Recent Advances in Cellulose-Based Structures as the Wound-Healing Biomaterials: A Clinically Oriented Review

An antifouling electrochemical biosensor based on oxidized bacterial cellulose and quaternized chitosan for reliable detection of involucrin in wound exudate

The monitoring of biomarkers in wound exudate is of great importance for wound care and treatment, and electrochemical biosensors with high sensitivity are potentially useful for this purpose. However, conventional electrochemical biosensors always suffer from severe biofouling when performed in the complex wound exudate. Herein, an antifouling electrochemical biosensor for the detection of involucrin in wound exudate was developed based on a wound dressing, oxidized bacterial cellulose (OxBC) and quaternized chitosan (QCS) composite hydrogel. The OxBC/QCS hydrogel was prepared using an in-situ chemical oxidation and physical blending method, and the proportion of OxBC and QCS was optimized to achieve electrical neutrality and enhanced hydrophilicity, therefore endowing the hydrogel with exceptional antifouling and antimicrobial properties. The involucrin antibody SY5 was covalently bound to the OxBC/QCS hydrogel to construct the biosensor, and it demonstrated a low limit of detection down to 0.45 pg mL-1 and a linear detection range from 1.0 pg mL-1 to 1.0 μg mL-1, and it was capable of detecting targets in wound exudate. Crucially, the unique antifouling and antimicrobial capability of the OxBC/QCS hydrogel not only extends its effective lifespan but also guarantees the sensing performance of the biosensor. The successful application of this wound dressing, OxBC/QCS hydrogel for involucrin detection in wound exudate demonstrates its promising potential in wound healing monitoring.

Nanocomposite Based on Bacterial Cellulose and Silver Nanoparticles Improve Wound Healing Without Exhibiting Toxic Effect

Wound healing is an important and complex process, containing a multifaceted process governed by sequential yet overlapping phases. Certain treatments can optimize local physiological conditions and improve wound healing. Silver nanoparticles (AgNP) are widely known for their antimicrobial activity. On the other hand, bacterial cellulose (BC) films have been used as a dressing that temporarily substitutes the skin, offering many advantages in optimizing wound healing, in addition to being highly biocompatible. Considering the promising activities of AgNP and BC films, the present study aimed to evaluate the wound healing activity in Wistar Hannover rats using a nanocomposite based on bacterial cellulose containing AgNP (AgBC). In a period of 21 days, its influence on the wound area, microbial growth, histopathological parameters, and collagen content were analyzed. In addition, toxicity indicators were assessed, such as weight gain, water consumption, and creatinine and alanine transaminase levels. After 14 days of injury, the animals treated with AgBC showed a significant increase in wound contraction. The treatment with AgBC significantly reduced the number of microbial colonies compared to other treatments in the first 48 h after the injury. At the end of the 21 experimental days, an average wound contraction rate greater than 97 % in relation to the initial area was observed, in addition to a significant increase in the amount of collagen fibers at the edge of the wounds, lower scores of necrosis, angiogenesis and inflammation, associated with no systemic toxicity. Therefore, it is concluded that the combination of preexisting products to form a new nanocomposite based on BC and AgNP amplified the biological activity of these products, increasing the effectiveness of wound healing and minimizing possible toxic effects of silver.

Gellan gum-based bi-polymeric hydrogel scaffolds loaded with Rosuvastatin calcium: A useful tool for tendon tissue regeneration

Statins have been long used in tissue engineering, besides their marketed hypolipidemic benefits. The aim of this research was to sustain the release of rosuvastatin calcium from bi-polymeric hydrogel scaffolds. A bi-polymer blend technique was used to enhance the mechanical properties of the fabricated hydrogels. Briefly, hydrogels were prepared via crosslinking gellan gum as the main polymer together with a secondary polymer in the presence of Ca2+. The fabricated hydrogels were assessed in terms of % swelling capacity, hydrolytic degradation and % drug released to determine the most efficient carrier system. The selected hydrogel exhibited a swelling capacity of 131.45±1.49 % following 3 weeks in an aqueous environment with a % weight loss of 15.73±1.86 % after 4 weeks post-equilibrium in aqueous medium. The results ensure a proper window for adequate drug diffusion and nutrient exchange. Sustained release was attained where 94.61±2.77 % of rosuvastatin was released at the 4-week mark. Later, FT-IR and DSC, were carried out and suggested the successful crosslinking and formation of new matrix. SEM images demonstrated the porous surface of the hydrogel while a Young's modulus of 888.558±73.549 kPa indicated the suitability of the hydrogel for soft tissue engineering. In-vivo testing involved implanting the selected hydrogel at precisely surgical cuts in the Achilles tendon of male Wistar Albino rats. Upon visual and microscopic evaluation, enhanced rates of fibrous tissue formation, vascularization and collagen expression were clearly noticed in the treatment group.

Cellulose Acetate-Based Wound Dressings Loaded with Bioactive Agents: Potential Scaffolds for Wound Dressing and Skin Regeneration

Wound healing and skin regeneration are major challenges in chronic wounds. Among the types of wound dressing products currently available in the market, each wound dressing material is designed for a specific wound type. Some of these products suffer from various shortcomings, such as poor antibacterial efficacy and mechanical performance, inability to provide a moist environment, poor permeability to oxygen and capability to induce cell migration and proliferation during the wound healing process. Hydrogels and nanofibers are widely reported wound dressings that have demonstrated promising capability to overcome these shortcomings. Cellulose acetate is a semisynthetic polymer that has attracted great attention in the fabrication of hydrogels and nanofibers. Loading bioactive agents such as antibiotics, essential oils, metallic nanoparticles, plant extracts, and honey into cellulose acetate-based nanofibers and hydrogels enhanced their biological effects, including antibacterial, antioxidant, and wound healing. This review reports cellulose acetate-based hydrogels and nanofibers loaded with bioactive agents for wound dressing and skin regeneration.

Recent advances in 3D printed cellulose-based wound dressings: A review on in vitro and in vivo achievements

Chronic wounds, especially diabetic ulcers, pose a significant challenge in regenerative medicine. Cellulose derivatives offer remarkable wound management properties, such as effective absorption and retention of wound exudates, maintaining an optimal moisture environment crucial for successful chronic wound regeneration. However, conventional dressings have limited efficacy in managing and healing these types of skin lesions, driving scientists to explore innovative approaches. The emergence of 3D printing has enabled personalized dressings that meet individual patient needs, improving the healing process and patient comfort. Cellulose derivatives meet the demanding requirements for biocompatibility, printability, and biofabrication necessary for 3D printing of biologically active scaffolds. However, the potential applications of nanocellulose and cellulose derivative-based inks for wound regeneration remain largely unexplored. Thus, this review provides a comprehensive overview of recent advancements in cellulose-based inks for 3D printing of personalized wound dressings. The composition and biofabrication approaches of cellulose-based wound dressings are thoroughly discussed, including the functionalization with bioactive molecules and antibiotics for improved wound regeneration. Similarly, the in vitro and in vivo performance of these dressings is extensively examined. In summary, this review aims to highlight the exceptional advantages and diverse applications of 3D printed cellulose-based dressings in personalized wound care.

Cellulose/Zeolitic Imidazolate Framework (ZIF-8) Composites with Antibacterial Properties for the Management of Wound Infections

Metal-organic frameworks (MOFs) are a class of crystalline porous materials with outstanding physical and chemical properties that make them suitable candidates in many fields, such as catalysis, sensing, energy production, and drug delivery. By combining MOFs with polymeric substrates, advanced functional materials are devised with excellent potential for biomedical applications. In this research, Zeolitic Imidazolate Framework 8 (ZIF-8), a zinc-based MOF, was selected together with cellulose, an almost inexhaustible polymeric raw material produced by nature, to prepare cellulose/ZIF-8 composite flat sheets via an in-situ growing single-step method in aqueous media. The composite materials were characterized by several techniques (IR, XRD, SEM, TGA, ICP, and BET) and their antibacterial activity as well as their biocompatibility in a mammalian model system were investigated. The cellulose/ZIF-8 samples remarkably inhibited the growth of Gram-positive and Gram-negative reference strains, and, notably, they proved to be effective against clinical isolates of Staphylococcus epidermidis and Pseudomonas aeruginosa presenting different antibiotic resistance profiles. As these pathogens are of primary importance in skin diseases and in the delayed healing of wounds, and the cellulose/ZIF-8 composites met the requirements of biological safety, the herein materials reveal a great potential for use as gauze pads in the management of wound infections.

Recent Advances in Electrospun Nanofiber-Based Strategies for Diabetic Wound Healing Application

Diabetic ulcers are the second largest complication caused by diabetes mellitus. A great number of factors, including hyperchromic inflammation, susceptible microbial infection, inferior vascularization, the large accumulation of free radicals, and other poor healing-promoting microenvironments hold back the healing process of chronic diabetic ulcer in clinics. With the increasing clinical cases of diabetic ulcers worldwide, the design and development of advanced wound dressings are urgently required to accelerate the treatment of skin wounds caused by diabetic complications. Electrospinning technology has been recognized as a simple, versatile, and cost-reasonable strategy to fabricate dressing materials composed of nanofibers, which possess excellent extracellular matrix (ECM)-mimicking morphology, structure, and biological functions. The electrospinning-based nanofibrous dressings have been widely demonstrated to promote the adhesion, migration, and proliferation of dermal fibroblasts, and further accelerate the wound healing process compared with some other dressing types like traditional cotton gauze and medical sponges, etc. Moreover, the electrospun nanofibers are commonly harvested in the structure of nonwoven-like mats, which possess small pore sizes but high porosity, resulting in great microbial barrier performance as well as excellent moisture and air permeable properties. They also serve as good carriers to load various bioactive agents and/or even living cells, which further impart the electrospinning-based dressings with predetermined biological functions and even multiple functions to significantly improve the healing outcomes of different chronic skin wounds while dramatically shortening the treatment procedure. All these outstanding characteristics have made electrospun nanofibrous dressings one of the most promising dressing candidates for the treatment of chronic diabetic ulcers. This review starts with a brief introduction to diabetic ulcer and the electrospinning process, and then provides a detailed introduction to recent advances in electrospinning-based strategies for the treatment of diabetic wounds. Importantly, the synergetic application of combining electrospinning with bioactive ingredients and/or cell therapy was highlighted. The review also discussed the advantages of hydrogel dressings by using electrospun nanofibers. At the end of the review, the challenge and prospects of electrospinning-based strategies for the treatment of diabetic wounds are discussed in depth.

Bacterial cellulose-based composites as vehicles for dermal and transdermal drug delivery: A review

In recent years, a significant amount of drugs have been taken orally, which are not as effective as desired. To solve this problem, bacterial cellulose-based dermal/transdermal drug delivery systems (BC-DDSs) with unique properties such as cell compatibility, hemocompatibility, tunable mechanical properties, and the ability to encapsulate various therapeutic agents with the controlled release have been introduced. A BC-dermal/transdermal DDS reduces first-pass metabolism and systematic side effects while improving patient compliance and dosage effectiveness by controlling drug release through the skin. The barrier function of the skin, especially the stratum corneum, can interfere with drug delivery. Few drugs can pass through the skin to reach effective concentrations in the blood to treat diseases. Due to their unique physicochemical properties and high potential to reduce immunogenicity and improve bioavailability, BC-dermal/transdermal DDSs are widely used to deliver various types of drugs for disease treatment. In this review, we describe the different types of BC-dermal/ transdermal DDSs, along with a critical discussion of the advantages and disadvantages of these systems. After the general presentation, the review is focused on recent advances in the preparation and applications of BC-based dermal/transdermal DDSs in various types of disease treatment.

rhEGF-Loaded Hydrogel in the Treatment of Chronic Wounds in Patients with Diabetes: Clinical Cases

The aim of the study was to evaluate the healing process of chronic wounds treated with carboxymethylcellulose loaded with recombinant human epidermal growth factor in patients with diabetes. The case series consisted of 10 patients treated at the university hospital for 12 weeks. Data were analyzed using SPSS version 22.0. according to the intention to treat the principle, without the loss or exclusion of the participants. The sample consisted of 70% (7/10) males with a mean age of 61.9 years (±9.4); all (100%) had diabetes mellitus and 70% (7/10) had systolic hypertension associated with diabetes mellitus. Sixty percent (6/10) presented lesions of diabetic etiology and 40% (4/10) presented lesions of venous etiology; 70% (7/10) had had lesions for less than 5 years. The mean glycated hemoglobin was 7.8% (±2.7%), while the mean ankle-arm index (AAI) was 0.94 (±0.21). The mean initial area of all wounds was 13.4 cm², and the mean final area was 7.8 cm², with a reduction rate of 28.9% over the 12 weeks of treatment. The reduction rate of diabetic ulcers was higher (33.4%) than that of venous ulcers (22.1%). Regarding the type of tissue, there was an increase in granulation and epithelialization, and a decrease in slough and the amount of exudate that were statistically significant (p = 0.021). No participant had severe or local adverse events during the study period. Epidermal growth factor was effective in the treatment of chronic wounds, especially diabetic ulcers, resulting in the reduction of the wound area and the improvement of tissue and exudate quality.

Valorization of Pineapple Residues from the Colombian Agroindustry to Produce Cellulose Nanofibers

Cellulose nanofiber is the world’s most advanced biomass material. Most importantly, it is biodegradable. In this work, nanofibers were obtained from pineapple leaves, a large solid waste in Colombia, using a combined extraction method (chemical procedures and ultrasound). The native fibers were bleached, hydrolyzed, treated with ultrasound, and characterized by scanning electron microscopy (SEM), infrared analysis (FTIR), thermogravimetric analysis (TGA), and transmission electron microscopy (TEM). As a comparison, a commercial microcrystalline cellulose sample was analyzed, which demonstrated the efficiency of cellulose extraction. The nanofibers had a diameter and a length of 18 nm and 237 nm, respectively, with a maximum degradation temperature of 306 °C. The analysis showed the efficiency of acid treatment combined with ultrasound to obtain nanofibers and confirmed that pineapple residues can be valorized by this method. These results indicate that lignocellulosic matrices from pineapple leaves have potential application for obtaining polymeric-type composite materials. Due to their morphology and characteristic physical properties, the cellulose nanofibers obtained in this work could be a promising material for use in a wealth of fields and applications such as filter material, high gas barrier packaging material, electronic devices, foods, medicine, construction, cosmetics, pharmacy, and health care, among others.

Editorial on Special Issue “Biomaterials, Polymers and Tissue Engineering”

The development of new materials, new manufacturing methods, and new techniques has attracted interest from many researchers in recent decades [...]

Biomaterials-Based Regenerative Strategies for Skin Tissue Wound Healing

Skin tissue wound healing proceeds through four major stages, including hematoma formation, inflammation, and neo-tissue formation, and culminates with tissue remodeling. These four steps significantly overlap with each other and are aided by various factors such as cells, cytokines (both anti- and pro-inflammatory), and growth factors that aid in the neo-tissue formation. In all these stages, advanced biomaterials provide several functional advantages, such as removing wound exudates, providing cover, transporting oxygen to the wound site, and preventing infection from microbes. In addition, advanced biomaterials serve as vehicles to carry proteins/drug molecules/growth factors and/or antimicrobial agents to the target wound site. In this review, we report recent advancements in biomaterials-based regenerative strategies that augment the skin tissue wound healing process. In conjunction with other medical sciences, designing nanoengineered biomaterials is gaining significant attention for providing numerous functionalities to trigger wound repair. In this regard, we highlight the advent of nanomaterial-based constructs for wound healing, especially those that are being evaluated in clinical settings. Herein, we also emphasize the competence and versatility of the three-dimensional (3D) bioprinting technique for advanced wound management. Finally, we discuss the challenges and clinical perspective of various biomaterial-based wound dressings, along with prospective future directions. With regenerative strategies that utilize a cocktail of cell sources, antimicrobial agents, drugs, and/or growth factors, it is expected that significant patient-specific strategies will be developed in the near future, resulting in complete wound healing with no scar tissue formation.

Employing Cellulose Nanofiber-Based Hydrogels for Burn Dressing

The aim of this research was to fabricate a burn dressing in the form of hydrogel films constructed with cellulose nanofibers (CNF) that has pain-relieving properties, in addition to wound healing. In this study, the hydrogels were prepared in the form of film. For this, CNF at weight ratios of 1, 2, and 3 wt.%, 1 wt.% of hydroxyethyl cellulose (HEC), and citric acid (CA) crosslinker with 10 and 20 wt.% were used. FE-SEM analysis showed that the structure of the CNF was preserved after hydrogel preparation. Cationization of CNF by C₆H₁₄NOCl was confirmed by FTIR spectroscopy. The drug release analysis results showed a linear relationship between the amount of absorption and the concentration of the drug. The MTT test (assay protocol for cell viability and proliferation) showed the high effectiveness of cationization of CNF and confirmed the non-toxicity of the resulting hydrogels.

Biocompatible and Antimicrobial Cellulose Acetate-Collagen Films Containing MWCNTs Decorated with TiO2 Nanoparticles for Potential Biomedical Applications

This research focuses on the synthesis of multi-walled carbon nanotubes (MWCNTs) decorated with TiO₂ nanoparticles (NPs) and incorporated in cellulose acetate-collagen film in order to obtain a new biomaterial with potential biomedical applications and improved antimicrobial activity. The successful decoration of the MWCNTs with TiO₂ NPs was confirmed by several structural and morphological analysis, such as Fourier transformed infrared spectroscopy, Raman spectroscopy, X-ray diffraction and transmission electron microscopy. The obtained nanocomposites were further incorporated into cellulose acetate-collagen films, at different concentrations and absorption kinetics, antimicrobial activity and in vitro biocompatibility of the obtained films was investigated. The antimicrobial tests sustained that the presence of the nanocomposites into the polymeric matrix is an important aspect in increasing and maintaining the antimicrobial activity of the polymeric wound dressings over time. The biocompatibility and cytotoxicity of the obtained films was evaluated using cellular viability/proliferation assay and fluorescent microscopy which revealed the ability of the obtained materials as potential wound dressing biomaterial.