First-Line Interactive Wound Dressing Update: A Comprehensive Review of the Evidence

Performance of a gelling fibre dressing in management of wounds in a community setting: a sub-analysis of the VIPES study

OBJECTIVE

To evaluate the use and performance of a gelling fibre dressing (Biatain Fiber; Coloplast A/S, Denmark) in the management of wounds in community nursing practice.

METHOD

A sub-analysis of the prospective, observational, real-world VIPES (Observatoire en Ville des Plaies ExSudatives) study was conducted. Patients with exuding wounds, for which nurses chose to apply the gelling fibre as a primary dressing, were included. Outcomes included assessments of wound condition and patient/nurse opinion.

RESULTS

Overall, 149 patients with acute (n=52; 34.9%) or hard-to-heal (chronic) (n=97; 65.1%) wounds were included. At baseline, mean±standard deviation wound age was 351.5±998.2 days, 108 (72.5%) wounds were moderately-to-highly exuding, and 126 (84.6%) showed exudate pooling in the wound bed. At the last follow-up visit, 29 (19.5%) wounds had healed, within a median of 36 days, and 64 (43.0%) were progressing towards healing. From baseline to the last follow-up visit, significant reductions in wound surface area (p<0.05), depth (p<0.01), exudate level (p<0.0001), and in the proportion of wounds with sloughy tissue (p<0.0001) were observed. Most wounds had no (n=86; 58.5% (two missing values)) or low exudate pooling (n=45; 30.6% (two missing values)) at the last visit and proportions of patients with healthy wound edges/periwound skin increased from baseline. At the last visit, wounds were considered improved by nurses in 71.4% (n=105) of cases, and by patients in 66.7% (n=98) of cases (two patients missing).

CONCLUSION

Patients who received treatment with the gelling fibre experienced improvements in the condition of a range of complex wounds. This analysis highlights the importance of adequate exudate management, and indicates how the selection of an appropriate wound dressing can encourage healing progression.

DECLARATION OF INTEREST

This study was financially supported by Laboratoires Coloplast SAS, Paris, France. Coloplast A/S funded the writing and editing of the article and contributed to its content. Coloplast A/S and Laboratoires Coloplast SAS reviewed the article for scientific accuracy. Nurses received financial compensation for their participation in the study. NA is a full-time employee of Coloplast A/S. APJ was an employee of Coloplast A/S when this article was written. FA was a full-time employee of Laboratoires Coloplast SAS at the time of publication development. RS and CJ are full-time employees of CEN Biotech. AK received an educational grant from Coloplast A/S to provide scientific input to the publication. The authors have no other conflicts of interest to declare.

Innovative approaches to wound healing: insights into interactive dressings and future directions

The objective of this review is to provide an up-to-date and all-encompassing account of the recent advancements in the domain of interactive wound dressings. Considering the gap between the achieved and desired clinical outcomes with currently available or under-study wound healing therapies, newer more specific options based on the wound type and healing phase are reviewed. Starting from the comprehensive description of the wound healing process, a detailed classification of wound dressings is presented. Subsequently, we present an elaborate and significant discussion describing interactive (unconventional) wound dressings. Latter includes biopolymer-based, bioactive-containing and biosensor-based smart dressings, which are discussed in separate sections together with their applications and limitations. Moreover, recent (2-5 years) clinical trials, patents on unconventional dressings, marketed products, and other information on advanced wound care designs and techniques are discussed. Subsequently, the future research direction is highlighted, describing peptides, proteins, and human amniotic membranes as potential wound dressings. Finally, we conclude that this field needs further development and offers scope for integrating information on the healing process with newer technologies.

Tranexamic acid loaded in a physically crosslinked trilaminate dressing for local hemorrhage control: Preparation, characterization, and in-vivo assessment using two different animal models

This work aimed at formulating a trilaminate dressing loaded with tranexamic acid. It consisted of a layer of 3 % sodium hyaluronate to initiate hemostasis. It was followed by a mixed porous layer of 5 % polyvinyl alcohol and 2 % kappa-carrageenan. This layer acted as a drug reservoir that controlled its release. The third layer was 5 % ethyl cellulose backing layer for unidirectional release of tranexamic acid towards the wound. The 3 layers were physically crosslinked by hydrogen bonding as confirmed by Infrared spectroscopy. Swelling and release studies were performed, and results proposed that increasing number of layers decreased swelling properties and sustained release of tranexamic acid for 8 h. In vitro blood coagulation study was performed using human blood and showed that the dressing significantly decreased coagulation time by 70.5 % compared to the negative control. In vivo hemostatic activity was evaluated using tail amputation model in Wistar rats. Statistical analysis showed the dressing could stop bleeding in a punctured artery of the rat tail faster than the negative control by 59 %. Cranial bone defect model in New Zealand rabbits was performed to check for bone hemostasis and showed significant decrease in the hemostatic time by 80 % compared to the control.

Evaluation of bone marrow-derived mesenchymal stem cells with eggshell membrane for full-thickness wound healing in a rabbit model

Biomaterials capable of managing wounds should have essential features like providing a natural microenvironment for wound healing and as support material for stimulating tissue growth. Eggshell membrane (ESM) is a highly produced global waste due to increased egg consumption. The unique and fascinating properties of ESM allow their potential application in tissue regeneration. The wound healing capacity of bone marrow-derived mesenchymal stem cells (BM-MSCs), ESM, and their combination in rabbits with full-thickness skin defect (2 × 2 cm2) was evaluated. Twenty-five clinically healthy New Zealand White rabbits were divided into five groups of five animals each, with group A receiving no treatment (control group), group B receiving only fibrin glue (FG), group C receiving FG and ESM as a dressing, group D receiving FG and BM-MSCs, and group E receiving a combination of FG, ESM, and BM-MSCs. Wound healing was assessed using clinical, macroscopical, photographic, histological, histochemical, hematological, and biochemical analysis. Macroscopic examination of wounds revealed that healing was exceptional in group E, followed by groups D and C, compared to the control group. Histopathological findings revealed improved quality and a faster rate of healing in group E compared to groups A and B. In addition, healing in group B treated with topical FG alone was nearly identical to that in control group A. However, groups C and D showed improved and faster recovery than control groups A and B. The macroscopic, photographic, histological, and histochemical evaluations revealed that the combined use of BM-MSCs, ESM, and FG had superior and faster healing than the other groups.

Design, optimization and pharmaceutical characterization of wound healing film dressings with chloramphenicol and ibuprofen

OBJECTIVE

The aim of the present study was to develop and optimize a wound dressing film loaded with chloramphenicol (CAM) and ibuprofen (IBU) using a Quality by Design (QbD) approach.

SIGNIFICANCE

The two drugs have been combined in the same dressing as they address two critical aspects of the wound healing process, namely prevention of bacterial infection and reduction of inflammation and pain related to injury.

METHODS

Three critical formulation variables were identified, namely the ratios of Kollicoat SR 30D, polyethylene glycol 400 and polyvinyl alcohol. These variables were further considered as factors of an experimental design, and 17 formulations loaded with CAM and IBU were prepared via solvent casting. The films were characterized in terms of dimensions, mechanical properties and bioadhesion. Additionally, the optimal formulation was characterized regarding tensile properties, swelling behavior, water vapor transmission rate, surface morphology, thermal behavior, goniometry, in vitro drug release, cell viability, and antibacterial activity.

RESULTS

The film was optimized by setting minimal values for the folding endurance, adhesive force and hardness. The optimally formulated film showed good fluid handling properties in terms of swelling behavior and water vapor transmission rate. IBU and CAM were released from the film up to 80.9% and 82.5% for 8 h. The film was nontoxic, and the antibacterial activity was prominent against Micrococcus spp. and Streptococcus pyogenes.

CONCLUSIONS

The QbD approach was successfully implemented to develop and optimize a novel film dressing promising for the treatment of low-exuding acute wounds prone to infection and inflammation.

The mutual regulation between γδ T cells and macrophages during wound healing

Macrophages are the main cells shaping the local microenvironment during wound healing. As the prime T cells in the skin, γδ T cells participate in regulating microenvironment construction, determining their mutual regulation helps to understand the mechanisms of wound healing, and explore innovative therapeutic options for wound repair. This review introduced their respective role in wound healing firstly, and then summarized the regulatory effect of γδ T cells on macrophages, including chemotaxis, polarization, apoptosis, and pyroptosis. Last, the retrograde regulation on γδ T cells by macrophages was also discussed. The main purpose is to excavate novel interventions for treating wound and provide new thought for further research.

Bioactive Dressing: A New Algorithm in Wound Healing

Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic acid, collagen, alginates, and polymers enriched with polyhexamethylene biguanide, chitin, and chitosan derivatives, create a conducive environment for healing, promoting moisture balance, pH regulation, oxygen permeability, and fluid management. Interactive dressings further enhance targeted action by serving as substrates for bioactive agents. The continuous evolution of BDs, with new products introduced annually, underscores the need for updated knowledge in wound care. To facilitate dressing selection, a practical algorithm considers wound exudate, infection probability, and bleeding, guiding clinicians through the process. This algorithm aims to optimize wound care by ensuring the appropriate selection of BDs tailored to individual patient needs, ultimately improving outcomes in wound management.

Bringing innovative wound care polymer materials to the market: Challenges, developments, and new trends

The development of innovative products for treating acute and chronic wounds has become a significant topic in healthcare, resulting in numerous products and innovations over time. The growing number of patients with comorbidities and chronic diseases, which may significantly alter, delay, or inhibit normal wound healing, has introduced considerable new challenges into the wound management scenario. Researchers in academia have quickly identified promising solutions, and many advanced wound healing materials have recently been designed; however, their successful translation to the market remains highly complex and unlikely without the contribution of industry experts. This review article condenses the main aspects of wound healing applications that will serve as a practical guide for researchers working in academia and industry devoted to designing, evaluating, validating, and translating polymer wound care materials to the market. The article highlights the current challenges in wound management, describes the state-of-the-art products already on the market and trending polymer materials, describes the regulation pathways for approval, discusses current wound healing models, and offers a perspective on new technologies that could soon reach consumers. We envision that this comprehensive review will significantly contribute to highlighting the importance of networking and exchanges between academia and healthcare companies. Only through the joint of these two actors, where innovation, manufacturing, regulatory insights, and financial resources act in harmony, can wound care products be developed efficiently to reach patients quickly and affordably.

Wound healing, scarring and management

Understanding wound healing is imperative for the dermatological physician to optimize surgical outcomes. Poor healing may result in negative functional, cosmetic and psychological sequelae. This review briefly outlines the physiology of wound healing, with a view to improving the management of wounds and scars, and minimizing the long-term scarring complications.

Development of PU foam dressings loaded with extract of Plectranthus amboinicus for burn wound healing

OBJECTIVE

To develop Plectranthus amboinicus extract loaded Polyurethane foam dressing for burn wound healing.

SIGNIFICANCE

Plectranthus amboinicus is traditionally used as an anti-inflammatory and wound-healing agent. Its incorporation in a PU foam dressing will offer the dual benefits of foam dressing as well as the healing potential of P. amboinicus.

METHODS

PU foam dressings were prepared and loaded with P. ambionicus leaf extract (PAE). The dressings were prepared with varying concentrations (0.5-2%) of extract along with Toluene diisocyanate, polypropylene glycol (PPG), and liquid paraffin. The dressings were characterized by Scanning Electron Microscopy and evaluated for Moisture Vapor Transmission Rate, absorption rate, porosity, and mechanical strength followed by in vivo burn wound-healing studies in comparison to a marketed dressing.

RESULTS

The MVTR was found to be optimum in formulations FD2-FD4 with values ranging from 2068.06 ± 0.99 to 2095.00 ± 0.25 g/m2/day. Absorption rate was found to be between 1.27 ± 0.01, 1.31 ± 0.00, and 1.30 ± 0.02 g/cm2 for formulations FD2-FD4. Formulations FD1, FD2, FD3, FD4 showed better porosity when compared to other formulations. Formulation FD4 was further characterized by micro-CT and a porosity of 46.32% was obtained. Tensile strength measurement indicated that the selected formulations were flexible enough to withstand regular handling during dressing changes. Acute dermal irritation performed on rabbits showed no irritation, erythema, eschar, and edema. In vivo wound-healing studies performed on albino wistar rats showed that the FD4 formulation has better wound healing property.

CONCLUSION

Plectranthus ambionicus-loaded PU foam dressing demonstrated promising burn wound-healing potential.

Fluid handling by foam wound dressings: From engineering theory to advanced laboratory performance evaluations

This article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure-function relationships and on advanced laboratory testing methods for pre-clinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions. Based on this comprehensive review, we propose a newly developed testing method, experimental metrics and clinical benchmarks that are clinically relevant and can set the standard for robust fluid handling performance evaluations. The purpose of this evaluative framework is to translate the physical characteristics and performance determinants of a foam dressing into achievable best clinical outcomes. These guiding principles are key to distinguishing desirable properties of a dressing that contribute to optimal performance in clinical settings.

Providing holistic care to children with cerebral palsy treated with transnasal neural stem cell transplantation

Objective

Holistic care is a key element in nursing care. Aiming at the heterogeneous disease of cerebral palsy, researchers focused on children with cerebral palsy who received transnasal transplantation of neural stem cells as a specific group. Based on establishing a multidisciplinary team, comprehensive care is carried out for this type of patient during the perioperative period to improve the effectiveness and safety of clinical research and increase the comfort of children.

Methods

Between January 2018 and June 2023, 22 children with cerebral palsy underwent three transnasal transplants of neural stem cells.

Results

No adverse reactions related to immune rejection were observed in the 22 children during hospitalization and follow-up. All children tolerated the treatment well, and the treatment was superior. One child developed nausea and vomiting after sedation; three had a small amount of bleeding of nasal mucosa after transplantation. Two children had a low fever (≤38.5°C), and one had a change in the type and frequency of complex partial seizures. Moreover, 3 children experienced patch shedding within 4 h of patch implantation into the nasal cavity.

Conclusion

The project team adopted nasal stem cell transplantation technology. Based on the characteristics of transnasal transplantation of neural stem cells in the treatment of neurological diseases in children, a comprehensive and novel holistic care plan is proposed. It is of great significance to guide caregivers of children to complete proper care, further improve the safety and effectiveness of treatment, and reduce the occurrence of complications.

Advances of regenerated and functionalized silk biomaterials and application in skin wound healing

The cocoon silk of silkworms (Bombyx mori) has multiple potential applications in biomedicine due to its good biocompatibility, mechanical properties, degradability, and plasticity. Numerous studies have confirmed that silk material dressings are more effective than traditional ones in the skin wound healing process. Silk material research has recently moved toward functionalized biomaterials and achieved remarkable results. Herein, we summarize the recent advances in functionalized silk materials and their efficacy in skin wound healing. In particular, transgenic technology has realized the specific expression of human growth factors in the silk glands of the silkworms, which lays the foundation for fabricating novel and low-cost functionalized materials. Without a green and safe preparation process, the best raw silk materials cannot be made into medically safe products. Therefore, we provide an overview of green and gentle approaches for silk degumming and silk sericin (SS) extraction. Moreover, we summarize and discuss the processing methods of silk fibroin (SF) and SS materials and their potential applications, such as burns, diabetic wounds, and other wounds. This review aims to enhance our understanding of new advances and directions in silk materials and guide future biomedical research.

Recent progress in polysaccharide and polypeptide based modern moisture-retentive wound dressings

Wounds were considered as defects in the tissues of the human skin and wound healing is said to be a tedious process as there are possibilities of infection or inflammation due to microorganisms. Modern moisture-retentive wound dressing (MMRWD) is opening a new window toward wound therapy. It comprises different types of wound dressing that has classified based on their functionality. Selective polysaccharide-polypeptide fiber composite materials such as hydrogels, hydrocolloids, hydro fibers, transparent-film dressing, and alginate dressing are discussed in this review as a type of MMRWD. The highlight of this polysaccharide and polypeptide based MMRWD is that it supports and enhances the healing of different types of wounds by moisture absorption thus preventing infection. This study has given enlightenment on the application of selected polysaccharide and polypeptide based MMRWD that enhances wound healing actions still it has been observed that the composite wound healing dressing is more effective than the single one. The nano-sized materials (synthetic nano drugs and phyto drugs) were found to increase the efficiency of healing action while coated in the wound dressing material. Future research is required to find out more possibilities of the different composite types of wound dressing in the healing action.

Nanofibrous polycaprolactone/gelatin scaffold containing gold nanoparticles: Physicochemical and biological characterization for wound healing

In this study, gold nanoparticles were loaded into poly (ε-caprolactone) (PCL)/gelatin nanofibrous matrices to fabricate a potential wound dressing. The mats were produced by electrospinning of PCL/gelatin solution supplemented with synthesized gold nanoparticles (200, 400 and 800 ppm). Prepared scaffolds were investigated regarding their chemical properties, morphology, mechanical properties, surface wettability, water-uptake capacity, water vapor permeability, porosity, blood compatibility, microbial penetration test and cellular response. In addition to in vivo study, a full-thickness excisional wound in a rat model was used to evaluate the healing effect of prepared scaffolds. Results showed appropriate mechanical properties and porosity of prepared scaffolds. With L929 cells, the PCL/gelatin scaffold containing 400 ppm gold nanoparticles demonstrated the greatest cell growth. In vivo results validated the favorable wound-healing benefits of the scaffold incorporating gold nanoparticles, which triggered wound healing compared to sterile gauze. Our results showed the capability of nanofibrous matrices containing gold nanoparticles for successful wound treatment.

Cis-2-Decenoic Acid and Bupivacaine Delivered from Electrospun Chitosan Membranes Increase Cytokine Production in Dermal and Inflammatory Cell Lines

Wound dressings serve to protect tissue from contamination, alleviate pain, and facilitate wound healing. The biopolymer chitosan is an exemplary choice in wound dressing material as it is biocompatible and has intrinsic antibacterial properties. Infection can be further prevented by loading dressings with cis-2-decenoic acid (C2DA), a non-antibiotic antimicrobial agent, as well as bupivacaine (BUP), a local anesthetic that also has antibacterial capabilities. This study utilized a series of assays to elucidate the responses of dermal cells to decanoic anhydride-modified electrospun chitosan membranes (DA-ESCMs) loaded with C2DA and/or BUP. Cytocompatibility studies determined the toxic loading ranges for C2DA, BUP, and combinations, revealing that higher concentrations (0.3 mg of C2DA and 1.0 mg of BUP) significantly decreased the viability of fibroblasts and keratinocytes. These high concentrations also inhibited collagen production by fibroblasts, with lower loading concentrations promoting collagen deposition. These findings provide insight into preliminary cellular responses to DA-ESCMs and can guide future research on their clinical application as wound dressings.

Natural and Synthetic Polymeric Biomaterials for Application in Wound Management

Biomaterials are at the forefront of the future, finding a variety of applications in the biomedical field, especially in wound healing, thanks to their biocompatible and biodegradable properties. Wounds spontaneously try to heal through a series of interconnected processes involving several initiators and mediators such as cytokines, macrophages, and fibroblasts. The combination of biopolymers with wound healing properties may provide opportunities to synthesize matrices that stimulate and trigger target cell responses crucial to the healing process. This review outlines the optimal management and care required for wound treatment with a special focus on biopolymers, drug-delivery systems, and nanotechnologies used for enhanced wound healing applications. Researchers have utilized a range of techniques to produce wound dressings, leading to products with different characteristics. Each method comes with its unique strengths and limitations, which are important to consider. The future trajectory in wound dressing advancement should prioritize economical and eco-friendly methodologies, along with improving the efficacy of constituent materials. The aim of this work is to give researchers the possibility to evaluate the proper materials for wound dressing preparation and to better understand the optimal synthesis conditions as well as the most effective bioactive molecules to load.

Research advances in smart responsive-hydrogel dressings with potential clinical diabetic wound healing properties

The treatment of chronic and non-healing wounds in diabetic patients remains a major medical problem. Recent reports have shown that hydrogel wound dressings might be an effective strategy for treating diabetic wounds due to their excellent hydrophilicity, good drug-loading ability and sustained drug release properties. As a typical example, hyaluronic acid dressing (Healoderm) has been demonstrated in clinical trials to improve wound-healing efficiency and healing rates for diabetic foot ulcers. However, the drug release and degradation behavior of clinically-used hydrogel wound dressings cannot be adjusted according to the wound microenvironment. Due to the intricacy of diabetic wounds, antibiotics and other medications are frequently combined with hydrogel dressings in clinical practice, although these medications are easily hindered by the hostile environment. In this case, scientists have created responsive-hydrogel dressings based on the microenvironment features of diabetic wounds (such as high glucose and low pH) or combined with external stimuli (such as light or magnetic field) to achieve controllable drug release, gel degradation, and microenvironment improvements in order to overcome these clinical issues. These responsive-hydrogel dressings are anticipated to play a significant role in diabetic therapeutic wound dressings. Here, we review recent advances on responsive-hydrogel dressings towards diabetic wound healing, with focus on hydrogel structure design, the principle of responsiveness, and the behavior of degradation. Last but not least, the advantages and limitations of these responsive-hydrogels in clinical applications will also be discussed. We hope that this review will contribute to furthering progress on hydrogels as an improved dressing for diabetic wound healing and practical clinical application.

Recent Advances of Natural-Polymer-Based Hydrogels for Wound Antibacterial Therapeutics

Hydrogels have a three-dimensional network structure and high-water content, are similar in structure to the extracellular matrix, and are often used as wound dressings. Natural polymers have excellent biocompatibility and biodegradability and are commonly utilized to prepare hydrogels. Natural-polymer-based hydrogels can have excellent antibacterial and bioactive properties by loading antibacterial agents or being combined with therapeutics such as phototherapy, which has great advantages in the field of treatment of microbial infections. In the published reviews of hydrogels used in the treatment of infectious wounds, the common classification criteria of hydrogels include function, source of antibacterial properties, type of antibacterial agent, etc. However, there are few reviews on the classification of hydrogels based on raw materials, and the description of natural-polymer-based hydrogels is not comprehensive and detailed. In this paper, based on the principle of material classification, the characteristics of seven types of natural polymers that can be used to prepare hydrogels are discussed, respectively, and the application of natural-polymer-based hydrogels in the treatment of infectious wounds is described in detail. Finally, the research status, limitations, and prospects of natural-polymer-based hydrogels are briefly discussed.

An update on wound management

Wound management involves an understanding of the aetiology and pathophysiology of a wound, the healing process and how best to manage both. Acute wounds can occur suddenly, such as burns and skin tears. Chronic wounds fail to progress through the normal stages of healing and can include ulcers, pressure injuries and infected wounds. Dressings and bandages provide the optimal environment for the healing of all wound types. It is important for healthcare practitioners to understand the key differences in their properties, uses and precautions. Selecting the ideal dressing or bandage can minimise the healing duration, reduce the bioburden, and improve a patient's quality of life.

Polymer-Based Hydrogel Loaded with Honey in Drug Delivery System for Wound Healing Applications

Excellent wound dressings should have crucial components, including high porosity, non-toxicity, high water absorption, and the ability to retain a humid environment in the wound area and facilitate wound healing. Unfortunately, current wound dressings hamper the healing process, with poor antibacterial, anti-inflammatory, and antioxidant activity, frequent dressing changes, low biodegradability, and poor mechanical properties. Hydrogels are crosslinked polymer chains with three-dimensional (3D) networks that have been applicable as wound dressings. They could retain a humid environment on the wound site, provide a protective barrier against pathogenic infections, and provide pain relief. Hydrogel can be obtained from natural, synthetic, or hybrid polymers. Honey is a natural substance that has demonstrated several therapeutic efficacies, including anti-inflammatory, antibacterial, and antioxidant activity, which makes it beneficial for wound treatment. Honey-based hydrogel wound dressings demonstrated excellent characteristics, including good biodegradability and biocompatibility, stimulated cell proliferation and reepithelization, inhibited bacterial growth, and accelerated wound healing. This review aimed to demonstrate the potential of honey-based hydrogel in wound healing applications and complement the studies accessible regarding implementing honey-based hydrogel dressing for wound healing.

Films for Wound Healing Fabricated Using a Solvent Casting Technique

Wound healing is a complex process that involves restoring the structure of damaged tissues through four phases: hemostasis, inflammation, proliferation, and remodeling. Wound dressings are the most common treatment used to cover wounds, reduce infection risk and the loss of physiological fluids, and enhance wound healing. Despite there being several types of wound dressings based on different materials and fabricated through various techniques, polymeric films have been widely employed due to their biocompatibility and low immunogenicity. Furthermore, they are non-invasive, easy to apply, allow gas exchange, and can be transparent. Among different methods for designing polymeric films, solvent casting represents a reliable, preferable, and highly used technique due to its easygoing and relatively low-cost procedure compared to sophisticated methods such as spin coating, microfluidic spinning, or 3D printing. Therefore, this review focuses on the polymeric dressings obtained using this technique, emphasizing the critical manufacturing factors related to pharmaceuticals, specifically discussing the formulation variables necessary to create wound dressings that demonstrate effective performance.

Advanced polymer hydrogels that promote diabetic ulcer healing: mechanisms, classifications, and medical applications

Diabetic ulcers (DUs) are one of the most serious complications of diabetes mellitus. The application of a functional dressing is a crucial step in DU treatment and is associated with the patient's recovery and prognosis. However, traditional dressings with a simple structure and a single function cannot meet clinical requirements. Therefore, researchers have turned their attention to advanced polymer dressings and hydrogels to solve the therapeutic bottleneck of DU treatment. Hydrogels are a class of gels with a three-dimensional network structure that have good moisturizing properties and permeability and promote autolytic debridement and material exchange. Moreover, hydrogels mimic the natural environment of the extracellular matrix, providing suitable surroundings for cell proliferation. Thus, hydrogels with different mechanical strengths and biological properties have been extensively explored as DU dressing platforms. In this review, we define different types of hydrogels and elaborate the mechanisms by which they repair DUs. Moreover, we summarize the pathological process of DUs and review various additives used for their treatment. Finally, we examine the limitations and obstacles that exist in the development of the clinically relevant applications of these appealing technologies. This review defines different types of hydrogels and carefully elaborate the mechanisms by which they repair diabetic ulcers (DUs), summarizes the pathological process of DUs, and reviews various bioactivators used for their treatment.

Dual-Function Hydrogel Dressings with a Dynamic Exchange of Iron Ions and an Antibiotic Drug for Treatment of Infected Wounds

Bacterial infection is a major problem with diabetic wounds that may result in nonhealing chronic ulcers. Here, we report an approach to antibacterial hydrogel dressings for enhanced treatment of infected skin wounds. A fibrous hydrogel was derived from cellulose nanocrystals that were modified with dopamine and cross-linked with gelatin. The hydrogel was loaded with gentamicin, an antibiotic drug. Enhanced antibacterial hydrogel performance resulted from (i) a highly specific sequestration of Fe³⁺ ions (much needed by bacteria) from the wound exudate and (ii) a dynamic exchange between gentamicin released from the hydrogel and Fe³⁺ ions withdrawn from the wound exudate. Such exchange was possible due to the high value of the binding constant of Fe³⁺ ions to dopamine. The hydrogel did not affect the metabolic activity of skin-related cells and showed enhanced antibacterial performance against common wound pathogens such as S. aureus and P. aeruginosa. Furthermore, it promoted healing of infected diabetic wounds due to a synergistic antibacterial effect providing the dynamic exchange between Fe³⁺ ions and gentamicin. This work provides a strategy for the design of dual-function wound dressings, with both starving and killing bacteria and enhanced wound healing performance.

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Visible-UVC upconversion polymer films for prevention of microbial infection

Bacterial infections caused by the growth and reproduction of pathogenic bacteria on wounds are one of the main reasons that hinder wound healing. Antibacterial wound dressings protect wounds from bacterial infections. Herein, we developed a polymeric antibacterial composite film using polyvinyl alcohol (PVA) and sodium alginate (SA) as the substrate. The film used praseodymium-doped yttrium orthosilicate (Y₂SiO₅: Pr³⁺, YSO-Pr) to convert visible light into short-wavelength ultraviolet light (UVC) to kill bacteria. The YSO-Pr/PVA/SA showed upconversion luminescence in photoluminescence spectrometry tests, and the emitted UVC inhibited Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli and Pseudomonas aeruginosa) bacteria in antibacterial tests. In vivo animal tests showed that YSO-Pr/PVA/SA is effective and safe for inhibiting bacteria in real wounds. The in vitro cytotoxicity test further confirmed the good biocompatibility of the antibacterial film. In addition, YSO-Pr/PVA/SA exhibited sufficient tensile strength. Overall, this study demonstrates the potential of upconversion materials for use in medical dressings.

Barrier Films and Dressings for the Prevention of Acute Radiation Dermatitis: A Systematic Review and Meta-Analysis

PURPOSE

This systematic review and meta-analysis aimed to evaluate the efficacy of barrier films and dressings in preventing acute radiation dermatitis (RD).

METHODS

OVID Medline, Embase, and Cochrane databases were searched from 1946 to September 2020 to identify randomized controlled trials on the use of barrier films or dressings to prevent RD. For comparable outcomes between studies, pooled effect sizes and 95% confidence intervals (CI) were calculated using the random effects analysis in RevMan 5.4.

RESULTS

Fourteen and 11 studies were included in the qualitative and quantitative analyses, respectively. Five types of barrier films used for RD were identified: Hydrofilm, StrataXRT®, Mepitel® Film, 3 M™ Cavilon™ No-Sting Barrier Film, and silver leaf nylon dressing. Hydrofilm and Mepitel Film significantly reduced the development of RD grade ≥ 2 in breast and head and neck cancer patients (RR 0.32, 95%CI 0.19, 0.56, p < 0.0001; RR 0.21, 95%CI 0.05, 0.89, p = 0.03, resp.). Moreover, Hydrofilm had a beneficial effect on patient-reported outcomes (PROs) (SMD -0.75, 95%CI -1.2, -0.29, p = 0.001). The meta-analyses on the other barrier films did not show any significant effect.

CONCLUSION

This review and meta-analysis demonstrated that Hydrofilm and Mepitel Film could effectively reduce RD severity and improve PROs. The evidence is generally weak for all the studies on barrier films and dressings due to a limited study number, high risk of bias, small sample sizes, and minimal comparable outcome measures. It's potential has been proven, but future research in this field is recommended to confirm the efficacy of these products and assess real-world feasibility.

Insulin modified Decellularized Adipose Tissue/Tremella Polysaccharide hydrogel loaded with ADSCs for skin wound healing

Full-thickness skin wounds still represent a challenge for clinical treatment. Adipose-derived stem cells (ADSCs) therapy is a promising approach to achieve efficient healing in skin wounds. The excellent cell scaffold can promote proliferation, differentiation and paracrine of ADSCs in wound microenvironment, and is a key factor in ADSCs application. Herein, we first prepared the composite hydrogel with decellularized adipose tissue (DAT) and tremella polysaccharide (TPS), and loaded insulin (INS) into the DAT/TPS composite hydrogel (DAT/TPS-gel) to fabricate an efficient carrier for ADSCs in treating skin wound. Our study showed that INS modified DAT/TPS-gel (INS-DAT/TPS-gel) can promote the proliferation, differentiation and paracrine of ADSCs. INS-DAT/TPS-gel laden with ADSCs (ADSCs/INS-DAT/TPS-gel) effectively facilitated the skin wound healing in SD rats. These findings indicated that INS-DAT/TPS-gel was an effective scaffold for ADSCs transplantation, and ADSCs/INS-DAT/TPS-gel provides a potential strategy for the treatment of skin wounds.

H2O2-PLA-(Alg)2Ca Hydrogel Enriched in Matrigel® Promotes Diabetic Wound Healing

Hydrogel-based dressings exhibit suitable features for successful wound healing, including flexibility, high water-vapor permeability and moisture retention, and exudate absorption capacity. Moreover, enriching the hydrogel matrix with additional therapeutic components has the potential to generate synergistic results. Thus, the present study centered on diabetic wound healing using a Matrigel-enriched alginate hydrogel embedded with polylactic acid (PLA) microspheres containing hydrogen peroxide (H2O2). The synthesis and physicochemical characterization of the samples, performed to evidence their compositional and microstructural features, swelling, and oxygen-entrapping capacity, were reported. For investigating the three-fold goal of the designed dressings (i.e., releasing oxygen at the wound site and maintaining a moist environment for faster healing, ensuring the absorption of a significant amount of exudate, and providing biocompatibility), in vivo biological tests on wounds of diabetic mice were approached. Evaluating multiple aspects during the healing process, the obtained composite material proved its efficiency for wound dressing applications by accelerating wound healing and promoting angiogenesis in diabetic skin injuries.

Fine-Tuning the Endcap Chemistry of Acrylated Poly(Ethylene Glycol)-Based Hydrogels for Efficient Burn Wound Exudate Management

Most commercial dressings with moderate to high exudate uptake capacities are mechanically weaker and/or require a secondary dressing. The current research article focuses on the development of hydrogel-based wound dressings combining mechanical strength with high exudate absorption capacities using acrylate-endcapped urethane-based precursors (AUPs). AUPs with varying poly(ethylene glycol) backbone molar masses (10 and 20 kg mol^-1 ) and endcap chemistries are successfully synthesized in toluene, subsequently processed into UV-cured hydrogel sheets and are benchmarked against several commercial wound dressings (Hydrosorb, Kaltostat, and Mepilex Ag). The AUP materials show high gel fractions (>90%) together with strong swelling degrees in water, phosphate buffered saline and simulated wound fluid (12.7-19.6 g g^-1 ), as well as tunable mechanical properties (e.g., Young's modulus: 0.026-0.061 MPa). The AUPs have significantly (p < 0.05) higher swelling degrees than the tested commercial dressings, while also being mechanically resistant. The elasticity of the synthesized materials leads to an increased resistance against fatigue. The di- and hexa-acrylated AUPs show excellent in vitro biocompatibility against human foreskin fibroblasts, as evidenced by indirect MTS assays and live/dead cell assays. In conclusion, the processed AUP materials demonstrate high potential for wound healing application and can even compete with commercially available dressings.

Diabetic wound healing approaches: an update

Diabetic wounds are of profound clinical importance. Despite immense efforts directed towards its management, it results in the development of amputations, following a diagnosis of diabetic foot. With a better understanding of the complexities of the microbalance involved in the healing process, researchers have developed advanced methods for the management of wounds as well as diagnostic tools (especially, for wound infections) to be delivered to clinics sooner. In this review, we address the newer developments that hope to drive the transition from bench to bedside in the coming decade.

Biomedical materials for wound dressing: recent advances and applications

Wound healing is vital to maintain the physiological functions of the skin. The most common treatment is the use of a dressing to cover the wound and reduce infection risk and the rate of secondary injuries. Modern wound dressings have been the top priority choice for healing various types of wounds owing to their outstanding biocompatibility and biodegradability. In addition, they also maintain temperature and a moist environment, aid in pain relief, and improve hypoxic environments to stimulate wound healing. Due to the different types of wounds, as well as the variety of advanced wound dressing products, this review will provide information on the clinical characteristics of the wound, the properties of common modern dressings, and the in vitro, in vivo as well as the clinical trials on their effectiveness. The most popular types commonly used in producing modern dressings are hydrogels, hydrocolloids, alginates, foams, and films. In addition, the review also presents the polymer materials for dressing applications as well as the trend of developing these current modern dressings to maximize their function and create ideal dressings. The last is the discussion about dressing selection in wound treatment and an estimate of the current development tendency of new materials for wound healing dressings.

Current research on fungi in chronic wounds

The occurrence of chronic wounds is a major global health issue. These wounds are difficult to heal as a result of disordered healing mechanisms. The most common types of chronic wounds are diabetic ulcers, pressure ulcers, arterial/venous ulcers and nonhealing surgical wounds. Although bacteria are an important cause of chronic nonhealing wounds, fungi also play a substantial role in them. The fungal infection rate varies with different chronic wound types, but overall, the prevalence of fungi is extremely underestimated in the clinical treatment and management of chronic wounds. Wounds and ulcers can be colonized by host cutaneous, commensal or environmental fungi and evolve into local infections, causing fungemia as well as invasive fungal disease. Furthermore, the fungi involved in nonhealing wound-related infections help commensal bacteria resist antibiotics and the host immune response, forcing wounds to become reservoirs for multiresistant species, which are considered a potential key factor in the microbial bioburden of wounds and ulcers. Fungi can be recalcitrant to the healing process. Biofilm establishment is the predominant mechanism of fungal resistance or tolerance to antimicrobials in chronic nonhealing wounds. Candida albicans yeast and Trichophyton rubrum filamentous fungi are the main fungi involved in chronic wound infection. Fungal species diversity and drug resistance phenotypes in different chronic nonhealing wound types will be emphasized. In this review, we outline the latest research on fungi in chronic wounds and discuss challenges and future perspectives related to diagnosing and managing chronic wounds.

Republication: In Vitro and Ex Vivo Analysis of Collagen Foams for Soft and Hard Tissue Regeneration

BACKGROUND/AIM

The aim of this study was the conception, production, material analysis and cytocompatibility analysis of a new collagen foam for medical applications.

MATERIALS AND METHODS

After the innovative production of various collagen sponges from bovine sources, the foams were analyzed ex vivo in terms of their structure (including pore size) and in vitro in terms of cytocompatibility according to EN ISO 10993-5/-12. In vitro, the collagen foams were compared with the established biomaterials cerabone and Jason membrane. Materials cerabone and Jason membrane.

RESULTS

Collagen foams with different compositions were successfully produced from bovine sources. Ex vivo, the foams showed a stable and long-lasting primary structure quality with a bubble area of 1,000 to 2,000 μm2 In vitro, all foams showed sufficient cytocompatibility.

CONCLUSION

Collagen sponges represent a promising material for hard and soft tissue regeneration. Future studies could focus on integrating and investigating different additives in the foams.

Polysaccharide-based hydrogel with photothermal effect for accelerating wound healing

Polysaccharide-based hydrogel has excellent biochemical function, abundant sources, good biocompatibility and other advantages, and has a broad application prospect in biomedical fields, especially in the field of wound healing. With its inherent high specificity and low invasive burden, photothermal therapy has shown great application prospect in preventing wound infection and promoting wound healing. Combining polysaccharide-based hydrogel with photothermal therapy (PTT), multifunctional hydrogel with photothermal, bactericidal, anti-inflammatory and tissue regeneration functions can be designed, so as to achieve better therapeutic effect. This review first focuses on the basic principles of hydrogel and PTT, and the types of polysaccharides that can be used to design hydrogels. In addition, according to the different materials that produce photothermal effects, the design considerations of several representative polysaccharide-based hydrogels are emphatically introduced. Finally, the challenges faced by polysaccharide-based hydrogels with photothermal properties are discussed, and the future prospects of this field are put forward.

In Vitro and In Vivo Characterization Methods for Evaluation of Modern Wound Dressings

Chronic wound management represents a major challenge in the healthcare sector owing to its delayed wound-healing process progression and huge financial burden. In this regard, wound dressings provide an appropriate platform for facilitating wound healing for several decades. However, adherent traditional wound dressings do not provide effective wound healing for highly exudating chronic wounds and need the development of newer and innovative wound dressings to facilitate accelerated wound healing. In addition, these dressings need frequent changing, resulting in more pain and discomfort. In order to overcome these issues, a wide range of affordable and innovative modern wound dressings have been developed and explored recently to accelerate and improve the wound healing process. However, a comprehensive understanding of various in vitro and in vivo characterization methods being utilized for the evaluation of different modern wound dressings is lacking. In this context, an overview of modern dressings and their complete in vitro and in vivo characterization methods for wound healing assessment is provided in this review. Herein, various emerging modern wound dressings with advantages and challenges have also been reviewed. Furthermore, different in vitro wound healing assays and in vivo wound models being utilized for the evaluation of wound healing progression and wound healing rate using wound dressings are discussed in detail. Finally, a summary of modern wound dressings with challenges and the future outlook is highlighted.

Optimizing Biodegradable Starch-Based Composite Films Formulation for Wound-Dressing Applications

This paper utilizes response surface methodology (RSM) design-based analyses to optimize starch-based wound dressings that were characterized based on weight loss (WL%), swelling index (SI%), and mechanical strength (TS). The wound-dressing materials were prepared by employing a modified casting method, using various concentrations of starch (0.5-2 w/w%), polyvinyl alcohol (PVA) (0.5-2 weight%), citric acid (1.5-4 weight%), and glycerol (1.5-4 weight%) to yield wound-dressing films with appropriate combinations of in vitro degradation, swelling index, and tensile strength. As a result of the response surface method-based analysis, the swelling index, in vitro degradation, and tensile strength were linearly related to variations in the formulation of organic components. Based on our experimental investigations, the optimized film (formulation: 1 weight% PVA, 2 weight% starch, 1.5 weight% citric acid, and 1.5 weight% glycerol) exhibited an outstanding swelling index (343.52%), suitable in vitro degradation (53.22%), and excellent tensile strength (8.82 MPa). The response surface plots for the dependent variables, swelling index (SI%), weight loss (WL%), and mechanical strength (TS), showed that in all dual relations, the PVA-starch combination significantly affected all dependent variables; however, the PVA-citric acid interaction showed the most excellent effect on the swelling index. As a result, every component of the resulting film had a lesser amount of all ingredients to achieve better properties at a lower material cost. Starch-based/PVA films have been identified in this paper as optimal and more affordable wound-dressing films.

Three wound types: common challenges with exudate, gaps and anatomical positioning

Complex wounds require combinations of technologies and regimes to match laboratory tests and address challenges of physiological processes, body contours, movement and ease of use during life-long self-management. Wound management for vascular and lymphatic disorders incorporate wound dressings, skin care and compression to address local wound needs and underlying pathologies, while allowing functionality for movement. In a similar manner, acute inflammatory conditions that become chronic require skin care and local conformable and absorbent wound management, but with simple, atraumatic retention methods without compression. Three types of conditions will be discussed in this article-venous leg ulcers with chronic oedema (VLU), hidradenitis suppurativa (HS) and pilonidal sinuses (PS). It focuses on overcoming challenges associated with excess exudate, compromised skin, dressing awkward areas and contours, while also demonstrating wound care similarities when administered by patients themselves.

Recent progress in nanocomposites of carbon dioxide fixation derived reproducible biomedical polymers

In recent years, the environmental problems accompanying the extensive application of biomedical polymer materials produced from fossil fuels have attracted more and more attentions. As many biomedical polymer products are disposable, their life cycle is relatively short. Most of the used or overdue biomedical polymer products need to be burned after destruction, which increases the emission of carbon dioxide (CO₂). Developing biomedical products based on CO₂ fixation derived polymers with reproducible sources, and gradually replacing their unsustainable fossil-based counterparts, will promote the recycling of CO₂ in this field and do good to control the greenhouse effect. Unfortunately, most of the existing polymer materials from renewable raw materials have some property shortages, which make them unable to meet the gradually improved quality and property requirements of biomedical products. In order to overcome these shortages, much time and effort has been dedicated to applying nanotechnology in this field. The present paper reviews recent advances in nanocomposites of CO₂ fixation derived reproducible polymers for biomedical applications, and several promising strategies for further research directions in this field are highlighted.

Hybrid-Based Wound Dressings: Combination of Synthetic and Biopolymers

Most commercialized wound dressings are polymer-based. Synthetic and natural polymers have been utilized widely for the development of wound dressings. However, the use of natural polymers is limited by their poor mechanical properties, resulting in their combination with synthetic polymers and other materials to enhance their mechanical properties. Natural polymers are mostly affordable, biocompatible, and biodegradable with promising antimicrobial activity. They have been further tailored into unique hybrid wound dressings when combined with synthetic polymers and selected biomaterials. Some important features required in an ideal wound dressing include the capability to prevent bacteria invasion, reduce odor, absorb exudates, be comfortable, facilitate easy application and removal as well as frequent changing, prevent further skin tear and irritation when applied or removed, and provide a moist environment and soothing effect, be permeable to gases, etc. The efficacy of polymers in the design of wound dressings cannot be overemphasized. This review article reports the efficacy of wound dressings prepared from a combination of synthetic and natural polymers.

Nano-Enabled Chronic Wound Healing Strategies: Burn and Diabetic Ulcer Wounds

The human skin serves as the body’s first line of defense against the environment. Diabetes mellitus (DM) and 2nd–4th degree burns, on the other hand, affect the skin’s protective barrier features. Burn wounds, hypermetabolic state, and hyperglycemia compromise the immune system leading to chronic wound healing. Unlike acute wound healing processes, chronic wounds are affected by reinfections which can lead to limb amputation or death. The conventional wound dressing techniques used to protect the wound and provide an optimal environment for repair have their limitations. Various nanomaterials have been produced that exhibit distinct features to tackle issues affecting wound repair mechanisms. This review discusses the emerging technologies that have been designed to improve wound care upon skin injury. To ensure rapid healing and possibly prevent scarring, different nanomaterials can be applied at different stages of healing (hemostasis, inflammation, proliferation, remodeling).

Silver Nanoparticles and Its Mechanistic Insight for Chronic Wound Healing: Review on Recent Progress

Wounds are structural and functional disruptions of skin that occur because of trauma, surgery, acute illness, or chronic disease conditions. Chronic wounds are caused by a breakdown in the finely coordinated cascade of events that occurs during healing. Wound healing is a long process that split into at least three continuous and overlapping processes: an inflammatory response, a proliferative phase, and finally the tissue remodeling. Therefore, these processes are extensively studied to develop novel therapeutics in order to achieve maximum recovery with minimum scarring. Several growth hormones and cytokines secreted at the site of lesions tightly regulates the healing processes. The traditional approach for wound management has been represented by topical treatments. Metal nanoparticles (e.g., silver, gold and zinc) are increasingly being employed in dermatology due to their favorable effects on healing, as well as in treating and preventing secondary bacterial infections. In the current review, a brief introduction on traditional would healing approach is provided, followed by focus on the potential of wound dressing therapeutic techniques functionalized with Ag-NPs.

Optimization of Oligomer Chitosan/Polyvinylpyrrolidone Coating for Enhancing Antibacterial, Hemostatic Effects and Biocompatibility of Nanofibrous Wound Dressing

A synergistic multilayer membrane design is necessary to satisfy a multitude of requirements of an ideal wound dressing. In this study, trilayer dressings with asymmetric wettability, composed of electrospun polycaprolactone (PCL) base membranes coated with oligomer chitosan (COS) in various concentrations of polyvinylpyrrolidone (PVP), are fabricated for wound dressing application. The membranes are expected to synergize the hygroscopic, antibacterial, hemostatic, and biocompatible properties of PCL and COS. The wound dressing was coated by spraying the solution of 3% COS and 6% PVP on the PCL base membrane (PVP6–3) three times, which shows good interaction with biological subjects, including bacterial strains and blood components. PVP6–3 samples confirm the diameter of inhibition zones of 20.0 ± 2.5 and 17.9 ± 2.5 mm against Pseudomonas aeruginosa and Staphylococcus aureus, respectively. The membrane induces hemostasis with a blood clotting index of 74% after 5 min of contact. In the mice model, wounds treated with PVP6–3 closed 95% of the area after 10 days. Histological study determines the progression of skin regeneration with the construction of granulation tissue, new vascular systems, and hair follicles. Furthermore, the newly-growth skin shares structural resemblances to that of native tissue. This study suggests a simple approach to a multi-purpose wound dressing for clinical treatment.

Thyme-Loaded Nanofibrous Dressing for Skin Wound Healing: A Combination of Chinese Traditional Medicine with Cutting-Edge Technology

The skin has vital functions and its defects and damages must be properly treated and healed. Chinese traditional herbal medicine has a long history in skin wound healing, and its merging with novel approaches (nanotechnology) has resulted in more promising results. The current study aimed to combine the biological properties of a long-lasting Chinese traditional herbal medicine (Thyme) with cutting-edge technology (electrospinning) to the fabricated interactive and bioactive wound dressing. The extract of Thyme was obtained and added into the polymeric solution and converted to the nanofibrous wound dressing. The SEM analysis revealed that the fabricated nanofibers were intact without deformity with an acceptable nanometric diameter. The release kinetics evaluation showed that 80±4% of the extract was released from the nanofibers during the first 24 h. Hemolysis lower than 8% for all nanofibers revealed hemocompatibility in the fabricated wound dressings. The in vitro studies confirmed the cytocompatibility of the nanofibers. The applied animal studies exhibited that the Thyme-loaded nanofibrous dressing enhanced the wound-healing process in a dose-dependent manner. These findings demonstrate the combination of Chinese traditional herbal medicine with modern cutting-edge technology, resulting in an interactive nanofibrous mat with promising potential as the wound dressing material.

Local wound management: A review of modern techniques and products

Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.

The cross-linked bacterial cellulose impregnated with octenidine dihydrochloride-based antiseptic as an antibacterial dressing material for highly-exuding, infected wounds

The highly absorbent, antibacterial dressings with a sustained release of the antimicrobial are considered necessary measures to counteract chronic wound biofilm-based infections. This study aimed to analyze wet and dry bacterial cellulose (BC) materials, modified by chemical cross-linking, and impregnated with an antiseptic based on octenidine dihydrochloride (OCT) in the context of its antibiofilm/antibacterial activity, exudate absorption, and cytotoxicity. The native BC was obtained from cost-effective, ecological-friendly potato juice (leftover from the starch industry). The ability to absorb and retain OCT, exudate absorption capacity, the kinetics of OCT release as well as antibiofilm/antibacterial activity of modified BC materials against biofilm-forming and planktonic bacteria (Staphylococcus aureus and Pseudomonas aeruginosa) were investigated. The performed analyses revealed that modified BC materials, thanks to their layered structure with numerous air spaces, were characterized by sustained exudate absorption and OCT release profile, which allowed them to exhibit high antimicrobial activity for up to 7 days, with a reduction of planktonic and biofilm cells of 84-100% and 69-93%, respectively. The modified BC materials showed also no cytotoxicity against fibroblast cell line L929 in vitro and were characterized by firm adhesion to the curved surfaces. These results indicate that cross-linked BC impregnated with OCT may be a particularly promising dressing material (obtained using sustainable processes), especially in the treatment of biofilm-infected, highly-exuding wounds.

Hydrogel-based dressings in the treatment of partial thickness experimentally induced burn wounds in rats

Purpose:

To compare four commercially available hydrogel formulations in the healing of partial thickness burns experimentally induced in rats.

Methods:

Wistar rats were used, and after the burn wound induction they were divided into the following treatment groups: G1) NaCl 0.9%; G2) 1% silver sulfadiazine; G3) Debrigel™; G4) Safgel™; G5) Dersani™; G6) Solosite™. The animals were followed during seven, 14 and 30 days after the injury induction. Morphometric, macroscopic and microscopic evaluations were performed.

Results:

The treatment with Dersani™ induced better results during the inflammatory and proliferative phases of the healing process (p<0.05). The animals treated with Safgel™ presented better scaring in the remodeling phase (p<0.05), and the treatment with Dersani™ and Solosite™ induced greater wound closure (p<0.05).

Conclusions:

The hydrogel-based dressings presented beneficial outcomes in the healing of burn wounds experimentally induced in rats due to their ability in maintain the humidity of the wound, in removing the exudate, in promoting cell migration and collagen production during the different phases of the healing process.