cross-linking polysaccharides and cerium oxide nanoparticles via calcium cations to form a sponge-like structure. The blend of micro- and macro-pores provides a suitable environment for nutrient distribution and keeps an adequate moisture level, mimicking the functions of the native cellular matrix. The release of cerium oxide nanoparticles occurs gradually, at the same time as the degradation of the biopolymer, promoting the attachment and viability of keratinocytes and fibroblast cells. It was found that stimulating epithelial regeneration is improved through the antioxidant effect and the adsorption capacity of hemoglobin. The results also indicate good in vitro biocompatibility and recommend them as promising dressings for skin wound treatments.

Application of novel strategies in chronic wound management with focusing on pressure ulcers: new perspective

Invading blood cells, extracellular tissue, and soluble mediators all play important roles in the wound-healing process. There is a substantial global burden of disease and mortality attributable to skin defects that do not heal. About 1% to 2% of the population in industrialized nations suffers from chronic wounds that don't heal, despite healthcare breakthroughs; this condition is very costly, costing about $25 billion each year in the US alone. Amputation, infection (affecting as many as 25% of chronic wounds), sepsis, and dermal replacements are all consequences of conventional therapeutic approaches like growth factor therapy and diabetic foot ulcers account for 85% of lower limb amputations. Despite these obstacles, scientists are constantly looking for new ways to speed healing and close wounds. The unique immunomodulatory capabilities and multipotency of mesenchymal stem cells (MSCs) have made them a potential therapeutic choice in tissue engineering and regenerative medicine. Animal models of wound healing have shown that MSCs can speed up the process by as much as 40% through enhancing angiogenesis, modulating inflammation, and promoting fibroblast migration. Clinical trials provide more evidence of their effectiveness; for instance, one RCT found that, after 12 weeks, patients treated with MSCs had a 72% smaller wound size than those in the control group. This review offers a thorough examination of MSCs by combining the latest research with preclinical evidence. Highlighting their potential to transform treatment paradigms, it delves into their biological properties, how they work during regeneration and healing, and therapeutic usefulness in controlling chronic wounds.

Wireless matrix metalloproteinase-9 sensing by smart wound dressing with controlled antibacterial nanoparticles release toward chronic wound management

Chronic wounds cause serious health and economic burdens on patients and society. Herein, a wireless and flexible smart wound dressing was developed for matrix metalloproteinase-9 (MMP-9) monitoring and antimicrobial treatment toward chronic wound management. The highly sensitive radio frequency MMP-9 sensor was realized based on a bioresponsive hydrogel with the bioactive peptide sequences. Taking advantage of the flexible inductive-capacitive (LC) circuit and bioresponsive hydrogel, the wireless and wearable smart wound dressing offered an efficient strategy for in-situ wound analysis. Besides, the controlled release of silver nanoparticles (AgNPs) from the degradable hydrogel exhibited significant antimicrobial efficacy against typical bacteria in wound infection including Escherichia coli and Staphylococcus aureus. The analysis of MMP-9 in wound exudate from diabetic foot ulcer (DFU) patients demonstrated good accuracy cross-validated with gold-standard fluorescent measurements, providing great potential for personalized wound management.

Multi-functional dressings for recovery and screenable treatment of wounds: A review

Considerable research has focused on advanced wound dressing technology over the past decade. The increasing emphasis on health and medical treatment is crucial to the modern healthcare system. Consequently, high-quality wound dressings with advanced standards are essential for superior medical care. Next-generation multifunctional wound dressings feature antibacterial properties, pain relief, biocompatibility, drug delivery, flexibility, and exudate absorption. Today, biomimetic models, tissue engineering, and synthetic skin are integrated with emerging wound healing technologies, offering a new perspective on wound management. Based on the classification model of multifunctional and advanced wound dressings, various AI-assisted wound management technologies are also highly efficient. The primary goals of advanced wound dressing technologies include faster wound healing, prevention of microbial contamination, preservation of skin aesthetics, reduction of treatment costs, and increased patient comfort. The latest technologies in this field not only promote faster healing and the treatment of deep wounds but also emphasize continuous control and monitoring of the healing process. These screenable wound dressings can be smart sensors to detect wound status based on parameters such as pH, moisture, temperature, and oxygen levels. This enables wound status monitoring and appropriate treatment responses. These technologies facilitate wound observation and monitoring, as well as the evaluation and control of the healing process through various models and strategies, such as the fabrication of functional nanomaterials, computer algorithms, and artificial intelligence. This review presents an overview of the most prominent new technologies in wound dressings, along with their innovative approaches.

Antimicrobial membranes based on polycaprolactone:pectin blends reinforced with zeolite faujasite for cloxacillin-controlled release

Multifunctional membranes applied to biomedical materials become attractive to support the biological agents and increase their properties. In this study, biopolymeric fibers based on polycaprolactone (PCL) and pectin (PEC) were reinforced with faujasite zeolite (FAU) for cloxacillin antibiotic (CLX) loading. FAU with a high specific surface area (347 ± 8 m2 g-1), high crystallinity and particles with a diameter of up to 100 nm were produced under optimized synthesis conditions (100 °C/4 h). Zeolites were incorporated into polymeric nanofibers to be a cloxacillin (CLX) carrier in wound treatment, using electrospinning as an efficient synthesis method. The fibers produced showed good mechanical resistance and the incorporation of CLX was proven by assays to inhibit the growth of Staphylococcus aureus bacteria. The controlled release of CLX in different pH conditions, which simulate the wound environment, was carried out for up to 229 h, achieving a released CLX concentration of up to 6.18 ± 0.02 mg L-1. These results prove that obtaining a hybrid fiber (polymer-zeolite) to incorporate drugs to be released in a controlled manner was successfully achieved. The bactericidal activity of this material shows that its use for measured applications could be an alternative to conventional methods.

Asymmetric natural wound dressing based on porous chitosan-alginate hydrogel/electrospun PCL-silk sericin loaded by 10-HDA for skin wound healing: In vitro and in vivo studies

An asymmetric wound dressing introduced, inspired by the skin structure made of chitosan and alginate hydrogel as the bottom layer and electrospun PCL-silk sericin (PCL-SS) as the top layer. In addition, an anti-inflammatory, bactericidal and immunomodulatory substance, 10-hydroxydecanoic acid (10-HDA), known as queen bee acid, was loaded in inner layer. The wound dressing was thoroughly characterized and confirmed to meet the criteria of a standard wound dressing through in vitro and in vivo studies. Although the mesoporous hydrogel layer shows 175 % swelling after being immersed in PBS (pH = 7.4) for 60 min and 80 % degradation after 14 days, the top layer shows 28 % swelling and 19 % degradation in the same time intervals. The hydrogel layer supports rapid wound healing, while the top layer offers protection against infection and physical threats. The dressing demonstrated antibacterial properties and enhanced cell proliferation at 1 % 10-HDA. Finally, the wound healing performance of the complete dressing was investigated in vivo using wistar rat. Clinical and histopathological assessments, along with the analysis of biophysical parameters of the skin healing, confirm that wound dressing with 10-HDA significantly accelerates wound healing compared to control groups, without any inflammatory side effects.

Perforator-Based Propeller Flap Application in Pressure Ulcer Reconstruction: A Comparative Analysis With Advancement Flaps

BACKGROUND

Pressure ulcers are a prevalent and debilitating condition, often necessitating surgical reconstruction. Various flap techniques, such as Advancement Flaps (AF) and Perforator-based Propeller Flaps (PBPF), are commonly used for pressure sore reconstruction. While both techniques have proven effective, there is limited research comparing their outcomes in different clinical scenarios. In recent years, PBPF has demonstrated favorable outcomes in various reconstruction fields. However, there remains a need to establish the optimal technique for specific clinical conditions and patient populations. Therefore, this study aims to compare the outcomes of PBPF and AF in patients undergoing pressure ulcer reconstruction.

METHODS

A retrospective analysis was performed on patients who underwent pressure sore reconstruction utilizing either AF or PBPF techniques between January 2020 and December 2023. Data on demographics, pressure ulcer details, operative time, hospital stay, recurrence rate, and complications were collected and analyzed.

RESULTS

In this study of 56 patients, 30 underwent AF, and 26 underwent PBPF. Demographic and clinical characteristics showed no significant differences. Clinical and surgical outcomes indicated no significant differences in defect size (p = 0.517), hospitalization period (p = 0.786), follow-up duration (p = 0.746), number of preoperative debridements (p = 0.781), time to recurrence (p = 0.224), or postoperative complications (p = 0.757). However, PBPF resulted in a smaller flap size (93.7 ± 29.5 cm2 for AF vs. 70.5 ± 19.7 cm2 for PBPF, p < 0.001), a longer operation time compared to AF (94.6 ± 39.1 min for AF vs. 161.0 ± 38.9 min for PBPF, p < 0.001), and lower recurrence rate in long-term follow-up (p = 0.036).

CONCLUSIONS

PBPF may have the drawback of prolonged surgical time due to the complexity of the surgical procedure. However, when applied appropriately, it can be a meaningful surgical approach for reducing the recurrence rate of pressure ulcers.

Polymer- and Lipid-Based Nanostructures Serving Wound Healing Applications: A Review

Management of hard-to-heal wounds often requires specialized care that surpasses the capabilities of conventional treatments. Even the most advanced commercial products lack the functionality to meet the needs of hard-to-heal wounds, especially those complicated by active infection, extreme bleeding, and chronic inflammation. The review explores how supramolecular nanovesicles and nanoparticles-such as dendrimers, micelles, polymersomes, and lipid-based nanocarriers-can be key to introducing advanced wound healing and monitoring properties to address the complex needs of hard-to-heal wounds. Their potential to enable advanced functions essential for next-generation wound healing products-such as hemostatic functions, transdermal penetration, macrophage polarization, targeted delivery, and controlled release of active pharmaceutical ingredients (antibiotics, gaseous products, anti-inflammatory drugs, growth factors)-is discussed via an extensive overview of the recent reports. These studies highlight that the integration of supramolecular systems in wound care is crucial for advancing toward a new generation of wound healing products and addressing significant gaps in current wound management practices. Current strategies and potential improvements regarding personalized therapies, transdermal delivery, and the promising critically evaluated but underexplored polymer-based nanovesicles, including polymersomes and proteinosomes, for wound healing.

A superelastic, biofluid-locking, and degradable dressing for wound healing

In medical field, light-weight, superelastic, and super-absorbing aerogels are highly desired for sensitive wounds with persistent exudations. Up to now, superelastic PU porous dressings are commonly employed, which impose environmental concerns both in their preparation and in their pollution after usage. Herein, carboxymethyl cellulose (CMC) was used to construct hierarchical aerogels via a dual-crosslinking and porogen leaching method. The hierarchical aerogel not only disperses stress at multiple scales, endowing the aerogel with superelasticity, but also deeply absorbs bioliquid through its hierarchical porous surfaces and strong wetting forces deriving from the abundant hydrophilic groups such as hydroxyl and carboxyl groups. Moreover, for practical use, the hierarchical CMC (H-CMC) dressing demonstrates superior absorbency than commercial elastic PU foam both in static and dynamic liquid absorption, faster wound healing than commercial CMC fiber dressing, and can fully degrade both in vivo and in soil. Thus, this research offers a universal approach to design hierarchical wound dressings using bio-based polyelectrolyte, presenting a wound dressing that is both environmentally-friendly and highly comfortable when applied in healing human sensitive injuries.

Hybrid Hydrogel Supplemented with Algal Polysaccharide for Potential Use in Biomedical Applications

Hydrogels are a viable option for biomedical applications due to their biocompatibility, biodegradability, and ability to incorporate various healing agents while maintaining their biological efficacy. This study focused on the preparation and characterization of novel hybrid hydrogels enriched with the natural algae compound Ulvan for potential use in wound dressings. The characterization of the hydrogel membranes involved multiple methods to assess their structural, mechanical, and chemical properties, such as pH measurements, swelling, moisture content and uptake, gel fraction, hydrolytic degradation, protein adsorption and denaturation tests, rheological measurements, SEM, biocompatibility testing, and scratch wound assay. The hydrogel obtained with a higher concentration of Ulvan (1 mg/mL) exhibited superior mechanical properties, a swelling index of 264%, a water content of 55%, and a lower degradation percentage. In terms of rheological properties, the inclusion of ULV in the hydrogel composition enhanced gel strength, and the Alginate + PVA + 1.0ULV sample demonstrated the greatest resistance to deformation. All hydrogels exhibited good biocompatibility, with cell viability above 70% and no obvious morphological modifications. The addition of Ulvan potentiates the regenerative effect of hydrogel membranes. Subsequent studies will focus on encapsulating bioactive compounds, investigating their release behavior, and evaluating their active biological effects.

Self-assembled Arginine-Glycine-Aspartic Acid Mimic Peptide Hydrogels as Multifunctional Biomaterials for Wound Healing

Clinical management of nonhealing ulcers requires advanced materials that can enhance wound closure rates without relying on the release of drugs or other growth factors to obviate systemic deleterious side effects. In our previous work, we synthesized an integrin-binding cell adhesive MNH2 {Fmoc-FFβAR(K)βA-NH2 consisting of an RGD mimic, [R(K)], with an amide terminus}, MOH {Fmoc-FFβAR(K)βA-OH consisting of an RGD mimic, [R(K)], with acid terminus}, and MR (Fmoc-FFβARGDβA-NH2 consisting of an RGD peptide, reference) with multifunctional activity. Here, we reported the synthesis, characterization, and performance of a reversed derivative, R-MNH2 (Fmoc-FFβA(K)RβA-NH2 consisting of an RGD mimic, [K(R)], with an amide terminus) of an antimicrobial cell adhesive peptide, MNH2. Both peptides (MNH2 and R-MNH2) were found to interact with αvβ3 integrin, as shown by docking studies; however, they differed in cell adhesive properties, hydrogel formation, and antimicrobial efficacy. Later, the wound healing ability of a series of RGD/RGD peptide mimics (MR, R-MNH2, MNH2, and MOH) was studied in a methicillin-resistant Staphylococcus aureus (MRSA)-infected Balb/c mouse model. All studied peptides showed cell adhesion and wound healing properties; however, only the amide-terminal RGD peptide mimic, MNH2, and its reversed derivative, R-MNH2, showed antimicrobial activity in both in vitro and in vivo studies. Of these, MNH2 showed the highest integrin-mediated spreading, migration, and proliferation of dermal cells in vitro as well as in vivo. Therefore, the MNH2 peptide mimic represents a paradigm shift in the development of dermoconductive strategies to treat chronic wounds.

A gelatin/acrylamide-based hydrogel for smart drug release monitoring and radiation-induced wound repair in breast cancer

Radiotherapy is a common local treatment for breast cancer, and while it is effective in targeting tumor cells, it inevitably causes significant side effects. These include excessive production of reactive oxygen species (ROS), repeated inflammatory, and severe skin ulceration, all of which can hinder the wound healing process. As a result, there is a pressing need for multifunctional medical dressings that can support wound repair following radiotherapy. In this study, we introduced a novel double-network interpenetrating hydrogel (GEMC), which combined gelatin grafted dopamine (GEDA), acrylamide, nano-clay (NC), and curcumin loaded nanoparticles (CCNPs). Unlike traditional single-function hydrogels, the GEMC hydrogel offered a combination of antioxidant properties, tissue adhesion, and real time drug tracking, effectively addressing the multifaceted challenges of wound healing after radiotherapy. The GEMC hydrogel exhibited impressive antioxidant activity and superior mechanical properties, which collectively improve the support and protection of wounded surfaces. Furthermore, GEMC promoted skin regeneration, angiogenesis and reduced inflammatory in a mouse model of radiotherapy-induced skin ulceration. These results highlight the hydrogel's potential to accelerate would healing and enhance the effectiveness of post-radiotherapy wound care, providing a promising new approach to improving the quality of skin recovery following radiotherapy.

Anticandidal Efficacy of Green Synthesized Silver Nanoparticles Using Trans-Himalayan Plant Extracts Against Drug Resistant Clinical Isolates of Candida auris

Candida auris is the most common, globally detected nosocomial fungal pathogen with multi-drug resistance. The high prevalence of C. auris infections has raised concern about drug resistance and adverse effects, compounded by a lack of effective alternative drugs. Bioengineered nanomaterials play a significant role in combating nosocomial infections. Silver nanoparticles (AgNPs) have emerged as an extensively used nanomaterial due to their prominent antimicrobial properties. One of the most promising approaches is to incorporate herbal extracts that contain a range of phytoconstituents, being used for curing various chronic illnesses. This study aimed to produce eco-friendly, cost-effective green synthesized AgNPs with trans-Himalayan medicinal plant extracts (Trillium govanianum & Bergenia ligulata) and assess their anticandidal and antibiofilm potential. The green-synthesized AgNPs formation and crystalline nature were confirmed by UV-visible spectroscopy, dynamic light scattering and X-ray diffraction analysis. The UV-Vis spectra of the AgNPs revealed bands in the range of 415-430 nm. Phytoconstituents as reducing agents were involved in the stabilization of AgNPs as identified by FTIR spectra. HR-TEM of AgNPs' displayed a spherical shape with size in the range of 10-100 nm. Results of activity tests performed using various C. auris clinical strains showed half maximum growth inhibition (IC50) at 8.02 µg/mL, which inhibited 65% of biofilm for T. govanianum extract. The free radical scavenging activity evaluated for green synthesized AgNPs using DPPH showed more than 90% antioxidant activity. Green synthesized AgNPs displayed potent growth inhibition (IC50) at 4.01 µg/mL with 87.0% biofilm inhibition. Green synthesized AgNPs coated bandages and catheters inhibited the growth of C. auris. This study concluded that green synthesized AgNPs formulation in conjunction with antifungal agents exhibits potential biomedical application and also could be used as alternative therapeutics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12088-024-01277-8.

Characterization of sustainable biocompatible materials based on chitosan: cellulose composites containing sporopollenin exine capsules

In this work, photothermal beam deflection spectrometric technique (BDS) is applied for non-contact and non-destructive characterization of chitosan (CS): cellulose (CEL) biocomposites with incorporated sporopollenin exine capsules (SEC). The objective was to determine the structural and thermal properties of synthesized CS:CEL:SEC composites with varying amounts of SEC, and to validate the BDS by photopyroelectric calorimetry (PPE) as an independent technique. It was found that CS:CEL biocomposites without SEC exhibit low porosities, which are on the order of 0.005 %, but can be increased by augmenting the content of CEL in the composite and/or by incorporation of SEC. By increasing the SEC content of CS:CEL composites to 50 % (w/w), the porosity increased up to 0.17 %. SEC also increases the surface roughness of biocomposite by over 2000-times to reach the roughness amplitude of 6 μm in composites with 50 % SEC. The thermal conductivities of investigated biocomposites were in the range of 40-80 mWm-1 K-1, while the thermal diffusivities were on the order of fractions of mm2s-1. With first validation of BDS results for thermal properties of CS:CEL-based composites, which show agreement with PPE results to within 5 %, this study confirms BDS technique as a perspectives tool for non-destructive characterization of CS:CEL:SEC biocomposites.

Effect of the molar mass of chitosan and film casting solvents on the properties of chitosan films loaded with Mentha spicata essential oil for potential application as wound dressing

Chitosan based films endowed with antibacterial features have witnessed remarkable progress as potential wound dressings. The current study aimed at appraising the effects of the molar mass of chitosan (MM) and the film casting acids on the properties of unplasticized chitosan films and plasticized MSO-embedded chitosan films in order to provide best suited film formulation as a potential candidate for wound dressing application. The prepared films were functionally characterized in terms of their qualitative assessment, thickness, density, swelling behavior, water vapor barrier, mechanical and antibacterial properties. Overall, all chitosan films displayed thickness lower than the human dermis even though thicker and denser films were produced with lactic acid. Assessment of the swelling behavior revealed that only high molar mass (HMM) chitosan films may be regarded as absorbent dressings. Moreover, unplasticized HMM lactate (HMM-LA) films furnished lower stiffness and higher percent strain break as compared to acetate films, due to the plasticizing effect of the remaining lactic acid as alluded by the FTIR analysis. Meanwhile, they provided suitable level of moisture and indicated substantial antibacterial activity against S. aureus and E. coli, the most commonly opportunistic bacteria found in infected skin wound. Plasticized chitosan films doped with MSO were significantly thicker and more permeable to water compared to unplasticized films. Furthermore, MSO significantly potentiate the antibacterial effect of chitosan-based films. Therefore, plasticized HMM-LA/MSO chitosan film flashing good swelling behavior, adequate WVTR and WVP, suitable mechanical properties and antibacterial performances substantiated to be a promising antibacterial dressing material for moderately exuding wounds.

Novel Supramolecular Hydrogel for Infected Diabetic Foot Ulcer Treatment

Multifunctional responsive hydrogels hold significant promise for diabetic foot ulcer (DFU) treatment, though their complex design and manufacturing present challenges. This study introduces a novel supramolecular guanosine-phenylboronic-chlorogenic acid (GBC) hydrogel developed using a dynamic covalent strategy. The hydrogel forms through guanosine quadruplex assembly in the presence of potassium ions and chlorogenic acid (CA) linkage via dynamic borate bonds. GBC hydrogels exhibit pH and glucose responsiveness, releasing more chlorogenic acid under acidic and high glucose conditions due to borate bond dissociation and G-quadruplex (G4) hydrogel disintegration. Experimental results indicate that GBC hydrogels exhibit good self-healing, shear-thinning, injectability, and swelling properties. Both in vitro and in vivo studies demonstrate the GBC hydrogel's good biocompatibility, ability to eliminate bacteria and reactive oxygen species (ROS), facilitate macrophage polarization from the M1 phenotype to the M2 phenotype (decreasing CD86 expression and increasing CD206 expression), exhibit anti-inflammatory effects (reducing TNF-α expression and increasing IL-10 expression), and promote angiogenesis (increasing VEGF, CD31, and α-SMA expression). Thus, GBC hydrogels accelerate DFU healing and enhance tissue remodeling and collagen deposition. This work provides a new approach to developing responsive hydrogels to expedite DFU healing.

Latest advance anti-inflammatory hydrogel wound dressings and traditional Lignosus rhinoceros used for wound healing agents

Wound healing is a physiological process occurring after the onset of a skin lesion aiming to reconstruct the dermal barrier between the external environment and the body. Depending on the nature and duration of the healing process, wounds are classified as acute (e.g., trauma, surgical wounds) and chronic (e.g., diabetic ulcers) wounds. The latter, often affect millions of people globally, take months to heal or not heal non-healing chronic wounds, are typically susceptible to microbial infection, and are a major cause of morbidity. Wounds can be treated with a variety of non-surgical (topical formulations, wound dressings) and surgical (debridement, skin grafts/flaps) methods. Three-dimensional (3D)-(bio) printing and traditional wound dressings are two examples of modern experimental techniques. This review focuses on several types of anti-inflammatory wound dressings, especially focusing on hydrogels and traditional macro-fungi like L. rhinocerotis as agents that promote wound healing. In this study, we introduced novel anti-inflammatory hydrogel dressings and offered innovative methods for application and preparation to aid in the healing. Additionally, we summarize the key elements required for wound healing and discuss our analysis of potential future issues. These findings suggest that L. rhinocerotis and various anti-inflammatory hydrogels can be considered as conventional and alternative macro-fungi for the treatment of non-communicable diseases. We summarized the development of functional hydrogel dressings and traditional Lignosus rhinoceros used for wound healing agents in recent years, as well as the current situation and future trends, in light of their preparation mechanisms and functional effects.

A novel polyurethane-based silver foam dressing with superior antimicrobial action for management of infected chronic wounds

Wound healing is a complex and dynamic process supported by several cellular events. Around 13 million individuals globally suffer from chronic wounds yearly, for which dressings with excellent antimicrobial activity and cell viability (>70%, as per ISO 10993) are needed. Excessive use of silver can cause cytotoxicity and has been linked to increasing antimicrobial resistance. In this study, HDI Ag foam was synthesized using a safer hexamethylene diisocyanate-based prepolymer (HDI prepolymer) instead of commonly used diisocyanates like TDI and MDI and substantially lower Ag content than that incorporated in other Ag foams. In vitro characteristics of the HDI Ag foam were evaluated in comparison with leading clinically used foam-based dressings. All dressings underwent a detailed characterization in accordance with industrially accepted BS EN 13726 standards. The HDI Ag foam exhibited highest antimicrobial efficiency againstS. aureusandP. aeruginosa(static condition), with the lowest amount of Ag (0.2 wt%) on the wound contact surface. The extracts from HDI Ag foam showed superior cell viability (>70%), when tested on the L929 mouse fibroblast cell line. Measurements of moisture vapor transmission, fluid handling, physico-chemical and mechanical properties ensured that the HDI foam was clinically acceptable for chronic wound patients.

Sea food by-products valorization for biomedical applications: evaluation of their wound regeneration capabilities in an Ex vivo skin model

Introduction

The skin is often exposed to harmful stimuli that might compromise its integrity and functionality. After an injury, the skin has a limited capability to restore its complex structure, and in the case of severe skin damage, surgical operations and rapid application of wound dressings are often required to promote optimal wound healing. Nowadays, collagen-based biomaterials are widely used in combination with bioactive molecules able to prevent excessive inflammation and possible infections. In line with a circular economy and blue biotechnology approach, it was recently demonstrated that both collagen and bioactive molecules (i.e., antioxidant compounds) can be sustainably obtained from sea food by-products and effectively used for biomaterial development. Herein, we describe and compare the application of two marine collagen-based wound dressings (CBWDs), produced with materials obtained from sea urchin food waste, for the treatment of skin lesions in a wound healing organ culture (WHOC) model.

Methods

The ex vivo WHOC model was set up starting from rat skin explants and the induced lesions were assigned into three different groups: control (CTRL) group, not treated, marine collagen wound dressing (MCWD) group, and antioxidants-enriched marine collagen wound dressing (A-MCWD) group. After 5 and 10 days, specimens were examined for organ maintenance and assessed for the healing process.

Results

Immunohistochemical results showed that both CBWDs were similarly successful in prolonging skin repair, preserving the epidermal barrier up to 5 days under static culture conditions. Histological and gene expression analysis highlighted that the A-MCWD might support and accelerate skin wound healing by exerting antioxidant activity and counteracting inflammation.

Discussion

Overall, these findings underline the potential of sea urchin food waste as a novel resource for the development of functional medical devices for the treatment of skin wounds.

Emerging Technological Advancement for Chronic Wound Treatment and Their Role in Accelerating Wound Healing

Chronic wounds are a major healthcare burden and may severely affect the social, mental, and economic status of the patients. Any impairment in wound healing stages due to underlying factors leads to a prolonged healing time and subsequently to chronic wounds. Traditional approaches for the treatment of chronic wounds include dressing free local therapy, dressing therapy, and tissue engineering based scaffold therapies. However, traditional therapies need improvisation and have been advanced through breakthrough technologies. The present review spans traditional therapies and further gives an extensive account of advancements in the treatment of chronic wounds. Cutting edge technologies, such as 3D printing, which includes inkjet printing, fused deposition modeling, digital light processing, extrusion-based printing, microneedle array-based therapies, gene therapy, which includes microRNAs (miRNAs) therapy, and smart wound dressings for real time monitoring of wound conditions through assessment of pH, temperature, oxygen, moisture, metabolites, and their use for planning of better treatment strategies have been discussed in detail. The review further gives the future direction of treatments that will aid in lowering the healthcare burden caused due to chronic wounds.

Two Novel Membranes Based on Collagen and Polyphenols for Enhanced Wound Healing

Two novel membranes based on collagen and two polyphenols, taxifolin pentaglutarate (TfG5) and a conjugate of taxifolin with glyoxylic acid (DfTf), were prepared. Fourier transform infrared spectroscopy examination confirmed the preservation of the triple helical structure of collagen. A scanning electron microscopy study showed that both materials had a porous structure. The incorporation of DfTf into the freeze-dried collagen matrix increased the aggregation of collagen fibers to a higher extent than the incorporation of TfG5, resulting in a more compact structure of the material containing DfTf. It was found that NIH/3T3 mouse fibroblasts were attached to, and relatively evenly spread out on, the surface of both newly obtained membranes. In addition, it was shown that the membranes enhanced skin wound healing in rats with a chemical burn induced by acetic acid. The treatment with the materials led to a faster reepithelization and granulation tissue formation compared with the use of other agents (collagen without polyphenols and buffer saline). It was also found that, in the wound tissue, the level of thiobarbituric acid reactive substances (TBARS) was significantly higher and the level of low-molecular-weight SH-containing compounds (RSH) was significantly lower than those in healthy skin, indicating a rise in oxidative stress at the site of injury. The treatment with collagen membranes containing polyphenols significantly decreased the TBARS level and increased the RSH level, suggesting the antioxidant/anti-inflammatory effect of the materials. The membrane containing TfG5 was more effective than other ones (the collagen membrane containing DfTf and collagen without polyphenols). On the whole, the data obtained indicate that collagen materials containing DfTf and TfG5 have potential as powerful therapeutic agents for the treatment of burn wounds.

Endogenous/exogenous stimuli‐responsive smart hydrogels for diabetic wound healing

Diabetes significantly impairs the body's wound‐healing capabilities, leading to chronic, infection‐prone wounds. These wounds are characterized by hyperglycemia, inflammation, hypoxia, variable pH levels, increased matrix metalloproteinase activity, oxidative stress, and bacterial colonization. These complex conditions complicate effective wound management, prompting the development of advanced diabetic wound care strategies that exploit specific wound characteristics such as acidic pH, high glucose levels, and oxidative stress to trigger controlled drug release, thereby enhancing the therapeutic effects of the dressings. Among the solutions, hydrogels emerge as promising due to their stimuli‐responsive nature, making them highly effective for managing these wounds. The latest advancements in mono/multi‐stimuli‐responsive smart hydrogels showcase their superiority and potential as healthcare materials, as highlighted by relevant case studies. However, traditional wound dressings fall short of meeting the nuanced needs of these wounds, such as adjustable adhesion, easy removal, real‐time wound status monitoring, and dynamic drug release adjustment according to the wound's specific conditions. Responsive hydrogels represent a significant leap forward as advanced dressings proficient in sensing and responding to the wound environment, offering a more targeted approach to diabetic wound treatment. This review highlights recent advancements in smart hydrogels for wound dressing, monitoring, and drug delivery, emphasizing their role in improving diabetic wound healing. It addresses ongoing challenges and future directions, aiming to guide their clinical adoption.

Development of κ-carrageenan-based transparent and absorbent biodegradable films for wound dressing applications

Wound healing remains a critical challenge in healthcare, requiring advanced wound dressings with superior properties like transparency, absorbency, and biocompatibility. However, gaps exist in the use of marine-derived biopolymers for sustainable dressings. This study addresses this gap by combining κ-carrageenan (KC) with polyvinyl pyrrolidone (PVP) to develop transparent and absorbent biodegradable films through solvent casting and lyophilization techniques. Lyophilized films exhibited superior absorbency (9.17 g/cm2) and moisture management, with a water vapour transmission rate of 3990.67 g/m2/24 h, while solvent-cast films showed 78 % transmittance, enabling wound visualization. Mechanical testing revealed high tensile strength (31.5 MPa) and folding endurance (410 folds), ensuring durability. In vitro bactericidal assays confirmed efficacy against MRSA and E. coli, and in vivo tests on Wistar rats showed complete wound healing within 16 days with 91.1 % closure, outperforming untreated controls (76.7 %). This is the first study to explore lyophilized KC-PVP films for wound dressing applications, demonstrating potential for drug release, absorbency, and biodegradability. The innovative combination of biopolymers and fabrication techniques offers a sustainable, high-performance solution for wound care.

Using patient-reported experiences to inform the use of foam dressings for hard-to-heal wounds: perspectives from a wound care expert panel

Caring for patients with hard-to-heal (chronic) wounds requires a multifaceted approach that addresses their diverse needs, which can contribute to the complexity of care. Wound care providers must have a comprehensive understanding of the patient's comorbid conditions and psychosocial issues to provide personalised and effective treatment. Key quality indicators for effective wound care involves not only selecting appropriate local wound care products, such as foam dressings, but also addressing individual patient experiences of wound-related pain, odour, itch, excessive wound drainage, and self-care needs. The purpose of this review is to inculcate the wound care practice community, research scientists and healthcare industry with a sense of accountability in order to work collaboratively in addressing these unmet care needs.

Silk fibroin/chitosan/montmorillonite sponge dressing: Enhancing hemostasis, antimicrobial activity, and angiogenesis for advanced wound healing applications

Open wounds present a significant challenge in healthcare, requiring careful management to prevent infection and promote wound healing. Advanced wound dressings are critical need to enhance their hemostatic capabilities, antimicrobial properties, and ability to support angiogenesis and sustained moisture for optimal healing. This study introduces a flexible hemostatic dressing designed for open wounds, integrating chitosan (CS) for hemostasis and biocompatibility, silk fibroin (SF) for mechanical strength, and montmorillonite (MMT) for enhanced drug transport. The CSSF@MMT dressings showed promising mechanical strength and swift hemostasis. The CIP-loaded CSSF@MMT demonstrated sustained release for up to one week, exhibiting antibacterial properties against both Gram-positive and Gram-negative bacteria. In vitro cell migration assay demonstrated that erythropoietin-loaded CSSF@MMT dressings promoted the proliferation and migration of endothelial cells. Similarly, the chick embryo chorioallantoic membrane study indicated the same dressings exhibited a significant increase in vascular regeneration. This research suggests that the CSSF@MMT sponge dressing, incorporated with CIP and erythropoietin, holds promise in effectively halting bleeding, creating a protective environment, diminishing inflammation, and fostering wound tissue regeneration. This potential makes it a significant advancement in open wound care, potentially lowering the need for limb amputation and decreasing wound care burden worldwide.