A silver-sulfadiazine-impregnated synthetic wound dressing composed of poly-L-leucine spongy matrix: an evaluation of clinical cases

Polymer Drugs and Polymeric Drugs X: Slow Release of 5-Fluorouracil from Biodegradable Poly(γ-Glutamic Acid) and its Benzyl Ester Matrices

We prepared poly(γ-glutamic acid)(γ-PGA) benzyl ester(γ-PBG) by the esterification of γ-PGA and benzyl bromide and evaluated the degradation behavior and its usefulness as a drug delivery system (DDS) matrix using 5-fluorouracil (5-FU) as a model drug. γ-PBG degraded in an acidic solution gradually for up to 130 days, and degraded very slowly in a phosphate buffer solution (pH 7.4). After 150 days, the weight loss of the γ-PBG film was only 10% in a phosphate buffer solution. A slow release of 5-FU from γ-PBG films was achieved. The release rate was affected by the pH of the outer solution and the loading drug. We observed an initial burst-release on the first day, after that, the release of 5-FU was diffusion-controlled. γ-PBG may be a novel biodegradable material that may be useful in the pharmaceutical, biomedical, and agricultural fields.

Bilayer Cryogel Wound Dressing and Skin Regeneration Grafts for the Treatment of Acute Skin Wounds

In this study, the potential of cryogel bilayer wound dressing and skin regenerating graft for the treatment of surgically created full thickness wounds was evaluated. The top layer was composed of polyvinylpyrrolidone-iodine (PVP-I) cryogel and served as the antiseptic layer, while the bottom regenerative layer was made using gelatin cryogel. Both components of the bilayer showed typical features of a cryogel interconnected macropore network, rapid swelling, high water uptake capacity of about 90%. Both PVP and gelatin cryogel showed high tensile strength of 45 and 10 kPa, respectively. Gelatin cryogel sheets were essentially elastic and could be stretched without any visible deformation. The antiseptic PVP-I layer cryogel sheet showed sustained iodine release and suppressed microbial growth when tested with skin pathogens (zone of inhibition ∼2 cm for sheet of 0.9 cm diameter). The gelatin cryogel sheet degraded in vitro in weeks. The gelatin cryogel sheet supported cell infiltration, attachment, and proliferation of fibroblasts and keratinocytes. Microparticles loaded with bioactive molecules (mannose-6-phosphate and human fibrinogen) were also incorporated in the gelatin cryogel sheets for their role in enhancing skin regeneration and scar free wound healing. In vivo evaluation of healing capacity of the bilayer cryogel was checked in rabbits by creating full thickness wound defect (diameter 2 cm). Macroscopic and microscopic observation at regular time intervals for 4 weeks demonstrated better and faster skin regeneration in the wound treated with cryogel bilayer as compared to untreated defect and the repair was comparable to commercial skin regeneration scaffold Neuskin-F. Complete skin regeneration was observed after 4 weeks of implantation with no sign of inflammatory response. Defects implanted with cryogel having mannose-6-phosphate showed no scar formation, while the wound treated with bilayer incorporated with human fibrinogen microparticles showed early signs of skin regeneration; epidermis formation occurred at 2 weeks after implantation.

Impregnation of silver sulfadiazine into bacterial cellulose for antimicrobial and biocompatible wound dressing

Silver sulfadiazine (SSD) is a useful antimicrobial agent for wound treatment. However, recent findings indicate that conventional SSD cream has several drawbacks for use in treatments. Bacterial cellulose (BC) is a promising material for wound dressing due to its outstanding properties of holding water, strength and degradability. Unfortunately, BC itself exhibits no antimicrobial activity. A combination of SSD and BC is envisaged to form a new class of wound dressing with both antimicrobial activity and biocompatibility, which has not been reported to date. To achieve antimicrobial activity, SSD particles were impregnated into BC by immersing BC into SSD suspension after ultrasonication, namely SSD-BC. Parameters influencing SSD-BC impregnation were systematically studied. Optimized conditions of sonication time for no less than 90 min and the proper pH value between 6.6 and 9.0 were suggested. The absorption of SSD onto the BC nanofibrous network was revealed by XRD and SEM analyses. The SSD-BC membranes exhibited significant antimicrobial activities against Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus evaluated by the disc diffusion method. In addition, the favorable biocompatibility of SSD-BC was verified by MTT colorimetry, epidermal cell counting method and optical microscopy. The results demonstrate the potential of SSD-BC membranes as a new class of antimicrobial and biocompatible wound dressing.

Development of a wound dressing composed of hyaluronic acid and collagen sponge with epidermal growth factor

This study was designed to investigate the effect of a wound dressing composed of hyaluronic acid (HA) and collagen (Col) sponge containing epidermal growth factor (EGF) on various parameters of wound healing in vitro and in vivo. High-molecular-weight (HMW) HA solution, hydrolyzed low-molecular-weight (LMW) HA solution and heat-denatured Col solution were mixed, followed by freeze-drying to obtain a spongy sheet. Cross-linkage between Col molecules was induced by UV irradiation to the spongy sheet (Type-I dressing). In a similar manner, a spongy sheet containing EGF was prepared (Type-II dressing). The efficacy of these products was firstly evaluated in vitro. Fibroblast proliferation was assessed in culture medium in the presence or absence of a piece of each wound dressing. EGF stimulated cell proliferation after UV irradiation and dry sterilization at 110°C for 1 h. In the second experiment, fibroblasts-embedded Col gels were elevated to the air-liquid interface to create a wound surface model, on which wound dressings were placed and cultured for 1 week. Cell proliferation and the production of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were investigated. With Type-II dressings, the amounts of VEGF and HGF released from fibroblasts in the Col gel were significantly increased compared with Type-I dressing. Next, the efficacy of these products was evaluated in vivo using Sprague-Dawley (SD) rats. Wound conditions after 1 and 2 weeks of treatment with the wound dressings were evaluated based on the gross and histological appearances. Type-II dressings promoted a decrease in wound size, re-epithelialization and granulation tissue formation associated with angiogenesis. These findings indicate that the combination of HA, Col and EGF promotes wound healing by stimulating fibroblast function.

Immobilization of derivatized dextran nanoparticles on konjac glucomannan/chitosan film as a novel wound dressing

The aim of this study was to prepare konjac glucomannan (KGM)/chitosan (CS) film containing glycidyl methacrylate derivatized dextran (dex-GMA)/acrylic acid(AAc) nanoparticles loaded with antibacterial agent. In this study, An optimized procedure chosen from three methods was used to prepare Erythromycin (EM)-loaded poly(dex-GMA/AAc) nanoparticles and obtained nanoparticles ranged from 50-200 nm. Film was found to have equilibrium water content (EWC) 99.3% which could prevent exudates on wound bed from accumulating and also have excellent water adsorption 2362.3 +/- 55.2%; the water vapor transmission rate (WVTR) was 2335 +/- 36 gm(-2) day(-1) and evaporative water loss from the film (EWL) was approximately 10% after 1 h and within 6 h it increased to 90%. Drug release of film containing nanoparticles or absent was determined, within 22 h accumulative release was 40.3%, 72.5% respectively. In conclusion, KGM/CS film containing nanoparticles could not only maintain a moist environment over wound bed in moderate to heavily exuding wound but also provide a continuous and sustained release of the antibacterial agent on the wound surface, which could be potential wound dressing.

Control of wound infections using a bilayer chitosan wound dressing with sustainable antibiotic delivery

A novel bilayer chitosan membrane was prepared by a combined wet/dry phase inversion method and evaluated as a wound dressing. This new type of bilayer chitosan wound dressing, consisting of a dense upper layer (skin layer) and a sponge-like lower layer (sublayer), is very suitable for use as a topical delivery of silver sulfadiazine (AgSD) for the control of wound infections. Physical characterization of the bilayer wound dressing showed that it has excellent oxygen permeability, that it controls the water vapor transmission rate, and that it promotes water uptake capability. AgSD dissolved from bilayer chitosan dressings to release silver and sulfadiazine. The release of sulfadiazine from the bilayer chitosan dressing displayed a burst release on the first day and then tapered off to a much slower release. However, the release of silver from the bilayer chitosan dressing displayed a slow release profile with a sustained increase of silver concentration. The cultures of Pseudomonas aeruginosa and Staphylococcus aureus in agar plates showed effective antimicrobial activity for 1 week. In vivo antibacterial tests confirmed that this wound dressing is effective for long-term inhibition of the growth of Pseudomonas aeruginosa and Staphylococcus aureus at an infected wound site. The results in this study indicate that the AgSD-incorporated bilayer chitosan wound dressing may be a material with potential antibacterial capability for the treatment of infected wounds.

Development of an artificial dermis preparation capable of silver sulfadiazine release

This article describes the antibacterial effects of an artificial dermis impregnated with silver sulfadiazine (Ag-SD) in vitro as well as in vivo. In the in vitro test, silver release from the artificial dermis impregnated with Ag-SD, by immersion in collagenase solution was controlled by the degradation of the collagen sponge. The artificial dermis impregnated with 3% or higher doses of Ag-SD completely suppressed the growth of Pseudomonas aeruginosa (Ps.) or Staphylococcus aureus (St.). The cytotoxicity test revealed that impregnation of 5% or higher doses of Ag-SD suppressed the growth of fibroblasts. However, when the artificial dermis impregnated with Ag-SD was implanted into full-thickness skin defects on the backs of guinea pigs, no tissue damage was histologically observed around the implanted site of the dermis. In the in vivo test, the artificial dermis impregnated with 10% Ag-SD, which was grafted on experimentally contaminated wounds in the backs of guinea pigs, macroscopically suppressed degradation of the collagen sponge, and significantly reduced the growth of both Ps. and St., compared with artificial dermis without Ag-SD. We conclude that collagen sponge impregnated with Ag-SD is a promising artificial dermis applicable to treat contaminated wounds.

Study on gelatin-containing artificial skin IV: A comparative study on the effect of antibiotic and EGF on cell proliferation during epidermal healing

Gelatin-hyaluronate sponge with and without antibiotic and epidermal growth factor (EGF) were prepared and compared. Four types of sponges were applied on the full-thickness dorsal skin defect of Wistar rat. The effects of antibiotic and EGF in gelatin-hyaluronate sponge on wound healing were investigated by light microscopy and image analyzer at postoperative days of 5, 12 and 21. An immunohistochemical technique, employing PC10, a monoclonal antibody against proliferating cell nuclear antigen (PCNA) was applied to wounded tissue sections. The number of PC10-positive cells was very high for the sponge with EGF at postoperative day 5, then gradually decreased with time. Also we found that antibiotics restrained the cell proliferation during the migratory phase. The sponge with both antibiotic and EGF showed good wound healing performances on the whole for a healing period. The epithelium was regenerated fast with EGF-impregnated sponges at day 5, but each sample had nearly the same length of regenerated epithelium at day 12.

Possibility of wound dressing using poly(L-leucine)/poly(ethylene glycol)/poly(L-leucine) triblock copolymer

ABA-type block copolymers (abbreviated as LEL) composed of poly(L-leucine) (PLL) as the A component and poly(ethylene glycol) (PEG) as the B component were synthesized by ring-opening polymerization of L-leucine N-carboxyanhydride initiated by primary amino group located at both ends of PEG chain. A silver sulfadiazine (AgSD)-impregnated wound dressing of sponge type was prepared by the lyophilization method. Morphological structure of this wound dressing by scanning electron microscopy was observed to be composed of a dense skin layer and a porous inner layer. Equilibrium water content of LEL wound dressing increased with an increase in PEG content in the block copolymer due to the hydrophilicity of PEG. AgSD release from AgSD-impregnated wound dressing in PBS buffer (pH = 7.4) was dependent on PEG content in the block copolymer. Release of AgSD was increased in proportion to the PEG content in the copolymer. Antibacterial capacity of AgSD-impregnated wound dressing was examined in agar plate against Pseudomonas aeruginosa and Staphylococcus aureus. It was found that the suppression of bacterial proliferation in the wound dressing was dependent upon the PEG content. In cytotoxicity test, cell damage did not occur by the release of AgSD from the LEL sponge matrix of AgSD-medicated wound dressing. In in vivo test, granulous tissue formation and wound contraction for the AgSD- and dehydroepiandrosterone-impregnated LEL-2 wound dressing were faster than for any other groups.

Polyamino acids as catalysts in asymmetric synthesis

The use of polyamino acids in asymmetric organic synthesis is reviewed. Particular emphasis is placed on the asymmetric epoxidation of alpha,beta-unsaturated ketones with hydrogen peroxide in the presence of polyalanine or polyleucine, and further transformations of the epoxide products.

Elastomers for biomedical applications

Current topics in elastomers for biomedical applications are reviewed. Elastomeric biomaterials, such as silicones, thermoplastic elastomers, polyolefin and polydiene elastomers, poly(vinyl chloride), natural rubber, heparinized polymers, hydrogels, polypeptides elastomers and others are described. In addition biomedical applications, such as cardiovascular devices, prosthetic devices, general medical care products, transdermal therapeutic systems, orthodontics, and ophthalmology are reviewed as well. Elastomers will find increasing use in medical products, offering biocompatibility, durability, design flexibility, and favorable performance/cost ratios. Elastomers will play a key role in medical technology of the future.

Cytotoxicity tests for antimicrobial agents using cultured skin substitutes fixed at interface of air and culture medium

The present study is focused on a new cytotoxicity test using cultured dermal and epidermal sheets, which are fixed at the air and medium interface as a wound surface model. The cultured dermal sheet is composed of human fibroblasts and a collagen matrix, and the cultured epidermal sheet is composed of human keratinocytes and a collagen matrix. Each cultured sheet was fixed at the air and medium interface, over which a piece of test specimen was placed. The in vitro system created, provides a mimetic wound surface since during wound repair, fibroblasts are embedded in an extracellular matrix, while keratinocytes migrate and proliferate on provisional granulation tissue. The results thus obtained in this cytotoxicity test are useful for determining the efficacious amount of antimicrobial agent used in clinical cases.