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Song Y, Fu Z, Zhu X, Zhang J, Bai W, Song B. The flower of Abelmoschus manihot (L.) medik exerts antioxidant effects by regulating the Nrf2 signalling pathway in scald injury. Wound Repair Regen 2024; 32:123-134. [PMID: 38151814 DOI: 10.1111/wrr.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/25/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Abstract
Scald is a common skin injury in daily life. It is well known that skin burns are associated with inflammation and oxidative stress. In our previous study, we found that Abelmoschus manihot (L.) medik had excellent therapeutic effects on scald-induced inflammation, but its effect on scald-induced oxidative stress was not reported. In this study, a deep second-degree scald model in mice was established, and the wound healing rate, healing time, malondialdehyde (MDA) and total superoxide dismutase (T-SOD) levels, and nuclear factor erythroid 2-related Factor 2 (Nrf2) expression in wound tissue were measured to evaluate the scald wound healing performance of extraction from A. manihot (L.) medik (EAM). Scalding activity in mice was examined in vivo by hot water-induced finger swelling. The treatment scald activities were also examined in vivo by subjecting mice to thermal water-induced digit swelling. Additionally, the antioxidant effect of EAM on fibroblasts was also used to determine the mechanism in vitro. The results showed that EAM not only decreased the wound healing time but also effectively regulated the levels of oxidising, MDA and T-SOD in wound tissue. Concurrently, EAM suppressed digit swelling and hyperalgesia. Furthermore, EAM had a significant protective effect on NIH-3T3 cells after H2 O2 injury by regulating the Nrf2 signalling pathway against oxidative injury. Therefore, EAM is a promising drug for the treatment of scald-induced inflammation.
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Affiliation(s)
- Ying Song
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
- Hangzhou King's Healthcare Pharmaceutical Technology Co., Ltd., Hangzhou, Zhejiang, China
| | - Zailin Fu
- Linping Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xinyi Zhu
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Jun Zhang
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Wenwen Bai
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Biwei Song
- Department of Pharmacology, Zhejiang University of Technology, Hangzhou, Zhejiang, China
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Thawabteh AM, Jibreen A, Karaman D, Thawabteh A, Karaman R. Skin Pigmentation Types, Causes and Treatment-A Review. Molecules 2023; 28:4839. [PMID: 37375394 DOI: 10.3390/molecules28124839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Human skin pigmentation and melanin synthesis are incredibly variable, and are impacted by genetics, UV exposure, and some drugs. Patients' physical appearance, psychological health, and social functioning are all impacted by a sizable number of skin conditions that cause pigmentary abnormalities. Hyperpigmentation, where pigment appears to overflow, and hypopigmentation, where pigment is reduced, are the two major classifications of skin pigmentation. Albinism, melasma, vitiligo, Addison's disease, and post-inflammatory hyperpigmentation, which can be brought on by eczema, acne vulgaris, and drug interactions, are the most common skin pigmentation disorders in clinical practice. Anti-inflammatory medications, antioxidants, and medications that inhibit tyrosinase, which prevents the production of melanin, are all possible treatments for pigmentation problems. Skin pigmentation can be treated orally and topically with medications, herbal remedies, and cosmetic products, but a doctor should always be consulted before beginning any new medicine or treatment plan. This review article explores the numerous types of pigmentation problems, their causes, and treatments, as well as the 25 plants, 4 marine species, and 17 topical and oral medications now on the market that have been clinically tested to treat skin diseases.
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Affiliation(s)
- Amin Mahmood Thawabteh
- Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Ramallah 00972, Palestine
- General Safety Section, General Services Department, Birzeit University, Bir Zeit 71939, Palestine
| | - Alaa Jibreen
- Research and Development Department, Beit Jala Pharmaceutical Co., Ltd., Beit Jala 97300, Palestine
| | - Donia Karaman
- Pharmaceutical Sciences Department, Faculty of Pharmacy, Al-Quds University, Jerusalem 20002, Palestine
| | - Alà Thawabteh
- Medical Imaging Department, Faculty of Health Profession, Al-Quds University, Jerusalem 20002, Palestine
| | - Rafik Karaman
- Pharmaceutical Sciences Department, Faculty of Pharmacy, Al-Quds University, Jerusalem 20002, Palestine
- Department of Sciences, University of Basilicata, Via dell'Ateneo Lucano 10, 85100 Potenza, Italy
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T A, Prabhu A, Baliga V, Bhat S, Thenkondar ST, Nayak Y, Nayak UY. Transforming Wound Management: Nanomaterials and Their Clinical Impact. Pharmaceutics 2023; 15:pharmaceutics15051560. [PMID: 37242802 DOI: 10.3390/pharmaceutics15051560] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Wound healing is a complex process that can be further complicated in chronic wounds, leading to prolonged healing times, high healthcare costs, and potential patient morbidity. Nanotechnology has shown great promise in developing advanced wound dressings that promote wound healing and prevent infection. The review article presents a comprehensive search strategy that was applied to four databases, namely Scopus, Web of Science, PubMed, and Google Scholar, using specific keywords and inclusion/exclusion criteria to select a representative sample of 164 research articles published between 2001 and 2023. This review article provides an updated overview of the different types of nanomaterials used in wound dressings, including nanofibers, nanocomposites, silver-based nanoparticles, lipid nanoparticles, and polymeric nanoparticles. Several recent studies have shown the potential benefits of using nanomaterials in wound care, including the use of hydrogel/nano silver-based dressings in treating diabetic foot wounds, the use of copper oxide-infused dressings in difficult-to-treat wounds, and the use of chitosan nanofiber mats in burn dressings. Overall, developing nanomaterials in wound care has complemented nanotechnology in drug delivery systems, providing biocompatible and biodegradable nanomaterials that enhance wound healing and provide sustained drug release. Wound dressings are an effective and convenient method of wound care that can prevent wound contamination, support the injured area, control hemorrhaging, and reduce pain and inflammation. This review article provides valuable insights into the potential role of individual nanoformulations used in wound dressings in promoting wound healing and preventing infections, and serves as an excellent resource for clinicians, researchers, and patients seeking improved healing outcomes.
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Affiliation(s)
- Ashwini T
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Ashlesh Prabhu
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Vishal Baliga
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Shreesha Bhat
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Siddarth T Thenkondar
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Yogendra Nayak
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Usha Y Nayak
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Teimouri M, Lalehzar SS. Evaluation of the therapeutic effect of dressing containing Silver (Ag coat) in the process of healing skin blisters caused by limb fractures: a clinical trial study. BMC Surg 2023; 23:101. [PMID: 37118690 PMCID: PMC10148518 DOI: 10.1186/s12893-023-02012-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/20/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The main activity of the skin is to create a protective barrier against damage. Loss of the skin due to injury or disease and failure to regenerate the affected area may result in disability, infection, or even death. We conducted a clinical trial to evaluate the therapeutic effect of dressing containing silver in process of healing skin blisters caused by limb fractures. METHOD This is a pioneering randomized trial that compares the effectiveness of two dressings containing silver (Ag coat) and Gaz Vaseline among patients with skin blisters due to bone fractures who were randomly selected from patients referred to the Kashani Medical Training Center. There were two treatment groups containing 16 patients treated with Ag coat and 15 patients treated with Gaz Vaseline. Pictures were taken of blisters on days 0, 7, and 14 to evaluate the healing process. The amount of pain, duration of the visit (measured by minutes), and general condition of the wound were checked. The amount of pain, duration of visit (measured by minutes) and general condition of the wound was checked. All continuous and categorical data are presented as mean ± standard deviation (SD) and frequency (percentage), respectively. Paired sample T-test and repeated measure analysis of variance (ANOVA), Chi-squared test was used. All pictures were analyzed by Mosaic soft ward. RESULT During this study, there was no significant difference between the mean of age and BMI and frequency of gender in the two study groups (P > 0.05). There was a significant difference in mean between the duration of the visit, number of dressings, and net cost of dressing [Formula: see text]. In the macroscopic study and analysis for evaluation and comparing wound area with the Mosaic soft ward, there was significant relation in time (p1 = 0.00). There is no significant difference between the groups (p2 = 0.84). There was a significant difference between time and group (p3 = 0.00). On day 14 the wound area between groups had a significant difference (p4 = 0.00) (Table 3). In the VAS score there was a significant difference in time, and group (p1,2 = 0.00), there was no significant relation between time and group (p3 = 0.62). On all days the wound area between groups had a significant difference (p4 = 0.00). CONCLUSION In conclusion, Ag coat dressing, not only has a significant effect on wound healing but also, decreases pain, shorter visit time, and its more cost-effective.
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Affiliation(s)
- Mehdi Teimouri
- Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Sadat Lalehzar
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Solidum JGN, Ceriales JA, Ong EP, Ornos EDB, Relador RJL, Quebral EPB, Lapeña JFF, Tantengco OAG, Lee KY. Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery. Maxillofac Plast Reconstr Surg 2023; 45:15. [PMID: 36995508 PMCID: PMC10060935 DOI: 10.1186/s40902-023-00383-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Nanotechnology and nanomedicine are rising novel fields in plastic and reconstructive surgery (PRS). The use of nanomaterials often goes with regenerative medicine. Due to their nanoscale, these materials stimulate repair at the cellular and molecular levels. Nanomaterials may be placed as components of nanocomposite polymers allowing enhancement of overall biochemical and biomechanical properties with improved scaffold properties, cellular attachment, and tissue regeneration. They may also be formulated as nanoparticle-based delivery systems for controlled release of signal factors or antimicrobials, for example. However, more studies on nanoparticle-based delivery systems still need to be done in this field. Nanomaterials are also used as frameworks for nerves, tendons, and other soft tissues. MAIN BODY In this mini-review, we focus on nanoparticle-based delivery systems and nanoparticles targeting cells for response and regeneration in PRS. Specifically, we investigate their roles in various tissue regeneration, skin and wound healing, and infection control. Cell surface-targeted, controlled-release, and inorganic nanoparticle formulations with inherent biological properties have enabled enhanced wound healing, tumor visualization/imaging, tissue viability, and decreased infection, and graft/transplantation rejection through immunosuppression. CONCLUSIONS Nanomedicine is also now being applied with electronics, theranostics, and advanced bioengineering technologies. Overall, it is a promising field that can improve patient clinical outcomes in PRS.
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Affiliation(s)
- Jea Giezl N Solidum
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Jeremy A Ceriales
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Erika P Ong
- College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Eric David B Ornos
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Ruth Joy L Relador
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Elgin Paul B Quebral
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Jose Florencio F Lapeña
- Department of Otolaryngology - Head and Neck Surgery, Section of Craniomaxillofacial Plastic and Restorative Surgery, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Ourlad Alzeus G Tantengco
- Department of Physiology, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines.
- Department of Biology, College of Science, De La Salle University, Manila, 1004, Philippines.
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
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Wang H, Huang X, Liang H, Sun X, Meng N, Zhou N. Synthesis and Characterization of Polydopamine‐Modified Montmorillonite Loaded with Silver Nanoparticles for Antibacterial Functionalization. ChemistrySelect 2023. [DOI: 10.1002/slct.202204371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Huiyan Wang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing 210046 China
| | - Xinrong Huang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing 210046 China
| | - Han Liang
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing 210046 China
| | - Xuemei Sun
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing 210046 China
| | - Na Meng
- School of Food Science and Pharmaceutical Engineering Nanjing Normal University Nanjing 210046 China
| | - Ninglin Zhou
- Jiangsu Collaborative Innovation Center for Biological Functional Materials, College of Chemistry and Materials Science Nanjing Normal University Nanjing 210023 China
- Jiangsu Key Laboratory of Biofunctional Materials Jiangsu Engineering Research Center for Biomedical Function Materials Nanjing 210023 China
- Nanjing Zhou Ninglin Advanced Materials Technology Company Limited Nanjing 211505 China
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7
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Kapusta O, Jarosz A, Stadnik K, Giannakoudakis DA, Barczyński B, Barczak M. Antimicrobial Natural Hydrogels in Biomedicine: Properties, Applications, and Challenges-A Concise Review. Int J Mol Sci 2023; 24:2191. [PMID: 36768513 PMCID: PMC9917233 DOI: 10.3390/ijms24032191] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Natural hydrogels are widely used as biomedical materials in many areas, including drug delivery, tissue scaffolds, and particularly wound dressings, where they can act as an antimicrobial factor lowering the risk of microbial infections, which are serious health problems, especially with respect to wound healing. In this review article, a number of promising strategies in the development of hydrogels with biocidal properties, particularly those originating from natural polymers, are briefly summarized and concisely discussed. Common strategies to design and fabricate hydrogels with intrinsic or stimuli-triggered antibacterial activity are exemplified, and the mechanisms lying behind these properties are also discussed. Finally, practical antibacterial applications are also considered while discussing the current challenges and perspectives.
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Affiliation(s)
- Oliwia Kapusta
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Sklodowska University, 20031 Lublin, Poland
| | - Anna Jarosz
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Sklodowska University, 20031 Lublin, Poland
| | - Katarzyna Stadnik
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Sklodowska University, 20031 Lublin, Poland
| | | | - Bartłomiej Barczyński
- 1st Department of Oncological Gynecology and Gynecology, Medical University in Lublin, 20-059 Lublin, Poland
| | - Mariusz Barczak
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Sklodowska University, 20031 Lublin, Poland
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Muacevic A, Adler JR. Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast. Cureus 2022; 14:e32842. [PMID: 36570107 PMCID: PMC9779910 DOI: 10.7759/cureus.32842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background The cardinal area of managing fire wounds is guided by adequately evaluating the burn-induced lesion's profundity and size. Superficial second-degree burns are often treated through daily reinstating with fresh sterile bandaging with appropriate topical antimicrobials to allow rapid spontaneous epithelialization. Around the world, a wide variety of substances are used to treat these wounds, from honey to synthetic biological dressings. Objective This study intended to determine honey's therapeutic potential compared with 1% silver sulfadiazine (Ag-SD) in arsenal-caused contusion medicament fulfillment. Methods A total of 70 cases were evaluated in this research work after fulfilling the required selection criteria during the study period of January 2014 to December 2014 and January 2017 to December 2017. Purposive selection criteria were adopted in the study to select research patients. The patients in Group-1 (n = 35) relied on honey as medication, while patients in Group-2 (n = 35) relied on 1% Ag-SD. Results In Group-1, exudation (68.4%) and sloughing (82.9%) were substantially reduced by Days 3 and 5 of therapeutic intervention, respectively. However, in Group-2, a reduction of exudation (17.1%) and sloughing (22.9%) occurred after Days 3 and 5 of treatment, respectively. Completion of the epithelialization process was observed among Group-1 and Group-2 cases. It was detected after Days 7 and 10 of treatment at 36.3% and 77% (Group-1) and 27% and 67% (Group-2), respectively. Around 3 ml of 1% honey was required per body surface area per dressing in Group-1. On the other hand, in Group-2, 2 gm Ag-SD was needed per body surface area per dressing. Conclusion Patients treated with honey found better clinical outcomes in managing superficial partial-thickness burns.
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Egro F, Repko A, Narayanaswamy V, Ejaz A, Kim D, Schusterman MA, Loughran A, Ayyash A, Towsend SM, Baker S, Ziembicki J, Marra K, Rubin P. Soluble chitosan derivative treats wound infections and promotes wound healing in a novel MRSA-infected porcine partial-thickness burn wound model. PLoS One 2022; 17:e0274455. [PMID: 36240206 PMCID: PMC9565743 DOI: 10.1371/journal.pone.0274455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/28/2022] [Indexed: 11/19/2022] Open
Abstract
Burns are physically debilitating and potentially fatal injuries. The most common etiology of burn wound infections in the US is methicillin-resistant Staphylococcus aureus (MRSA), which is particularly recalcitrant when biofilms form. The current standard of care, silver sulfadiazine (SSD) is effective in reducing bacterial load, but less effective in improving burn wound healing. New treatments that can manage infection while simultaneously improving healing would provide a benefit in the treatment of burns. Porcine models are frequently used as a model for human wound healing but can be expensive due to the need to separate wounds to avoid cross contamination. The porcine model developed in this study offers the capability to study multiple partial thickness burn wound (PTBW) sites on a single animal with minimal crosstalk to study wound healing, infection, and inflammation. The current study evaluates a wound rinse and a wound gel formulated with a non-toxic, polycationic chitosan derivative that is hypothesized to manage infection while also promoting healing, providing a potential alternate to SSD. Studies in vitro and in this PTBW porcine model compare treatment with the chitosan derivative formulations to SSD. The wound rinse and wound gel are observed to disrupt mature MRSA biofilms in vitro and reduce the MRSA load in vivo when compared to that of the standard of care. In vivo data further show increased re-epithelialization and faster healing in burns treated with wound rinse/gel as compared to SSD. Taken together, the data demonstrate the potential of the wound rinse/gel to significantly enhance healing, promote re-epithelialization, and reduce bacterial burden in infected PTBW using an economical porcine model.
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Affiliation(s)
- Francesco Egro
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Alex Repko
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Asim Ejaz
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Deokyeol Kim
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - M. Asher Schusterman
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Ali Ayyash
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Shenda Baker
- Synedgen Inc., Claremont, CA, United States of America
| | - Jenny Ziembicki
- Department of Surgery, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA, United States of America
| | - Kacey Marra
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, PA, United States of America
| | - Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, PA, United States of America
- * E-mail:
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Muacevic A, Adler JR. A Systematic Review and Meta-Analysis Comparing Burn Healing Outcomes Between Silver Sulfadiazine and Aloe vera. Cureus 2022; 14:e30815. [PMID: 36337821 PMCID: PMC9621733 DOI: 10.7759/cureus.30815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/28/2022] [Indexed: 11/30/2022] Open
Abstract
Burn wounds remain a prevalent problem in the developed and developing world. A multitude of remedies has been tested. This study evaluated the healing time of second- and third-degree burn wounds between silver sulfadiazine (SSD) and Aloe vera (AV). In July 2020, a systematic review of MEDLINE (Ovid) and PubMed (National Library of Medicine) was performed to identify studies that reported healing of second- and third-degree burns using either SSD or AV. Articles meeting the inclusion criteria were screened and carefully analyzed. Our goal was to report the healing time for these burns using SSD and AV. A total of eight studies published between 1988 and 2018 reporting healing of second- and third-degree burns using SSD and AV were included in this review. Six were cohort studies and two were randomized controlled trials. The studies included both animal and human subjects. The meta-analysis demonstrated that the mean time to wound healing favored AV (RR: -1.34, 95% CI: -1.8 to 0.9, p < 0.001). It would seem that time to healing benefitted those burns in which AV was utilized. In conclusion, increased consideration and emphasis should be placed on using AV to aid the healing of second- and third-degree burns.
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Devi MV, Poornima V, Sivagnanam UT. Wound healing in second-degree burns in rats treated with silver sulfadiazine: a systematic review and meta-analysis. J Wound Care 2022; 31:S31-S45. [DOI: 10.12968/jowc.2022.31.sup4.s31] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: This study aims to assess the wound healing efficacy in second-degree burns in rats treated with 1% silver sulfadiazine (SSD)—a sulfonamide antibiotic. Method: This is a systematic literature review and meta-analysis performed according to the PICO (Population, Intervention, Comparison and Outcomes) strategy. Results: The review found 100 studies in PubMed, Web of Science and other search engines. Of these, 70 studies were pre-selected after removing duplicates. After independent analysis by two reviewers, only seven studies met the inclusion criteria for meta-analysis. All studies except one showed faster wound closure by the application of silver sulfadiazine ointment. Using a random effects model, healing was faster in SSD-treated groups when compared to the control group on day 21, with a statistically significant mean difference of –2.72 days (95% confidence interval: –4.99, –0.45) between treatment and control groups (p<0.01). Conclusion: The results of this meta-analysis revealed that SSD aided in faster healing of second-degree burns.
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Affiliation(s)
- Mohan Vimala Devi
- Biological Materials Laboratory, CSIR–Central Leather Research Institute, Adyar, Chennai, India
- Department of Leather Technology, (Housed at CSIR–Central Leather Research Institute), Alagappa College of Technology, Anna University, Chennai-600020, India
| | - Velswamy Poornima
- Biological Materials Laboratory, CSIR–Central Leather Research Institute, Adyar, Chennai, India
- Department of Leather Technology, (Housed at CSIR–Central Leather Research Institute), Alagappa College of Technology, Anna University, Chennai-600020, India
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12
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Girija AR, Balasubramanian S, Cowin AJ. Nanomaterials-based drug delivery approaches for wound healing. Curr Pharm Des 2022; 28:711-726. [DOI: 10.2174/1381612828666220328121211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/22/2022]
Abstract
Abstract:
Wound healing is a complex and dynamic process that requires intricate synchronization between multiple cell types within appropriate extracellular microenvironment. Wound healing process involves four overlapping phases in a precisely regulated manner, consisting of hemostasis, inflammation, proliferation, and maturation. For an effective wound healing all four phases must follow in a sequential pattern within a time frame. Several factors might interfere with one or more of these phases in healing process, thus causing improper or impaired wound healing resulting in non-healing chronic wounds. The complications associated with chronic non-healing wounds, along with the limitations of existing wound therapies, have led to the development and emergence of novel and innovative therapeutic interventions. Nanotechnology presents unique and alternative approaches to accelerate the healing of chronic wounds by the interaction of nanomaterials during different phases of wound healing. This review focuses on recent innovative nanotechnology-based strategies for wound healing and tissue regeneration based on nanomaterials, including nanoparticles, nanocomposites and scaffolds. The efficacy of the intrinsic therapeutic potential of nanomaterials (including silver, gold, zinc oxide, copper, cerium oxide, etc.) and the ability of nanomaterials as carriers (liposomes, hydrogels, polymeric nanomaterials, nanofibers) as therapeutic agents associated with wound-healing applications have also been addressed. The significance of these nanomaterial-based therapeutic interventions for wound healing needs to be highlighted to engage researchers and clinicians towards this new and exciting area of bio-nanoscience. We believe that these recent developments will offer researchers an updated source on the use of nanomaterials as an advanced approach to improve wound healing.
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Renuka RR, Julius A, Yoganandham ST, Umapathy D, Ramadoss R, Samrot AV, Vijay DD. Diverse nanocomposites as a potential dressing for diabetic wound healing. Front Endocrinol (Lausanne) 2022; 13:1074568. [PMID: 36714604 PMCID: PMC9874089 DOI: 10.3389/fendo.2022.1074568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023] Open
Abstract
Wound healing is a programmed process of continuous events which is impaired in the case of diabetic patients. This impaired process of healing in diabetics leads to amputation, longer hospitalisation, immobilisation, low self-esteem, and mortality in some patients. This problem has paved the way for several innovative strategies like the use of nanotechnology for the treatment of wounds in diabetic patients. The use of biomaterials, nanomaterials have advanced approaches in tissue engineering by designing multi-functional nanocomposite scaffolds. Stimuli-responsive scaffolds that interact with the wound microenvironment and controlled release of bioactive molecules have helped in overcoming barriers in healing. The use of different types of nanocomposite scaffolds for faster healing of diabetic wounds is constantly being studied. Nanocomposites have helped in addressing specific issues with respect to healing and improving angiogenesis. Method: A literature search was followed to retrieve the articles on strategies for wound healing in diabetes across several databases like PubMed, EMBASE, Scopus and Cochrane database. The search was performed in May 2022 by two researchers independently. They keywords used were "diabetic wounds, nanotechnology, nanocomposites, nanoparticles, chronic diabetic wounds, diabetic foot ulcer, hydrogel". Exclusion criteria included insulin resistance, burn wound, dressing material.
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Affiliation(s)
- Remya Rajan Renuka
- Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India
- *Correspondence: Remya Rajan Renuka, ; Danis D. Vijay,
| | - Angeline Julius
- Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India
| | - Suman Thodhal Yoganandham
- Department of Environmental Engineering, Institute of Industrial Technology Changwon National University, Changwon, Gyeongsangnamdo, Republic of Korea
- School of Smart and Green Engineering, Changwon National University, Changwon, Gyeongsangnamdo, Republic of Korea
| | - Dhamodharan Umapathy
- Department of Research, Karpaga Vinayaga Institute of Medical Science and Research Centre, Madhuranthagam, Tamilnadu, India
| | - Ramya Ramadoss
- Department of Oral Biology, Saveetha Dental College, Chennai, Tamilnadu, India
| | - Antony V. Samrot
- School of Bioscience, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Danis D. Vijay
- Department of Research, Karpaga Vinayaga Institute of Medical Science and Research Centre, Madhuranthagam, Tamilnadu, India
- *Correspondence: Remya Rajan Renuka, ; Danis D. Vijay,
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Mukti AA, Prasetyo A, Prajoko YW, Najatullah N, Susilaningsih N. The Superior Outcome of Collagen Nanosilver in Increasing Macrophage and Collagen on Deep Dermal Burn Wound Healing. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study aims to prove the superior outcome of collagen nanosilver in increasing macrophage and collagen on deep dermal burn wound healing.
METHODS: This study was a randomized control trial design. All animals used were male Sprague Dawley rats aged 12–14 weeks old and weighed about 200–250 g. Each rat gets four site injuries and is given treatments. The treatment group includes: I (negative control using NaCl 0.9%), II (positive control using silver sulfadiazine cream), III (treatment with nanosilver collagen cream 1%), and IV (treatment with collagen nanosilver cream 2%). Macrophages counts were assessed using IHC F40/80 and collagen density was assessed using Masson’s trichrome staining.
RESULTS: Macrophage on day 6 showed a significant difference as seen in group III and group IV. A significant difference was also obtained between macrophage on day 3 and day 6 from group IV, likewise between collagen between day 3 and day 6 from group III and IV. Collagen nanosilver acts as an antimicrobial and anti-inflammatory agent by increasing the mechanism of activation and migration of macrophages to the site of injury. Moreover, this formula modulated the collagen deposition, which forms the tissue fibers which ultimately provide a conducive environment for wound healing.
CONCLUSION: Collagen nanosilver has a superior outcome in the increasing macrophage cell count and collagen density of deep dermal burn wound healing.
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Khalil MA, El Maghraby GM, Sonbol FI, Allam NG, Ateya PS, Ali SS. Enhanced Efficacy of Some Antibiotics in Presence of Silver Nanoparticles Against Multidrug Resistant Pseudomonas aeruginosa Recovered From Burn Wound Infections. Front Microbiol 2021; 12:648560. [PMID: 34616370 PMCID: PMC8488261 DOI: 10.3389/fmicb.2021.648560] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 08/20/2021] [Indexed: 11/28/2022] Open
Abstract
Burn wound infections with multidrug-resistant (MDR) bacteria are shown in many countries as severe widespread health threats. Consequently, attention has been devoted to new nanoparticle-based materials in the field of antimicrobial chemotherapy for burn wound infections. This study aimed to evaluate both in vitro and in vivo efficacies of nanoparticle–antibiotic combinations as new classes of materials subjected against MDR Pseudomonas aeruginosa. Out of 40 Gram-negative isolates, 23 P. aeruginosa were recovered from patients with burn wound infections attending different hospitals in Tanta, Egypt. The susceptibility test revealed that 95.7% of P. aeruginosa isolates were MDR with a high incidence of resistance against carbenicillin. Antibacterial activities of silver nanoparticles (Ag-NPs) against the isolates examined showed various inhibition zone diameters ranging from 11 to 17 mm. Strong synergistic efficacy of neomycin was reported in combination with Ag-NPs against MDR P. aeruginosa P8 and P14 isolates. The in vivo effectiveness of various pharmaceutical formulations prepared from a combination of neomycin antibiotic with Ag-NPs in the treatment of induced bacterially infected mice burns showed that maximum healing activity along with faster wound contraction reported with the combination of neomycin-Ag-NPs in the spray formulation. Generally, data indicated that incorporating Ag-NPs in combination with certain antibiotics may be a new, promising application for wound treatments, especially burns infected with MDR P. aeruginosa.
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Affiliation(s)
- Maha A Khalil
- Biology Department, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.,Botany and Microbiology Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Gamal M El Maghraby
- Pharmaceutical Technology Department, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt
| | - Fatma I Sonbol
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt
| | - Nanis G Allam
- Biology Department, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Perihan S Ateya
- Biology Department, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Sameh S Ali
- Botany and Microbiology Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt.,Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, 212013, China
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16
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Biological Activity of Propolis Ointment with the Addition of 1% Nanosilver in the Treatment of Experimentally-Evoked Burn Wounds. Polymers (Basel) 2021; 13:polym13142312. [PMID: 34301074 PMCID: PMC8309302 DOI: 10.3390/polym13142312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022] Open
Abstract
The main objective of this study was to assess the pharmacological efficacy of ointments containing 1% propolis and 1% nanosilver, compared to the conventional treatment of burn wounds. In the evaluation of the results, we used clinical observation of scars, microbiological examinations, pathomorphological examinations, and analysis of free radicals. The analysis of the experiment results concerning the therapeutic effectiveness of the propolis ointment revealed its wide-ranging antibacterial action (against Gram-positive and Gram-negative bacteria). The 1% propolis ointment was found to accelerate neoangiogenesis and epithelialization, have a positive effect on the healing of burn wounds, improve the cosmetic look of scars, and have no side-effects. The analysis of free radicals in burn wounds showed impressive activity of the 1% nanosilver ointment in the reduction of free radicals. No synergism of pharmacological activity of propolis and nanosilver was shown. A comparative evaluation of the acquired research material allows us to provide a favorable opinion on the topical treatment of burn wounds with 1% propolis. The obtained results show that the 1% propolis ointment reduces healing time, offers antimicrobial action, and has a positive effect on the normal process of scar formation.
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17
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Atriwal T, Azeem K, Husain FM, Hussain A, Khan MN, Alajmi MF, Abid M. Mechanistic Understanding of Candida albicans Biofilm Formation and Approaches for Its Inhibition. Front Microbiol 2021; 12:638609. [PMID: 33995297 PMCID: PMC8121174 DOI: 10.3389/fmicb.2021.638609] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/30/2021] [Indexed: 12/18/2022] Open
Abstract
In recent years, the demand for novel antifungal therapies has increased several- folds due to its potential to treat severe biofilm-associated infections. Biofilms are made by the sessile microorganisms attached to the abiotic or biotic surfaces, enclosed in a matrix of exopolymeric substances. This results in new phenotypic characteristics and intrinsic resistance from both host immune response and antimicrobial drugs. Candida albicans biofilm is a complex association of hyphal cells that are associated with both abiotic and animal tissues. It is an invasive fungal infection and acts as an important virulent factor. The challenges linked with biofilm-associated diseases have urged scientists to uncover the factors responsible for the formation and maturation of biofilm. Several strategies have been developed that could be adopted to eradicate biofilm-associated infections. This article presents an overview of the role of C. albicans biofilm in its pathogenicity, challenges it poses and threats associated with its formation. Further, it discusses strategies that are currently available or under development targeting prostaglandins, quorum-sensing, changing surface properties of biomedical devices, natural scaffolds, and small molecule-based chemical approaches to combat the threat of C. albicans biofilm. This review also highlights the recent developments in finding ways to increase the penetration of drugs into the extracellular matrix of biofilm using different nanomaterials against C. albicans.
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Affiliation(s)
- Tanu Atriwal
- Medicinal Chemistry Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Kashish Azeem
- Medicinal Chemistry Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Fohad Mabood Husain
- Department of Food Science and Nutrition, College of Food and Agriculture Science, King Saud University, Riyadh, Saudi Arabia
| | - Afzal Hussain
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Muhammed Nadeem Khan
- Department of Tashreehul Badan, Faculty of Unani Medicine, Aligarh Muslim University, Aligarh, India
| | - Mohamed F Alajmi
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Abid
- Medicinal Chemistry Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
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18
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Kuerban D, Maimaiti M, Chen Z. Effects and Safety of Different Silver Preparation in Burns Treatment: A Bayesian Network Meta-analysis. INT J LOW EXTR WOUND 2021; 22:298-306. [PMID: 33909511 DOI: 10.1177/15347346211004032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Silver formulation has been used for external use of burn wounds for several decades, mainly including silver sulfadiazine (SSD), nanosilver dressing (NSD), and silver ion dressing (SID). At present, there is no simultaneous comparison of the effects of silver formulation on burn wounds. The databases were retrieved in an orderly manner from the dates of their establishment to May 2020, including PubMed, the Cochrane Library, Web of Science, and Clinical Trials. Then a network meta-analysis was conducted using R and RevMan 5.1 software. A total of 13 randomized controlled trials (RCTs) involving 945 patients with burns were included. A pairwise meta-analysis of the results was presented: the wound healing time in the SID or NSD treatment group was less than that in the SSD group; and in relieving the pain there was a statistical difference between the SSD, SID, or NSD groups. Network meta-analysis of the results was presented: the wound healing time and relieving the pain in the SID or NSD treatment group were less than that in the SSD group, but there was no statistical difference between the SID and NSD groups. The possibility of NSD in the wound healing time being the best treatment was 75.2%, followed by SID (36.6%), and finally SSD (1.1%); and the possibility of NSD being the best relieving the pain was 83.5%; followed by SID (60.0%), and finally SSD (16.3%). According to the evidence, treatment for burns with NSD can improve the wound healing time and relieve the pain of wounds.
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Affiliation(s)
- Dilixiati Kuerban
- People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, P.R. China
| | - Maisiwuti Maimaiti
- People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, P.R. China
| | - Zhao Chen
- People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, P.R. China
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19
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Effect of Silver Nanoparticles on Healing of Third-Degree Burns Infected with Pseudomonas Aeruginosa in Laboratory Mice. MACEDONIAN VETERINARY REVIEW 2021. [DOI: 10.2478/macvetrev-2020-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The treatment of full-thickness skin burn using nanomaterials is promising as a medical application reducing the risk of infection and severe dermal scarring. Therefore, this study aims to evaluate the effectiveness of nanomaterials, particularly 3% silver nanoparticles containing ointment (3% SNO), on the full-thickness skin burn of laboratory mice. A total number of 36 male mice were used, equally divided into three groups: negative control (not burned and not treated); positive control (+ve) (burned and treated with castor oil and white petroleum jelly); and SNO-treated group (burned and treated with 3% SNO). The skin of the animals’ back was shaved. A 2x0.5 cm metal plate was heated on a burner to burn the skin of the animals of positive control and SNO-treated groups. Pseudomonas aeruginosa bacterial suspension was applied to the burnt area. The application of SNO, as well as the mixture of white petroleum jelly and castor oil, was started after 6 hours of inducing burns and continued for 14 days (three times daily) in the respected groups. The SNO-treated group showed accelerated healing within 14 days demonstrated by re-epithelialization of the epidermal layer and proliferation of the fibroblasts in the dermal layer. Less healing evidence was observed in the +ve control group in the same period. In conclusion, to our knowledge, this is the first study that uses a 3% SNO formula and has found that it has a promising impact on the treatment of infected skin burns.
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20
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Kumar A, Behl T, Chadha S. A rationalized and innovative perspective of nanotechnology and nanobiotechnology in chronic wound management. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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21
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Handayani E, Masithoh RF. A small-scale re-evaluation of the efficacy of silver sulfadiazine for burns. Br J Community Nurs 2020; 25:S34-S38. [PMID: 33300848 DOI: 10.12968/bjcn.2020.25.sup12.s34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Burns remain one of the most common injuries contributing to an increase in trauma incidence in hospitals, particularly in developing countries. Therefore, it is essential to identify the appropriate care for these wounds. Silver sulfadiazine has been widely used for the treatment of burns, but its efficacy has not been re-evaluated in recent years. Therefore, this small-scale study aimed at re-evaluating the use of silver sulfadiazine in patients with burns at a hospital in Magelang, Indonesia. A total of seven patients with second- and third-degree burns were involved and received silver sulfadiazine for 5 months (March to July 2020). Data on their wounds were collected three times and evaluated by using the Nursing Outcomes Classification (NOC) observation method. Wound outcomes were evaluated using on the basis of wound healing by secondary intention. Silver sulfadiazine was found to be effective; 85.7% of the wound area showed granulation tissue, and 75-100% of the wound area showed epithelialisation. However, patients complained of pain during silver sulfadiazine treatment. Therefore, additional nursing interventions seem to be needed to manage burns.
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Affiliation(s)
- Estrin Handayani
- both from the Department of Medical Surgical Nursing, Universitas Muhammadiyah Magelang, Indonesia
| | - Robiul Fitri Masithoh
- both from the Department of Medical Surgical Nursing, Universitas Muhammadiyah Magelang, Indonesia
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22
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The Effects of Silver Sulfadiazine on Methicillin-Resistant Staphylococcus aureus Biofilms. Microorganisms 2020; 8:microorganisms8101551. [PMID: 33050001 PMCID: PMC7600712 DOI: 10.3390/microorganisms8101551] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA), the most commonly detected drug-resistant microbe in hospitals, adheres to substrates and forms biofilms that are resistant to immunological responses and antimicrobial drugs. Currently, there is a need to develop alternative approaches for treating infections caused by biofilms to prevent delays in wound healing. Silver has long been used as a disinfectant, which is non-specific and has relatively low cytotoxicity. Silver sulfadiazine (SSD) is a chemical complex clinically used for the prevention of wound infections after injury. However, its effects on biofilms are still unclear. In this study, we aimed to analyze the mechanisms underlying SSD action on biofilms formed by MRSA. The antibacterial effects of SSD were a result of silver ions and not sulfadiazine. Ionized silver from SSD in culture media was lower than that from silver nitrate; however, SSD, rather than silver nitrate, eradicated mature biofilms by bacterial killing. In SSD, sulfadiazine selectively bound to biofilms, and silver ions were then liberated. Consequently, the addition of an ion-chelator reduced the bactericidal effects of SSD on biofilms. These results indicate that SSD is an effective compound for the eradication of biofilms; thus, SSD should be used for the removal of biofilms formed on wounds.
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Thanganadar Appapalam S, Paul B, Arockiasamy S, Panchamoorthy R. Phytofabricated silver nanoparticles: Discovery of antibacterial targets against diabetic foot ulcer derived resistant bacterial isolates. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 117:111256. [PMID: 32919626 DOI: 10.1016/j.msec.2020.111256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/28/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022]
Abstract
The present study selected the predominant multi antibiotic-resistant diabetic foot ulcer (DFU) derived bacterial isolates such as Pseudomonas aeruginosa (PA), Escherichia coli (EC), Staphylococcus aureus (SA) and Bacillus subtilis (BS) and evaluated their response against the well-characterized Aerva lanata (AL) reduced multiple phytochemicals fabricated silver nanoparticles (AL-AgNPs). The overnight culture of DFU isolates was processed and subjected to various studies such as antimicrobial activity, growth kinetics, biofilm disruption, reactive oxygen species (ROS), membrane leakage, membrane permeability, and damage and genotoxicity. The molecular docking of AL phytochemicals was also performed with bacterial enzyme DNA gyrase. Interestingly, AL-AgNPs were produced the remarkable antibacterial effect against the resistant DFU isolates, which was closely similar to the effect of AL-AgNPs observed against the reference strains. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of AL-AgNPs against the DFU isolates were found to be 5-15 μg/mL and 10-20 μg/mL, respectively. The AL-AgNPs were depicted a concentration-dependent growth inhibition of DFU bacterial isolates. The MIC and MBC of AL-AgNPs were effectively destroyed the preformed biofilms of DFU isolates. Furthermore, the MBC of AL-AgNPs was displayed the increased intracellular ROS accumulation, membrane leakage, permeability and damage, and genotoxicity in the DFU isolates. Additionally, the in silico study revealed that the AL phytochemicals were fitted over the binding pocket of the DNA gyrase B subunit. The observed results were confirmed that the negative impacts of the AL-AgNPs at the level of the membrane and intracellular components of DFU isolates.
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Affiliation(s)
| | - Benedict Paul
- Department of Biotechnology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, Tamil Nadu, India
| | - Sumathy Arockiasamy
- Department of Biomedical Sciences, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, Tamil Nadu, India
| | - Rajasekar Panchamoorthy
- Department of Biotechnology, Rajalakshmi Engineering College, Thandalam, Chennai 602 105, Tamil Nadu, India.
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Krishnaswami V, Raju NS, Alagarsamy S, Kandasamy R. Novel Nanocarriers for the Treatment of Wound Healing. Curr Pharm Des 2020; 26:4591-4600. [PMID: 32611292 DOI: 10.2174/1381612826666200701203432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/08/2020] [Indexed: 11/22/2022]
Abstract
The sequence of biochemical and cellular responses restoring the integrity of the subcutaneous tissue of the skin is termed as wound healing. Inflammatory cytokine suppression and inflammatory transduction cascades are the major targets for wound healing. Formulations for wound healing should promote neovascularization and angiogenic pathways by increasing the expression of vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor. Medication used for wound healing promotes antiinflammatory associated with anti-bacterial action. In order to boost the effectiveness of current medical treatments, the cutting-edge nanotechnology offers many novel therapies. This review summarized and discussed wound healing, types of wounds, natural materials used for wound healing, metallic nanoparticles and current nano drug delivery systems used for wound healing with special emphasis on the angiogenesis role in the healing of wounds.
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Affiliation(s)
- Venkateshwaran Krishnaswami
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamilnadu, India
| | - Nikhishaa Sree Raju
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamilnadu, India
| | - Shanmugarathinam Alagarsamy
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamilnadu, India
| | - Ruckmani Kandasamy
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamilnadu, India
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Sukmawati D, Eryani A, Damayanti L. Silver Sulfadiazine's Effect on Keratin-19 Expression as Stem Cell Marker in Burn Wound Healing. Biomedicine (Taipei) 2020; 10:5-11. [PMID: 33854915 PMCID: PMC7608848 DOI: 10.37796/2211-8039.1014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Burn wounds are one of the causes of cutaneous injury that involve both epidermal and dermal layers of skin. Silver sulfadiazine (SSD) has been widely used to treat burn wounds, however recent studies have found the treatment to have some drawbacks, such as cellular toxicity effects. Cutaneous wound regeneration is known to start from the basal layer of the epidermal epithelial cells, which are enriched with highly proliferative cells. Keratin-19 (K19) is one of the epidermal stem cell biomarkers found in the skin. This study aims to explore the expression of K19 in burn wound tissue and to investigate the effect of SSD on its expression. METHODS We created a burn wound model in Sprague Dawley rats and randomly divided them into control and SSD groups. Wound closure was evaluated (visitrak) overtime series followed by histological evaluation of K19 expression in the wound tissue (immunohistochemistry staining). RESULTS Our model successfully represents full-thickness damage caused by a burn wound. The SSD group showed a faster reduction of wound surface area (wound closure) compared to the control group with the peak at day 18 post wounding (p < 0.05). K19 expression was found in both groups and was distributed on epidermal layers, hair follicles and dermis of granulation tissue showing similar patterns. CONCLUSION Topical application of SSD on burn wounds showed superiority in wound closure and is likely to have no harmful effect on epidermal stem cells. However, further study is required to investigate the effect of silver species on cell viability and toxicity effects during long term treatment.
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Affiliation(s)
- Dewi Sukmawati
- Department of Histology, Faculty of Medicine Universitas Indonesia, Jln. Salemba Raya No. 6 Jakarta, 10430, Jakarta, Indonesia
| | - Astheria Eryani
- Department of Histology, Faculty of Medicine Tarumanagara University, Jln. Letjen S. Parman No.1, Tomang, Grogol Petamburan, Jakarta, 11440, Indonesia
| | - Lia Damayanti
- Department of Histology, Faculty of Medicine Universitas Indonesia, Jln. Salemba Raya No. 6 Jakarta, 10430, Jakarta, Indonesia
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26
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Lara HH, Ixtepan-Turrent L, Yacaman MJ, Lopez-Ribot J. Inhibition of Candida auris Biofilm Formation on Medical and Environmental Surfaces by Silver Nanoparticles. ACS APPLIED MATERIALS & INTERFACES 2020; 12:21183-21191. [PMID: 31944650 PMCID: PMC8243355 DOI: 10.1021/acsami.9b20708] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Candida auris is an emerging pathogenic fungus implicated in healthcare-associated outbreaks and causes bloodstream infections associated with high mortality rates. Biofilm formation represents one of the major pathogenetic traits associated with this microorganism. Unlike most other Candida species, C. auris has the ability to survive for weeks on different surfaces. Therefore, there is an urgent need to develop new effective control strategies to combat the threat of C. auris. Advances in nanotechnologies have emerged that carry significant potential impact against Candida biofilms. We obtained pure round silver nanoparticles (AgNPs) (1 to 3 nm in diameter) using a microwave-assisted synthetic approach. When tested against C. auris, our results indicated a potent inhibitory activity both on biofilm formation (half maximal inhibitory concentration (IC50) of 0.06 ppm) and against preformed biofilms (IC50 of 0.48 ppm). Scanning electron microscopy images of AgNP-treated biofilms showed cell wall damage mostly by disruption and distortion of the outer surface of the fungal cell wall. In subsequent experiments AgNPs were used to functionalize medical and environmental surfaces. Silicone elastomers functionalized with AgNPs demonstrated biofilm inhibition (>50%) at relatively low concentrations (2.3 to 0.28 ppm). Bandage dressings loaded with AgNPs inhibited growth of C. auris biofilms by more than 80% (2.3 to 0.017 ppm). Also, to demonstrate long-lasting protection, dressings loaded with AgNPs (0.036 ppm) were washed thoroughly with phosphate-buffered saline, maintaining protection against the C. auris growth from cycles 1 to 3 (>80% inhibition) and from cycles 4 to 6 (>50% inhibition). Our results demonstrate the dose-dependent activity of AgNPs against biofilms formed by C. auris on both medical (silicone elastomer) and environmental (bandage fibers) surfaces. The AgNPs-functionalized fibers retain the fungicidal effect even after repeated thorough washes. Overall these results point to the utility of silver nanoparticles to prevent and control infections caused by this emerging pathogenic fungus.
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Affiliation(s)
- Humberto H. Lara
- Department of Biology and South Texas Center for Emerging Infectious Diseases
| | - Liliana Ixtepan-Turrent
- Departamento de Ciencias Basicas, Division de Ciencia de la Salud, Universidad de Monterrey, San Pedro Garza García, Nuevo León 66238, México
| | - Miguel Jose Yacaman
- Department of Applied Physics and Materials Science, Northern Arizona University, 700 South Osborne Drive, Flagstaff, Arizona 86011, United States
| | - Jose Lopez-Ribot
- Department of Biology and South Texas Center for Emerging Infectious Diseases
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Pourhajibagher M, Partoazar A, Alaeddini M, Etemad-Moghadam S, Bahador A. Photodisinfection effects of silver sulfadiazine nanoliposomes doped-curcumin on Acinetobacter baumannii: a mouse model. Nanomedicine (Lond) 2020; 15:437-452. [DOI: 10.2217/nnm-2019-0315] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Aim: To evaluate the antimicrobial effects of photoexcited silver sulfadiazine nanoliposomes (AgSD-NLs) doped by curcumin (AgSD-NLs@Cur) on Acinetobacter baumannii. Materials & methods: Following characterization, the cytotoxic and hemolytic activities of AgSD-NLs@Cur were evaluated. The antimicrobial activities of AgSD-NLs@Cur-mediated antimicrobial photodynamic therapy (aPDT) were determined. Histopathological examination of the burn wound sites of infected mice treated with photoexcited AgSD-NLs@Cur was assessed. Results: No significant cytotoxic and hemolytic activities were observed. There was a decrease in the Acinetobacter baumannii count in planktonic and biofilm forms and the gene expression level using AgSD-NLs@Cur-aPDT (p < 0.05). Histopathological analysis indicated the epidermis developed markedly and the bacterial load decreased significantly after aPDT. Conclusion: Photoexcited AgSD-NLs@Cur has an antimicrobial potential against A. baumannii.
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Affiliation(s)
- Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Partoazar
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Alaeddini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahroo Etemad-Moghadam
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Oral Microbiology Laboratory, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Karaky N, Kirby A, McBain AJ, Butler JA, El Mohtadi M, Banks CE, Whitehead KA. Metal ions and graphene-based compounds as alternative treatment options for burn wounds infected by antibiotic-resistant Pseudomonas aeruginosa. Arch Microbiol 2020; 202:995-1004. [PMID: 31915886 PMCID: PMC7223729 DOI: 10.1007/s00203-019-01803-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/17/2019] [Accepted: 12/21/2019] [Indexed: 11/25/2022]
Abstract
Burn infections caused by Pseudomonas aeruginosa pose a major complication in wound healing. This study aimed to determine the antimicrobial effect of metal ions, graphene (Gr), and graphene oxide (GO), individually and in combination, against the planktonic and biofilm states of two antimicrobially resistant clinical strains of P. aeruginosa each with different antibiotic resistance profiles. Minimum inhibitory, minimum bactericidal, and fractional inhibitory concentrations were performed to determine the efficacy of the metal ions and graphene composites individually and their synergy in combination. Crystal violet biofilm and XTT assays measured the biofilm inhibition and metabolic activity, respectively. Molybdenum, platinum, tin, gold, and palladium ions exhibited the greatest antimicrobial activity (MIC = 7.8–26.0 mg/L), whilst GO and Gr demonstrated moderate-to-no effect against the planktonic bacterial cells, irrespective of their antibiograms. Biofilms were inhibited by zinc, palladium, silver, and graphene. In combination, silver–graphene and molybdenum–graphene inhibited both the planktonic and biofilm forms of the bacteria making them potential candidates for development into topical antimicrobials for burns patients infected with antibiotic-resistant P. aeruginosa.
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Affiliation(s)
- Nathalie Karaky
- Microbiology at Interfaces, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK
| | - Andrew Kirby
- Leeds Institute of Medical Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Andrew J McBain
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Jonathan A Butler
- Microbiology at Interfaces, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK
| | - Mohamed El Mohtadi
- Microbiology at Interfaces, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK
| | - Craig E Banks
- Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK
| | - Kathryn A Whitehead
- Microbiology at Interfaces, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK.
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Roman M, Rigo C, Castillo-Michel H, Urgast DS, Feldmann J, Munivrana I, Vindigni V, Mičetić I, Benetti F, Barbante C, Cairns WRL. Spatiotemporal distribution and speciation of silver nanoparticles in the healing wound. Analyst 2020; 145:6456-6469. [DOI: 10.1039/d0an00607f] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
First observation of AgNPs dynamics in the wounds of real patients through elemental imaging and speciation.
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Affiliation(s)
- Marco Roman
- Ca’ Foscari University of Venice
- Department of Environmental Sciences
- Informatics and Statistics (DAIS)
- 30172 Venice Mestre
- Italy
| | - Chiara Rigo
- Ca’ Foscari University of Venice
- Department of Environmental Sciences
- Informatics and Statistics (DAIS)
- 30172 Venice Mestre
- Italy
| | | | - Dagmar S. Urgast
- University of Aberdeen
- Trace Element Speciation Laboratory
- Aberdeen AB24 3UE
- UK
| | - Jörg Feldmann
- University of Aberdeen
- Trace Element Speciation Laboratory
- Aberdeen AB24 3UE
- UK
- University of Graz
| | - Ivan Munivrana
- University Hospital of Padua
- Burns Centre
- Division of Plastic Surgery
- 35128 Padua
- Italy
| | - Vincenzo Vindigni
- University Hospital of Padua
- Burns Centre
- Division of Plastic Surgery
- 35128 Padua
- Italy
| | - Ivan Mičetić
- University of Padua
- Department of Biomedical Sciences
- 35131 Padua
- Italy
| | - Federico Benetti
- EcamRicert Srl
- European Centre for the Sustainable Impact of Nanotechnology (ECSIN)
- Corso Stati Uniti 4
- 35127 Padua
- Italy
| | - Carlo Barbante
- Ca’ Foscari University of Venice
- Department of Environmental Sciences
- Informatics and Statistics (DAIS)
- 30172 Venice Mestre
- Italy
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Abazari M, Ghaffari A, Rashidzadeh H, Momeni Badeleh S, Maleki Y. Current status and future outlook of nano-based systems for burn wound management. J Biomed Mater Res B Appl Biomater 2019; 108:1934-1952. [PMID: 31886606 DOI: 10.1002/jbm.b.34535] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/03/2019] [Accepted: 11/16/2019] [Indexed: 01/07/2023]
Abstract
Wound healing process is a natural and intricate response of the body to its injuries and includes a well-orchestrated sequence of biochemical and cellular phenomena to restore the integrity of skin and injured tissues. Complex nature and associated complications of burn wounds lead to an incomplete and prolonged recovery of these types of wounds. Among different materials and systems which have been used in treating the wounds, nanotechnology driven therapeutic systems showed a great opportunity to improvement and enhancement of the healing process of different type of wounds. The aim of this study is to provide an overview of the recent studies about the various nanotechnology-based management of burn wounds and the future outlook of these systems in this area. Laboratory and animal models for assessing the efficacy of these systems in burn wound management also discussed.
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Affiliation(s)
- Morteza Abazari
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azadeh Ghaffari
- Department of Food and Drug Control, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.,Pharmaceutical Nanotechnology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hamid Rashidzadeh
- Department of pharmaceutical biomaterial, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Safa Momeni Badeleh
- Department of Food and Drug Control, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Yaser Maleki
- Department of Nanochemistry, Institute for Advanced Studies in Basic Sciences, Zanjan, Iran
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31
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Amin K, Moscalu R, Imere A, Murphy R, Barr S, Tan Y, Wong R, Sorooshian P, Zhang F, Stone J, Fildes J, Reid A, Wong J. The future application of nanomedicine and biomimicry in plastic and reconstructive surgery. Nanomedicine (Lond) 2019; 14:2679-2696. [DOI: 10.2217/nnm-2019-0119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Plastic surgery encompasses a broad spectrum of reconstructive challenges and prides itself upon developing and adopting new innovations. Practice has transitioned from microsurgery to supermicrosurgery with a possible future role in even smaller surgical frontiers. Exploiting materials on a nanoscale has enabled better visualization and enhancement of biological processes toward better wound healing, tumor identification and viability of tissues, all cornerstones of plastic surgery practice. Recent advances in nanomedicine and biomimicry herald further reconstructive progress facilitating soft and hard tissue, nerve and vascular engineering. These lay the foundation for improved biocompatibility and tissue integration by the optimization of engineered implants or tissues. This review will broadly examine each of these technologies, highlighting areas of progress that reconstructive surgeons may not be familiar with, which could see adoption into our armamentarium in the not-so-distant future.
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Affiliation(s)
- Kavit Amin
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The Transplant Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Roxana Moscalu
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Angela Imere
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Materials, School of Natural Sciences, Faculty of Science & Engineering Research Institutes, The University of Manchester, MSS Tower, Manchester, UK
| | - Ralph Murphy
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Simon Barr
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Youri Tan
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Richard Wong
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Parviz Sorooshian
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fei Zhang
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Materials, School of Natural Sciences, Faculty of Science & Engineering Research Institutes, The University of Manchester, MSS Tower, Manchester, UK
| | - John Stone
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The Transplant Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - James Fildes
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- The Transplant Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Adam Reid
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Jason Wong
- Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Khansa I, Schoenbrunner AR, Kraft CT, Janis JE. Silver in Wound Care-Friend or Foe?: A Comprehensive Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2390. [PMID: 31592393 PMCID: PMC6756674 DOI: 10.1097/gox.0000000000002390] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/19/2019] [Indexed: 12/12/2022]
Abstract
Due to its strong antimicrobial activity, silver is a commonly used adjunct in wound care. However, it also has the potential to impair healing by exerting toxic effects on keratinocytes and fibroblasts. The published literature on the use of silver in wound care is very heterogeneous, making it difficult to generate useful treatment guidelines. METHODS A search of high-quality studies on the use of silver in wound care was performed on PubMed. A detailed qualitative analysis of published articles was performed to evaluate the evidence for the use of silver in infected wounds, clean wounds, burns, and over closed surgical incisions. RESULTS Fifty-nine studies were included in this qualitative analysis. We found that, overall, the quality of the published research on silver is poor. While there is some evidence for short-term use of dressings containing nanocrystalline silver in infected wounds, the use of silver-containing dressings in clean wounds and over closed surgical incisions is not indicated. Negative-pressure wound therapy accelerates the healing of contaminated wounds, especially when silver is used as an adjunct. For burns, silver sulfadiazine slows healing and should not be used. Instead, nanocrystalline silver, or alternatives such as octenidine and polyhexanide, lead to less infection and faster healing. CONCLUSIONS In infected wounds, silver is beneficial for the first few days/weeks, after which nonsilver dressings should be used instead. For clean wounds and closed surgical incisions, silver confers no benefit. The ideal silver formulations are nanocrystalline silver and silver-coated polyurethane sponge for negative-pressure wound therapy. Silver sulfadiazine impairs wound healing. Proper use of silver-containing dressings is essential to optimize wound healing.
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Affiliation(s)
- Ibrahim Khansa
- From the Division of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Anna R. Schoenbrunner
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Casey T. Kraft
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Young AE, Davies A, Bland S, Brookes S, Blazeby JM. Systematic review of clinical outcome reporting in randomised controlled trials of burn care. BMJ Open 2019; 9:e025135. [PMID: 30772859 PMCID: PMC6398699 DOI: 10.1136/bmjopen-2018-025135] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Systematic reviews collate trial data to provide evidence to support clinical decision-making. For effective synthesis, there must be consistency in outcome reporting. There is no agreed set of outcomes for reporting the effect of burn care interventions. Issues with outcome reporting have been identified, although not systematically investigated. This study gathers empirical evidence on any variation in outcome reporting and assesses the need for a core outcome set for burn care research. METHODS Electronic searches of four search engines were undertaken from January 2012 to December 2016 for randomised controlled trials (RCTs), using medical subject headings and free text terms including 'burn', 'scald' 'thermal injury' and 'RCT'. Two authors independently screened papers, extracted outcomes verbatim and recorded the timing of outcome measurement. Duplicate outcomes (exact wording ± different spelling), similar outcomes (albumin in blood, serum albumin) and identical outcomes measured at different times were removed. Variation in outcome reporting was determined by assessing the number of unique outcomes reported across all included trials. Outcomes were classified into domains. Bias was reduced using five researchers and a patient working independently and together. RESULTS 147 trials were included, of which 127 (86.4%) were RCTs, 13 (8.8%) pilot studies and 7 (4.8%) RCT protocols. 1494 verbatim clinical outcomes were reported; 955 were unique. 76.8% of outcomes were measured within 6 months of injury. Commonly reported outcomes were defined differently. Numbers of unique outcomes per trial varied from one to 37 (median 9; IQR 5,13). No single outcome was reported across all studies demonstrating inconsistency of reporting. Outcomes were classified into 54 domains. Numbers of outcomes per domain ranged from 1 to 166 (median 11; IQR 3,24). CONCLUSIONS This review has demonstrated heterogeneity in outcome reporting in burn care research which will hinder amalgamation of study data. We recommend the development of a Core Outcome Set. PROSPERO REGISTRATION NUMBER CRD42017060908.
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Affiliation(s)
- Amber E Young
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Sara Brookes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Jane M Blazeby
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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35
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Nethi SK, Das S, Patra CR, Mukherjee S. Recent advances in inorganic nanomaterials for wound-healing applications. Biomater Sci 2019; 7:2652-2674. [DOI: 10.1039/c9bm00423h] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The emergence of inorganic nanoparticles has generated considerable expectation for solving various biomedical issues including wound healing and tissue regeneration. This review article highlights the role and recent advancements of inorganic nanoparticles for wound healing and tissue regeneration along with their advantages, clinical status, challenges and future directions.
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Affiliation(s)
- Susheel Kumar Nethi
- Department of Experimental and Clinical Pharmacology
- College of Pharmacy
- University of Minnesota
- Minneapolis
- USA
| | - Sourav Das
- Department of Applied Biology
- CSIR-Indian Institute of Chemical Technology
- Hyderabad 500007
- India
- Academy of Scientific and Innovative Research (AcSIR)
| | - Chitta Ranjan Patra
- Department of Applied Biology
- CSIR-Indian Institute of Chemical Technology
- Hyderabad 500007
- India
- Academy of Scientific and Innovative Research (AcSIR)
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Piaggesi A, Låuchli S, Bassetto F, Biedermann T, Marques A, Najafi B, Palla I, Scarpa C, Seimetz D, Triulzi I, Turchetti G, Vaggelas A. Advanced therapies in wound management: cell and tissue based therapies, physical and bio-physical therapies smart and IT based technologies. J Wound Care 2018; 27:S1-S137. [DOI: 10.12968/jowc.2018.27.sup6a.s1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Alberto Piaggesi
- Prof, Director, EWMA Scientific Recorder (Editor), Diabetic Foot Section of the Pisa University Hospital, Department of Endocrinology and Metabolism, University of Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Severin Låuchli
- Chief of Dermatosurgery and Woundcare, EWMA Immediate Past President (Co-editor), Department of Dermatology, University Hospital, Zurich, Råmistrasse 100, 8091 Zärich, Schwitzerland
| | - Franco Bassetto
- Prof, Head of Department, Clinic of Plastic and Reconstructive Surgery, University of Padova, Via Giustiniani, 35100 Padova
| | - Thomas Biedermann
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, August Forel-Strasse 7, 8008 Zürich, Switzerland
| | - Alexandra Marques
- University of Minho, 3B's Research Group in Biomaterials, Biodegradables and Biomimetics, Avepark - Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR, Portugal
| | - Bijan Najafi
- Professor of Surgery, Director of Clinical Research, Division of Vascular Surgery and Endovascular Therapy, Director of Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030-3411, US
| | - Ilaria Palla
- Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Carlotta Scarpa
- Clinic of Plastic and Reconstructive Surgery, University of Padova, Via Giustiniani, 35100 Padova
| | - Diane Seimetz
- Founding Partner, Biopharma Excellence, c/o Munich Technology Center, Agnes-Pockels-Bogen 1, 80992 Munich, Germany
| | - Isotta Triulzi
- Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Giuseppe Turchetti
- Fulbright Scholar, Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Annegret Vaggelas
- Consultant, Biopharma Excellence, c/o Munich Technology Center, Agnes-Pockels-Bogen 1, 80992 Munich, Germany
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Dissemond J, Böttrich JG, Braunwarth H, Hilt J, Wilken P, Münter KC. Evidence for silver in wound care - meta-analysis of clinical studies from 2000-2015. J Dtsch Dermatol Ges 2018; 15:524-535. [PMID: 28485879 DOI: 10.1111/ddg.13233] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/27/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Given that the scientific evidence for silver in wound care is generally considered insufficient, there is uncertainty among users regarding its clinical use. MATERIAL AND METHODS A group of experts evaluated the clinical studies on silver in wound management published from 2000-2015. RESULTS Overall, 851 articles were identified, 173 of which were included and categorized. There were 31 randomized controlled trials (RCTs) and eight cohort studies. Twenty-eight of these studies showed statistically significant outcome parameters in support of silver. While nine of these studies investigated burn injuries, 20 addressed other indications (venous leg ulcers: 9; pressure ulcers: 3; chronic wounds: 2; diabetic foot ulcer: 1; other types of wounds: 5). In 16 studies, the primary parameter was wound healing, whereas quality of life including pain was assessed in twelve studies; cost-effectiveness, in eight studies; reduction of bacterial load, in three studies. Based on these results, a treatment algorithm for the clinical use of silver in wound care has been developed. CONCLUSIONS The present meta-analysis shows that the evidence base for silver in wound management is significantly better than perceived in the current scientific debate. Thus, if used selectively and for a limited period of time, silver not only has antimicrobial effects but is also characterized by an improvement in quality of life and good cost-effectiveness.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venereology, and Allergology, University Hospital Essen, Essen, Germany
| | | | | | - Jörg Hilt
- Smith & Nephew GmbH, Hamburg, Germany
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Khafaga AF, Abu-Ahmed HM, El-Khamary AN, Elmehasseb IM, Shaheen HM. Enhancement of Equid Distal Limb Wounds Healing by Topical Application of Silver Nanoparticles. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2017.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mofazzal Jahromi MA, Sahandi Zangabad P, Moosavi Basri SM, Sahandi Zangabad K, Ghamarypour A, Aref AR, Karimi M, Hamblin MR. Nanomedicine and advanced technologies for burns: Preventing infection and facilitating wound healing. Adv Drug Deliv Rev 2018; 123:33-64. [PMID: 28782570 PMCID: PMC5742034 DOI: 10.1016/j.addr.2017.08.001] [Citation(s) in RCA: 258] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 12/11/2022]
Abstract
According to the latest report from the World Health Organization, an estimated 265,000 deaths still occur every year as a direct result of burn injuries. A widespread range of these deaths induced by burn wound happens in low- and middle-income countries, where survivors face a lifetime of morbidity. Most of the deaths occur due to infections when a high percentage of the external regions of the body area is affected. Microbial nutrient availability, skin barrier disruption, and vascular supply destruction in burn injuries as well as systemic immunosuppression are important parameters that cause burns to be susceptible to infections. Topical antimicrobials and dressings are generally employed to inhibit burn infections followed by a burn wound therapy, because systemic antibiotics have problems in reaching the infected site, coupled with increasing microbial drug resistance. Nanotechnology has provided a range of molecular designed nanostructures (NS) that can be used in both therapeutic and diagnostic applications in burns. These NSs can be divided into organic and non-organic (such as polymeric nanoparticles (NPs) and silver NPs, respectively), and many have been designed to display multifunctional activity. The present review covers the physiology of skin, burn classification, burn wound pathogenesis, animal models of burn wound infection, and various topical therapeutic approaches designed to combat infection and stimulate healing. These include biological based approaches (e.g. immune-based antimicrobial molecules, therapeutic microorganisms, antimicrobial agents, etc.), antimicrobial photo- and ultrasound-therapy, as well as nanotechnology-based wound healing approaches as a revolutionizing area. Thus, we focus on organic and non-organic NSs designed to deliver growth factors to burned skin, and scaffolds, dressings, etc. for exogenous stem cells to aid skin regeneration. Eventually, recent breakthroughs and technologies with substantial potentials in tissue regeneration and skin wound therapy (that are as the basis of burn wound therapies) are briefly taken into consideration including 3D-printing, cell-imprinted substrates, nano-architectured surfaces, and novel gene-editing tools such as CRISPR-Cas.
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Affiliation(s)
- Mirza Ali Mofazzal Jahromi
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences (JUMS), Jahrom, Iran; Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences (JUMS), Jahrom, Iran
| | - Parham Sahandi Zangabad
- Research Center for Pharmaceutical Nanotechnology (RCPN), Tabriz University of Medical Science (TUOMS), Tabriz, Iran; Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Moosavi Basri
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Bioenvironmental Research Center, Sharif University of Technology, Tehran, Iran; Civil & Environmental Engineering Department, Shahid Beheshti University, Tehran, Iran
| | - Keyvan Sahandi Zangabad
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Polymer Engineering, Sahand University of Technology, PO Box 51335-1996, Tabriz, Iran; Nanomedicine Research Association (NRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ameneh Ghamarypour
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Biology, Science and Research Branch, Islamic Azad university, Tehran, Iran
| | - Amir R Aref
- Department of Medical Oncology, Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Mahdi Karimi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Dermatology, Harvard Medical School, Boston, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, USA.
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Norman G, Christie J, Liu Z, Westby MJ, Jefferies JM, Hudson T, Edwards J, Mohapatra DP, Hassan IA, Dumville JC. Antiseptics for burns. Cochrane Database Syst Rev 2017; 7:CD011821. [PMID: 28700086 PMCID: PMC6483239 DOI: 10.1002/14651858.cd011821.pub2] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. OBJECTIVES To assess the effects and safety of antiseptics for the treatment of burns in any care setting. SEARCH METHODS In September 2016 we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions based on language, date of publication or study setting. SELECTION CRITERIA We included randomised controlled trials (RCTs) that enrolled people with any burn wound and assessed the use of a topical treatment with antiseptic properties. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, risk of bias assessment and data extraction. MAIN RESULTS We included 56 RCTs with 5807 randomised participants. Almost all trials had poorly reported methodology, meaning that it is unclear whether they were at high risk of bias. In many cases the primary review outcomes, wound healing and infection, were not reported, or were reported incompletely.Most trials enrolled people with recent burns, described as second-degree and less than 40% of total body surface area; most participants were adults. Antiseptic agents assessed were: silver-based, honey, Aloe Vera, iodine-based, chlorhexidine or polyhexanide (biguanides), sodium hypochlorite, merbromin, ethacridine lactate, cerium nitrate and Arnebia euchroma. Most studies compared antiseptic with a topical antibiotic, primarily silver sulfadiazine (SSD); others compared antiseptic with a non-antibacterial treatment or another antiseptic. Most evidence was assessed as low or very low certainty, often because of imprecision resulting from few participants, low event rates, or both, often in single studies. Antiseptics versus topical antibioticsCompared with the topical antibiotic, SSD, there is low certainty evidence that, on average, there is no clear difference in the hazard of healing (chance of healing over time), between silver-based antiseptics and SSD (HR 1.25, 95% CI 0.94 to 1.67; I2 = 0%; 3 studies; 259 participants); silver-based antiseptics may, on average, increase the number of healing events over 21 or 28 days' follow-up (RR 1.17 95% CI 1.00 to 1.37; I2 = 45%; 5 studies; 408 participants) and may, on average, reduce mean time to healing (difference in means -3.33 days; 95% CI -4.96 to -1.70; I2 = 87%; 10 studies; 979 participants).There is moderate certainty evidence that, on average, burns treated with honey are probably more likely to heal over time compared with topical antibiotics (HR 2.45, 95% CI 1.71 to 3.52; I2 = 66%; 5 studies; 140 participants).There is low certainty evidence from single trials that sodium hypochlorite may, on average, slightly reduce mean time to healing compared with SSD (difference in means -2.10 days, 95% CI -3.87 to -0.33, 10 participants (20 burns)) as may merbromin compared with zinc sulfadiazine (difference in means -3.48 days, 95% CI -6.85 to -0.11, 50 relevant participants). Other comparisons with low or very low certainty evidence did not find clear differences between groups.Most comparisons did not report data on infection. Based on the available data we cannot be certain if antiseptic treatments increase or reduce the risk of infection compared with topical antibiotics (very low certainty evidence). Antiseptics versus alternative antisepticsThere may be some reduction in mean time to healing for wounds treated with povidone iodine compared with chlorhexidine (MD -2.21 days, 95% CI 0.34 to 4.08). Other evidence showed no clear differences and is of low or very low certainty. Antiseptics versus non-antibacterial comparatorsWe found high certainty evidence that treating burns with honey, on average, reduced mean times to healing in comparison with non-antibacterial treatments (difference in means -5.3 days, 95% CI -6.30 to -4.34; I2 = 71%; 4 studies; 1156 participants) but this comparison included some unconventional treatments such as amniotic membrane and potato peel. There is moderate certainty evidence that honey probably also increases the likelihood of wounds healing over time compared to unconventional anti-bacterial treatments (HR 2.86, 95% C 1.60 to 5.11; I2 = 50%; 2 studies; 154 participants).There is moderate certainty evidence that, on average, burns treated with nanocrystalline silver dressings probably have a slightly shorter mean time to healing than those treated with Vaseline gauze (difference in means -3.49 days, 95% CI -4.46 to -2.52; I2 = 0%; 2 studies, 204 participants), but low certainty evidence that there may be little or no difference in numbers of healing events at 14 days between burns treated with silver xenograft or paraffin gauze (RR 1.13, 95% CI 0.59 to 2.16 1 study; 32 participants). Other comparisons represented low or very low certainty evidence.It is uncertain whether infection rates in burns treated with either silver-based antiseptics or honey differ compared with non-antimicrobial treatments (very low certainty evidence). There is probably no difference in infection rates between an iodine-based treatment compared with moist exposed burn ointment (moderate certainty evidence). It is also uncertain whether infection rates differ for SSD plus cerium nitrate, compared with SSD alone (low certainty evidence).Mortality was low where reported. Most comparisons provided low certainty evidence that there may be little or no difference between many treatments. There may be fewer deaths in groups treated with cerium nitrate plus SSD compared with SSD alone (RR 0.22, 95% CI 0.05 to 0.99; I2 = 0%, 2 studies, 214 participants) (low certainty evidence). AUTHORS' CONCLUSIONS It was often uncertain whether antiseptics were associated with any difference in healing, infections, or other outcomes. Where there is moderate or high certainty evidence, decision makers need to consider the applicability of the evidence from the comparison to their patients. Reporting was poor, to the extent that we are not confident that most trials are free from risk of bias.
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Affiliation(s)
- Gill Norman
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Janice Christie
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Zhenmi Liu
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Maggie J Westby
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Jayne M Jefferies
- National Institute for Health and Care Excellence (NICE)Evidence Information ServicesLevel 1A, City Tower, Piccadilly PlazaManchesterUKM1 4BT
| | - Thomas Hudson
- National Institute for Health and Care Excellence (NICE)Evidence Information ServicesLevel 1A, City Tower, Piccadilly PlazaManchesterUKM1 4BT
| | - Jacky Edwards
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe HospitalBurn Centre, Acute BlockSouthmoor RoadManchesterUKM23 9LT
| | - Devi Prasad Mohapatra
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)Plastic SurgeryDepartment of Plastic Surgery, 4th Floor, Superspeciality BlockJIPMERPuducherryPuducherryIndia605006
| | - Ibrahim A Hassan
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe HospitalMicrobiologySouthmoor RoadManchesterUKM23 9LT
| | - Jo C Dumville
- University of Manchester, Manchester Academic Health Science CentreDivision of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & HealthJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
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Dissemond J, Böttrich JG, Braunwarth H, Hilt J, Wilken P, Münter KC. Evidenz von Silber in der Wundbehandlung - Metaanalyse der klinischen Studien von 2000-2015. J Dtsch Dermatol Ges 2017; 15:524-536. [DOI: 10.1111/ddg.13233_g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/27/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Joachim Dissemond
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum Essen
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Hamdan S, Pastar I, Drakulich S, Dikici E, Tomic-Canic M, Deo S, Daunert S. Nanotechnology-Driven Therapeutic Interventions in Wound Healing: Potential Uses and Applications. ACS CENTRAL SCIENCE 2017; 3:163-175. [PMID: 28386594 PMCID: PMC5364456 DOI: 10.1021/acscentsci.6b00371] [Citation(s) in RCA: 245] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Indexed: 05/09/2023]
Abstract
The chronic nature and associated complications of nonhealing wounds have led to the emergence of nanotechnology-based therapies that aim at facilitating the healing process and ultimately repairing the injured tissue. A number of engineered nanotechnologies have been proposed demonstrating unique properties and multiple functions that address specific problems associated with wound repair mechanisms. In this outlook, we highlight the most recently developed nanotechnology-based therapeutic agents and assess the viability and efficacy of each treatment, with emphasis on chronic cutaneous wounds. Herein we explore the unmet needs and future directions of current technologies, while discussing promising strategies that can advance the wound-healing field.
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Affiliation(s)
- Suzana Hamdan
- Department of Biochemistry
and Molecular Biology, Miller School of Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United
States
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program,
Department of Dermatology and Cutaneous Surgery, Miller School of
Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United States
| | - Stefan Drakulich
- Wound Healing and Regenerative Medicine Research Program,
Department of Dermatology and Cutaneous Surgery, Miller School of
Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United States
| | - Emre Dikici
- Department of Biochemistry
and Molecular Biology, Miller School of Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United
States
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program,
Department of Dermatology and Cutaneous Surgery, Miller School of
Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United States
| | - Sapna Deo
- Department of Biochemistry
and Molecular Biology, Miller School of Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United
States
| | - Sylvia Daunert
- Department of Biochemistry
and Molecular Biology, Miller School of Medicine, University of Miami, 1011 NW 15th Street, Miami, Florida 33136, United
States
- E-mail:
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The Effects of Topical Vitamin C Solution on Burn Wounds Granulation: A Randomized Clinical Trial. ACTA ACUST UNITED AC 2016. [DOI: 10.5812/jmb.8301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Gao L, Gan H, Meng Z, Gu R, Wu Z, Zhu X, Sun W, Li J, Zheng Y, Sun T, Dou G. Evaluation of genipin-crosslinked chitosan hydrogels as a potential carrier for silver sulfadiazine nanocrystals. Colloids Surf B Biointerfaces 2016; 148:343-353. [DOI: 10.1016/j.colsurfb.2016.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/22/2016] [Accepted: 06/09/2016] [Indexed: 12/16/2022]
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El-Feky GS, Sharaf SS, El Shafei A, Hegazy AA. Using chitosan nanoparticles as drug carriers for the development of a silver sulfadiazine wound dressing. Carbohydr Polym 2016; 158:11-19. [PMID: 28024533 DOI: 10.1016/j.carbpol.2016.11.054] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 11/07/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022]
Abstract
Burn wounds environment favors the growth of micro-organisms causing delay in wound healing. The traditional treatment with antimicrobial creams offer inaccurate doses. In the present study, a dressing coated with silver sulfadiazine (SSD) loaded chitosan nanoparticles (CSNPs) for the controlled-release of SSD into burn wound to control bacterial growth was investigated. CSNPs were formulated with different concentrations of chitosan and CM-β-CD and loaded with SSD complexed in 1:1 molar ratio with CM-β-CD, CSNPs were assessed for their particle size, polydispersity index, morphology and association efficiency. The formula showing the best characteristics was selected for the preparation of SSD loaded CSNPs wound dressing through a padding process with/without the use of cross-linker. The dressing was characterized for its physical properties, in addition, FTIR, X-ray, SEM and in vitro release were used for characterization. The dressing was proven effective for the inhibition of the growth of Gram positive and Gram negative bacteria as well as candida on an infected wound.
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Affiliation(s)
- Gina S El-Feky
- Pharmaceutical Technology Department, National Research Center, Dokki, Cairo, Egypt; Faculty of Pharmacy, October University for Modern Sciences and Arts, Egypt.
| | - Samar S Sharaf
- Textile Research Division, National Research Center, Dokki, Cairo, Egypt
| | - Amira El Shafei
- Textile Research Division, National Research Center, Dokki, Cairo, Egypt
| | - Aisha A Hegazy
- Textile Research Division, National Research Center, Dokki, Cairo, Egypt
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Gopinath PM, Ranjani A, Dhanasekaran D, Thajuddin N, Archunan G, Akbarsha MA, Gulyás B, Padmanabhan P. Multi-functional nano silver: A novel disruptive and theranostic agent for pathogenic organisms in real-time. Sci Rep 2016; 6:34058. [PMID: 27666290 PMCID: PMC5036090 DOI: 10.1038/srep34058] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/06/2016] [Indexed: 01/09/2023] Open
Abstract
The present study was aimed at evaluating the fluorescence property, sporicidal potency against Bacillus and Clostridium endospores, and surface disinfecting ability of biogenic nano silver. The nano silver was synthesized using an actinobacterial cell-filtrate. The fluorescence property as well as imaging facilitator potency of this nano silver was verified adopting spectrofluorometer along with fluorescent and confocal laser scanning microscope wherein strong emission and bright green fluorescence, respectively, on the entire spore surface was observed. Subsequently, the endospores of B. subtilis, B. cereus, B. amyloliquefaciens, C. perfringens and C. difficile were treated with physical sporicides, chemical sporicides and nano silver, in which the nano silver brought about pronounced inhibition even at a very low concentration. Finally, the environmental surface-sanitizing potency of nano silver was investigated adopting cage co-contamination assay, wherein vital organs of mice exposed to the nano silver-treated cage did not show any signs of pathological lesions, thus signifying the ability of nano silver to completely disinfect the spore or reduce the count required for infection. Taken these observations together, we have shown the multi-functional biological properties of the nano silver, synthesized using an actinobacterial cell-filtrate, which could be of application in advanced diagnostics, biomedical engineering and therapeutics in the near future.
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Affiliation(s)
| | - Anandan Ranjani
- Department of Microbiology, Bharathidasan University, Tiruchirappalli-620 024, India
| | - Dharumadurai Dhanasekaran
- Department of Microbiology, Bharathidasan University, Tiruchirappalli-620 024, India
- National Centre for Alternatives to Animal Experiments (NCAAE), Bharathidasan University, Tiruchirappalli-620 024, India
| | - Nooruddin Thajuddin
- Department of Microbiology, Bharathidasan University, Tiruchirappalli-620 024, India
- National Centre for Alternatives to Animal Experiments (NCAAE), Bharathidasan University, Tiruchirappalli-620 024, India
| | - Govindaraju Archunan
- National Centre for Alternatives to Animal Experiments (NCAAE), Bharathidasan University, Tiruchirappalli-620 024, India
- Centre for Pheromone Technology, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli-620 024, India
| | - Mohammad Abdulkader Akbarsha
- National Centre for Alternatives to Animal Experiments (NCAAE), Bharathidasan University, Tiruchirappalli-620 024, India
- Department of Food Science and Nutrition, College of Food and Agriculture, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Balázs Gulyás
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore
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Dua K, Malipeddi VR, Madan J, Gupta G, Chakravarthi S, Awasthi R, Kikuchi IS, De Jesus Andreoli Pinto T. Norfloxacin and metronidazole topical formulations for effective treatment of bacterial infections and burn wounds. Interv Med Appl Sci 2016; 8:68-76. [PMID: 28386462 PMCID: PMC5370353 DOI: 10.1556/1646.8.2016.2.4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/18/2016] [Accepted: 04/22/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Our various previous findings have shown the suitability of norfloxacin in the treatment of bacterial infections and burn wounds in alone as well as in combination with Curcuma longa in various topical (ointments, gels, and creams) and transdermal drug delivery systems. AIMS AND METHODS Keeping these facts in consideration, we have made an another attempt to prepare semisolid formulations containing 1% w/w of norfloxacin and metronidazole with different bases like Carbopol, polyethylene glycol, and hydroxypropylmethyl cellulose for effective treatment of bacterial infections and burn wounds. The prepared formulations were evaluated for physicochemical parameters, in vitro drug release, antimicrobial activity, and burn wound healing properties. RESULTS The prepared formulations were compared with Silver Sulfadiazine cream 1%, USP. Antimicrobial activity of norfloxacin semisolid formulations was found to be equally effective against both aerobic and anaerobic bacteria in comparison to a marketed formulation of Silver Sulfadiazine 1% cream, USP. Based on the burn wound healing property, the prepared norfloxacin semisolid formulation was found to be in good agreement with marketed Silver Sulfadiazine 1% cream, USP. CONCLUSIONS These findings suggest formulations containing norfloxacin and metronidazole may also prove as an effective alternative for existing remedies in the treatment of bacterial infections and burn wounds.
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Affiliation(s)
- Kamal Dua
- School of Pharmacy and Biomedical Sciences, The University of Newcastle, Newcastle, Callaghan, Australia
| | | | - Jyotsna Madan
- Department of Pharmaceutics, Sinhgad Technical Education Society, Smt. Kashibai Navale College of Pharmacy, Pune, Maharashtra, India
| | - Gaurav Gupta
- School of Medicine, The University of Newcastle, Newcastle, Callaghan, Australia
| | | | | | - Irene Satiko Kikuchi
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Parani M, Lokhande G, Singh A, Gaharwar AK. Engineered Nanomaterials for Infection Control and Healing Acute and Chronic Wounds. ACS APPLIED MATERIALS & INTERFACES 2016; 8:10049-69. [PMID: 27043006 DOI: 10.1021/acsami.6b00291] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Nanoengineered biomaterials have dramatically expanded the range of tools used for infection control and to accelerate wound healing. This review thoroughly describes the developments that are shaping this emerging field and evaluates the potential wound healing applications of recently developed engineered nanomaterials for both acute and chronic wounds. Specifically, we will assess the unique characteristics of engineered nanomaterials that render them applicable for wound healing and infection control. A range of engineered nanomaterials, including polymeric-, metallic- and ceramic-based nanomaterials, that could be used as therapeutic delivery agents to accelerate regeneration of damaged dermal and epidermal tissues are also detailed. Finally, we will detail the current state of engineered nanomaterials for wound regeneration and will identify promising new research directions in infection control.
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Affiliation(s)
- Madasamy Parani
- Genomics Laboratory, Department of Genetic Engineering, SRM University , Chennai, Tamil Nadu 603 203, India
| | | | - Ankur Singh
- Sibley School of Mechanical and Aerospace Engineering, Cornell University , Ithaca, New York 14853, United States
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Toussaint J, Chung WT, Osman N, McClain SA, Raut V, Singer AJ. Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine. Acad Emerg Med 2015. [PMID: 26202791 DOI: 10.1111/acem.12723] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Second-degree burns are very common but their management is controversial. These burns may be treated with either topical antimicrobial agents or advanced occlusive dressings; however, there is no established treatment comparator for preclinical studies. This study was designed to determine which of two commonly used comparator therapies (a silver-containing advanced dressing or a topical antibiotic ointment) resulted in faster reepithelialization and less scarring. The hypothesis was that second-degree burns treated with a topical antimicrobial ointment would heal faster and with less scarring than those treated with a silver-containing occlusive foam dressing in a porcine model. METHODS Deep partial-thickness burns were created on the flanks of three anesthetized female domestic pigs (20 to 25 kg) using a 150-g aluminum bar preheated in 80°C water bath and applied to the skin for 20 seconds using a force of 2 kg. The burn eschars were excised 48 hours later with an electric dermatome set at a depth of 0.75 mm. The wound beds were treated with a thin layer of triple-antibiotic petrolatum-based ointment (changed three times weekly) or a silver-containing foam dressing (changed once weekly). Full-thickness punch biopsies were obtained at 9, 11, 14, 16, 18, and 21 days for determination of percentage complete wound reepithelialization and at 28 days for measurement of scar depth. RESULTS At all dressing changes the wounds treated with the topical antibiotic appeared moist, while those treated with the silver-based dressings appeared dry. At day 21 all wounds treated with the ointment were completely reepithelialized, while only 55% of those treated with the silver dressing were reepithelialized (p < 0.001). Scar depth at day 28 was also significantly less in wounds treated with the topical antibiotic ointment (4.3 mm vs. 5.1 mm, difference = 0.7 mm; 95% confidence interval [CI] = 0.1 to 1.4 mm). There was less scar contraction in wounds treated with the topical antibiotic compared with the silver-based dressing (mean ± SD = 25.0% ± 14.6% vs. 38.9% ± 16.9%, difference = 13.9%; 95% CI = 5.7% to 22.0%). CONCLUSIONS In this model of excised deep partial-thickness burns, a triple-antibiotic ointment enhanced reepithelialization and reduced scar depth and contraction compared with a silver-based foam dressing. This triple-antibiotic ointment should be considered as a control for studies evaluating novel topical burn therapies.
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Affiliation(s)
- Jimmy Toussaint
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
| | - Won Taek Chung
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
| | - Naureen Osman
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
| | - Steve A. McClain
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
| | - Vivek Raut
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
| | - Adam J. Singer
- Department of Emergency Medicine; Stony Brook University; Stony Brook NY
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