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Pawar B, Otavi S, Singh A, Kaur S, Tekade RK. On-demand Opto-Laser activatable nanoSilver ThermoGel for treatment of full-thickness diabetic wound in a mouse model. BIOMATERIALS ADVANCES 2024; 164:213994. [PMID: 39153455 DOI: 10.1016/j.bioadv.2024.213994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/03/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
Patients suffering from diabetes mellitus are prone to develop diabetic wounds that are non-treatable with conventional therapies. Hence, there is an urgent need of hour to develop the therapy that will overcome the lacunas of conventional therapies. This investigation reports the Quality by Design-guided one-pot green synthesis of unique Opto-Laser activatable nanoSilver ThermoGel (OL→nSil-ThermoGel) for hyperthermia-assisted treatment of full-thickness diabetic wounds in mice models. The characterization findings confirmed the formation of spherical-shaped nanometric Opto-Laser activatable nanoSilver (30.75 ± 2.7 nm; ∆T: 37 ± 0.2 °C → 66.2 ± 0.1 °C; at 1.8 W/cm2 NIR laser density). The findings indicated acceptable in vitro cytocompatibility and significant keratinocyte migration (95.04 ± 0.07 %) activity of OL→nSil towards HaCaT cells. The rheological data of OL→nSil hybridized in situ thermoresponsive gel (OL→nSil-ThermoGel) showed the gelling temperature at 32 ± 2 °C. In vivo studies on full-thickness diabetic wounds in a Mouse model showed OL→nSil-ThermoGel accelerated wound closure (94.42 ± 1.03 %) and increased collagen synthesis, angiogenesis, and decreased inflammatory markers. Similarly, immunohistochemistry study showed significant angiogenesis and faster phenotypic switching of fibroblasts to myofibroblasts in OL→nSil-ThermoGel treated diabetic wounds. Histological evaluation revealed a marked rise in keratinocyte migration, organized collagen deposition, and early regeneration of the epithelial layer compared to the diabetic wound control. In conclusion, the OL→nSil-ThermoGel modulates the cytokines, re-epithelialization, protein expression, and growth factors, thereby improving the repair and regeneration of diabetic wounds in mice.
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Affiliation(s)
- Bhakti Pawar
- National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar 382355, Gujarat, India
| | - Shivam Otavi
- National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar 382355, Gujarat, India
| | - Amrita Singh
- National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar 382355, Gujarat, India
| | - Simranjeet Kaur
- National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar 382355, Gujarat, India
| | - Rakesh K Tekade
- National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opp. Air force station, Gandhinagar 382355, Gujarat, India.
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Xiao Y, Xu K, Zhao P, Ji L, Hua C, Jia X, Wu X, Diao L, Zhong W, Lyu G, Xing M. Microgels sense wounds' temperature, pH and glucose. Biomaterials 2024; 314:122813. [PMID: 39270627 DOI: 10.1016/j.biomaterials.2024.122813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 08/23/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024]
Abstract
Wound healing concerns almost all bed-side related diseases. With our increasing comprehension of healing nature, the physical and chemical natures behind the wound microenvironment have been decoupled. Wound care demands timely screening and prompt diagnosis of wound complications such as infection and inflammation. Biosensor by the way of exhaustive collection, delivery, and analysis of data, becomes indispensable to arrive at an ideal healing upshot and controlling complications by capturing in-situ wound status. Electrochemical based sensors carry some potential unstable performance subjected to the electrical circuitry and power access and contamination. The colorimetric sensors are free from those concerns. We report that microsensors designed from O/W/O of capillary fluids can continuously monitor wound temperature, pH and glucose concentration. We combined three different types of microgels to encapsulate liquid crystals of cholesterol, nontoxic fuel litmus and two glucose-sensitizing enzymes. A smartphone applet was then developed to convert wound healing images to RGB of digitalizing data. The microgel dressing effectively demonstrates the local temperature change, pH and glucose levels of the wound in high resolution where a microgel is a 'pixel'. They are highly responsive, reversible and accurate. Monitoring multiple physicochemical and physiological indicators provides tremendous potential with insight into healing processing.
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Affiliation(s)
- Yuqin Xiao
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China; Wuxi School of Medicine, Jiangnan University, Wuxi 214000, China
| | - Kaige Xu
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, R3T 2N2, Canada
| | - Peng Zhao
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China
| | - Leilei Ji
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China; Wuxi School of Medicine, Jiangnan University, Wuxi 214000, China
| | - Chao Hua
- Medical School of Nantong University, Nantong, 226019, China
| | - Xiaoli Jia
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China; Wuxi School of Medicine, Jiangnan University, Wuxi 214000, China
| | - Xiaozhuo Wu
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, R3T 2N2, Canada
| | - Ling Diao
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China
| | - Wen Zhong
- Department of Biosystems Engineering, University of Manitoba, Winnipeg, R3T 2N2, Canada
| | - Guozhong Lyu
- Burn & Trauma Treatment Center, The Affiliated Hospital of Jiangnan University, Wuxi 214000, China; Wuxi School of Medicine, Jiangnan University, Wuxi 214000, China; Medical School of Nantong University, Nantong, 226019, China; National Research Center for Emergency Medicine, Beijing, China.
| | - Malcolm Xing
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, R3T 2N2, Canada.
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Qu Z, Wang Y, Dong Y, Li X, Hao L, Sun L, Zhou L, Jiang R, Liu W. Intelligent electrospinning nanofibrous membranes for monitoring and promotion of the wound healing. Mater Today Bio 2024; 26:101093. [PMID: 38818528 PMCID: PMC11137601 DOI: 10.1016/j.mtbio.2024.101093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
The incidence of chronic wound healing is promoted by the growing trend of elderly population, obesity, and type II diabetes. Although numerous wound dressings have been studied over the years, it is still challenging for many wound dressings to perfectly adapt to the healing process due to the dynamic and complicated wound microenvironment. Aiming at an optimal reproduction of the physiological environment, multifunctional electrospinning nanofibrous membranes (ENMs) have emerged as a promising platform for the wound treatment owing to their resemblance to extracellular matrix (ECM), adjustable preparation processes, porousness, and good conformability to the wound site. Moreover, profiting from the booming development of human-machine interaction and artificial intelligence, a next generation of intelligent electrospinning nanofibrous membranes (iENMs) based wound dressing substrates that could realize the real-time monitoring of wound proceeding and individual-based wound therapy has evoked a surge of interest. In this regard, general wound-related biomarkers and process are overviewed firstly and representative iENMs stimuli-responsive materials are briefly summarized. Subsequently, the emergent applications of iENMs for the wound healing are highlighted. Finally, the opportunities and challenges for the development of next-generation iENMs as well as translating iENMs into clinical practice are evaluated.
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Affiliation(s)
- Zhi Qu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong Province, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Yang Wang
- Department of Plastic and Reconstructive Surgery, Cell & Matrix Research Institute, Kyungpook National University School of Medicine, Daegu, 41944, South Korea
| | - Yanhong Dong
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Xinmeng Li
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Lingwan Hao
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Liwei Sun
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Lu Zhou
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Rujian Jiang
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Weihua Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, Shandong Province, China
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Galdino-Júnior H, Martins de Oliveira Segundo E, Gomes Malaquias S, Vinaud MC, Pereira LV, Guimarães RA, Bachion MM. Effect of Heated Saline Solution on Pain Intensity, Wound Bed Temperature, and Comfort during Chronic Wound Dressing Changes: Crossover Randomized Clinical Trial. Adv Skin Wound Care 2024; 37:1-8. [PMID: 38648246 DOI: 10.1097/asw.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To evaluate the use of heated saline solution during wound cleaning on the intensity of pain related to the procedure, the temperature of the wound bed, and the comfort of patients with chronic wounds. Further, to investigate patient preference in relation to the temperature of the solution used for cleaning. METHODS Crossover, single-blind, clinical trial with 32 people with chronic wounds. Providers cleaned the wounds with room temperature and heated saline solution. Participants were randomized into group 1 A/B (heated solution first, room temperature second) or group 2 B/A (room temperature solution first, heated solution second), with a 10-minute washout period. Investigators evaluated pain intensity, wound bed temperature, and patient-reported comfort and preference. RESULTS The heated solution was preferred (P = .04) and more often referred to as comfortable (P = .04) by the participants. There was no difference in pain intensity before and after cleaning with room temperature (2.03; P = .155) and heated saline (2.25; P = .44). The heated solution increased the temperature of the wound bed by 0.5 °C. CONCLUSIONS Although heating saline solution could be an important comfort measure during dressing changes, quantitatively, the temperature of the solution did not significantly change the temperature of the wound bed nor the intensity of pain patients experienced.
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Affiliation(s)
- Hélio Galdino-Júnior
- Hélio Galdino-Júnior, MPH, RN, is Associate Professor, Federal University of Goiás, Goiânia, Goiás, Brazil. Emilson Martins de Oliveira Segundo, MSN, RN, is ICU Nursing Coordinator, Hospital Ortopédico Promed-Hapvida NotreDame Intermédica, Goiânia. Also at the Federal University of Goiás, Suelen Gomes Malaquias, MSN, RN, is Adjunct Professor; Marina Clare Vinaud, PhD, is Associate Professor; Lilian Varanda Pereira, PhD, RN, is Full Professor; Rafael Alves Guimarães, PhD, RN, is Adjunct Professor; and Maria Márcia Bachion, PhD, RN, is Full Professor. The authors have disclosed no financial relationships related to this article. Submitted January 5, 2023; accepted in revised form March 14, 2023
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5
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Svensby AU, Nygren E, Gefen A, Cullen B, Ronkvist ÅM, Gergely A, Craig MD. The importance of the simulated wound fluid composition and properties in the determination of the fluid handling performance of wound dressings. Int Wound J 2024; 21:e14861. [PMID: 38738669 PMCID: PMC11089840 DOI: 10.1111/iwj.14861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 05/14/2024] Open
Abstract
Effective fluid handling by wound dressings is crucial in the management of exuding wounds through maintaining a clean, moist environment, facilitating healing by removing excess exudate and promoting tissue regeneration. In this context, the availability of reliable and clinically relevant standardised testing methods for wound dressings are critical for informed decision making by clinicians, healthcare administrators, regulatory/reimbursement bodies and product developers. The widely used standard EN 13726 specifies the use of Solution A, an aqueous protein-free salt solution, for determining fluid-handling capacity (FHC). However, a simulated wound fluid (SWF) with a more complex composition, resembling the protein, salt, and buffer concentrations found in real-world clinical exudate, would provide a more clinically relevant dressing performance assessment. This study compared selected physicochemical parameters of Solution A, an alternative, novel simulated wound fluid (SWF A), and a benchmark reference serum-containing solution (SCS) simulating chronic wound exudate. Additionally, FHC values for eight advanced bordered and non-bordered foam dressings were determined for all three test fluids, following EN 13726. Our findings demonstrate a close resemblance between SWF A and SCS. This study highlights the critical importance of selecting a physiochemically appropriate test fluid for accurate FHC testing resulting in clinically meaningful evaluation of dressing performance.
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Affiliation(s)
- Anna U. Svensby
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - Erik Nygren
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium
- Department of Mathematics and StatisticsFaculty of SciencesHasseltBelgium
| | | | - Åsa M. Ronkvist
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - AnnBritt Gergely
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - Marina D. Craig
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
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6
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Fuchs B, Mert S, Kuhlmann C, Taha S, Birt A, Nickelsen J, Schenck TL, Giunta RE, Wiggenhauser PS, Moellhoff N. Biocompatibility of Synechococcus sp. PCC 7002 with Human Dermal Cells In Vitro. Int J Mol Sci 2024; 25:3922. [PMID: 38612734 PMCID: PMC11012068 DOI: 10.3390/ijms25073922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/22/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Being the green gold of the future, cyanobacteria have recently attracted considerable interest worldwide. This study investigates the adaptability and biocompatibility of the cyanobacterial strain Synechococcus sp. PCC 7002 with human dermal cells, focusing on its potential application in biomedical contexts. First, we investigated the adaptability of Synechococcus PCC 7002 bacteria to human cell culture conditions. Next, we evaluated the biocompatibility of cyanobacteria with common dermal cells, like 3T3 fibroblasts and HaCaT keratinocytes. Therefore, cells were directly and indirectly cocultured with the corresponding cells, and we measured metabolic activity (AlamarBlue assay) and proliferation (cell count and PicoGreen assay). The lactate dehydrogenase (LDH) assay was performed to determine the cytotoxic effect of cyanobacteria and their nutrition medium on human dermal cells. The cyanobacteria exhibited exponential growth under conventional human cell culture conditions, with the temperature and medium composition not affecting their viability. In addition, the effect of illumination on the proliferation capacity was investigated, showing a significant impact of light exposure on bacterial growth. The measured oxygen production under hypoxic conditions demonstrated a sufficient oxygen supply for further tissue engineering approaches depending on the number of bacteria. There were no significant adverse effects on human cell viability and growth under coculture conditions, whereas the LDH assay assessed signs of cytotoxicity regarding 3T3 fibroblasts after 2 days of coculturing. These negative effects were dismissed after 4 days. The findings highlight the potential of Synechococcus sp. PCC 7002 for integration into biomedical approaches. We found no cytotoxicity of cyanobacteria on 3T3 fibroblasts and HaCaT keratinocytes, thus paving the way for further in vivo studies to assess long-term effects and systemic reactions.
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Affiliation(s)
- Benedikt Fuchs
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Sinan Mert
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Constanze Kuhlmann
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Sara Taha
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Alexandra Birt
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Jörg Nickelsen
- Molecular Plant Science, Department Biology I, LMU Munich, 80336 Munich, Germany;
| | - Thilo Ludwig Schenck
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Riccardo Enzo Giunta
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Paul Severin Wiggenhauser
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
| | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (S.M.); (C.K.); (S.T.); (A.B.); (T.L.S.); (R.E.G.); (P.S.W.); (N.M.)
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7
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Chen Y, Zhang X, Wang Q, Du C, Dong CM. Wound microenvironment regulatory poly(L-glutamic acid) composite hydrogels containing metal ion-coordinated nanoparticles for effective hemostasis and wound healing. Biomater Sci 2024; 12:1211-1227. [PMID: 38240342 DOI: 10.1039/d3bm01978k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Regulating the wound microenvironment to promote proliferation, vascularization, and wound healing is challenging for hemostats and wound dressings. Herein, polypeptide composite hydrogels have been simply fabricated by mixing a smaller amount of metal ion-coordinated nanoparticles into dopamine-modified poly(L-glutamic acid) (PGA), which had a microporous size of 10-16 μm, photothermal conversion ability, good biocompatibility, and multiple biological activities. In vitro scratch healing of fibroblast L929 cells and the tube formation of HUVECs provide evidence that the PGA composite hydrogels could promote cell proliferation, migration, and angiogenesis with the assistance of mild photothermia. Moreover, these composite hydrogels plus mild photothermia could effectively eliminate reactive oxygen species (ROS), alleviate inflammation, and polarize the pro-inflammatory M1 macrophage phenotype into the pro-healing M2 phenotype to accelerate wound healing, as assessed by means of fluorescent microscopy, flow cytometry, and quantitative real-time polymerase chain reaction (qRT-PCR). Meanwhile, a rat liver bleeding model illustrates that the composite hydrogels reduced the blood loss ratio to about 10% and shortened the hemostasis time to about 25 s better than commercial chitosan-based hemostats. Furthermore, the full-thickness rat skin defect models showcase that the composite hydrogels plus mild photothermia could proheal wounds completely with a fast healing rate, optimal neovascularization, and collagen deposition. Therefore, the biodegradable polypeptide PGA composite hydrogels are promising as potent wound hemostats and dressings.
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Affiliation(s)
- Yanzheng Chen
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, P. R. China.
| | - Xueliang Zhang
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, P. R. China.
| | - Qing Wang
- Department of Stomatology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, P. R. China
| | - Chang Du
- Clinical Cancer Institute, Center for Translational Medicine, Naval Military Medical University, Shanghai, 200433, P. R. China.
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200240, P. R. China
| | - Chang-Ming Dong
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, P. R. China.
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8
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Gefen A, Alves P, Beeckman D, Cullen B, Lázaro‐Martínez JL, Lev‐Tov H, Santamaria N, Swanson T, Woo K, Söderström B, Svensby A, Malone M, Nygren E. Fluid handling by foam wound dressings: From engineering theory to advanced laboratory performance evaluations. Int Wound J 2024; 21:e14674. [PMID: 38353372 PMCID: PMC10865423 DOI: 10.1111/iwj.14674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024] Open
Abstract
This article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure-function relationships and on advanced laboratory testing methods for pre-clinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions. Based on this comprehensive review, we propose a newly developed testing method, experimental metrics and clinical benchmarks that are clinically relevant and can set the standard for robust fluid handling performance evaluations. The purpose of this evaluative framework is to translate the physical characteristics and performance determinants of a foam dressing into achievable best clinical outcomes. These guiding principles are key to distinguishing desirable properties of a dressing that contribute to optimal performance in clinical settings.
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Affiliation(s)
- Amit Gefen
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium
- Department of Mathematics and Statistics, Faculty of SciencesHasselt UniversityHasseltBelgium
| | - Paulo Alves
- Wounds Research Lab, Centre for Interdisciplinary Research in Health, Faculty of Nursing and Health SciencesUniversidade Católica PortuguesaPortoPortugal
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium
- Swedish Centre for Skin and Wound Research, Faculty of Medicine and Health, School of Health SciencesÖrebro UniversityÖrebroSweden
| | | | | | - Hadar Lev‐Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Hospital Miller School of MedicineMiamiFloridaUSA
| | - Nick Santamaria
- School of Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | | | - Kevin Woo
- School of NursingQueen's UniversityKingstonOntarioCanada
| | - Bengt Söderström
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - Anna Svensby
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
| | - Matthew Malone
- Research and Development, Bioactives and Wound Biology, Mölnlycke Health Care AB, Gothenburg, Sweden; and Infectious Diseases and Microbiology, School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Erik Nygren
- Wound Care Research and DevelopmentMölnlycke Health Care ABGothenburgSweden
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9
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Ryu H, Song JW, Luan H, Sim Y, Kwak SS, Jang H, Jo YJ, Yoon HJ, Jeong H, Shin J, Park DY, Kwon K, Ameer GA, Rogers JA. Materials and Device Designs for Wireless Monitoring of Temperature and Thermal Transport Properties of Wound Beds during Healing. Adv Healthc Mater 2024; 13:e2302797. [PMID: 37983897 DOI: 10.1002/adhm.202302797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Chronic wounds represent a major health risk for diabetic patients. Regeneration of such wounds requires regular medical treatments over periods that can extend for several months or more. Schemes for monitoring the healing process can provide important feedback to the patient and caregiver. Although qualitative indicators such as malodor or fever can provide some indirect information, quantitative measurements of the wound bed have the potential to yield important insights. The work presented here introduces materials and engineering designs for a wireless system that captures spatio-temporal temperature and thermal transport information across the wound continuously throughout the healing process. Systematic experimental and computational studies establish the materials aspects and basic capabilities of this technology. In vivo studies reveal that both the temperature and the changes in this quantity offer information on wound status, with indications of initial exothermic reactions and mechanisms of scar tissue formation. Bioresorbable materials serve as the foundations for versions of this device that create possibilities for monitoring on and within the wound site, in a way that bypasses the risks of physical removal.
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Affiliation(s)
- Hanjun Ryu
- Department of Advanced Materials Engineering, Chung-Ang University, Anseong, 17546, Republic of Korea
- Department of Intelligence Energy and Industry, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Joseph W Song
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Center for Advanced Regenerative Engineering, Northwestern University, Evanston, IL, 60208, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
| | - Haiwen Luan
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Youngmin Sim
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Sung Soo Kwak
- Center for Bionics of Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, 02456, Republic of Korea
| | - Hokyung Jang
- Science Corp. 1010 Atlantic Ave. 100, Alameda, CA, 94501, USA
| | - Young Jin Jo
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
| | - Hong-Joon Yoon
- Department of Electronic Engineering, Gachon University, Seongnam, 13120, Republic of Korea
| | - Hyoyoung Jeong
- Department of Electrical and Computer Engineering, University of California, Davis, Davis, CA, 95616, USA
| | - Jaeho Shin
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
| | - Do Yun Park
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Kyeongha Kwon
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Guillermo Antonio Ameer
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Center for Advanced Regenerative Engineering, Northwestern University, Evanston, IL, 60208, USA
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
- Chemistry of Life Processes Institute, Northwestern University, Evanston, IL, 60208, USA
- International Institute for Nanotechnology, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for Bionanotechnology, Evanston, IL, 60208, USA
| | - John A Rogers
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Center for Advanced Regenerative Engineering, Northwestern University, Evanston, IL, 60208, USA
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, 60208, USA
- Chemistry of Life Processes Institute, Northwestern University, Evanston, IL, 60208, USA
- International Institute for Nanotechnology, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for Bionanotechnology, Evanston, IL, 60208, USA
- Department of Mechanical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, 60208, USA
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Evanston, IL, 60208, USA
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10
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Vaz LM, Branco R, Morais PV, Guiomar AJ. Sterilized Polyhexanide-Releasing Chitosan Membranes with Potential for Use in Antimicrobial Wound Dressings. MEMBRANES 2023; 13:877. [PMID: 37999363 PMCID: PMC10673555 DOI: 10.3390/membranes13110877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
Wound infection is a common complication of chronic wounds. It can impair healing, which may not occur without external help. Antimicrobial dressings (AMDs) are a type of external help to infected chronic wounds. In this study, highly porous membranes made of only chitosan and containing the antiseptic polyhexanide (poly(hexamethylene biguanide); PHMB) were prepared by cryogelation, aiming to be used in AMDs. These membranes exhibited a water swelling capacity of 748%, a water drop penetration time of 11 s in a dry membrane and a water vapor transmission rate of 34,400 g H2O/m2/24 h when in contact with water. The best drug loading method involved simultaneous loading by soaking in a PHMB solution and sterilization by autoclaving, resulting in sterilized, drug-loaded membranes. When these membranes and a commercial PHMB-releasing AMD were assayed under the same conditions, albeit far from the in vivo conditions, their drug release kinetics were comparable, releasing PHMB for ca. 6 and 4 h, respectively. These membranes exhibited high antibacterial activity against Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, which are bacterial species commonly found in infected wounds and blood clotting activity. The obtained results suggest that these membranes may have potential for use in the development of AMDs.
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Affiliation(s)
- Luís M. Vaz
- Chemical Process Engineering and Forest Products Research Centre, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal;
| | - Rita Branco
- Centre for Mechanical Engineering, Materials and Processes, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal; (R.B.); (P.V.M.)
| | - Paula V. Morais
- Centre for Mechanical Engineering, Materials and Processes, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal; (R.B.); (P.V.M.)
| | - António Jorge Guiomar
- Chemical Process Engineering and Forest Products Research Centre, Department of Life Sciences, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal;
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11
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Gu R, Zhou H, Zhang Z, Lv Y, Pan Y, Li Q, Shi C, Wang Y, Wei L. Research progress related to thermosensitive hydrogel dressings in wound healing: a review. NANOSCALE ADVANCES 2023; 5:6017-6037. [PMID: 37941954 PMCID: PMC10629053 DOI: 10.1039/d3na00407d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/27/2023] [Indexed: 11/10/2023]
Abstract
Wound healing is a dynamic and complex process in which the microenvironment at the wound site plays an important role. As a common material for wound healing, dressings accelerate wound healing and prevent external wound infections. Hydrogels have become a hot topic in wound-dressing research because of their high water content, good biocompatibility, and adjustable physical and chemical properties. Intelligent hydrogel dressings have attracted considerable attention because of their excellent environmental responsiveness. As smart polymer hydrogels, thermosensitive hydrogels can respond to small temperature changes in the environment, and their special properties make them superior to other hydrogels. This review mainly focuses on the research progress in thermosensitive intelligent hydrogel dressings for wound healing. Polymers suitable for hydrogel formation and the appropriate molecular design of the hydrogel network to achieve thermosensitive hydrogel properties are discussed, followed by the application of thermosensitive hydrogels as wound dressings. We also discuss the future perspectives of thermosensitive hydrogels as wound dressings and provide systematic theoretical support for wound healing.
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Affiliation(s)
- Ruting Gu
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Haiqing Zhou
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Zirui Zhang
- Emergency Departments, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Yun Lv
- School of Nursing, Qingdao University Qingdao 266000 China
| | - Yueshuai Pan
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Qianqian Li
- Ophthalmology Department, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Changfang Shi
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Yanhui Wang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University Qingdao 266000 China
| | - Lili Wei
- Office of the Dean, The Affiliated Hospital of Qingdao University Qingdao 266000 China
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12
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Orlov A, Ciliberti M, Somma R, Gefen A. A robotic venous leg ulcer system reveals the benefits of negative pressure wound therapy in effective fluid handling. Int Wound J 2023; 21:e14426. [PMID: 37786996 PMCID: PMC10828725 DOI: 10.1111/iwj.14426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023] Open
Abstract
We applied a market-leading, single-use negative pressure wound therapy device to a robotic venous leg ulcer system and compared its fluid handling performance with that of standard of care, superabsorbent and foam dressings and compression therapy. For each tested product, we determined a metrics of retained, residual, evaporated and (potential) leaked fluid shares, for three exudate flow regimes representing different possible clinically relevant scenarios. The single-use negative pressure wound therapy system under investigation emerged as the leading treatment option in the aspects of adequate fluid handling and consistent delivery of therapeutic-level wound-bed pressures. The superabsorbent dressing performed reasonably in fluid handling (resulting in some pooling but no leakage), however, it quickly caused excessive wound-bed pressures due to swelling, after less than a day of simulated use. The foam dressing exhibited the poorest fluid handling performance, that is, pooling in the wound-bed as well as occasional leakage, indicating potential inflammation and peri-wound skin maceration risks under real-world clinical use conditions. These laboratory findings highlight the importance of advanced robotic technology as contemporary means to simulate patient and wound behaviours and inform selection of wound care technologies and products, in ways that are impossible to achieve if relying solely on clinical trials and experience.
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Affiliation(s)
- Aleksei Orlov
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
| | - Marino Ciliberti
- Wound Care Centre (Centro Aziendale di Riparazione Tissutale)Castellammare di StabiaItaly
| | - Rosa Somma
- Wound Care Centre (Centro Aziendale di Riparazione Tissutale)Castellammare di StabiaItaly
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
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13
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Coelho GA, Secretan PH, Tortolano L, Charvet L, Yagoubi N. Evolution of the Chronic Venous Leg Ulcer Microenvironment and Its Impact on Medical Devices and Wound Care Therapies. J Clin Med 2023; 12:5605. [PMID: 37685674 PMCID: PMC10488485 DOI: 10.3390/jcm12175605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Studies have reported that the constituents of the wound microenvironment are likely to have critical roles in the degradation and fate of the polymeric matrix and the compounds dissolved in the wound dressing matrix. Thus, chronic wound assessment and the design of effective medical devices and drug products for wound care partly rely on an in-depth understanding of the wound microenvironment. The main aim of this review is to identify and discuss the different stages of chronic wound progression, focusing on the changes in the biochemical composition of the wound microenvironment, with particular attention given to venous leg ulcers (VLUs), as they are one of the most prevalent chronic wound aetiologies. The pathophysiology of venous ulcers is detailed, followed by a thorough review of what is known about the VLU microenvironment and its changes as a function of the evolution of the VLU. Simulating conditions for VLU are then discussed with the view of highlighting potentially relevant simulating media as a function of VLU evolution for a better assessment of biological safety, in particular medical devices intended to be in contact with these wounds.
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Affiliation(s)
- Gisele Abreu Coelho
- Laboratoire Matériaux et Santé, Université Paris-Saclay, 91400 Orsay, France; (P.-H.S.); (L.T.); (N.Y.)
- Urgo Recherche Innovation et Développement, 21300 Chenove, France;
| | - Philippe-Henri Secretan
- Laboratoire Matériaux et Santé, Université Paris-Saclay, 91400 Orsay, France; (P.-H.S.); (L.T.); (N.Y.)
| | - Lionel Tortolano
- Laboratoire Matériaux et Santé, Université Paris-Saclay, 91400 Orsay, France; (P.-H.S.); (L.T.); (N.Y.)
- Department of Pharmacy, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, 94000 Créteil, France
| | - Loïc Charvet
- Urgo Recherche Innovation et Développement, 21300 Chenove, France;
| | - Najet Yagoubi
- Laboratoire Matériaux et Santé, Université Paris-Saclay, 91400 Orsay, France; (P.-H.S.); (L.T.); (N.Y.)
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14
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Derwin R, Patton D, Strapp H, Moore Z. Wound pH and temperature as predictors of healing: an observational study. J Wound Care 2023; 32:302-310. [PMID: 37094930 DOI: 10.12968/jowc.2023.32.5.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The aim of this study was to measure wound pH, wound temperature and wound size together to gain further understanding of their impact as predictors of wound healing outcomes. METHOD This study employed a quantitative non-comparative, prospective, descriptive observational design. Participants with both acute and hard-to-heal (chronic) wounds were observed weekly for four weeks. Wound pH was measured using pH indicator strips, wound temperature was measured using an infrared camera and wound size was measured using the ruler method. RESULTS Most of the 97 participants (65%, n=63) were male; participant's ages ranged between 18 and 77 years (mean: 42±17.10. Most of the wounds observed were surgical 60%, (n=58) and 72% (n=70) of the wounds were classified as acute, with 28% (n=27) classified as hard-to-heal wounds. At baseline, there was no significant difference in pH between acute and hard-to-heal wounds; overall the mean pH was 8.34±0.32, mean temperature was 32.86±1.78°C) and mean wound area was 910.50±1132.30mm2. In week 4, mean pH was 7.71±1.11, mean temperature was 31.90±1.76°C and mean wound area was 339.90±511.70mm2. Over the study follow-up period, wound pH ranged from 5-9, from week 1 to week 4, mean pH reduced by 0.63 units from 8.34 to 7.71. Furthermore, there was a mean 3% reduction in wound temperature and a mean 62% reduction in wound size. CONCLUSION The study demonstrated that a reduction in pH and temperature was associated with increased wound healing as evidenced by a corresponding reduction in wound size. Thus, measuring pH and temperature in clinical practice may provide clinically meaningful data pertaining to wound status.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | | | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- School of Nursing & Midwifery, Griffith University, Queensland, Australia
- School of Health Sciences, Faculty of Life and Health Sciences Ulster University, Northern Ireland
- Cardiff University, Cardiff, Wales
- Department of Nursing, Fakeeh College for Medical Sciences, Jeddah, KSA
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- Lida Institute, Shanghai, China
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15
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Wang X, Ma Y, Lu F, Chang Q. The diversified hydrogels for biomedical applications and their imperative roles in tissue regeneration. Biomater Sci 2023; 11:2639-2660. [PMID: 36790251 DOI: 10.1039/d2bm01486f] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Repair and regeneration of tissues after injury are complex pathophysiological processes. Microbial infection, malnutrition, and an ischemic and hypoxic microenvironment in the injured area can impede the typical healing cascade. Distinguished by biomimicry of the extracellular matrix, high aqueous content, and diverse functions, hydrogels have revolutionized clinical practices in tissue regeneration owing to their outstanding hydrophilicity, biocompatibility, and biodegradability. Various hydrogels such as smart hydrogels, nanocomposite hydrogels, and acellular matrix hydrogels are widely used for applications ranging from bench-scale to an industrial scale. In this review, some emerging hydrogels in the biomedical field are briefly discussed. The protective roles of hydrogels in wound dressings and their diverse biological effects on multiple tissues such as bone, cartilage, nerve, muscle, and adipose tissue are also discussed. The vehicle functions of hydrogels for chemicals and cell payloads are detailed. Additionally, this review emphasizes the particular characteristics of hydrogel products that promote tissue repair and reconstruction such as anti-infection, inflammation regulation, and angiogenesis.
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Affiliation(s)
- Xinhui Wang
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 510515, China.
| | - Yuan Ma
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 510515, China.
| | - Feng Lu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 510515, China.
| | - Qiang Chang
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 510515, China.
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16
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Guiomar AJ, Urbano AM. Polyhexanide-Releasing Membranes for Antimicrobial Wound Dressings: A Critical Review. MEMBRANES 2022; 12:1281. [PMID: 36557188 PMCID: PMC9781366 DOI: 10.3390/membranes12121281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
The prevalence of chronic, non-healing skin wounds in the general population, most notably diabetic foot ulcers, venous leg ulcers and pressure ulcers, is approximately 2% and is expected to increase, driven mostly by the aging population and the steady rise in obesity and diabetes. Non-healing wounds often become infected, increasing the risk of life-threatening complications, which poses a significant socioeconomic burden. Aiming at the improved management of infected wounds, a variety of wound dressings that incorporate antimicrobials (AMDs), namely polyhexanide (poly(hexamethylene biguanide); PHMB), have been introduced in the wound-care market. However, many wound-care professionals agree that none of these wound dressings show comprehensive or optimal antimicrobial activity. This manuscript summarizes and discusses studies on PHMB-releasing membranes (PRMs) for wound dressings, detailing their preparation, physical properties that are relevant to the context of AMDs, drug loading and release, antibacterial activity, biocompatibility, wound-healing capacity, and clinical trials conducted. Some of these PRMs were able to improve wound healing in in vivo models, with no associated cytotoxicity, but significant differences in study design make it difficult to compare overall efficacies. It is hoped that this review, which includes, whenever available, international standards for testing AMDs, will provide a framework for future studies.
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Affiliation(s)
- António Jorge Guiomar
- Chemical Process Engineering and Forest Products Research Centre, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Ana M. Urbano
- Molecular Physical-Chemistry R&D Unit, Center of Investigation in Environment, Genetics and Oncobiology-CIMAGO, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
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17
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Orlov A, Gefen A. Fluid handling performance of wound dressings tested in a robotic venous leg ulcer system under compression therapy. Int Wound J 2022; 20:1384-1392. [PMID: 36267049 PMCID: PMC10088854 DOI: 10.1111/iwj.13985] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/30/2022] Open
Abstract
We designed, developed, built, and utilised a robotic system of a leg with two venous leg ulcers for testing the fluid handling performance of three wound dressing types. The results showed that a foam-based dressing technology is inferior in fluid handling performance when applied to an exuding venous leg ulcer, such that the dressing needs to manage the exudate in a vertical configuration with respect to the ground, that is, so that gravity pulls the exudate to concentrate in a small region at the bottom of the dressing. Moreover, wound dressings containing superabsorbent polymers do not necessarily function equally in fluid handling for venous leg ulcer scenarios, as the extreme requirements from the dressing (to manage the viscous fluid of a vertical and typically highly-exuding wound) appear to distinguish between optimal and suboptimal product performances despite that the tested products contain a superabsorbent, theoretically lumping them together to belong to a so-called 'superabsorbent dressing category'. In other words, it is a false premise to categorise products from different manufacturers into families based on material contents, and then assume that their laboratory or clinical performance is equal, so that from this point they can be judged solely on the basis of price.
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Affiliation(s)
- Aleksei Orlov
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv-Yafo, Israel
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18
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Brown MS, Browne K, Kirchner N, Koh A. Adhesive-Free, Stretchable, and Permeable Multiplex Wound Care Platform. ACS Sens 2022; 7:1996-2005. [PMID: 35797971 DOI: 10.1021/acssensors.2c00787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The wound healing process remains a poorly understood biological mechanism. The high morbidity and mortality rates associated with chronic wounds are a critical concern to the health care industry. Although assessments and treatment options exist, these strategies have primarily relied on static wound dressings that do not consider the dynamic physicochemical microenvironment and can often create additional complications through the frequent dressing changing procedure. Inspired by the need for engineering "smart" bandages, this study resulted in a multifaceted approach to developing an adhesive-free, permeable, and multiplex sensor system. The electronic-extracellular matrix (e-ECM) platform is capable of noninvasively monitoring chemical and physical changes in real-time on a flexible, stretchable, and permeable biointegrated platform. The multiplex sensors are constructed atop a soft, thin, and microfibrous substrate of silicone to yield a conformal, adhesive-free, convective, or diffusive wound exudate flow, and passive gas transfer for increased cellular epithelization and unobstructed physical and chemical sensor monitoring at the wound site. This platform emulates the native epidermal mechanics and physical extracellular matrix architecture for intimate bio-integration. The multiple biosensor array can continuously examine inflammatory biomarker such as lactate, glucose, pH, oxygen, and wound temperature that correlates to the wound healing status. Additionally, a heating element was incorporated to maintain the optimal thermal conditions at the wound bed. The e-ECM electrochemical biosensors were tested in vitro, within phosphate-buffered saline, and ex vivo, within wound exudate. The "smart" wound bandage combines biocompatible materials, treatments, and monitoring modalities on a microfibrous platform for complex wound dynamic control and analysis.
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Affiliation(s)
- Matthew S Brown
- Department of Biomedical Engineering, State University of New York at Binghamton, Binghamton, New York 13902, United States
| | - Karen Browne
- Decker College of Nursing and Health Sciences, State University of New York at Binghamton, Johnson City, New York 13790, United States.,Wound, Ostomy, Continence Inpatient Department, United Health Services Hospital, Johnson City, New York 13790, United States
| | - Nancy Kirchner
- Wound, Ostomy, Continence Inpatient Department, United Health Services Hospital, Johnson City, New York 13790, United States
| | - Ahyeon Koh
- Department of Biomedical Engineering, State University of New York at Binghamton, Binghamton, New York 13902, United States
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19
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Derwin R, Patton D, Avsar P, Strapp H, Moore Z. The impact of topical agents and dressing on pH and temperature on wound healing: A systematic, narrative review. Int Wound J 2021; 19:1397-1408. [PMID: 34931445 PMCID: PMC9493238 DOI: 10.1111/iwj.13733] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
Abstract
To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, Web of Science, and Scopus. Data synthesis and analysis were conducted using a structured narrative synthesis. The quality of the included clinical studies was appraised using the Evidence-Based Literature (EBL) Critical Appraisal Tool. A total of six clinical studies were assessed as eligible for inclusion, A total of six dressings/topical agents were assessed and the types of wounds included non-healing chronic wounds. Of the studies, five explored pH and one explored temperature. The EBL validity of the clinical studies was low (mean quality score was 51.3%). The five clinical studies that explored pH investigated different dressings and topical agents reporting an associated reduction in pH and improved wound outcomes. One clinical study investigated the impact of topical sodium nitrite on temperature and found that sodium nitrite increased peri-wound skin temperature and improved wound outcomes with a reduction in leg ulcer size. Given the low certainty of the evidence, we cannot confidently recommend the use of any particular topical agent or dressing to manipulate pH, or temperature to improve wound outcomes. Thus, there is a need for further research to develop a greater understanding of this topic. Irish Research Council, Enterprise Partnership Scheme.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- Wounds and Trauma Research Centre, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pinar Avsar
- Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Helen Strapp
- Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Zena Moore
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Head of School of Nursing and Midwifery and Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Nursing, Lida Institute, Shanghai, China.,School of Nursing and Midwifery, University of Wales, Cardiff, UK
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20
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Lin YH, Chen YC, Cheng KS, Yu PJ, Wang JL, Ko NY. Higher Periwound Temperature Associated with Wound Healing of Pressure Ulcers Detected by Infrared Thermography. J Clin Med 2021; 10:jcm10132883. [PMID: 34209633 PMCID: PMC8269037 DOI: 10.3390/jcm10132883] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/25/2022] Open
Abstract
Visual and empirical assessments do not enable the early detection of wound deterioration or necroses. No suitable objective indicator for predicting poor wound-healing is currently available. We used infrared thermography to determine the association between wound temperature and pressure-wound healing. We examined patients with grades 2–4 pressure ulcers from a medical center in southern Taiwan and recorded the temperatures of the wound bed, periwound, and normal skin using infrared thermographic cameras. A total of 50 pressure ulcers and 248 infrared-thermography temperature records were analyzed. Normal skin temperature was not related to pressure ulcer wound healing. In a multivariate analysis, higher malnutrition universal-screening-tool scores were associated with poor wound-healing (p = 0.020), and higher periwound-temperature values were associated with better wound-healing (p = 0.028). In patients who had higher periwound-skin temperature than that of the wound bed, that result was also associated with better wound-healing (p = 0.002). Wound-bed and periwound temperatures differed significantly with the grade of the pressure ulcer, and a high periwound temperature was positively correlated with wound healing. Infrared thermography can objectively serve as indicators for assessing pressure-ulcer healing.
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Affiliation(s)
- Yen-Hsi Lin
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Kuo-Sheng Cheng
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan;
| | - Po-Jui Yu
- Department of Nursing, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Jiun-Ling Wang
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 701, Taiwan
- Correspondence: (J.-L.W.); (N.-Y.K.); Tel.: +886-6-2353535 (ext. 4703) (J.-L.W.); +886-6-2353535 (ext. 5838) (N.-Y.K.)
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: (J.-L.W.); (N.-Y.K.); Tel.: +886-6-2353535 (ext. 4703) (J.-L.W.); +886-6-2353535 (ext. 5838) (N.-Y.K.)
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