Silver. I: Its antibacterial properties and mechanism of action

Explorations of the chemical constitution and aqueous solution status of caries-arresting silver(I)-diammine fluoride and silver(I)-fluoride products using high-resolution 19F NMR analysis. Spectroscopic and SEM investigations of their interactions with human saliva: evidence for the in vivo salivary-catalysed autoconstruction of Ag/AgCl-based nanoparticles (IV-SCAN)-part I

Introduction

Silver(I)-diammine fluoride (SDF) and silver(I)-fluoride (SF) complexes have been successfully employed for the arrest of dental caries for many years. However, to date there are very few studies available reporting on the molecular structural compositional and solution status of these agents [typically applied as highly-concentrated 38% (w/v) solutions]. Here, we explored the solution status and chemical constitution of commercially-available SDF and SF products, and secondly investigated the multicomponent interplay of these products with biomolecules present in intact human whole-mouth salivary supernatants (WMSSs) in vitro.

Methods

High-resolution 19F NMR analysis was employed to explore SDF and SF product solutions, and to determine WMSS fluoride (F-) concentrations, whereas ammonia (NH3) release form SDF was tracked by 1H NMR spectroscopy. SEM and thin-film FTIR-ATR analyses were employed to explore the atomic and molecular compositions of sequentially-generated AgCl deposits and chromophoric Ag/AgCl nanoparticles (CSNPs); the time-dependent generation of the latter was followed spectrophotometrically.

Results

19F NMR spectra of aqueous SF solutions contained a very broad F- signal (Δv1/2 70 Hz), demonstrating that much of its solvated F- content was rapidly exchanging with Ag(I) on the NMR timescale, but those of SDF had a much sharper resonance, similar to that of "free" F- (4 Hz). Moreover, further NMR results revealed that a popular SDF product contained high molar excesses of both F- and NH3. Treatment of WMSSs with SDF and SF generated an off-white precipitate, which slowly developed into CSNPs at 23°C; SEM demonstrated high contents of both silver and chloride in this material (ca.1:1 atomic content ratio). FTIR-ATR analysis found that the CSNPs formed contained a range of salivary biomolecules, which appear to encapsulate the Ag/AgCl core (significant thiocyanate contents were also found). In conclusion, NMR results acquired demonstrated that SF, but not SDF, product solutions feature rapidly-exchanging F - between its "free" and Ag(I)-bound forms, and that SDF contains large excesses of both F- and its NH3 ligands. Characterised AgCl deposits and CSNPs were sequentially produced from the interactions of these complexes with WMSS biomolecules.

Discussion

In view of their well-known microbicidal and cariostatic properties, the observed autobioconstruction of CSNPs involving salivary catalysis is of much therapeutic significance.

Salivary and urinary assessment of fluoride and silver ion concentrations after silver diamine fluoride application in children: a prospective cohort study

PURPOSE

The purpose of the study was to determine the fluoride (F) and silver (Ag) ions levels in the saliva and urine of healthy children after silver diamine fluoride (SDF) application on dental carious lesions.

METHODS

Sixty children (4-6 years with ≥ 3 caries lesions) were recruited from the outpatient department of Pediatric Dentistry. From each child, 3 ml unstimulated saliva samples were collected at baseline, one hour, and 24 h after SDF application. Similarly, 3 ml urine samples were collected prior to and after 24 h of SDF application. F and Ag ion concentrations were determined by fluoride ion-selective electrode (ISE) and inductively coupled plasma mass spectrometry (ICPMS), respectively.

RESULTS

The mean ± standard deviation (SD) baseline, 1-h, and 24-h salivary F concentrations (ppm) were 0.07 ± 0.07, 0.93 ± 0.48, and 0.19 ± 0.19, respectively, while the mean baseline and 24-h urinary F concentrations (ppm) were 0.33 ± 0.20 ppm and 0.43 ± 0.25 ppm, respectively. The mean baseline, 1-h, and 24-h salivary Ag concentrations (ppb) were 4.22 ± 3.15, 4198 ± 350, and 56.93 ± 37, respectively. The mean baseline and 24-h urinary Ag concentrations (ppb) were 2.80 ± 2.93 ppb and 4.72 ± 4.0 ppb, respectively. There were statistically elevated F and Ag ion concentrations at 1 h and 24 h after SDF application as compared to the baseline.

CONCLUSION

Salivary and urinary F and Ag ions concentrations elevated significantly at 24 h following SDF applications in children. A significant high recovery of these ions in urine indicates minimal systemic absorption, thus intermittent topical application of 38% SDF has a minimal risk of toxicity.

Silver Organometallics that are Highly Potent Thioredoxin and Glutathione Reductase Inhibitors: Exploring the Correlations of Solution Chemistry with the Strong Antibacterial Effects

The antibacterial activity of silver species is well-established; however, their mechanism of action has not been adequately explored. Furthermore, issues of low-molecular silver compounds with cytotoxicity, stability, and solubility hamper their progress to drug leads. We have investigated silver N-heterocyclic carbene (NHC) halido complexes [(NHC)AgX, X = Cl, Br, and I] as a promising new type of antibacterial silver organometallics. Spectroscopic studies and conductometry established a higher stability for the complexes with iodide ligands, and nephelometry indicated that the complexes could be administered in solutions with physiological chloride levels. The complexes showed a broad spectrum of strong activity against pathogenic Gram-negative bacteria. However, there was no significant activity against Gram-positive strains. Further studies clarified that tryptone and yeast extract, as components of the culture media, were responsible for this lack of activity. The reduction of biofilm formation and a strong inhibition of both glutathione and thioredoxin reductases with IC50 values in the nanomolar range were confirmed for selected compounds. In addition to their improved physicochemical properties, the compounds with iodide ligands did not display cytotoxic effects, unlike the other silver complexes. In summary, silver NHC complexes with iodide secondary ligands represent a useful scaffold for nontoxic silver organometallics with improved physicochemical properties and a distinct mechanism of action that is based on inhibition of thioredoxin and glutathione reductases.

A Randomized Trial of Ionic Silver Dressing to Reduce Surgical Site Infection After Gastrointestinal Surgery

Objective

To determine whether Aquacel Ag Hydrofiber dressings containing ionic silver are superior to film dressings for preventing superficial surgical site infections (SSI) in patients undergoing elective gastrointestinal surgery.

Background

Multiple clinical trials have assessed the effectiveness of silver-containing wound dressings; however, systematic reviews failed to find any advantages of these dressings and concluded that there was insufficient evidence to indicate that they prevented wound infections. This study aimed to evaluate the efficacy of Aquacel Ag Hydrofiber dressings for preventing superficial SSIs in patients undergoing gastrointestinal surgery.

Methods

Patients undergoing elective gastrointestinal surgery were randomly assigned to receive either Aquacel Ag Hydrofiber (study group) or film dressings (control group). The primary end point was superficial SSI within 30 days after surgery (UMIN Clinical Trials Registry ID: 000043081).

Results

A total of 865 patients (427 study group, 438 control group) were qualified for primary end-point analysis. The overall rate of superficial SSIs was significantly lower in the study group than in the control group (6.8% vs 11.4%, P = 0.019). There was no significant difference in superficial SSI rates between the groups in patients undergoing upper gastrointestinal surgery; however, the rate was significantly lower in the study group in patients undergoing lower gastrointestinal surgery (P = 0.042). Multivariate analysis identified Aquacel Ag Hydrofiber dressings as an independent factor for reducing superficial SSIs (odds ratio, 0.602; 95% confidence interval, 0.367-0.986; P = 0.044).

Conclusions

Aquacel Ag Hydrofiber dressings can reduce superficial SSIs compared to film dressings in patients undergoing elective gastrointestinal surgery, especially lower gastrointestinal surgery.

Innovative approach: utilizing silver nanoparticles sheet for improved rabbit cecal anastomosis healing

Introduction

Anastomotic leakage is a severe complication associated with gastrointestinal surgery. The process of intestinal wound healing is crucial for the successful outcome of digestive tract surgical repair procedures. This research aimed to determine the impact of silver nanoparticles sheet (Acticoat) on the anastomotic healing of the cecum in rabbits.

Methods

A total of 48 New Zealand male rabbits in good health were used for cecum transection and anastomosis. The animals were randomized into the control group (C) and the silver nanoparticles group (AgNPs). In the C group, the transected cecum was end-to-end anastomosed with a single layer of simple continuous suture pattern using 3-0 polyglyconate. In contrast, a silver nanoparticle sheet (Acticoat) was covered around the sutured anastomotic line in the AgNPs group. Postoperatively, abdominal ultrasound imaging and the Bristol Rabbit Pain Score (BRPS) were measured on days 7, 15, and 30. Eight rabbits from each group were euthanized at each time point to assess macroscopic findings, bursting pressure tests, tensile strength tests, histopathological examinations, and immunohistochemical analyses.

Results

The AgNPs group demonstrated a significant increase in the cecal lumen diameter wall (p ≤ 0.001), burst pressure measurement (p ≤ 0.02), and tensile strength (p ≤ 0.01). Conversely, the AgNPs group had significantly lower BRPS scores (p ≤ 0.01). In addition, histopathological examinations revealed that AgNPs significantly reduced inflammatory cell infiltration (neutrophils and macrophages) and enhanced collagen deposition. Immunohistochemical analyses revealed a significant increase (p ≤ 0.01) of α-SMA and a reduction of CD31 in the anastomotic tissue of the AgNPs group.

Discussion

The results of the present study indicate that the utilization of the AgNPs sheet (Acticoat®) effectively enhanced the strength of cecum anastomosis, resulting in a reduction in anastomosis leakages, pain scores, and abdominal adhesions. Additionally, the bursting pressure values in the rabbit model were significantly increased.

Polycaprolactone Nanofibers Functionalized by Fibronectin/Gentamicin and Implanted Silver for Enhanced Antibacterial Properties, Cell Adhesion, and Proliferation

Novel nanomaterials used for wound healing should have many beneficial properties, including high biological and antibacterial activity. Immobilization of proteins can stimulate cell migration and viability, and implanted Ag ions provide an antimicrobial effect. However, the ion implantation method, often used to introduce a bactericidal element into the surface, can lead to the degradation of vital proteins. To analyze the surface structure of nanofibers coated with a layer of plasma COOH polymer, fibronectin/gentamicin, and implanted with Ag ions, a new X-ray photoelectron spectroscopy (XPS) fitting method is used for the first time, allowing for a quantitative assessment of surface biomolecules. The results demonstrated noticeable changes in the composition of fibronectin- and gentamicin-modified nanofibers upon the introduction of Ag ions. Approximately 60% of the surface chemistry has changed, mainly due to an increase in hydrocarbon content and the introduction of up to 0.3 at.% Ag. Despite the significant degradation of fibronectin molecules, the biological activity of Ag-implanted nanofibers remained high, which is explained by the positive effect of Ag ions inducing the generation of reactive oxygen species. The PCL nanofibers with immobilized gentamicin and implanted silver ions exhibited very significant antipathogen activity to a wide range of Gram-positive and Gram-negative strains. Thus, the results of this work not only make a significant contribution to the development of new hybrid fiber materials for wound dressings but also demonstrate the capabilities of a new XPS fitting methodology for quantitative analysis of surface-related proteins and antibiotics.

Multi-disciplinary management of type 1 and 2 skin tears using a silver-based hydrofiber dressing

Skin tear is a common problem encountered in the emergency department. If it is not properly managed, it can lead to wound infection, skin necrosis and a need for further surgical intervention and skin grafting. Current management is to cleanse the wound, replace the thin skin tear followed by coverage with a dressing that is inducive for wound healing. Several dressings have been suggested for the coverage of these wounds. But, up to now, there has been no mention of the use of a silver-based hydrofiber dressing in the management of this condition. The objective of this study was to explore the use of a silver-based hydrofiber dressing for the management of paper-thin skin tears. We retrospectively reviewed all patients with Type 1 or 2 skin tears that had undergone management using a silver-based hydrofiber dressing between October 2019 and October 2020. Demographic data and medical history was obtained by retrospective chart review. Data that was collected included: age, sex, comorbid illnesses, defect location, defect size, complications, number of times the silver-based hydrofiber dressing was replaced and the number of days required to achieve complete wound healing. A total of 65 patients were included in the study. There were 42 males and 23 females. There were 28 patients whose age was greater then 85 years old, of which 14 patients were over 90 years old. The mean number of outpatient visits was 2. The mean defect size was 33 cm2 (range 1 cm × 1 cm to 18 × 10 cm). The mean number of days required for total wound healing was 13 days (range 7-21). We did not encounter any patients that required further surgical debridement or split-thickness skin grafting. The use of a silver-based hydrofiber dressing was well tolerated by the elderly population as it provided an easy, efficient, economical and effective form of management of skin tears. We suggest that a silver-based hydrofiber dressing can be used as a first-line treatment method for type 1 and 2 skin tears.

Antimicrobial Wound Dressings: A Concise Review for Clinicians

Wound management represents a substantial clinical challenge due to the growing incidence of chronic skin wounds resulting from venous insufficiency, diabetes, and obesity, along with acute injuries and surgical wounds. The risk of infection, a key impediment to healing and a driver of increased morbidity and mortality, is a primary concern in wound care. Recently, antimicrobial dressings have emerged as a promising approach for bioburden control and wound healing. The selection of a suitable antimicrobial dressing depends on various parameters, including cost, wound type, local microbial burden and the location and condition of the wound. This review covers the different types of antimicrobial dressings, their modes of action, advantages, and drawbacks, thereby providing clinicians with the knowledge to optimize wound management.

Metal complexes of xanthine and its derivatives: Synthesis and biological activity

Xanthine and its derivatives are considered an important class of N-heterocyclic purine compounds that have gained significant importance in medicinal chemistry. N-heterocyclic carbene (NHC) and N-coordinated metal complexes of xanthine and its derivatives have revealed a range of new possibilities for their use as therapeutic agents in addition to their established catalytic behavior. The metal complexes of xanthine and its derivatives have been designed and synthesized for the exploration of their potential therapeutic applications. These metal complexes based on the xanthine scaffold exhibited various potential medicinal applications including anticancer, antibacterial, and antileishmanial activity. The metal complexes of xanthine and its derivatives shall pave the way for the rational design and development of new therapeutic agents. In the present comprehensive review, we highlighted the recent advancements in the synthesis and medicinal applications of metal complexes based on N-heterocyclic carbene (NHC) derived from xanthine scaffolds.

Hydrogel-Containing Biogenic Silver Nanoparticles: Antibacterial Action, Evaluation of Wound Healing, and Bioaccumulation in Wistar Rats

Wound infections are feared complications due to their potential to increase healthcare costs and cause mortality since multidrug-resistant bacteria reduce treatment options. This study reports the development of a carbomer hydrogel containing biogenic silver nanoparticles (bioAgNPs) and its effectiveness in wound treatment. This hydrogel showed in vitro bactericidal activity after 2 h, according to the time-kill assay. It also reduced bacterial contamination in rat wounds without impairing their healing since the hydrogel hydrophilic groups provided hydration for the injured skin. The high number of inflammatory cells in the first days of the skin lesion and the greater degree of neovascularization one week after wound onset showed that the healing process occurred normally. Furthermore, the hydrogel-containing bioAgNPs did not cause toxic silver accumulation in the organs and blood of the rats. This study developed a bioAgNP hydrogel for the treatment of wounds; it has a potent antimicrobial action without interfering with cicatrization or causing silver bioaccumulation. This formulation is effective against bacteria that commonly cause wound infections, such as Pseudomonas aeruginosa and Staphylococcus aureus, and for which new antimicrobials are urgently needed, according to the World Health Organization's warning.

Antibacterial Properties of Mesoporous Silica Nanoparticles Modified with Fluoroquinolones and Copper or Silver Species

Antibiotic resistance is a global problem and bacterial biofilms contribute to its development. In this context, this study aimed to perform the synthesis and characterization of seven materials based on silica mesoporous nanoparticles functionalized with three types of fluoroquinolones, along with Cu2+ or Ag+ species to evaluate the antibacterial properties against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa, including clinical and multi-drug-resistant strains of S. aureus and P. aeruginosa. In addition, in order to obtain an effective material to promote wound healing, a well-known proliferative agent, phenytoin sodium, was adsorbed onto one of the silver-functionalized materials. Furthermore, biofilm studies and the generation of reactive oxygen species (ROS) were also carried out to determine the antibacterial potential of the synthesized materials. In this sense, the Cu2+ materials showed antibacterial activity against S. aureus and E. coli, potentially due to increased ROS generation (up to 3 times), whereas the Ag+ materials exhibited a broader spectrum of activity, even inhibiting clinical strains of MRSA and P. aeruginosa. In particular, the Ag+ material with phenytoin sodium showed the ability to reduce biofilm development by up to 55% and inhibit bacterial growth in a "wound-like medium" by up to 89.33%.

Nanocrystalline Silver Layer of Knitted Polyester Outperforms Other Silver-Containing Wound Dressings in an In Vitro Wound Model

Background Silver possesses cytotoxic properties against many microorganisms and is regularly used in wound care. Current evidence supporting the use of one type of silver-containing wound dressing (SCWD) is insufficient. Materials and methods To examine the ability of selected SCWDs to inhibit the growth of two strains of bacteria (Escherichia coli and Staphylococcus aureus) commonly found in wounds, an in vitro wound model was used. Bacteria were applied to the surface of nutrient agar, and a piece of each SCWD was applied to the bacteria. The plates were incubated at 37°C overnight. The zone of inhibition (ZI) around each SCWD was measured in cm2. Results The mean ZI for Acticoat Flex-3 on E. coli was 1.59 ± 0.15 cm2, which was significantly greater than that observed for Aquacel Ag (p<0.001), Mepilex Ag (p<0.0001), Mepitel Ag (p<0.001), Optifoam (p<0.0001), and Tegaderm Alginate Ag (p<0.01), but statistically indistinguishable from Maxorb II Ag. The mean ZI on S. aureus was 1.21 ± 0.16 cm2, which was greater than Aquacel Ag (p<0.05), Mepilex (p<0.0001), Optifoam (p<0.0001), and Tegaderm Alginate Ag (p<0.05), but statistically indistinguishable from Maxorb II Ag or Mepitel Ag. Conclusion Of the SCWDs tested, Acticoat Flex-3 demonstrated the most robust antimicrobial effect. Herein, we show that Acticoat Flex-3 may provide the most wound protection against bacterial infection. In conclusion, these data provide clinicians with additional independent evidence to inform their clinical practice on the use of specific wound dressings.

Self-Sanitizing Polycaprolactone Electrospun Nanofiber Membrane with Ag Nanoparticles

The objective of this research was to develop an environment-friendly and scalable method for the production of self-sanitizing electrospun nanofibers. This was achieved by immobilizing silver nanoparticles (Ag NPs) onto plasma-treated surfaces of biodegradable polycaprolactone (PCL) nanofibers. The plasma deposited polymer layer containing carboxyl groups played a critical role in providing a uniform distribution of Ag NPs on the nanofiber surface. Ag ions were absorbed by electrostatic interaction and then reduced under the action of UV-light. The concentration and release of Ag ions were analyzed using the EDXS/XPS and ICP AES methods, respectively. Although high levels of Ag ions were detected after 3 h of immersion in water, the material retained a sufficient amount of silver nanoparticles on the surface (~2.3 vs. 3.5 at.% as determined by XPS), and the release rate subsequently decreased over the next 69 h. The antipathogenic properties of PCL-Ag were tested against gram-negative and gram-positive bacteria, fungi, and biofilm formation. The results showed that the PCL-Ag nanofibers exhibit significant antimicrobial activity against a wide range of microorganisms, including those that cause human infections. The incorporation of Ag NPs into PCL nanofibers resulted in a self-sanitizing material that can be used in variety of applications, including wound dressings, water treatment, and air filtration. The development of a simple, scalable, and environmentally friendly method for the fabrication of these nanofibers is essential to ensure their widespread use in various industries. The ability to control the concentration and release rate of Ag ions in the PCL nanofibers will be critical to optimize their efficacy while minimizing their potential toxicity to human cells and the environment.

Structure-Activity Relationships in NHC-Silver Complexes as Antimicrobial Agents

Silver has a long history of antimicrobial activity and received an increasing interest in last decades owing to the rise in antimicrobial resistance. The major drawback is the limited duration of its antimicrobial activity. The broad-spectrum silver containing antimicrobial agents are well represented by N-heterocyclic carbenes (NHCs) silver complexes. Due to their stability, this class of complexes can release the active Ag⁺ cations in prolonged time. Moreover, the properties of NHC can be tuned introducing alkyl moieties on N-heterocycle to provide a range of versatile structures with different stability and lipophilicity. This review presents designed Ag complexes and their biological activity against Gram-positive, Gram-negative bacteria and fungal strains. In particular, the structure-activity relationships underlining the major requirements to increase the capability to induce microorganism death are highlighted here. Moreover, some examples of encapsulation of silver-NHC complexes in polymer-based supramolecular aggregates are reported. The targeted delivery of silver complexes to the infected sites will be the most promising goal for the future.

Enhanced effectiveness of silver diamine fluoride application with light curing on natural dentin carious lesions: an in vitro study

This study aimed to compare the mean mineral density difference (mMDD) and surface morphology of 10- and 60-s silver diamine fluoride (SDF)-applied dentin carious lesions and to study the effect of an additional 20-s light curing (LC) on SDF-treated teeth. Forty primary molar blocks with natural dentin carious lesions were measured for baseline lesion depth and mineral density using Image-Pro Plus software. The samples were randomly distributed into 4 groups; 38% SDF applied for 1) 10-s (10SDF), 2) 60-s (60SDF), 3) 10-s + LC (10SDF + LC), 4) 60-s + LC (60SDF + LC) and an additional control group to assess the outcome of pH-cycling only. Then all the groups underwent a 7-d bacterial pH-cycling. The dentin carious lesions' mMDD was determined by digital subtraction radiographic analysis. The surface morphology and elemental profile were assessed by scanning electron microscopy and energy-dispersive X-ray spectroscopy. The mMDD of the dentin lesions was analyzed using two-way ANOVA, generalized linear models analysis. Light curing was the only factor that affected the mMDD (p = 0.007). The mMDD in the 10SDF + LC and 60SDF + LC groups were significantly higher than those without light curing (p = 0.041 and 0.041, respectively). The 60SDF + LC group demonstrated a significantly higher mMDD than the 10SDF group (p = 0.010), while that in the 10SDF + LC group was similar to the 60SDF group (p = 1.00). Scanning electron microscopy revealed denser mineral content layers, which were likely silver and chloride, in the 10SDF + LC and 60SDF + LC groups than in the 10SDF and 60SDF groups, respectively. In conclusion, shortened application time with light curing enhanced SDF remineralization similarly to the conventional method.

Novel Study Antimicrobial and Biocompatibility Effect of Magnesium Silver Alloys 1% on Bovine Bacterial Species

MgAg 1% alloys inhibit bacterial growth during the dry-off period. MgAg1% silver and magnesium amount was determined and the supernatant was used for the detection of antibacterial tests against S. aureus and E. coli and Geobacillus stearothermophilus var. calidolacits. The antibacterial effect of AgNO3 solution and degradation medium of MgAg1% sticks were evaluated. The bouillon dilution test showed a 5-fold reduction in bacterial colonies. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) calculations were used to test the antibacterial activity. The Brilliant Black Reduction Test (BRT-MRL screening test) showed inhibition of Geobacillus stearothermophilus bacteria at AgNO3 concentrations 0.01 mmol/l and 3 ml of degradation medium. Results were satisfying, concerning biocompatibility, degradation, and antibacterial effects.

Multifunctional, Adhesive, and PDA-Coated Bioactive Glass Reinforced Composite Hydrogel for Regenerative Wound Healing

Effective wound management imposes several challenges in clinical outcomes due to the complexity of the wound microenvironment, bacterial infections, impaired angiogenesis, aggravated inflammation, and enduring pain. In addition, adhesion on wet biological tissue is another extremely challenging task. Addressing all the issues is necessary for an effective wound healing process. Herein, we developed a unique multifunctional, adhesive composite hydrogel composed of gelatin, chitosan, polydopamine-coated bioactive glass (BG), and curcumin-capped silver nanoparticles (Cur-AgNPs) to target the multifaceted complexity of the wound. The PDA-coated BG serves multiple purposes: (1) adhesivity: catechol groups of PDA and Ca ion released from BG chelate the group present in the hydrogel network and surrounding tissues, (2) angiogenesis: promotes vascularization due to the release of Si from BG, and (3) BG also serves as the "reservoir" for the pain-relieving diclofenac sodium drug with a sustained-release behavior. Cur-AgNPs provide excellent bactericidal and anti-inflammatory properties to the composite hydrogel. In situ application of the composite hydrogel could serve the purpose of a "skin biomimetic" and work as a barrier along with bactericidal properties to inhibit the microbial growth. The multifunctional composite hydrogel (MCH) targeted multiple aspects of wound repair including pain alleviation, elimination of microbes (up to 99%), reduced inflammation, high adhesivity, and increased angiogenesis for effective skin regeneration. The MCH showed excellent wound healing potential as significant wound closure was observed at day 7 and also significantly upregulated the expression of crucial genes involved in the skin regeneration process along with increasing vascularization in the wound area.

Mechanochemical Preparation, Solid-State Characterization, and Antimicrobial Performance of Copper and Silver Nitrate Coordination Polymers with L- and DL-Arginine and Histidine

The antimicrobial activity of the novel coordination polymers obtained by co-crystallizing the amino acids arginine or histidine, as both enantiopure L and racemic DL forms, with the salts Cu(NO3)2 and AgNO3 has been investigated to explore the effect of chirality in the cases of enantiopure and racemic forms. The compounds [Cu·AA·(NO3)2]CPs and [Ag·AA·NO3]CPs (AA = L-Arg, DL-Arg, L-His, DL-His) were prepared by mechanochemical, slurry, and solution methods and characterized by X-ray single-crystal and powder diffraction in the cases of the copper coordination polymers, and by powder diffraction and by solid-state NMR spectroscopy in the cases of the silver compounds. The two pairs of coordination polymers, [Cu·L-Arg·(NO3)2·H2O]CP and [Cu·DL-Arg·(NO3)2·H2O]CP, and [Cu·L-Hys·(NO3)2·H2O]CP and [Cu·DL-His·(NO3)2·H2O]CP, have been shown to be isostructural in spite of the different chirality of the amino acid ligands. A similar structural analogy could be established for the silver complexes on the basis of SSNMR. The activity against the bacterial pathogens Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus was assessed by carrying out disk diffusion assays on lysogeny agar media showing that, while there is no significant effect arising from the use of enantiopure or chiral amino acids, the coordination polymers exert an appreciable antimicrobial activity comparable, when not superior, to that of the metal salts alone.

Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface

Despite the huge improvements made in adhesive technology over the past 50 years, there are still some unresolved issues regarding the durability of the adhesive interface. A complete sealing of the interface between the resin and the dentin substrate remains difficult to achieve, and it is doubtful whether an optimal interdiffusion of the adhesive system within the demineralized collagen framework can be produced in a complete and homogeneous way. In fact, it is suggested that hydrolytic degradation, combined with the action of dentin matrix enzymes, destabilizes the tooth-adhesive bond and disrupts the unprotected collagen fibrils. While a sufficient resin–dentin adhesion is usually achieved immediately, bonding efficiency declines over time. Thus, here, a review will be carried out through a bibliographic survey of scientific articles published in the last few years to present strategies that have been proposed to improve and/or develop new adhesive systems that can help prevent degradation at the adhesive interface. It will specially focus on new clinical techniques or new materials with characteristics that contribute to increasing the durability of adhesive restorations and avoiding the recurrent replacement restorative cycle and the consequent increase in damage to the tooth.

Treatment of infection and inflammation associated with COVID-19, multi-drug resistant pneumonia and fungal sinusitis by nebulizing a nanosilver solution

Solutions containing Ag⁰ nanoclusters, Ag⁺¹, and higher oxidation state silver, generated from nanocrystalline silver dressings, were anti-inflammatory against porcine skin inflammation. The dressings have clinically-demonstrated broad-spectrum antimicrobial activity, suggesting application of nanosilver solutions in treating pulmonary infection. Nanosilver solutions were tested for antimicrobial efficacy; against HSV-1 and SARS-CoV-2; and nebulized in rats with acute pneumonia. Patients with pneumonia (ventilated), fungal sinusitis, burns plus COVID-19, and two non-hospitalized patients with COVID-19 received nebulized nanosilver solution. Nanosilver solutions demonstrated pH-dependent antimicrobial efficacy; reduced infection and inflammation without evidence of lung toxicity in the rat model; and inactivated HSV-1 and SARS-CoV-2. Pneumonia patients had rapidly reduced pulmonary symptoms, recovering pre-illness respiratory function. Fungal sinusitis-related inflammation decreased immediately with infection clearance within 21 days. Non-hospitalized patients with COVID-19 experienced rapid symptom remission. Nanosilver solutions, due to anti-inflammatory, antiviral, and antimicrobial activity, may be effective for treating respiratory inflammation and infections caused by viruses and/or microbes.

Metals and metal oxides polymer frameworks as advanced anticorrosive materials: design, performance, and future direction

Metals (Ms) and metal oxides (MOs) possess a strong tendency to coordinate and combine with organic polymers to form respective metal–polymer frameworks (MPFs) and metal oxide polymer frameworks (MOPFs). MPFs and MOPFs can be regarded as composites of organic polymers. MPFs and MOPFs are widely used for industrial and biological applications including as anticorrosive materials in the aqueous phase as well as in the coating conditions. The presence of the Ms and MOs in the polymer coatings improves the corrosion inhibition potential of MPFs and MOPFs by improving their self-healing properties. The Ms and MOs fill the micropores and cracks through which corrosive species such as water, oxygen, and corrosive ions and salts can diffuse and destroy the coating structures. Therefore, the Ms and MOs enhance the durability as well as the effectiveness of the polymer coatings. The present review article is intended to describe the corrosion inhibition potential of some MPFs and MOPFs of some most frequently utilized transition metal elements such as Ti, Si, Zn, Ce, Ag, and Au. The mechanism of corrosion inhibition of MPFs and MOPFs is also described in the presence and absence of metal and metal oxides.

Arbutin Stabilized Silver Nanoparticles: Synthesis, Characterization, and Its Catalytic Activity against Different Organic Dyes

In this study, we report one-pot, single step synthesis of silver nanoparticles stabilized by using arbutin. The concentration of reducing agent (NaBH4) used in the preparation was kept at double, and arbutin was used as a stabilizing agent. The confirmation of prepared silver nanoparticles was done by color change and UV-Vis surface plasmon resonance peak at 435 nm in UV-Vis spectrum. Size dispersion of nanoparticles was carried out by Dynamic Light Scattering (DLS) and surface charge on nanoparticles. Stability was analyzed by Zeta potential. A strong negative charge indicated that nanoparticles are well stabilized throughout the solution. Morphology and 3D topographic images were obtained by Atomic Force Microscopy (AFM). The crystalline nature of nanoparticles was elucidated by X-ray diffraction analysis. The size and morphology of solid, well-grinded nanoparticles was proceeded by Scanning Electron Microscopy (SEM). The catalytic activities of nanoparticles were carried out against methylene blue, methyl orange, safranin, and eosin. The results demonstrated that synthesized silver nanoparticles commenced the degradation reaction of dyes mentioned. Prepared silver nanoparticles are found to have adequate catalytic activity, as it can be comprehended in time-dependent UV-Vis spectrums of dyes after treating them with AgNPs.

Intramolecular Folding of PolyT Oligonucleotides Induced by Cooperative Binding of Silver(I) Ions

Ag⁺-bridged T-Ag⁺-T was recently discovered in a Ag⁺-DNA nanowire crystal, but it was reported that Ag⁺ had little to no affinity to T nucleobases and T-rich oligonucleotides in solution. Therefore, the binding mode for the formation of this type of novel metallo base pair in solution is elusive. Herein, we demonstrate that Ag⁺ can interact with polyT oligonucleotides once the concentration of Ag⁺ in solution exceeds a threshold value. The threshold value is independent of the concentration of the polyT oligonucleotide but is inversely proportional to the length of the polyT oligonucleotide. The polyT oligonucleotides are intramolecularly folded due to their positively cooperative formation and the stack of T-Ag⁺-T base pairs, resulting in the 5'- and 3'-ends being in close proximity to each other. The intramolecular Ag⁺-folded polyT oligonucleotide has a higher thermal stability than the duplex and can be reversibly modulated by cysteine.

Clinical and primary evidence of silver diamine fluoride on root caries management

Root caries is a growing problem for the worldwide aging population. Silver diamine fluoride (SDF) contains high concentrations of silver and fluoride ions, which prevents and arrests root caries, as well as dentin caries in the primary teeth of young children. Unlike other fluoride products that mainly reduce the formation of new carious lesions, 38% SDF is an effective agent that can efficiently arrest the carious process, remineralize the decayed dental tissues, and protect the tooth structure against the formation of new caries lesions. The use of SDF can result in more caries-resistant tooth structures. Despite these merits, its clinical disadvantages are the deep penetration of silver ions and sequential formation of silver compounds, which cause esthetic concern due to the discoloration and impaired efficacy of dentin bonding after using SDF. Thus, this narrative review, by addressing the primary experimental results and clinical applications of SDF on root caries, proposes management methods for root caries in conjunction with the application of SDF. We propose a two-visit treatment protocol to take advantage of the SDF application for root surface caries and utilize the discoloration caused by SDF.

The effects of aqueous extract of Labisia Pumila (Blume) Fern.-Vill. Var. Alata on wound contraction, hydroxyproline content and histological assessments in superficial partial thickness of second-degree burn model

Background: Burns are considered a critical care problem in emergency medicine, resulting in physical, psychological, and chronic disabilities. Silver sulfadiazine is the gold standard in topical burn treatment but was associated with toxicity to keratinocytes and fibroblasts, which may delay wound healing. In discovering potential alternative treatments for burn wound healing, this study was performed to determine the effect of Labisia Pumila (Blume) Fern.-Vill. Var. Alata (LPVa) extract on thermal-burn wounds in rats.

Methods: A total of 50 Sprague-Dawley male rats were categorized into five groups. There were three control groups; normal control (left untreated), negative control (given ointment base) and positive control (given silver sulfadiazine). Meanwhile, the two intervention groups were given with 2% LPVa leaf and root extracts, respectively. Burn wounds were inflicted on the loin region of the rat by applying a heated steel rod at 80°C for 10 s. On days 3, 7, 14, and 21, wounds were measured macroscopically using a digital calliper and one animals of each group were sacrificed, and the wounded skin were excised for histomorphological assessments. The wounds were excised for hydroxyproline content on Day 14 of treatment.

Result: For wound contraction percentage, both the leaf and root extracts of LPVa showed a significant reduction in burn wound size on Day 7 onwards, when compared to other groups. For hydroxyproline content, only the leaf extract of LPVa produced significantly higher content compared to both negative and normal control groups. In terms of histological examination, the leaf extract group demonstrated a superior healing effect than the root extract group.

Conclusion: Both leaf and root extracts of LPVa could promote wound healing in the thermal-burn wound rat model, with leaf extract being superior to root extract.

Curcumin and Capsaicin-Loaded Ag-Modified Mesoporous Silica Carriers: A New Alternative in Skin Treatment

Biologically active substances of natural origin offer a promising alternative in skin disease treatment in comparison to synthetic medications. The limiting factors for the efficient application of natural compounds, such as low water solubility and low bioavailability, can be easily overcome by the development of suitable delivery systems. In this study, the exchange with the template procedure was used for the preparation ofa spherical silver-modified mesoporous silica nanocarrier. The initial and drug-loaded formulations are fully characterized by different physico-chemical methods. The incipient wetness impregnation method used to load health-promoting agents, curcumin, and capsaicin in Ag-modified carriers separately or in combinationresulted in high loading efficiency (up to 33 wt.%). The interaction between drugs and carriers was studied by ATR-FTIR spectroscopy. The release experiments of both active substances from the developed formulations were studied in buffers with pH 5.5, and showed improved solubility. Radical scavenging activity and ferric-reducing antioxidant power assays were successfully used for the evaluation of the antiradical and antioxidant capacity of the curcumin or/and capsaicin loaded on mesoporous carriers. Formulations containing a mixture of curcumin and capsaicin were characterized bypotentiation of their antiproliferative effect against maligning cells, and it was confirmed that the system for simultaneous delivery of both drugs has lower IC₅₀ values than the free substances.The antibacterial tests showed better activity of the obtained delivery systems in comparison with the pure curcumin and capsaicin. Considering the obtained results, it can be concluded that the obtained delivery systems are promising for potential dermal treatment.

Synthesis and Biological Characterization of Phyto-Fabricated Silver Nanoparticles from Azadirachta indica

Nanoparticles (NPs) have garnered a lot of interest in sectors like medicine, cosmetics, food, and pharmaceuticals for antibacterial catalytic properties, reduced toxicity, and easy production. Biological synthesis of silver nanoparticle (AgNPs) is considered as green, eco-friendly, and cost-effective approach; therefore, Azadirachta indica extracts were utilized for a dual role of fabrication and functionalization of AgNPs. Optical and physical characterizations were achieved for confirming the biosynthesized AgNPs. SEM images detected quasi-spherical AgNPs of 44.04 to 66.50 nm. Some of potent phytochemicals like flavonoids and proteins from Azadirachta indica formed a strong coating or capping on the AgNPs without affecting their secondary structure by interacting with Ag+ and NPs for the formation of AgNPs. AgNPs exhibited strong antibacterial activity (MIC 10 μg/ml) against multidrug-resistant bacteria Enterococcus faecalis; at different concentrations, no IC50 values were recorded for AgNPs as well as Azadirachta indica signifying low cytotoxicity in the exposed concentration range. The DNA degradation activity of AgNPs through the TUNEL assay revealed no significant increase in the overall FITC mean fluorescence intensity as well as a DNA fragmentation index with 5.45% DNA damage (10 μg/ml AgNPs). Drug uptake of AgNPs was also investigated through a permeability assay via Caco-2 cell lines at test concentrations where apparent permeability was detected as moderate.

Significant and rapid reduction of free endotoxin using a dialkylcarbamoyl chloride-coated wound dressing

OBJECTIVE

Endotoxin causes inflammation and can impair wound healing. Conventional methods that reduce bioburden in wounds by killing microorganisms using antibiotics, topical antimicrobials or antimicrobial dressings may induce endotoxin release from Gram-negative bacteria. Another approach is to reduce bioburden by adsorbing microorganisms, without killing them, using dialkylcarbamoyl chloride (DACC)-coated wound dressings. This study evaluated the endotoxin-binding ability of a DACC-coated wound dressing (Sorbact Compress, Abigo Medical AB, Sweden) in vitro, including its effect on the level of natural endotoxin released from Gram-negative bacteria.

METHOD

Different concentrations of purified Pseudomonas aeruginosa endotoxin and a DACC-coated dressing were incubated at 37°C for various durations. After incubation, the dressing was removed and endotoxin concentration in the solution was quantified using a Limulus amebocyte lysate (LAL) assay. The DACC-coated dressing was also incubated with Pseudomonas aeruginosa cells for one hour at 37°C. After incubation, the dressing and bacterial cells were removed and shed endotoxin remaining in the solution was quantified.

RESULTS

Overnight incubation of the DACC-coated wound dressing with various concentrations of purified Pseudomonas aeruginosa endotoxin (96-11000 EU/ml) consistently and significantly reduced levels of free endotoxin by 93-99% (p<0.0001). A significant endotoxin reduction of 39% (p<0.001) was observed after five minutes. The DACC-coated dressing incubated with clinically relevant Pseudomonas aeruginosa cells also reduced shed endotoxin by >99.95% (p<0.0001).

CONCLUSION

In this study, we showed that a DACC-coated wound dressing efficiently and rapidly binds both purified and shed endotoxin from Pseudomonas aeruginosa in vitro. This ability to remove both endotoxin and bacterial cells could promote the wound healing process.

A Review on Antibacterial Biomaterials in Biomedical Applications: From Materials Perspective to Bioinks Design

In tissue engineering, three-dimensional (3D) printing is an emerging approach to producing functioning tissue constructs to repair wounds and repair or replace sick tissue/organs. It allows for precise control of materials and other components in the tissue constructs in an automated way, potentially permitting great throughput production. An ink made using one or multiple biomaterials can be 3D printed into tissue constructs by the printing process; though promising in tissue engineering, the printed constructs have also been reported to have the ability to lead to the emergence of unforeseen illnesses and failure due to biomaterial-related infections. Numerous approaches and/or strategies have been developed to combat biomaterial-related infections, and among them, natural biomaterials, surface treatment of biomaterials, and incorporating inorganic agents have been widely employed for the construct fabrication by 3D printing. Despite various attempts to synthesize and/or optimize the inks for 3D printing, the incidence of infection in the implanted tissue constructs remains one of the most significant issues. For the first time, here we present an overview of inks with antibacterial properties for 3D printing, focusing on the principles and strategies to accomplish biomaterials with anti-infective properties, and the synthesis of metallic ion-containing ink, chitosan-containing inks, and other antibacterial inks. Related discussions regarding the mechanics of biofilm formation and antibacterial performance are also presented, along with future perspectives of the importance of developing printable inks.

First Report on the Phenotypic and Genotypic Susceptibility Profiles to Silver Nitrate in Bacterial Strains Isolated from Infected Leg Ulcers in Romanian Patients

Silver-ion-based antiseptics are widely used in treating chronic leg ulcers and, given the emergence of resistance to such compounds, the investigation of silver susceptibility and resistance profiles of pathogenic strains isolated from this type of wound is a topic of great interest. Therefore, in this study, 125 bacterial strains isolated from 103 patients with venous ulcers were investigated to elucidate their susceptibility to silver-nitrate solutions in planktonic and biofilm growth states, and the associated genetic determinants. The isolated strains, both in the planktonic and biofilm growth phases, showed high sensitivity to the standard concentration of 1/6000 silver-nitrate solution. It was noticed that even at concentrations lower than the clinical one (the first 2–3 binary dilutions in the case of planktonic cultures and the first 6–7 binary dilutions in the case of biofilms), the antiseptic solution proved to maintain its antibacterial activity. The phenotypic results were correlated with the genetic analysis, highlighting the presence of silver-resistance genes (sil operon) in only a few of the tested Staphylococcus sp. (especially in S. aureus) strains, Escherichia coli and Pseudomonas aeruginosa strains. These results demonstrate that despite its large use, this antiseptic remains a viable treatment alternative for the management of chronic leg wounds.

Advances in the Sensing and Treatment of Wound Biofilms

Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor-based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point-of-care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound-induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.

Engineered Nanotechnology: An Effective Therapeutic Platform for the Chronic Cutaneous Wound

The healing of chronic wound infections, especially cutaneous wounds, involves a complex cascade of events demanding mutual interaction between immunity and other natural host processes. Wound infections are caused by the consortia of microbial species that keep on proliferating and produce various types of virulence factors that cause the development of chronic infections. The mono- or polymicrobial nature of surface wound infections is best characterized by its ability to form biofilm that renders antimicrobial resistance to commonly administered drugs due to poor biofilm matrix permeability. With an increasing incidence of chronic wound biofilm infections, there is an urgent need for non-conventional antimicrobial approaches, such as developing nanomaterials that have intrinsic antimicrobial-antibiofilm properties modulating the biochemical or biophysical parameters in the wound microenvironment in order to cause disruption and removal of biofilms, such as designing nanomaterials as efficient drug-delivery vehicles carrying antibiotics, bioactive compounds, growth factor antioxidants or stem cells reaching the infection sites and having a distinct mechanism of action in comparison to antibiotics—functionalized nanoparticles (NPs) for better incursion through the biofilm matrix. NPs are thought to act by modulating the microbial colonization and biofilm formation in wounds due to their differential particle size, shape, surface charge and composition through alterations in bacterial cell membrane composition, as well as their conductivity, loss of respiratory activity, generation of reactive oxygen species (ROS), nitrosation of cysteines of proteins, lipid peroxidation, DNA unwinding and modulation of metabolic pathways. For the treatment of chronic wounds, extensive research is ongoing to explore a variety of nanoplatforms, including metallic and nonmetallic NPs, nanofibers and self-accumulating nanocarriers. As the use of the magnetic nanoparticle (MNP)-entrenched pre-designed hydrogel sheet (MPS) is found to enhance wound healing, the bio-nanocomposites consisting of bacterial cellulose and magnetic nanoparticles (magnetite) are now successfully used for the healing of chronic wounds. With the objective of precise targeting, some kinds of “intelligent” nanoparticles are constructed to react according to the required environment, which are later incorporated in the dressings, so that the wound can be treated with nano-impregnated dressing material in situ. For the effective healing of skin wounds, high-expressing, transiently modified stem cells, controlled by nano 3D architectures, have been developed to encourage angiogenesis and tissue regeneration. In order to overcome the challenge of time and dose constraints during drug administration, the approach of combinatorial nano therapy is adopted, whereby AI will help to exploit the full potential of nanomedicine to treat chronic wounds.

Prevention and treatment of burn wound infections: the role of topical antimicrobials

INTRODUCTION

Infections related to the skin are the principal drivers of morbidity and mortality following severe burn, therefore a diverse armamentarium of topical antimicrobial agents were developed over the history of burn care. The last 30 years witnessed dramatic changes in the application of surgical intervention and utilization of topical therapies.

AREAS COVERED

We explore well-known topical antimicrobial products used in burn care. First, we investigate how fundamental changes in the practice of burn surgery influenced the choice of topical therapies used. Then, we examine antimicrobial creams and ointments commonly recognized due to their long record of use in burn care. Next, we dive into antimicrobial solutions commonly used as adjuncts to surgical intervention. Finally, we explore representative antimicrobial dressings, an ever-advancing roster of products opening the door to the next era in burn care. We also describe how these new agents relate to already established tools in present-day burn care.

EXPERT OPINION

In the current day, though the wisdom of early excision and wound closure remains valid, we continue to strive to minimize aggressive wound excision and disfiguring donor tissue collection while securing rapid wound closure. To this end, antimicrobial therapies are titrated to optimize operative outcomes and provide non-operative wound care when appropriate. Antimicrobial agents bridge the gap with the next generation of skin substitute and skin replacement therapies.

Nanoapatites Doped and Co-Doped with Noble Metal Ions as Modern Antibiofilm Materials for Biomedical Applications against Drug-Resistant Clinical Strains of Enterococcus faecalis VRE and Staphylococcus aureus MRSA

The main aim of our research was to investigate antiadhesive and antibiofilm properties of nanocrystalline apatites doped and co-doped with noble metal ions (Ag⁺, Au⁺, and Pd²⁺) against selected drug-resistant strains of Enterococcus faecalis and Staphylococcus aureus. The materials with the structure of apatite (hydroxyapatite, nHAp; hydroxy-chlor-apatites, OH-Cl-Ap) containing 1 mol% and 2 mol% of dopants and co-dopants were successfully obtained by the wet chemistry method. The majority of them contained an additional phase of metallic nanoparticles, in particular, AuNPs and PdNPs, which was confirmed by the XRPD, FTIR, UV–Vis, and SEM–EDS techniques. Extensive microbiological tests of the nanoapatites were carried out determining their MIC, MBC value, and FICI. The antiadhesive and antibiofilm properties of the tested nanoapatites were determined in detail with the use of fluorescence microscopy and computer image analysis. The results showed that almost all tested nanoapatites strongly inhibit adhesion and biofilm production of the tested bacterial strains. Biomaterials have not shown any significant cytotoxic effect on fibroblasts and even increased their survival when co-incubated with bacterial biofilms. Performed analyses confirmed that the nanoapatites doped and co-doped with noble metal ions are safe and excellent antiadhesive and antibiofilm biomaterials with potential use in the future in medical sectors.

A review of recent advances in metal ion hydrogels: mechanism, properties and their biological applications

The mechanisms, common properties and biological applications of different types of metal ion hydrogels are summarized.

Biomaterials assisted reconstructive urology: The pursuit of an implantable bioengineered neo-urinary bladder

Urinary bladder is a dynamic organ performing complex physiological activities. Together with ureters and urethra, it forms the lower urinary tract that facilitates urine collection, low-pressure storage, and volitional voiding. However, pathological disorders are often liable to cause irreversible damage and compromise the normal functionality of the bladder, necessitating surgical intervention for a reconstructive procedure. Non-urinary autologous grafts, primarily derived from gastrointestinal tract, have long been the gold standard in clinics to augment or to replace the diseased bladder tissue. Unfortunately, such treatment strategy is commonly associated with several clinical complications. In absence of an optimal autologous therapy, a biomaterial based bioengineered platform is an attractive prospect revolutionizing the modern urology. Predictably, extensive investigative research has been carried out in pursuit of better urological biomaterials, that overcome the limitations of conventional gastrointestinal graft. Against the above backdrop, this review aims to provide a comprehensive and one-stop update on different biomaterial-based strategies that have been proposed and explored over the past 60 years to restore the dynamic function of the otherwise dysfunctional bladder tissue. Broadly, two unique perspectives of bladder tissue engineering and total alloplastic bladder replacement are critically discussed in terms of their status and progress. While the former is pivoted on scaffold mediated regenerative medicine; in contrast, the latter is directed towards the development of a biostable bladder prosthesis. Together, these routes share a common aspiration of designing and creating a functional equivalent of the bladder wall, albeit, using fundamentally different aspects of biocompatibility and clinical needs. Therefore, an attempt has been made to systematically analyze and summarize the evolution of various classes as well as generations of polymeric biomaterials in urology. Considerable emphasis has been laid on explaining the bioengineering methodologies, pre-clinical and clinical outcomes. Some of the unaddressed challenges, including vascularization, innervation, hollow 3D prototype fabrication and urinary encrustation, have been highlighted that currently delay the successful commercial translation. More importantly, the rapidly evolving and expanding concepts of bioelectronic medicine are discussed to inspire future research efforts towards the further advancement of the field. At the closure, crucial insights are provided to forge the biomaterial assisted reconstruction as a long-term therapeutic strategy in urological practice for patients' care.

The Two Weapons against Bacterial Biofilms: Detection and Treatment

Bacterial biofilms are defined as complex aggregates of bacteria that grow attached to surfaces or are associated with interfaces. Bacteria within biofilms are embedded in a self-produced extracellular matrix made of polysaccharides, nucleic acids, and proteins. It is recognized that bacterial biofilms are responsible for the majority of microbial infections that occur in the human body, and that biofilm-related infections are extremely difficult to treat. This is related with the fact that microbial cells in biofilms exhibit increased resistance levels to antibiotics in comparison with planktonic (free-floating) cells. In the last years, the introduction into the market of novel compounds that can overcome the resistance to antimicrobial agents associated with biofilm infection has slowed down. If this situation is not altered, millions of lives are at risk, and this will also strongly affect the world economy. As such, research into the identification and eradication of biofilms is important for the future of human health. In this sense, this article provides an overview of techniques developed to detect and imaging biofilms as well as recent strategies that can be applied to treat biofilms during the several biofilm formation steps.

Advances in the Sensing and Treatment of Wound Biofilms

Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor‐based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point‐of‐care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound‐induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.

Antimicrobial Action of Biocompatible Silver Microspheres and Their Role in the Potential Treatment of Fungal Keratitis

Silver nanoparticles have drawn considerable attention as excellent antimicrobial agents because of their characteristics, including broad antimicrobial spectrum, durable antimicrobial property, and large specific surface area. However, the toxicity of silver nanoparticles limits the in vivo application in the antimicrobial therapy field. Here, we developed a novel silver-based biomaterial to achieve favorable biocompatibility as well as enhanced antimicrobial activity. Silver microspheres (AgMPs) were synthesized using bovine serum albumin as a template and H₂O₂ as an activator. Electron microscopy results showed that AgMPs had a honeycombed inner structure with an approximate diameter of 800 nm. The minimum inhibitory concentration results exhibited that AgMPs had effective antimicrobial action against bacteria and fungi when the concentration was greater than 32 and 16 μg/mL, respectively. The cell proliferation results suggested that AgMPs have no influence on corneal epithelial cell growth when the concentration was under 25 μg/mL. The in vivo antifungal therapy experiments demonstrated that 25 μg/mL AgMPs could effectively combat Candida smooth wound infections. Overall, AgMPs exhibited substantial antimicrobial action on fungi in addition to biosafety on corneal epithelial cells at a concentration within 16-25 μg/mL. Our study shows that AgMPs can be used as an ocular surface drop candidate to treat fungal keratitis.

A Systematic Review: Topical Sucralfate for Burn Wound

BACKGROUND: Topical sucralfate has been used for burn and non-burn skin and mucosal lesion with remarkable results. The healing rate of mucosa is faster than skin lesion. AIM: A current systematic review was conducted to objectively evaluate wound healing benefits of topical sucralfate for burn wound and to show on which degree of burn wound it works compare with another topical agents of burn wound therapy. METHODS: Databases were searched for relevant studies: Google Scholar, PUBMED, and ProQuest. Data sources were searched using MeSH terms: “topical sucralfate” and “burn wound” for all publications up to December 2018. All English papers were included. Only studies performed in humans were included in this study. A total of 2437 publications were found, of which 3 studies met the inclusion criteria and were relevant to be used in this systematic review. The primary outcome was burn wound healing. DATA EXTRACTION: Data from retrieved studies were reviewed and tabulated according to year of publication, study design, human or animal studies, characteristics of the population, and outcomes. DATA SYNTHESIS: A total of 2 randomized controlled trials (RCTs) and 1 observational comparative study were found. All trials are on second degree burn wound patients. Jadad score was used to assess the methodological quality of the RCTs. One RCT and one comparative study demonstrated favorable outcomes with the use of topical sucralfate. There is one publication with no significant differences. CONCLUSIONS: This systematic review shows a noticeably beneficial effect of topical sucralfate for burn wound. It is better than other topical agent in wound healing rate, decreased infection rate and enhancement of epithelialization also granulation with no local or systemic adverse reactions. However, multicenter RCT with larger sample size are needed to make recommendation for burn wound treatment.