Wound Dressings – A Practical Review

Rapidly curable zinc chondroitin sulfate @ methacrylated hyaluronic acid hydrogel: a novel photocurable biomaterial tailored for emergency wound management

In today's emergency medical field, rapid hemostasis and wound healing technologies are of paramount importance. However, traditional methods, although effective, have limitations such as slow hemostasis, susceptibility to infection, and unsuitability for irregular wounds. To address these issues, this study combined methacrylated hyaluronic acid (HAMA) with zinc chondroitin sulfate (CSZn) to successfully develop a novel sprayable photocurable hydrogel, CSZn@HAMA. Material characterization confirmed that CSZn was effectively loaded into HAMA, while retaining HAMA's photocurable and sprayable properties. This allows the CSZn@HAMA hydrogel to rapidly solidify and form a tight protective film over the wound after spraying. Further cell experiments demonstrated that this hydrogel has significant anti-inflammatory effects and can effectively promote collagen production and angiogenesis. Therefore, CSZn@HAMA has emerged as a promising biomaterial for wound management in emergency medical care.

Investigating the absorbent properties of carboxymethyl cellulose-chitosan‑carbon dots nanocomposite sponge using photoacoustic microscopy

Recently, sponge biopolymers containing nanoparticles have attracted attention for the preparation of wound-healing products such as wound dressings. Due to the optically non-transparent nature of nanocomposite sponges, only limited microscopic methods have been used to investigate the structural changes caused by adding nanomaterials. The use of various microscopic characterization methods can lead to a better understanding of the performance of nanomaterials in improving the properties of polymer sponges. In this study, photoacoustic microscopy (PAM) imaging was used as a 3D imaging technique to visualize blood penetration and spreading in the fabricated nanocomposite sponges. To form a sponge nanocomposite, carboxymethylcellulose/chitosan (CMC/CS) biopolymers are bonded to green-synthesized carbon dots (CD). The results showed that adding CD to CMC/CS biopolymer and forming CMC/CS/CD nanocomposites caused changes in the cavity structure, resulting in increased porosity and more water absorption and retention, which was better for fluid absorption and therefore more helpful for wound dressing applications. In addition, an investigation of blood penetration and its distribution by PAM showed that by adding CD to composite sponges, blood penetration, diffusion, and absorption increased. Based on these findings, using CD and CMC/CS together can improve the physicochemical properties of sponge nanocomposites, making them ideal for wound dressing.

Ambient Humidity-Dependent Tensile Behavior and Shape Memory Properties of Cinnamoyl Photo-Cross-Linked Poly(2-ethyl-2-oxazoline) Nanofibers

Electrospun, water-stable nanofiber membranes made from hydrophilic, biocompatible poly(2-ethyl-2-oxazoline) (PEtOx) networks hold significant promise in biomedical applications, particularly in wound management. However, their mechanical behavior under varying environmental conditions remains poorly understood. This work provides an in-depth analysis of the tensile properties of photo-cross-linked cinnamoyl-modified high-molar-mass PEtOx (PEtOx-Cin) nanofiber membranes with varying ambient humidity, assessing their practical handling prior to application as wound dressings, while exploring their shape memory properties as basis for potential humidity-actuated wound closure. Cinnamoyl modification and cross-linking of PEtOx-Cin mats significantly improve moisture stability, accelerate moisture sorption, and raise the glass transition temperature (Tg) through newly formed covalent intermolecular bonds. At higher relative humidity (%RH) from 25 to 65%RH, moisture sorption induces plasticization, shifting the Tg below room temperature and transforming the membranes from brittle to highly ductile and elastomeric. This glass-to-rubber transition under ambient conditions enables humidity-stimulated shape memory behavior, revealing excellent temporary shape fixity at low humidity and rapid recovery to the original shape upon exposure to high humidity. The presented findings advance the understanding of cross-linked PEtOx-Cin nanofiber membranes, and while further optimization is needed to enhance mechanical stability at high humidity for improved handling, they underscore their unique potential for next-generation wound closure dressings.

Preparation and applications of magnetic nanocellulose composites: A review

Cellulose is the most abundant biomass material in the world. Magnetic nanoparticles can be used as reinforcing materials to give cellulose more functions due to their unique magnetism. According to the dispersion stability of nanocellulose, magnetic nanocellulose is divided into homogeneous preparation and heterogeneous preparation. In addition, the directional arrangement of nanocellulose by external magnetic field is also a way of cellulose functionalization. The current preparation of magnetic nanocellulose is mainly based on heterogeneous preparation. Magnetic nanofiber cellulose has great application potential in the field of biomedicine and sewage purification due to its special magnetic properties. It can also be applied to sensors, food packaging and other fields. In this paper, the preparation methods of magnetic nanocellulose and its physical magnetism are introduced. Then, the application of magnetic nanocellulose in different fields is reviewed. Finally, the current challenges of magnetic nanocellulose are summarized and the future development trend is prospected.

Smart self-healing hydrogel wound dressings for diabetic wound treatment

Diabetic wounds are difficult to treat clinically because they heal poorly, often leading to severe complications such as infections and amputations. Hydrogels with smart self-healing properties show great promise for treating diabetic wounds. These hydrogels are capable of continuously and dynamically responding to changes in the wound environment, feature improved mechanical qualities and the capacity to self-heal damage. We explore the latest developments in smart self-healing hydrogels for diabetic wound healing in this review. First, we systematically summarize the obstacles in treating diabetic wounds. We then highlighted the significance of smart self-healing hydrogels, explaining their stimulus-responsive mechanisms and self-healing design approaches, along with their applications in addressing these challenges. Finally, we discussed the unresolved obstacles and potential avenues for future research. We anticipate that this review will facilitate the continued refinement of smart self-healing hydrogels for diabetic wound dressings, aiming for broader clinical adoption.

Hydrogel Dressings as Insulin Delivery Systems for Diabetic Wounds

Diabetic wounds are one of the most common and challenging complications of diabetes. Similar to chronic wounds, diabetic wounds are difficult to treat due to prolonged inflammation, a lack of angiogenesis, abnormal differentiation of new scar tissue, and the occurrence of numerous bacterial infections. Moreover, elevated sugar levels in tissues disrupt the healing process by enhancing inflammatory reactions, disrupting signaling pathways, and leading to the production of abnormal biological structures, which contribute to improper cell differentiation. Traditional dressings, such as bandages, gauze, and semi-occlusive foams, are inadequate for diabetic wounds with high exudation; moreover, frequently changing the dressing can cause secondary irritation. Hence, innovative hydrogel dressings are being developed, which, thanks to their soft polymer matrix, provide an ideal substrate for regenerating tissue. Hydrogels also allow for the introduction and controlled release of growth factors, making them a promising solution for treating diabetic wounds. Recently, researchers have focused on insulin, a hormone secreted by the human body to lower blood sugar levels, due to its interesting characteristics, such as supporting anti-inflammatory and proangiogenic processes and stimulating cell migration and proper proliferation. This review discusses the most important aspects of diabetes and diabetic wounds and traditional and innovative treatment methods, particularly hydrogel dressings used as systems for insulin delivery in response to glucose concentration.

Physicochemically Cross-linked Injectable Hydrogel: an Adhesive Skin Substitute for Burned Wound Therapy

Burns carry a large surface area, varying in shapes and depths, and an elevated risk of infection. Regardless of the underlying etiology, burns pose significant medical challenges and a high mortality rate. Given the limitations of current therapies, tissue-engineering-based treatments for burns are inevitable. Herein, we developed a natural physicochemically cross-linked adhesive injectable skin substitute (SS) comprising chitosan (Ch) and silk fibroin (SF), cross-linked with tannic acid (TA) through hydrogen bonding, and incorporated with fresh platelet-rich fibrin (FPRF). SF was also chimerically cross-linked with riboflavin (RF) under visible light to ensure desirable biodegradability rate and nontoxicity. Double cross-linked SS exhibited a semibilayer (SBSS) structure with smaller pores in the upper layer. In the CaCl2-treated FPRF, the activated platelets augmented vascular endothelial growth factor (VEGF) and platelet-derived GF (PDGF) release. The resultant SBSS possessed optimal adhesion, hemocompatibility, and significant antibacterial and antioxidant activities (P ≤ 0.05). The rat liver injury model confirmed the rapid hemostatic effect of SBSS. Furthermore, the bottom layer of SBSS promoted L929 fibroblast growth, proliferation, and migration. SBSS-treated wounds showed lower inflammatory cells, earlier epithelialization, significant angiogenesis, and faster healing. The proposed SBSS could be an ideal remedy for burn wound therapy.

Injectable and self-healing carboxymethyl chitosan/carboxymethyl cellulose/marine snail peptide hydrogel for infected wound healing

Treatment of bacterial infected full-thickness wounds remains a great challenge in clinic. Herein, a HYP hydrogel was prepared using carboxymethyl chitosan, dialdehyde carboxymethyl cellulose, and marine snail peptide (Tyr-Ile-Ala-Glu-Asp-Ala-Glu-Arg) as starting materials. The marine snail peptide with good antioxidant activity could remove the reactive oxygen species in wound sites, thereby alleviating the excessive inflammatory response. The dynamic Schiff-base bonds endowed HYP with good injectable and self-healing abilities. HYP exhibited suitable gelation time, good rheological properties, and unique porosity structure, which were conducive to wound healing. In vitro biological studies indicated that HYP showed good biocompatibility, low hemolysis ratio, and improved antibacterial and antioxidant activities. In vivo study revealed that HYP could promote wound healing in a bacterial infected full-thickness skin defect rat model. The wound tissues showed reduced number of inflammatory cells, newly formed hair follicles, and obvious collagen deposition. The expression of inflammatory and angiogenesis related biomarkers (IL-6, IL-10, CD31, and α-SMA) significantly improved. Therefore, HYP hydrogel showed great application prospect as a wound dressing for bacterial infected wound.

Hybrid thermosensitive hydrogel/amniotic membrane structure incorporating S-nitrosothiol microparticles: potential uses for controlled nitric oxide delivery

Insufficient levels of nitric oxide may lead to chronic and acute wounds. Additionally, it is crucial that nitric oxide is prepared in a controlled-release manner due to its gaseous nature and short half-life. To address this issue, utilizing nitric oxide donors, particularly S-nitrosothiols such as S-nitrosoglutathione (GSNO), could efficiently overcome instability and aid in biomedical applications. Decellularized human amniotic membranes are also best known for their anti-inflammatory, angiogenic, and antimicrobial properties to promote wound epithelization. In this study, a novel nitric oxide-generated wound dressing based on an amniotic membrane was investigated. This construct consisted of a chitosan/β-glycerophosphate thermosensitive hydrogel covered with a decellularized human amniotic layer embedded with GSNO-loaded polylactic acid microparticles. The structure of GSNO was confirmed by spectrometric, elemental, and chemical analyses. The GSNO-loaded microparticles had a diameter of 40.66 ± 6.92 µm, and an encapsulation efficiency of 45.6 ± 6.74%. The hybrid construct and GSNO-loaded microparticles enhanced the long-term stable release of GSNO compared to free GSNO. The construct released nitric oxide ranging from 24 to 68 nM/mg during 7 days. The thermosensitive hydrogel was formed at 32.7 ± 1 °C and had a porous structure with a pore size of 41.76 ± 9.76 µm. The MTT and live/dead assays performed on human dermal fibroblast cells demonstrated suitable cell viability and adhesion to the final construct. Further, hemolysis analysis revealed less than a 5% hemolysis rate due to negligible blood cell adhesion. Overall, the prepared hybrid construct demonstrated suitable characteristics as a potential active wound dressing capable of controlled nitric oxide delivery.

Evaluation of Carboxymethyl Cellulose/Gelatin Hydrogel-Based Dressing Containing Cefdinir for Wound Healing Promotion in Animal Model

The skin serves as a critical barrier against external pathogens, and its wound healing is a complex biological process that requires careful management to ensure optimal tissue regeneration. Hydrogels, a class of hydrophilic polymers, have emerged as promising materials for wound dressings due to their biocompatibility, biodegradability, and ability to create a moist wound environment conducive to cell proliferation and migration. In this research, a hydrogel dressing containing cefdinir (Cef) was made from a combination of carboxymethyl cellulose (CMC) and gelatin (Gel) by a physical crosslinking method, and their physicochemical, mechanical, and biological properties were investigated. Results show that the addition of Cef does not cause a significant change in the morphology or the tensile strength of the wound dressing. The swelling and degradation rate of the hydrogel slightly increased in the presence of Cef. The presence of Cef enhanced antibacterial effects up to 2.5-fold against P. aeruginosa (35 mm), S. aureus (36 mm), and S. pyogenes (35 mm). The results of the cytotoxicity test showed the absence of cytotoxicity in both drug-containing and drug-free wound dressings, as well as a survival rate of over 75% in cells after 48 h. The drug-containing wound dressing accelerates the formation of the epidermis layer and the production of fibroblast cells, and as a result, accelerates the wound healing process. The percentage of wound healing on the ninth day of treatment for an untreated wound was 30%, while this percentage was 40% with a wound dressing without medicine and 60% with a wound dressing containing medicine, and on the fifteenth day of treatment, the wound treated with both wound dressings had more than 85% healing. As a result, it is possible to use CMC/Gel hydrogel polymeric wound dressing containing Cef as a wound dressing for wound healing, according to the desired physicochemical properties and biocompatibility.

Lysozyme-enhanced cellulose nanofiber, chitosan, and graphene oxide multifunctional nanocomposite for potential burn wound healing applications

The demand for advanced biomaterials in medical treatments is rapidly expanding. To address this demand, a nanocomposite of cellulose nanofiber (CNF) with chitosan (Ch) and graphene oxide (GO) was developed for burn wound treatment. The CNF-Ch-GO nanocomposites were characterized and their biological properties were evaluated. Microscopic images showed a uniform distribution of CNF, Ch, and GO with a porous structure. ATR-FTIR and XRD analyses confirmed the chemical structures, while a thermogravimetric study confirmed the stability of CNF-Ch-GO nanocomposite under a N2 atmosphere. The synthesized CNF-Ch-GO nanocomposite exhibited rapid absorption, absorbing 1781.7 ± 53.7 % PBS in 2 min. It demonstrated a Young's modulus of 11.90 ± 0.06 MPa in a hydrated condition, indicating its mechanical stability in water. Furthermore, it displayed excellent biocompatibility and hemocompatibility with 96.23 ± 12.21 % cell viability and 0.21 ± 0.08 % of hemolysis. Additionally, the blood clotting index of CNF-Ch-GO was comparable to that of standard dressing gauze. To enhance antimicrobial efficacy, CNF-Ch-GO was conjugated with lysozyme. This biotic and abiotic conjugation resulted in 92.17 % ± 3.02 % and 94.99 ± 2.1 % eradication of Escherichia coli and Staphylococcus aureus, respectively. The enhanced antimicrobial properties, biocompatibility, and mechanical stability of the superabsorbent CNF-Ch-GO nanocomposite indicate its significant potential for advanced burn wound healing applications.

Current progress of protein-based dressing for wound healing applications - A review

Protein-based wound dressings have garnered increasing interest in recent years owing to their distinct physical, chemical, and biological characteristics. The intricate molecular composition of proteins gives rise to unique characteristics, such as exceptional biocompatibility, biodegradability, and responsiveness, which contribute to the promotion of wound healing. Wound healing is an intricate and ongoing process influenced by multiple causes, and it consists of four distinct phases. Various treatments have been developed to repair different types of skin wounds, thanks to advancements in medical technology and the recognition of the diverse nature of wounds. This review has literature reviewed within the last 3-5 years-the recent progress and development of protein in wound dressings and the fundamental properties of an ideal wound dressing. Herein, the recent strides in protein-based state-of-the-art wound dressing emphasize the significant challenges and summarize future perspectives for wound healing applications.

Flap-Free Tendon Coverage Using Autologous Fat Grafts Enhanced with Platelet-Rich Plasma and Growth Factors at a Secondary Level Hospital: A Case Report

BACKGROUND

Autologous fat grafting, enriched with platelet-rich plasma (PRP), has been established as an effective and affordable treatment for various types of wound healing. However, its efficacy in managing wounds with tendon exposure has not been thoroughly investigated.

METHODS

We report the case of a 40-year-old male who sustained a severe friction burn on his hand and forearm from a car accident, resulting in significant tissue loss and exposed extensor tendons.

RESULTS

Traditional wound treatment strategies were not implemented due to specific patient circumstances. After initial surgical management failed to prevent necrosis and maintain coverage of the exposed tendons, the patient underwent a novel treatment involving autologous fat grafting combined with PRP and growth factors. The procedure was repeated twice within a month to promote granular tissue formation over that area and facilitate subsequent coverage with an epidermoreticular graft. By day 21 post-initial graft, the exposed tendons were 98% covered with granular tissue. Complete wound coverage was achieved by day 60, and by day 130 the patient had regained 90% functionality of the affected limbs.

CONCLUSIONS

This case illustrates the potential of autologous fat grafting combined with PRP and growth factors as a viable, flap-free alternative for covering tendon exposures. This approach not only enhances wound healing but also supports functional recovery, underscoring the need for further research into its broader applicative potentials.

Synergistic nanocoating with layer-by-layer functionalized PCL membranes enhanced by manuka honey and essential oils for advanced wound healing

Chronic wounds represent a significant global health concern, statistically impacting 1-2% of the population in developed countries throughout their lifetimes. These wounds cause considerable discomfort for patients and necessitate substantial expenditures of time and resources for treatment. Among the emerging therapeutic approaches, medicated dressings incorporating bioactive molecules, including natural compounds, are particularly promising. Hence, the objective of this study was to develop novel antimicrobial dressings for wound treatment. Specifically, polycaprolactone membranes were manufactured using the electrospinning technique and subsequently coated with natural polyelectrolytes (chitosan as a polycation and a mixture of manuka honey with essential oils nanoemulsions as a polyanion) employing the Layer-by-Layer assembly technique. Physico-chemical and morphological characterization was conducted through QCM-D, FTIR-ATR, XPS, and SEM analyses. The results from SEM and QCM-D demonstrated successful layer deposition and coating formation. Furthermore, FTIR-ATR and XPS analyses distinguished among different coating compositions. The coated membranes were tested in the presence of fibroblast cells, demonstrating biocompatibility and expression of genes coding for VEGF, COL1, and TGF-β1, which are associated with the healing process (assessed through RT-qPCR analysis). Finally, the membranes exhibited excellent antibacterial activity against both Staphylococcus aureus and Pseudomonas aeruginosa, with higher bacterial strain inhibition observed when cinnamon essential oil nanoemulsion was incorporated. Taken together, these results demonstrate the potential application of nanocoated membranes for biomedical applications, such as wound healing.

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.

Development of alginate/chitosan hydrogel loaded with obestatin and evaluation of collagen type I, III, VEGF and TGF-β1 gene expression for skin repair in a rat model (in vitro and in vitro study)

BACKGROUND

Skin injuries have long been recognized as a prevalent type of physical injury. As a result, numerous research studies have been performed to discover an effective mechanism for wound healing. Therefore, tissue engineering of skin has developed as a potential solution for traditional methods of treating skin injuries.

METHODS AND MATERIALS

Alginate/Chitosan hydrogel was mixed with 1, 10, 100, and 150 µM Obestatin, and evaluated the morphology, cumulative release, hemocompatibility and cytocompatibility, water absorption, cell viability, weight loss, and antibacterial characteristics of three-dimensional (3D) alginate (Alg) and chitosan (Cs) hydrogels during the process of wound curing. Various concentrations of Obestatin (Obes) were utilized for this purpose. Finally, the hydrogels that were made were tested on a full-thickness dermal wound in a Wistar rat model. The curative effects were determined by analyzing RNA expression and examining tissue stained with Masson's trichrome (MT) and hematoxylin-eosin (H&E).

RESULTS

The biodegradability of this hydrogel was verified using weight loss testing, which demonstrated a reduction of around 90% after a period of 3 days. Furthermore, the MTT assay demonstrated that hydrogels have a beneficial effect on cell proliferation without inducing any harmful effects. Furthermore, the hydrogels produced demonstrated higher wound closure in vivo compared to the wounds treated with gauze (negative control group). Among the hydrogel groups, the chitosan/alginate/obestatin 100 µM group exhibited the apical percentage of wound closure, gene expression, and secondary epithelialization, but in 150 µM concentrations, we saw a lower rate of cell growth and proliferation and increase in hemolysis. In addition, RT-PCR analysis demonstrated that a concentration of 100 µM obestatin resulted in an upregulation in the expression of mRNA for vascular endothelial growth factor (VEGF), collagen type I & type III, and transforming growth factor-beta (TGF-β).

CONCLUSION

The present study suggests that 3D Alg/Cs hydrogels with a concentration of 100 µM obestatin have the potential for clinical application in the treatment of skin injuries.

Films based on TEMPO-oxidized chitosan nanoparticles: Obtaining and potential application as wound dressings

A series of novel films based on TEMPO-oxidized chitosan nanoparticles were prepared by casting method. Fourier transform infrared spectroscopy (FTIR) was employed to ascertain the chemical structure of TEMPO-oxidized chitosan. The surface morphology of the TEMPO-oxidized chitosan nanoparticles was analyzed by atomic force microscopy (AFM). The physicochemical (area density, thickness, iodine sorption, roughness), functional (moisture sorption, liquid absorption capacity, weight loss upon contact with the liquid, and water vapor transmission rate), antibacterial, and antioxidant properties of films based on TEMPO-oxidized chitosan nanoparticles were also investigated. The physicochemical properties of the films varied widely: area density ranged from 77.83 ± 0.06 to184.46 ± 0.05 mg/cm2, thickness varied between 80.5 ± 1.6 and 200.5 ± 1.6 μm, iodine sorption spanned from 333.7 ± 2.1 to166.4 ± 2.2 mg I2/g, and roughness ranged from 4.1 ± 0.2 to 5.6 ± 0.3 nm. Similarly, the functional properties also varied significantly: moisture sorption ranged from 4.76 ± 0.03 to 9.62 ± 0.11 %, liquid absorption capacity was between 129.04 ± 0.24 and 159.33 ± 0.73 % after 24 h, weight loss upon contact with the liquid varied between 31.06 ± 0.35 and 45.88 ± 0.58 % after 24 h and water vapor transmission rate ranged from 1220.10 ± 2.91to1407.77 ± 5.22 g/m2 day. Despite the wide variations in physicochemical and functional properties, all films showed maximum bacterial reduction of Staphylococcus aureus and Escherichia coli, although they exhibited low antioxidant activity. The results suggest that the films could be effectively utilized as antibacterial wound dressings.

Motion-Accommodating Dual-Layer Hydrogel Dressing to Deliver Adipose-Derived Stem Cells to Wounds

BACKGROUND

Current dressing materials cannot secure a cell survival-promoting wound environment for stem cell delivery due to insufficient assimilation to skin motion. The authors developed a novel motion-accommodating dual-layer hydrogel dressing for stem cell delivery into such wounds.

METHODS

Dorsal hand skin movement was evaluated to determine the potential range of deformation for a dressing. The outer hydrogel (OH) was fabricated with an alginate-acrylamide double-network hydrogel with a covalently cross-linked elastomer coat. The tough adhesive consisted of a chitosan-based bridging polymer and coupling reagents. OH material properties and adhesiveness on porcine skin were measured. An oxidized alginate-based inner hydrogel (IH) containing human adipose-derived stem cells (ASCs) was evaluated for cell-supporting and cell-releasing properties. The OH's function as a secondary dressing, and dual-layer hydrogel cell delivery potential in wounds were assessed in a rodent model.

RESULTS

The dual-layer hydrogel consisted of OH and IH. The OH target range of deformation was up to 25% strain. The OH adhered to porcine skin, and showed significantly higher adhesion energy than common secondary dressings and endured 900 flexion-extension cycles without detachment. OH showed a similar moisture vapor transmission rate as moisture-retentive dressings. IH maintained embedded cell survival for three days with significant cell release on the contacting surface. OH showed less fibrotic wound healing than other secondary dressings in vivo. The dual-layer hydrogel successfully delivered ASCs into open wounds of nude mice (13 ± 3 cells/HPF).

CONCLUSIONS

The novel dual-layer hydrogel can accommodate patient movement and deliver ASCs into the wound bed by securing the wound microenvironment.

Thermally Stabilised Poly(vinyl alcohol) Nanofibrous Materials Produced by Scalable Electrospinning: Applications in Tissue Engineering

Electrospinning is a widely employed manufacturing platform for tissue engineering applications because it produces structures that closely mimic the extracellular matrix. Herein, we demonstrate the potential of poly(vinyl alcohol) (PVA) electrospun nanofibers as scaffolds for tissue engineering. Nanofibers were created by needleless direct current electrospinning from PVA with two different degrees of hydrolysis (DH), namely 98% and 99% and subsequently heat treated at 180 °C for up to 16 h to render them insoluble in aqueous environments without the use of toxic cross-linking agents. Despite the small differences in the PVA chemical structure, the changes in the material properties were substantial. The higher degree of hydrolysis resulted in non-woven supports with thinner fibres (285 ± 81 nm c.f. 399 ± 153 nm) that were mechanically stronger by 62% (±11%) and almost twice as more crystalline than those from 98% hydrolysed PVA. Although prolonged heat treatment (16 h) did not influence fibre morphology, it reduced the crystallinity and tensile strength for both sets of materials. All samples demonstrated a lack or very low degree of haemolysis (<5%), and there were no notable changes in their anticoagulant activity (≤3%). Thrombus formation, on the other hand, increased by 82% (±18%) for the 98% hydrolysed samples and by 71% (±10%) for the 99% hydrolysed samples, with heat treatment up to 16 h, as a direct consequence of the preservation of the fibrous morphology. 3T3 mouse fibroblasts showed the best proliferation on scaffolds that were thermally stabilised for 4 and 8 h. Overall these scaffolds show potential as 'greener' alternatives to other electrospun tissue engineering materials, especially in cases where they may be used as delivery vectors for heat tolerant additives.

Coatings Based on Essential Oils for Combating Antibiotic Resistance

In the current era of widespread antimicrobial resistance, the utilization of essential oils (EOs) derived from plants has emerged as a promising alternative in combating pathogens that have developed resistance to antibiotics. This review explores the therapeutic potential of essential oils as valuable tools in restoring the efficacy of antibiotics, highlighting their unique ability to affect bacteria in multiple ways and target various cellular systems. Despite the challenge of elucidating their precise mode of action, EOs have shown remarkable results in rigorous testing against a diverse range of bacteria. This review explores the multifaceted role of EOs in combating bacterial microorganisms, emphasizing their extraction methods, mechanisms of action, and comparative efficacy against synthetic antibiotics. Key findings underscore the unique strategies EOs deploy to counter bacteria, highlighting significant differences from conventional antibiotics. The review extends to advanced coating solutions for medical devices, exploring the integration of EO formulations into these coatings. Challenges in developing effective EO coatings are addressed, along with various innovative approaches for their implementation. An evaluation of these EO coatings reveals their potential as formidable alternatives to traditional antibacterial agents in medical device applications. This renaissance in exploring natural remedies emphasizes the need to combine traditional wisdom with modern scientific advancements to address the urgent need for effective antimicrobial solutions in the post-antibiotic era.

Performance of a gelling fibre dressing in management of wounds in a community setting: a sub-analysis of the VIPES study

OBJECTIVE

To evaluate the use and performance of a gelling fibre dressing (Biatain Fiber; Coloplast A/S, Denmark) in the management of wounds in community nursing practice.

METHOD

A sub-analysis of the prospective, observational, real-world VIPES (Observatoire en Ville des Plaies ExSudatives) study was conducted. Patients with exuding wounds, for which nurses chose to apply the gelling fibre as a primary dressing, were included. Outcomes included assessments of wound condition and patient/nurse opinion.

RESULTS

Overall, 149 patients with acute (n=52; 34.9%) or hard-to-heal (chronic) (n=97; 65.1%) wounds were included. At baseline, mean±standard deviation wound age was 351.5±998.2 days, 108 (72.5%) wounds were moderately-to-highly exuding, and 126 (84.6%) showed exudate pooling in the wound bed. At the last follow-up visit, 29 (19.5%) wounds had healed, within a median of 36 days, and 64 (43.0%) were progressing towards healing. From baseline to the last follow-up visit, significant reductions in wound surface area (p<0.05), depth (p<0.01), exudate level (p<0.0001), and in the proportion of wounds with sloughy tissue (p<0.0001) were observed. Most wounds had no (n=86; 58.5% (two missing values)) or low exudate pooling (n=45; 30.6% (two missing values)) at the last visit and proportions of patients with healthy wound edges/periwound skin increased from baseline. At the last visit, wounds were considered improved by nurses in 71.4% (n=105) of cases, and by patients in 66.7% (n=98) of cases (two patients missing).

CONCLUSION

Patients who received treatment with the gelling fibre experienced improvements in the condition of a range of complex wounds. This analysis highlights the importance of adequate exudate management, and indicates how the selection of an appropriate wound dressing can encourage healing progression.

DECLARATION OF INTEREST

This study was financially supported by Laboratoires Coloplast SAS, Paris, France. Coloplast A/S funded the writing and editing of the article and contributed to its content. Coloplast A/S and Laboratoires Coloplast SAS reviewed the article for scientific accuracy. Nurses received financial compensation for their participation in the study. NA is a full-time employee of Coloplast A/S. APJ was an employee of Coloplast A/S when this article was written. FA was a full-time employee of Laboratoires Coloplast SAS at the time of publication development. RS and CJ are full-time employees of CEN Biotech. AK received an educational grant from Coloplast A/S to provide scientific input to the publication. The authors have no other conflicts of interest to declare.

Whey protein-loaded 3D-printed poly (lactic) acid scaffolds for wound dressing applications

Chronic skin wounds pose a global clinical challenge, necessitating effective treatment strategies. This study explores the potential of 3D printed Poly Lactic Acid (PLA) scaffolds, enhanced with Whey Protein Concentrate (WPC) at varying concentrations (25, 35, and 50% wt), for wound healing applications. PLA's biocompatibility, biodegradability, and thermal stability make it an ideal material for medical applications. The addition of WPC aims to mimic the skin's extracellular matrix and enhance the bioactivity of the PLA scaffolds. Fourier Transform Infrared Spectroscopy results confirmed the successful loading of WPC into the 3D printed PLA-based scaffolds. Scanning Electron Microscopy (SEM) images revealed no significant differences in pore size between PLA/WPC scaffolds and pure PLA scaffolds. Mechanical strength tests showed similar tensile strength between pure PLA and PLA with 50% WPC scaffolds. However, scaffolds with lower WPC concentrations displayed reduced tensile strength. Notably, all PLA/WPC scaffolds exhibited increased strain at break compared to pure PLA. Swelling capacity was highest in PLA with 25% WPC, approximately 130% higher than pure PLA. Scaffolds with higher WPC concentrations also showed increased swelling and degradation rates. Drug release was found to be prolonged with increasing WPC concentration. After seven days of incubation, cell viability significantly increased in PLA with 50% WPC scaffolds compared to pure PLA scaffolds. This innovative approach could pave the way for personalized wound care strategies, offering tailored treatments and targeted drug delivery. However, further studies are needed to optimize the properties of these scaffolds and validate their effectiveness in clinical settings.

Silver-loaded poly(vinyl alcohol)/polycaprolactone polymer scaffold as a biocompatible antibacterial system

A chronic nonhealing wound poses a significant risk for infection and subsequent health complications, potentially endangering the patient's well-being. Therefore, effective wound dressings must meet several crucial criteria, including: (1) eliminating bacterial pathogen growth within the wound, (2) forming a barrier against airborne microbes, (3) promoting cell proliferation, (4) facilitating tissue repair. In this study, we synthesized 8 ± 3 nm Ag NP with maleic acid and incorporated them into an electrospun polycaprolactone (PCL) matrix with 1.6 and 3.4 µm fiber sizes. The Ag NPs were anchored to the matrix via electrospraying water-soluble poly(vinyl) alcohol (PVA), reducing the average sphere size from 750 to 610 nm in the presence of Ag NPs. Increasing the electrospraying time of Ag NP-treated PVA spheres demonstrated a more pronounced antibacterial effect. The resultant silver-based material exhibited 100% inhibition of gram-negative Escherichia coli and gram-positive Staphylococcus aureus growth within 6 h while showing non-cytotoxic effects on the Vero cell line. We mainly discuss the preparation method aspects of the membrane, its antibacterial properties, and cytotoxicity, suggesting that combining these processes holds promise for various medical applications.

Green Electrospun Poly(vinyl alcohol)/Gelatin-Based Nanofibrous Membrane by Incorporating 45S5 Bioglass Nanoparticles and Urea for Wound Dressing Applications: Characterization and In Vitro and In Vivo Evaluations

This study reports the fabrication and characterization of poly(vinyl alcohol) (PVA) and gelatin (Gel)-based nanofiber membranes cross-linked with citric acid (CA) by a green electrospinning method in which nano 45S5 bioglass (BG) and urea were incorporated. Various combinations of PVA, gelatin, and BG were prepared, and nanofiber membranes with average fiber diameters between 238 and 595 nm were fabricated. Morphological, chemical, and mechanical properties, porosity, swelling, water retention, and water vapor transmission rate of the fabricated membranes were evaluated. PVA:Gel (90:10), 15% CA, and 3% BG were determined as the optimum blend for nanofiber membrane fabrication via electrospinning. The membrane obtained using this blend was further functionalized with 10% w/w polymer urea coating by the electrospray method following the cross-linking. In vitro biocompatibility tests revealed that the fabricated membranes were all biocompatible except for the one that functionalized with urea. In vivo macroscopic and histopathological analysis results of PVA/Gel/BG and PVA/Gel/BG/Urea treated wounds indicated increased collagenization and vascularization and had an anti-inflammatory effect. Furthermore, careful examination of the in vivo macroscopic results of the PVA/Gel/BG/Urea membrane indicated its potential to decrease uneven scar formation. In conclusion, developed PVA/Gel/BG and PVA/Gel/BG/Urea electrospun membranes with multifunctional and biomimetic features may have the potential to be used as beneficial wound dressings.

Biomimetic Materials for Skin Tissue Regeneration and Electronic Skin

Biomimetic materials have become a promising alternative in the field of tissue engineering and regenerative medicine to address critical challenges in wound healing and skin regeneration. Skin-mimetic materials have enormous potential to improve wound healing outcomes and enable innovative diagnostic and sensor applications. Human skin, with its complex structure and diverse functions, serves as an excellent model for designing biomaterials. Creating effective wound coverings requires mimicking the unique extracellular matrix composition, mechanical properties, and biochemical cues. Additionally, integrating electronic functionality into these materials presents exciting possibilities for real-time monitoring, diagnostics, and personalized healthcare. This review examines biomimetic skin materials and their role in regenerative wound healing, as well as their integration with electronic skin technologies. It discusses recent advances, challenges, and future directions in this rapidly evolving field.

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.

Effects of electromagnetic therapy in treating patients with venous leg ulcers: An overview of systematic reviews

This study aims to evaluate the effects of electromagnetic therapy (EMT) on the treatment of venous leg ulcers (VLUs) by synthesising and appraising available meta-analyses (MAs) and systematic reviews (SRs). A comprehensive literature search was conducted across major databases up to 10 January 2024, focusing on SRs/MAs that investigated the use of EMT for VLUs. Selection criteria followed the PICO framework, and dual-author extraction was used for accuracy. Quality assessment tools included AMSTAR2, ROBIS, PRISMA, and GRADE. The search yielded five eligible studies. The reviews collectively presented moderate methodological quality and a low risk of bias in several domains. Reporting quality was high, albeit with inconsistencies in fulfilling certain PRISMA checklist items. The evidence quality, primarily downgraded due to small sample sizes, was rated as moderate. Whilst some studies suggest potential benefits of EMT in the treatment of VLUs, the overall evidence is inconclusive due to methodological limitations and limited sample sizes. This review underscores the need for future research with more rigorous methodologies and larger cohorts to provide clearer insights into the efficacy of EMT for VLUs.

Zinc/aluminum-layered double hydroxide-gallic acid doped carboxymethyl cellulose nanocomposite films for wound healing

Effective loading and delivering the wound healing-based materials to the wound site and area with an optimum concentration and limited cytotoxicity are essential for a complete and fast healing process. Here, we have designed Zn/Al-LDH nanoparticles-loaded CMC films for encapsulation and delivery of gallic acid (GA) in order to develop an effective and efficient wound-healing scaffold. The physicochemical properties of the prepared Zn/Al-LDH nanohybrids were thoroughly characterized by several characterization techniques, such as FESEM, Hi-TEM, FTIR, and XRD techniques. The thermal properties of the scaffolds were evaluated by DSC and TGA analysis. The release profiles of GA from fabricated films were studied over 8 h by UV-vis spectroscopy. In vitro drug release studies in PBS solutions with pH 7.4 showed a mono-phasic profile in which the liberation of the drug mainly occurred by scaffold erosion and increased by increasing the experiment period. The in vitro antibacterial activity of Zn/Al-LDH-GA-loaded CMC films was assessed by disk diffusion and cell viability contact tests. The results showed the desired antibacterial activity against Staphylococcus aureus and Escherichia coli bacteria. Incorporating GA within CMC and CMC-Zn/Al-LDH films rereleased good cytocompatibility at the studied incubation time and different concentrations toward human normal HFF cell line than the free drug. The results of the present study indicated that the Zn/Al-LDH and Zn/Al-LDH-GA-loaded CMC have promising wound healing features to further develop a better future for clinical remedy of the different non-healing and hard-to-heal wounds.

Hydrogel-Based Skin Regeneration

The skin is subject to damage from the surrounding environment. The repair of skin wounds can be very challenging due to several factors such as severe injuries, concomitant infections, or comorbidities such as diabetes. Different drugs and wound dressings have been used to treat skin wounds. Tissue engineering, a novel therapeutic approach, revolutionized the treatment and regeneration of challenging tissue damage. This field includes the use of synthetic and natural biomaterials that support the growth of tissues or organs outside the body. Accordingly, the demand for polymer-based therapeutic strategies for skin tissue defects is significantly increasing. Among the various 3D scaffolds used in tissue engineering, hydrogel scaffolds have gained special significance due to their unique properties such as natural mimicry of the extracellular matrix (ECM), moisture retention, porosity, biocompatibility, biodegradability, and biocompatibility properties. First, this article delineates the process of wound healing and conventional methods of treating wounds. It then presents an examination of the structure and manufacturing methods of hydrogels, followed by an analysis of their crucial characteristics in healing skin wounds and the most recent advancements in using hydrogel dressings for this purpose. Finally, it discusses the potential future advancements in hydrogel materials within the realm of wound healing.

Functionally multifaceted alginate/curdlan/agarose-based bilayer fibro-porous dressings for addressing full-thickness diabetic wounds

Full-thickness diabetic wounds are chronic injuries characterized by bleeding, excessive exude, and prolonged inflammation. Single-layer dressings fail to address their disturbed pathophysiology. Therefore, bilayer dressings with structural and compositional differences in each layer have gained attention. We hypothesized that natural polymer (alginate, curdlan, and agarose) based bilayer dressings with inherent healing properties could effectively resolve these issues. Hence, bilayer dressings were fabricated by electrospinning curdlan/agarose/ polyvinyl alcohol blend (top layer) on an alginate/agarose/polyvinyl alcohol-based lyophilized porous (bottom) layer. Ciprofloxacin was incorporated in both layers as a potential antibacterial drug. The bilayer dressing exhibited high swelling (~1300 %), biocompatibility (>90 % with NIH 3T3 and L929 mouse fibroblasts), and hemocompatibility (hemolysis <5 %). In vitro, scratch assay revealed a faster wound closure (~ 95-100 %) than control. Inhibition zone assay revealed antibacterial activity against Staphylococcus aureus and Escherichia coli. Real-time (in vitro) gene expression experiments performed using human THP-1 macrophages exhibited a significant increase in anti-inflammatory cytokines (4.51 fold in IL-10) and a decrease in pro-inflammatory cytokines (1.42 fold in IL-6) in comparison to lipopolysaccharide. Thus, fabricated dressings with high swelling, hemostatic, immunomodulatory, and antibacterial characteristics can serve as potential multifunctional and sustainable templates for healing full-thickness diabetic wounds.

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.

Cellulose Acetate-Based Wound Dressings Loaded with Bioactive Agents: Potential Scaffolds for Wound Dressing and Skin Regeneration

Wound healing and skin regeneration are major challenges in chronic wounds. Among the types of wound dressing products currently available in the market, each wound dressing material is designed for a specific wound type. Some of these products suffer from various shortcomings, such as poor antibacterial efficacy and mechanical performance, inability to provide a moist environment, poor permeability to oxygen and capability to induce cell migration and proliferation during the wound healing process. Hydrogels and nanofibers are widely reported wound dressings that have demonstrated promising capability to overcome these shortcomings. Cellulose acetate is a semisynthetic polymer that has attracted great attention in the fabrication of hydrogels and nanofibers. Loading bioactive agents such as antibiotics, essential oils, metallic nanoparticles, plant extracts, and honey into cellulose acetate-based nanofibers and hydrogels enhanced their biological effects, including antibacterial, antioxidant, and wound healing. This review reports cellulose acetate-based hydrogels and nanofibers loaded with bioactive agents for wound dressing and skin regeneration.

Functional hydrogel-based wound dressings: A review on biocompatibility and therapeutic efficacy

Chronic wounds, burns, and surgical incisions represent critical healthcare challenges that significantly impact patient quality of life and strain healthcare resources. In response to these pressing needs, the field of wound healing has witnessed a radical advancement with the emergence of functional hydrogel-based dressings. This review article underscores the severity and importance of this transformative study in the domain of wound healing. The hydrogel matrix offers a moist and supportive environment that facilitates cellular migration, proliferation, and tissue regeneration, vital for efficient wound closure. Their conformable nature ensures patient comfort, reducing pain and uneasiness during dressing changes, particularly in chronic wounds where frequent interventions are required. Beyond their structural merits, functional hydrogel dressings possess the capability of incorporating bioactive molecules such as growth factors and antimicrobial agents. This facilitates targeted and sustained delivery of therapeutics directly to the wound site, addressing the multifactorial nature of chronic wounds and enhancing the healing trajectory. The integration of advanced nanotechnology has propelled the design of hydrogel dressings with enhanced mechanical strength and controlled drug release profiles, amplifying their therapeutic potential. In conclusion, the significance of this study lies in its ability to revolutionize wound healing practices and positively impact the lives of countless individuals suffering from chronic wounds and burns. As this transformative technology gains momentum, it holds the promise of addressing a major healthcare burden worldwide, thus heralding a new era in wound care management.

Using 1,8-cineole plasma with both pulsed and continuous depositions to modify commercially available wound dressing materials

The current clinical standards for infected chronic wounds are oral and topical antibiotics. These strategies are problematic because antibiotic resistance can occur with prolonged use. As an alternative to clinical methods, essential oils show promise in preventing bacterial growth. Specifically, 1,8-cineole-an active component in eucalyptus oil-exhibits antifungal, anti-inflammatory, and antibacterial properties. Applying 1,8-cineole directly onto a wound is challenging, however, due to its volatile nature. To combat this issue, plasma-enhanced chemical vapor deposition (PECVD) has been established as a method to deposit a stable 1,8-cineole-derived film on model surfaces (e.g., glass and electrospun polystyrene nanofibers). The current study represents an extension of previous work, where both pulsed and continuous 1,8-cineole plasmas were used to deposit a 1,8-cineole-derived film on two commercially available wound dressings. Three surface analyses were conducted to characterize the plasma-modified dressings. First, water contact angle goniometry data demonstrated a decrease in hydrofiber wettability after treatment. Through scanning electron spectroscopy, the surface morphology of both materials did not change upon treatment. When comparing pulsed and continuous treatments, deconvolution of high-resolution C1s x-ray photoelectron spectra showed no differences in functional group retention. Importantly, the chemical compositions of treated wound dressings were different compared to untreated materials. Overall, this work seeks to elucidate how different PECVD parameters affect the surface properties of wound dressings. Understanding these parameters represents a key step toward developing alternative chronic wound therapies.

Design and characterization of adipose-derived mesenchymal stem cell loaded alginate/pullulan/hyaluronic acid hydrogel scaffold for wound healing applications

Recently, significant attention has been focused on the progression of skin equivalents to facilitate faster wound healing and thereby skin restoration. The main aim of this study was the design and characterization of a novel polysaccharide-based hydrogel scaffold by using alginate, pullulan, and hyaluronic acid polymers to provide an appropriate microenvironment to deliver Adipose-derived mesenchymal Stem Cells (ASC) in order to promote wound healing in an animal model. Characterization of synthesized hydrogel was done by using a field emission scanning electron microscope (FE-SEM), Fourier Transform-Infrared spectroscopy (FT-IR), and Differential Scanning Calorimetry (DSC). Also, contact angle analysis, the swelling and mechanical tests were performed. As a result of in vitro studies, cells can be attached, alive, and migrate through the prepared hydrogel scaffold. Finally, the therapeutic effect of the cell-seeded hydrogels was tested in the full-thickness animal wound model. Based on obtained results, the hydrogel-ASC treatment improved the healing process and accelerated wound closure.

The effect of silicon groups on the physicochemical property and bioactivity of L-phenylalanine derived poly(amide-imide)

Poly(amide-imide) (PAI), serving as a synthetic polymer, has been widely used in industry for excellent mechanical properties, chemical resistance and high thermal stability. However, lack of suitable cell niche and biological activity limited the further application of PAI in biomedical engineering. Herein, silicon modified L-phenylalanine derived poly(amide-imide) (PAIS) was synthesized by introducing silica to L-phenylalanine derived PAI to improve physicochemical and biological performances. The influence of silicon amount on physicochemical, immune, and angiogenic performances of PAIS were systemically studied. The results show that PAIS exerts excellent hydrophilic, mechanical, biological activity. PAIS shows no effects on the number of macrophages, but can regulate macrophage polarization and angiogenesis in a dose-dependent manner. This study advanced our understanding of silicon modification in PAI can modulate cell responses via initiating silicon concentration regulation. The acquired knowledge will provide a new strategy to design and optimize biomedical PAI in the future.

Cyclodextrin regulated natural polysaccharide hydrogels for biomedical applications-a review

Cyclodextrin and its derivative (CDs) are natural building blocks for linking with other components to afford functional biomaterials. Hydrogels are polymer network systems that can form hydrophilic three-dimensional network structures through different cross-linking methods and are developing as potential materials in biomedical applications. Natural polysaccharide hydrogels (NPHs) are widely adopted in biomedical field with good biocompatibility, biodegradability, low cytotoxicity, and versatility in emulating natural tissue properties. Compared with conventional NPHs, CD regulated natural polysaccharide hydrogels (CD-NPHs) maintain good biocompatibility, while improving poor mechanical qualities and unpredictable gelation times. Recently, there has been increasing and considerable usage of CD-NPHs while there is still no review comprehensively introducing their construction, classification, and application of these hydrogels from the material point of view regarding biomedical fields. To draw a complete picture of the current and future development of CD-NPHs, we systematically overview the classification of CD-NPHs, and provide a holistic view on the role of CD-NPHs in different biomedical fields, especially in drug delivery, wound dressing, cell encapsulation, and tissue engineering. Moreover, the current challenges and prospects of CD-NPHs are discussed rationally, providing an insight into developing vibrant fields of CD-NPHs-based biomedicine, and facilitating their translation from bench to clinical medicine.

Gellan Gum in Wound Dressing Scaffolds

Several factors, such as bacterial infections, underlying conditions, malnutrition, obesity, ageing, and smoking are the most common issues that cause a delayed process of wound healing. Developing wound dressings that promote an accelerated wound healing process and skin regeneration is crucial. The properties of wound dressings that make them suitable for the acceleration of the wound healing process include good antibacterial efficacy, excellent biocompatibility, and non-toxicity, the ability to provide a moist environment, stimulating cell migration and adhesion, and providing gaseous permeation. Biopolymers have demonstrated features appropriate for the development of effective wound dressing scaffolds. Gellan gum is one of the biopolymers that has attracted great attention in biomedical applications. The wound dressing materials fabricated from gellan gum possess outstanding properties when compared to traditional dressings, such as good biocompatibility, biodegradability, non-toxicity, renewability, and stable nature. This biopolymer has been broadly employed for the development of wound dressing scaffolds in different forms. This review discusses the physicochemical and biological properties of gellan gum-based scaffolds in the management of wounds.

Dual Crosslinked Ion-Based Bacterial Cellulose Composite Hydrogel Containing Polyhexamethylene Biguanide

Composite bacterial cellulose (BC) based hydrogel with alginate (A) or pectin (P) or alginate and pectin was fabricated via a physical crosslinking technique using calcium chloride (CaCl₂) solution and incorporated with polyhexamethylene biguanide (PHMB) as an effective antimicrobial drug by immersion method. After that, the physicochemical properties of all hydrogel formulations were characterized. The result showed that the formulations with PHMB performed better physicochemical properties than the hydrogel without PHMB. Fourier transform infrared spectroscopy (FT-IR) showed the interaction between PHMB and the carboxylic group of alginate and pectin. BC/A-PHMB hydrogel performed suitable mechanical strength, fluid uptake ability, water retention property, drug content, high integrity value, and maximum swelling degree. Moreover, in vitro cell viability of BC/A-PHMB hydrogel revealed high biocompatibility with human keratinocyte cell line (HaCaT) and demonstrated prolong released of PHMB in Tris-HCl buffer pH 7.4, while rapid release in phosphate buffer saline pH 7.4. BC/A-PHMB hydrogel demonstrated good anti-bacterial activity against S. aureus and P. aeruginosa. In conclusion, BC/A-PHMB hydrogel could be a potential dual crosslinked ion-based hydrogel for wound dressing with anti-bacterial activity.

Multifunctional and Smart Wound Dressings—A Review on Recent Research Advancements in Skin Regenerative Medicine

The healing of wounds is a dynamic function that necessitates coordination among multiple cell types and an optimal extracellular milieu. Much of the research focused on finding new techniques to improve and manage dermal injuries, chronic injuries, burn injuries, and sepsis, which are frequent medical concerns. A new research strategy involves developing multifunctional dressings to aid innate healing and combat numerous issues that trouble incompletely healed injuries, such as extreme inflammation, ischemic damage, scarring, and wound infection. Natural origin-based compounds offer distinct characteristics, such as excellent biocompatibility, cost-effectiveness, and low toxicity. Researchers have developed biopolymer-based wound dressings with drugs, biomacromolecules, and cells that are cytocompatible, hemostatic, initiate skin rejuvenation and rapid healing, and possess anti-inflammatory and antimicrobial activity. The main goal would be to mimic characteristics of fetal tissue regeneration in the adult healing phase, including complete hair and glandular restoration without delay or scarring. Emerging treatments based on biomaterials, nanoparticles, and biomimetic proteases have the keys to improving wound care and will be a vital addition to the therapeutic toolkit for slow-healing wounds. This study focuses on recent discoveries of several dressings that have undergone extensive pre-clinical development or are now undergoing fundamental research.

Evaluation of Melia azedarach extract-loaded poly (vinyl alcohol)/pectin hydrogel for burn wound healing

Background

In this study, a hydrogel comprising poly (vinyl alcohol)/pectin (PVA/PET) was prepared by the addition of Melia azedarach extract for epithelial restoration. M. azedarach extract (MAE) contains volatile organic plant-derived compounds with antimicrobial properties. MAE has a variety of physiological properties, including antimicrobial, insecticidal, and anti-inflammatory activity. This study aimed to investigate whether MAE-loaded PVA/PET hydrogels have protective effects against burn wound healing.

Methods and findings

To mix M. azedarach with the gel, nanoparticles containing M. azedarach were prepared using chitosan/maltodextrin as the wall material. A PVA/PET hydrogel containing M. azedarach was developed and its applicability as a wound dressing was evaluated. In the in vitro scratch assay, MAE treatment showed a scratch recovery-promoting effect comparable to that of the positive control TGF-β1. The MAE-PVA/PET hydrogel was found to be non-toxic, and the antibacterial activity of the hydrogel was excellent against both gram-positive and gram-negative bacteria. Furthermore, as the formulated hydrogel demonstrated strong antimicrobial activity, its wound-healing efficacy was investigated in vivo using a rat model.

Conclusion

MAE was found to be effective against burn wounds and to have antimicrobial activity in vitro and in vivo.

Application of chitosan nanoparticles in skin wound healing

The rising prevalence of impaired wound healing and the consequential healthcare burdens have gained increased attention over recent years. This has prompted research into the development of novel wound dressings with augmented wound healing functions. Nanoparticle (NP)-based delivery systems have become attractive candidates in constructing such wound dressings due to their various favourable attributes. The non-toxicity, biocompatibility and bioactivity of chitosan (CS)-based NPs make them ideal candidates for wound applications. This review focusses on the application of CS-based NP systems for use in wound treatment. An overview of the wound healing process was presented, followed by discussion on the properties and suitability of CS and its NPs in wound healing. The wound healing mechanisms exerted by CS-based NPs were then critically analysed and discussed in sections, namely haemostasis, infection prevention, inflammatory response, oxidative stress, angiogenesis, collagen deposition, and wound closure time. The results of the studies were thoroughly reviewed, and contradicting findings were identified and discussed. Based on the literature, the gap in research and future prospects in this research area were identified and highlighted. Current evidence shows that CS-based NPs possess superior wound healing effects either used on their own, or as drug delivery vehicles to encapsulate wound healing agents. It is concluded that great opportunities and potentials exist surrounding the use of CSNPs in wound healing.

Collagen-Based Nanofibers for Skin Regeneration and Wound Dressing Applications

Skin regeneration after an injury is very vital, but this process can be impeded by several factors. Regenerative medicine is a developing biomedical field with the potential to decrease the need for an organ transplant. Wound management is challenging, particularly for chronic injuries, despite the availability of various types of wound dressing scaffolds in the market. Some of the wound dressings that are in clinical practice have various drawbacks such as poor antibacterial and antioxidant efficacy, poor mechanical properties, inability to absorb excess wound exudates, require frequent change of dressing and fails to offer a suitable moist environment to accelerate the wound healing process. Collagen is a biopolymer and a major constituent of the extracellular matrix (ECM), making it an interesting polymer for the development of wound dressings. Collagen-based nanofibers have demonstrated interesting properties that are advantageous both in the arena of skin regeneration and wound dressings, such as low antigenicity, good biocompatibility, hemostatic properties, capability to promote cellular proliferation and adhesion, and non-toxicity. Hence, this review will discuss the outcomes of collagen-based nanofibers reported from the series of preclinical trials of skin regeneration and wound healing.

An Overview of Cellulose Derivatives-Based Dressings for Wound-Healing Management

Presently, notwithstanding the progress regarding wound-healing management, the treatment of the majority of skin lesions still represents a serious challenge for biomedical and pharmaceutical industries. Thus, the attention of the researchers has turned to the development of novel materials based on cellulose derivatives. Cellulose derivatives are semi-synthetic biopolymers, which exhibit high solubility in water and represent an advantageous alternative to water-insoluble cellulose. These biopolymers possess excellent properties, such as biocompatibility, biodegradability, sustainability, non-toxicity, non-immunogenicity, thermo-gelling behavior, mechanical strength, abundance, low costs, antibacterial effect, and high hydrophilicity. They have an efficient ability to absorb and retain a large quantity of wound exudates in the interstitial sites of their networks and can maintain optimal local moisture. Cellulose derivatives also represent a proper scaffold to incorporate various bioactive agents with beneficial therapeutic effects on skin tissue restoration. Due to these suitable and versatile characteristics, cellulose derivatives are attractive and captivating materials for wound-healing applications. This review presents an extensive overview of recent research regarding promising cellulose derivatives-based materials for the development of multiple biomedical and pharmaceutical applications, such as wound dressings, drug delivery devices, and tissue engineering.

Composite Polyurethane-Polylactide (PUR/PLA) Flexible Filaments for 3D Fused Filament Fabrication (FFF) of Antibacterial Wound Dressings for Skin Regeneration

This paper addresses the potential application of flexible thermoplastic polyurethane (TPU) and poly(lactic acid) (PLA) compositions as a material for the production of antibacterial wound dressings using the Fused Filament Fabrication (FFF) 3D printing method. On the market, there are medical-grade polyurethane filaments available, but few of them have properties required for the fabrication of wound dressings, such as flexibility and antibacterial effects. Thus, research aimed at the production, characterization and modification of filaments based on different TPU/PLA compositions was conducted. The combination of mechanical (tensile, hardness), structural (FTIR), microscopic (optical and SEM), degradation (2 M HCl, 5 M NaOH, and 0.1 M CoCl₂ in 20% H₂O₂) and printability analysis allowed us to select the most promising composition for further antibacterial modification (COMP-7,5PLA). The thermal stability of the chosen antibiotic—amikacin—was tested using processing temperature and HPLC. Two routes were used for the antibacterial modification of the selected filament—post-processing modification (AMI-1) and modification during processing (AMI-2). The antibacterial activity and amikacin release profiles were studied. The postprocessing modification method turned out to be superior and suitable for wound dressing fabrication due to its proven antimicrobial activity against E. coli, P. fluorescens, S. aureus and S. epidermidis bacteria.