Modern Wound Dressings: Hydrogel Dressings

Physically Cross-Linked PVA Hydrogels as Potential Wound Dressings: How Freezing Conditions and Formulation Composition Define Cryogel Structure and Performance

Objectives: Hydrogels produced using the freeze-thaw method have demonstrated significant potential for wound management applications. However, their production requires precise control over critical factors including freezing temperature and the choice of matrix-forming excipients, for which no consensus on the optimal conditions currently exists. This study aimed to address this gap by evaluating the effects of the above-mentioned variables on cryogel performance. Methods: Mechanical properties, absorption capacity, and microstructure were assessed alongside advanced analyses using differential scanning calorimetry (DSC) and low-field nuclear magnetic resonance relaxometry (LF TD NMR). Results: The results demonstrated that fully hydrolyzed polyvinyl alcohol (PVA) with a molecular weight above 61,000 g/mol is essential for producing high-performance cryogels. Among the tested formulations, an 8% (w/w) PVA56-98 solution (Mw~195,000; DH = 98.0-98.8%) with 10% (w/w) propylene glycol (PG) provided the best balance of stretchability, durability, and low adhesion. Notably, while -25 °C is often used for cryogel preparation, freezing the gel precursor at -80 °C yielded superior results, producing materials with more open, interconnected structures and enhanced mechanical strength and elasticity-deviating from conventional practices. Conclusions: The designed cryogel prototypes exhibited functional properties comparable to or even surpassing commercial wound dressings, except for absorption capacity, which remained lower. Despite this, the cryogel prototypes demonstrated potential as wound dressings, particularly for use in dry or minimally exuding wounds. All in all, this study provides a comprehensive analysis of the physicochemical and functional properties of PVA cryogels, establishing a strong foundation for the development of advanced wound dressing systems.

Development of carboxymethyl cellulose/gelatin hydrogel loaded with Omega-3 for skin regeneration

Hydrogels have several characteristics, including biocompatibility, physical similarity with the skin's extracellular matrix, and regeneration capacity. Cell migration and proliferation are facilitated by natural polymers such as gelatin (Gel) and carboxymethyl cellulose (CMC). Gelatin dressing acts as a structural framework for cell migration into the wound area, stimulating cell division and promoting granulation tissue formation. Omega-3 fatty acids from fish oil may prevent wound infection and improve the healing of wounds in the early stages. We studied the preparation of wound dressing containing Omega-3 and its ability to heal wounds. In this study, CMC-Gel hydrogels containing different concentrations of Omega-3 were investigated in full-thickness wounds. After the fabrication of the hydrogels by using surfactant (tween 20) and microemulsion method (oil in water), various tests such as SEM, Water uptake evaluation, weight loss, cell viability, blood compatibility, and in vivo study in rat cutaneous modeling during 14 days were performed to evaluate the properties of the fabricated hydrogels. The analysis of the hydrogels revealed that they possess porous structures with interconnected pores, with an average size of 83.23 ± 6.43 μm. The hydrogels exhibited a swelling capacity of up to 60% of their initial weight within 24 h, as indicated by the weight loss and swelling measurements. Cell viability study with the MTT technique showed that no cytotoxicity was observed at the recommended dosage, however, increasing the amount of omega-3 caused hemolysis, cell death, and inhibition of coagulation activity. An in vivo study in adult male rats with a full-thickness model showed greater than 91% improvement of the primary wound region after 2 weeks of treatment. Histological analysis demonstrated Omega-3 in hydrogels, which is a promising approach for topical skin treatment to prevent scar, and has shown efficacy as wound dressing by improving the repair process at the defect site.

Chitosan microflower-embedded gelatin sponges for advanced wound management and hemostatic applications

The study explored the antimicrobial, antibiofilm, and hemostatic properties of chitosan microflowers (CMF) in sponge form. The main objective was to enhance the preparation of CMF by employing varying quantities of calcium chloride (CaCl2) and tripolyphosphate (TPP). CMF was then combined with gelatin (GE) in different proportions to produce three sponge samples: CMF0@GE, CMF1@GE, and CMF2@GE. The CMF had a morphology like that of a flower and produced surfaces with a porous sponge-like structure. The antibacterial activity, as determined by the zone of inhibition (ZOI), increased with greater doses of CMF. Among the tested samples, CMF2@GE had the greatest activity against Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecium. CMF2@GE successfully suppressed biofilm formation, decreased clotting time to an average of 212.67 s, and exhibited excellent biocompatibility by preserving over 90 % viability of human skin fibroblast cells at dosages below 100 μg/mL. The results indicated that gelatin sponges filled with CMF have considerable promise as flexible medical instruments for wound healing and infection control.

Novel Functional Dressing Materials for Intraoral Wound Care

Intraoral wounds represent a particularly challenging category of mucosal and hard tissue injuries, characterized by the unique structures, complex environment, and distinctive healing processes within the oral cavity. They have a common occurrence yet frequently inflict significant inconvenience and pain on patients, causing a serious decline in the quality of life. A variety of novel functional dressings specifically designed for the moist and dynamic oral environment have been developed and realized accelerated and improved wound healing. Thoroughly analyzing and summarizing these materials is of paramount importance in enhancing the understanding and proficiently managing intraoral wounds. In this review, the particular processes and unique characteristics of intraoral wound healing are firstly described. Up-to-date knowledge of various forms, properties, and applications of existing products are then intensively discussed, which are categorized into animal products, plant extracts, natural polymers, and synthetic products. To conclude, this review presents a comprehensive framework of currently available functional intraoral wound dressings, with an aim to provoke inspiration of future studies to design more convenient and versatile materials.

A pan-cancer dye for solid-tumour screening, resection and wound monitoring via short-wave and near-infrared fluorescence imaging

The efficacy of fluorescence-guided surgery in facilitating the real-time delineation of tumours depends on the optical contrast of tumour tissue over healthy tissue. Here we show that CJ215-a commercially available, renally cleared carbocyanine dye sensitive to apoptosis, and with an absorption and emission spectra suitable for near-infrared fluorescence imaging (wavelengths of 650-900 nm) and shortwave infrared (SWIR) fluorescence imaging (900-1,700 nm)-can facilitate fluorescence-guided tumour screening, tumour resection and the assessment of wound healing. In tumour models of either murine or human-derived breast, prostate and colon cancers and of fibrosarcoma, and in a model of intraperitoneal carcinomatosis, imaging of CJ215 with ambient light allowed for the delineation of nearly all tumours within 24 h after intravenous injection of the dye, which was minimally taken up by healthy organs. At later timepoints, CJ215 provided tumour-to-muscle contrast ratios up to 100 and tumour-to-liver contrast ratios up to 18. SWIR fluorescence imaging with the dye also allowed for quantifiable non-contact wound monitoring through commercial bandages. CJ215 may be compatible with existing and emerging clinical solutions.

DNA hydrogels and their derivatives in biomedical engineering applications

Deoxyribonucleotide (DNA) is uniquely programmable and biocompatible, and exhibits unique appeal as a biomaterial as it can be precisely designed and programmed to construct arbitrary shapes. DNA hydrogels are polymer networks comprising cross-linked DNA strands. As DNA hydrogels present programmability, biocompatibility, and stimulus responsiveness, they are extensively explored in the field of biomedicine. In this study, we provide an overview of recent advancements in DNA hydrogel technology. We outline the different design philosophies and methods of DNA hydrogel preparation, discuss its special physicochemical characteristics, and highlight the various uses of DNA hydrogels in biomedical domains, such as drug delivery, biosensing, tissue engineering, and cell culture. Finally, we discuss the current difficulties facing DNA hydrogels and their potential future development.

Enhancing Wound Healing: A Comprehensive Review of Sericin and Chelidonium majus L. as Potential Dressings

Wound healing, a complex physiological process orchestrating intricate cellular and molecular events, seeks to restore tissue integrity. The burgeoning interest in leveraging the therapeutic potential of natural substances for advanced wound dressings is a recent phenomenon. Notably, Sericin, a silk-derived protein, and Chelidonium majus L. (C. majus), a botanical agent, have emerged as compelling candidates, providing a unique combination of natural elements that may revolutionize conventional wound care approaches. Sericin, renowned for its diverse properties, displays unique properties that accelerate the wound healing process. Simultaneously, C. majus, with its diverse pharmacological compounds, shows promise in reducing inflammation and promoting tissue regeneration. As the demand for innovative wound care solutions increases, understanding the therapeutic potential of natural products becomes imperative. This review synthesizes current knowledge on Sericin and C. majus, envisioning their future roles in advancing wound management strategies. The exploration of these natural substances as constituents of wound dressings provides a promising avenue for developing sustainable, effective, and biocompatible materials that could significantly impact the field of wound healing.

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

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

Sensing patches for biomarker identification in skin-derived biofluids

In conventional clinical disease diagnosis and screening based on biomarker detection, most analysis samples are collected from serum, blood. However, these invasive collection methods require specific instruments, professionals, and may lead to infection risks. Additionally, the diagnosis process suffers from untimely results. The identification of skin-related biomarkers plays an unprecedented role in early disease diagnosis. More importantly, these skin-mediated approaches for collecting biomarker-containing biofluid samples are noninvasive or minimally invasive, which is more preferable for point-of-care testing (POCT). Therefore, skin-based biomarker detection patches have been promoted, owing to their unique advantages, such as simple fabrication, desirable transdermal properties and no requirements for professional medical staff. Currently, the skin biomarkers extracted from sweat, interstitial fluid (ISF) and wound exudate, are achieved with wearable sweat patches, transdermal MN patches, and wound patches, respectively. In this review, we detail these three types of skin patches in biofluids collection and diseases-related biomarkers identification. Patch classification and the corresponding manufacturing as well as detection strategies are also summarized. The remaining challenges in clinical applications and current issues in accurate detection are discussed for further advancement of this technology (Scheme 1).

Release of natural extracts from PVA and PVA-CMC hydrogel wound dressings: a power law swelling/delivery

Introduction

PVA hydrogels present many characteristics of the ideal dressing, although without antimicrobial properties. The present work aims to study the physical, mechanical and release characteristics of hydrogel wound dressings loaded with either of two natural herbal products, sage extract and dragon's blood.

Methods

Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC) and tensile mechanical testing were used to investigate the structure and properties of the gels. Swelling and degradation tests were conducted according to ISO 10993-9. Release characteristics were studied using UV Spectrophotometry.

Results

PVA matrices incorporating sage extract or dragon's blood (DB) present hydrogen bonding between these components. PVA-CMC hydrogels containing sage present similar spectra to PVA-CMC alone, probably indicating low miscibility or interaction between the matrix and sage. The opposite is found for DB, which exhibits more pronounced interference with crystallinity than sage. DB and NaCMC negatively affect Young's modulus and failure strength. All samples appear to reach equilibrium swelling degree (ESD) in 24 h. The addition of DB and sage to PVA increases the gels' swelling capacity, indicating that the substances likely separate PVA chains. The inclusion of CMC contributes to high media uptake. The kinetics profile of media uptake for 4 days is described by a power-law model, which is correlated to the drug delivery mechanism.

Discussion

A PVA-CMC gel incorporating 15% DB, the highest amount tested, shows the most favorable characteristics for flavonoid delivery, as well as flexibility and swelling capacity.

Citric acid cross-linked pomegranate peel extract-loaded pH-responsive β-cyclodextrin/carboxymethyl tapioca starch hydrogel film for diabetic wound healing

Pomegranate peel extract (PPE) hydrogel films filled with citric acid (CA) and β-cyclodextrin-carboxymethyl tapioca starch (CMS) were designed mainly to prevent wound infections and speed up the healing process. FTIR and NMR studies corroborated the carboxymethylation of neat tapioca starch (NS). CMS exhibited superior swelling behavior than NS. The amount of CA and β-CD controlled the physicochemical parameters of developed PPE/CA/β-CD/CMS films. Optimized film (OF) exhibited acceptable swellability, wound fluid absorptivity, water vapor transmission rate, water contact angle, and mechanical properties. Biodegradable, biocompatible, and antibacterial films exhibited pH dependence in the release of ellagic acid for up to 24 h. In mice model, PPE/CA/β-CD/CMS hydrogel film treatment showed promising wound healing effects, including increased collagen deposition, reduced inflammation, activation of the Wingless-related integration site (wnt) pathway leading to cell division, proliferation, and migration to the wound site. The expression of the WNT3A gene did not show any significant differences among all the studied groups. Developed PPE-loaded CA/β-CD/CMS film promoted wound healing by epithelialization, granulation tissue thickness, collagen deposition, and angiogenesis, hence could be recommended as a biodegradable and antibacterial hydrogel platform to improve the cell proliferation during the healing of diabetic wounds.

Micelle-Containing Hydrogels and Their Applications in Biomedical Research

Hydrogels are one of the most commonly used materials in our daily lives, which possess crosslinked three-dimensional network structures and are capable of absorbing large amounts of fluid. Due to their outstanding properties, such as flexibility, tunability, and biocompatibility, hydrogels have been widely employed in biomedical research and clinics, especially in on-demand drug release. However, traditional hydrogels face various limitations, e.g., the delivery of hydrophobic drugs due to their highly hydrophilic interior environment. Therefore, micelle-containing hydrogels have been designed and developed, which possess both hydrophilic and hydrophobic microenvironments and enable the storage of diverse cargos. Based on the functionalities of micelles, these hydrogels can be classified into micelle-doped and chemically/physically crosslinked types, which were reported to be responsive to varied stimuli, including temperature, pH, irradiation, electrical signal, magnetic field, etc. Here, we summarize the research advances of micelle-containing hydrogels and provide perspectives on their applications in the biomedical field based on the recent studies from our own lab and others.

Multifunctional hydrogels based on photothermal therapy: A prospective platform for the postoperative management of melanoma

Preventing the recurrence of melanoma after surgery and accelerating wound healing are among the most challenging aspects of melanoma management. Photothermal therapy has been widely used to treat tumors and bacterial infections and promote wound healing. Owing to its efficacy and specificity, it may be used for postoperative management of tumors. However, its use is limited by the uncontrollable distribution of photosensitizers and the likelihood of damage to the surrounding normal tissue. Hydrogels provide a moist environment with strong biocompatibility and adhesion for wound healing owing to their highly hydrophilic three-dimensional network structure. In addition, these materials serve as excellent drug carriers for tumor treatment and wound healing. It is possible to combine the advantages of both of these agents through different loading modalities to provide a powerful platform for the prevention of tumor recurrence and wound healing. This review summarizes the design strategies, research progress and mechanism of action of hydrogels used in photothermal therapy and discusses their role in preventing tumor recurrence and accelerating wound healing. These findings provide valuable insights into the postoperative management of melanoma and may guide the development of promising multifunctional hydrogels for photothermal therapy.

Incorporation of natural and synthetic polymers into honey hydrogel for wound healing: A review

Background and Aims

The difficulty in treating chronic wounds due to the prolonged inflammation stage has affected a staggering 6.5 million people, accompanied by 25 billion USD annually in the United States alone. A 1.9% rise in chronic wound prevalence among Medicare beneficiaries was reported from 2014 to 2019. Besides, the global wound care market values were anticipated to increase from USD 20.18 billion in 2022 to USD 30.52 billion in 2030, suggesting an expected rise in chronic wounds financial burdens. The lack of feasibility in using traditional dry wound dressings sparks hydrogel development as an alternative approach to tackling chronic wounds. Since ancient times, honey has been used to treat wounds, including burns, and ongoing studies have also demonstrated its wound-healing capabilities on cellular and animal models. However, the fluidity and low mechanical strength in honey hydrogel necessitate the incorporation of other polymers. Therefore, this review aims to unravel the characteristics and feasibility of natural (chitosan and gelatin) and synthetic (polyvinyl alcohol and polyethylene glycol) polymers to be incorporated in the honey hydrogel.

Methods

Relevant articles were identified from databases (PubMed, Google Scholar, and Science Direct) using keywords related to honey, hydrogel, and polymers. Relevant data from selected studies were synthesized narratively and reported following a structured narrative format.

Results

The importance of honey's roles and mechanisms of action in wound dressings were discussed. Notable studies concerning honey hydrogels with diverse polymers were also included in this article to provide a better perspective on fabricating customized hydrogel wound dressings for various types of wounds in the future.

Conclusion

Honey's incapability to stand alone in hydrogel requires the incorporation of natural and synthetic polymers into the hydrogel. With this review, it is hoped that the fabrication and commercialization of the desired honey composite hydrogel for wound treatment could be brought forth.

Exosome-loaded biomaterials for tendon/ligament repair

Exosomes, a specialised type of extracellular vesicle, have attracted significant attention in the realm of tendon/ligament repair as a potential biologic therapeutic tool. While the competence of key substances responsible for the delivery function was gradually elucidated, series of shortcomings exemplified by the limited stability still need to be improved. Therefore, how to take maximum advantage of the biological characteristics of exosomes is of great importance. Recently, the comprehensive exploration and application of biomedical engineering has improved the availability of exosomes and revealed the future direction of exosomes combined with biomaterials. This review delves into the present application of biomaterials such as nanomaterials, hydrogels, and electrospun scaffolds, serving as the carriers of exosomes in tendon/ligament repair. By pinpointing and exploring their strengths and limitations, it offers valuable insights, paving the way the future direction of biomaterials in the application of exosomes in tendon/ligament repair in this field.

From Nature to Healing: Development and Evaluation of Topical Cream Loaded with Pine Tar for Cutaneous Wound Repair

Despite the numerous efforts to find an appropriate therapeutic modality, diabetic wounds remain a global unsolved problem. Therefore, our study aimed to develop a topical formulation loaded with pine tar and to investigate its wound-healing capacity. After phytochemical profiling of pine tar, an oil-in-water emulsion with 1% pine tar was prepared. The physical, chemical, and microbiological stability of prepared pine tar cream (PTC) was assessed during six months. Additionally, safety potential was examined in healthy rats, while wound-healing potential was accessed by creating excision wounds in diabetic rats. Diabetic animals were divided into four groups: untreated or topically treated with either the cream base, PTC, or silver sulfadiazine cream. Wound healing was monitored at the following time points (0, 7, 14, and 21 days) through macroscopic, biochemical, and histological examinations. Our PTC formula showed good physicochemical properties and remained stable and compatible for cutaneous application. PTC showed a remarkable increase in wound closure rate and led to attenuation of morphological alterations in skin samples. These findings were associated with significantly improved redox status and enhanced hydroxyproline levels in PTC relative to the untreated and cream base groups. Our results demonstrated that PTC might serve as a promising tool for the management of diabetic wounds.

Chitosan-based multifunctional oxygenating antibiotic hydrogel dressings for managing chronic infection in diabetic wounds

Current treatment strategies for infection of chronic wounds often result in compromised healing and necrosis due to antibiotic toxicity, and underlying biomarkers affected by treatments are not fully known. Here, a multifunctional dressing was developed leveraging the unique wound-healing properties of chitosan, a natural polysaccharide known for its numerous benefits in wound care. The dressing consists of an oxygenating perfluorocarbon functionalized methacrylic chitosan (MACF) hydrogel incorporated with antibacterial polyhexamethylene biguanide (PHMB). A non-healing diabetic infected wound model with emerging metabolomics tools was used to explore the anti-infective and wound healing properties of the resultant multifunctional dressing. Direct bacterial bioburden assessment demonstrated superior antibacterial properties of hydrogels over a commercial dressing. However, wound tissue quality analyses confirmed that sustained PHMB for 21 days resulted in tissue necrosis and disturbed healing. Therefore, a follow-up comparative study investigated the best treatment course for antiseptic application ranging from 7 to 21 days, followed by the oxygenating chitosan-based MACF treatment for the remainder of the 21 days. Bacterial counts, tissue assessments, and lipidomics studies showed that 14 days of application of MACF-PHMB dressings followed by 7 days of MACF dressings provides a promising treatment for managing infected non-healing diabetic skin ulcers.

How the combination of alginate and chitosan can fabricate a hydrogel with favorable properties for wound healing

Wound management has always been a significant concern, particularly for men, and the search for effective wound dressings has led to the emergence of hydrogels as a promising solution. In recent years, hydrogels, with their unique properties, have gained considerable importance in wound management. Among the various types of hydrogels, those incorporating chitosan and alginate, two distinct chemical materials, have shown potential in accelerating wound healing. This review aims to discuss the desirable characteristics of an effective wound dressing, explore the alginate/chitosan-based hydrogels developed by different researchers, and analyze their effects on wound healing through in vitro and in vivo assessments. In vitro tests encompass a wide range of evaluations, including swelling capacity, degradation rate, porosity, Fourier Transform Infrared Spectroscopy, X-ray diffraction analysis, moisture vapor transmission rate, release studies, mechanical properties, microscopic observation, antibacterial properties, compatibility assessment, cell adhesion investigation, blood clotting capability, cell migration analysis, water contact angle determination, and structural stability. Furthermore, in vivo assessments encompass the examination of wound closure rate, modulation of gene expression, as well as histopathological and immunohistochemical studies.

All-in-one hydrogel patches with sprayed bFGF-loaded GelMA microspheres for infected wound healing studies

The current wound healing process faces numerous challenges such as bacterial infection, inflammation and oxidative stress. However, wound dressings used to promote wound healing, are not well suited to meet the clinical needs. Hyaluronic acid (HA) not only has excellent water absorption and good biocompatibility but facilitates cell function and tissue regeneration. Dopamine, on the other hand, increases the overall viscosity of the hydrogel and possesses antioxidant property. Furthermore, chitosan exhibits outstanding performance in antimicrobial, anti-inflammatory and antioxidant activities. Basic fibroblast growth factor (bFGF) is conducive to cell proliferation and migration, vascular regeneration and wound healing. Hence, we designed an all-in-one hydrogel patch containing dopamine and chitosan framed by hyaluronic acid (HDC) with sprayed gelatin methacryloyl (GelMA) microspheres loaded with bFGF (HDC-bFGF). The hydrogel patch exhibits excellent adhesive, anti-inflammatory, antioxidant and antibacterial properties. In vitro experiments, the HDC-bFGF hydrogel patch not only showed significant inhibitory effect on RAW cell inflammation and Staphylococcus aureus (S. aureus) growth but also effectively scavenged free radicals, in addition to promoting the migration of 3 T3 cells. In the mice acute infected wound model, the HDC-bFGF hydrogel patch adhered to the wound surface greatly accelerated the healing process via its anti-inflammatory and antioxidant activities, bacterial inhibition and pro-vascularization effects. Therefore, the multifunctional HDC-bFGF hydrogel patch holds great promise for clinical application.

A Novel Food Bore Protein Hydrogel with Silver Ions for Promoting Burn Wound Healing

Hydrogels have emerged as a promising option for treating local scald wounds due to their unique physical and chemical properties. This study aims to evaluate the efficacy of ovalbumin/gelatin composite hydrogels in repairing deep II-degree scald wounds using a mouse dorsal skin model. Trauma tissues collected at various time points are analyzed for total protein content, hydroxyproline content, histological features, and expression of relevant markers. The results reveal that the hydrogel accelerates the healing process of scalded wounds, which is 17.27% higher than the control group. The hydrogel treatment also effectively prevents wound enlargement and redness of the edges caused by infection during the initial stage of scalding. The total protein and hydroxyproline content of the treated wounds are significantly elevated. Additionally, the hydrogel up-regulates the expression of VEGF (a crucial angiogenic factor) and down-regulates CD68 (a macrophage marker). In summary, this study provides valuable insights into the potential of multifunctional protein-based hydrogels in wound healing.

Multifunctional double-network hydrogel with antibacterial and anti-inflammatory synergistic effects contributes to wound healing of bacterial infection

Wound infection not only hinders the time sequence of tissue repair, but also may lead to serious complications. Multifunctional wound dressings with biocompatibility, excellent mechanical properties and antibacterial properties can promote wound healing during skin infection and reduce the use of antibiotics. In this study, a multifunctional dual-network antibacterial hydrogel was constructed based on the electrostatic interaction of two polyelectrolytes, hydroxypropyl trimethyl ammonium chloride chitosan (HACC) and sodium alginate (SA). Attributing to the suitable physical crosslinking between HACC and SA, the hydrogel not only has good biocompatibility, mechanical property, but also has broad-spectrum antibacterial properties. In vivo results showed that the hydrogel could regulate M2 polarization, promote early vascular regeneration, and create a good microenvironment for wound healing. Therefore, this hydrogel is an effective multifunctional wound dressing. Consequently, we propose a novel hydrogel with combined elements to expedite the intricate repair of wound infection.

Preparation and characterization of PVA/chitosan nanofibers loaded with Dragon's blood or poly helixan as wound dressings

Nanofibers have been investigated in regenerative medicine. Dragon's blood (DB)- and poly helixan PF (PHPF) are natural materials used in cosmetics. Herein, we generated DB- and PHPF-loaded polyvinyl alcohol/chitosan (PVA/CS/DB and PVA/CS/PHPF, respectively) nanofibers. PVA/CS/DB and PVA/CS/PHPF nanofibers had an average diameter of 547.5 ± 17.13 and 521 ± 24.67 nm, respectively as assessed by SEM, and a degradation rate of 43.1 and 47.6 % after 14 days, respectively. PVA/CS/DB and PVA/CS/PHPF nanofibers had a hemolysis rate of 0.10 and 0.39 %, respectively, and a water vapor transmission rate of ∼2200 g.m-2.day-1. These nanofibers exhibited favorable antimicrobial activity against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Bacillus subtilis in vitro. PVA/CS/DB and PVA/CS/PHPF nanofibers demonstrated a sustained release of 77.91 and 76.55 % over 72 h. PVA/CS/DB and PVA/CS/PHPF nanofibers had a high rate of cytocompatibility and significantly improved the viability of NIH/3T3 cells as compared with free drugs or unloaded nanofibers. Histological inspection via H&E and Verhoeff's staining demonstrated PVA/CS/DB and PVA/CS/PHPF nanofibers enhanced the wound healing and damaged tissue recovery of unsplinted wound models by promoting epithelial layer formation, collagen deposition, and enhancing the presence of fibroblasts. Conclusively, PVA/CS/DB and PVA/CS/PHPF can be introduced as potential wound dressing candidates with favorable properties.

Advanced Dressings for Chronic Wound Management

Wound healing, particularly for chronic wounds, presents a considerable difficulty due to differences in biochemical and cellular processes that occur in different types of wounds. Recent technological breakthroughs have notably advanced the understanding of diagnostic and therapeutic approaches to wound healing. The evolution in wound care has seen a transition from traditional textile dressings to a variety of advanced alternatives, including self-healing hydrogels, hydrofibers, foams, hydrocolloids, environment responsive dressings, growth factor-based therapy, bioengineered skin substitutes, and stem cell and gene therapy. Technological advancements, such as 3D printing and electronic skin (e-skin) therapy, contribute to the customization of wound healing. Despite these advancements, effectively managing chronic wounds remains challenging. This necessitates the development of treatments that consider performance, risk-benefit balance, and cost-effectiveness. This review discusses innovative strategies for the healing of chronic wounds. Incorporating biomarkers into advanced dressings, coupled with corresponding biosensors and drug delivery formulations, enables the theranostic approach to the treatment of chronic wounds. Furthermore, integrating advanced dressings with power sources and user interfaces like near-field communication, radio frequency identification, and Bluetooth enhances real-time monitoring and on-demand drug delivery. It also provides a thorough evaluation of the advantages, patient compliance, costs, and durability of advanced dressings, emphasizing smart formulations and their preparation methods.

Multifunctional antibacterial hydrogels for chronic wound management

Chronic wounds have gradually evolved into a global health challenge, comprising long-term non-healing wounds, local tissue necrosis, and even amputation in severe cases. Accordingly, chronic wounds place a considerable psychological and economic burden on patients and society. Chronic wounds have multifaceted pathogenesis involving excessive inflammation, insufficient angiogenesis, and elevated reactive oxygen species levels, with bacterial infection playing a crucial role. Hydrogels, renowned for their excellent biocompatibility, moisture retention, swelling properties, and oxygen permeability, have emerged as promising wound repair dressings. However, hydrogels with singular functions fall short of addressing the complex requirements associated with chronic wound healing. Hence, current research emphasises the development of multifunctional antibacterial hydrogels. This article reviews chronic wound characteristics and the properties and classification of antibacterial hydrogels, as well as their potential application in chronic wound management.

Infection-Free and Enhanced Wound Healing Potential of Alginate Gels Incorporating Silver and Tannylated Calcium Peroxide Nanoparticles

The treatment of chronic wounds involves precise requirements and complex challenges, as the healing process cannot go beyond the inflammatory phase, therefore increasing the healing time and implying a higher risk of opportunistic infection. Following a better understanding of the healing process, oxygen supply has been validated as a therapeutic approach to improve and speed up wound healing. Moreover, the local implications of antimicrobial agents (such as silver-based nano-compounds) significantly support the normal healing process, by combating bacterial contamination and colonization. In this study, silver (S) and tannylated calcium peroxide (CaO2@TA) nanoparticles were obtained by adapted microfluidic and precipitation synthesis methods, respectively. After complementary physicochemical evaluation, both types of nanoparticles were loaded in (Alg) alginate-based gels that were further evaluated as possible dressings for wound healing. The obtained composites showed a porous structure and uniform distribution of nanoparticles through the polymeric matrix (evidenced by spectrophotometric analysis and electron microscopy studies), together with a good swelling capacity. The as-proposed gel dressings exhibited a constant and suitable concentration of released oxygen, as shown for up to eight hours (UV-Vis investigation). The biofilm modulation data indicated a synergistic antimicrobial effect between silver and tannylated calcium peroxide nanoparticles, with a prominent inhibitory action against the Gram-positive bacterial biofilm after 48 h. Beneficial effects in the human keratinocytes cultured in contact with the obtained materials were demonstrated by the performed tests, such as MTT, LDH, and NO.

Preparation of Gel Forming Polymer-Based Sprays for First Aid Care of Skin Injuries

Currently, there are several types of materials for the treatment of wounds, burns, and other topical injuries available on the market. The most used are gauzes and compresses due to their fluid absorption capacity; however, these materials adhere to the surface of the lesions, which can lead to further bleeding and tissue damage upon removal. In the present study, the development of a polymer-based gel that can be applied as a spray provides a new vision in injury protection, respecting the requirements of safety, ease, and quickness of both applicability and removal. The following polymeric sprays were developed to further obtain gels based on different polymers: hydroxypropyl cellulose (HPC), polyvinyl pyrrolidone (PVP) and hydroxypropyl methylcellulose (HPMC) using polyethylene glycol (PEG) as a plasticizer. The developed sprays revealed suitable properties for use in topical injuries. A protective film was obtained when sprayed on a surface through a casting mechanism. The obtained films adhered to the surface of biological tissue (pig muscle), turning into a gel when the exudate was absorbed, and proved to be washable with saline solution and contribute to the clotting process. Moreover, biocompatibility results showed that all materials were biocompatible, as cell viability was over 90% for all the materials.

AI energized hydrogel design, optimization and application in biomedicine

Traditional hydrogel design and optimization methods usually rely on repeated experiments, which is time-consuming and expensive, resulting in a slow-moving of advanced hydrogel development. With the rapid development of artificial intelligence (AI) technology and increasing material data, AI-energized design and optimization of hydrogels for biomedical applications has emerged as a revolutionary breakthrough in materials science. This review begins by outlining the history of AI and the potential advantages of using AI in the design and optimization of hydrogels, such as prediction and optimization of properties, multi-attribute optimization, high-throughput screening, automated material discovery, optimizing experimental design, and etc. Then, we focus on the various applications of hydrogels supported by AI technology in biomedicine, including drug delivery, bio-inks for advanced manufacturing, tissue repair, and biosensors, so as to provide a clear and comprehensive understanding of researchers in this field. Finally, we discuss the future directions and prospects, and provide a new perspective for the research and development of novel hydrogel materials for biomedical applications.

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

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

The role of hydrogels in the management of brain tumours: a narrative review

Conventional therapeutic techniques for brain tumours have limitations and side effects, necessitating the need for alternative treatment options. MRI-monitored therapeutic hydrogel systems show potential as a non-surgical approach for brain tumour treatment. Hydrogels have unique physical and chemical properties that make them promising for brain tumour treatment, including the ability to encapsulate therapeutic agents, provide sustained and controlled drug release, and overcome the blood-brain barrier for better penetration. By combining hydrogel systems with MRI techniques, it is possible to develop therapeutic approaches that provide real-time monitoring and controlled release of therapeutic agents. Surgical resection remains important, but there is a growing need for alternative approaches that can complement or replace traditional methods. The objective of this comprehensive narrative review is to evaluate the potential of MRI-monitored therapeutic hydrogel systems in non-surgical brain tumour treatment.

Advancements in Regenerative Hydrogels in Skin Wound Treatment: A Comprehensive Review

This state-of-the-art review explores the emerging field of regenerative hydrogels and their profound impact on the treatment of skin wounds. Regenerative hydrogels, composed mainly of water-absorbing polymers, have garnered attention in wound healing, particularly for skin wounds. Their unique properties make them well suited for tissue regeneration. Notable benefits include excellent water retention, creating a crucially moist wound environment for optimal healing, and facilitating cell migration, and proliferation. Biocompatibility is a key feature, minimizing adverse reactions and promoting the natural healing process. Acting as a supportive scaffold for cell growth, hydrogels mimic the extracellular matrix, aiding the attachment and proliferation of cells like fibroblasts and keratinocytes. Engineered for controlled drug release, hydrogels enhance wound healing by promoting angiogenesis, reducing inflammation, and preventing infection. The demonstrated acceleration of the wound healing process, particularly beneficial for chronic or impaired healing wounds, adds to their appeal. Easy application and conformity to various wound shapes make hydrogels practical, including in irregular or challenging areas. Scar minimization through tissue regeneration is crucial, especially in cosmetic and functional regions. Hydrogels contribute to pain management by creating a protective barrier, reducing friction, and fostering a soothing environment. Some hydrogels, with inherent antimicrobial properties, aid in infection prevention, which is a crucial aspect of successful wound healing. Their flexibility and ability to conform to wound contours ensure optimal tissue contact, enhancing overall treatment effectiveness. In summary, regenerative hydrogels present a promising approach for improving skin wound healing outcomes across diverse clinical scenarios. This review provides a comprehensive analysis of the benefits, mechanisms, and challenges associated with the use of regenerative hydrogels in the treatment of skin wounds. In this review, the authors likely delve into the application of rational design principles to enhance the efficacy and performance of hydrogels in promoting wound healing. Through an exploration of various methodologies and approaches, this paper is poised to highlight how these principles have been instrumental in refining the design of hydrogels, potentially revolutionizing their therapeutic potential in addressing skin wounds. By synthesizing current knowledge and highlighting potential avenues for future research, this review aims to contribute to the advancement of regenerative medicine and ultimately improve clinical outcomes for patients with skin wounds.

A Nanocomposite Dynamic Covalent Cross-Linked Hydrogel Loaded with Fusidic Acid for Treating Antibiotic-Resistant Infected Wounds

Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high levels of morbidity and is considered a difficult-to-treat infection, often requiring nonstandard treatment regimens and antibiotics. Since over 40% of the emerging antibiotic compounds have insufficient solubility that limits their bioavailability and thus efficacy through oral or intravenous administration, it is crucial that alternative drug delivery products be developed for wound care applications. Existing effective treatments for soft tissue MRSA infections, such as fusidic acid (FA), which is typically administered orally, could also benefit from alternative routes of administration to improve local efficacy and bioavailability while reducing the required therapeutic dose. Herein, we report an antimicrobial poly(oligoethylene glycol methacrylate) (POEGMA)-based composite hydrogel loaded with fusidic acid-encapsulating self-assembled polylactic acid-b-poly(oligo(ethylene glycol) methyl ether methacrylate) (PLA-POEGMA) nanoparticles for the treatment of MRSA-infected skin wounds. The inclusion of the self-assembled nanoparticles (380 nm diameter when loaded with fusidic acid) does not alter the favorable mechanical properties and stability of the hydrogel in the context of its use as a wound dressing, while fusidic acid (FA) can be released from the hydrogel over ∼10 h via a diffusion-controlled mechanism. The antimicrobial studies demonstrate a clear zone of inhibition in vitro and a 1-2 order of magnitude inhibition of bacterial growth in vivo in an MRSA-infected full-thickness excisional murine wound model even at very low antibiotic doses. Our approach thus can both circumvent challenges in the local delivery of hydrophobic antimicrobial compounds and directly deliver antimicrobials into the wound to effectively combat methicillin-resistant infections using a fraction of the drug dose required using other clinically relevant strategies.

Multifunctional chitosan-based hydrogel wound dressing loaded with Acanthopanax senticosus and Osmundastrum cinnamomeum: Preparation, characterization and coagulation mechanism

Considerable potential exists for the development of natural polymer hydrogels that possess notable antibacterial and anti-inflammatory properties, along with excellent biocompatibility and mechanical attributes, to expedite the healing of skin wounds. Recent endeavors have focused on formulating an optimal hydrogel dressing for wound hemostasis and repair. In this pursuit, we have crafted a composite hydrogel using carboxymethyl chitosan and alginic acid, cross-linked with EDC/NHS, and enriched with extracts from Acanthopanax senticosus and Osmundastrum cinnamomeum. This synthesized hydrogel showcases commendable features, including significant swelling capacity (135 ± 3.6%), proficient water retention (94.421 ± 0.154%), and effective water vapor permeability (5845.011 ± 467.799 g/m2/d). Moreover, our drug-loaded hydrogels (CMCS/SA/AS/OC) have demonstrated remarkable efficacy in accelerating wound healing in both in vivo and in vitro models. On the 7th day, the wound healing rate reached 94.905% ± 0.498%, and by the 14th day, the wound was nearly fully healed (98.08% ± 0.323%) with the emergence of hair coverage. Furthermore, these hydrogels exhibited remarkable hemostatic properties, the platelet activity was 89.37% ± 1.29% and the platelet adhesion rate was 66.36% ± 1.42%. In order to elucidate the coagulation mechanism of the Acanthopanax senticosus and Osmundastrum cinnamomeum extracts, a network pharmacology approach was carried out. 41 active compounds and 107 potential therapeutic targets associated with these extracts were identified, revealing a total of 132 coagulation pathways. Platelet activation and complement and coagulation cascades pathways showed the highest levels of enrichment by KEGG analysis, serving as potential mechanisms through which the active components in AS/OC may facilitate coagulation by targeting relevant factors. In summary, our study has successfully developed an innovative drug-loaded hydrogel that not only enhances wound hemostasis and healing but also provides insights into the underlying mechanisms through network pharmacology. This work establishes a robust theoretical foundation for the medical application of our hydrogel.

A Printable Hydrogel Loaded with Medicinal Plant Extract for Promoting Wound Healing

How to promote wound healing is still a major challenge in the healthcare while macrophages are a critical component of the healing process. Compared to various bioactive drugs, many plants have been reported to facilitate the wound healing process by regulating the immune response of wounds. In this work, a Three-dimensional (3D) printed hydrogel scaffold loaded with natural Centella asiatica extract (CA extract) is developed for wound healing. This CA@3D scaffold uses gelatin (Gel) and sodium alginate (SA) with CA extract as bio-ink for 3D printing. The CA extract contains a variety of bioactive compounds that make the various active ingredients in Centella asiatica work in concert. The printed CA@3D scaffold can fit the shape of wound, orchestrate the macrophages and immune responses within the wound, and promote wound healing compared to commercial wound dressings. The underlying mechanism of promoting wound healing is also illuminated by applying multi-omic analyses. Moreover, the CA extract loaded 3D scaffold also showed great ability to promote wound healing in diabetic chronic wounds. Due to its ease of preparation, low-cost, biosafety, and therapeutic outcomes, this work proposes an effective strategy for promoting chronic wound healing.

Fabrication of a core-shell nanofibrous wound dressing with an antioxidant effect on skin injury

Oxidative stress is one of the obstacles preventing wound regeneration, especially for chronic wounds. Herein, designing a wound dressing with an anti-oxidant function holds great appeal for enhancing wound regeneration. In this study, a biocompatible and degradable nanofiber with a core-shell structure was fabricated via coaxial electrospinning, in which polycaprolactone (PCL) was applied as the core structure, while the shell was composed of a mixture of silk fibroin (SF) and tocopherol acetate (TA). The electrospun PST nanofibers were proven to have a network structure with significantly enhanced mechanical properties. The PSTs exhibited a diameter distribution with an average of 321 ± 134 nm, and the water contact angle of their surface is 124 ± 2°. The PSTs also exhibited good tissue compatibility, which can promote the adhesion and proliferation of L929 cells. Besides, the dissolution of silk fibroin encourages the release of TA, which could play a synergistic effect and regulate the oxidative stress effect in the damaged area, for it promotes the adhesion and proliferation of skin fibroblasts (L929), reduces the cytotoxicity of hydrogen peroxide to cells, and lowers the level of reactive oxygen species. The animal experiment indicated that the PSTs would promote the reconstruction of skin. These nanofibers are expected to repair skin ulcers related to diabetes.

Recent Developments in 3D-(Bio)printed Hydrogels as Wound Dressings

Wound healing is a physiological process occurring after the onset of a skin lesion aiming to reconstruct the dermal barrier between the external environment and the body. Depending on the nature and duration of the healing process, wounds are classified as acute (e.g., trauma, surgical wounds) and chronic (e.g., diabetic ulcers) wounds. The latter take several months to heal or do not heal (non-healing chronic wounds), are usually prone to microbial infection and represent an important source of morbidity since they affect millions of people worldwide. Typical wound treatments comprise surgical (e.g., debridement, skin grafts/flaps) and non-surgical (e.g., topical formulations, wound dressings) methods. Modern experimental approaches include among others three dimensional (3D)-(bio)printed wound dressings. The present paper reviews recently developed 3D (bio)printed hydrogels for wound healing applications, especially focusing on the results of their in vitro and in vivo assessment. The advanced hydrogel constructs were printed using different types of bioinks (e.g., natural and/or synthetic polymers and their mixtures with biological materials) and printing methods (e.g., extrusion, digital light processing, coaxial microfluidic bioprinting, etc.) and incorporated various bioactive agents (e.g., growth factors, antibiotics, antibacterial agents, nanoparticles, etc.) and/or cells (e.g., dermal fibroblasts, keratinocytes, mesenchymal stem cells, endothelial cells, etc.).

Understanding the ideal wound healing mechanistic behavior using in silico modelling perspectives: A review

Complexity of the entire body precludes an accurate assessment of the specific contributions of tissues or cells during the healing process, which might be expensive and time consuming. Because of this, controlling the wound's size, depth, and dimensions may be challenging, and there is not yet an efficient and reliable chronic wound model representation. Furthermore, given the inherent challenges associated with conducting non-invasive in vivo investigations, it becomes peremptory to explore alternative methodologies for studying wound healing. In this context, biologically-realistic mathematical and computational models emerge as a valuable framework that can effectively address this need. Therefore, it might improve our approach to understanding the process at its core. This article will examines all facets of wound healing, including the kinds, pathways, and most current developments in wound treatment worldwide, particularly in silico modelling utilizing both mathematical and structure-based modelling techniques. It may be helpful to identify the crucial traits through the feedback loop of computer models and experimental investigations in order to build innovative therapies to cure wounds. Hence the effectiveness of personalised medicine and more targeted therapy in the healing of wounds may be enhanced by this interdisciplinary expertise.

Multifunctional hydrogel bioscaffolds based on polysaccharide to promote wound healing: A review

Various types of skin wounds pose challenges in terms of healing and susceptibility to infection, which can have a significant impact on physical and mental well-being, and in severe cases, may result in amputation. Conventional wound dressings often fail to provide optimal support for these wounds, thereby impeding the healing process. As a result, there has been considerable interest in the development of multifunctional polymer matrix hydrogel scaffolds for wound healing. This review offers a comprehensive review of the characteristics of polysaccharide-based hydrogel scaffolds, as well as their applications in different types of wounds. Additionally, it evaluates the advantages and disadvantages associated with various types of multifunctional polymer and polysaccharide-based hydrogel scaffolds. The objective is to provide a theoretical foundation for the utilization of multifunctional hydrogel scaffolds in promoting wound healing.

Fast-Gelling Polyethylene Glycol/Polyethyleneimine Hydrogels Degradable by Visible-Light

The treatment of burn wounds remains a clinical challenge due to the need for repeated dressings changes. Therefore, the development of a dressing system that can be atraumatically removed from the wound bed can be considered a breakthrough and improve treatment times. In this work, the development of an injectable, fast-gelling hydrogel is proposed that can change its mechanical properties when exposed to visible light. The hydrogels are prepared by a "click" amino-yne reaction between poly(ethylene glycol) (PEG) functionalized with propiolic acid and the amino groups of poly(ethyleneimine) (PEI). The hydrogels exhibit a fast gelation time, which can be adjusted by changing the weight percentage and molecular weight of the precursors. They also exhibit good swelling ability and adhesion to living tissues. More importantly, their mechanical properties changed upon irradiation with green light. This loss of properties is achieved by a 1 O2 -mediated mechanism, as confirmed by the degradation of the β-aminoacrylate linker. Moreover, the in vitro cell compatibility results of the hydrogels and their degradation products show good cytocompatibility. Therefore, it is believed that these hydrogels can be considered as materials with great potential for an innovative strategy for the treatment of burn wounds.

Application of Chitosan-Based Hydrogel in Promoting Wound Healing: A Review

Chitosan is a linear polyelectrolyte with active hydroxyl and amino groups that can be made into chitosan-based hydrogels by different cross-linking methods. Chitosan-based hydrogels also have a three-dimensional network of hydrogels, which can accommodate a large number of aqueous solvents and biofluids. CS, as an ideal drug-carrying material, can effectively encapsulate and protect drugs and has the advantages of being nontoxic, biocompatible, and biodegradable. These advantages make it an ideal material for the preparation of functional hydrogels that can act as wound dressings for skin injuries. This review reports the role of chitosan-based hydrogels in promoting skin repair in the context of the mechanisms involved in skin injury repair. Chitosan-based hydrogels were found to promote skin repair at different process stages. Various functional chitosan-based hydrogels are also discussed.

A pan-cancer agent for screening, resection and wound monitoring via NIR and SWIR imaging

Fluorescence guided surgery (FGS) facilitates real time tumor delineation and is being rapidly established clinically. FGS efficacy is tied to the utilized dye and provided tumor contrast over healthy tissue. Apoptosis, a cancer hallmark, is a desirable target for tumor delineation. Here, we preclinically in vitro and in vivo, validate an apoptosis sensitive commercial carbocyanine dye (CJ215), with absorption and emission spectra suitable for near infrared (NIR, 650-900nm) and shortwave infrared (SWIR, 900-1700nm) fluorescence imaging (NIRFI, SWIRFI). High contrast SWIRFI for solid tumor delineation is demonstrated in multiple murine and human models including breast, prostate, colon, fibrosarcoma and intraperitoneal colorectal metastasis. Organ necropsy and imaging highlighted renal clearance of CJ215. SWIRFI and CJ215 delineated all tumors under ambient lighting with a tumor-to-muscle ratio up to 100 and tumor-to-liver ratio up to 18, from 24 to 168 h post intravenous injection with minimal uptake in healthy organs. Additionally, SWIRFI and CJ215 achieved non-contact quantifiable wound monitoring through commercial bandages. CJ215 provides tumor screening, guided resection, and wound healing assessment compatible with existing and emerging clinical solutions.

Kick-Starting Wound Healing: A Review of Pro-Healing Drugs

Cutaneous wound healing consists of four stages: hemostasis, inflammation, proliferation/repair, and remodeling. While healthy wounds normally heal in four to six weeks, a variety of underlying medical conditions can impair the progression through the stages of wound healing, resulting in the development of chronic, non-healing wounds. Great progress has been made in developing wound dressings and improving surgical techniques, yet challenges remain in finding effective therapeutics that directly promote healing. This review examines the current understanding of the pro-healing effects of targeted pharmaceuticals, re-purposed drugs, natural products, and cell-based therapies on the various cell types present in normal and chronic wounds. Overall, despite several promising studies, there remains only one therapeutic approved by the United States Food and Drug Administration (FDA), Becaplermin, shown to significantly improve wound closure in the clinic. This highlights the need for new approaches aimed at understanding and targeting the underlying mechanisms impeding wound closure and moving the field from the management of chronic wounds towards resolving wounds.

Vancomycin-loaded hydrogels with thermal-responsive, self-peeling, and sustainable antibacterial properties for wound dressing

Wound dressings play an important role in wound healing. However, many wound dressings lack antibacterial properties and are difficult to remove from newly grown tissues, causing secondary wound injuries and repeated medical treatment. This study reports a new type of thermal-responsive hydrogel dressing consisting of vancomycin-loaded gelatin nanospheres (GNs) and poly((N-isopropylacrylamide)-co-N-(methylol acrylamide)) functional components that could impart self-peeling and sustainable antibacterial properties. SEM images showed that the prepared hydrogel possessed a porous microstructure and the homogeneous distribution of GNs in its network. Excellent swelling ratios and thermal-induced self-peeling characteristics were confirmed by qualitative analysis. The GNs not only enhanced the strain at break of the hydrogel, but also acted as drug carriers to slow down the drug release from the hydrogel, achieving sustainable antibacterial properties and balanced biocompatibility. Therefore, this vancomycin-loaded hydrogel with self-peeling characteristics provides an effective way of preventing wound infection and can be used as a novel platform for wide-ranging applications of wound dressings.

Stimuli-responsive polysaccharide-based smart hydrogels for diabetic wound healing: Design aspects, preparation methods and regulatory perspectives

Diabetes adversely affects wound-healing responses, leading to the development of chronic infected wounds. Such wound microenvironment is characterized by hyperglycaemia, hyperinflammation, hypoxia, variable pH, upregulation of matrix metalloproteinases, oxidative stress, and bacterial colonization. These pathological conditions pose challenges for the effective wound healing. Therefore, there is a paradigm shift in diabetic wound care management wherein abnormal pathological conditions of the wound microenvironment is used as a trigger for controlling the drug release or to improve properties of wound dressings. Hydrogels composed of natural polysaccharides showed tremendous potential as wound dressings as well as stimuli-responsive materials due to their unique properties such as biocompatibility, biodegradability, hydrophilicity, porosity, stimuli-responsiveness etc. Hence, polysaccharide-based hydrogels have emerged as advanced healthcare materials for diabetic wounds. In this review, we presented important aspects for the design of hydrogel-based wound dressings with an emphasis on biocompatibility, biodegradability, entrapment of therapeutic agents, moisturizing ability, swelling, and mechanical properties. Further, various crosslinking methods that enable desirable properties and stimuli responsiveness to the hydrogels have been mentioned. Subsequently, state-of-the-art developments in mono- and multi- stimuli-responsive hydrogels have been presented along with the case studies. Finally regulatory perspectives, challenges for the clinical translation and future prospects have been discussed.

Electrospun Antimicrobial Drug Delivery Systems and Hydrogels Used for Wound Dressings

Wounds and chronic wounds can be caused by bacterial infections and lead to discomfort in patients. To solve this problem, scientists are working to create modern wound dressings with antibacterial additives, mainly because traditional materials cannot meet the general requirements for complex wounds and cannot promote wound healing. This demand is met by material engineering, through which we can create electrospun wound dressings. Electrospun wound dressings, as well as those based on hydrogels with incorporated antibacterial compounds, can meet these requirements. This manuscript reviews recent materials used as wound dressings, discussing their formation, application, and functionalization. The focus is on presenting dressings based on electrospun materials and hydrogels. In contrast, recent advancements in wound care have highlighted the potential of thermoresponsive hydrogels as dynamic and antibacterial wound dressings. These hydrogels contain adaptable polymers that offer targeted drug delivery and show promise in managing various wound types while addressing bacterial infections. In this way, the article is intended to serve as a compendium of knowledge for researchers, medical practitioners, and biomaterials engineers, providing up-to-date information on the state of the art, possibilities of innovative solutions, and potential challenges in the area of materials used in dressings.

Electrospun nylon 6/hyaluronic acid/chitosan bioactive nanofibrous composite as a potential antibacterial wound dressing

Hyaluronic acid (HA) and chitosan (CS), as natural biomaterials, display excellent biocompatibility and stimulate the growth and proliferation of fibroblasts. Furthermore, nylon 6 (N6) is a low-cost polymer with good compatibility with human tissues and high mechanical stability. In this study, HA and CS were applied to modify N6 nanofibrous mat (N6/HA/CS) for potential wound dressing. N6/HA/CS nanofibrous composite mats were developed using a simple one-step electrospinning technique at different CS concentrations of 1, 2, and 3 wt%. The results demonstrated that incorporating HA and CS into N6 resulted in increased hydrophilicity, as well as favorable physical and mechanical properties. In addition, the minimum inhibitory concentration and (MIC) optical density techniques were used to determine the antibacterial properties of N6/HA/CS nanofibrous composite mats, and the results demonstrated that the composites could markedly inhibit the growth of Gram-positive bacteria Staphylococcus aureus and Gram-negative bacteria Escherichia coli. Because of its superior mechanical properties, substantial antimicrobial effects, and hydrophilic surface, N6/HA/CS at 2 wt% of CS (N6/HA/CS2) was chosen as the most suitable nanofibrous mat. The swelling, porosity, gel content, and in vitro degradation studies imply that N6/HA/CS2 nanofibrous composite mat has proper moisture retention and biodegradability. Furthermore, the N6/HA/CS2 nanofibrous composite mat was discovered to be nontoxic to L929 fibroblast cells and to even improve cell proliferation. Based on the findings, this research offers a simple and rapid method for creating material that could be utilized as prospective wound dressings in clinical environments.

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

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

Tailored chitosan/glycerol micropatterned composite dressings by 3D printing for improved wound healing

Wound infection control is a primary clinical concern nowadays. Various innovative solutions have been developed to fabricate adaptable wound dressings with better control of infected wound healing. This work presents a facile approach by leveraging 3D printing to fabricate chitosan/glycerol into composite dressings with tailored micropatterns to improve wound healing. The bioinks of chitosan/glycerol were investigated as suitable for 3D printing. Then, three tailored micropatterns (i.e., sheet, strip, and mesh) with precise geometry control were 3D printed onto a commercial dressing to fabricate the micropatterned composite dressings. In vitro and in vivo studies indicate that these micropatterned dressings could speed up wound healing due to their increased water uptake capacity (up to ca. 16-fold@2 min), benign cytotoxicity (76.7 % to 90.4 % of cell viability), minor hemolytic activity (<1 %), faster blood coagulation effects (within 76.3 s), low blood coagulation index (14.5 % to 18.7 % @ 6 min), enhanced antibacterial properties (81.0 % to 86.1 % against S. aureus, 83.7 % to 96.5 % against E. coli), and effective inhibition of wound inflammation factors of IL-1β and TNF-α. Such tailored micropatterned composite dressing is facile to obtain, highly reproducible, and cost-efficient, making it a promising implication for improved and personalized contaminated wound healing.

Low-adhesion and low-swelling hydrogel based on alginate and carbonated water to prevent temporary dilation of wound sites

Hydrogel-based wound dressings have been developed for rapid wound healing; however, their adhesive properties have not been adequately investigated. Excessive adhesion to the skin causes wound expansion and pain when hydrogels absorb exudates and swell at wound sites. Herein, we developed a low-adhesion and low-swelling hydrogel dressing using alginate, which is non-adhesive to cells and skin tissue, CaCO3, and carbonated water. The alginate/CaCO3 solution rapidly formed a hydrogel upon the addition of carbonated water, and the CO2 in the hydrogel diffused into the atmosphere, preventing acidification and obtaining a pH value suitable for wound healing. Remarkably, the skin adhesion and swelling of the hydrogel were 11.9- to 16.5-fold and 1.9-fold lower, respectively, than those of clinical low-adhesion hydrogel dressings. In vivo wound-healing tests in mice demonstrated its therapeutic efficacy, and the prepared hydrogel prevented temporary wound dilation during early healing. These results illustrate the importance of controlling skin adhesion and swelling in wound dressings and demonstrate the potential clinical applications of this wound-friendly hydrogel dressing.

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

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