Core-Shell Structured Antimicrobial Nanofiber Dressings Containing Herbal Extract and Antibiotics Combination for the Prevention of Biofilms and Promotion of Cutaneous Wound Healing

Resveratrol-Ampicillin Dual-Drug Loaded Polyvinylpyrrolidone/Polyvinyl Alcohol Biomimic Electrospun Nanofiber Enriched with Collagen for Efficient Burn Wound Repair

Background

The healing of burn wounds is a complicated physiological process that involves several stages, including haemostasis, inflammation, proliferation, and remodelling to rebuild the skin and subcutaneous tissue integrity. Recent advancements in nanomaterials, especially nanofibers, have opened a new way for efficient healing of wounds due to burning or other injuries.

Methods

This study aims to develop and characterize collagen-decorated, bilayered electrospun nanofibrous mats composed of PVP and PVA loaded with Resveratrol (RSV) and Ampicillin (AMP) to accelerate burn wound healing and tissue repair.

Results

Nanofibers with smooth surfaces and web-like structures with diameters ranging from 200 to 400 nm were successfully produced by electrospinning. These fibres exhibited excellent in vitro properties, including the ability to absorb wound exudates and undergo biodegradation over a two-week period. Additionally, these nanofibers demonstrated sustained and controlled release of encapsulated Resveratrol (RSV) and Ampicillin (AMP) through in vitro release studies. The zone of inhibition (ZOI) of PVP-PVA-RSV-AMP nanofibers against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) was found 31±0.09 mm and 12±0.03, respectively, which was significantly higher as compared to positive control. Similarly, the biofilm study confirmed the significant reduction in the formation of biofilms in nanofiber-treated group against both S. aureus and E. coli. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis proved the encapsulation of RSV and AMP successfully into nanofibers and their compatibility. Haemolysis assay (%) showed no significant haemolysis (less than 5%) in nanofiber-treated groups, confirmed their cytocompatibility with red blood cells (RBCs). Cell viability assay and cell adhesion on HaCaT cells showed increased cell proliferation, indicating its biocompatibility as well as non-toxic properties. Results of the in-vivo experiments on a burn wound model demonstrated potential burn wound healing in rats confirmed by H&E-stained images and also improved the collagen synthesis in nanofibers-treated groups evidenced by Masson-trichrome staining. The ELISA assay clearly indicated the efficient downregulation of TNF-alpha and IL-6 inflammatory biomarkers after treatment with nanofibers on day 10.

Conclusion

The RSV and AMP-loaded nanofiber mats, developed in this study, expedite burn wound healing through their multifaceted approach.

Thermoresponsive in situ forming and self-healing double-network hydrogels as injectable dressings for silymarin/levofloxacin delivery for treatment of third-degree burn wounds

Our study aimed to introduce a novel double-cross-linked and thermoresponsive hydrogel with remarkable potential for accelerating third-degree burn wound healing. Burn injuries are recognized as challenging, critical wounds. Especially in third-degree burns, treatment is demanding due to extended wounds, irregular shapes, significant exudation, and intense pain during dressing changes. In this work, hydrogels made of zwitterionic chitosan and dialdehyde starch (ZCS and ZDAS) were created to deliver silymarine (SM) and levofloxacin (LEV). The hydrogels were effortlessly produced using dynamic Schiff base linkages and ionic interactions between ZCS and ZDAS at appropriate times. The pore uniformity, gel fraction, and commendable swelling properties can imply a suitable degree of Schiff base cross-link. The hydrogel demonstrated outstanding shape retention, and significant self-healing and flexibility abilities, enabling it to uphold its form even during bodily movements. After injecting biocompatible hydrogel on the wound, a notable acceleration in wound closure was observed on day 21 (98.1 ± 1.10 %) compared to the control group (75.1 ± 6.13 %), and histopathological analysis revealed a reduction of inflammation that can be linked to remarkable antioxidant and antibiotic properties. The results demonstrate the hydrogel's efficacy in promoting burn wound healing, making it a promising candidate for medical applications.

Recent progress of electrospun nanofibers as burning dressings

Burns are a global public health problem, which brings great challenges to public health and the economy. Severe burns often lead to systemic infection, shock, multiple organ failure, and even death. With the increasing demand for the therapeutic effect of burn wounds, traditional dressings have been unable to meet people's needs due to their single function and many side effects. In this context, electrospinning shows a great prospect on the way to open up advanced wound dressings that promote wound repairing and prevent infection. With its large specific surface area, high porosity, and similar to natural extracellular matrix (ECM), electrospun nanofibers can load drugs and accelerate wound healing. It provides a promising solution for the treatment and management of burn wounds. This review article introduces the concept of burn and the types of electrospun nanofibers, then summarizes the polymers used in electrospun nanofiber dressings. Finally, the drugs (plant extracts, small molecule drugs and nanoparticles) loaded with electrospun burn dressings are summarized. Some promising aspects for developing commercial electrospun burn dressings are proposed.

Coaxial nanofibers encapsulated with Ampelopsis brevipedunculata extract and green synthesized AgNPs for wound repair

Silver nanoparticles (AgNPs) synthesized from Aloe vera extract exhibited a pronounced antibacterial effect, while the Ampelopsis brevipedunculata extract (ABE) showcased a high antioxidant capacity for wound healing. Spherical AgNPs with a particle size of 28.82 nm crystallized in a face-centered-cubic lattice. AgNPs/polyvinyl alcohol (PVA) and ABE/polycaprolactone (PCL) underwent electrospinning to produce coaxial and electrosprayed nanofibers, respectively. The developed coaxial nanofibers demonstrated a strain of 159%, a Young's modulus of elasticity of 7080.14 kPa, a 3.9-fold swelling ratio, a water contact angle of 38.91°, characteristic hydrophilicity, and an adequate water vapor transmission rate of 2272 g/m2/day. ABE exhibited no cytotoxicity to L929 cells and induced a twofold increase in the cell migration rate. Upon applying the developed coaxial nanofiber on an in vivo rat model with a 9 mm wound diameter, the wound rapidly and completely healed within 10 days, with a healing speed 60% greater than that of the control group. Histopathological analysis revealed that the coaxial group did not exhibit inflammation, showed complete epithelization, and featured a well-arranged deposition of collagen on the 10th day.

Innovative Electrospun Nanofiber Mats Based on Polylactic Acid Composited with Silver Nanoparticles for Medical Applications

Nanofibers are some of the most attractive materials that can modify functionalities for developing new kinds of specific applications and are mainly used as a biomedical material. Herein, we designed and prepared antibacterial nonwoven fiber mats of PLA and PLA composited with Ag nanoparticles by electrospinning. The effects of varying filler contents on their chemical, surface morphology, thermal, water absorbency, and antibacterial properties were investigated using FTIR, SEM/EDS, DSC, swelling ratio, and qualitative and quantitative antibacterial tests. FTIR and EDS spectra indicated that Ag nanoparticles were incorporated in the PLA without chemical bonding. SEM revealed that the average diameter of the PLA nanofibers containing the Ag nanoparticles was more significant than those without those particles. In addition, fiber diameters are proportional to the amount of Ag nanoparticle contents. DSC indicated that the Ag nanoparticles can be incorporated within the PLA matrix without strongly affecting their thermal properties. Moreover, the crystallinity of the composite nonwoven fiber mats was higher than those of fiber mats in the neat PLA. However, TGA revealed that the loaded Ag can improve the thermal stability of the PLA electrospun fiber mats. Accordingly, the antibacterial activities revealed that all the composite nanofiber mats exhibited excellent resistance against S. aureus and E. coli bacterial strains. In addition, in the cell toxicity study, all produced hybrids of nonwoven fiber mats induced a reduction in cell viability for the L929 fibroblast cells. Our results suggest that the designed and prepared nonwoven fiber mats may have good potential for use in the biomedical field, particularly in wound dressing applications.

Essential Oils Infused Poly-ε-Caprolactone/Gelatin Electrospun Nanofibrous Mats: Biocompatibility and Antibacterial Study

Infections caused by antibiotic-resistant pathogens result in a delayed wound-healing process. As an approach to prevent infections, alternatives in the form of natural antimicrobial products have become public interest. Essential oils derived from plants are used as antimicrobials owing to their broad-spectrum activity against pathogenic organisms. In this study, essential oil from seeds of watermelon, jackfruit, and papaya was incorporated into poly-ε-caprolactone/gelatin nanofibers using an electrospinning technique. The synthesized nanofibers were smooth, continuous, and bead-free. The nanofibers were found to be mechanically competent as confirmed by the universal tensile tester. The antibacterial activity of the various essential oil-loaded nanofibrous mats was determined by disc diffusion assay. Furthermore, they were found to be non-toxic and biocompatible by MTT and CMFDA assays on fibroblast cells. The obtained results have demonstrated that essential oil-loaded nanofiber mats are promising alternatives to conventional antibacterial wound dressings.

Herbal active ingredient-loaded poly(ω-pentadecalactone-co-δ-valerolactone)/gelatin nanofibrous membranes

Recently, there has been an accelerating interest in novel biocompatible wound dressings made of nano-sized materials, especially nanofibers. Electrospun nanofibers provide high surface area and mimic the extracellular matrix which enhances biocompatibility. Besides, nanofibrous structures have high active ingredient loading capacity as a result of their high surface-to-volume ratio and porosity. In the present study, curcumin-loaded poly(ω-pentadecalactone-co-δ-valerolactone)/gelatin (PDL-VL/Gel) nanofibrous membranes were fabricated to be used for healing skin wounds. Poly(ω-pentadecalactone-co-δ-valerolactone) copolymer has been enzymatically synthesized in previous studies, thus it improves the originality of the membrane. It was aimed to obtain a synergetic effect and increase the novelty of the work by blending synthetic and natural polymers. Moreover, it was preferred to provide antibacterial activity by the incorporation of a herbal ingredient (curcumin) as a natural alternative to commercial antibiotics. Varied amounts of curcumin (5-25 %, w:v) were electrospun together with PDL-VL/Gel (equal volume ratio) polymer blend (fiber diameters ranged between 554 and 1074 nm) and several characterizations (morphological and molecular structure, wettability characteristics, and thermal behavior) were applied to examine the curcumin incorporation. Afterwards, in vitro curcumin release studies were carried out and mathematical modeling was applied to release data to clarify the transport mechanism. Curcumin release profiles comprised of an initial burst release in the first hour followed by a sustained release through 24 h. Based on the antibacterial activity test results, 15 % curcumin loading ratio was found to be sufficient for the treatment of skin wounds infected by Gram-negative (E. coli) and Gram-positive (S. aureus and B. subtilis) bacteria. Additionally, nanofibrous membranes did not lead to cytotoxicity, and curcumin content further enhanced the viability of fibroblasts. Thus, the presented antibacterial nanofibrous membrane is suggested to be applied for the treatment of wound infections and accelerating the healing process.

Phase Change Material-Embedded Multifunctional Janus Nanofiber Dressing with Directional Moisture Transport, Controlled Release of Anti-Inflammatory Drugs, and Synergistic Antibacterial Properties

Wound healing is a systematic and complex process that involves various intrinsic and extrinsic factors affecting different stages of wound repair. Therefore, multifunctional wound dressings that can modulate these factors to promote wound healing are in high demand. In this work, a multifunctional Janus electrospinning nanofiber dressing with antibacterial and anti-inflammatory properties, controlled release of drugs, and unidirectional water transport was prepared by depositing coaxial nanofibers on a hydrophilic poly(ε-caprolactone)@polydopamine-ε-polyl-lysine (PCL@PDA-ε-PL) nanofiber membrane. The coaxial nanofiber was loaded with the phase change material lauric acid (LA) in the shell layer and anti-inflammatory ibuprofen (IBU) in the core layer. Among them, LA with a melting point of 43 °C served as a phase change material to control the release of IBU. The phase transition of LA was induced by near-infrared (NIR) irradiation that triggered the photothermal properties of PDA. Moreover, the Janus nanofiber dressing exhibited synergistic antimicrobial properties for Escherichia coli and Staphylococcus aureus due to the photothermal properties of PDA and antibacterial ε-PL. The prepared Janus nanofiber dressing also exhibited anti-inflammatory activity and biocompatibility. In addition, the Janus nanofiber dressing had asymmetric wettability that enabled directional water transport, thereby draining excessive wound exudate. The water vapor transmission test indicated that the Janus nanofiber dressing had good air permeability. Finally, skin wound healing evaluation in rats confirmed its efficacy in promoting wound healing. Therefore, this strategy of designing and manufacturing a multifunctional Janus nanofiber dressing had great potential in wound healing applications.

Electrospun Scaffolds as Antimicrobial Herbal Extract Delivery Vehicles for Wound Healing

Herbal extracts have been used in traditional remedies since the earliest myths. They have excellent antimicrobial, anti-inflammatory, and antioxidant activities owing to various bioactive components in their structure. However, due to their inability to reach a target and low biostability, their use with a delivery vehicle has come into prominence. For this purpose, electrospun nanofibrous scaffolds have been widely preferred for the delivery and release of antimicrobial herbal extracts due to the flexibility and operational versatility of the electrospinning technique. Herein, we briefly reviewed the electrospun nanofibrous scaffolds as delivery systems for herbal extracts with a particular focus on the preclinical studies for wound-healing applications that have been published in the last five years. We also discussed the indirect effects of herbal extracts on wound healing by altering the characteristics of electrospun mats.

Bletilla striata composite nanofibrous membranes prepared by emulsion electrospinning for enhanced healing of diabetic wounds

Diabetic wounds impose enormous distress and financial burden on patients, and finding effective dressings to manage wounds is critical. As a Chinese herbal medicine with a long history of Clinical application, Bletilla striata has significant medicinal effects in the therapy of various wounds. In this study, PLA and the pharmacodynamic substances of Bletilla striata were prepared into fibrous scaffolds by emulsion electrospinning technology for the management of diabetic wounds in mice. The results of scanning electron microscopy showed that the core-shell structure fibre was successfully obtained by emulsion electrospinning. The fibre membrane exhibited excellent water absorption capability and water vapor transmission rate, could inhibit the growth of Staphylococcus aureus and Pseudomonas aeruginosa, had good compatibility, and achieved excellent healing effect on diabetic wounds. Especially in the in vivo wound healing experiment, the wound healing rate of composite fibre membrane treatment reached 98.587 ± 2.149% in 16 days. This work demonstrated the good therapeutic effect of the developed fibrous membrane to diabetic wound, and this membrane could be potentially applied to chronic wound healing.

Multi-Functional Chitosan Nanovesicles Loaded with Bioactive Manganese for Potential Wound Healing Applications

Chronic skin wound is a chronic illness that possesses a risk of infection and sepsis. In particular, infections associated with antibiotic-resistant bacterial strains are challenging to treat. To combat this challenge, a suitable alternative that is complementary to antibiotics is desired for wound healing. In this work, we report multi-functional nanoscale chitosan vesicles loaded with manganese (Chi-Mn) that has potential to serve as a new tool to augment traditional antibiotic treatment for skin wound healing. Chi-Mn showed antioxidant activity increase over time as well as antimicrobial activity against E. coli and P. aeruginosa PA01. The modified motility assay that mimicked a skin wound before bacterial colonization showed inhibition of bacterial growth with Chi-Mn treatment at a low area density of 0.04 µg of Mn per cm2. Furthermore, this study demonstrated the compatibility of Chi-Mn with a commercial antibiotic showing no loss of antimicrobial potency. In vitro cytotoxicity of Chi-Mn was assessed with macrophages and dermal cell lines (J774A.1 and HDF) elucidating biocompatibility at a wide range (2 ppm-256 ppm). A scratch wound assay involving human dermal fibroblast (HDF) cells was performed to assess any negative effect of Chi-Mn on cell migration. Confocal microscopy study confirmed that Chi-Mn tested at the MIC (16 ppm Mn) has no effect on cell migration with respect to control. Overall, this study demonstrated the potential of Chi-Mn nanovesicles for wound healing applications.

Multi-material electrospinning: from methods to biomedical applications

Electrospinning as a versatile, simple, and cost-effective method to engineer a variety of micro or nanofibrous materials, has contributed to significant developments in the biomedical field. However, the traditional electrospinning of single material only can produce homogeneous fibrous assemblies with limited functional properties, which oftentimes fails to meet the ever-increasing requirements of biomedical applications. Thus, multi-material electrospinning referring to engineering two or more kinds of materials, has been recently developed to enable the fabrication of diversified complex fibrous structures with advanced performance for greatly promoting biomedical development. This review firstly gives an overview of multi-material electrospinning modalities, with a highlight on their features and accessibility for constructing different complex fibrous structures. A perspective of how multi-material electrospinning opens up new opportunities for specific biomedical applications, i.e., tissue engineering and drug delivery, is also offered.

Perspectives of nanofibrous wound dressings based on glucans and galactans - A review

Wound healing is a complex and dynamic process that needs an appropriate environment to overcome infection and inflammation to progress well. Wounds lead to morbidity, mortality, and a significant economic burden, often due to the non-availability of suitable treatments. Hence, this field has lured the attention of researchers and pharmaceutical industries for decades. As a result, the global wound care market is expected to be 27.8 billion USD by 2026 from 19.3 billion USD in 2021, at a compound annual growth rate (CAGR) of 7.6 %. Wound dressings have emerged as an effective treatment to maintain moisture, protect from pathogens, and impede wound healing. However, synthetic polymer-based dressings fail to comprehensively address optimal and quick regeneration requirements. Natural polymers like glucan and galactan-based carbohydrate dressings have received much attention due to their inherent biocompatibility, biodegradability, inexpensiveness, and natural abundance. Also, nanofibrous mesh supports better proliferation and migration of fibroblasts because of their large surface area and similarity to the extracellular matrix (ECM). Thus, nanostructured dressings derived from glucans and galactans (i.e., chitosan, agar/agarose, pullulan, curdlan, carrageenan, etc.) can overcome the limitations associated with traditional wound dressings. However, they require further development pertaining to the wireless determination of wound bed status and its clinical assessment. The present review intends to provide insight into such carbohydrate-based nanofibrous dressings and their prospects, along with some clinical case studies.

Fabrication and characterization of PVA@PLA electrospinning nanofibers embedded with Bletilla striata polysaccharide and Rosmarinic acid to promote wound healing

In this study, a novel nanofiber material with Polylactic acid (PLA), natural plant polysaccharides-Bletilla striata polysaccharide (BSP) and Rosmarinic acid (RA) as the raw materials to facilitate wound healing was well prepared through coaxial electrospinning. The morphology of RA-BSP-PVA@PLA nanofibers was characterized through scanning electron microscopy (SEM), and the successful formation of core-shell structure was verified under confocal laser microscopy (CLSM) and Fourier transform infrared spectroscopy (FTIR). RA-BSP-PVA@PLA exhibited suitable air permeability for wound healing, as indicated by the result of the water vapor permeability (WVTR) study. The results of tension test results indicated the RA-BSP-PVA@PLA nanofiber exhibited excellent flexibility and better accommodates wounds. Moreover, the biocompatibility of RA-BSP-PVA@PLA was examined through MTT assay. Lastly, RA-BSP-PVA@PLA nanofibers can induce wound tissue growth, as verified by the rat dorsal skin wound models and tissue sections. Furthermore, RA-BSP-PVA@PLA can facilitate the proliferation and transformation of early wound macrophages, and down-regulate MPO⁺ expression of on the wound, thus facilitating wound healing, as confirmed by the result of immunohistochemical. Thus, RA-BSP-PVA@PLA nanofibers show great potential as wound dressings in wound healing.

Why traditional herbal medicine promotes wound healing: Research from immune response, wound microbiome to controlled delivery

Impaired wound healing in chronic wounds has been a significant challenge for clinicians and researchers for decades. Traditional herbal medicine (THM) has a long history of promoting wound healing, making them culturally accepted and trusted by a great number of people in the world. However, for a long time, the understanding of herbal medicine has been limited and incomplete, particularly in the allopathic medicine-dominated research system. The therapeutic effects of individual components isolated from THM are found less pronounced compared to synthetic chemical medicine, and the clinical efficacy is always inferior to herbs. In the present article, we review and discuss underlying mechanisms of the skin microbiome involved in the wound healing process; THM in regulating immune responses and commensal microbiome. We additionally propose few pioneer ideas and studies in the development of therapeutic strategies for controlled delivery of herbal medicine. This review aims to promote wound care with a focus on wound microbiome, immune response, and topical drug delivery systems. Finally, future development trends, challenges, and research directions are discussed.

Phytochemical-Based Nanomaterials against Antibiotic-Resistant Bacteria: An Updated Review

Antibiotic-resistant bacteria (ARB) is a growing global health threat, leading to the search for alternative strategies to combat bacterial infections. Phytochemicals, which are naturally occurring compounds found in plants, have shown potential as antimicrobial agents; however, therapy with these agents has certain limitations. The use of nanotechnology combined with antibacterial phytochemicals could help achieve greater antibacterial capacity against ARB by providing improved mechanical, physicochemical, biopharmaceutical, bioavailability, morphological or release properties. This review aims to provide an updated overview of the current state of research on the use of phytochemical-based nanomaterials for the treatment against ARB, with a special focus on polymeric nanofibers and nanoparticles. The review discusses the various types of phytochemicals that have been incorporated into different nanomaterials, the methods used to synthesize these materials, and the results of studies evaluating their antimicrobial activity. The challenges and limitations of using phytochemical-based nanomaterials, as well as future directions for research in this field, are also considered here. Overall, this review highlights the potential of phytochemical-based nanomaterials as a promising strategy for the treatment against ARB, but also stresses the need for further studies to fully understand their mechanisms of action and optimize their use in clinical settings.

Recent progress in the manipulation of biochemical and biophysical cues for engineering functional tissues

Tissue engineering (TE) is currently considered a cutting-edge discipline that offers the potential for developing treatments for health conditions that negatively affect the quality of life. This interdisciplinary field typically involves the combination of cells, scaffolds, and appropriate induction factors for the regeneration and repair of damaged tissue. Cell fate decisions, such as survival, proliferation, or differentiation, critically depend on various biochemical and biophysical factors provided by the extracellular environment during developmental, physiological, and pathological processes. Therefore, understanding the mechanisms of action of these factors is critical to accurately mimic the complex architecture of the extracellular environment of living tissues and improve the efficiency of TE approaches. In this review, we recapitulate the effects that biochemical and biophysical induction factors have on various aspects of cell fate. While the role of biochemical factors, such as growth factors, small molecules, extracellular matrix (ECM) components, and cytokines, has been extensively studied in the context of TE applications, it is only recently that we have begun to understand the effects of biophysical signals such as surface topography, mechanical, and electrical signals. These biophysical cues could provide a more robust set of stimuli to manipulate cell signaling pathways during the formation of the engineered tissue. Furthermore, the simultaneous application of different types of signals appears to elicit synergistic responses that are likely to improve functional outcomes, which could help translate results into successful clinical therapies in the future.

Recent advancement of nanotherapeutics in accelerating chronic wound healing process for surgical wounds and diabetic ulcers

One of the greatest challenges faced during surgical procedures is closing and healing of wounds, which are essential in the field of orthopaedics, trauma, intensive care and general surgery. One of the main causes of death has been linked to chronic wounds, especially in immunosuppressant or diabetic patients. Due to increasing chronic wound fatality along with different pathologies associated with them, the current therapeutic methods are insufficient which has established an eminent need for innovative techniques. Traditionally, wound healing was carried out using formulations and ointments containing silver combined with different biomaterial, but was found to be toxic. Hence, the advent of alternative nanomaterial-based therapeutics for effective wound healing have come into existence. In this review, we have discussed an overview of wound infections such as different wound types, the wound healing process, dressing of wounds and conventional therapies. Furthermore, we have explored various nanotechnological advances made in wound healing therapy which include the use of promising candidates such as organic, inorganic, hybrid nanoparticles/nanocomposites and synthetic/natural polymer-based nanofibers. This review further highlights nanomaterial-based applications for regeneration of tissue in wound healing and can provide a base for researchers worldwide to contribute to this advancing medical area of wound therapy.

Coassembly of Fiber Hydrogel with Antibacterial Activity for Wound Healing

Wound healing remains a critical challenge due to its vulnerability to bacterial infection and the complicated inflammatory microenvironment. Herein, we report a novel antibacterial hydrogel constructed only by gallic acid (GA) and phycocyanin (PC), which is expected for the treatment of bacteria-infected wounds. These GA/PC hydrogels (GP) was found to coassemble into fibrous networks with a diameter of around 2 μm mainly through noncovalent interactions of hydrogen bonds, van der Waals force, and π interaction. Notably, these GP hydrogels showed excellent rheological properties (i.e., storage modulus of more than 9.0 × 10⁴ Pa) and outstanding biocompatibility and antibacterial activities. Thanks to the incorporation of GA and PC, the GP hydrogels enabled adherence to the moist wound tissue and achieved a sustained release of GA and PC into the wound skin, therefore effectively attenuating inflammation and accelerating wound healing both in normal mice and bacteria-infected mice through regulating the expression of the tight junction protein and the alleviation of oxidative stress. Considering these results, these GP hydrogels are demonstrated to be a promising candidate for bacteria-infected wound healing.

Biodegradable Sodium Alginate/Carrageenan/Cellulose Composite Hydrogel Wound Dressings Containing Herbal Extracts for Promoting Blood Coagulation and Wound Healing

Accelerating the coagulation process and preventing wound infection are major challenges in the wound care process. Therefore, new multifunctional wound dressings with procoagulant, antibacterial, and antioxidant properties have enormous potential for clinical application. In this work, biodegradable hydrogels containing herbal extracts are prepared for wound dressings. First, the active ingredients are extracted from Amaranthus spinosus (A. spinosus) and Rubia cordifolia (R. cordifolia) and added to the hydrogels prepared from microcrystalline cellulose (MCC), carrageenan, and sodium alginate. Then the composite hydrogels are air-dried to obtain the wound dressings. The wound dressings prepared in this work have good biocompatibility and moisture retention. The mechanical properties of the wound dressings are further improved with the addition of MCC. Besides, the wound dressings have excellent procoagulant, antibacterial, and antioxidant properties due to the presence of R. cordifolia extract. Overall, the most effective group of wound dressings with different ingredient formulations reduces clotting time by 75% and largely inhibits bacterial growth. The wound dressings perform well in the animal wound models to promote wound healing. These results indicate that the hydrogel wound dressings prepared in this work have great potential for medical applications.

Layer-by-layer assembly of peptides-decorated coaxial nanofibrous membranes with antibiofilm and visual pH sensing capability

The countermeasure of biofilm infections leaving a challenge due to a dense antibiotic-resistant barrier formed by extracellular polymeric substances (EPS). Although antibiotic alternative methods have been developed to combat biofilms, develop effective remedies coupling with timely feedback about the therapeutic effect are still in urgent demand. To this end, we construct an intelligent coaxial electrospun nanofibrous membranes (ENMs) that integrated therapy of infections and in situ visualized diagnosis. Specifically, pH-sensitive alizarin was incorporated into polyamide 6 to subtly consist core layer and curcumin (Cur) was formulated with degradable polyglycolic acid (PGA) to composed of the shell layer. The shell layer can gradually release curcumin along with the degradation of PGA. Moreover, epsilon-poly-_L-lysine (ε-PL) was deposited on coaxial ENMs via layer-by-layer self-assembly technique to disturb EPS integrity. As a result of the treatment, two different Gram-positive and Gram-negative bacteria displayed increased susceptibility to the drug hybrids. The degradation of PGA would trigger a sustained release of Cur and ε-PL, and once the core layer exposing, the acidic microenvironment of Staphylococcus aureus and Pseudomonas aeruginosa biofilm could be detected in situ by emerging visualized color change to timely feedback. Besides, the ENMs showed good biocompatibility. It paves a feasible and effective avenue for constructing a facile treatment and diagnosis platform for wound biofilm infections.

Dual-Functional Nanofibrous Patches for Accelerating Wound Healing

Bacterial infections and inflammation are two main factors for delayed wound healing. Coaxial electrospinning nanofibrous patches, by co-loading and sequential co-delivering of anti-bacterial and anti-inflammation agents, are promising wound dressing for accelerating wound healing. Herein, curcumin (Cur) was loaded into the polycaprolactone (PCL) core, and broad-spectrum antibacterial tetracycline hydrochloride (TH) was loaded into gelatin (GEL) shell to prepare PCL-Cur/GEL-TH core-shell nanofiber membranes. The fibers showed a clear co-axial structure and good water absorption capacity, hydrophilicity and mechanical properties. In vitro drug release results showed sequential release of Cur and TH, in which the coaxial mat showed good antioxidant activity by DPPH test and excellent antibacterial activity was demonstrated by a disk diffusion method. The coaxial mats showed superior biocompatibility toward human immortalized keratinocytes. This study indicates a coaxial nanofiber membrane combining anti-bacterial and anti-inflammation agents has great potential as a wound dressing for promoting wound repair.

Electrospinning of botanicals for skin wound healing

Being the first barrier between the human body and external environments, our skin is highly vulnerable to injuries. As one of the conventional therapies, botanicals prepared in different topical formulations have been applied as medical care for centuries. With the current increase of clinical requirements, applications of botanicals are heading towards nanotechnologies, typically fused with electrospinning that forms nanofibrous membranes suitable for skin wound healing. In this review, we first introduced the main process of wound healing, and then presented botanicals integrated into electrospun matrices as either loaded drugs, or carriers, or membrane coatings. In addition, by addressing functional features of individual botanicals in the healing of injured skin, we further discussed the bioactivity of botanical electrospun membranes in relevant to the medical issues solved in the process of wound healing. As achieved by pioneer studies, due to infrequent adverse effects and the diversity in resources of natural plants, the development of electrospun products based on botanicals is gaining greater attention. However, investigations in this field have mainly focused on different methodologies used in the preparation of nanofibrous membranes containing botanicals, their translation into clinical practices remains unaddressed. Accordingly, we propose that potential clinical applications of botanical electrospun membranes require not only the further expansion and understanding of botanicals, but also an establishment of standard criteria for the evaluation of wound healing and evolutions of technologies to support the large-scale manufacturing industry.

Polysaccharide Electrospun Nanofibers for Wound Healing Applications

As a type of biological macromolecule, natural polysaccharides have been widely used in wound healing due to their low toxicity, good biocompatibility, degradability and reproducibility. Electrospinning is a versatile and simple technique for producing continuous nanoscale fibers from a variety of natural and synthetic polymers. The application of electrospun nanofibers as wound dressings has made great progress and they are considered one of the most effective wound dressings. This paper reviews the preparation of polysaccharide nanofibers by electrospinning and their application prospects in the field of wound healing. A variety of polysaccharide nanofibers, including chitosan, starch, alginate, and hyaluronic acid are introduced. The preparation strategy of polysaccharide electrospun nanofibers and their functions in promoting wound healing are summarized. In addition, the future prospects and challenges for the preparation of polysaccharide nanofibers by electrospinning are also discussed.

Recent Advances in Designing Fibrous Biomaterials for the Domain of Biomedical, Clinical, and Environmental Applications

Unique properties and potential applications of nanofibers have emerged as innovative approaches and opportunities in the biomedical, healthcare, environmental, and biosensor fields. Electrospinning and centrifugal spinning strategies have gained considerable attention among all kinds of strategies to produce nanofibers. These techniques produce nanofibers with high porosity and surface area, adequate pore architecture, and diverse chemical compositions. The extraordinary characteristics of nanofibers have unveiled new gates in nanomedicine to establish innovative fiber-based formulations for biomedical use, healthcare, and a wide range of other applications. The present review aims to provide a comprehensive overview of nanofibers and their broad range of applications, including drug delivery, biomedical scaffolds, tissue/bone-tissue engineering, dental applications, and environmental remediation in a single place. The review begins with a brief introduction followed by potential applications of nanofibers. Finally, the future perspectives and current challenges of nanofibers are demonstrated. This review will help researchers to engineer more efficient multifunctional nanofibers with improved characteristics for their effective use in broad areas. We strongly believe this review is a reader's delight and will help in dealing with the fundamental principles and applications of nanofiber-based scaffolds. This review will assist students and a broad range of scientific communities to understand the significance of nanofibers in several domains of nanotechnology, nanomedicine, biotechnology, and environmental remediation, which will set a benchmark for further research.

Tuning the Drug Release from Antibacterial Polycaprolactone/Rifampicin-Based Core-Shell Electrospun Membranes: A Proof of Concept

The employment of coaxial fibers for guided tissue regeneration can be extremely advantageous since they allow the functionalization with bioactive compounds to be preserved and released with a long-term efficacy. Antibacterial coaxial membranes based on poly-ε-caprolactone (PCL) and rifampicin (Rif) were synthesized here, by analyzing the effects of loading the drug within the core or on the shell layer with respect to non-coaxial matrices. The membranes were, therefore, characterized for their surface properties in addition to analyzing drug release, antibacterial efficacy, and biocompatibility. The results showed that the lower drug surface density in coaxial fibers hinders the interaction with serum proteins, resulting in a hydrophobic behavior compared to non-coaxial mats. The air-plasma treatment increased their hydrophilicity, although it induced rifampicin degradation. Moreover, the substantially lower release of coaxial fibers influenced the antibacterial efficacy, tested against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Indeed, the coaxial matrices were inhibitory and bactericidal only against S. aureus, while the higher release from non-coaxial mats rendered them active even against E. coli. The biocompatibility of the released rifampicin was assessed too on murine fibroblasts, revealing no cytotoxic effects. Hence, the presented coaxial system should be further optimized to tune the drug release according to the antibacterial effectiveness.

3D PCL/collagen nanofibrous medical dressing for one-time treatment of diabetic foot ulcers

Nanofibrous dressings exhibit high specific surface areas, good histocompatibility, enhanced wound healing, and reduced inflammation, which have broad technological implications for treating diabetic foot ulcers (DFUs). However, current nanofibrous dressings still suffer from high resistance to cell infiltration and multiple dressing changes. In this study, polycaprolactone (PCL) and collagen were adopted as electrospinning materials to prepare a 3D PCL/Collagen (PC) nanofibrous dressing (3D-PC) using aqueous phase fibre reassembly technology. The matrix metalloproteinases (MMPs) inhibitor doxycycline hyclate (DCH)-loaded halloysite nanotubes (HNTs) (DCH@HNTs) and antibacterial agent cephalexin (CEX) were loaded onto the dressing to prepare a multifunctional 3D drug-loaded PCL/Collagen nanofibrous dressing to promote DFU wound healing. The obtained 3D nanofibrous dressing exhibited high water absorption capacity and swelling capacity. It showed good antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) in vitro antibacterial test. In addition, the 3D nanofibrous dressing demonstrated good biocompatibility. It could significantly reduce the frequency of dressing changes and improve the healing of DFU wounds compared with the conventional multiple dressing changes method, suggesting a potential candidate for healing diabetic wounds.

Waterproof and Breathable Wound Dressing Composited By Expanded Polytetrafluoroethylene Backing and Hydrogel

Wound dressings with waterproof, breathable and bacterial-resistant properties are still rarely realized. In this work, a newly hydrogel-based dressing is designed with a backing of expanded polytetrafluoroethylene (ePTFE) film. The ePTFE grafting with polyvinylpyrrolidone (PVP) brush is composited with hydrogel successfully with an adhesion energy of ∼80 kJ/m² . In this resultant composite, the ePTFE backing contributes excellent breathability, water resistance and bacterial barrier property. The water vapor transmission rate of the composite is 4.83 × 10³  g/m² ·24 h, which can maintain the mosit evironment of wound and relive pain by evaporating water. Notably, it can withstand 500 mm water column for over 300 s, which is obviously better than the commonly used nonwoven fabric backing materials. It can also prevent the invasion of bacteria, because the pores of ePTFE backing are smaller than those of most common bacterial. As a result, the composite with an ePTFE film backing has a positive effect in accelerating wound healing, promoting the reconstruction of intact epidermis and reducing inflammation. This article is protected by copyright. All rights reserved.

Engineering and Evaluation of Forcespun Gelatin Nanofibers as an Isorhamnetin Glycosides Delivery System

Opuntia ficus-indica (L.) Mill (OFI) is considered a natural source of bioactive phytochemicals, mainly isorhamnetin glycosides (IRGs). These compounds have demonstrated antioxidant, anti-inflammatory, and anticancer activities, among others. The development of a suitable delivery system for these compounds is needed to improve their chemical and biological stability. This study aimed to evaluate the feasibility of fabrication and characterization of IRG-loaded gelatin (GL) forcespun fibers and crosslinking with glutaraldehyde (GTA). Two different percentages (25% and 30% w/v) of GL were evaluated with 12% (w/v) OFI flour to obtain nanofibers GL/OFI1 and GL/OFI2, respectively. The morphology and physicochemical properties of the fibers were investigated. The results indicated that the diameters of the fibers were on the nanoscale. The amount of IRGs was determined using high-performance liquid chromatography (HPLC). The IRGs release and the cytocompatibility of the nanofibers were also evaluated. GL concentration significantly affected the IRG release. Among both nanofibers, the GL/OFI2 nanofiber achieved a cumulative IRGs release of 63% after 72 h. Both fibers were shown to be biocompatible with human skin/fibroblast cells. Specifically, GL/OFI1 nanofibers exhibited favorable features for their application as an extract-coupled release system. The IRGs-embedded GL nanofiber mats may become a good alternative for the delivery of phytochemicals for the health sector and biomedical applications.

An Updated Account On Formulations And Strategies For The Treatment Of Burn Infection – A Review

Background:

Burn injury is considered one of the critical injuries of the skin. According to WHO (World Health Organization), approximately 3,00,000 deaths are caused each year mainly due to fire burns, with additional deaths attributed to heat and other causes of burn e.g., electric devices, chemical materials, radioactive rays, etc. More than 95% of burn injuries occur in developing countries.

Introduction:

Burn injuries have been a prominent topic of discussion in this present era of advancements. Burns are one of the common and devastating forms of trauma. Burn injuries are involved in causing severe damage to skin tissues and various other body parts triggered particularly by fire,blaze, or exposure to chemicals and heated substances. They leave a long-lasting negative impact on the patients in terms of their physical and mental health.

Method:

The various methods and bioactive hydrogels, a viable and widely utilised approach for treating chronic wounds remains a bottleneck. Many traditional approaches such as woven material, conventional antimicrobial agents, hydrogel sheets, creams are utilised in wound healing. Nowadays, lipid-based nanoparticles, nanofibres systems, and foam-based formulations heal the wound.

Result:

The prepared formulation shows wound healing activity when tested on rat model. The nanofibres containing SSD help in the burn-wound healing study on Male Sprague Dawley (SD) rats. The healing effect on rats was examined by western blot analysis, digital camera observation, and histological analyses.

Conclusion:

Burn is also considered the most grievous form of trauma. Nowadays, several large and foam-based formulations are used in wound healing, which heals the wound better than previously existing formulations and is less prone to secondary infection. Recently, nanofiber delivery has piqued the interest of academics over the years because of its excellent features, which include an extraordinarily high surface to volume ratio, a highly porous structure, and tiny pore size.

A review of current advancements for wound healing: Biomaterial applications and medical devices

Wound healing is a complex process that is critical in restoring the skin's barrier function. This process can be interrupted by numerous diseases resulting in chronic wounds that represent a major medical burden. Such wounds fail to follow the stages of healing and are often complicated by a pro‐inflammatory milieu attributed to increased proteinases, hypoxia, and bacterial accumulation. The comprehensive treatment of chronic wounds is still regarded as a significant unmet medical need due to the complex symptoms caused by the metabolic disorder of the wound microenvironment. As a result, several advanced medical devices, such as wound dressings, wearable wound monitors, negative pressure wound therapy devices, and surgical sutures, have been developed to correct the chronic wound environment and achieve skin tissue regeneration. Most medical devices encompass a wide range of products containing natural (e.g., chitosan, keratin, casein, collagen, hyaluronic acid, alginate, and silk fibroin) and synthetic (e.g., polyvinyl alcohol, polyethylene glycol, poly[lactic‐co‐glycolic acid], polycaprolactone, polylactic acid) polymers, as well as bioactive molecules (e.g., chemical drugs, silver, growth factors, stem cells, and plant compounds). This review addresses these medical devices with a focus on biomaterials and applications, aiming to deliver a critical theoretical reference for further research on chronic wound healing.

Bacteriological Investigation and Drug Resistance Analysis of Chronic Refractory Wound Secretions: A Clinical Study

BACKGROUND

Chronic refractory wounds were common and the treatments were complicated for burn and plastic surgeons. This study was to investigate the bacterial distribution characteristics and bacterial drug resistance of chronic refractory wound secretions.

METHODS

The authors retrospectively analyzed 425 patients with chronic refractory wound infection. The results of bacterial culture of wound secretions and drug sensitivity test were retrospectively analyzed. Further, the location area of the wound was divided into 4 regions, and the difference of the bacterial culture results between different regions was analyzed.

RESULTS

The wound secretions were cultured into 401 bacterial strains, including 206 gram-positive bacteria strains, accounting for 51.4%, with the highest detection rate of Staphylococcus aureus at 26.2% (105/401). There were 195 gram-negative bacteria strains, accounting for 48.6%, with the highest detection rate of Pseudomonas aeruginosa at 14.2% (57/401). There were 6 fungal strains. The proportion of gram-negative bacteria in the III region of the wound zone was significantly greater than that in the other 3 regions.

CONCLUSIONS

The detection rate of gram-positive bacteria and gram-negative bacteria of chronic refractory wound secretions is not much different. However, in the area close to the perineum (III region), gram-negative bacteria is significantly higher, which has a certain reference value for the use of antibiotics in clinical practice.Level of evidence: Level 4.

Antibacterial, antioxidant and anti-inflammatory PLCL/gelatin nanofiber membranes to promote wound healing

Epigallocatechin-3-O-gallate (EGCG) is a green biomedical agent for promoting wound healing, which possess excellent antibacterial, antioxidant and anti-inflammatory activities. For improving the low bioavailability challenges of EGCG in vivo, we had successful created a low-cost and simple wound dressing Poly (L-Lactic-co-caprolactone) (PLCL)/Gelatin/EGCG/Core-shell nanofiber membrane (PGEC) with drug sustained release capacity through coaxial electrospinning technology. In vitro experimental indicated that the core-shell structure wound dressing had excellent biocompatibility, antibacterial and antioxidant ability, which could support cell viability and proliferation, encourage re-epithelialization during the healing process, inhibit subsequent wound infection and thus promote wound regeneration. In vivo experimental demonstrated that PGEC wound dressing could promote wound healing, the histological results further demonstrated that PGEC not only facilitated early wound closure but also influenced cellular differentiation and tissue organization. Meanwhile, PGEC had excellent hemostatic ability. Taken all together, we believed that the PGEC wound dressing, which could localize delivery of EGCG, had high potential clinical application for promoting wound healing, hemostasis or other related clinical applications in the future.

Electrospun Structural Hybrids of Acyclovir-Polyacrylonitrile at Acyclovir for Modifying Drug Release

In traditional pharmaceutics, drug–crystalline nanoparticles and drug–polymer composites are frequently explored for their ability to modify drug release profiles. In this study, a novel sort of hybrid with a coating of acyclovir crystalline nanoparticles on acyclovir-polyacrylonitrile composites was fabricated using modified, coaxial electrospinning processes. The developed acyclovir-polyacrylonitrile at the acyclovir nanohybrids was loaded with various amounts of acyclovir, which could be realized simply by adjusting the sheath fluid flow rates. Compared with the electrospun composite nanofibers from a single-fluid blending process, the nanohybrids showed advantages of modifying the acyclovir release profiles in the following aspects: (1) the initial release amount was more accurately and intentionally controlled; (2) the later sustained release was nearer to a zero-order kinetic process; and (3) the release amounts at different stages could be easily allocated by the sheath fluid flow rate. X-ray diffraction results verified that the acyclovir nanoparticles were in a crystalline state, and Fourier-transform infrared spectra verified that the drug acyclovir and the polymer polyacrylonitrile had a good compatibility. The protocols reported here could pave the way for developing new types of functional nanostructures.

Electrospun Fibers Loaded with Natural Bioactive Compounds as a Biomedical System for Skin Burn Treatment. A Review

Burns are a major threat to public health and the economy due to their costly and laborious treatment and high susceptibility to infection. Efforts have been made recently to investigate natural bioactive compounds with potential use in wound healing. The importance lies in the capacities that these compounds could possess both in infection control by common and resistant microorganisms, as well as in the regeneration of the affected tissues, having in both cases low adverse effects. However, some bioactive molecules are chemically unstable, poorly soluble, and susceptible to oxidative degradation or have low bioavailability. Therefore, developing new technologies for an efficient treatment of wound healing poses a real challenge. In this context, electrospun nanofibers have gained increasing research interest because bioactive molecules can be easily loaded within the nanofiber, resulting in optimal burst control and enhanced drug stability. Additionally, the nanofibers can mimic the extracellular collagen matrix, providing a suitable highly porous structural support for growing cells that facilitate and accelerate skin burns healing. This review gives an overview of the current state of electrospun fibers loaded with natural bioactive compounds as a biomedical system for skin burn treatment.

Electrospun Medicated Nanofibers for Wound Healing: Review

With the increasing demand for wound care and treatment worldwide, traditional dressings have been unable to meet the needs of the existing market due to their limited antibacterial properties and other defects. Electrospinning technology has attracted more and more researchers' attention as a simple and versatile manufacturing method. The electrospun nanofiber membrane has a unique structure and biological function similar to the extracellular matrix (ECM), and is considered an advanced wound dressing. They have significant potential in encapsulating and delivering active substances that promote wound healing. This article first discusses the common types of wound dressing, and then summarizes the development of electrospun fiber preparation technology. Finally, the polymers and common biologically active substances used in electrospinning wound dressings are summarized, and portable electrospinning equipment is also discussed. Additionally, future research needs are put forward.