Antibacterial Collagen-Based Nanocomposite Dressings for Promoting Infected Wound Healing

Injectable Polysaccharide-Based Hydrogel with Glucose Responsiveness as an Immunoregulatory Platform for Enhanced Diabetic Wound Healing

Persistent excessive inflammatory response in diabetic wounds caused by the imbalance of the immune microenvironment leads to delayed or nonhealing of the wounds. Timely attenuation of inflammation through immunoregulation is a crucial strategy to accelerate diabetic wound closure. Here, the protocatechuic acid (PCA)- and deferoxamine (DFO)-loaded polysaccharide-based immunoregulatory hydrogel (POCP@D) was developed by the dual-cross-linking strategy of borate ester bonds and imine bonds to promote advanced healing of full-thickness diabetic wounds. The POCP@D hydrogel showed good tissue adhesiveness property, flexibility, mechanical strength, injectability, self-healing, and glucose-responsive drug release properties, besides strong broad-spectrum antibacterial and antioxidant activities. The POCP@D hydrogel acted as an immunoregulatory platform to remold the in vivo immune microenvironment of diabetic wounds by regulating the M2-type macrophage polarization and timely relieving wound inflammation, thus promoting collagen deposition, angiogenesis, and the development of diabetic wounds from the inflammatory stage to the proliferative stage and ultimately achieving high-quality skin tissue regeneration. Overall, our developed immunoregulatory hydrogel held great potential for refractory diabetic wound therapy in clinical settings.

Protein-Based Multifunctional Hydrogel Adhesive for Wound Healing

Wound healing is a complex and highly orchestrated biological process that encompasses four distinct stages including: hemostasis, inflammation, proliferation, and remodeling. Each stage is characterized by specific physiological responses and tissue repair mechanisms that collectively facilitate the restoration of tissue integrity. To achieve comprehensive wound management, the development of targeted hydrogel bioadhesives is of paramount importance. Hydrogel-based bioadhesives, characterized by their excellent physical properties and biocompatibility, have demonstrated significant potential in the field of wound treatment. However, the current research on protein-based hydrogel bioadhesives for wound healing remains limited. This review systematically examines the design principles of ideal hydrogel bioadhesives and their essential functions in wound repair. It provides an overview of the latest advancements multifunctional hydrogel bioadhesives derived from various proteins, including collagen, silk fibroin (SF), sericin, fibrin, gelatin (Gel), keratin, and casein. It also evaluates their performance in practical applications. Finally, the review highlights the primary challenges facing protein-based hydrogel bioadhesives in the field of wound healing and outlines prospective research directions, with the goal of advancing the development and clinical application of these technologies.

Dual-step photo-induced self-assembled hydrogel for endogenous oral mucosal wound healing

By introducing piezoelectric materials into hydrogel oral dressings, a microelectric field could be generated under stress stimulation, thus facilitating oral wound healing. However, to adapt to the moist and dynamic environment of the oral cavity, traditional "step-by-step" synthesis often requires the combination of materials with different functionalities. Given the property differences between these materials, this strategy typically involves complex experimental procedures and unnecessary energy consumption. In this study, with the concept of "integrated construction", we innovatively proposed a dual-step photo-induced method and successfully fabricated composite hydrogels with excellent performance. We introduced abundant oxygen vacancies into ZnO, leveraging the enhanced interface dynamics to achieve sustained photo-induced effect. With a double-network polymer framework as a template, this method could achieve the photo-induced spontaneous in-situ synthesis of polydopamine (PDA) within hydrogel without any extra special experimental conditions and complex operation procedures. We conducted a thorough analysis of the mechanism underlying this photo-induced method and applied the as-prepared hydrogel for the treatment of oral wounds, which significantly accelerated the healing process due to the outstanding comprehensive performance of hydrogel. These results suggest novel ideas and theoretical support for the facile construction of high-performance hydrogels based on photodynamic principles, demonstrating immense potential for future applications in wound dressings.

Sandwich-like chitosan/collagen barrier membrane with passivated magnesium mesh as the skeleton

Guided bone regeneration (GBR) technique is a standard therapy for reconstructing alveolar bone defects clinically, with the GBR membrane serving as the key medical device in this technique. However, the most commonly used collagen barrier membranes usually have poor mechanical properties and are prone to collapse during clinical use. Herein, a sandwich-like barrier membrane was developed with crosslinked chitosan as dense layer, crosslinked collagen as loose layer and passivated magnesium mesh as the skeleton. Surface modification has improved the corrosion resistance of magnesium mesh. Thanks to the introduction of magnesium mesh skeleton and crosslinking modification, the mechanical properties and supporting effects of barrier membrane have been improved. The dense layer of barrier membrane showed dense structure while the loose layer showed porous structure as expected. The barrier membrane showed good antibacterial performance against gram-positive and gram-negative bacteria owing to the antibacterial activity of chitosan and the added chlorhexidine acetate. Furthermore, the barrier membrane met the requirements of biocompatibility for implanted biomaterials. Interestingly, the barrier membrane had good anti-inflammatory activity to accelerate the transition from inflammatory to proliferative stage and can promote osteogenic differentiation of MC3T3-E1 cells. Overall, the sandwich-like barrier membrane has a wide application prospect to guide bone regeneration.

Recent advances in nanomaterials and their mechanisms for infected wounds management

Wounds infected by bacteria pose a considerable challenge in the field of healthcare, particularly with the increasing prevalence of antibiotic-resistant pathogens. Traditional antibiotics often fail to achieve effective results due to limited penetration, resistance development, and inadequate local concentration at wound sites. These limitations necessitate the exploration of alternative strategies that can overcome the drawbacks of conventional therapies. Nanomaterials have emerged as a promising solution for tackling bacterial infections and facilitating wound healing, thanks to their distinct physicochemical characteristics and multifunctional capabilities. This review highlights the latest developments in nanomaterials that demonstrated enhanced antibacterial efficacy and improved wound healing outcomes. The antibacterial mechanisms of nanomaterials are varied, including ion release, chemodynamic therapy, photothermal/photodynamic therapy, electrostatic interactions, and delivery of antibacterial drugs, which not only combat bacterial infections but also address the challenges posed by biofilms and antibiotic resistance. Furthermore, these nanomaterials create an optimal environment for tissue regeneration, promoting faster wound closure. By leveraging the unique attributes of nanomaterials, there is a significant opportunity to revolutionize the management of infected wounds and markedly improve patient outcomes.

Fabrication and applications of biofunctional collagen biomaterials in tissue engineering

Collagen is extensively used in tissue engineering for various organ tissue regeneration due to the main component of human organ extracellular matrix (ECM) and their inherent nature bioactivity. Collagen various types naturally exist in different organ ECMs. Collagen fabricated with natural ECM mimics architecture, composition and mechanical properties for various organ tissue regeneration. Collagen fabrication with organ-specific biofunctionality facilitated organ tissue engineering as compared to unmodified collagen biomaterials. Collagen biofunctionality improved by subjecting collagen to synthesis, fibers and surface modifications, and blending with other components. Furthermore, collagen is loaded with bioactive molecules, growth factors, drugs and cells also enhancing the biofunctionality of collagen biomaterials. In this review, we will explore the recent advancements in biofunctional collagen biomaterials fabrication with organ-specific biofunctionality in tissue engineering to resolve various organ tissue engineering issues and regeneration challenges. Biofunctional collagen biomaterials stimulate microenvironments inside and around the implants to excellently regulate cellular activities, differentiate cells into organ native cells, enhanced ECM production and remodeling to regenerate organ tissues with native structure, function and maturation. This review critically explored biofunctional collagen biomaterials fabrication in resolving various organ tissue engineering issues and regeneration challenges, and opening new directions of biofunctional collagen biomaterials fabrication, design and applications.

Unveiling the Potential of Protein-Based Sustainable Antibacterial Materials

The surge in bacterial growth and the escalating resistance against a multitude of antibiotic drugs have burgeoned into an alarming global threat, necessitating urgent and innovative interventions. In response to this peril, scientists have embarked on the development of advanced biocompatible antibacterial materials, aiming to counteract not only bacterial infections but also the pervasive issue of food spoilage resulting from microbial proliferation. Protein-based biopolymers and their meticulously engineered composites are at the forefront of this endeavor. Their potential in combating this severe global concern presents an approach that intersects the domains of biomedicine and environmental science. The present review article delves into the intricate extraction processes employed to derive various proteins from their natural sources, unraveling the complex biochemical pathways that underpin their antibacterial properties. Expanding on the foundational knowledge, the review also provides a comprehensive synthesis of functionalized proteins modified to enhance their antibacterial efficacy, unveiling a realm of possibilities for tailoring solutions to specific biomedical and environmental applications. The present review navigates through their antibacterial applications; from wound dressings to packaging materials with inherent antibacterial properties, the potential applications underscore the versatility and adaptability of these materials. Moreover, this comprehensive review serves as a valuable roadmap, guiding future research endeavors in reshaping the landscape of natural antibacterial materials on a global scale.

Material Design, Fabrication Strategies, and the Development of Multifunctional Hydrogel Composites Dressings for Skin Wound Management

The skin is fragile, making it very vulnerable to damage and injury. Untreated skin wounds can pose a serious threat to human health. Three-dimensional polymer network hydrogels have broad application prospects in skin wound dressings due to their unique properties and structure. The therapeutic effect of traditional hydrogels is limited, while multifunctional composite hydrogels show greater potential. Multifunctional hydrogels can regulate wound moisture through formula adjustment. Moreover, hydrogels can be combined with bioactive ingredients to improve their performance in wound healing applications. Stimulus-responsive hydrogels can respond specifically to the wound environment and meet the needs of different wound healing stages. This review summarizes the material types, structure, properties, design considerations, and formulation strategies for multifunctional hydrogel composite dressings used in wound healing. We discuss various types of recently developed hydrogel dressings, highlights the importance of tailoring their physicochemical properties, and addresses potential challenges in preparing multifunctional hydrogel wound dressings.

NIR-Actuated Botanicals/Nanozymes Nanofibrous Membranes for Antibiotic-Free Triple-Synergistic Therapy Against Polymicrobial Wound Infections

Polymicrobial wound infection represents a significant contributor to infectious disease-related morbidity and mortality globally. Traditionally, the management of such infection relies heavily on high doses of antibiotics, often resulting in systemic side effects and exacerbating antibiotic resistance. Consequently, there is an urgent need to develop a safe and effective platform for antibiotic-free treatment of polymicrobial wound infections. In this study, a near-infrared (NIR) light-actuated nanofibrous membrane incorporating botanicals and nanozymes is presented for antibiotic-free triple-synergistic therapy against polymicrobial wound infections. The membrane integrates berberine hydrochloride (BBH)-loaded hollow zinc-doped carbon nanocubes into polyvinyl alcohol (PVA) nanofibrous membranes. Upon low-intensity 808 nm NIR laser irradiation (0.3 W cm-2), the membrane achieved a controlled release of BBH and enhanced peroxidase-like (POD-like) enzyme activity. This NIR light-actuated botanical/photothermal therapy (PTT)/chemodynamic therapy (CDT) system demonstrated high efficacy in eradicating methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa both in vitro and in vivo. Furthermore, it mitigated inflammation and promoted wound healing in polymicrobial infection wounds, highlighting its potential as a promising alternative to antibiotic-based therapies.

Advanced biomaterials in pressure ulcer prevention and care: from basic research to clinical practice

Pressure ulcers are a common and serious medical condition. Conventional treatment methods often fall short in addressing the complexities of prevention and care. This paper provides a comprehensive review of recent advancements in advanced biomaterials for pressure ulcer management, emphasizing their potential to overcome these limitations. The study highlights the roles of biomaterials in enhancing wound healing, preventing infections, and accelerating recovery. Specific focus is placed on the innovation and application of multi-functional composite materials, intelligent systems, and personalized solutions. Future research should prioritize interdisciplinary collaboration to facilitate the clinical translation of these materials, providing more effective and tailored treatment approaches. These advancements aim to improve the quality of life and health outcomes for patients by offering more reliable, efficient, and patient-specific therapeutic options.

Block cationic copolymer/quaternary ammonium chitosan-based composite antibacterial hydrogel dressings with NIR photothermal effects for bacteria-infected wound healing

Wound infections caused by pathogenic bacteria can cause delayed wound healing and even threaten the life of patients. Drug resistance and effectiveness with regard to traditional wound dressings have become urgent issues which need to be addressed. The antibacterial effect of hydrogels, as novel wound dressings, is through contact-active antibacterial was limited by the contact area and time. In this paper, MXene (a 2D carbonitride) has been employed as the substrate and via the in-situ reduction of silver nanoparticles and the polymerization of dopamine on its surface the photothermal agent MXene-Ag-PDA was obtained. This was then introduced into the hydrogel matrix via the block cationic polymer (AM-VBIMBr-AAPBA), oxidized sodium alginate (OSA) and quaternary ammonium chitosan (HACC). Multifunctional composite hydrogels (PNVAO/M-A-P) possessing photo-thermal effects and inherent antibacterial activity were obtained after crosslinking, and were employed as medical materials to promote the healing of infected wounds. The cationic groups contained in the PNVAO/M-A-P were capable of capturing and killing bacteria by electrostatic interactions, and produced local heat killing adsorption and residual bacteria in the surrounding solution under NIR irradiation, thereby shortening the antibacterial cycle and improving the sterilization efficiency. Meanwhile, the introduction of glycerin in the hydrogel improved its anti-freezing and anti-drying properties, enabling the hydrogel to function stably under extreme environments. PNVAO/M-A-P composite hydrogels based on chemical and dynamic crosslinking exhibited the desired mechanical strength, and via their self-healing ability can adapt to dynamic wounds. The hydrogel dressing showed excellent anti-freezing and anti-drying properties, high bovine serum albumin (BSA) adsorption capacity (308.17 mg·g-1), good biocompatibility (the cell viability exceeded 100 % after 48 h of incubation), antioxidant properties and excellent antibacterial activity (the sterilization rate can reach 99.9 %). Furthermore, the hydrogel was applied to infected wound treatment and was able to control the wound infection, reduce pro-inflammatory factor production, promote collagen deposition and neovascularization formation, and thus promote wound healing. Therefore, multifunctional composite hydrogels with synergistic antibacterial effects can be used as an novel dressing for the treatment of bacterial infected wounds.

Recent Development of Fibrous Hydrogels: Properties, Applications and Perspectives

Fibrous hydrogels (FGs), characterized by a 3D network structure made from prefabricated fibers, fibrils and polymeric materials, have emerged as significant materials in numerous fields. However, the challenge of balancing mechanical properties and functions hinders their further development. This article reviews the main advantages of FGs, including enhanced mechanical properties, high conductivity, high antimicrobial and anti-inflammatory properties, stimulus responsiveness, and an extracellular matrix (ECM)-like structure. It also discusses the influence of assembly methods, such as fiber cross-linking, interfacial treatments of fibers with hydrogel matrices, and supramolecular assembly, on the diverse functionalities of FGs. Furthermore, the mechanisms for improving the performance of the above five aspects are discussed, such as creating ion carrier channels for conductivity, in situ gelation of drugs to enhance antibacterial and anti-inflammatory properties, and entanglement and hydrophobic interactions between fibers, resulting in ECM-like structured FGs. In addition, this review addresses the application of FGs in sensors, dressings, and tissue scaffolds based on the synergistic effects of optimizing the performance. Finally, challenges and future applications of FGs are discussed, providing a theoretical foundation and new insights for the design and application of cutting-edge FGs.

Recent advances in bioactive wound dressings

Traditional wound dressings, despite their widespread use, face limitations, such as poor infection control and insufficient healing promotion. To address these challenges, bioactive materials have emerged as a promising solution in wound care. This comprehensive review explores the latest developments in wound healing technologies, starting with an overview of the importance of effective wound management, emphasising the need for advanced bioactive wound dressings. The review further explores various bioactive materials, defining their characteristics. It covers a wide range of natural and synthetic biopolymers used to develop bioactive wound dressings. Next, the paper discusses the incorporation of bioactive agents into wound dressings, including antimicrobial and anti-inflammatory agents, alongside regenerative components like growth factors, platelet-rich plasma, platelet-rich fibrin and stem cells. The review also covers fabrication techniques for bioactive wound dressings, highlighting techniques like electrospinning, which facilitated the production of nanofibre-based dressings with controlled porosity, the sol-gel method for developing bioactive glass-based dressings, and 3D bioprinting for customised, patient-specific dressings. The review concludes by addressing the challenges and future perspectives in bioactive wound dressing development. It includes regulatory considerations, clinical efficacy, patient care protocol integration and wound healing progress monitoring. Furthermore, the review considers emerging trends such as smart materials, sensors and personalised medicine approaches, offering insights into the future direction of bioactive wound dressing research.

Sacrificial hydrogen bonds enhance the performance of covalently crosslinked composite films derived from soy protein isolate and dialdehyde starch

Soy protein films have the advantage of being eco-friendly and renewable, but their practical applications are hindered by the mechanical properties. The exceptional tensile strength and fracture toughness of natural silk stem from sacrificial hydrogen bonds it contains that effectively dissipates energy. In this study, we draw inspiration from silk's structural principles to create biodegradable films based on soy protein isolate (SPI). Notably, composite films containing sodium lignosulfonate (LS) demonstrate exceptional strain at break (up to 153%) due to the augmentation of reversible hydrogen bonding, contrasted to films with the addition of solely dialdehyde starch (DAS). The enhancement of tensile strength is realized through a combination of Schiff base cross-linking and sacrificial hydrogen bonding. Furthermore, the incorporation of LS markedly improves the films' ultraviolet (UV) blocking capabilities and hydrophobicity. This innovative design strategy holds great promise for advancing the production of eco-friendly SPI-based films that combine strength and toughness.

Milk exosome-infused fibrous matrix for treatment of acute wound

To provide an advanced therapy for wound recovery, in this study, pasteurized bovine milk-derived exosomes (mEXO) are immobilized onto a polydopamine (PDA)-coated hyaluronic acid (HA)-based electrospun nanofibrous matrix (mEXO@PMAT) via a simple dip-coating method to formulate an mEXO-immobilized mesh as a wound-healing biomaterial. Purified mEXOs (∼82 nm) contain various anti-inflammatory, cell proliferation, and collagen synthesis-related microRNAs (miRNAs), including let-7b, miR-184, and miR-181a, which elicit elevated mRNA expression of keratin5, keratin14, and collagen1 in human keratinocytes (HaCaT) and fibroblasts (HDF). The mEXOs immobilized onto the PDA-coated meshes are gradually released from the meshes over 14 days without burst-out effect. After treatment with HaCaT and HDF, the degree of in vitro cell migration increases significantly in the mEXO@PMAT-treated HaCaT and HDF cells compared to the unmodified or PDA-coated meshes-treated cells. Additionally, the mEXO@PMAT provides significantly faster wound closure in vivo without notable toxicity. Thus, the sustained liberation of bioactive mEXO from the meshes can effectively enhance cell proliferation in vitro and accelerate wound closure in vivo, which could be harnessed mEXO@PMAT as a promising wound-healing biomaterial.

Multifunctional Nanofiber Membranes Constructed by Microfluidic Blow-Spinning to Inhibit Scar Formation at Early Intervention Stage

Pathological scarring has been a challenge in skin injury repair since ancient times, and prophylactic treatment in the early stages of wound healing usually results in delayed wound healing. In this study, poly(ethylene oxide) (PEO) and chitosan (CTS) were used as carrier materials to construct multifunctional pirfenidone (PFD)/CTS/PEO (PCP) nanofiber membranes (NFMs) loaded with PFD by microfluidic blow-spinning (MBS). MBS is a good method for quickly, safely, and greenly constructing large-area manufacturing of inexpensive NFMs. PCP NFMs were uniform in external morphology, with diameters ranging from 200 to 500 nm. The encapsulation efficiency of the drug-loaded PCP NFMs was above 80%, which had a good slow release, visualization, water absorption, and biocompatibility. The inhibitory effect of PCP NFMs on normal human dermal fibroblasts was dose-dependent and inhibited the expression of the transforming growth factor-β1/SMAD family member 3 (TGF-β1/SMAD3) signaling pathway. PCP NFMs showed significant antibacterial effects against both Staphylococcus aureus and Escherichia coli. In the rabbit ear scar experiment, the wound healed about 70% on day 5 and almost completely on day 10 after PCP-3 NFMs treatment, with the thinnest scar tissue, skin color, tenderness close to normal tissue, and a Vancouver scar scale score of less than 5. PCP-3 NFMs had good effects on anti-inflammatory, wound healing, and collagen-I deposition reducing effects. In conclusion, PCP-3 NFMs can both promote wound healing and intervene to inhibit pathological scarring in advance, making them a potential multifunctional wound dressing for early prevention and treatment of pathological scarring.

Nanofiber-reinforced self-healing polysaccharide-based hydrogel dressings for pH discoloration monitoring and treatment of infected wounds

The escalating global health concern arises from chronic wounds induced by bacterial infections, posing a significant threat to individuals. Consequently, an imperative exist for the development of hydrogel dressings to facilitate prompt wound monitoring and efficacious wound management. To this end, pH-sensitive bromothymol blue (BTB) and pH-responsive drug tetracycline hydrochloride (TH) were introduced into the polysaccharide-based hydrogel to realize the integration of wound monitoring and controlled treatment. Polysaccharide-based hydrogels were formed via a Schiff base reaction by cross-linking carboxymethyl chitosan (CMCS) on an oxidized sodium alginate (OSA) skeleton. BTB was used as a pH indicator to monitor wound infection through visual color changes visually. TH could be dynamically released through the pH response of the Schiff base bond to provide effective treatment and long-term antibacterial activity for chronically infected wounds. In addition, introducing polylactic acid nanofibers (PLA) enhanced the mechanical properties of hydrogels. The multifunctional hydrogel has excellent mechanical, self-healing, injectable, antibacterial properties and biocompatibility. Furthermore, the multifaceted hydrogel dressing under consideration exhibits noteworthy capabilities in fostering the healing process of chronically infected wounds. Consequently, the research contributes novel perspectives towards the advancement of intelligent and expeditious bacterial infection monitoring and dynamic treatment platforms.

Advancements in employing two-dimensional nanomaterials for enhancing skin wound healing: a review of current practice

The two-dimensional nanomaterials are characterized by their ultra-thin structure, diverse chemical functional groups, and remarkable anisotropic properties. Since its discovery in 2004, graphene has attracted significant scientific interest due to its potential applications in various fields, including electronics, energy systems, and biomedicine. In medicine, graphene is used for designing smart drug delivery systems, especially for antibiotics, and biosensing. Skin trauma is a prevalent dermatological condition that increasingly contributes to morbidities and mortalities, thus representing a significant health burden. During tissue damage, rapid skin repair is crucial to prevent blood loss and infection. Therefore, drugs used for skin trauma must possess antimicrobial and anti-inflammatory properties. Two-dimensional (2D) nanomaterials possess remarkable physical, chemical, optical, and biological characteristics due to their uniform shape, increased surface area, and surface charge. Graphene and its derivatives, transition-metal dichalcogenides (TMDs), black phosphorous (BP), hexagonal boron nitride (h-BN), MXene, and metal-organic frameworks (MOFs) are among the commonly used 2D nanomaterials. Moreover, they exhibit antibacterial and anti-inflammatory properties. This review presents a comprehensive discussion of the clinical approaches employed for wound healing treatment and explores the applications of commonly used 2D nanomaterials to enhance wound healing outcomes.

Nanomaterials: innovative approaches for addressing key objectives in periodontitis treatment

Periodontitis is a chronic inflammatory disease primarily caused by dental plaque, which is a significant global public health concern due to its high prevalence and severe impact on oral, and even systemic diseases. The current therapeutic plan focuses on three objectives: pathogenic bacteria inhibition, inflammation control, and osteogenic differentiation induction. Existing treatments still have plenty of drawbacks, thus, there is a pressing need for novel methods to achieve more effective treatment effects. Nanomaterials, as emerging materials, have been proven to exert their inherent biological properties or serve as stable drug delivery platforms, which may offer innovative solutions in periodontitis treatment. Nanomaterials utilized in periodontitis treatment fall into two categories, organic and inorganic nanomaterials. Organic nanomaterials are known for their biocompatibility and their potential to promote tissue regeneration and cell functions, including natural and synthetic polymers. Inorganic nanomaterials, such as metal, oxides, and mesoporous silica nanoparticles, exhibit unique physicochemical properties that make them suitable as antibacterial agents and drug delivery platforms. The inorganic nanosurface provides terrain induction for cell migration and osteogenic regeneration at defect sites by introducing different surface morphologies. Inorganic nanomaterials also play a role in antibacterial photodynamic therapy (aPDT) for eliminating pathogenic bacteria in the oral cavity. In this review, we will introduce multiple forms and applications of nanomaterials in periodontitis treatment and focus on their roles in addressing the key therapeutic objectives, to emphasize their promising future in achieving more effective and patient-friendly approaches toward periodontal tissue regeneration and overall health.

Natural Regenerative Hydrogels for Wound Healing

Regenerative hydrogels from natural polymers have come forth as auspicious materials for use in regenerative medicine, with interest attributed to their intrinsic biodegradability, biocompatibility, and ability to reassemble the extracellular matrix. This review covers the latest advances in regenerative hydrogels used for wound healing, focusing on their chemical composition, cross-linking mechanisms, and functional properties. Key carbohydrate polymers, including alginate, chitosan, hyaluronic acid, and polysaccharide gums, including agarose, carrageenan, and xanthan gum, are discussed in terms of their sources, chemical structures and specific properties suitable for regenerative applications. The review further explores the categorization of hydrogels based on ionic charge, response to physiological stimuli (i.e., pH, temperature) and particularized roles in wound tissue self-healing. Various methods of cross-linking used to enhance the mechanical and biological performance of these hydrogels are also examined. By highlighting recent innovations and ongoing challenges, this article intends to give a detailed understanding of natural hydrogels and their potential to revolutionize regenerative medicine and improve patient healing outcomes.

A comprehensive exploration of hydrogel applications in multi-stage skin wound healing

Hydrogels, as an emerging biomaterial, have found extensive use in the healing of wounds due to their distinctive physicochemical structure and functional properties. Moreover, hydrogels can be made to match a range of therapeutic requirements for materials used in wound healing through specific functional modifications. This review provides a step-by-step explanation of the processes involved in cutaneous wound healing, including hemostasis, inflammation, proliferation, and reconstitution, along with an investigation of the factors that impact these processes. Furthermore, a thorough analysis is conducted on the various stages of the wound healing process at which functional hydrogels are implemented, including hemostasis, anti-infection measures, encouraging regeneration, scar reduction, and wound monitoring. Next, the latest progress of multifunctional hydrogels for wound healing and the methods to achieve these functions are discussed in depth and categorized for elucidation. Finally, perspectives and challenges associated with the clinical applications of multifunctional hydrogels are discussed.

Injectable and Near-Infrared Light-Controllable Fibrin Hydrogels with Antimicrobial and Immunomodulating Properties for Infected Wound Healing

The management of infected wounds poses a significant challenge due to the growing issue of antibiotic resistance, underscoring the urgent necessity to innovate and implement alternative therapeutic strategies. These strategies should be capable of eliminating bacterial infections in infected wounds while circumventing the induction of multi-drug resistance. In the current study, we developed an easily prepared and injectable fibrin gel (FG) loaded with nanoparticles (NPs) that exhibit antibacterial and immunomodulatory properties to facilitate the healing of infected wounds. Initially, a novel type of NP was generated through the electrostatic interaction between the photothermal agent, mPEG-modified polydopamine (MPDA), and the nitric oxide (NO) donor, S-nitrosocysteamine (SNO). This interaction resulted in the formation of NPs referred to as SNO-loaded MPDA (SMPDA). Subsequently, the SMPDA was encapsulated into the FG using a double-barreled syringe, thereby producing the SMPDA-loaded FG (SMPDA/G). Experimental results revealed that SMPDA/G could effectively eliminate bacterial infections and alter the immune microenvironment. This efficacy is attributed to the synergistic combination of NO therapy and photothermal therapy, along with the role of SMPDA in facilitating M2 macrophage polarization within the gel. Accordingly, these findings suggest that the SMPDA/G holds substantial promise for clinical application in infected wound healing.

Recent advancements in natural polymers-based self-healing nano-materials for wound dressing

The field of wound healing has witnessed remarkable progress in recent years, driven by the pursuit of advanced wound dressings. Traditional dressing materials have limitations like poor biocompatibility, nonbiodegradability, inadequate moisture management, poor breathability, lack of inherent therapeutic properties, and environmental impacts. There is a compelling demand for innovative solutions to transcend the constraints of conventional dressing materials for optimal wound care. In this extensive review, the therapeutic potential of natural polymers as the foundation for the development of self-healing nano-materials, specifically for wound dressing applications, has been elucidated. Natural polymers offer a multitude of advantages, possessing exceptional biocompatibility, biodegradability, and bioactivity. The intricate engineering strategies employed to fabricate these polymers into nanostructures, thereby imparting enhanced mechanical robustness, flexibility, critical for efficacious wound management has been expounded. By harnessing the inherent properties of natural polymers, including chitosan, alginate, collagen, hyaluronic acid, and so on, and integrating the concept of self-healing materials, a comprehensive overview of the cutting-edge research in this emerging field is presented in the review. Furthermore, the inherent self-healing attributes of these materials, wherein they exhibit innate capabilities to autonomously rectify any damage or disruption upon exposure to moisture or body fluids, reducing frequent dressing replacements have also been explored. This review consolidates the existing knowledge landscape, accentuating the benefits and challenges associated with these pioneering materials while concurrently paving the way for future investigations and translational applications in the realm of wound healing.

A self-healing crosslinked-xanthan gum/soy protein based film containing halloysite nanotube and propolis with antibacterial and antioxidant activity for wound healing

Traumatic multidrug-resistant bacterial infections are the most threat to wound healing. Lower extremity wounds under diabetic conditions display a significant delay during the healing process. To overcome these challenges, the utilization of protein-based nanocomposite dressings is crucial in implementing a successful regenerative medicine approach. These dressings hold significant potential as polymer scaffolds, allowing them to mimic the properties of the extracellular matrix (ECM). So, the objective of this study was to develop a nanocomposite film using dialdehyde-xanthan gum/soy protein isolate incorporated with propolis (PP) and halloysite nanotubes (HNTs) (DXG-SPI/PP/HNTs). In this protein-polysaccharide hybrid system, the self-healing capability was demonstrated through Schiff bonds, providing a favorable environment for cell encapsulation in the field of tissue engineering. To improve the properties of the DXG-SPI film, the incorporation of polyphenols found in PP, particularly flavonoids, is proposed. The synthesized films were subjected to investigations regarding degradation, degree of swelling, and mechanical characteristics. Additionally, halloysite nanotubes (HNTs) were introduced into the DXG-SPI/PP nanocomposite films as a reinforcing filler with varying concentrations of 3 %, 5 %, and 7 % by weight. The scanning electron microscope (SEM) analysis confirmed the proper embedding and dispersion of HNTs onto the DXG-SPI/PP nanocomposite films, leading to functional interfacial interactions. The structure and crystallinity of the synthesized nanocomposite films were characterized using Fourier Transform Infrared Spectrometry (FTIR) and X-ray diffraction (XRD), respectively. Moreover, the developed DXG-SPI/PP/HNTs nanocomposite films significantly improved cell growth of NIH-3T3 fibroblast cells in the presence of PP and HNTs, indicating their cytocompatibility. The antibacterial activity of the nanocomposite was evaluated against Escherichia coli (E. Coli) and Staphylococcus aureus (S. Aureus), which are commonly associated with wound infections. Overall, our findings suggest that the synthesis of DXG-SPI/PP/HNTs nanocomposite scaffolds holds great promise as a clinically relevant biomaterial and exhibits strong potential for numerous challenging biomedical applications.

All-in-One Self-Powered Microneedle Device for Accelerating Infected Diabetic Wound Repair

Diabetic wound healing remains a significant clinical challenge due to the complex microenvironment and attenuated endogenous electric field. Herein, a novel all-in-one self-powered microneedle device (termed TZ@mMN-TENG) is developed by combining the multifunctional microneedle carried tannin@ZnO microparticles (TZ@mMN) with the self-powered triboelectric nanogenerator (TENG). In addition to the delivery of tannin and Zn2+, TZ@mMN also effectively conducts electrical stimulation (ES) to infected diabetic wounds. As a self-powered device, the TENG can convert biomechanical motion into exogenous ES to accelerate the infected diabetic wound healing. In vitro experiment demonstrated that TZ@mMN shows excellent conductive, high antioxidant ability, and effective antibacterial properties against both Staphylococcus aureus and Escherichia coli (>99% antibacterial rates). Besides, the TZ@mMN-TENG can effectively promote cell proliferation and migration. In the diabetic rat full-thickness skin wound model infected with Staphylococcus aureus, the TZ@mMN-TENG can eliminate bacteria, accelerate epidermal growth (regenerative epidermis: ≈303.3 ± 19.1 µm), enhance collagen deposition, inhibit inflammation (lower TNF-α and IL-6 expression), and promote angiogenesis (higher CD31 and VEGF expression) to accelerate infected wound repair. Overall, the TZ@mMN-TENG provides a promising strategy for clinical application in diabetic wound repair.

Application of extracellular matrix cross-linked by microbial transglutaminase to promote wound healing

One primary focus of skin tissue engineering has been the creation of innovative biomaterials to facilitate rapid wound healing. Extracellular matrix (ECM), an essential biofunctional substance, has recently been discovered to play a crucial role in wound healing. Consequently, we endeavored to decellularize ECM from pig achilles tendon and refine its mechanical and biological properties through modification by utilizing cross-linking agents. Glutaraldehyde (GA), 1-ethyl-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS), double aldol starch (DAS), and microbial transglutaminase (MTG) were utilized to produce crosslinked ECM variants (GA-ECM, EDC/NHS-ECM, DAS-ECM, and MTG-ECM). Comprehensive assessments were conducted to evaluate the physical properties, biocompatibility, and wound healing efficacy of each material. The results indicated that MTG-ECM exhibited superior tensile strength, excellent hydrophilicity, minimal cytotoxicity, and the best pro-healing impact among the four modified scaffolds. Staining analysis of tissue sections further revealed that MTG-ECM impeded the transition from type III collagen to type I collagen in the wound area, potentially reducing the development of wound scar. Therefore, MTG-ECM is expected to be a potential pro-skin repair scaffold material to prevent scar formation.

Dissolving Hyaluronic Acid-Based Microneedles to Transdermally Deliver Eugenol Combined with Photothermal Therapy for Acne Vulgaris Treatment

A microneedle transdermal drug delivery system simultaneously avoids systemic toxicity of oral administration and low efficiency of traditional transdermal administration, which is of great significance for acne vulgaris therapy. Herein, eugenol-loaded hyaluronic acid-based dissolving microneedles (E@P-EO-HA MNs) with antibacterial and anti-inflammatory activities are developed for acne vulgaris therapy via eugenol transdermal delivery integrated with photothermal therapy. E@P-EO-HA MNs are pyramid-shaped with a sharp tip and a hollow cavity structure, which possess sufficient mechanical strength to penetrate the stratum corneum of the skin and achieve transdermal delivery, in addition to excellent in vivo biocompatibility. Significantly, E@P-EO-HA MNs show effective photothermal therapy to destroy sebaceous glands and achieve antibacterial activity against deep-seated Propionibacterium acnes (P. acnes) under near-infrared-light irradiation. Moreover, cavity-loaded eugenol is released from rapidly dissolved microneedle bodies to play a sustained antibacterial and anti-inflammatory therapy on the P. acnes infectious wound. E@P-EO-HA MNs based on a synergistic therapeutic strategy combining photothermal therapy and eugenol transdermal administration can significantly alleviate inflammatory response and ultimately facilitate the repair of acne vulgaris. Overall, E@P-EO-HA MNs are expected to be clinically applied as a functional minimally invasive transdermal delivery strategy for superficial skin diseases therapy in skin tissue engineering.

Mussel-inspired "all-in-one" sodium alginate/carboxymethyl chitosan hydrogel patch promotes healing of infected wound

Hydrogels have been widely used as wound dressings to accelerate wound healing. However, due to the impaired skin barrier at the wound site, external bacteria can easily invade the wound and cause infection. In this study, we designed a dopamine-modified sodium alginate/carboxymethyl chitosan/polyvinylpyrrolidone (CPD) hydrogel, which was able to promote wound healing while preventing wound infection. Due to the high content of catechol groups, the CPD hydrogel exhibited good tissue adhesion ability and a significant scavenging ability for DPPH• and PTIO• radicals. Under near-infrared laser irradiation, the temperature of CPD hydrogel increased significantly, which significantly killed the Staphylococcus aureus and Escherichia coli. The cell migration test confirmed that CPD hydrogel could promote the cell migration ratio. In the in vivo wound healing test for infected full-thickness skin defect, CPD hydrogel significantly inhibited bacterial proliferation and enhanced wound healing rate. Therefore, the multifunctional hydrogel is expected to be applied to wound healing.

Anti-adhesive and antibacterial chitosan/PEO nanofiber dressings with high breathability for promoting wound healing

Wound dressings are crucial for wound healing. Ideal wound dressings should possess many functions such as wettability, antibacterial activity and anti-adherent property to promote wound healing. In the present study solution blown spinning (SBS) technology was applied to prepare chitosan/polyethylene oxide (CS/PEO) nanofiber dressings in high efficiency. The obtained nanofiber dressings were treated with anhydrous ethanol to improve the fiber structure and enhance the functionality of the fiber dressings. The results show that the treated nanofibers had higher crystallinities and higher CS contents. The CS/PEO nanofiber dressings fabricated by using no additives and crosslinking had excellent wettability, water stability and antibacterial activity against Escherichia coli and Staphylococcus aureus reached to over 99.99 %. In addition, the CS/PEO nanofiber dressings exhibited high breathability, antioxidant activity and anti-adhesion function. The in vivo animal experiment confirmed that the nanofiber dressings enhanced cell proliferation and significantly accelerated the wound healing within 10 days. The developed CS/PEO nanofiber dressings have great potential in the clinical field of wound healing.

pH Switchable Nanozyme Platform for Healing Skin Tumor Wound Infected with Drug-Resistant Bacteria

Nanozymes capable of generating reactive oxygen species have recently emerged as promising treatments for wounds infected with drug-resistant bacteria, possessing a reduced possibility of inducing resistance. However, the therapeutic effect is limited by a shortage of endogenous oxy-substrates and undesirable off-target biotoxicity. Herein, a ferrocenyl coordination polymer (FeCP) nanozyme, featuring pH switchable peroxidase (POD)- and catalase (CAT)-like activity is incorporated with indocyanine green (ICG) and calcium peroxide (CaO2 ) to fabricate an H2 O2 /O2 self-supplying system (FeCP/ICG@CaO2 ) for precise treatment of bacterial infections. At the wound site, CaO2 reacts with water to generate H2 O2 and O2 . Acting as a POD mimic under an acidic bacterial microenvironment, FeCP catalyzes H2 O2 into hydroxyl radicals to prevent infection. However, FeCP switches to CAT-like activity in neutral tissue, decomposing H2 O2 into H2 O and O2 to prevent oxidative damage and facilitate wound healing. Additionally, FeCP/ICG@CaO2 shows photothermal therapy capability, as ICG can emit heat under near-infrared laser irradiation. This heat assists FeCP in fully exerting its enzyme-like activity. Thus, this system achieves an antibacterial efficiency of 99.8% in vitro for drug-resistant bacteria, and effectively overcomes the main limitations of nanozyme-based treatment assays, resulting in satisfactory therapeutic effects in repairing normal and special skin tumor wounds infected with drug-resistant bacteria.

Hydrophobic Tetracycline Immobilized in Fibrous Hyaluronan Regulates Adhesive Collagen-Based Hydrogel Stability for Infected Wound Healing

Collagen-based hydrogels have a significant impact on wound healing, but they suffer from structural instability and bacterial invasion in infected wounds. Here, electrospun nanofibers of esterified hyaluronan (HA-Bn/T) are developed to immobilize the hydrophobic antibacterial drug tetracycline by π-π stacking interaction. Dopamine-modified hyaluronan and HA-Bn/T are employed simultaneously to stabilize the structure of collagen-based hydrogel by chemically interweaving the collagen fibril network and decreasing the rate of collagen degradation. This renders it injectable for in situ gelation, with suitable skin adhesion properties and long-lasting drug release capability. This hybridized interwoven hydrogel promotes the proliferation and migration of L929 cells and vascularization in vitro. It presents satisfactory antibacterial ability against Staphylococcus aureus and Escherichia coli. The structure also retains the functional protein environment provided by collagen fiber, inhibits the bacterial environment of infected wounds, and modulates local inflammation, resulting in neovascularization, collagen deposition, and partial follicular regeneration. This strategy offers a new solution for infected wound healing.