Antibacterial, hemostasis, adhesive, self-healing polysaccharides-based composite hydrogel wound dressing for the prevention and treatment of postoperative adhesion

Biomimetic nanostructural materials based on placental amniotic membrane-derived nanofibers for self-healing and anti-adhesion during cesarean section

Cesarean section (CS) is highly prevalent surgery among females. However, current absorbable anti-adhesion membranes used clinically can partially prevent postoperative adhesions but show limited efficacy in tissue regeneration, leaving post-cesarean women at risk for severe complications including cesarean scar pregnancy, placenta previa, and uterine rupture. Herein, we designed a fully amniotic membrane (AM)-derived biomimetic nanostructural materials (AM-BNMs) as an anti-adhesion barrier, and validated its therapeutic efficacy in a rat CS model. The biomaterial consisted of AM-extracellular matrix (ECM) nanofibers, enriched with hemostatic proteins (collagen, S100A8, S100A9, etc.), carrying AM mesenchymal stem cells (MSCs)-secretome that exhibited significantly elevated levels of pro-regenerative factors (miR-302a-3p, angiogenin, VEGF, etc.) compared to endogenous secretion. The reconstituted AM-BNMs demonstrated synergistic effects at CS wounds, effectively preventing adhesion formation while promoting hemostasis and tissue regeneration. In summary, this readily accessible human-derived biomaterial shows promising potential in preventing adhesion-related complications and enhancing uterine wound healing, thereby promoting female reproductive health.

Biomimetic Hydrogels - Tools for Regenerative Medicine, Oncology, and Understanding Medical Gas Plasma Therapy

Biomimetic hydrogels enable biochemical, cell biology, and tissue-like studies in the third dimension. Smart hydrogels are also frequently used in tissue engineering and as drug carriers for intra- or extracutaneous regenerative medicine. They have also been studied in bio-sensor development, 3D cell culture, and organoid growth optimization. Yet, many hydrogel types, adjuvant components, and cross-linking methods have emerged over decades, diversifying and complexifying such studies. Here, an evaluative overview is provided, mapping potential applications to the corresponding hydrogel tuning. Strikingly, hydrogels are ideal for studying locoregional therapy modalities, such as cold medical gas plasma technology. These partially ionized gases produce various reactive oxygen species (ROS) types along with other physico-chemical components such as ions and electric fields, and the spatio-temporal effects of these components delivered to diseased tissues remain largely elusive to date. Hence, this work outlines the promising applications of hydrogels in biomedical research in general and cold plasma science in particular and underlines the great potential of these smart scaffolds for current and future research and therapy.

Water triggered injectable polylactic acid hydrogel based on zwitterionic sulfobetaine modification for incompressible bleeding and tissue anti-adhesion

Massive blood loss is the main cause of prehospital trauma-related death, the development of rapid and effective hemostatic materials is imminent. Injectable hydrogels have the advantages of covering irregular bleeding sites and quickly closing the wound. However, its inherent viscosity can easily precipitate tissue adhesion in vivo and other complications. Based on the anti-protein properties of zwitterion and our previous work about in situ hemostatic/anti-adhesion hydrogel material, we have synthesized a series of injectable hydrogel composed of sulfobetaine-modified polylactic acid (PLA) and gelatin (Gel). These hydrogels could form a smooth film structure by simple water triggering, thereby conferring anti-adhesive properties. We visualized the changes in surface hydrophobicity using fluorescent probes and demonstrated tissue adhesion, rapid hydrophobic interface response, as well as rapid hemostasis for incompressible wounds through in vivo and in vitro experiments. Additionally, we explored the application of hydrogel materials in the scenario of postoperative bleeding, which can effectively prevent unnecessary adhesion through rapid film formation and the anti-protein property of sulfobetaine. We believe that this multifunctional hemostatic hydrogel has the potential to serve as a prehospital emergency treatment of incompressible bleeding and benefit to the postoperative recovery of patients.

Biodegradable antimicrobial films prepared in a continuous way by melt extrusion using plant extracts as effective components

Packaging plays an important role in delaying food spoilage. However, conventional packaging films do not have antimicrobial properties. Films with antimicrobial components are receiving growing research interest. However, many of the reported studies use conventional non-degradable polymers during film preparation, posing a significant threat to the environment and sustainable development. Furthermore, conventional inorganic antibacterial agents are commonly used during film preparation, posing a risk to food safety. In this study, antibacterial compounds were extracted from diverse plants, and then biodegradable antimicrobial films were prepared in a continuous way via the melt extrusion method. Especially, films prepared using Vernicia fordii and Phyllanthus urinaria extracts showed effective antibacterial activities against common foodborne pathogens. This study is the first to prepare antibacterial films in a continuous way using natural plant extracts as the effective components, and may shed new light on future research in preparing green antibacterial films via environment-friendly approaches.

Research progress on animal models of peritoneal adhesion

Peritoneal adhesion is a common complication of abdominal and pelvic surgery that can cause various clinical symptoms, including abdominal pain, intestinal obstruction, and female infertility, significantly impacting patient quality of life. Animal models of peritoneal adhesion are important tools for studying the mechanisms of adhesion formation and evaluating the effectiveness of prevention and treatment. Various methods for constructing animal models of peritoneal adhesion include physical injury, chemical injury, ischemia, infection, foreign body stimulation, and simulated surgery; however, none can fully simulate peritoneal adhesion in patients clinically. Therefore, this review aimed to explore previous methods used to construct peritoneal adhesion animal models and summarize their principles, characteristics, and applications. Similarly, it summarizes macroscopic and microscopic evaluation indicators, such as peritoneal adhesion gross assessment, histological scoring, and molecular markers. On the basis of this, we proposed a new animal model of peritoneal adhesion that simulates the factors contributing to peritoneal adhesion formation in clinical surgery. peritoneal adhesion formation was stable and standardized using our proposed model, providing a foundation for the establishment and application of peritoneal adhesion animal models.

Recent advancements in bioadhesive self-healing hydrogels for effective chronic wound care

Chronic wounds are a critical and costly complication that affects millions of patients each year, especially patients suffering from diabetes, and constitute a serious global healthcare problem that needs immediate attention. In this direction, novel dressings that can integrate appropriate physicochemical and biological features, mechanical durability, and the capacity for therapy are of great clinical importance. For instance, self-healable hydrogels, with antibacterial activity and high tissue adhesion, have attracted increasing attention for wound management applications. Despite their potential, existing self-healable hydrogel networks exhibit limitations in mechanical strength and adhesion, tissue regeneration, antibacterial efficacy, and scalability, indicating a need for further improvement in the field. This review focuses on exactly these recent advances in the field with a special focus on self-healing adhesive hydrogel-based wound dressings as well as their structures, construction strategies, adhesion mechanisms, and emerging usage in the wound healing field. By shedding light on these developments, we aim to contribute to the ongoing pursuit of enhanced solutions for chronic wound care.

Adhesive Nanoparticle-in-Microgel System with ROS Scavenging Capability and Hemostatic Activity for Postoperative Adhesion Prevention

Postoperative adhesion is a noteworthy clinical complication in abdominal surgery due to the existing physical barriers are unsatisfactory and inefficient in preventing its occurrence. In this work, an elaborate nanoparticle-in-microgel system (nMGel) is presented for postoperative adhesion prevention. nMGel is facilely formed by crosslinking manganese dioxide (MnO2) nanoparticles-loaded gelatin microspheres with polydopamine using a modified emulsification-chemical crosslinking method, generating a nano-micron spherical hydrogel. After drying, powdery nMGel with sprayability can perfectly cover irregular wounds and maintains robust tissue adhesiveness even in a wet environment. Additionally, nMGel possesses prominent antioxidant and free radical scavenging activity, which protects cell viability and preserves cell biological functions in an oxidative microenvironment. Furthermore, nMGel displays superior hemostatic property as demonstrated in mouse tail amputation models and liver trauma models. Importantly, nMGel can be conveniently administrated in a mouse cecal defect model to prevent adhesion between the injured cecum and the peritoneum by reducing inflammation, oxidative stress, collagen synthesis, and angiogenesis. Thus, the bioactive nMGel offers a practical and efficient approach for ameliorating postsurgical adhesion.

Advancements and Challenges in Self-Healing Hydrogels for Wound Care

This manuscript explores self-healing hydrogels as innovative solutions for diverse wound management challenges. Addressing antibiotic resistance and tailored wound care, these hydrogels exhibit promising outcomes, including accelerated wound closure and tissue regeneration. Advancements in multifunctional hydrogels with controlled drug release, antimicrobial properties, and real-time wound assessment capabilities signal a significant leap toward patient-centered treatments. However, challenges such as scalability, long-term safety evaluation, and variability in clinical outcomes persist. Future directions emphasize personalized medicine, manufacturing innovation, rigorous evaluation through clinical trials, and interdisciplinary collaboration. This manuscript features the ongoing pursuit of effective, adaptable, and comprehensive wound care solutions to transform medical treatments and improve patient outcomes.

Injectable Multifunctional Composite Hydrogel as a Combination Therapy for Preventing Postsurgical Adhesion

Postsurgical adhesion (PA) is a common and serious postoperative complication that affects millions of patients worldwide. However, current commercial barrier materials are insufficient to inhibit diverse pathological factors during PA formation, and thus, highly bioactive materials are needed. Here, this work designs an injectable multifunctional composite hydrogel that can serve as a combination therapy for preventing PA. In brief, this work reveals that multiple pathological events, such as chronic inflammatory and fibrotic processes, contribute to adhesion formation in vivo, and such processes can not be attenuated by barrier material (e.g., hydrogel) alone treatments. To solve this limitation, this work designs a composite hydrogel made of the cationic self-assembling peptide KLD2R and TGF-β receptor inhibitor (TGF-βRi)-loaded mesenchymal stem cell-derived nanovesicles (MSC-NVs). The resulting composite hydrogel displays multiple functions, including physical separation of the injured tissue areas, antibacterial effects, and local delivery and sustained release of anti-inflammatory MSC-NVs and antifibrotic TGF-βRi. As a result, this composite hydrogel effectively inhibited local inflammation, fibrosis and adhesion formation in vivo. Moreover, the hydrogel also exhibits good biocompatibility and biodegradability in vivo. Together, the results highlight that this "all-in-one" composite hydrogel strategy may provide insights into designing advanced therapies for many types of tissue injury.

Biocompatible Nanocomposites for Postoperative Adhesion: A State-of-the-Art Review

To reduce and prevent postsurgical adhesions, a variety of scientific approaches have been suggested and applied. This includes the use of advanced therapies like tissue-engineered (TE) biomaterials and scaffolds. Currently, biocompatible antiadhesive constructs play a pivotal role in managing postoperative adhesions and several biopolymer-based products, namely hyaluronic acid (HA) and polyethylene glycol (PEG), are available on the market in different forms (e.g., sprays, hydrogels). TE polymeric constructs are usually associated with critical limitations like poor biocompatibility and mechanical properties. Hence, biocompatible nanocomposites have emerged as an advanced therapy for postoperative adhesion treatment, with hydrogels and electrospun nanofibers among the most utilized antiadhesive nanocomposites for in vitro and in vivo experiments. Recent studies have revealed that nanocomposites can be engineered to generate smart three-dimensional (3D) scaffolds that can respond to different stimuli, such as pH changes. Additionally, nanocomposites can act as multifunctional materials for the prevention of adhesions and bacterial infections, as well as tissue healing acceleration. Still, more research is needed to reveal the clinical potential of nanocomposite constructs and the possible success of nanocomposite-based products in the biomedical market.

Antibacterial chitosan-based composite sponge with synergistic hemostatic effect for massive haemorrhage

Uncontrollable acute bleeding and wound infection pose significant challenges in emergency treatment and surgical operations. Therefore, the research and development of highly efficient antibacterial hemostatic agents are of great importance in reducing the mortality rate among patients with massive hemorrhage. In this study, we utilized hydrophobically modified chitosan (HM-CS) and gallic acid chitosan (GA-CS) to create a composite sponge (HM/GA-CS) that exhibits complementary advantages. The composite sponge combines the alkyl chain and polyphenol structure, allowing it to adsorb blood cells and plasma proteins simultaneously. This synergistic effect was confirmed through various tests, including blood cell adhesion, plasma protein barrier behavior, and in vitro hemostatic testing. Furthermore, experiments conducted on a rat liver injury model demonstrated that the composite sponge achieved rapid coagulation within 52 s, resulting in significantly lower bleeding volume compared with traditional gauze. In addition, the incorporation of GA-CS into HM-CS enhanced the antibacterial properties of the composite sponge. The antibacterial rate of the composite sponge against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) reached 100 % and 98.2 %, respectively. To evaluate its biocompatibility, the composite sponge underwent blood compatibility and cell activity tests, confirming its suitability. The HM/GA-CS sponge holds promising applications in managing cases of massive hemorrhage.

The hemostatic effect and wound healing of novel collagen-containing polyester dressing

Collagen plays an important role in hemostasis and tissue repair processes. Traditional passive wound dressings like gauze, bandage, and cotton wool could hardly fit the open wounds and exerted no active effect on wound healing. Even worse, they would adhere to the skin tissue, causing dehydration and second injury upon replacement. Polyester is commonly used in the medical field and is a safe and inexpensive polymer. Due to the hydrophobic surface, polyester does not adhere to tissue; however, polyester does not have the hemostatic properties. We designed a material composed of collagen and polyester, encapsulated hydrolyzed collagen in polyester particles, and made collagen-polyester non-woven fabric by melt blowing method, The collagen content was 1% and the collagen-polyester dressing exhibited a hydrophobic nature, preventing moisture from sticking to its surface. The purpose of this study was to compare the hemostatic effect of collagen-polyester nonwovens with conventional polyester pads, and to observe the adhesion of the pads to the wound. The wound healing and shrinkage rates of collagen-polyester dressings and conventional pads were compared in a rat wound healing test. The hemostatic test showed that the polyester pads containing 1% collagen significantly shortened the bleeding time compared with the traditional polyester pads, and retained the hydrophobicity and non-adhesion properties. The collagen-polyester dressing had better angiogenesis and granulation degree than the control group on the 14th day, and reduced the wound shrinkage rate. Collagen polyester dressings have excellent hemostasis, regeneration, shrinkage reduction and non-adhering for wounds. Overall, the novel collagen-containing polyester dressing is ideal choice for wound dressings.

Degradable carrier-free spray hydrogel based on self-assembly of natural small molecule for prevention of postoperative adhesion

Postoperative peritoneal adhesion (PPA) is frequent and extremely dangerous complication after surgery. Different tactics have been developed to reduce it. However, creating a postoperative adhesion method that is multifunctional, biodegradable, biocompatible, low-toxic but highly effective, and therapeutically applicable is still a challenge. Herein, we have prepared a degradable spray glycyrrhetinic acid hydrogel (GAG) based on natural glycyrrhetinic acid (GA) by straightforward heating and cooling without the use of any additional chemical cross-linking agents to prevent postoperative adhesion. The resultant hydrogel was demonstrated to possess various superior anti-inflammatory activity, and multiple functions, such as excellent degradability and biocompatibility. Specifically, spraying characteristic and excellent antibacterial activities essentially eliminated secondary infections during the administration of drugs in surgical wounds. In the rat models, the carrier-free spray GAG could not only slow-release GA to inhibit inflammatory response, but also serve as physical anti-adhesion barrier to reduce collagen deposition and fibrosis. The sprayed GAG would shed a new light on the prevention of postoperative adhesion and broaden the application of the hydrogels based on natural products in biomedical fields.

Modern Approaches in Wounds Management

Wound management represents a well-known continuous challenge and concern of the global healthcare systems worldwide. The challenge is on the one hand related to the accurate diagnosis, and on the other hand to establishing an effective treatment plan and choosing appropriate wound care products in order to maximize the healing outcome and minimize the financial cost. The market of wound dressings is a dynamic field which grows and evolves continuously as a result of extensive research on developing versatile formulations with innovative properties. Hydrogels are one of the most attractive wound care products which, in many aspects, are considered ideal for wound treatment and are widely exploited for extension of their advantages in healing process. Smart hydrogels (SHs) offer the opportunities of the modulation physico-chemical properties of hydrogels in response to external stimuli (light, pressure, pH variations, magnetic/electric field, etc.) in order to achieve innovative behavior of their three-dimensional matrix (gel-sol transitions, self-healing and self-adapting abilities, controlled release of drugs). The SHs response to different triggers depends on their composition, cross-linking method, and manufacturing process approach. Both native or functionalized natural and synthetic polymers may be used to develop stimuli-responsive matrices, while the mandatory characteristics of hydrogels (biocompatibility, water permeability, bioadhesion) are preserved. In this review, we briefly present the physiopathology and healing mechanisms of chronic wounds, as well as current therapeutic approaches. The rational of using traditional hydrogels and SHs in wound healing, as well as the current research directions for developing SHs with innovative features, are addressed and discussed along with their limitations and perspectives in industrial-scale manufacturing.

Matricaria chamomilla essential oil-loaded hybrid electrospun nanofibers based on polycaprolactone/sulfonated chitosan/ZIF-8 nanoparticles for wound healing acceleration

Recently, developing antibacterial wound dressings based on biomaterials display good biocompatibility and the potential to accelerate wound healing. For this aim, we prepared eco-friendly and biodegradable nanofibers (NFs) based on N-(3-sulfopropyl)chitosan/ poly (ε-caprolactone) incorporated by zeolite imidazolate framework-8 nanoparticles (ZIF-8 NPs) and chamomile essential oil (MCEO) via the electrospinning technique for their efficacy as wound dressing scaffolds. Fabricated NFs were characterized and studied for their structural, morphological, mechanical, hydrophilic, and thermal stability properties. The results of scanning electron microscopy (SEM) revealed that adding the ZIF-8 NPs/ MCEO, very slightly influenced the average diameter of NFs (PCL/SPCS (90:10) with 90 ± 32 nm). The developed uniform MCEO-loaded ZIF-8/PCL/SPCS NFs displayed better cytocompatibility, proliferation, and physicochemical properties (e.g. thermal stability and mechanical properties) than neat NFs. The results of cytocompatibility, DAPI (4',6-diamidino-2-phenylindole) staining study, and SEM micrographs demonstrated that formulated NFs had promising adhesion and proliferation against normal human foreskin fibroblasts-2 (HFF-2 cell line). The prepared NFs revealed excellent antibacterial activity against both Staphylococcus aureus and Escherichia coli with inhibition of 32.3 mm and 31.2 mm, respectively. Accordingly, the newly developed antibacterial NFs hold great potential as effective biomaterials for use as an active platform in wound healing applications.

Homogeneous silver nanoparticle loaded polydopamine/polyethyleneimine-coated bacterial cellulose nanofibers for wound dressing

Utilizing mussel-inspired chemistry is an advanced strategy for surface modification, because dopamine (DA) can form a material-independent adhesive coating and further functionalization can be achieved, including the production of silver nanoparticles (AgNPs). Nevertheless, DA easily aggregates in the nanofiber network structure of bacterial cellulose (BC), which not only blocks the pores in the BC structure but also leads to the formation of large silver particles and the burst release of highly cytotoxic silver ions. Herein, a homogeneous AgNP-loaded polydopamine (PDA)/polyethyleneimine (PEI) coated BC was constructed via a Michael reaction between PDA and PEI. Under the action of PEI, the PDA/PEI coating was uniformly attached to the BC fiber surface with a thickness of approximately 4 nm, and homogeneous AgNPs were produced on the uniform PDA/PEI/BC (PPBC) fiber surface. The sustained release of silver ions was better from AgNPs@PPBC than from AgNPs@PDA/BC. The obtained AgNPs@PPBC exhibited excellent antibacterial activities and cytocompatibility. The results of the in vivo assay indicated that the AgNPs@PPBC dressing could inhibit S. aureus infection and inflammation, promote hair follicle growth, enhance collagen deposition, and accelerate wound healing within 12 days compared with BC. These results illustrate that the homogeneous AgNPs@PPBC dressing has great potential for treating infected wounds.

Prevention strategies of postoperative adhesion in soft tissues by applying biomaterials: Based on the mechanisms of occurrence and development of adhesions

Postoperative adhesion (POA) widely occurs in soft tissues and usually leads to chronic pain, dysfunction of adjacent organs and some acute complications, seriously reducing patients' quality of life and even being life-threatening. Except for adhesiolysis, there are few effective methods to release existing adhesion. However, it requires a second operation and inpatient care and usually triggers recurrent adhesion in a great incidence. Hence, preventing POA formation has been regarded as the most effective clinical strategy. Biomaterials have attracted great attention in preventing POA because they can act as both barriers and drug carriers. Nevertheless, even though much reported research has been demonstrated their efficacy on POA inhibition to a certain extent, thoroughly preventing POA formation is still challenging. Meanwhile, most biomaterials for POA prevention were designed based on limited experiences, not a solid theoretical basis, showing blindness. Hence, we aimed to provide guidance for designing anti-adhesion materials applied in different soft tissues based on the mechanisms of POA occurrence and development. We first classified the postoperative adhesions into four categories according to the different components of diverse adhesion tissues, and named them as "membranous adhesion", "vascular adhesion", "adhesive adhesion" and "scarred adhesion", respectively. Then, the process of the occurrence and development of POA were analyzed, and the main influencing factors in different stages were clarified. Further, we proposed seven strategies for POA prevention by using biomaterials according to these influencing factors. Meanwhile, the relevant practices were summarized according to the corresponding strategies and the future perspectives were analyzed.

A multi-crosslinking strategy of organic and inorganic compound bio-adhesive polysaccharide-based hydrogel for wound hemostasis

Polysaccharides are naturally occurring polymers with exceptional biodegradable and biocompatible qualities that are used as hemostatic agents. In this study, photoinduced CC bond network and dynamic bond network binding was used to give polysaccharide-based hydrogels the requisite mechanical strength and tissue adhesion. The designed hydrogel was composed of modified carboxymethyl chitosan (CMCS-MA) and oxidized dextran (OD), and introduced hydrogen bond network through tannic acid (TA) doping. Halloysite nanotubes (HNTs) were also added, and the effects of various doping amount on the performance of the hydrogel were examined, in order to enhance the hemostatic property of hydrogel. Experiments on vitro degradation and swelling demonstrated the strong structural stability of hydrogels. The hydrogel has improved tissue adhesion strength, with a maximum adhesion strength of 157.9 kPa, and demonstrated improved compressive strength, with a maximum compressive strength of 80.9 kPa. Meanwhile, the hydrogel had a low hemolysis rate and had no inhibition on cell proliferation. The created hydrogel exhibited a significant aggregation effect on platelets and a reduced blood clotting index (BCI). Importantly, the hydrogel can quickly adhere to seal the wound and has good hemostatic effect in vivo. Our work successfully prepared a polysaccharide-based bio-adhesive hydrogel dressing with stable structure, appropriate mechanical strength, and good hemostatic properties.

Formation of substituted dioxanes in the oxidation of gum arabic with periodate

Renewable polysaccharide feedstocks are of interest in bio-based food packaging, coatings and hydrogels. Their physical properties often need to be tuned by chemical modification, e.g. by oxidation using periodate, to introduce carboxylic acid, ketone or aldehyde functional groups. The reproducibility required for application on an industrial scale, however, is challenged by uncertainty about the composition of product mixtures obtained and of the precise structural changes that the reaction with periodate induces. Here, we show that despite the structural diversity of gum arabic, primarily rhamnose and arabinose subunits undergo oxidation, whereas (in-chain) galacturonic acids are unreactive towards periodate. Using model sugars, we show that periodate preferentially oxidises the anti 1,2-diols in the rhamnopyranoside monosaccharides present as terminal groups in the biopolymer. While formally oxidation of vicinal diols results in the formation of two aldehyde groups, only traces of aldehydes are observed in solution, with the main final products obtained being substituted dioxanes, both in solution and in the solid state. The substituted dioxanes form most likely by the intramolecular reaction of one aldehyde with a nearby hydroxyl group, followed by hydration of the remaining aldehyde to form a geminal diol. The absence of significant amounts of aldehyde functional groups in the modified polymer impacts crosslinking strategies currently attempted in the preparation of renewable polysaccharide-based materials.

Mussel-Inspired Multifunctional Hydrogels with Adhesive, Self-Healing, Antioxidative, and Antibacterial Activity for Wound Healing

Antibacterial hydrogel wound dressings with adhesive and antioxidant activity are desirable for treating skin injuries in clinical care. Hereby, a series of multifunctional hydrogel wound dressings with high adhesive, self-healing, antioxidant, and antibacterial activity were designed and fabricated using dopamine (DA) and quercetin (QT). The multifunctional hydrogels were constructed by the interpenetrated quaternized chitosan chain segments and polyacrylamide network. The catechol groups on DA, QT, and the quaternary ammonium groups in the hydrogel system endow hydrogels with high strength, excellent adhesion, and self-healing ability. The results confirmed the admirable hemocompatibility and remarkable antibacterial activity of the multifunction hydrogels against Staphylococcus aureus and Escherichia coli. Consequently, multifunction hydrogels with satisfactory adhesive and antibacterial activity are appropriate alternative materials in the fields of tissue adhesive and wound dressing applications.

Quarternized chitosan/quercetin/polyacrylamide semi-interpenetrating network hydrogel with recoverability, toughness and antibacterial properties for wound healing

Antibiotic abuse has posed enormous burdens on patients and healthcare systems. Hence, the design and development of non-antibiotic wound dressings to meet clinical demand are urgently desired. However, there remains one of the impediments to hydrogel wound dressings that integrated with good recoverability, toughness, and excellent antibacterial properties. Herein, a series of semi-interpenetrating network (semi-IPN) hydrogels with exceptional mechanical performance and remarkable antibacterial activity based on quaternized chitosan (QCS) and polyacrylamide (PAM) were developed using a one-pot method. Additionally, the antibacterial activity of semi-IPN hydrogel against S. aureus and E. coli was enhanced by integrating it with quercetin (QT). The semi-IPN hydrogels also exhibited high recoverability and toughness, outstanding liquid absorbability (the swelling ratio reached 565 ± 12 %), and a satisfying water vapor transmission rate. Moreover, the semi-IPN hydrogels presented ideal hemocompatibility and cytocompatibility. These high-elastic hydrogels are promising candidates for potential applications in wound dressing, tissue repair, chronic wound care, as well as other biomedical fields.

An Antibacterial and Antiadhesion In Situ Forming Hydrogel with Sol-Spray System for Noncompressible Hemostasis

Noncompressible hemorrhage is a major cause of posttrauma death and occupies the leading position among potentially preventable trauma-associated deaths. Recently, multiple studies have shown that strongly adhesive materials can serve as hemostatic materials for noncompressible hemorrhage. However, the risk of severe tissue adhesion limits the use of adhesive hydrogels as hemostatic materials. Here, we report a promising material system comprising an injectable sol and liquid spray as a potential solution. Injectable sol is mainly composed of gelatin (GEL) and sodium alginate (SA), which possess hemostasis and adhesive properties. The liquid spray component, a mixture of tannic acid (TA) and calcium chloride (CaCl₂), rapidly forms an antibacterial, antiadhesive and smooth film structure upon contact with the sol. In vitro and in vivo experiments demonstrated the bioabsorbable, biocompatible, antibacterial, and antiadhesion properties of the in situ forming hydrogel with a sol-spray system. Importantly, the addition of tranexamic acid (TXA) enhanced hemostatic performance in noncompressible areas and in deep wound hemorrhage. Our study offers a new multifunctional hydrogel system to achieve noncompressible hemostasis.

Acetylated Distarch Phosphate-Mediated Tough and Conductive Hydrogel for Antibacterial Wearable Sensors

Conductive, stretchable, and flexible hydrogel wearable sensors have attracted extensive attention in the fields of artificial intelligence and electronic equipment. However, it is an enormous challenge to fabricate conductive hydrogel sensors with biocompatibility, antibacterial properties, and toughness. Here, a highly conductive hydrogel with excellent toughness, good biocompatibility, and strong antibacterial properties was prepared by incorporating acetylated distarch phosphate (ADSP) into poly(vinyl alcohol) (PVA)/polyhexamethylene biguanide hydrochloride (PHMG). The addition of ADSP not only ionized sodium ions to make the hydrogel conductive but also provided abundant hydroxyl groups to form hydrogen bonds with PVA to improve the toughness of the hydrogel. Furthermore, PHMG endowed the hydrogel with antibacterial properties toward E. coli (Escherichia coli, Gram-negative bacteria) and S. aureus (Staphylococcus aureus, Gram-positive bacteria). Meanwhile, the hydrogel was implanted in mice for 14 days, and the surrounding tissue remained in good condition. More importantly, the hydrogel could detect ECG signals and electrical signals under different actions. This study affords a novel approach for exploiting wearable sensors with antibacterial properties and biocompatibility.

Self-healing, injectable hydrogel based on dual dynamic covalent cross-linking against postoperative abdominal cavity adhesion

Clinically, increasing the peritoneal barrier is an effective adjunct to reducing postoperative peritoneal adhesion. This study presents a facile template for preparing a supramolecular hybrid hydrogel through dynamic covalent cross-linking between carboxymethyl chitosan (CMCS), 2-formylphenylboronic acid (2-FPBA), and quercetin (Que). The as-prepared complex CMCS/2-FPBA/Que (CFQ) hydrogel exhibited favorable antibacterial, anti-inflammatory, and antioxidant effects. A L929 cytotoxicity evaluation confirmed the favorable cytocompatibility of the CFQ hydrogel. The postoperative anti-adhesion ability of the CFQ hydrogel was further evaluated in rats with lateral wall defects and cecal abrasions. Compared with control groups, the tissue adhesion rate was significantly reduced by increasing the Que concentration in all the hydrogel-treated groups. Additionally, the sustained-release time of the C3F0.8Q0.08 hydrogel can exceed 14 days, which is highly desirable for clinical wound treatment. STATEMENT OF SIGNIFICANCE: Postoperative adhesions are a very common postoperative complication that seriously affects the quality of life of patients. The currently commonly used methods for preventing adhesion mainly use degradable barrier materials for physical separation. In this study, we prepared a dual dynamic covalently cross-linked CFQ hydrogel, which is not only degradable and injectable, but also has multiple properties such as antibacterial, antioxidant and anti-inflammatory, which can effectively prevent postoperative adhesion and promote wound healing.

Design of nanoconstructs that exhibit enhanced hemostatic efficiency and bioabsorbability

Hemorrhage is a prime cause of death in civilian and military traumatic injuries, whereby a significant proportion of death and complications occur prior to paramedic arrival and hospital resuscitation. Hence, it is crucial to develop hemostatic materials that are able to be applied by simple processes and allow control over bleeding by inducing rapid hemostasis, non-invasively, until subjects receive necessary medical care. This tutorial review discusses recent advances in synthesis and fabrication of degradable hemostatic nanomaterials and nanocomposites. Control of assembly and fine-tuning of composition of absorbable (i.e., degradable) hemostatic supramolecular structures and nanoconstructs have afforded the development of smart devices and scaffolds capable of efficiently controlling bleeding while degrading over time, thereby reducing surgical operation times and hospitalization duration. The nanoconstructs that are highlighted have demonstrated hemostatic efficiency pre-clinically in animal models, while also sharing characteristics of degradability, bioabsorbability and presence of nano-assemblies within their compositions.

Poly(aspartic acid) based self-healing hydrogel with blood coagulation characteristic for rapid hemostasis and wound healing applications

External hemorrhage, caused by insufficient hemostasis or surgical failure, could leads to shock or even tissue necrosis as the results of excessive blood loss. Furthermore, delayed coagulation, chronic inflammation, bacterial infection and slow cell proliferation are also major challenges to effective wound repairing. In this study, a novel hemostatic hydrogel was prepared by cross-linking inorganic polyphosphate (PolyP) conjugated poly(aspartic acid) hydrazide (PAHP) and PEO₉₀ dialdehyde (PEO₉₀ DA). Based on the dynamic characteristics of the acylhydrazone bond, the hydrogel could repair its cracks when broken under external forces. At the same time, the hydrogel showed outstanding biocompatibility and tissue adhesion with remarkable hemostatic performance. The New Zealand rabbit ear artery used as a in vivo hemostasis model and the results showed the PAHP hydrogel could stop bleeding of traumatic wound and reduce blood loss significantly. Meanwhile, the PAHP hydrogel presented intrinsic antibacterial activity, thus could inhibit the bacterial infection. In addition, the hydrogel loaded with mouse epidermal growth factor (mEGF) accelerated the wound repair rate and promoted the regeneration of fresh tissue in the mouse full thickness skin defect model. Altogether, the PAHP hydrogels exhibits great potential in the biomedical application, especially in wound dressing materials and tissue repairing.

N, O-carboxymethyl chitosan/oxidized cellulose composite sponge containing ε-poly-l-lysine as a potential wound dressing for the prevention and treatment of postoperative adhesion

Herein, we designed and fabricated a biodegradable composite sponge which main component contained N, O-carboxymethyl chitosan (N,O-CS) and oxidized cellulose nanocrystals (TOCN) as a potential wound dressing for the prevention and treatment of postoperative adhesion. In order to improve antimicrobial properties of N,O-CS/TOCN composite sponges, natural antimicrobial agents (ε-Poly-l-Lysine，EPL) were successfully introduced and the EPL/N,O-CS/TOCN composite sponge exhibited excellent antibacterial properties and biological security. The EPL/N,O-CS/TOCN composite sponge can be degraded in vivo within 3 weeks. Finally, we analyzed the anti-adhesion performance of EPL/N,O-CS/TOCN composite sponge through a rat model of sidewall defect-cecum abrasion. These results demonstrated that EPL/N,O-CS/TOCN-treated group can effectively reduce the peritoneal adhesion formation than the commercial soluble gauze group and normal saline group, which mainly attribute to the excellent hemostatic function and tissue repair function of EPL/N,O-CS/TOCN composite sponge. It is believed that the EPL/N,O-CS/TOCN composite sponge will prove to be as a new medical device treat the internal tissue/organ repair and simultaneous prevention of postoperative adhesion.

An Injectable Peptide Hydrogel Constructed of Natural Antimicrobial Peptide J-1 and ADP Shows Anti-Infection, Hemostasis, and Antiadhesion Efficacy

Postoperative adhesion is a common complication of abdominal surgery, which always has many adverse effects in patients. At present, there is still a lack of effective treatment measures and materials to prevent adhesion in the clinics. Herein, we report the potential use of J-1-ADP hydrogel formed by natural antimicrobial peptide jelleine-1 (J-1) self-assembling in adenosine diphosphate (ADP) sodium solution to prevent postsurgery adhesion formation. J-1-ADP hydrogel was found to have good antimicrobial activity against the bacteria and fungi tested and can be used to prevent tissue infection, which was thought to be one of the incitements of adhesion. Due to ADP being a platelet-activating factor, J-1-ADP hydrogel showed significant hemostatic activity in vitro verified by whole blood coagulation, plasma coagulation, platelet activation, and platelet adhesion assays. Further, it showed potent hemostatic activity in a mouse liver hemorrhage model. Bleeding was believed to be a cause of the formation of postsurgery adhesion. J-1-ADP hydrogel had a significant antiadhesion effect in a rat side wall defect-cecum abrasion model. In addition, it had good biocompatibility and degradation properties. So the present study may provide an alternative strategy for designing antimicrobial peptide hydrogel material to prevent postoperative adhesion formation in the clinic.

Organic acid cross-linked 3D printed cellulose nanocomposite bioscaffolds with controlled porosity, mechanical strength, and biocompatibility

Herein, we fabricated chemically cross-linked polysaccharide-based three-dimensional (3D) porous scaffolds using an ink composed of nanofibrillated cellulose, carboxymethyl cellulose, and citric acid (CA), featuring strong shear thinning behavior and adequate printability. Scaffolds were produced by combining direct-ink-writing 3D printing, freeze-drying, and dehydrothermal heat-assisted cross-linking techniques. The last step induces a reaction of CA. Degree of cross-linking was controlled by varying the CA concentration (2.5–10.0 wt.%) to tune the structure, swelling, degradation, and surface properties (pores: 100-450 μm, porosity: 86%) of the scaffolds in the dry and hydrated states. Compressive strength, elastic modulus, and shape recovery of the cross-linked scaffolds increased significantly with increasing cross-linker concentration. Cross-linked scaffolds promoted clustered cell adhesion and showed no cytotoxic effects as determined by the viability assay and live/dead staining with human osteoblast cells. The proposed method can be extended to all polysaccharide-based materials to develop cell-friendly scaffolds suitable for tissue engineering applications.

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Chemically cross-linked polysaccharide-based 3D porous scaffolds were fabricated

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Physicochemical and mechanical properties increased with cross-linker concentration

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Lower cross-linker concentration led to higher porosity and interconnected pores

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Scaffolds promoted clustered cell adhesion and showed no cytotoxic effects

Electrospun Antibacterial Nanomaterials for Wound Dressings Applications

Chronic wounds are caused by bacterial infections and create major healthcare discomforts; to overcome this issue, wound dressings with antibacterial properties are to be utilized. The requirements of antibacterial wound dressings cannot be fulfilled by traditional wound dressing materials. Hence, to improve and accelerate the process of wound healing, an antibacterial wound dressing is to be designed. Electrospun nanofibers offer a promising solution to the management of wound healing, and numerous options are available to load antibacterial compounds onto the nanofiber webs. This review gives us an overview of some recent advances of electrospun antibacterial nanomaterials used in wound dressings. First, we provide a brief overview of the electrospinning process of nanofibers in wound healing and later discuss electrospun fibers that have incorporated various antimicrobial agents to be used in wound dressings. In addition, we highlight the latest research and patents related to electrospun nanofibers in wound dressing. This review also aims to concentrate on the importance of nanofibers for wound dressing applications and discuss functionalized antibacterial nanofibers in wound dressing.