Development of reduced graphene oxide (rGO)-isabgol nanocomposite dressings for enhanced vascularization and accelerated wound healing in normal and diabetic rats

Lauric acid-loaded biomimetic, biocompatible, and antioxidant jelly fig (Ficus awkeotsang Makino) pectin hydrogel accelerates wound healing in diabetic rats

Herein, we have presented a lauric acid (LA)-loaded jelly fig pectin (JFP)-based biocompatible hydrogel, which possesses strong antioxidant and antibacterial properties to treat diabetic wounds. The antioxidant and antibacterial activity of the JFP + LA hydrogels were beneficial in eliminating the reactive oxygen species (ROS) and bacterial infection in the wound bed, thereby protecting the wound surface and accelerating the tissue repair process. The in vivo diabetic wound healing studies demonstrated that applying JFP + LA hydrogels improved the rate of wound contraction and reduced the epithelialization time significantly. The epithelialization period of the control, JFP, JFP + LA 0.5 %, and JFP + LA 1 % hydrogels were 28 ± 1.5 days, 24 ± 1 days, 18.5 ± 1 days, and 19 ± 1 days, respectively. JFP also enhanced the neovascularization and collagen synthesis during wound healing. The incorporation of LA reduced the inflammation and helped recruit macrophages to proceed to other phases of wound healing in rats treated with JFP + LA hydrogels. The results presented provide insight into the clinical management of infected diabetic wounds. Overall, the results demonstrated that the JFP + LA hydrogels were an inexpensive dressing material that accelerated the healing of diabetic wounds.

Therapeutic Properties of M2 Macrophages in Chronic Wounds: An Innovative Area of Biomaterial-Assisted M2 Macrophage Targeted Therapy

Wound healing is a dynamic, multi-stage process essential for restoring skin integrity. Dysregulated wound healing is often linked to impaired macrophage function, particularly in individuals with chronic underlying conditions. Macrophages, as key regulators of wound healing, exhibit significant phenotypic diversity, ranging from the pro-healing M2 phenotype to the pro-inflammatory M1 phenotype. Imbalances in the M1/M2 ratio or hyperactivation of the M1 phenotype can delay the normal healing. Consequently, strategies aimed at suppressing the M1 phenotype or promoting the shift of local skin macrophages toward the M2 phenotype can potentially treat chronic non-healing wounds. This manuscript provides an overview of macrophages' role in normal and pathological wound-healing processes. It examines various therapeutic approaches targeting M2 macrophages, such as ex vivo-activated macrophage therapy, immunopharmacological strategies, and biomaterial-directed macrophage polarization. However, it also highlights that M2 macrophage therapies and immunopharmacological interventions may have drawbacks, including rapid phenotypic changes, adverse effects on other skin cells, biotoxicity, and concerns related to biocompatibility, stability, and drug degradation. Therefore, there is a need for more targeted macrophage-based therapies that ensure optimal biosafety, allowing for effective reprogramming of dysregulated macrophages and improved therapeutic outcomes. Recent advances in nano-biomaterials have demonstrated promising regenerative potential compared to traditional treatments. This review discusses the progress of biomaterial-assisted macrophage targeting in chronic wound repair and addresses the challenges faced in its clinical application. Additionally, it explores novel design concepts for combinational therapies, such as incorporating regenerative particles like exosomes into dressing materials or encapsulating them in microneedling systems to enhance wound healing rates.

Fabrication of Thymol-loaded Isabgol/Konjac Glucomannan-based Microporous Scaffolds with Enriched Antioxidant and Antibacterial Properties for Skin Tissue Engineering Applications

An antioxidant, antibacterial, and biocompatible biomaterial is essential to repair skin wounds effectively. Here, we have employed two natural biopolymers, isabgol (ISAB) and konjac glucomannan (KGM), to prepare microporous scaffolds by freezing and lyophilization. The scaffolds are loaded with thymol (THY) to impart potent antioxidant and antibacterial activities. The physicochemical properties of the ISAB+KGM+THY scaffold, like porosity (41.8±2.4 %), swelling, and biodegradation, were optimal for tissue regeneration application. Compared to the control, ISAB+KGM+THY scaffolds promote attachment, migration, and proliferation of L929 fibroblasts. The antioxidant activity of the ISAB+KGM+THY scaffold was significantly improved after loading THY. This would protect the tissues from oxidative damage. The antibacterial activity of the ISAB+KGM+THY scaffold was significantly higher than that of the control, which would help prevent bacterial infection. The vascularization ability of the ISAB+KGM scaffold was not altered by incorporating THY in the ISAB+KGM scaffold. Therefore, a strong antioxidant, antibacterial, and biocompatible nature of the ISAB+KGM+THY scaffold could be useful for various biomedical applications.

Two-dimensional nanomaterials: A multifunctional approach for robust for diabetic wound repair

Diabetic wounds pose a clinical challenge due to persistent inflammation, severe bacterial infections, inadequate vascularization, and pronounced oxidative stress. Current therapeutic modalities fail to provide satisfactory outcomes in managing these conditions, resulting in considerable patient distress. Two-dimensional nanomaterials (2DNMs), characterized by their unique nanosheet structures, expansive surface areas, and remarkable physicochemical properties, have garnered considerable attention for their potential in therapeutic applications. Emerging 2DNMs can be loaded with various pharmacological agents, including small molecules, metal ions, and liposomes. Moreover, they can be integrated with various biomaterials such as hydrogels, microneedles, and microspheres, thus demonstrating unprecedented advantages in expediting the healing process of diabetic wounds. Moreover, 2DNMs exhibit exceptional performance characteristics, including high biocompatibility, effective antimicrobial properties, optimal phototherapeutic effects, and enhanced electrostimulation capabilities. These properties enable them to modulate the wound microenvironment, leading to widespread application in tissue repair with remarkable outcomes. This review delineates several emerging 2DNMs, such as graphene and its derivatives, black phosphorus, MXenes, and transition metal dichalcogenides, in the context of diabetic wound repair. Furthermore, it elucidates the translational challenges and future perspectives of 2DNMs in wound healing treatments. Overall, 2DNMs present a highly promising strategy for ameliorating diabetic wounds, thus providing novel avenues for diagnostic and therapeutic strategies in diabetic wound management.

l-Arginine-Loaded Oxidized Isabgol/Chitosan-Based Biomimetic Composite Scaffold Accelerates Collagen Synthesis, Vascularization, and Re-epithelialization during Wound Healing in Diabetic Rats

Impaired wound healing in diabetic wounds is common due to infection, inflammation, less collagen synthesis, and vascularization. Diabetic wound healing in patients is still a challenge and needs an ideal wound dressing to treat and manage diabetic wounds. Herein, an efficacious wound dressing biomaterial was fabricated by cross-linking oxidized isabgol (Oisab) and chitosan (Cs) via trisodium trimetaphosphate and Schiff base bonds. l-Arginine (l-Arg) was incorporated as a bioactive substance in the Oisab + Cs scaffold to promote cell adhesion, cell proliferation, collagen synthesis, and vascularization. The fabricated scaffolds showed microporous networks in the scanning electron microscopy analysis. The scaffold also possessed excellent hemocompatibility. In vitro studies using fibroblasts (L929 and human dermal fibroblast cells) confirmed the cytocompatibility of these scaffolds. The results of the in vivo chicken chorioallantoic membrane assay confirmed the proangiogenic activity of the Oisab + Cs + l-Arg scaffolds. The wound-healing potential of these scaffolds was studied in streptozotocin-induced diabetic rats. This in vivo study showed that the period of epithelialization in the Oisab + Cs + l-Arg scaffold-treated wounds was 21.67 ± 1.6 days, which was significantly faster than the control (30.33 ± 2.5 days). Histological and immunohistochemical studies showed that the Oisab + Cs + l-Arg scaffolds significantly accelerated the rate of wound contraction by reducing inflammation, improving collagen synthesis, and promoting neovascularization. These findings suggest that the Oisab + Cs + l-Arg scaffolds could be beneficial in treating diabetic wounds in clinical applications.

Advances in nucleic acid delivery strategies for diabetic wound therapy

In recent years, the prevalence of diabetic wounds has significantly increased, posing a substantial medical challenge due to their propensity for infection and delayed healing. These wounds not only increase mortality rates but also lead to amputations and severe mobility issues. To address this, advancements in bioactive molecules such as genes, growth factors, proteins, peptides, stem cells, and exosomes into targeted gene therapies have emerged as a preferred strategy among researchers. Additionally, the integration of photothermal therapy (PTT), nucleic acid, and gene therapy, along with 3D printing technology and the layer-by-layer (LBL) self-assembly approach, shows promise in diabetic wound treatment. Effective delivery of small interfering RNA (siRNA) relies on gene vectors. This review provides an in-depth exploration of the pathophysiological characteristics observed in diabetic wounds, encompassing diminished angiogenesis, heightened levels of reactive oxygen species, and impaired immune function. It further examines advancements in nucleic acid delivery, targeted gene therapy, advanced drug delivery systems, layer-by-layer (LBL) techniques, negative pressure wound therapy (NPWT), 3D printing, hyperbaric oxygen therapy, and ongoing clinical trials. Through the integration of recent research insights, this review presents innovative strategies aimed at augmenting the multifaceted management of diabetic wounds, thus paving the way for enhanced therapeutic outcomes in the future.

Teicoplanin-Decorated Reduced Graphene Oxide Incorporated Silk Protein Hybrid Hydrogel for Accelerating Infectious Diabetic Wound Healing and Preventing Diabetic Foot Osteomyelitis

Developing hybrid hydrogel dressings with anti-inflammatory, antioxidant, angiogenetic, and antibiofilm activities with higher bone tissue penetrability to accelerate diabetic wound healing and prevent diabetic foot osteomyelitis (DFO) is highly desirable in managing diabetic wounds. Herein, the glycopeptide teicoplanin is used for the first time as a green reductant to chemically reduce graphene oxide (GO). The resulting teicoplanin-decorated reduced graphene oxide (rGO) is incorporated into a mixture of silk proteins (SP) and crosslinked with genipin to yield a physicochemically crosslinked rGO-SP hybrid hydrogel. This hybrid hydrogel exhibits high porosity, self-healing, shear-induced thinning, increased cell proliferation and migration, and mechanical properties suitable for tissue engineering. Moreover, the hybrid hydrogel eradicates bacterial biofilms with a high penetrability index in agar and hydroxyapatite disks covered with biofilms, mimicking bone tissue. In vivo, the hybrid hydrogel accelerates the healing of noninfected wounds in a diabetic rat and infected wounds in a diabetic mouse by upregulating anti-inflammatory cytokines and downregulating matrix metalloproteinase-9, promoting M2 macrophage polarization and angiogenesis. The implantation of hybrid hydrogel into the infected site of mouse tibia improves bone regeneration. Hence, the rGO-SP hybrid hydrogel can be a promising wound dressing for treating infectious diabetic wounds, providing a further advantage in preventing DFO.

Advances in graphene-based 2D materials for tendon, nerve, bone/cartilage regeneration and biomedicine

Two-dimensional (2D) materials, especially graphene-based materials, have important implications for tissue regeneration and biomedicine due to their large surface area, transport properties, ease of functionalization, biocompatibility, and adsorption capacity. Despite remarkable progress in the field of tissue regeneration and biomedicine, there are still problems such as unclear long-term stability, lack of in vivo experimental data, and detection accuracy. This paper reviews recent applications of graphene-based materials in tissue regeneration and biomedicine and discusses current issues and prospects for the development of graphene-based materials with respect to promoting the regeneration of tendons, neuronal cells, bone, chondrocytes, blood vessels, and skin, as well as applications in sensing, detection, anti-microbial activity, and targeted drug delivery.

Exploring the biocompatibility and healing activity of actinobacterial-enhanced reduced nano-graphene oxide in in vitro and in vivo model and induce bone regeneration through modulation of OPG/RANKL/RUNX2/ALP pathways

BACKGROUND

The development of cost-effective, simple, environment-friendly biographene is an area of interest. To accomplish environmentally safe, benign culturing that has advantages over other methods to reduce the graphene oxide (GO), extracellular metabolites from actinobacteria associated with mushrooms were used for the first time.

METHODS

Bactericidal effect of GO against methicillin-resistant Staphylococcus aureus, antioxidant activity, and hydroxyapatite-like bone layer formation, gene expression analysis and appropriate biodegradation of the microbe-mediated synthesis of graphene was studied.

RESULTS

Isolated extracellular contents Streptomyces achromogenes sub sp rubradiris reduced nano-GO to graphene (rGO), which was further examined by spectrometry and suggested an efficient conversion and significant reduction in the intensity of all oxygen-containing moieties and shifted crystalline peaks. Electron microscopic results also suggested the reduction of GO layer. In addition, absence of significant toxicity in MG-63 cell line, intentional free radical scavenging prowess, liver and kidney histopathology, and Wistar rat bone regeneration through modulation of OPG/RANKL/RUNX2/ALP pathways show the feasibility of the prepared nano GO.

CONCLUSIONS

The study demonstrates the successful synthesis of biographene from actinobacterial extracellular metabolites, its potential biomedical applications, and its promising role in addressing health and environmental concerns.

Advancements in 3D-printable polysaccharides, proteins, and synthetic polymers for wound dressing and skin scaffolding - A review

This review investigates the most recent advances in personalized 3D-printed wound dressings and skin scaffolding. Skin is the largest and most vulnerable organ in the human body. The human body has natural mechanisms to restore damaged skin through several overlapping stages. However, the natural wound healing process can be rendered insufficient due to severe wounds or disturbances in the healing process. Wound dressings are crucial in providing a protective barrier against the external environment, accelerating healing. Although used for many years, conventional wound dressings are neither tailored to individual circumstances nor specific to wound conditions. To address the shortcomings of conventional dressings, skin scaffolding can be used for skin regeneration and wound healing. This review thoroughly investigates polysaccharides (e.g., chitosan, Hyaluronic acid (HA)), proteins (e.g., collagen, silk), synthetic polymers (e.g., Polycaprolactone (PCL), Poly lactide-co-glycolic acid (PLGA), Polylactic acid (PLA)), as well as nanocomposites (e.g., silver nano particles and clay materials) for wound healing applications and successfully 3D printed wound dressings. It discusses the importance of combining various biomaterials to enhance their beneficial characteristics and mitigate their drawbacks. Different 3D printing fabrication techniques used in developing personalized wound dressings are reviewed, highlighting the advantages and limitations of each method. This paper emphasizes the exceptional versatility of 3D printing techniques in advancing wound healing treatments. Finally, the review provides recommendations and future directions for further research in wound dressings.

Graphene in 3D Bioprinting

Three-dimensional (3D) bioprinting is a fast prototyping fabrication approach that allows the development of new implants for tissue restoration. Although various materials have been utilized for this process, they lack mechanical, electrical, chemical, and biological properties. To overcome those limitations, graphene-based materials demonstrate unique mechanical and electrical properties, morphology, and impermeability, making them excellent candidates for 3D bioprinting. This review summarizes the latest developments in graphene-based materials in 3D printing and their application in tissue engineering and regenerative medicine. Over the years, different 3D printing approaches have utilized graphene-based materials, such as graphene, graphene oxide (GO), reduced GO (rGO), and functional GO (fGO). This process involves controlling multiple factors, such as graphene dispersion, viscosity, and post-curing, which impact the properties of the 3D-printed graphene-based constructs. To this end, those materials combined with 3D printing approaches have demonstrated prominent regeneration potential for bone, neural, cardiac, and skin tissues. Overall, graphene in 3D bioprinting may pave the way for new regenerative strategies with translational implications in orthopedics, neurology, and cardiovascular areas.

Development of nanocomposites based on chitosan/reduced graphene oxide for wound healing application

Nanocomposites containing different effective materials have various effects, such as antioxidant, and anti-inflammatory activity, which are desirable for wound dressing. Herein, nanocomposites based on chitosan/reduced graphene oxide (CS/rGO) containing curcumin (CS/rGO/Cur), curcumin and papain (CS/rGO/Cur/Pa), curcumin, papain, and collagen peptide (CS/rGO/CP/Cur/Pa), prepared using ionic gelation method and characterized by Fourier Transform Infrared (FTIR), Differential Light Scattering (DLS), X-ray diffraction (XRD), and Scanning Electron Microscope (SEM). Subsequently, the nanocomposite's potential for wound healing was studied through parameters such as porosity, swelling, degradability, anti-inflammatory, antioxidant, antibacterial, cell viability, and in-vivo. The results of FTIR, XRD, SEM, and DLS showed that the nanocomposites synthesized properly with an almost spherical morphology, an average diameter of below 100 nm (mostly 40-85 nm), and a hydrodynamic diameter of 455-616 nm. The various tests demonstrated the nanocomposite's effectiveness in wound healing. The results showed that CS/rGO/CP/Cur/Pa increased the anti-inflammatory and cell viability up to 99.7 % and 395 %, respectively, which is higher than others. Animal tests on rats showed that CS/rGO/CP/Cur/Pa accelerated the wound healing rate up to 70 %. In conclusion, the results showed that the nanocomposites based on CS/rGO significantly improve wound healing, and the presence of collagen peptides boost their wound healing potency.

Urethral Microenvironment Adapted Sodium Alginate/Gelatin/Reduced Graphene Oxide Biomimetic Patch Improves Scarless Urethral Regeneration

The nasty urine microenvironment (UME) is an inherent obstacle that hinders urethral repair due to fibrosis and swelling of the oftentimes adopted hydrogel-based biomaterials. Here, using reduced graphene oxide (rGO) along with double-freeze-drying to strengthen a 3D-printed patch is reported to realize scarless urethral repair. The sodium alginate/gelatin/reduced graphene oxide (SA/Gel/rGO) biomaterial features tunable stiffness, degradation profile, and anti-fibrosis performance. Interestingly, the 3D-printed alginate-containing composite scaffold is able to respond to Ca2+ present in the urine, leading to enhanced structural stability and strength as well as inhibiting swelling. The investigations present that the swelling behaviors, mechanical properties, and anti-fibrosis efficacy of the SA/Gel/rGO patch can be modulated by varying the concentration of rGO. In particular, rGO in optimal concentration shows excellent cell viability, migration, and proliferation. In-depth mechanistic studies reveal that the activation of cell proliferation and angiogenesis-related proteins, along with inhibition of fibrosis-related gene expressions, play an important role in scarless repair by the 3D-printed SA/Gel/rGO patch via promoting urothelium growth, accelerating angiogenesis, and minimizing fibrosis in vivo. The proposed strategy has the potential of resolving the dilemma of necessary biomaterial stiffness and unwanted fibrosis in urethral repair.

Procedural Promotion of Multiple Stages in the Wound Healing Process by Graphene-Spiky Silica Heterostructured Nanoparticles

Background

Multiple stages including hemostasis, inflammation, proliferation, and remodeling were involved in the wound healing process. The increase in nanomaterials in recent years has extended the scope of tools for wound healing; however, it is still difficult to achieve the four multistage procedures simultaneously.

Materials and Methods

In this study, graphene-spiky silica heterostructured nanoparticles (GS) were synthesized for the procedural acceleration of the multistage in wound healing process. The nanobridge effect of GS was analyzed through the adhesion of two skins, the antibacterial effect was assessed in Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus) bacteria, cell proliferation and migration were investigated in mouse embryonic fibroblast (NIH-3T3) cells, and the in vivo wound healing effect was examined in female BALB/c mice with a cutting wound and E. coli or S. aureus bacteria infection on the back.

Results

First, GS has a strong nanobridge effect on the rapid closure of wounds because the spiky architecture on the surface of GS facilitates the adhesion of skins, promoting the hemostasis stage. Second, graphene exhibits antimicrobial activities both in chemical and physical interactions, especially under simulated sunlight irradiation. Third, graphene plays an important role in scaffolding function, together with the spiky topographical architecture of GS, accelerating the proliferation and maturation stages.

Conclusion

By periodically promoting every stage of wound healing, GS combined with simulated sunlight irradiation could significantly accelerate wound healing. With a simple composition and compact structure but multiple functions, this strategy will be the guideline for the development of ideal wound-healing nanomaterials.

Reduced graphene oxide coated alginate scaffolds: potential for cardiac patch application

BACKGROUND

Cardiovascular diseases, particularly myocardial infarction (MI), are the leading cause of death worldwide and a major contributor to disability. Cardiac tissue engineering is a promising approach for preventing functional damage or improving cardiac function after MI. We aimed to introduce a novel electroactive cardiac patch based on reduced graphene oxide-coated alginate scaffolds due to the promising functional behavior of electroactive biomaterials to regulate cell proliferation, biocompatibility, and signal transition.

METHODS

The fabrication of novel electroactive cardiac patches based on alginate (ALG) coated with different concentrations of reduced graphene oxide (rGO) using sodium hydrosulfite is described here. The prepared scaffolds were thoroughly tested for their physicochemical properties and cytocompatibility. ALG-rGO scaffolds were also tested for their antimicrobial and antioxidant properties. Subcutaneous implantation in mice was used to evaluate the scaffolds' ability to induce angiogenesis.

RESULTS

The Young modulus of the scaffolds was increased by increasing the rGO concentration from 92 ± 4.51 kPa for ALG to 431 ± 4.89 kPa for ALG-rGO-4 (ALG coated with 0.3% w/v rGO). The scaffolds' tensile strength trended similarly. The electrical conductivity of coated scaffolds was calculated in the semi-conductive range (~ 10-4 S/m). Furthermore, when compared to ALG scaffolds, human umbilical vein endothelial cells (HUVECs) cultured on ALG-rGO scaffolds demonstrated improved cell viability and adhesion. Upregulation of VEGFR2 expression at both the mRNA and protein levels confirmed that rGO coating significantly boosted the angiogenic capability of ALG against HUVECs. OD620 assay and FE-SEM observation demonstrated the antibacterial properties of electroactive scaffolds against Escherichia coli, Staphylococcus aureus, and Streptococcus pyogenes. We also showed that the prepared samples possessed antioxidant activity using a 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging assay and UV-vis spectroscopy. Histological evaluations confirmed the enhanced vascularization properties of coated samples after subcutaneous implantation.

CONCLUSION

Our findings suggest that ALG-rGO is a promising scaffold for accelerating the repair of damaged heart tissue.

Exploring the bioactivity of reduced graphene oxide and TiO2 nanocomposite for the regenerative medicinal applications

Millions of people globally suffer from issues related to chronic wounds due to infection, burn, obesity, and diabetes. Nanocomposite with antibacterial and anti-inflammatory properties is a promising material to promote wound healing. This investigation primarily aims to synthesize reduced graphene oxide and titanium dioxide (rGO@TiO2) nanocomposite for wound healing applications. The rGO@TiO2 nanocomposite was synthesized by the one-step hydrothermal technique, and the physicochemical characterization of synthesized nanocomposite was performed by X-ray diffraction, Fourier transforms infrared spectroscopy, Raman spectroscopy, scanning electron microscopy, transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy, and dynamic light scattering. Further, the nanocomposite antibacterial, cytotoxicity, and wound-healing properties were analyzed by disc diffusion method, MTT assay, and in vitro scratch assay, respectively. Based on the TEM images, the average particle size of TiO2 nanoparticles was around 9.26 ± 1.83 nm. The characteristics peak of Ti-O-Ti bonds was observed between 500 and 850 cm-1 in the Fourier transforms infrared spectrum. The Raman spectrum of graphene oxide (GO) was obtained for bands D and G at 1354 cm-1 and at 1593 cm-1, respectively. This GO peak intensity was reduced in rGO, revealing the oxygen functional group reduction. Moreover, the rGO@TiO2 nanocomposite exhibited dose-dependent antibacterial properties against the positive and negative bacterium. The cytotoxicity for 5-100 µg/mL of rGO@TiO2 nanocomposite was above the half-maximal inhibitory concentration value. The in vitro scratch assay for rGO@TiO2 indicates that the nanocomposite promotes cell proliferation and migration. The nanocomposite recovered the wound within 48 h. The rGO@TiO2 nanocomposite shows potential materials for wound healing applications.

Graphene-Based Material-Mediated Immunomodulation in Tissue Engineering and Regeneration: Mechanism and Significance

Tissue engineering and regenerative medicine hold promise for improving or even restoring the function of damaged organs. Graphene-based materials (GBMs) have become a key player in biomaterials applied to tissue engineering and regenerative medicine. A series of cellular and molecular events, which affect the outcome of tissue regeneration, occur after GBMs are implanted into the body. The immunomodulatory function of GBMs is considered to be a key factor influencing tissue regeneration. This review introduces the applications of GBMs in bone, neural, skin, and cardiovascular tissue engineering, emphasizing that the immunomodulatory functions of GBMs significantly improve tissue regeneration. This review focuses on summarizing and discussing the mechanisms by which GBMs mediate the sequential regulation of the innate immune cell inflammatory response. During the process of tissue healing, multiple immune responses, such as the inflammatory response, foreign body reaction, tissue fibrosis, and biodegradation of GBMs, are interrelated and influential. We discuss the regulation of these immune responses by GBMs, as well as the immune cells and related immunomodulatory mechanisms involved. Finally, we summarize the limitations in the immunomodulatory strategies of GBMs and ideas for optimizing GBM applications in tissue engineering. This review demonstrates the significance and related mechanism of the immunomodulatory function of GBM application in tissue engineering; more importantly, it contributes insights into the design of GBMs to enhance wound healing and tissue regeneration in tissue engineering.

Enhanced diabetic wound healing using platelet-derived extracellular vesicles and reduced graphene oxide in polymer-coordinated hydrogels

Impaired wound healing is a significant complication of diabetes. Platelet-derived extracellular vesicles (pEVs), rich in growth factors and cytokines, show promise as a powerful biotherapy to modulate cellular proliferation, angiogenesis, immunomodulation, and inflammation. For practical home-based wound therapy, however, pEVs should be incorporated into wound bandages with careful attention to delivery strategies. In this work, a gelatin-alginate hydrogel (GelAlg) loaded with reduced graphene oxide (rGO) was fabricated, and its potential as a diabetic wound dressing was investigated. The GelAlg@rGO-pEV gel exhibited excellent mechanical stability and biocompatibility in vitro, with promising macrophage polarization and reactive oxygen species (ROS)-scavenging capability. In vitro cell migration experiments were complemented by in vivo investigations using a streptozotocin-induced diabetic rat wound model. When exposed to near-infrared light at 2 W cm- 2, the GelAlg@rGO-pEV hydrogel effectively decreased the expression of inflammatory biomarkers, regulated immune response, promoted angiogenesis, and enhanced diabetic wound healing. Interestingly, the GelAlg@rGO-pEV hydrogel also increased the expression of heat shock proteins involved in cellular protective pathways. These findings suggest that the engineered GelAlg@rGO-pEV hydrogel has the potential to serve as a wound dressing that can modulate immune responses, inflammation, angiogenesis, and follicle regeneration in diabetic wounds, potentially leading to accelerated healing of chronic wounds.

Rational design of antimicrobial peptide conjugated graphene-silver nanoparticle loaded chitosan wound dressing

Wound dressing with poor antibacterial properties, the tendency to adhere to the wound site, poor mechanical strength, and lack of porosity and flexibility are the major cause of blood loss, delayed wound repair, and sometimes causes death during the trauma or injury. In such cases, hydrogel-based antibacterial wound dressing would be a boon to the existing dressing as the moist environment will maintain the cooling temperate and proper exchange of atmosphere around the wound. In the present study, the multifunctional graphene with silver and ε-Poly-l-lysine reinforced into the chitosan matrix (CGAPL) was prepared as a nanobiocomposite wound dressing. The contact angle measurement depicted the hydrophilic property of CGAPL nanobiocomposite dressing (water contact angle 42°), while the mechanical property was 78.9 MPa. The antibacterial and cell infiltration study showed the antimicrobial property of CGAPL nanobiocomposite wound dressing. It also demonstrated no cytotoxicity to the L929 fibroblast cells. Chorioallantoic Membrane (CAM) assay showed the pro-angiogenic potential of CGAPL nanobiocomposite wound dressing. In-vitro scratch wound assay confirmed the migration of cells and increased cell adhesion and proliferation within 18 h of culture on the surface of CGAPL nanobiocomposite dressing. Later, the in-vivo study in the Wistar rat model showed that CGAPL nanobiocomposite dressing significantly enhanced the wound healing process as compared to the commercially available wound dressing Tegaderm (p-value <0.01) and Fibroheal@Ag (p-value <0.005) and obtained complete wound closure in 14 days. Histology study further confirmed the complete healing process, re-epithelization, and thick epidermis tissue formation. The proposed CGAPL nanobiocomposite wound dressing thus offers a novel wound dressing material with an efficient and faster wound healing property.

Procedural Promotion of Wound Healing by Graphene-Barium Titanate Nanosystem with White Light Irradiation

Background

Wound healing is a continuous and complex process that comprises multiple phases including hemostasis, inflammation, multiplication (proliferation) and remodeling. Although a variety of nanomaterials have been developed to control infection and accelerate wound healing, most of them can only promote one phase but not multiple phases, resulting in lower efficient healing. Although various formulations such as nitric oxide releasing wound dressings were developed for dual action, the nanostructure synthesis and the encapsulation process were complex.

Materials and Methods

Here, we report on the design of graphene-barium titanate nanosystem to procedural promote the wound healing process. The antibacterial effect was assessed in Gram-negative Escherichia coli bacteria (E. coli) and Gram-positive Staphylococcus aureus bacteria (S. aureus), the cell proliferation and migration experiment was investigated in mouse embryonic fibroblast (NIH-3T3) cells, and the wound healing effect was analyzed in female BALB/c mice with infected skin wound on the back.

Results

Results showed that graphene-barium titanate nanosystem could generate abundant ROS to kill both E. coli and S. aureus. The growth curves, bacterial viability, colony number formation and scanning electron microscopy (SEM) images of E. coli and S. aureus all confirmed the antibacterial effect. Cell Counting Kit-8 (CCK-8) assay displayed that GBT possesses great biocompatibility. EdU assay showed that GBT plus white light irradiation significantly promoted the proliferation and migration of NIH-3T3 cells. Scratch assay found that GBT could achieve a fast scratch closure compared to the control. In vivo wound healing effect indicates that GBT can accelerate wound repair procedure.

Conclusion

GBT nanocomposite is capable of programmatically accelerating wound healing through multiple stages, including production of a large amount of ROS after white light exposure to effectively kill E. coli and S. aureus to prevent wound infection and as a scaffold to accelerate fibroblast proliferation and migration to the wound to accelerate wound healing.

Progress of research on graphene and its derivatives in bone and cartilage repair

In recent years, graphene and its derivatives have gained wide attention in the biomedical field due to their good physicochemical properties, biocompatibility, and bioactivity. Its good antibacterial, osteoinductive and drug-carrying properties make it a promising application in the field of orthopedic biomaterials. This paper introduces the research progress of graphene and its derivatives in bone tissue engineering and cartilage tissue engineering and presents an outlook on the future development of graphene-based materials in orthopedics.

In vitro and in vivo effect of novel GA-CSNPs loaded col-fibrin nanocomposite scaffold on diabetic wound healing

A non-healing wound is a common problem associated with diabetes mellitus. Chronic inflammation, challenging re-epithelization, unusual growth factors, and impaired angiogenesis are the multifactorial events that contribute to impaired wounds. Hence, in the present work, an innovative GA-CSNPs nanocomposite scaffold has been fabricated by integrating Gallic acid (GA) loaded chitosan nanoparticles (GA-CSNPs) into a genipin crosslinked collagen-fibrin (Col-fibrin) scaffold as wound dressing material. The in vitro RT-PCR study carried out using NIH/3T3 mouse fibroblast cells showed that treatment with GA-CSNPs nanocomposite scaffold aids in an upsurge in the expression of Col-I, III, and VEGF, which further supports the synthesis of extracellular matrix, increases neovascularization and development of the established vascular system. In vivo wound contraction study results revealed that diabetic wounds treated with GA-CSNPs nanocomposite scaffold show a faster rate of wound closure (p < .001), histopathology results showed accelerated fibroblast cell migration, reduction of the inflammatory cells, enhanced collagen along with hexosamine synthesis. In addition, immunohistochemistry results showed increased vascularization, a significant decrease in macrophage recruitment, and reduced expression of MMP-9 compared to the Col-fibrin scaffold and Control groups. Overall data suggest that the fabricated GA-CSNPs nanocomposite porous 3-D scaffold can be a hopeful therapeutic choice for diabetic wound management.

Quaternary ammonium salt-modified isabgol scaffold as an antibacterial dressing to improve wound healing

Chronic wounds require suitable treatment and management strategies for proper healing. Among other causes, infection delays the healing of wounds and increases the risk of wound-related complications. In this study, an inherently antibacterial and biocompatible wound dressing is developed to enhance the healing. Chemical modification of a natural polysaccharide, Isabgol with epoxypropyltrimethylammonium chloride, renders antibacterial activity to the material. This is the first report of such chemical modification of this polymer for biomedical applications. The modified material is freeze-dried to obtain porous scaffolds. ¹³C NMR and FTIR analysis confirmed the modification of the Isabgol polymer chains with EPTMAC. SEM analysis confirmed the porous structure of the scaffold that would allow the exchange of gases and nutrients through the matrix. The material can swell up to 17 times its initial weight, allowing it to absorb wound exudates and maintain a moist environment at the wound site. Thermogravimetric analysis and compression testing showed that the scaffold has suitable thermal and mechanical properties. The material is antibacterial and can potentially prevent infections at the wound site. In vitro studies have confirmed that these scaffolds are cytocompatible and hemocompatible. These properties indicate that the EPTMAC-modified Isabgol scaffolds would be suitable for wound dressing applications.

Modulation of Macrophage Function by Bioactive Wound Dressings with an Emphasis on Extracellular Matrix-Based Scaffolds and Nanofibrous Composites

Bioactive wound dressings that are capable of regulating the local wound microenvironment have attracted a very large interest in the field of regenerative medicine. Macrophages have many critical roles in normal wound healing, and the dysfunction of macrophages significantly contributes to impaired or non-healing skin wounds. Regulation of macrophage polarization towards an M2 phenotype provides a feasible strategy to enhance chronic wound healing, mainly by promoting the transition of chronic inflammation to the proliferation phase of wound healing, upregulating the level of anti-inflammatory cytokines around the wound area, and stimulating wound angiogenesis and re-epithelialization. Based on this, modulation of macrophage functions by the rational design of bioactive scaffolds has emerged as a promising way to accelerate delayed wound healing. This review outlines current strategies to regulate the response of macrophages using bioactive materials, with an emphasis on extracellular matrix-based scaffolds and nanofibrous composites.

Wound dressing based on PVA nanofiber containing silk fibroin modified with GO/ZnO nanoparticles for superficial wound healing: In vitro and in vivo evaluations

Silk fibroin (SF), extracted from Bombyx mori, has unique physicochemical properties to achieve an efficient wound dressing. In this study, reduced graphene oxide (RGO)/ZnO NPs/silk fibroin nanocomposite was made, and an innovative nanofiber of SF/polyvinyl alcohol (PVA)/RGO/ZnO NPs was ready with the electrospinning technique and successfully characterized. The results of MIC and OD analyses were used to investigate the synthesized materials' antibacterial effects and displayed that the synthesized materials could inhibit growth against Staphylococcus aureus and Escherichia coli bacteria. However, both in vitro cytotoxicity (MTT) and scratch wound studies have shown that RGO/ZnO NPs and SF/PVA/RGO/ZnO NPs are not only non-toxic to NIH 3T3 fibroblasts, but also can cause cell viability, cell proliferation, and cell migration. Furthermore, improving the synthesized nanofiber's structural properties in the presence of RGO and ZnO NPs has been confirmed by performing tensile strength, contact angle, and biodegradation analyses. Also, in a cell attachment analysis, fibroblast cells had migrated and expanded well in the nanofibrous structures. Moreover, in vivo assay, SF/PVA/RGO/ZnO NPs nanofiber treated rats and has been shown significant healing activity and tissue regeneration compared with other treated groups. Therefore, this study suggests that SF/PVA/RGO/ZnO NPs nanofiber is a hopeful wound dressing for preventing bacteria growth and improving superficial wound repair.

Graphene-Based Materials for Inhibition of Wound Infection and Accelerating Wound Healing

Bacterial infection of the wound could potentially cause serious complications and an enormous medical and financial cost to the rapid emergence of drug-resistant bacteria. Nanomaterials are an emerging technology, that has been researched as possible antimicrobial nanomaterials for the inhibition of wound infection and enhancement of wound healing. Graphene is 2-dimensional (2D) sheet of sp² carbon atoms in a honeycomb structure. It has superior properties, strength, conductivity, antimicrobial, and molecular carrier abilities. Graphene and its derivatives, Graphene oxide (GO) and reduced GO (rGO), have antibacterial activity and could damage bacterial morphology and lead to the leakage of intracellular substances. Besides, for wound infection management, Graphene-platforms could be functionalized by different antibacterial agents such as metal-nanoparticles, natural compounds, and antibiotics. The Graphene structure can absorb near-infrared wavelengths, allowing it to be used as antimicrobial photodynamic therapy. Therefore, Graphene-based material could be used to inhibit pathogens that cause serious skin infections and destroy their biofilm community, which is one of the biggest challenges in treating wound infection. Due to its agglomerated structure, GO hydrogel could entrap and stack the bacteria; thus, it prevents their initial attachment and biofilm formation. The sharp edges of GO could destroy the extracellular polymeric substance surrounding the biofilm and ruin the biofilm biomass structure. As well as, Chitosan and different natural and synthetic polymers such as collagen and polyvinyl alcohol (PVA) also have attracted a great deal of attention for use with GO as wound dressing material. To this end, multi-functional polymers based on Graphene and blends of synthetic and natural polymers can be considered valid non-antibiotic compounds useful against wound infection and improvement of wound healing. Finally, the global wound care market size was valued at USD 20.8 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 5.4% from 2022 to 2027 (USD 27.2 billion). This will encourage academic as well as pharmaceutical and medical device industries to investigate any new materials such as graphene and its derivatives for the treatment of wound healing.

Levofloxacin loaded clove oil nanoscale emulgel promotes wound healing in Pseudomonas aeruginosa biofilm infected burn wound in mice

Owing to their tolerance to antibiotics, bacterial biofilms continue to pose a threat to mankind and are leading cause for non-healing of burn wounds. Within the biofilm matrix, antibiotics become functionally inactive due to restricted penetration and enzymatic degradation leading to rise of antimicrobial resistance. The objective of present investigation was to develop and characterize levofloxacin (LFX) loaded clove oil nanoscale emulgel (LFX-NE gel) and evaluate its in vivo therapeutic efficacy in Pseudomonas aeruginosa biofilm infected burn wound in mice. The optimized emulgel was found to possess good texture profile and showed shear thinning behavior. In vitro release study demonstrated complete drug release in 8 h and emulgel was found to be stable for 3 months at 25 °C and 40 °C. In vivo study revealed biofilm dispersal, complete wound closure, re-epithelialization and collagen deposition by LFX-NE gel in comparison to various control groups. LFX-NE gel was able to clear the infection within 7 days of treatment and promote wound healing as well. Therefore, administration of LFX-incorporated NE gel could be a beneficial treatment strategy for P. aeruginosa biofilm-infected burn wounds.

Efficacy of Graphene-Based Nanocomposite Gels as a Promising Wound Healing Biomaterial

The development of biocompatible nanocomposite hydrogels with effective wound healing/microbicidal properties is needed to bring out their distinguished characteristics in clinical applications. The positive interaction between graphene oxide/reduced graphene oxide (GO/rGO) and hydrogels and aloe vera gel represents a strong strategy for the advancement of therapeutic approaches for wound healing. In this study, the synthesis, characterization, and angiogenic properties of graphene-based nanocomposite gels have been corroborated and substantiated through several in vitro and in vivo assays. In this respect, graphene oxide was synthesized by incorporating a modified Hummer's method and ascertained by Raman spectroscopy. The obtained GO and rGO were uniformly dispersed into the aloe vera gel and hydrogel, respectively, as wound healing materials. These formulations were characterized via in vitro bio-chemical techniques and were found suitable for the appropriate cell viability, attachment, and proliferation. In addition, in vivo experiments were conducted using male Wistar rats. This revealed that the GO/rGO-based gels stimulated wound contraction and re-epithelialization compared to that of the non-treatment group. From the study, it is suggested that GO/rGO-based aloe vera gel can be recommended as a promising candidate for wound healing applications.

A critical review on nanomaterial based therapeutics for diabetic wound healing

Diabetes mellitus is a chronic endocrine disease that occurs mostly in the state of hyperglycemia (elevated blood glucose level). In the recent times, diabetes is listed under world's utmost critical health issues. Wound treatment procedures are complicated in diabetic individuals all over the world. Diabetic wound care not only involves high-cost, but also the primary cause of hospitalization, which can lead to amputation thereby reducing diabetic patient life expectancy. To lower the risk of amputation, wound healing requires the development of effective treatments. Traditional management systems for Diabetes are frequently chastised due to their high costs, difficulties in maintaining a sustainable supply chain and limited disposal alternatives. The worrisome rise in diabetes prevalence has sparked a surge of interest in the discovery of viable remedies to supplement existing treatments. Nanomaterials wound healing has a lot of potential for treating and preventing wound infections and it has recently gained popularity owing to its ability to transport drugs to the wound area in a regulated fashion, potentially overpowering the limits of traditional approaches. This research assessed several nanosystems, such as nanocarriers and nanotherapeutics, to explore how they can benefit in diabetic wound healing, with a focus on current obstacles and future prospects.

The wound healing effect of collagen/adipose-derived stem cells (ADSCs) hydrogel: In vivo study

BACKGROUND

The complex wound healing process involves activating and synchronizing intracellular, intercellular, and extracellular components. Adipose tissue is attracting attention to promote wound healing. Within subcutaneous adipose tissue, stromal vascular cells and their subsets release growth factors and cytokines critical for neovascularization and wound repair.

OBJECTIVES

This study evaluated human placental collagen/adipose-derived stem cells (ADSCs) hydrogel for wound healing in rats.

METHODS

In this study, ADSCs were harvested, cultured, and mixed with placental collagen. Twelve rats were used, and their backs were excised three times each. Group one received collagen/ADSCs, group two collagen, and group three non-filled (control) excisions. The healing processes were assessed by histological analysis, taking photographs, and calculating the percentage of wound contraction in mentioned times.

RESULTS

Histopathological analysis revealed that the content of fibroblasts, follicles of the hair, and angiogenesis in group one was significantly more than in other groups. Group one had a significant result compared with the collagen and control groups. In group one, significant wound healing and wound contraction were observed with 52% and 80% wound contraction at 7 and 14 days, respectively.

CONCLUSION

Collagen/ADSCs can be considered a suitable candidate hydrogel in wound healing with a high potential for enhancing wound repairing.

A comprehensive review on the applications of carbon-based nanostructures in wound healing: from antibacterial aspects to cell growth stimulation

A wound is defined as damage to the integrity of biological tissue, including skin, mucous membranes, and organ tissues. The treatment of these injuries is an important challenge for medical researchers. Various materials have been used for wound healing and dressing applications among which carbon nanomaterials have attracted significant attention due to their remarkable properties. In the present review, the latest studies on the application of carbon nanomaterials including graphene oxide (GO), reduced graphene oxide (rGO), carbon dots (CDs), carbon quantum dots (CQDs), carbon nanotubes (CNTs), carbon nanofibers (CNFs), and nanodiamonds (NDs) in wound dressing applications are evaluated. Also, a variety of carbon-based nanocomposites with advantages such as biocompatibility, hemocompatibility, reduced wound healing time, antibacterial properties, cell-adhesion, enhanced mechanical properties, and enhanced permeability to oxygen has been reported for the treatment of various wounds.

Scaffolds in the microbial resistant era: Fabrication, materials, properties and tissue engineering applications

Due to microbial infections dramatically affect cell survival and increase the risk of implant failure, scaffolds produced with antimicrobial materials are now much more likely to be successful. Multidrug-resistant infections without suitable prevention strategies are increasing at an alarming rate. The ability of cells to organize, develop, differentiate, produce a functioning extracellular matrix (ECM) and create new functional tissue can all be controlled by careful control of the extracellular microenvironment. This review covers the present state of advanced strategies to develop scaffolds with antimicrobial properties for bone, oral tissue, skin, muscle, nerve, trachea, cardiac and other tissue engineering applications. The review focuses on the development of antimicrobial scaffolds against bacteria and fungi using a wide range of materials, including polymers, biopolymers, glass, ceramics and antimicrobials agents such as antibiotics, antiseptics, antimicrobial polymers, peptides, metals, carbon nanomaterials, combinatorial strategies, and includes discussions on the antimicrobial mechanisms involved in these antimicrobial approaches. The toxicological aspects of these advanced scaffolds are also analyzed to ensure future technological transfer to clinics. The main antimicrobial methods of characterizing scaffolds' antimicrobial and antibiofilm properties are described. The production methods of these porous supports, such as electrospinning, phase separation, gas foaming, the porogen method, polymerization in solution, fiber mesh coating, self-assembly, membrane lamination, freeze drying, 3D printing and bioprinting, among others, are also included in this article. These important advances in antimicrobial materials-based scaffolds for regenerative medicine offer many new promising avenues to the material design and tissue-engineering communities.

Leveraging the advancements in functional biomaterials and scaffold fabrication technologies for chronic wound healing applications

Exploring new avenues for clinical management of chronic wounds holds the key to eliminating socioeconomic burdens and health-related concerns associated with this silent killer. Engineered biomaterials offer great promise for repair and regeneration of chronic wounds because of their ability to deliver therapeutics, protect the wound environment, and support the skin matrices to facilitate tissue growth. This mini review presents recent advances in biomaterial functionalities for enhancing wound healing and demonstrates a move from sub-optimal methods to multi-functionalized treatment approaches. In this context, we discuss the recently reported biomaterial characteristics such as bioadhesiveness, antimicrobial properties, proangiogenic attributes, and anti-inflammatory properties that promote chronic wound healing. In addition, we highlight the necessary mechanical and mass transport properties of such biomaterials. Then, we discuss the characteristic properties of various biomaterial templates, including hydrogels, cryogels, nanomaterials, and biomolecule-functionalized materials. These biomaterials can be microfabricated into various structures, including smart patches, microneedles, electrospun scaffolds, and 3D-bioprinted structures, to advance the field of biomaterial scaffolds for effective wound healing. Finally, we provide an outlook on the future while emphasizing the need for their detailed functional behaviour and inflammatory response studies in a complex in vivo environment for superior clinical outcomes and reduced regulatory hurdles.

Biomaterials-Based Regenerative Strategies for Skin Tissue Wound Healing

Skin tissue wound healing proceeds through four major stages, including hematoma formation, inflammation, and neo-tissue formation, and culminates with tissue remodeling. These four steps significantly overlap with each other and are aided by various factors such as cells, cytokines (both anti- and pro-inflammatory), and growth factors that aid in the neo-tissue formation. In all these stages, advanced biomaterials provide several functional advantages, such as removing wound exudates, providing cover, transporting oxygen to the wound site, and preventing infection from microbes. In addition, advanced biomaterials serve as vehicles to carry proteins/drug molecules/growth factors and/or antimicrobial agents to the target wound site. In this review, we report recent advancements in biomaterials-based regenerative strategies that augment the skin tissue wound healing process. In conjunction with other medical sciences, designing nanoengineered biomaterials is gaining significant attention for providing numerous functionalities to trigger wound repair. In this regard, we highlight the advent of nanomaterial-based constructs for wound healing, especially those that are being evaluated in clinical settings. Herein, we also emphasize the competence and versatility of the three-dimensional (3D) bioprinting technique for advanced wound management. Finally, we discuss the challenges and clinical perspective of various biomaterial-based wound dressings, along with prospective future directions. With regenerative strategies that utilize a cocktail of cell sources, antimicrobial agents, drugs, and/or growth factors, it is expected that significant patient-specific strategies will be developed in the near future, resulting in complete wound healing with no scar tissue formation.

Application of a Cascaded Nanozyme in Infected Wound Recovery of Diabetic Mice

The emergence of peroxidase (POD)-like nanozyme-derived catalytic therapy has provided a promising choice for reactive oxygen species (ROS)-mediated broad-spectrum antibacterials to replace antibiotics, but it still suffers from limitations of low therapeutic efficiency and unusual addition of unstable H₂O₂. Considering that the higher blood glucose in diabetic wounds provides much more numerous nutrients for bacterial growth, a cascade nanoenzymatic active material was developed by coating glucose oxidase (GOx) onto POD-like Fe₂(MoO₄)₃ [Fe₂(MoO₄)₃@GOx]. GOx could consume the nutrient of glucose to produce gluconic acid (weakly acidic) and H₂O₂, which could be subsequently converted into highly oxidative ^•OH via the catalysis of POD-like Fe₂(MoO₄)₃. Accordingly, the synergistic effect of starvation and ROS-mediated therapy showed significantly efficient antibacterial effect while avoiding the external addition of H₂O₂ that affects the stability and efficacy of the therapy system. Compared with the bactericidal rates of 46.2-59.404% of GOx or Fe₂(MoO₄)₃ alone on extended-spectrum β-lactamases producing Escherichia coli and methicillin-resistant Staphylococcus aureus, those of the Fe₂(MoO₄)₃@GOx group are 98.396 and 98.776%, respectively. Animal experiments showed that the as-synthesized Fe₂(MoO₄)₃@GOx could much efficiently promote the recovery of infected wounds in type 2 diabetic mice while showing low cytotoxicity in vivo.

Nanomaterials-based drug delivery approaches for wound healing

Abstract:

Wound healing is a complex and dynamic process that requires intricate synchronization between multiple cell types within appropriate extracellular microenvironment. Wound healing process involves four overlapping phases in a precisely regulated manner, consisting of hemostasis, inflammation, proliferation, and maturation. For an effective wound healing all four phases must follow in a sequential pattern within a time frame. Several factors might interfere with one or more of these phases in healing process, thus causing improper or impaired wound healing resulting in non-healing chronic wounds. The complications associated with chronic non-healing wounds, along with the limitations of existing wound therapies, have led to the development and emergence of novel and innovative therapeutic interventions. Nanotechnology presents unique and alternative approaches to accelerate the healing of chronic wounds by the interaction of nanomaterials during different phases of wound healing. This review focuses on recent innovative nanotechnology-based strategies for wound healing and tissue regeneration based on nanomaterials, including nanoparticles, nanocomposites and scaffolds. The efficacy of the intrinsic therapeutic potential of nanomaterials (including silver, gold, zinc oxide, copper, cerium oxide, etc.) and the ability of nanomaterials as carriers (liposomes, hydrogels, polymeric nanomaterials, nanofibers) as therapeutic agents associated with wound-healing applications have also been addressed. The significance of these nanomaterial-based therapeutic interventions for wound healing needs to be highlighted to engage researchers and clinicians towards this new and exciting area of bio-nanoscience. We believe that these recent developments will offer researchers an updated source on the use of nanomaterials as an advanced approach to improve wound healing.

Progress in the Development of Graphene-Based Biomaterials for Tissue Engineering and Regeneration

Over the last few decades, tissue engineering has become an important technology for repairing and rebuilding damaged tissues and organs. The scaffold plays an important role and has become a hot pot in the field of tissue engineering. It has sufficient mechanical and biochemical properties and simulates the structure and function of natural tissue to promote the growth of cells inward. Therefore, graphene-based nanomaterials (GBNs), such as graphene and graphene oxide (GO), have attracted wide attention in the field of biomedical tissue engineering because of their unique structure, large specific surface area, good photo-thermal effect, pH response and broad-spectrum antibacterial properties. In this review, the structure and properties of typical GBNs are summarized, the progress made in the development of GBNs in soft tissue engineering (including skin, muscle, nerve and blood vessel) are highlighted, the challenges and prospects of the application of GBNs in soft tissue engineering have prospected.

Carbon-Based Nanomaterials: Carbon Nanotubes, Graphene and Fullerenes in Control of Burns Infections and Wound Healing

Burn injuries are extremely debilitating, resulting in high morbidity and mortality rates around the world. The risk of infection escalates in correlation with impairment of skin integrity, creating a barrier to healing and possibly leading to sepsis. With its numerous advantages over traditional treatment methods, nanomaterial-based wound healing has immense capability for treating and preventing wound infections. Carbon-based nanomaterials (CNMs) owing to their distinctive physicochemical and biological properties have emerged as promising platform for biomedical applications. Carbon nanotubes, graphene, fullerenes, and their nanocomposites have demonstrated broad antimicrobial activity against invasive bacteria, fungi, and viruses causing burn wound infection. The specific mechanisms that govern the antimicrobial activity of CNMs must be understood in order to ensure the safe and effective incorporation of these structures into biomaterials. However, it is challenging to decouple individual and synergistic contributions of physical, chemical, and electrical effects of CNMs on cells. This review reported on significant advances in the application of CNMs in burn wound infection and wound healing, with brief discussion on the interaction between different families of CNMs and microorganisms to assess antimicrobial performance.

Topical gel-based biomaterials for the treatment of diabetic foot ulcers

Diabetic foot ulcers (DFUs) are a devastating ailment for many diabetic patients with increasing prevalence and morbidity. The complex pathophysiology of DFU wound environments has made finding effective treatments difficult. Standard wound care treatments have limited efficacy in healing these types of chronic wounds. Topical biomaterial gels have been developed to implement novel treatment approaches to improve therapeutic effects and are advantageous due to their ease of application, tunability, and ability to improve therapeutic release characteristics. Here, we provide an updated, comprehensive review of novel topical biomaterial gels developed for treating chronic DFUs. This review will examine preclinical data for topical gel treatments in diabetic animal models and clinical applications, focusing on gels with protein/peptides, drug, cellular, herbal/antioxidant, and nano/microparticle approaches. STATEMENT OF SIGNIFICANCE: By 2050, 1 in 3 Americans will develop diabetes, and up to 34% of diabetic patients will develop a diabetic foot ulcer (DFU) in their lifetime. Current treatments for DFUs include debridement, infection control, maintaining a moist wound environment, and pressure offloading. Despite these interventions, a large number of DFUs fail to heal and are associated with a cost that exceeds $31 billion annually. Topical biomaterials have been developed to help target specific impairments associated with DFU with the goal to improve healing. A summary of these approaches is needed to help better understand the current state of the research. This review summarizes recent research and advances in topical biomaterials treatments for DFUs.

Growth factors, as biological macromolecules in bioactivity enhancing of electrospun wound dressings for diabetic wound healing: A review

Impaired wound healing is of the most conspicuous characteristics of diabetic mellitus. Reduced blood flow, chronic inflammatory reactions, infection, endothelial dysfunction, elevated levels of reactive oxygen species, and metabolic disorders cause wounds to heal more slowly in these patients. Previous studies have reported useful impacts of growth factors in management of such wounds. However, due to their short half-life and low stability, a suitable delivery platform with sustained release profile may boost their healing potential. Controlled and localized delivery of growth factors via electrospun fibers have been extensively explored in previous studies. The electrospinning method; although not new, has turned out to be extremely effective for the preparation of delivery carriers for growth factors. Due to their structural resemblance to native tissues' extracellular matrix, high encapsulation efficacy, tunability, and high surface to volume ratio, electrospun scaffolds have gained significant attention in drug delivery and tissue engineering. In the current review, careful integration of current research regarding the applications of growth factors' delivery through electrospun fibers in diabetic wounds healing has been done. This review will not only give an insight into the current updates, but will also highlights the future perspectives and challenges.

An Update on Graphene-Based Nanomaterials for Neural Growth and Central Nervous System Regeneration

Thanks to their reduced size, great surface area, and capacity to interact with cells and tissues, nanomaterials present some attractive biological and chemical characteristics with potential uses in the field of biomedical applications. In this context, graphene and its chemical derivatives have been extensively used in many biomedical research areas from drug delivery to bioelectronics and tissue engineering. Graphene-based nanomaterials show excellent optical, mechanical, and biological properties. They can be used as a substrate in the field of tissue engineering due to their conductivity, allowing to study, and educate neural connections, and guide neural growth and differentiation; thus, graphene-based nanomaterials represent an emerging aspect in regenerative medicine. Moreover, there is now an urgent need to develop multifunctional and functionalized nanomaterials able to arrive at neuronal cells through the blood-brain barrier, to manage a specific drug delivery system. In this review, we will focus on the recent applications of graphene-based nanomaterials in vitro and in vivo, also combining graphene with other smart materials to achieve the best benefits in the fields of nervous tissue engineering and neural regenerative medicine. We will then highlight the potential use of these graphene-based materials to construct graphene 3D scaffolds able to stimulate neural growth and regeneration in vivo for clinical applications.

Conductive Biomaterials as Bioactive Wound Dressing for Wound Healing and Skin Tissue Engineering

Conductive biomaterials based on conductive polymers, carbon nanomaterials, or conductive inorganic nanomaterials demonstrate great potential in wound healing and skin tissue engineering, owing to the similar conductivity to human skin, good antioxidant and antibacterial activities, electrically controlled drug delivery, and photothermal effect. However, a review highlights the design and application of conductive biomaterials for wound healing and skin tissue engineering is lacking. In this review, the design and fabrication methods of conductive biomaterials with various structural forms including film, nanofiber, membrane, hydrogel, sponge, foam, and acellular dermal matrix for applications in wound healing and skin tissue engineering and the corresponding mechanism in promoting the healing process were summarized. The approaches that conductive biomaterials realize their great value in healing wounds via three main strategies (electrotherapy, wound dressing, and wound assessment) were reviewed. The application of conductive biomaterials as wound dressing when facing different wounds including acute wound and chronic wound (infected wound and diabetic wound) and for wound monitoring is discussed in detail. The challenges and perspectives in designing and developing multifunctional conductive biomaterials are proposed as well.