Biopolymeric, Nanopatterned, Fibrous Carriers for Wound Healing Applications

A critical overview of challenging roles of medicinal plants in improvement of wound healing technology

PURPOSE

Chronic diseases often hinder the natural healing process, making wound infections a prevalent clinical concern. In severe cases, complications can arise, potentially leading to fatal outcomes. While allopathic treatments offer numerous options for wound repair and management, the enduring popularity of herbal medications may be attributed to their perceived minimal side effects. Hence, this review aims to investigate the potential of herbal remedies in efficiently treating wounds, presenting a promising alternative for consideration.

METHODS

A literature search was done including research, reviews, systematic literature review, meta-analysis, and clinical trials considered. Search engines such as Pubmed, Google Scholar, and Scopus were used while retrieving data. Keywords like Wound healing 'Wound healing and herbal combinations', 'Herbal wound dressing', Nanotechnology and Wound dressing were used.

RESULT

This review provides valuable insights into the role of natural products and technology-based formulations in the treatment of wound infections. It evaluates the use of herbal remedies as an effective approach. Various active principles from herbs, categorized as flavonoids, glycosides, saponins, and phenolic compounds, have shown effectiveness in promoting wound closure. A multitude of herbal remedies have demonstrated significant efficacy in wound management, offering an additional avenue for care. The review encompasses a total of 72 studies, involving 127 distinct herbs (excluding any common herbs shared between studies), primarily belonging to the families Asteraceae, Fabaceae, and Apiaceae. In research, rat models were predominantly utilized to assess wound healing activities. Furthermore, advancements in herbal-based formulations using nanotechnology-based wound dressing materials, such as nanofibers, nanoemulsions, nanofiber mats, polymeric fibers, and hydrogel-based microneedles, are underway. These innovations aim to enhance targeted drug delivery and expedite recovery. Several clinical-based experimental studies have already been documented, evaluating the efficacy of various natural products for wound care and management. This signifies a promising direction in the field of wound treatment.

CONCLUSION

In recent years, scientists have increasingly utilized evidence-based medicine and advanced scientific techniques to validate the efficacy of herbal medicines and delve into the underlying mechanisms of their actions. However, there remains a critical need for further research to thoroughly understand how isolated chemicals extracted from herbs contribute to the healing process of intricate wounds, which may have life-threatening consequences. This ongoing research endeavor holds great promise in not only advancing our understanding but also in the development of innovative formulations that expedite the recovery process.

Phytoconstituent-Loaded Nanofibrous Meshes as Wound Dressings: A Concise Review

In the past, wounds were treated with natural materials, but modern wound dressings include functional elements to expedite the process of healing and to improve skin recovery. Due to their exceptional properties, nanofibrous wound dressings are now the most cutting-edge and desirable option. Similar in structure to the skin’s own extracellular matrix (ECM), these dressings can promote tissue regeneration, wound fluid transportation, and air ductility for cellular proliferation and regeneration owing to their nanostructured fibrous meshes or scaffolds. Many academic search engines and databases, such as Google Scholar, PubMed, and Sciencedirect, were used to conduct a comprehensive evaluation of the literature for the purposes of this investigation. Using the term “nanofibrous meshes” as a keyword, this paper focuses on the importance of phytoconstituents. This review article summarizes the most recent developments and conclusions from studies on bioactive nanofibrous wound dressings infused with medicinal plants. Several wound-healing methods, wound-dressing materials, and wound-healing components derived from medicinal plants were also discussed.

The Antioxidant and In Vitro Wound Healing Activity of Cotyledon orbiculata Aqueous Extract and the Synthesized Biogenic Silver Nanoparticles

The synthesis of silver nanoparticles using biogenic methods, particularly plants, has led to the discovery of several effective nanoparticles. In many instances, plant-derived silver nanoparticles have been shown to have more activity than the plant extract which was used to synthesize the nanoparticles. Silver nanoparticles have been successfully synthesized using the medicinal plant, Cotyledon orbiculata. This is a shrub found in the Western Cape province of South Africa. It has a long history of use in traditional medicine in the treatment of wounds and skin infections. The C. orbiculata synthesized silver nanoparticles (Cotyledon-AgNPs) were reported to have good antimicrobial and anti-inflammatory activities; however, their wound-healing properties have not been determined. This study aimed to determine the wound healing activity of Cotyledon-AgNPs using the scratch assay. Gene expression studies were also done to determine the nanoparticles' mechanism of action. The Cotyledon-AgNPs showed good antioxidant, growth-promoting and cell migration properties. Gene expression studies showed that the C. orbiculata water extract and Cotyledon-AgNPs promoted wound healing by upregulating genes involved in cell proliferation, migration and growth while downregulating pro-inflammatory genes. This confirms, for the first time that a water extract of C. orbiculata and silver nanoparticles synthesized from this extract are good wound-healing agents.

The potential application of natural products in cutaneous wound healing: A review of preclinical evidence

Under normal circumstances, wound healing can be summarized as three processes. These include inflammation, proliferation, and remodeling. The vast majority of wounds heal rapidly; however, a large percentage of nonhealing wounds have still not been studied significantly. The factors affecting wound nonhealing are complex and diverse, and identifying an effective solution from nature becomes a key goal of research. This study aimed to highlight and review the mechanisms and targets of natural products (NPs) for treating nonhealing wounds. The results of relevant studies have shown that the effects of NPs are associated with PI3K-AKT, P38MAPK, fibroblast growth factor, MAPK, and ERK signaling pathways and involve tumor growth factor (TNF), vascular endothelial growth factor, TNF-α, interleukin-1β, and expression of other cytokines and proteins. The 25 NPs that contribute to wound healing were systematically summarized by an inductive collation of the six major classes of compounds, including saponins, polyphenols, flavonoids, anthraquinones, polysaccharides, and others, which will further direct the attention to the active components of NPs and provide research ideas for further development of new products for wound healing.

Recent applications of electrical, centrifugal, and pressurised emerging technologies for fibrous structure engineering in drug delivery, regenerative medicine and theranostics

Advancements in technology and material development in recent years has led to significant breakthroughs in the remit of fiber engineering. Conventional methods such as wet spinning, melt spinning, phase separation and template synthesis have been reported to develop fibrous structures for an array of applications. However, these methods have limitations with respect to processing conditions (e.g. high processing temperatures, shear stresses) and production (e.g. non-continuous fibers). The materials that can be processed using these methods are also limited, deterring their use in practical applications. Producing fibrous structures on a nanometer scale, in sync with the advancements in nanotechnology is another challenge met by these conventional methods. In this review we aim to present a brief overview of conventional methods of fiber fabrication and focus on the emerging fiber engineering techniques namely electrospinning, centrifugal spinning and pressurised gyration. This review will discuss the fundamental principles and factors governing each fabrication method and converge on the applications of the resulting spun fibers; specifically, in the drug delivery remit and in regenerative medicine.

Development and Evaluation of Rifampicin Loaded Alginate-Gelatin Biocomposite Microfibers

Various systematic phases such as inflammation, tissue proliferation, and phases of remodeling characterize the process of wound healing. The natural matrix system is suggested to maintain and escalate these phases, and for that, microfibers were fabricated employing naturally occurring polymers (biopolymers) such as sodium alginate, gelatin and xanthan gum, and reinforcing material such as nanoclay was selected. The fabrication of fibers was executed with the aid of extrusion-gelation method. Rifampicin, an antibiotic, has been incorporated into a biopolymeric solution. RF1, RF2, RF3, RF4 and RF5 were coded as various formulation batches of microfibers. The microfibers were further characterized by different techniques such as SEM, DSC, XRD, and FTIR. Mechanical properties and physical evaluations such as entrapment efficiency, water uptake and in vitro release were also carried out to explain the comparative understanding of the formulation developed. The antimicrobial activity and whole blood clotting of fabricated fibers were additionally executed, hence they showed significant results, having excellent antimicrobial properties; they could be prominent carriers for wound healing applications.

Medicinal plants and their components for wound healing applications

Background

Wound is an anatomical and functional disruption of the skin following an injury. In response to the injury, wound healing is a complex process of tissue repair or remodeling. Historically, plants and plant-based constituents have been extensively used for the treatment and management of different types of wounds. In the current times, different types of biopolymers are being researched for developing economical, sustainable, stable, and effective delivery system for the treatment of wounds.

Main text

The present review article attempts to enlist medicinal plants which have been reported to be effective in the treatment of wounds. Plant constituent-based wound dressings have also been discussed systematically including patented formulations reported by different inventors.

Conclusion

The compiled data aims to update the researchers/scientists which will be helpful in providing them a directional view in understanding the role and importance of plant-based components for the treatment and management of wounds.

Tissue factor-loaded collagen/alginate hydrogel beads as a hemostatic agent

Uncontrolled hemorrhage accounts for a significant proportion of annual mortality worldwide. The development of bioinspired hemostatic composites can effectively reduce hemorrhage and related deaths. This work aims to develop an efficient hemostatic agent by incorporating tissue factor (TF) integrated liposomes and collagen, which are capable of augmenting different inherent hemostatic mechanisms, into hemostasis-stimulating alginate matrix. The composite of TF, collagen and alginate (TCA) was made into hydrogel beads with a diameter range of 2.5-3.5 mm, followed by electron microscopy, infrared spectroscopy, rheological, and swelling characterization to confirm its composition and hydrogel nature. When the TCA beads were introduced into simulated body fluid, a controlled release of the loaded TF-liposomes was observed, which also accelerated with the increase of temperature, obtaining intact free proteoliposomes as demonstrated by fluorescence measurement. It is further seen that TCA beads induced the coagulation of whole rabbit blood in about 4.5 min, as compared to ~14.4 min for the control with only recalcified blood. The lipidated TF, collagen and alginate in TCA beads showed a positive synergistic effect on coagulation, while among them a decreasing procoagulant effect was observed. Finally, we demonstrated by a live/dead cell assay that TCA particles had undetectable cytotoxicity. Thus, the TCA hydrogel macrobeads may offer a potential platform for the development of potent hemostatic agents.

Rifampicin-Loaded Alginate-Gelatin Fibers Incorporated within Transdermal Films as a Fiber-in-Film System for Wound Healing Applications

The various biological and molecular cascades including different stages or phases such as inflammation, tissue proliferation, and remodeling phases, which significantly define the wound healing process. The natural matrix system is suggested to increase and sustain these cascades. Biocompatible biopolymers, sodium alginate and gelatin, and a drug (Rifampicin) were used for the preparation of fibers into a physical crosslinking solution using extrusion-gelation. The formed fibers were then loaded in transdermal films for wound healing applications. Rifampicin, an antibiotic, antibacterial agent was incorporated into fibers and afterwards the fibers were loaded into transdermal films. Initially, rifampicin fibers were developed using biopolymers including alginate and gelatin, and were further loaded into polymeric matrix which led to the formation of transdermal films. The transdermal films were coded as TF1, TF2, TF3 and TF4.The characterization technique, FTIR, was used to describe molecular transitions within fibers, transdermal films, and was further corroborated using SEM and XRD. In mechanical properties, the parameters, such as tensile strength and elongation-at-break (extensibility), were found to be ranged between 2.32 ± 0.45 N/mm² to 14.32 ± 0.98 N/mm² and 15.2% ± 0.98% to 30.54% ± 1.08%. The morphological analysis firmed the development of fibers and fiber-loaded transdermal films. Additionally, physical evaluation such as water uptake study, water transmission rate, swelling index, moisture content, and moisture uptake study were executed to describe comparative interpretation of the formulations developed. In vivo studies were executed using a full thickness cutaneous wound healing model, the transdermal films developed showed higher degree of contraction, i.e., 98.85% ± 4.04% as compared to marketed formulation (Povidone). The fiber-in-film is a promising delivery system for loading therapeutic agents for effective wound care management.

Epidermal stimulating factors-gelatin/polycaprolactone coaxial electrospun nanofiber: ideal nanoscale material for dermal substitute

In this study, an ideal nano-scale material, named epidermal stimulating (ES) factors-gelatin/polycaprolactone (GT/PCL) nanofiber, was fabricated using a coaxial electrospinning technique. The ES-GT/PCL nanofibers possessed a highly porous structure with qualified mechanical properties for transplantation. With ES factors stored in the core and GT/PCL in the shell, the ES factors could be protected and released in a sustained manner. After seeding L929 cell line on ES-GT/PCL nanofibers for 7 days in vitro, the proliferation of cells was nearly 1.5 folds compared to the control group. The in vivo study showed that ES-GT/PCL nanofibers can accelerate skin wound healing rate during the healing course, especially on the early stage. The epidermal and dermal thickness, as well as skin appendages and fat tissue, were the most similar to the native skin. These findings provided valuable insights into the addition of multiple bioactive factors to nanometre biomaterials, and optimising the advantages of the compositions as a promising potential dermal substitute construct.