Engineering Sustainable Antimicrobial Release in Silica-Cellulose Membrane with CaCO3-Aided Processing for Wound Dressing Application

Three-Dimensional Printed Cellulose for Wound Dressing Applications

Wounds are skin tissue damage due to trauma. Many factors inhibit the wound healing phase (hemostasis, inflammation, proliferation, and alteration), such as oxygenation, contamination/infection, age, effects of injury, sex hormones, stress, diabetes, obesity, drugs, alcoholism, smoking, nutrition, hemostasis, debridement, and closing time. Cellulose is the most abundant biopolymer in nature which is promising as the main matrix of wound dressings because of its good structure and mechanical stability, moisturizes the area around the wound, absorbs excess exudate, can form elastic gels with the characteristics of bio-responsiveness, biocompatibility, low toxicity, biodegradability, and structural similarity with the extracellular matrix (ECM). The addition of active ingredients as a model drug helps accelerate wound healing through antimicrobial and antioxidant mechanisms. Three-dimensional (3D) bioprinting technology can print cellulose as a bioink to produce wound dressings with complex structures mimicking ECM. The 3D printed cellulose-based wound dressings are a promising application in modern wound care. This article reviews the use of 3D printed cellulose as an ideal wound dressing and their properties, including mechanical properties, permeability aspect, absorption ability, ability to retain and provide moisture, biodegradation, antimicrobial property, and biocompatibility. The applications of 3D printed cellulose in the management of chronic wounds, burns, and painful wounds are also discussed.

Therapeutic Potential of Extracellular Vesicles from Different Stem Cells in Chronic Wound Healing

Wound healing has long been a complex problem, especially in chronic wounds. Although debridement, skin grafting, and antimicrobial dressings have been used to treat chronic wounds, their treatment period is long, expensive, and has specific rejection reactions. The poor treatment results of traditional methods have caused psychological stress to patients and a substantial economic burden to society. Extracellular vesicles (EVs) are nanoscale vesicles secreted by cells. They play an essential role in intercellular communication. Numerous studies have confirmed that stem cell-derived extracellular vesicles (SC-EVs) can inhibit overactive inflammation, induce angiogenesis, promote re-epithelization, and reduce scar formation. Therefore, SC-EVs are expected to be a novel cell-free strategy for chronic wound treatment. We first summarize the pathological factors that hinder wound healing and discuss how SC-EVs accelerate chronic wound repair. And then, we also compare the advantages and disadvantages of different SC-EVs for chronic wound treatment. Finally, we discuss the limitations of SC-EVs usage and provide new thoughts for future SC-EVs research in chronic wound treatment.

A Double-Layer Hydrogel Dressing with High Mechanical Strength and Water Resistance Used for Drug Delivery

Hydrogel dressings provide a moist wound healing environment, absorb the exudates of the wound, and have better biocompatibility than traditional dressings. However, it is still difficult to meet the needs of modern medicine due to the defects in drug burst release, weak mechanical strength, and poor water retention. To solve these problems, we developed a double-layer (DL) hydrogel based on β-cyclodextrin polymer (β-CDP), poly(vinyl alcohol) (PVA), and carboxymethyl cellulose sodium (CMC) via a layer-by-layer method. Inspired by natural coconut, this hydrogel consisted of a drug release layer (DRL) and a mechanical support layer (MSL). In our design, the introduction of β-CDP into the DRL slowed the drug release rate of the DL hydrogel. Furthermore, the mechanical strength of the hydrogel was improved by immersing the MSL in a calcium chloride/boric acid solution. Combining these two layers, the tensile strength and elongation at break of the DL hydrogel reached 1504 kPa and 400%, respectively. More interestingly, the release mechanism of DL hydrogel conformed to the diffusion-relaxation-erosion model, which was different from traditional hydrogel dressings. Therefore, the as-prepared DL structure represents a feasible solution for fabricating high-performance mechanical hydrogel dressings with sustained drug release properties, and the DL hydrogel has potential to be used for medical dressings applied in daily life.

Evaluation of Magnesium-Phosphate Particle Incorporation into Co-Electrospun Chitosan-Elastin Membranes for Skin Wound Healing

Major challenges facing clinicians treating burn wounds are the lack of integration of treatment to wound, inadequate mechanical properties of treatments, and high infection rates which ultimately lead to poor wound resolution. Electrospun chitosan membranes (ESCM) are gaining popularity for use in tissue engineering applications due to their drug loading ability, biocompatibility, biomimetic fibrous structure, and antimicrobial characteristics. This work aims to modify ESCMs for improved performance in burn wound applications by incorporating elastin and magnesium-phosphate particles (MgP) to improve mechanical and bioactive properties. The following ESCMs were made to evaluate the individual components’ effects; (C: chitosan, CE: chitosan-elastin, CMg: chitosan-MgP, and CEMg: chitosan-elastin-MgP). Membrane properties analyzed were fiber size and structure, hydrophilic properties, elastin incorporation, MgP incorporation and in vitro release, mechanical properties, degradation profiles, and in vitro cytocompatibility with NIH3T3 fibroblasts. The addition of both elastin and MgP increased the average fiber diameter of CE (~400 nm), CMg (~360 nm), and CEMg (565 nm) compared to C (255 nm). Water contact angle analysis showed elastin incorporated membranes (CE and CEMg) had increased hydrophilicity (~50°) compared to the other groups (C and CMg, ~110°). The results from the degradation study showed mass retention of ~50% for C and CMg groups, compared to ~ 30% seen in CE and CEMg after 4 weeks in a lysozyme/PBS solution. CMg and CEMg exhibited burst-release behavior of ~6 µg/ml or 0.25 mM magnesium within 72 h. In vitro analysis with NIH3T3 fibroblasts showed CE and CEMg groups had superior cytocompatibility compared to C and CMg. This work has demonstrated the successful incorporation of elastin and MgP into ESCMs and allows for future studies on burn wound applications.

Evaluation of Bacterial Cellulose Dressing versus Vaseline Gauze in Partial Thickness Burn Wounds and Skin Graft Donor Sites: A Two-Center Randomized Controlled Clinical Study

Objective

Bacterial cellulose (BC) dressing, which can maintain a moist environment and prevent the invasion of pathogens, has become a competitive dressing material for burn wound treatment. This study was conducted to evaluate the treatment efficacy of a novel China-made BC dressing for the treatment of second-degree burn wounds and skin graft donor sites.

Methods

212 patients with second-degree burn wounds or skin graft donor sites were enrolled from two research centers. They were randomly assigned to the BC dressing group (study group) or the Vaseline gauze (VG) dressing group (control group). Wound conditions were assessed before and after treatment. Dressings were changed according to the condition of the wound bed. Healing rate and healing time were recorded as primary endpoints to evaluate the efficacy of BC dressing against VG dressing. Erythema, swelling, exudation, bleeding, subeschar purulence, and pain were assessed as secondary endpoints.

Results

207 participants completed the trial and their wounds all healed within 28 days. The average healing times for superficial and deep secondary burn wounds and skin graft donor sites in the BC group were 8.12, 15.77, and 10.55 days, respectively. In the VG group, the average healing times for superficial and deep secondary burn wounds and skin graft donor sites were 9.30, 15.27, and 11.19 days, respectively. The healing time of superficial burn wounds in the BC group was statistically shorter than that in the VG group. There was no difference in the frequency of dressing changing between two groups. The BC dressing showed equal efficacy with the VG dressing at all secondary endpoints.

Conclusion

The novel BC dressing could be used for the management of second-degree burn wounds and skin graft donor sites. With a shorter healing time in superficial secondary burn wound than that of the VG dressing, the BC dressing showed noninferiority in the treatment of superficial and deep secondary burn wounds and skin graft donor sites versus the VG dressing. This study is registered with the Chinese Clinical Trial Registry (registry number: ChiCTR1800014377 (http://www.chictr.org.cn)).

An Overview on the Recent Advances in the Treatment of Infected Wounds: Antibacterial Wound Dressings

A wound can be surgical, cuts from an operation or due to accident and trauma. The infected wound, as a result of bacteria growth within the damaged skin, interrupts the natural wound healing process and significantly impacts the quality of life. Wound dressing is an important segment of the skincare industry with its economic burden estimated at $ 20.4 billion (in 2021) in the global market. The results of recent clinical trials suggest that the use of modern dressings can be the easiest, most accessible, and most cost-effective way to treat chronic wounds and, hence, holds significant promise. With the sheer number of dressings in the market, the selection of correct dressing is confusing for clinicians and healthcare workers. The aim of this research was to review widely used types of antibacterial wound dressings, as well as emerging products, for their efficiency and mode of action. In this review, we focus on introducing antibiotics and antibacterial nanoparticles as two important and clinically widely used categories of antibacterial agents. The perspectives and challenges for paving the way for future research in this field are also discussed. This article is protected by copyright. All rights reserved.

Fabrication of novel bio-adsorbent and its application for the removal of Cu(II) from aqueous solution

As eco-friendly adsorption material, hydroxyapatite (Ca₅(PO₄)₃OH, HA) has been extensively applied to the removal of heavy metal ions. However, separating and recovering of HA powder after the adsorption process limits their application. Alginate-based composite beads (HCA) encapsulated with HA and cellulose were designed to remove Cu(II) from aqueous solution. Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS) were used for characteristic analysis. An extensive discussion in terms of HCA adsorption capacity, effect of various Cu(II) concentration, and analysis of the involved mechanisms of Cu(II) removal on the biosorption. HCA beads showed that the maximum adsorption capacity for Cu(II) of 64.14 mg/g at pH = 5 with 8 h contact time. The Langmuir adsorption isotherm and second-order kinetic model gave the closest fit. HCA beads display good regeneration ability after four cycles and offer potentiality for practical application.

Mesoporous silica incorporated PCL/Curcumin nanofiber for wound healing application

Electrospinning, a recent fast-emerging technique highly applicable in the production of nanofibers has gained vast recognition owing to its explicit applications in various domains. Amongst which, the production of nanoscaffolds for wound healing applications has been focused recently due to advantages over conventional wound healing methods. In the present research, a composite nanoscaffold comprising SBA-15 (Santa Barbara Amorphous), amine functionalized SBA-15 polycaprolactone (PCL) and curcumin was investigated for its potentiality in wound healing therapeutics. The high biocompatibility and cell adhesion of amine functionalized SBA-15 and the widely explored antimicrobial properties of curcumin added benefit for the wound healing target. The prepared highly interconnected electrospun fibers with porous structure were characterized through various studies such as FTIR, XRD, SEM and EDAX. Further, antibacterial studies against both Gram positive (Bacillus subtilis) and Gram negative (Escherichia coli) strains revealed an improved zone of inhibition. Major invitro studies such as cell migration, proliferation, bio-compatibility was experimented through cell adhesion and live and dead assay using Swiss 3T6 cell lines. In vivo studies on female Wister rats using the fabricated nanofibers incorporated with curcumin and amine functionalized SBA-15 showed 99% scar-less wound healing within 21 days. Re-epithelization of tissue, collagen deposition and formation of granulation tissue were observed from the results of Hematoxylin-Eosin and Masson's tri-chrome staining. From the observations, it can be concluded that the fabricated nanoscaffold could be an effective substrate for wound healing therapeutics.

Silica/Protein and Silica/Polysaccharide Interactions and Their Contributions to the Functional Properties of Derived Hybrid Wound Dressing Hydrogels

Multifunctional and biocompatible hydrogels are on the focus of wound healing treatments. Protein and polysaccharides silica hybrids are interesting wound dressing alternatives. The objective of this review is to answer questions such as why silica for wound dressings reinforcement? What are the roles and contributions of silane precursors and silica on the functional properties of hydrogel wound dressings? The effects of tailoring the porous, morphological, and chemical characteristics of synthetic silicas on the bioactivity of hybrid wound dressings hydrogels are explored in the first part of the review. This is followed by a commented review of the mechanisms of silica/protein and silica/polysaccharide interactions and their impact on the barrier, scaffold, and delivery matrix functions of the derived hydrogels. Such information has important consequences for wound healing and paves the way to multidisciplinary researches on the production, processing, and biomedical application of this kind of hybrid materials.

Dual-functional calcium alginate hydrogel beads for disinfection control and removal of dyes in water

For the decontamination of both pathogenic microorganism and toxic dye from wastewater, new type of materials should be exploited to fabricate more cost-effective, eco-friendly biosorbent. Herein, a promising hydrogel beads based on the incorporation of nano‑silver/diatomite into calcium alginate (named as Ag-DE@CAH) was designed to disinfect water and remove methylene blue (MB). Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Scanning electron microscopy (SEM), and Transmission electron microscopy (TEM), etc. were utilized for characterization analysis. Compared with nano‑silver/diatomite (Ag-DE), the novel Ag-DE@CAH beads displayed a better sustained release profile for Ag⁺, and it noteworthy that the concentration of Ag⁺ in aqueous media is below the limit of the World Health Organization (WHO) standard (100 ppb) for a 30-days release experiment. It was found that Ag-DE@CAH beads exhibited better disinfection ability towards Escherichia coli (E. coli) than Staphylococcus aureus (S. aureus), and the maximum adsorption capacities of Ag-DE@CAH for MB was 128.21 mg/g. In addition, the as-prepared Ag-DE@CAH beads showed superior and reusable performance in the process of adsorption experiments for MB. Overall, the study indicates that the materials with both excellent disinfection and adsorption properties have potential application prospects for water purification.

Improving Fibrin Hydrogels' Mechanical Properties, through Addition of Silica or Chitosan-Silica Materials, for Potential Application as Wound Dressings

Fibrin is a protein-based hydrogel formed during blood coagulation. It can also be produced in vitro from human blood plasma, and it is capable of resisting high deformations. However, after each deformation process, it loses high amounts of water, which subsequently makes it mechanically unstable and, finally, difficult to manipulate. The objective of this work was to overcome the in vitro fibrin mechanical instability. The strategy consists of adding silica or chitosan-silica materials and comparing how the different materials electrokinetic-surface properties affect the achieved improvement. The siliceous materials electrostatic and steric stabilization mechanisms, together with plasma protein adsorption on their surfaces, were corroborated by DLS and ζ-potential measurements before fibrin gelling. These properties avoid phase separation, favoring homogeneous incorporation of the solid into the forming fibrin network. Young's modulus of modified fibrin hydrogels was evaluated by AFM to quantitatively measure stiffness. It increased 2.5 times with the addition of 4 mg/mL silica. A similar improvement was achieved with only 0.7 mg/mL chitosan-silica, which highlighted the contribution of hydrophilic chitosan chains to fibrinogen crosslinking. Moreover, these chains avoided the fibroblast growth inhibition onto modified fibrin hydrogels 3D culture observed with silica. In conclusion, 0.7 mg/mL chitosan-silica improved the mechanical stability of fibrin hydrogels with low risks of cytotoxicity. This easy-to-manipulate modified fibrin hydrogel makes it suitable as a wound dressing biomaterial.

Naturally derived nano- and micro-drug delivery vehicles: halloysite, vaterite and nanocellulose

We discuss prospects for halloysite nanotubes, vaterite crystals and nanocellulose to enter the market of biomaterials for drug delivery and tissue engineering, and their potential for economically viable production from abundant natural sources.

X-ray shielding structural and properties design for the porous transparent BaSO4/cellulose nanocomposite membranes

Since effective shielding of X-rays was required in medical, aviation and nuclear fields, a novel X-ray shielding BaSO₄/cellulose nanocomposite membrane (BSCM) material with porous transparent structure has been designed. The effects of carboxylated nano-BaSO₄ (BS) addition on the physical and morphological properties of the cellulose membrane (CM) were investigated. Meanwhile, the influence of X-ray shielding capacity was studied by different layers of composite membranes and the shielding mechanism of the X-ray was also discussed. Scanning electron microscopy (SEM) images displayed the aggregations of BS in the cellulose surface. Fourier transform infrared spectroscopy (FTIR) showed that the incorporation of BS into CM caused molecular interactions between CM and BS. Brunauer-Emmett-Teller (BET) indicated that the load of BS contributed little to the specific surface area and pore size. Meanwhile, the water vapor transmission rates (WVTR) also stayed at the same level before and after the binding of BS. The swelling ratios, weight loss ratios and mechanical property were decreased along with the addition of BS. The radiation shielding ability was enhanced. Therefore, this work was regarded as a possible example that the BSCM was designed as X-ray radiation shielding material or sandwich filler material in the implication of radiation shielding glass.