An active wound dressing for controlled convective mass transfer with the wound bed

Microfluidic Biomaterials

Since their initial description in 2005, biomaterials that are patterned to contain microfluidic networks ("microfluidic biomaterials") have emerged as promising scaffolds for a variety of tissue engineering and related applications. This class of materials is characterized by the ability to be readily perfused. Transport and exchange of solutes within microfluidic biomaterials is governed by convection within channels and diffusion between channels and the biomaterial bulk. Numerous strategies have been developed for creating microfluidic biomaterials, including micromolding, photopatterning, and 3D printing. In turn, these materials have been used in many applications that benefit from the ability to perfuse a scaffold, including the engineering of blood and lymphatic microvessels, epithelial tubes, and cell-laden tissues. This article reviews the current state of the field and suggests new areas of exploration for this unique class of materials.

Tissue Engineering of the Microvasculature

The ability to generate new microvessels in desired numbers and at desired locations has been a long-sought goal in vascular medicine, engineering, and biology. Historically, the need to revascularize ischemic tissues nonsurgically (so-called therapeutic vascularization) served as the main driving force for the development of new methods of vascular growth. More recently, vascularization of engineered tissues and the generation of vascularized microphysiological systems have provided additional targets for these methods, and have required adaptation of therapeutic vascularization to biomaterial scaffolds and to microscale devices. Three complementary strategies have been investigated to engineer microvasculature: angiogenesis (the sprouting of existing vessels), vasculogenesis (the coalescence of adult or progenitor cells into vessels), and microfluidics (the vascularization of scaffolds that possess the open geometry of microvascular networks). Over the past several decades, vascularization techniques have grown tremendously in sophistication, from the crude implantation of arteries into myocardial tunnels by Vineberg in the 1940s, to the current use of micropatterning techniques to control the exact shape and placement of vessels within a scaffold. This review provides a broad historical view of methods to engineer the microvasculature, and offers a common framework for organizing and analyzing the numerous studies in this area of tissue engineering and regenerative medicine. © 2019 American Physiological Society. Compr Physiol 9:1155-1212, 2019.

Topical Therapy As Adjuvant Treatment to Save a Limb With Critical Ischemia From Extensive and Deep Diabetic Foot Infection When Revascularization Is Not Feasible

BACKGROUND

Patients with diabetes mellitus are susceptible to foot ulcerations associated with the complex triad of peripheral sensory neuropathy, vasculopathy, and trauma. Local infection of a diabetic foot ulcer (DFU) acts a significant deterrent to healing because the response to aggressive debridement antimicrobial therapy is limited when peripheral circulation is poor.

CASE REPORT

We share an experience of using silver-impregnated hydrofiber wound dressing as an alternative to amputation in an 85-year-old female patient with an infected, ischemic DFU. This patient had a long-standing history of diabetes mellitus and hypertension for more than 30 years; both conditions were managed with oral medications. Penetrative injury caused by toothpicks resulted in 2 ulcers over the right lateral and medial plantar areas of her right foot. The DFUs were present within a period of 6 months. Due to the deep wound and progressively worsening infection, she was admitted for systemic antibiotics, debridement, and plantar fasciotomy. Percutaneous transluminal angioplasty was indicated, but the patient refused due to concerns related to potential nephrotoxicity associated with contrast use. Amputation was proposed as the final resort if the critical ischemia showed no improvement. Before undertaking amputation, silver-impregnated hydrofiber dressings were applied to the DFUs, along with antiplatelet medications. Following 4 months of treatment, the right medial plantar ulcer healed completely and the DFU over the lateral plantar ulcer was 75% smaller in surface area. Both DFUs remained healed when evaluated at 8 months.

CONCLUSION

We found that a silver-impregnated hydrofiber dressing, combined with antiplatelet medications, allowed the patient to avoid amputation despite 2 deep and extensively infected DFUs with critical limb ischemia when revascularization was not feasible.

Implementation of tetra-poly(ethylene glycol) hydrogel with high mechanical strength into microfluidic device technology

Hydrogels have several excellent characteristics suitable for biomedical use such as softness, biological inertness and solute permeability. Hence, integrating hydrogels into microfluidic devices is a promising approach for providing additional functions such as biocompatibility and porosity, to microfluidic devices. However, the poor mechanical strength of hydrogels has severely limited device design and fabrication. A tetra-poly(ethylene glycol) (tetra-PEG) hydrogel synthesized recently has high mechanical strength and is expected to overcome such a limitation. In this research, we have comprehensively studied the implementation of tetra-PEG gel into microfluidic device technology. First, the fabrication of tetra-PEG gel/PDMS hybrid microchannels was established by developing a simple and robust bonding technique. Second, some fundamental features of tetra-PEG gel/PDMS hybrid microchannels, particularly fluid flow and mass transfer, were studied. Finally, to demonstrate the unique application of tetra-PEG-gel-integrated microfluidic devices, the generation of patterned chemical modulation with the maximum concentration gradient: 10% per 20 μm in a hydrogel was performed. The techniques developed in this study are expected to provide fundamental and beneficial methods of developing various microfluidic devices for life science and biomedical applications.

Novel wound dressing based on nanofibrous PHBV-keratin mats

Keratin is an important protein used for wound healing and tissue recovery. In this study, keratin was first extracted from raw materials and chemically modified to obtain stable keratin (m-keratin). The raw and m-keratin were examined by Raman spectroscopy. The molecular weight of the m-keratin was analysed by SDS-PAGE. The m-keratin was then blended with poly(hydroxybutylate-co-hydroxyvalerate) (PHBV) and electrospun to afford nanofibrous mats. These mats were characterized by field emission scanning electron microscopy (FE-SEM), electron spectroscopy for chemical analysis (ESCA) and atomic force microscopy (AFM). From the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) data, it was found that introduction of keratin enhanced cell proliferation. From wound-healing test and histological examination results, it was shown that the composite mats accelerated wound recovery remarkably as compared to the PHBV control. It was concluded that PHBV-keratin may be a good candidate as a wound dressing.

Designing polyHEMA substrates that mimic the viscoelastic response of soft tissue

Matching the mechanical properties of a biomaterial to soft tissue is often overlooked despite the fact that it is well known that cells respond to and are capable of changing their mechanical environment. In this paper, we used NaCl and alginate beads as porogens to make a series of micro- and macro-porous pHEMA substrates (poly(2-hydroxyethly methacrylate)) and quantified their mechanical behavior under low-magnitude shear loads over physiologically relevant frequencies. Using a stress-controlled rheometer, we performed isothermal (37°C) frequency response experiments between 0.628 and 75.4rad/s (0.01-12Hz) at 0.1% strain. Both micro- and macro-porous pHEMA substrates were predominately elastic in nature with a narrow range of G' and G″ values that mimicked the response of human skin. The magnitude of the G' and G″ values of the macro-porous substrates were designed to closely match human skin. To determine how cell growth might alter their mechanical properties, pHEMA substrates were functionalized and human skin fibroblasts grown on them for fourteen days. As a result of cell growth, the magnitude of G' and G″ increased at low frequencies while also altering the degree of high frequency dependence, indicating that cellular interactions with the micro-pore infrastructure has a profound effect on the viscoelastic behavior of the substrates. These data could be fit to a mathematical model describing a soft-solid. A quantitative understanding of the mechanical behavior of biomaterials in regimes that are physiologically relevant and how these mechanics may change after implantation may aid in the design of new materials.

Dense type I collagen matrices that support cellular remodeling and microfabrication for studies of tumor angiogenesis and vasculogenesis in vitro

Type I collagen is a favorable substrate for cell adhesion and growth and is remodelable by many tissue cells; these characteristics make it an attractive material for the study of dynamic cellular processes. Low mass fraction (1.0-3.0 mg/ml), hydrated collagen matrices used for three-dimensional cell culture permit cellular movement and remodeling, but their microstructure and mechanics fail to mimic characteristics of many extracellular matrices in vivo and limit the definition of fine-scale geometrical features (<1 mm) within scaffolds. In this study, we worked with hydrated type I collagen at mass fractions between 3.0 and 20 mg/ml to define the range of densities over which the matrices support both microfabrication and cellular remodeling. We present pore and fiber dimensions based on confocal microscopy and longitudinal modulus and hydraulic permeability based on confined compression. We demonstrate faithful reproduction of simple pores of 50 μm-diameter over the entire range and formation of functional microfluidic networks for mass fractions of at least 10.0 mg/ml. We present quantitative characterization of the rate and extent of cellular remodelability using human umbilical vein endothelial cells. Finally, we present a co-culture with tumor cells and discuss the implications of integrating microfluidic control within scaffolds as a tool to study spatial and temporal signaling during tumor angiogenesis and vascularization of tissue engineered constructs.

Development of a calcium-chelating hydrogel for treatment of superficial burns and scalds

Aims: Superficial burns and scalds are usually managed conservatively with traditional dressings. Failure to heal within 3 weeks leads to their management by skin grafting. Our aim was to develop a biomaterial to actively promote keratinocyte migration in superficial burns by modulating local cation concentrations to accelerate keratinocyte migration and deter wounds from contracting, thus potentially reducing the number of such wounds requiring grafting. Materials & methods: We investigated polymeric hydrogels for their Ca2+ chelating properties and enhancement of keratinocyte migration in human tissue-engineered skin models. Results: Dimethylaminoethyl methacrylate:methacrylic acid hydrogel coupled with elevated [Mg2+] reduced media [Ca2+], potentiating keratinocyte migration in tissue-engineered skin models, it also significantly reduced wound model contraction. Conclusion: Dimethylaminoethyl methacrylate:methacrylic acid hydrogels could promote wound healing and reduce wound contraction, a significant complication in burn wound healing.