Pectin–Zeolite-Based Wound Dressings with Controlled Albumin Release

Innovative Use of an Injectable, Self-Healing Drug-Loaded Pectin-Based Hydrogel for Micro- and Supermicro-Vascular Anastomoses

Microvascular surgery plays a crucial role in reconnecting micrometer-scale vessel ends. Suturing remains the gold standard technique for small vessels; however, suturing the collapsed lumen of microvessels is challenging and time-consuming, with the risk of misplaced sutures leading to failure. Although multiple solutions have been reported, the emphasis has predominantly been on resolving challenges related to arteries rather than veins, and none has proven superior. In this study, we introduce an innovative solution to address these challenges through the development of an injectable lidocaine-loaded pectin hydrogel by using computational and experimental methods. To understand the extent of interactions between the drug and the pectin chain, molecular dynamics (MD) simulations and quantum mechanics (QM) calculations were conducted in the first step of the research. Then, a series of experimental studies were designed to prepare lidocaine-loaded injectable pectin-based hydrogels, and their characterization was performed by using Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and rheological analysis. After all the results were evaluated, the drug-loaded pectin-based hydrogel exhibiting self-healing properties was selected as a potential candidate for in vivo studies to determine its performance during operation. In this context, the hydrogel was injected into the divided vessel ends and perivascular area, allowing for direct suturing through the gel matrix. While our hydrogel effectively prevented vasospasm and facilitated micro- and supermicro-vascular anastomoses, it was noted that it did not cause significant changes in late-stage imaging and histopathological analysis up to 6 months. We strongly believe that pectin-based hydrogel potentially enhanced microlevel arterial, lymphatic, and particularly venous anastomoses.

Unraveling the Mechanisms Involved in the Beneficial Effects of Magnesium Treatment on Skin Wound Healing

The skin wound healing process consists of hemostatic, inflammatory, proliferative, and maturation phases, with a complex cellular response by multiple cell types in the epidermis, dermis, and immune system. Magnesium is a mineral essential for life, and although magnesium treatment promotes cutaneous wound healing, the molecular mechanism and timing of action of the healing process are unknown. This study, using human epidermal-derived HaCaT cells and human normal epidermal keratinocyte cells, was performed to investigate the mechanism involved in the effect of magnesium on wound healing. The expression levels of epidermal differentiation-promoting factors were reduced by MgCl2, suggesting an inhibitory effect on epidermal differentiation in the remodeling stage of the late wound healing process. On the other hand, MgCl2 treatment increased the expression of matrix metalloproteinase-7 (MMP7), a cell migration-promoting factor, and enhanced cell migration via the MEK/ERK pathway activation. The enhancement of cell migration by MgCl2 was inhibited by MMP7 knockdown, suggesting that MgCl2 enhances cell migration which is mediated by increased MMP7 expression. Our results revealed that MgCl2 inhibits epidermal differentiation but promotes cell migration, suggesting that applying magnesium to the early wound healing process could be beneficial.

Single-Walled (Magnetic) Carbon Nanotubes in a Pectin Matrix in the Design of an Allantoin Delivery System

Single-walled carbon nanotubes (SWCNTs) outperform other materials due to their high conductivity, large specific surface area, and chemical resistance. They have numerous biomedical applications, including the magnetization of the SWCNT (mSWCNT). The drug loading and release properties of see-through pectin hydrogels doped with SWCNTs and mSWCNTs were evaluated in this study. The active molecule in the hydrogel structure is allantoin, and calcium chloride serves as a cross-linker. In addition to mixing, absorption, and swelling techniques, drug loading into carbon nanotubes was also been studied. To characterize the films, differential scanning calorimetry (DSC), thermal gravimetric analysis (TGA), Fourier transform infrared (FTIR) spectroscopy, surface contact angle measurements, and opacity analysis were carried out. Apart from these, a rheological analysis was also carried out to examine the flow properties of the hydrogels. The study was also expanded to include N-(9-fluorenyl methoxycarbonyl)glycine-coated SWCNTs and mSWCNTs as additives to evaluate the efficiency of the drug-loading approach. Although the CNT additive was used at a 1:1000 weight ratio, it had a significant impact on the hydrogel properties. This effect, which was first observed in the thermal properties, was confirmed in rheological analyses by increasing solution viscosity. Additionally, rheological analysis and drug release profiles show that the type of additive causes a change in the matrix structure. According to TGA findings, even though SWCNTs and mSWCNTs were not coated more than 5%, the coating had a significant effect on drug release control. In addition to all findings, cell viability tests revealed that hydrogels with various additives could be used for visual wound monitoring, hyperthermia treatment, and allantoin release in wound treatment applications.

A double-layer cellulose/pectin-soy protein isolate-pomegranate peel extract micro/nanofiber dressing for acceleration of wound healing

Multi-layered wound dressings can closely mimic the hierarchical structure of the skin. Herein, a double-layer dressing material is fabricated through electrospinning, comprised of a nanofibrous structure as a healing-support layer or the bottom layer (BL) containing pectin (Pec), soy protein isolate (SPI), pomegranate peel extract (P), and a cellulose (Cel) microfiber layer as a protective/monitoring layer or top layer (TL). The formation of a fine bilayer structure was confirmed using scanning electron microscopy. Cel/Pec-SPI-P dressing showed a 60.05 % weight loss during 7 days of immersion in phosphate buffered solution. The ultimate tensile strength, elastic modulus, and elongation at break for different dressings were within the range of 3.14-3.57 MPa, 32.26-36.58 MPa, and 59.04-63.19 %, respectively. The release of SPI and phenolic compounds from dressings were measured and their antibacterial activity was evaluated. The fabricated dressing was non-cytotoxic following exposure to human keratinocyte cells. The Cel/Pec-SPI-P dressing exhibited excellent cell adhesion and migration as well as angiogenesis. More importantly, in vivo experiments on Cel/Pec-SPI-P dressings showed faster epidermal layer formation, blood vessel generation, collagen deposition, and a faster wound healing rate. Overall, it is anticipated that the Cel/Pec-SPI-P bilayer dressing facilitates wound treatment and can be a promising approach for clinical use.

Therapeutic Management of Malignant Wounds: An Update

OPINION STATEMENT

Malignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternatives for better malignant wound management. The last decade screened literature evidenced an increasing interest in developing natural treatment alternatives based on beehive, plant extracts, pure vegetal compounds, and bacteriocins. Promising therapeutics can also be envisaged by involving nanotechnology due to either intrinsic biological activities or drug delivery properties of nanomaterials. Despite recent progress in the field of malignant wound care, the literature is still mainly based on in vitro and in vivo studies on small animal models, while the case reports and clinical trials (less than 10 and only one providing public results) remain scarce. Some innovative treatment approaches are used in clinical practice without prior extensive testing in fungating wound patients. Extensive research is urgently needed to fill this knowledge gap and translate the identified promising therapeutic approaches to more advanced testing stages toward creating multidimensional wound care strategies.

Zeolites as Ingredients of Medicinal Products

Development of new medicinal products for particular therapeutic treatment or for better manipulations with better quality and less side effects are possible as a result of advanced inorganic and organic materials application, among which zeolites, due to their properties and versatility, have been gaining attention. This paper is an overview of the development in the use of zeolite materials and their composites and modifications as medicinal products for several purposes such as active agents, carriers, for topical treatments, oral formulations, anticancer, the composition of theragnostic systems, vaccines, parenteral dosage forms, tissue engineering, etc. The objective of this review is to explore the main properties of zeolites and associate them with their drug interaction, mainly addressing the advances and studies related to the use of zeolites for different types of treatments due to their zeolite characteristics such as molecule storage capacity, physical and chemical stability, cation exchange capacity, and possibility of functionalization. The use of computational tools to predict the drug-zeolite interaction is also explored. As conclusion was possible to realize the possibilities and versatility of zeolite applications as being able to act in several aspects of medicinal products.

Design Considerations, Formulation Approaches, and Strategic Advances of Hydrogel Dressings for Chronic Wound Management

Wound healing is a complex and dynamic physiological process consisting of a series of cellular and molecular events that initiate immediately after a tissue lesion, to reconstruct the skin layer. It is indubitable that patients with chronic wounds, severely infected wounds, or any metabolic disorder of the wound microenvironment always endure severe pain and discomfort that affect their quality of life. It is essential to treat chronic wounds for conserving the physical as well as mental well-being of affected patients and for convalescing to improve their quality of life. For supporting and augmenting the healing process, the selection of pertinent wound dressing is essential. A substantial reduction in healing duration, disability, associated cost, and risk of recurrent infections can be achieved via engineering wound dressings. Hydrogels play a leading role in the path of engineering ideal wound dressings. Hydrogels, comprising water to a large extent, providing a moist environment, being comfortable to patients, and having biocompatible and biodegradable properties, have found their success as suitable wound dressings in the market. The exploitation of hydrogels is increasing perpetually after substantiation of their broader therapeutic actions owing to their resemblance to dermal tissues, their capability to stimulate partial skin regeneration, and their ability to incorporate therapeutic moieties promoting wound healing. This review entails properties of hydrogel supporting wound healing, types of hydrogels, cross-linking mechanisms, design considerations, and formulation strategies of hydrogel engineering. Various categories of hydrogel wound dressing fabricated recently are discussed based on their gel network composition, degradability, and physical and chemical cross-linking mechanisms, which provide an outlook regarding the importance of tailoring the physicochemical properties of hydrogels. The examples of marketed hydrogel wound dressings are also incorporated along with the future perspectives and challenges associated with them.

Carrageenan-Based Compounds as Wound Healing Materials

The following review is focused on carrageenan, a heteroglycan-based substance that is a very significant wound healing biomaterial. Every biomaterial has advantages and weaknesses of its own, but these drawbacks are typically outweighed by combining the material in various ways with other substances. Carrageenans' key benefits include their water solubility, which enables them to keep the wound and periwound damp and absorb the wound exudate. They have low cytotoxicity, antimicrobial and antioxidant qualities, do not stick to the wound bed, and hence do not cause pain when removed from the wounded region. When combined with other materials, they can aid in hemostasis. This review emphasizes the advantages of using carrageenan for wound healing, including the use of several mixes that improve its properties.

Effects of Drug-Free Pectin Hydrogel Films on Thermal Burn Wounds in Streptozotocin-Induced Diabetic Rats

This study aims to examine the influence of drug-free pectin hydrogel films on partial-thickness burn wounds using streptozotocin-induced diabetic rats as the animal model. Thirty male Sprague Dawley rats were included in the wound healing study, and scalding water was used to produce wounds in the dorsum region of the rats. Two different formulations of pectin hydrogel films, PH 2.5% and PH 5%, were prepared using a solvent evaporation method. MEBO^® (moist exposed burn ointment), a commercial herbal formulation was used as a positive control. The progress of the wound healing was observed and compared between untreated normal rats, untreated diabetic rats, diabetic rats treated with MEBO^®, diabetic rats treated with PH 2.5%, and diabetic rats treated with PH 5%. The results showed that diabetic rats treated with PH 5% healed faster than the untreated diabetic rats and diabetic rats treated with PH 2.5%. Interestingly, the diabetic rats treated with PH 5% healed as well as diabetic rats treated with MEBO^®, where wounds were healed entirely on day 20. Nevertheless, both PH 2.5% and PH 5% showed a greater zone of inhibition than MEBO^® when tested against Staphylococcus aureus.