Targeted Clindamycin Delivery Systems: Promising Options for Preventing and Treating Bacterial Infections Using Biomaterials

Targeted therapy represents a real opportunity to improve the health and lives of patients. Developments in this field are confirmed by the fact that the global market for drug carriers was worth nearly $40 million in 2022. For this reason, materials engineering and the development of new drug carrier compositions for targeted therapy has become a key area of research in pharmaceutical drug delivery in recent years. Ceramics, polymers, and metals, as well as composites, are of great interest, as when they are appropriately processed or combined with each other, it is possible to obtain biomaterials for hard tissues, soft tissues, and skin applications. After appropriate modification, these materials can release the drug directly at the site requiring a therapeutic effect. This brief literature review characterizes routes of drug delivery into the body and discusses biomaterials from different groups, options for their modification with clindamycin, an antibiotic used for infections caused by aerobic and anaerobic Gram-positive bacteria, and different methods for the final processing of carriers. Examples of coating materials for skin wound healing, acne therapy, and bone tissue fillers are given. Furthermore, the reasons why the use of antibiotic therapy is crucial for a smooth and successful recovery and the risks of bacterial infections are explained. It was demonstrated that there is no single proven delivery scheme, and that the drug can be successfully released from different carriers depending on the destination.

Reinforced hydrogel building via formation of alginate-chitosan double network with pH & salt-responsiveness and electric conductivity for soft actuators

Aiming at green and friendly environmental protection, polyvinyl alcohol/sodium alginate/chitosan (PSCS) double network hydrogel was successfully prepared through diffusing the high molecular weight chitosan into PVA/sodium alginate (PS) hydrogel without any other toxic reagents. The polyanion hydrogels could be significantly enhanced by immersing the polyanion hydrogel in high molecular weight chitosan solution without requiring specific structure. The PSCS hydrogel had a compact and rough surface structure with the smaller porosities and larger crystallization degree compared with polyvinyl alcohol/sodium alginate hydrogels and polyvinyl alcohol/sodium alginate/Ca2+ (PSCa) hydrogels. The PSCS hydrogel possessed excellent hydrolysis resistance, the significant pH-sensitive and salt-sensitive swelling. In addition, the flexibility, Young's modulus and mechanical properties of PSCS hydrogel can be adjusted through the changing the content of sodium alginate. Moreover, PS, PSCa and PSCS had electric conductivity, and PSCS showed twice the conductivity compared to PS hydrogel. Based on differences of swelling ratio, a PSCS bilayer hydrogel was designed and showed excellent pH-driven deformation ability. The PSCS hydrogel is expected to expand the application of hydrogels in conditions involving stimulus response, and might serve as a promising intelligent actuators or soft robots.

Antibacterial and Anti-Inflammatory Polysaccharide from Fructus Ligustri Lucidi Incorporated in PVA/Pectin Hydrogels Accelerate Wound Healing

In cutaneous wound healing, an overproduction of inflammatory chemokines and bacterial infections impedes the process. Hydrogels can maintain a physiologically moist microenvironment, absorb chemokines, prevent bacterial infection, inhibit bacterial reproduction, and facilitate wound healing at a wound site. The development of hydrogels provides a novel treatment strategy for the entire wound repair process. Here, a series of Fructus Ligustri Lucidi polysaccharide extracts loaded with polyvinyl alcohol (PVA) and pectin hydrogels were successfully fabricated through the freeze-thaw method. A hydrogel containing a 1% mixing weight ratio of FLL-E (named PVA-P-FLL-E1) demonstrated excellent physicochemical properties such as swellability, water retention, degradability, porosity, 00drug release, transparency, and adhesive strength. Notably, this hydrogel exhibited minimal cytotoxicity. Moreover, the crosslinked hydrogel, PVA-P-FLL-E1, displayed multifunctional attributes, including significant antibacterial properties, earlier re-epithelialization, production of few inflammatory cells, the formation of collagen fibers, deposition of collagen I, and faster remodeling of the ECM. Consequently, the PVA-P-FLL-E1 hydrogel stands out as a promising wound dressing due to its superior formulation and enhanced healing effects in wound care.

Cryostructuring of Polymeric Systems: 67 Properties and Microstructure of Poly(Vinyl Alcohol) Cryogels Formed in the Presence of Phenol or Bis-Phenols Introduced into the Aqueous Polymeric Solutions Prior to Their Freeze-Thaw Processing

Poly(vinyl alcohol) (PVA) physical cryogels that contained the additives of o-, m-, and p-bis-phenols or phenol were prepared, and their physico-chemical characteristics and macroporous morphology and the solute release dynamics were evaluated. These phenolic additives caused changes in the viscosity of initial PVA solutions before their freeze-thaw processing and facilitated the growth in the rigidity of the resultant cryogels, while their heat endurance decreased. The magnitude of the effects depended on the interposition of phenolic hydroxyls in the molecules of the used additives and was stipulated by their H-bonding with PVA OH-groups. Subsequent rinsing of such "primary" cryogels with pure water led to the lowering of their rigidity. The average size of macropores inside these heterophase gels also depended on the additive type. It was found also that the release of phenolic substances from the additive-containing cryogels occurred via virtually a free diffusion mechanism; therefore, drug delivery systems such as PVA cryogels loaded with either pyrocatechol, resorcinol, hydroquinone, or phenol, upon the in vitro agar diffusion tests, exhibited antibacterial activity typical of these phenols. The promising biomedical potential of the studied nanocomposite gel materials is supposed.

Blood Coagulation Activities of Cotton-Alginate-Copper Composites

Alginate-based materials have gained significant attention in the medical industry due to their biochemical properties. In this article, we aimed to synthesize Cotton-Alginate-Copper Composite Materials (COT-Alg(-)Cu(2+)). The main purpose of this study was to assess the biochemical properties of new composites in the area of blood plasma coagulation processes, including activated partial thromboplastin time (aPTT), prothrombin time (PT), and thrombin time (TT). This study also involved in vitro antimicrobial activity evaluation of materials against representative colonies of Gram-positive and Gram-negative bacteria and antifungal susceptibility tests. The materials were prepared by immersing cotton fibers in an aqueous solution of sodium alginate, followed by ionic cross-linking of alginate chains within the fibers with Cu(II) ions to yield antimicrobial activity. The results showed that the obtained cotton-alginate-copper composites were promising materials to be used in biomedical applications, e.g., wound dressing.

Fabrication and evaluation of vitamin doped Zno/AgNPs nanocomposite based wheat gluten films: a promising findings for burn wound treatment

Burn wound treatment remains a significant issue in wound care management especially when multidrug resistant bacterial infection and accumulation are present. Delayed wound healing is mostly due to ineffectiveness of commercially available wound dressings that protects the wound but less efficient in healing perspective. Therefore, nano-based wound dressing might be efficient solution for wound healing management. The present study reports the fabrication and evaluation of zinc oxide (ZnO) or silver nanoparticles (Ag NPs) capped with vitamin A or E nanocomposite that were incorporated in wheat gluten (WG) films. The chemical structure, phase purity, and morphological features confirmed the successful coating of NPs by vitamins A and E and their interaction with WG during film casting. The maximum swelling response was observed by NPs vitamin composite WG films than control films while slow release of vitamins and NPs from films was observed up to 24 h. WG films either carrying ZnO or Ag NPs, and vitamin A or E demonstrated significant antioxidant and antibacterial potential. The NPs-vitamin composite loaded WG films showed wound contraction within 14 days during in vivo burn wound healing experiments on mice model. The rates of wound healing, re-epithelialization, collagen deposition with fibroblast regeneration, adipocytes, and hair follicle development were observed through visual and histopathological examination. The study reveals that vitamin A or E doped ZnO or Ag NPs fabricated in WG can be efficiently used against burn wounds due to their physiochemical and biological properties. Furthermore the biocompatible nature and biodegradable potential make the films more prone to mankind maneuver for initial protection and healing remedy.

Alginates Combined with Natural Polymers as Valuable Drug Delivery Platforms

Alginates (ALG) have been used in biomedical and pharmaceutical technologies for decades. ALG are natural polymers occurring in brown algae and feature multiple advantages, including biocompatibility, low toxicity and mucoadhesiveness. Moreover, ALG demonstrate biological activities per se, including anti-hyperlipidemic, antimicrobial, anti-reflux, immunomodulatory or anti-inflammatory activities. ALG are characterized by gelling ability, one of the most frequently utilized properties in the drug form design. ALG have numerous applications in pharmaceutical technology that include micro- and nanoparticles, tablets, mucoadhesive dosage forms, wound dressings and films. However, there are some shortcomings, which impede the development of modified-release dosage forms or formulations with adequate mechanical strength based on pure ALG. Other natural polymers combined with ALG create great potential as drug carriers, improving limitations of ALG matrices. Therefore, in this paper, ALG blends with pectins, chitosan, gelatin, and carrageenans were critically reviewed.

Influence of Cedar Essential Oil on Physical and Biological Properties of Hemostatic, Antibacterial, and Antioxidant Polyvinyl Alcohol/Cedar Oil/Kaolin Composite Hydrogels

Polyvinyl alcohol (PVA) is a safe and biodegradable polymer. Given the unique physical and chemical properties of PVA, we physically cross-linked PVA with kaolin (K) and cedar essential oil (Ced) using the freeze-thawing approach to fabricate PVA/Ced/K sponge hydrogels as hemostatic, antibacterial, and antioxidant wound healing materials. The physicochemical characteristics of PVA/Ced/K hydrogels, including water swelling profiles and gel fractions, were surveyed. Additionally, the functional groups of hydrogels were explored by Fourier transform infrared spectroscopy (FTIR), while their microstructures were studied using scanning electron microscopy (SEM). Furthermore, the thermal features of the hydrogels were probed by thermal gravimetric analysis (TGA) and differential scanning calorimetry (DSC). Evidently, alterations in cedar concentrations resulted in significant variations in size, water uptake profiles, and hydrolytic degradation of the hydrogels. The incorporation of cedar into the PVA/K endowed the hydrogels with significantly improved antibacterial competency against Bacillus cereus (B. cereus) and Escherichia coli (E. coli). Moreover, PVA/Ced/K exhibited high scavenging capacities toward ABTS^•+ and DPPH free radicals. Beyond that, PVA/Ced/K hydrogels demonstrated hemocompatibility and fast blood clotting performance in addition to biocompatibility toward fibroblasts. These findings accentuate the prospective implementation of PVA/Ced/K composite hydrogel as a wound dressing.

Bio-Hybrid Hydrogels Incorporated into a System of Salicylic Acid-pH/Thermosensitive Nanocarriers Intended for Cutaneous Wound-Healing Processes

In this paper, the preparation method of bio-hybrid hydrogels incorporated into a system of salicylic acid-pH/thermosensitive nanocarriers to speed up the wound-healing process was developed. This combination creates a dual drug delivery system, which releases the model hydrophobic active substance—salicylic acid—in a gradual and controlled manner for an extended time. Our research team has determined the various properties of bio-hybrid hydrogels based on their physicochemical (swelling degree, and degradation), structural (FT-IR), morphological (SEM), and mechanical (elongation tests) traits. Moreover, empty pH/thermosensitive nanocarriers and their salicylic acid-containing systems were characterized using the following methods: DLS, TG/DTG, and DSC. Additionally, salicylic acid release profiles directly from thermosensitive nanocarriers were compared to the bio-hybrid matrix. These studies were conducted in PBS (pH = 7.4) for 7 days using the USP4 method. To evaluate the antibacterial properties of the obtained materials, the inhibition of growth of Staphylococcus aureus, Escherichia coli, Candida albicans, and Aspergillus niger—as the main microorganisms responsible for human infections—were tested. The obtained results indicated that the pH/thermosensitive nanocarrier–salicylic acid system and bio-hybrid hydrogels are characterized by antibacterial activity against both S. aureus and E. coli.

Electrospun PVA/CuONPs/Bitter Gourd Nanofibers with Improved Cytocompatibility and Antibacterial Properties: Application as Antibacterial Wound Dressing

Antibacterial and cyto-compatible tricomponent composite electrospun nanofibers comprised of polyvinyl alcohol (PVA), copper II oxide nanoparticles (CuONPs), and Momordica charantia (bitter gourd, MC) extract were examined for their potential application as an effective wound dressing. Metallic nanoparticles have a wide range of applications in biomedical engineering because of their excellent antibacterial properties; however, metallic NPs have some toxic effects as well. The green synthesis of nanoparticles is undergoing development with the goal of avoiding toxicity. The aim of adding Momordica charantia extract was to reduce the toxic effects of copper oxide nanoparticles as well as to impart antioxidant properties to electrospun nanofibers. Weight ratios of PVA and MC extract were kept constant while the concentration of copper oxide was optimized to obtain good antibacterial properties with reduced toxicity. Samples were characterized for their morphological properties, chemical interactions, crystalline structures, elemental analyses, antibacterial activity, cell adhesion, and toxicity. All samples were found to have uniform morphology without any bead formation, while an increase in diameters was observed as the CuO concentration was increased in nanofibers. All samples exhibited antibacterial properties; however, the sample with CuO concentration of 0.6% exhibited better antibacterial activity. It was also observed that nanofibrous mats exhibited excellent cytocompatibility with fibroblast (NIH3T3) cells. The mechanical properties of nanofibers were slightly improved due to the addition of nanoparticles. By considering the excellent results of nanofibrous mats, they can therefore be recommended for wound dressing applications.

Composite Nanocellulose Fibers-Based Hydrogels Loading Clindamycin HCl with Ca2+ and Citric Acid as Crosslinking Agents for Pharmaceutical Applications

Biocomposite hydrogels based on nanocellulose fibers (CNFs), low methoxy pectin (LMP), and sodium alginate (SA) were fabricated via the chemical crosslinking technique. The selected CNFs-based hydrogels were loaded with clindamycin hydrochloride (CM), an effective antibiotic as a model drug. The properties of the selected CNFs-based hydrogels loaded CM were characterized. The results showed that CNFs-based hydrogels composed of CNFs/LMP/SA at 1:1:1 and 2:0.5:0.5 mass ratios exhibited high drug content, suitable gel content, and high maximum swelling degree. In vitro assessment of cell viability revealed that the CM-incorporated composite CNFs-based hydrogels using calcium ion and citric acid as crosslinking agents exhibited high cytocompatibility with human keratinocytes cells. In vitro drug release experiment showed the prolonged release of CM and the hydrogel which has a greater CNFs portion (C₂P_0.5A_0.5/Ca + Ci/CM) demonstrated lower drug release than the hydrogel having a lesser CNFs portion (C₁P₁A₁/Ca + Ci/CM). The proportion of hydrophilic materials which were low methoxy pectin and sodium alginate in the matrix system influences drug release. In conclusion, biocomposite CNFs-based hydrogels composed of CNFs/LMP/SA at 1:1:1 and 2:0.5:0.5 mass ratios, loading CM with calcium ion and citric acid as crosslinking agents were successfully developed for the first time, suggesting their potential for pharmaceutical applications, such as a drug delivery system for healing infected wounds.

Controlled and Local Delivery of Antibiotics by 3D Core/Shell Printed Hydrogel Scaffolds to Treat Soft Tissue Infections

Soft tissue infections in open fractures or burns are major cause for high morbidity in trauma patients. Sustained, long-term and localized delivery of antimicrobial agents is needed for early eradication of these infections. Traditional (topical or systemic) antibiotic delivery methods are associated with a variety of problems, including their long-term unavailability and possible low local concentration. Novel approaches for antibiotic delivery via wound coverage/healing scaffolds are constantly being developed. Many of these approaches are associated with burst release and thus seldom maintain long-term inhibitory concentrations. Using 3D core/shell extrusion printing, scaffolds consisting of antibiotic depot (in the core composed of low concentrated biomaterial ink 3% alginate) surrounded by a denser biomaterial ink (shell) were fabricated. Denser biomaterial ink (composed of alginate and methylcellulose or alginate, methylcellulose and Laponite) retained scaffold shape and modulated antibiotic release kinetics. Release of antibiotics was observed over seven days, indicating sustained release characteristics and maintenance of potency. Inclusion of Laponite in shell, significantly reduced burst release of antibiotics. Additionally, the effect of shell thickness on release kinetics was demonstrated. Amalgamation of such a modular delivery system with other biofabrication methods could potentially open new strategies to simultaneously treat soft tissue infections and aid wound regeneration.

Polyglutamic acid grafted dopamine modified collagen-polyvinyl alcohol hydrogel for a potential wound dressing

Natural collagen has good biocompatibility and ability to promote tissue regeneration and repair, but the poor mechanical properties and intolerance of degradation of natural collagen limit its applications in the biomedical field. In this research, we synthesized a skin wound repair hydrogel with good biological activity, high strength and excellent water absorption properties. Inspired by the theory of wet healing, dopamine was introduced into the side chain of the water-absorbing polymer polyglutamic acid to synthesize a cross-linking agent (PGAD) with both water absorption and cell adhesion ablities, and then it was introduced into collagen/polyvinyl alcohol (PVA-COL) system to form a double network hydrogel. Scanning electron microscope observation of the morphological characteristics of the hydrogel showed that after the introduction of PGAD, the hydrogel formed an obvious pore structure, and the swelling rate showed that the introduction of PGAD significantly improved the water absorption rate of the hydrogel.In addition, PVA-COL-PGAD hydrogel has good mechanical properties and water absorption behavior.In vitro experimental results revealed that the hydrogel has good biocompatibility. In vivo wound healing experiments showed that hydrogel can promote wound healing process.These results indicated that our hydrogel has great potential as a medical wound dressing.

Efficient removal of nitrate, manganese, and tetracycline by a polyvinyl alcohol/sodium alginate with sponge cube immobilized bioreactor

The co-existence of nitrate, manganese (Mn), and antibiotics are of a wide concern. In this study, a denitrifying and manganese-oxidizing Zoogloea Q7 bacterium was immobilized using polyvinyl alcohol/sodium alginate with sponge cube (PVA/SA@sponge cube) in the reactor. The optimal operation parameters of the bioreactor were explored. Maximum nitrate, Mn(II), and tetracycline (TC) removal efficiencies of 93.00, 72.34, and 57.32% were achieved with HRT of 10 h, pH of 6.5, Mn(II) concentration of 20 mg L^-1, and TC of 1 mg L^-1, respectively. Fluorescence excitation-emission matrix (EEM) proved that the microorganism in the bioreactor was greatly active. Scanning electron microscope (SEM) images demonstrated that Zoogloea Q7 was commendably immobilized on the novel material. X-ray diffraction (XRD) analysis suggested that the bioprecipitate was mainly composed of MnO₂ and MnCO_3. Through high-throughput analysis, Zoogloea sp. Q7 was considered to be the dominant bacteria present in the bioreactor.

Alginate and alginate composites for biomedical applications

Alginate is an edible heteropolysaccharide that abundantly available in the brown seaweed and the capsule of bacteria such as Azotobacter sp. and Pseudomonas sp. Owing to alginate gel forming capability, it is widely used in food, textile and paper industries; and to a lesser extent in biomedical applications as biomaterial to promote wound healing and tissue regeneration. This is evident from the rising use of alginate-based dressing for heavily exuding wound and their mass availability in the market nowadays. However, alginate also has limitation. When in contact with physiological environment, alginate could gelate into softer structure, consequently limits its potential in the soft tissue regeneration and becomes inappropriate for the usage related to load bearing body parts. To cater this problem, wide range of materials have been added to alginate structure, producing sturdy composite materials. For instance, the incorporation of adhesive peptide and natural polymer or synthetic polymer to alginate moieties creates an improved composite material, which not only possesses better mechanical properties compared to native alginate, but also grants additional healing capability and promote better tissue regeneration. In addition, drug release kinetic and cell viability can be further improved when alginate composite is used as encapsulating agent. In this review, preparation of alginate and alginate composite in various forms (fibre, bead, hydrogel, and 3D-printed matrices) used for biomedical application is described first, followed by the discussion of latest trend related to alginate composite utilization in wound dressing, drug delivery, and tissue engineering applications.

The synergistic effect of topical insulin and clindamycin on acute dermal wound healing in rat model: a histological study

Reducing the duration of wound healing is important to decrease the chance of infection. Insulin as a peptide hormone has a role in wound healing. Also, the use of clindamycin in the treatment of skin wounds has been studied very little. The aim of this study was to evaluate the synergistic effect of insulin and clindamycin on full-thickness wound healing. In this study, 24 Wistar rats (weight 180-200 g) were randomly divided into four equal groups: control (Eucerin), clindamycin, insulin, and insulin + clindamycin. Drugs were administered in the form of an ointment daily for twelve days. Wound healing rate and wound criteria such as epithelialization, neovascularization, collagen deposition, inflammation, and tissue granulation were investigated histologically on days 3, 7, and 14. The wound healing rate in the insulin + clindamycin group was significantly higher than the other groups on day 7 but there was no significant difference between groups on day 14. In addition, the combination of insulin and clindamycin had a beneficial effect on reducing inflammation and increasing collagen deposition, fibroblast maturation, neovascularization, and keratinization. The data showed that the topical application of insulin with clindamycin has an effective role in full-thickness wound healing by reducing inflammation and accelerating wound closure.

Evaluation of wound healing potential of new composite liposomal films containing coenzyme Q10 and d-panthenyl triacetate as combinational treatment

Conventional formulations can not achieve wound healing efficiently and fail to accelerate wound regeneration. To overcome these problems, it was planned to develop nanoformulations that perform a positive effect on the wound healing duration and are suitable for topical use. In this study, liposomal film formulations that encapsulated d-panthenyl triacetate (PTA) and coenzyme Q10 (CoQ10) were optimized by using response surface methodology (RSM) and were analyzed for their wound healing efficacy and cytotoxicity on fibroblast (CCD1079 Sk) and keratinocyte (HEKa) cells. Swelling index, puncture strength, and puncture deformation values, which were choosen as dependent variables for the liposomal film formulation were found as 556.9% ± 21.3, 3.98 ± 0.98 N/mm², and 6.57% ± 1.12, respectively. Cumulative release of 65.32% for PTA and 12.23% for CoQ10 was obtained after 24 hours of in vitro release study in sink conditions. The in vitro cytotoxicity and wound healing assay results suggested that optimum formulation could be used safely on fibroblast and keratinocyte cells and provided wound closure entirely after 24 h. Consequently, the optimum liposomal film containing PTA and CoQ10 formulations could be proposed as an innovative approach in wound healing treatment, considering their release, mechanical properties, stability, and effectiveness.

Design and Development of Hybrid Hydrogels for Biomedical Applications: Recent Trends in Anticancer Drug Delivery and Tissue Engineering

The applications of hydrogels in biomedical field has been since multiple decades. Discoveries in biology and chemistry render this platform endowed with much engineering potentials and growing continuously. Novel approaches in constructing these materials have led to the production of complex hybrid hydrogels systems that can incorporate both natural and synthetic polymers and other functional moieties for mediated cell response, tunable release kinetic profiles, thus they are used and research for diverse biomedical applications. Recent advancement in this field has established promising techniques for the development of biorelevant materials for construction of hybrid hydrogels with potential applications in the delivery of cancer therapeutics, drug discovery, and re-generative medicines. In this review, recent trends in advanced hybrid hydrogels systems incorporating nano/microstructures, their synthesis, and their potential applications in tissue engineering and anticancer drug delivery has been discussed. Examples of some new approaches including click reactions implementation, 3D printing, and photopatterning for the development of these materials has been briefly discussed. In addition, the application of biomolecules and motifs for desired outcomes, and tailoring of their transport and kinetic behavior for achieving desired outcomes in hybrid nanogels has also been reviewed.

Hemostatic and antibacterial PVA/Kaolin composite sponges loaded with penicillin-streptomycin for wound dressing applications

Hemorrhage is the major hindrance over the wound healing, which triggers microbial infections and might provoke traumatic death. Herein, new hemostatic and antibacterial PVA/Kaolin composite sponges were crosslinked using a freeze-thawing approach and boosted by penicillin–streptomycin (Pen-Strep). Physicochemical characteristics of developed membranes were analyzed adopting Fourier transformed infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), a thermal gravimetric analyzer (TGA), and differential scanning calorimetry (DSC). Furthermore, the impacts of kaolin concentrations on porosity, swelling behavior, gel fraction, and degradation of the membranes were investigated. SEM analyses revealed a spongy-like structure of hydrogels associated with high dispersion of kaolin inside PVA matrix. The thermal characteristics of PVA/Kaolin were significantly ameliorated compared to the prime PVA. Moreover, the results exhibited significant variations of swelling performance, surface roughness and pore capacity due to the alterations of kaolin contents. Besides, the adhesive strength ability was manifestly enhanced for PVA-K0.1 sponge. Biomedical evaluations including antibacterial activity, blood clotting index and thrombogenicity of the membranes were studied. The contact of PVA/Kaolin to blood revealed notable augmentation in blood clotting. Furthermore, the incorporation of kaolin into PVA presented mild diminution in antibacterial activities. Moreover, PVA/Kaolin composites illustrated no cellular toxicity towards fibroblast cells. These remarkable features substantiate that the PVA-K0.1 sponge could be applied as a multifunctional wound dressing.

Preparation of smooth and macroporous hydrogel via hand-held blender for wound healing applications: in vitro and in vivo evaluations

Wound dressings play an indispensable role in wound healing. However, traditional wound dressings have several disadvantages, such as poor mechanical properties and small pore diameters, which do not allow sufficient gas exchange. To overcome these shortcomings, this paper reports a polyvinyl alcohol (PVA)-based hydrogel physically crosslinked at -20 °C and containing polyethylene glycol (PEG) and nanohydroxyapatite (HAP). The physical and chemical properties of the hydrogels formed by different stirring methods (stirring with a glass rod or a hand-held homogenizer) were compared. The average roughness of Gel 1 (prepared using a hand-held homogenizer) is 112.6 nm, which is much lower than the average surface roughness of Gel 2 (1222 nm, prepared using a glass rod). Moreover, the hydrogel made by the unconventional mixing method (with a homogenizer) showed better performance, including a more interconnected open-pore microstructure and better mechanical properties. Finally, a full-thickness skin defect test was performed. The experimental results demonstrated that the hydrogel has considerable potential for applications in wound dressings.

Layered biocompatible pH-responsive antibacterial composite film based on HNT/PLGA/chitosan for controlled release of minocycline as burn wound dressing

In the present study, a promising pH-responsive wound dressing was prepared. Halloysite nanotube (HNT) composites were modified with different concentration of both poly (lactic-co-glycolic acid) (PLGA) and chitosan (CS) through the Layer-by-Layer (LbL) strategy for targeted and controlled drug delivery of minocycline (MC). The resulting composites were characterized by FT-IR, XRD, zeta-potential, TGA, FE-SEM and TEM studies. Studying the biodegradability, water uptake, photostability, and water vapor transmission of resulting composites revealed that the composite film absorbed wound secretions, did not degrade, and penetrated properly to wound during the treatment. The results of protein adsorption showed that the optimized composite (C₄₀P₆₀MNT) was blood-compatible. Studying the release profile of the drug showed pH-responsive behavior that was fitted with Korsmeyer-Peppas kinetic model. In-vitro antibacterial testing showed that the C₄₀P₆₀MNT sample had an acceptable effect on the inhibition of gram-positive and gram-negative bacteria. In wound healing test (in-vivo studies), this MC loaded composite film showed faster healing of the burn wound in rat compare to the control sample. Due to the characteristics of the optimized sample, it can be considered as a promising candidate for pH-responsive drug delivery in the treatment of chronic burn wounds.

New Developments in Medical Applications of Hybrid Hydrogels Containing Natural Polymers

New trends in biomedical applications of the hybrid polymeric hydrogels, obtained by combining natural polymers with synthetic ones, have been reviewed. Homopolysaccharides, heteropolysaccharides, as well as polypeptides, proteins and nucleic acids, are presented from the point of view of their ability to form hydrogels with synthetic polymers, the preparation procedures for polymeric organic hybrid hydrogels, general physico-chemical properties and main biomedical applications (i.e., tissue engineering, wound dressing, drug delivery, etc.).

Does antibiotic use accelerate or retard cutaneous repair? A systematic review in animal models

BACKGROUND

The presence of infections is one of the main factors that leads to delays in healing or non-closure of cutaneous wounds. Although the goal of antibiotic use is to treat or prevent infection, there is currently no agreement on the effectiveness of these products.

AIM

The aim of this study was to evaluate the efficacy of antibiotic use during the healing process of skin wounds in animal models not intentionally infected, as well as to analyze the advances and limitations of the studies carried out in this field.

MAIN METHODS

This systematic review was performed according to the PRISMA guidelines, using a structured search on the MedLine (PubMed) and Scopus platforms to retrieve studies published until August 29, 2018, 13:35p.m. The studies included were limited to those that used excision or incision wound models and that were not intentionally infected. The data for the animal models, antibiotic used, and the main results of the studies were extracted, and compared where possible. Bias analysis and methodological quality assessments were examined through the SYRCLE's Risk of Bias tool.

KEY FINDINGS

Twenty-seven studies were selected. Overall, the effects of the antibiotic on the wound decreased inflammatory cell infiltration and promoted an increased number of fibroblasts, extracellular matrix constituents, re-epithelialization and tissue strength. A great deal of important information about the methodology was not presented, such as: the statistical analysis used, the animal model (sex and age), antibiotic dosage, blinding and randomization of the animals chosen.

SIGNIFICANCE

Based on the results found, we believe that antibiotic therapy can be considered a viable alternative for the treatment of cutaneous wounds. However, current evidence obtained from the methodological quality analysis points towards a high risk of bias. This is due to the incomplete characterization of the experimental design and treatment protocol, which compromises the reproducibility of the studies.

Preparation of Lutein-Loaded PVA/Sodium Alginate Nanofibers and Investigation of Its Release Behavior

This investigation aims to study the characteristics and release properties of lutein-loaded polyvinyl alcohol/sodium alginate (PVA/SA) nanofibers prepared by electrospinning. In order to increase PVA/SA nanofibers' water-resistant ability for potential biomedical applications, the electrospun PVA/SA nanofibers were cross-linked with a mixture of glutaraldehyde and saturated boric acid solution at room temperature. The nanofibers were characterized using scanning electron microscopy (SEM) and X-ray diffractometer (XRD). Disintegration time and contact angle measurements testified the hydrophilicity change of the nanofibers before and after cross-linking. The lutein release from the nanofibers after cross-linking was measured by an ultraviolet absorption spectrophotometer, which showed sustained release up to 48 h and followed anomalous (non-Fickian) release mechanism as indicated by diffusion exponent value obtained from the Korsmeyer-Peppas equation. The results indicated that the prepared lutein-loaded PVA/SA nanofibers have great potential as a controlled release system.

Biopolymer-based biomaterials for accelerated diabetic wound healing: A critical review

Non-healing, chronic wounds place a huge burden on healthcare systems as well as individual patients. These chronic wounds especially diabetic wounds will ultimately lead to compromised mobility, amputation of limbs and even death. Currently, wounds and limb ulcers associated with diabetes remain significant health issues; the associated healthcare cost ultimately leads to the increased clinical burden. The presence of diabetes interrupts a highly coordinated cascade of events in the wound closure process. Advances in the understanding of pathophysiological conditions associated with diabetic wounds lead to the development of drug delivery systems which can enhance wound healing by targeting various phases of the impaired processes. Wound environments typically contain degradative enzymes, along with an elevated pH and demonstrate a physiological cascade involved in the regeneration of tissue, which requires the application of an effective delivery system. This article aims to review the pathophysiological conditions associated with chronic and diabetic wounds. The delivery systems, involved in their treatment are described, highlighting potential biomaterials and polymers for establishing drug delivery systems, specifically for the treatment of diabetic wounds and the promotion of the associated mechanisms involved in advanced wound healing. Emerging approaches and engineered devices for effective wound care are reported. The discussion will give insight into the mechanisms relevant to all stages of wound healing.

Wound healing properties of PVA/starch/chitosan hydrogel membranes with nano Zinc oxide as antibacterial wound dressing material

In this work, hydrogel membranes were developed based on poly vinyl alcohol (PVA), starch (St), and chitosan (Cs) hydrogels with nano Zinc oxide (nZnO). PVA/St/Cs/nZnO hydrogel membranes were prepared by freezing-thawing cycles, and the aqueous PVA/St solutions were prepared by dissolving PVA in distilled water. After the dissolution of PVA, starch was mixed, and the mixture was stirred. Then, chitosan powder was added into acetic acid, and the mixture was stirred to form a chitosan solution. Subsequently, Cs, St and PVA solutions were blended together to form a homogeneous PVA/St/Cs ternary blend solution. Measurement of Equilibrium Swelling Ratio (ESR), Water Vapor Transmission Test (WVTR), mechanical properties, scanning electron microscopy (SEM), MTT [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide] assay, antibacterial studies, in vivo wound healing effect and histopathology of the hydrogel membranes were then performed. The examination revealed that the hydrogel membranes were more effective as a wound dressing in the early stages of wound healing and that the gel could be used in topic applications requiring a large spectrum of antibacterial activity; namely, as a bandage for wound dressing.

Effects of different cellulose membranes regenerated from Styela clava tunics on wound healing

The aim of this study was to investigate the therapeutic effects of three different cellulose membranes (CMs) manufactured from Styela clava tunics (SCTs) on the healing of cutaneous wounds. We examined the physical properties and therapeutic effects of three CMs regenerated from SCTs (referred to as SCT- CMs), including normal CM (SCT-CM), freeze-dried SCT-CM (FSCT-CM) and sodium alginate-supplemented SCT-CM (ASCT-CM) on skin regeneration and angiogenesis using Sprague-Dawley (SD) rats. FSCT-CM exhibited an outstanding interlayered structure, a high tensile strength (1.64 MPa), low elongation (28.59%) and a low water vapor transmission rate (WVTR) compared with the other SCT-CMs, although the fluid uptake rate was maintained at a medium level. In the SD rats with surgically wounded skin, the wound area and score of wound edge were lower in the FSCT-CM-treated group than in the gauze (GZ)-treated group on days 3–6 and 12–14. In addition, a significant attenuation in the histopathological changes was observed in the FSCT-CM-treated group. Furthermore, the expression level of collagen-1 and the signaling pathway of transforming growth factor (TGF)-β1 were significantly stimulated by the topical application of FSCT-CM. However, no signs of toxicity were detected in the livers or kidneys of the three SCT-CM-treated groups. Overall, our data indicate that the FSCT-CM may accelerate the process of wound healing in the surgically wounded skin of SD rats through the regulation of angiogenesis and connective tissue formation without inducing any specific toxicity.

A review on polymeric hydrogel membranes for wound dressing applications: PVA-based hydrogel dressings

This review presents the past and current efforts with a brief description on the featured properties of hydrogel membranes fabricated from biopolymers and synthetic ones for wound dressing applications. Many endeavors have been exerted during past ten years for developing new artificial polymeric membranes, which fulfill the demanded conditions for the treatment of skin wounds. This review mainly focuses on representing specifications of ideal polymeric wound dressing membranes, such as crosslinked hydrogels compatible with wound dressing purposes. But as the hydrogels with single component have low mechanical strength, recent trends have offered composite or hybrid hydrogel membranes to achieve the typical wound dressing requirements.

Preparation and in vitro evaluation of melatonin-loaded HA/PVA gel formulations

Melatonin-loaded hyaluronic acid (HA) and poly(vinyl alcohol) (PVA) gels were prepared by using freeze-thaw technique and an emulsion method followed by freeze-thaw technique to produce a new synergistic system for topical application. Freeze-thaw hydrogels and emulgels were characterized by means of Fourier transform infrared spectroscopy, rheology and swelling tests. The porous structure of the hydrogels was shown by scanning electron microscopy observations and thermal properties were tested by differential scanning calorimetry measurements. Bioadhesion and in vitro release characterization of formulations were performed by texture profile analysis and dialysis bag method, respectively. The pore size of both formulations was ranging from 900 nm to 30 μm. Melatonin showed a good compatibility with the polymeric matrices as the pores were smaller for the drug-loaded systems. In vitro release studies showed that the release was improved by emulgel formulations. After 24 h, the release percentage was found to be 13.240% ± 1.094 and 15.192% ± 2.270 for hydrogel and emulgel, respectively. Emulgels had better bioadhesion properties than simple freeze-thaw samples. As a conclusion, regarding the in vitro characterization studies HA and PVA hydrogel and emulgel formulations and their lyophilized forms could be promising systems for topical application of melatonin.

Influence of hydrophilic polymers on functional properties and wound healing efficacy of hydrocolloid based wound dressings

The purpose of this study was to investigate the influence of different hydrophilic polymers on the swelling, bioadhesion and mechanical strength of hydrocolloid wound dressings (HCDs) in order to provide an appropriate composition for a hydrocolloid wound dressing system. In this study, the HCDs were prepared with styrene-isoprene-styrene copolymer (SIS) and polyisobutylene (PIB) as the base using a hot melting method. Additionally, numerous SIS/PIB-based HCDs were prepared with six hydrophilic polymers, and their wound dressing properties were assessed. Finally, the wound healing efficacy of the selected formulations was compared to a commercial wound dressing. The swelling ratio, bioadhesive force and mechanical strengths of HCDs were increased in the order of sodium alginate>sodium CMC=poloxamer=HPMC>PVA=PVP, sodium alginate>sodium CMC=poloxamer>PVA>HPMC=PVP and sodium alginate≥PVA>PVP=HPMC=sodium CMC>poloxamer, respectively. Among the hydrophilic polymers tested, sodium alginate most enhanced the swelling capacity, bioadhesive force and mechanical strengths. Thus, the hydrophilic polymers played great role in the swelling, bioadhesion and mechanical strength of SIS/PIB-based HCDs. The HCD formulation composed of PIB, SIS, liquid paraffin and sodium alginate at the weight ratio of 20/25/12/43 gave better wound dressing properties and more excellent wound healing efficacy than the commercial wound dressing. Therefore, the novel HCD formulation could be a promising hydrocolloid system for wound dressings.

Development of a novel sodium fusidate-loaded triple polymer hydrogel wound dressing: Mechanical properties and effects on wound repair

To develop a novel sodium fusidate-loaded triple polymer hydrogel dressing (TPHD), numerious polyvinyl alcohol-based (PVA) hydrogel dressings were prepared with various hydrophilic polymers using the freeze-thaw method, and their hydrogel dressing properties were assessed. Among the hydrophilic polymers tested, sodium alginate (SA) improved the swelling capacity the most, and polyvinyl pyrrolidone (PVP) provided the greatest improvement in bioadhesive stength and mechanical properties. Thus, PVA based-TPHDs were prepared using different ratios of PVP:SA. The effect of selected PVP:SA ratios on the swelling capacity, bioadhesive strength, mechanical properties, and drug release, permeation and deposition characteristics of sodium fusidate-loaded PVA-based TPHDs were assessed. As the ratio of PVP:SA increased in PVA-loaded TPHD, the swelling capacity, mechanical properties, drug release, permeation and deposition were improved. The TPHD containing PVA, PVP, SA and sodium fusidate at the weight ratio of 10/6/1/1 showed excellent hydrogel dressing properties, release, permeation and deposition of drug. Within 24h, 71.8 ± 1.3% of drug was released. It permeated 625.1 ± 81.2 μg/cm(2) through the skin and deposited of 313.8 ± 24.1 μg/cm(2) within 24h. The results of in vivo pharmacodynamic studies showed that sodium fusidate-loaded TPHD was more effective in improving the repair process than was a commercial product. Thus, this sodium fusidate-loaded TPHD could be a novel tool in wound care.