Development of Cellulose Nanofibril/Casein-Based 3D Composite Hemostasis Scaffold for Potential Wound-Healing Application

Casein-based hydrogels: Advances and prospects

Casein-based hydrogels (Casein Gels) possess advantageous properties, including mechanical strength, stability, biocompatibility, and even adhesion, conductivity, sensing capabilities, as well as controlled-releasing behavior of drugs. These features are attributed to their gelation methods and functionalization with various polymers. Casein Gels is an important protein-based material in the food industry, in terms of dairy and functional foods, biological and medicine, in terms of carrier for bioactive and sensitive drugs, wound healing, and flexible sensors and wearable devices. Herein, this review aims to highlight the importance of the features mentioned above via a comprehensive investigation of Casein Gels through multiple directions and dimensional applications. Firstly, the composition, structure, and properties of casein, along with the gelation methods employed to create Casein Gels are elaborated, which serves as a foundation for further exploration. Then, the application progresses of Casein Gels in dairy products, functional foods, medicine, flexible sensors and wearable devices, are thoroughly discussed to provide insights into the diverse fields where Casein Gels have shown promise and utility. Lastly, the existing challenges and future research trends are highlighted from an interdisciplinary perspective. We present the latest research advances of Casein Gels and provide references for the development of multifunctional biomass-based hydrogels.

Exploring the potential of selective oxidation in bioconjugation of collagen with xyloglucan carboxylates

Xyloglucan (XG), as a natural biopolymer, possesses a sound biocompatibility and an impressive biodegradability, which are usually featured with abundant hydroxyl groups available for the bioconjugation with a bioactive moiety, suggesting a promising or unique value possibly applied in the field of biomedicine. In this study, XG was extracted from Tamarind seeds and subjected to four regioselective oxidation methods to introduce carboxyl groups onto the XG molecules for a bioconjugation with collagen. Galactose oxidase and reducing end aldehyde group oxidation mainly resulted in a low carboxylate content at ∼0.34 mmol/g, whereas the primary and secondary hydroxyl group oxidations would lead to a high carboxyl content at ∼0.84 mmol/g. The number-average molar mass (Mn) and weight-average molar mass (Mw) of XG were 8.8 × 105 g/mol and 1.1 × 106 g/mol, respectively. The oxidized XGs were then subjected to a further biofunctionalization with the collagen through EDC/NHS coupling, which exhibited a degree of conjugation rate, ranged from 50 % to 72 %. The collagen-conjugated at the C6 position of XGs exhibited the highest cell viability recorded at 168 % in promoting cell growth and proliferation after 72 h of culture, surpassing that of pure collagen recorded at 138 %, which may indeed suggest a promising value in a biomedical application.

A Photo-induced Cross-Linking Enhanced A and B Combined Multi-Functional Spray Hydrogel Instantly Protects and Promotes of Irregular Dynamic Wound Healing

Wounds in harsh environments can face long-term inflammation and persistent infection, which can slow healing. Wound spray is a product that can be rapidly applied to large and irregularly dynamic wounds, and can quickly form a protective film in situ to inhibit external environmental infection. In this study, a biodegradable A and B combined multi-functional spray hydrogel is developed with methacrylate-modified chitosan (CSMA1st) and ferulic acid (FA) as type A raw materials and oxidized Bletilla striata polysaccharide (OBSP) as type B raw materials. The precursor CSMA1st-FA/OBSP (CSOB-FA1st) hydrogel is formed by the self-cross-linking of dynamic Schiff base bonds, the CSMA-FA/OBSP (CSOB-FA) hydrogel is formed quickly after UV-vis light, so that the hydrogel fits with the wound. Rapid spraying and curing provide sufficient flexibility and rapidity for wounds and the hydrogel has good injectability, adhesive, and mechanical strength. In rats and miniature pigs, the A and B combined spray hydrogel can shrink wounds and promote healing of infected wounds, and promote the enrichment of fibrocyte populations. Therefore, the multifunctional spray hydrogel combined with A and B can protect irregular dynamic wounds, prevent wound infection and secondary injury, and be used for safe and effective wound treatment, which has a good prospect for development.

3D Printing of Polysaccharide-Based Hydrogel Scaffolds for Tissue Engineering Applications: A Review

In tissue engineering, 3D printing represents a versatile technology employing inks to construct three-dimensional living structures, mimicking natural biological systems. This technology efficiently translates digital blueprints into highly reproducible 3D objects. Recent advances have expanded 3D printing applications, allowing for the fabrication of diverse anatomical components, including engineered functional tissues and organs. The development of printable inks, which incorporate macromolecules, enzymes, cells, and growth factors, is advancing with the aim of restoring damaged tissues and organs. Polysaccharides, recognized for their intrinsic resemblance to components of the extracellular matrix have garnered significant attention in the field of tissue engineering. This review explores diverse 3D printing techniques, outlining distinctive features that should characterize scaffolds used as ideal matrices in tissue engineering. A detailed investigation into the properties and roles of polysaccharides in tissue engineering is highlighted. The review also culminates in a profound exploration of 3D polysaccharide-based hydrogel applications, focusing on recent breakthroughs in regenerating different tissues such as skin, bone, cartilage, heart, nerve, vasculature, and skeletal muscle. It further addresses challenges and prospective directions in 3D printing hydrogels based on polysaccharides, paving the way for innovative research to fabricate functional tissues, enhancing patient care, and improving quality of life.

Preparation and Application of Hemostatic Hydrogels

Hemorrhage remains a critical challenge in various medical settings, necessitating the development of advanced hemostatic materials. Hemostatic hydrogels have emerged as promising solutions to address uncontrolled bleeding due to their unique properties, including biocompatibility, tunable physical characteristics, and exceptional hemostatic capabilities. In this review, a comprehensive overview of the preparation and biomedical applications of hemostatic hydrogels is provided. Particularly, hemostatic hydrogels with various materials and forms are introduced. Additionally, the applications of hemostatic hydrogels in trauma management, surgical procedures, wound care, etc. are summarized. Finally, the limitations and future prospects of hemostatic hydrogels are discussed and evaluated. This review aims to highlight the biomedical applications of hydrogels in hemorrhage management and offer insights into the development of clinically relevant hemostatic materials.

Biocompatible arabinogalactan-chitosan scaffolds for photothermal pharmacology in wound healing and tissue regeneration

Delayed wound healing is often caused by bacterial infections and persistent inflammation. Multifunctional materials with anti-bacterial, anti-inflammatory, and hemostatic properties are crucial for accelerated wound healing. In this study, we report a biomacromolecule-based scaffold (ArCh) by uniquely combining arabinogalactan (Ar) and chitosan (Ch) using a Schiff-based reaction. Further, the optimized ArCh scaffolds were loaded with Glycyrrhizin (GA: anti-inflammatory molecule) conjugated NIR light-absorbing Copper sulfide (CuS) nanoparticles. The resultant GACuS ArCh scaffolds were characterized for different wound healing parameters in in-vitro and in-vivo models. Our results indicated that GACuS ArCh scaffolds showed excellent swelling, biodegradation, and biocompatibility in vitro. Further results obtained indicated that GACuS ArCh scaffolds demonstrated mild hyperthermia and enhanced hemostatic, anti-oxidant, anti-bacterial, and wound-healing effects when exposed to NIR light. The scaffolds, upon further validation, may be beneficial in accelerating wound healing and tissue regeneration response.

Biofabrication of Cellulose-based Hydrogels for Advanced Wound Healing: A Special Emphasis on 3D Bioprinting

Even with the current advancements in wound management, addressing most skin injuries and wounds continues to pose a significant obstacle for the healthcare industry. As a result, researchers are now focusing on creating innovative materials utilizing cellulose and its derivatives. Cellulose, the most abundant biopolymer in nature, has unique properties that make it a promising material for wound healing, such as biocompatibility, tunable physiochemical characteristics, accessibility, and low cost. 3D bioprinting technology has enabled the production of cellulose-based wound dressings with complex structures that mimic the extracellular matrix. The inclusion of bioactive molecules such as growth factors offers the ability to aid in promoting wound healing, while cellulose creates an ideal environment for controlled release of these biomolecules and moisture retention. The use of 3D bioprinted cellulose-based wound dressings has potential benefits for managing chronic wounds, burns, and painful wounds by promoting wound healing and reducing the risk of infection. This review provides an up-to-date summary of cellulose-based dressings manufactured by 3D bioprinting techniques by looking into wound healing biology, biofabrication methods, cellulose derivatives, and the existing cellulose bioinks targeted toward wound healing.

Recent advances in harnessing biological macromolecules for wound management: A review

Wound dressings (WDs) are an essential component of wound management and serve as an artificial barrier to isolate the injured site from the external environment, thereby helping to prevent exogenous infections and supporting healing. However, maintaining a moist wound environment, providing protection from infection, good biocompatibility, and allowing for gas exchange, remain a challenge in device design. Functional wound dressings (FWDs) prepared from hybrid biological macromolecule-based materials can enhance efficacy of these systems for skin wound management. This review aims to provide an overview of the state-of-the-art FWDs within the field of wound management, with a specific focus on hybrid biomaterials, techniques, and applications developed over the past five years. In addition, we highlight the incorporation of biological macromolecules in WDs, the emergence of smart WDs, and discuss the existing challenges and future prospects for the development of advanced WDs.

Biosafety consideration of nanocellulose in biomedical applications: A review

Nanocellulose-based biomaterials have gained significant attention in various fields, especially in medical and pharmaceutical areas, due to their unique properties, including non-toxicity, high specific surface area, biodegradability, biocompatibility, and abundant feasible and sophisticated strategies for functional modification. The biosafety of nanocellulose itself is a prerequisite to ensure the safe and effective application of biomaterials as they interact with living cells, tissues, and organs at the nanoscale. Potential residual endogenous impurities and exogenous contaminants could lead to the failure of the intended functionalities or even serious health complications if they are not adequately removed and assessed before use. This review summarizes the sources of impurities in nanocellulose that may pose potential hazards to their biosafety, including endogenous impurities that co-exist in the cellulosic raw materials themselves and exogenous contaminants caused by external exposure. Strategies to reduce or completely remove these impurities are outlined and classified as chemical, physical, biological, and combined methods. Additionally, key points that require careful consideration in the interpretation of the biosafety evaluation outcomes were discussed to ensure the safety and effectiveness of the nanocellulose-based biomaterials in medical applications.

Recent advances and biomedical application of 3D printed nanocellulose-based adhesive hydrogels: A review

Nanocellulose-based tissue adhesives show promise for achieving rapid hemostasis and effective wound healing. Conventional methods, such as sutures and staples, have limitations, prompting the exploration of bioadhesives for direct wound adhesion and minimal tissue damage. Nanocellulose, a hydrolysis product of cellulose, exhibits superior biocompatibility and multifunctional properties, gaining interest as a base material for bioadhesive development. This study explores the potential of nanocellulose-based adhesives for hemostasis and wound healing using 3D printing techniques. Nanocellulose enables the creation of biodegradable adhesives with minimal adverse effects and opens avenues for advanced wound healing and complex tissue regeneration, such as skin, blood vessels, lungs, cartilage, and muscle. This study reviews recent trends in various nanocellulose-based 3D printed hydrogel patches for tissue engineering applications. The review also introduces various types of nanocellulose and their synthesis, surface modification, and bioadhesive fabrication techniques via 3D printing for smart wound healing.

Recent advances in 3D printed cellulose-based wound dressings: A review on in vitro and in vivo achievements

Chronic wounds, especially diabetic ulcers, pose a significant challenge in regenerative medicine. Cellulose derivatives offer remarkable wound management properties, such as effective absorption and retention of wound exudates, maintaining an optimal moisture environment crucial for successful chronic wound regeneration. However, conventional dressings have limited efficacy in managing and healing these types of skin lesions, driving scientists to explore innovative approaches. The emergence of 3D printing has enabled personalized dressings that meet individual patient needs, improving the healing process and patient comfort. Cellulose derivatives meet the demanding requirements for biocompatibility, printability, and biofabrication necessary for 3D printing of biologically active scaffolds. However, the potential applications of nanocellulose and cellulose derivative-based inks for wound regeneration remain largely unexplored. Thus, this review provides a comprehensive overview of recent advancements in cellulose-based inks for 3D printing of personalized wound dressings. The composition and biofabrication approaches of cellulose-based wound dressings are thoroughly discussed, including the functionalization with bioactive molecules and antibiotics for improved wound regeneration. Similarly, the in vitro and in vivo performance of these dressings is extensively examined. In summary, this review aims to highlight the exceptional advantages and diverse applications of 3D printed cellulose-based dressings in personalized wound care.

Radical adducts formation mechanism of CH3CO2∙ and CH3CO3∙ realized decomposition of chitosan by plasma catalyzed peracetic acid

High-molecular-weight chitosan has limited applications due to unsatisfactory solubility and hydrophilicity. Discharge plasma coupled with peracetic acid (PAA) oxidation ("plasma+PAA") realized fast depolymerization of high-molecular-weight chitosan in this study. The molecular weight of chitosan rapidly declined to 81.1 kDa from initial 682.5 kDa within 60 s of "plasma+PAA" treatment, and its reaction rate constant was 12-fold higher than single plasma oxidation. Compared with 1O2, ∙CH3, CH3O2·, and O2∙-, CH3CO2∙ and CH3CO3∙ played decisive roles in the chitosan depolymerization in the plasma+PAA system through mechanisms of radical adduct formation. The attacks of CH3CO2∙ and CH3CO3∙ destroyed the β-(1,4) glycosidic bonds and hydrogen bonds of chitosan, leading to generation of low-molecular-weight chitosan; the main chain structure of chitosan was not changed during the depolymerization process. Furthermore, the generated low-molecular-weight chitosan exhibited greater antioxidant activities than original chitosan. Overall, this study revealed the radical adduct formation mechanisms of CH3CO2∙ and CH3CO3∙ for chitosan decomposition, providing an alternative for fast depolymerization of high-molecular-weight chitosan.

3D printing-mediated microporous starch hydrogels for wound hemostasis

Starch hydrogels with biodegradability and cytocompatibility are good alternatives to traditional dressings. Herein, oxidized starch hydrogel loaded with coagulation factor Ca2+ ions (CaOMS) is successfully constructed by green hot-extrusion 3D printing technology (HE-3DP). In vitro study demonstrated the good water absorbing capacity (845.15-1194.20%) and blood cell and platelet adhesion of CaOMS to assist hemostasis owing to the boosted network structure density, gel strength, and the release of activated Ca2+ ions. More importantly, in vivo experiments further demonstrated CaOMS could maintain the weight loss caused by blood loss from wounds and has excellent hemostatic (65 s) and wound healing properties by promoting the secretion of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) expression. The advantages of CaOMS, including rapid and effective hemostasis, effective wound healing, low cost, easy usage, and adaptability to fit various wound shapes, make it a promising biomaterial for achieving fast hemostasis and wound healing.

Facile fabrication of self-healing, injectable and antimicrobial cationic guar gum hydrogel dressings driven by hydrogen bonds

Developing self-healing polysaccharide hydrogels offers a promising strategy for the healing of full-thickness skin wounds. However, the green and facile fabrication of self-healing polysaccharide hydrogel dressings is challenging. Herein, a novel hydrogen-bonded polysaccharide hydrogel consisting only of cationic guar gum (CG) and CuCl₂ was developed by simply mixing CG and Cu²⁺ solution. A strong enough intermolecular hydrogen bonding could be formed between ipsilateral hydroxyl groups to induce rapid gelation. Benefiting from dynamic and reversible linkages, cationic guar gum-Cu²⁺ (CG-Cu) hydrogels exhibited self-healing, injectable and self-adaption. The CG-Cu hydrogels possessed favorable mechanical strength (compression strength: 50-89 kPa), excellent biocompatibility (cell viability: >95 %; hemolysis ratio: < 5 %) and satisfying antibacterial ability. In vivo degradation tests showed that the CG-Cu hydrogels could be completely degraded after 21 days. Furthermore, in-situ injected CG-Cu hydrogel dressings could perfectly cover wounds to reduce risk of infection and accelerated full-thickness skin generation. In conclusion, this study may provide a new simple and straightforward strategy to prepare self-healing polysaccharide hydrogels based on hydrogen bonding to expand its application in the field of biomedicine and tissue regeneration.

Antibacterial, injectable, and adhesive hydrogel promotes skin healing

With the development of material science, hydrogels with antibacterial and wound healing properties are becoming common. However, injectable hydrogels with simple synthetic methods, low cost, inherent antibacterial properties, and inherent promoting fibroblast growth are rare. In this paper, a novel injectable hydrogel wound dressing based on carboxymethyl chitosan (CMCS) and polyethylenimine (PEI) was discovered and constructed. Since CMCS is rich in -OH and -COOH and PEI is rich in -NH₂, the two can interact through strong hydrogen bonds, and it is theoretically feasible to form a gel. By changing their ratio, a series of hydrogels can be obtained by stirring and mixing with 5 wt% CMCS aqueous solution and 5 wt% PEI aqueous solution at volume ratios of 7:3, 5:5, and 3:7. Characterized by morphology, swelling rate, adhesion, rheological properties, antibacterial properties, in vitro biocompatibility, and in vivo animal experiments, the hydrogel has good injectability, biocompatibility, antibacterial (Staphylococcus aureus: 56.7 × 10⁷ CFU/mL in the blank group and 2.5 × 10⁷ CFU/mL in the 5/5 CPH group; Escherichia coli: 66.0 × 10⁷ CFU/mL in the blank group and 8.5 × 10⁷ CFU/mL in the 5/5 CPH group), and certain adhesion (0.71 kPa in the 5/5 CPH group) properties which can promote wound healing (wound healing reached 98.02% within 14 days in the 5/5 CPH group) and repair of cells with broad application prospects.

Tailorable Lignocellulose-Based Aerogel to Achieve the Balance between Evaporation Enthalpy and Water Transport Rate for Efficient Solar Evaporation

Solar-driven interfacial evaporation technology has become an effective approach to alleviate freshwater shortage. To improve its evaporation efficiency, the pore-size dependence of the water transport rate and evaporation enthalpy in the evaporator should be further investigated. Based on the transportation of water and nutrients in natural wood, we facilely designed a lignocellulose aerogel-based evaporator using carboxymethyl nanocellulose (CMNC) cross-linking, bidirectional freezing, acetylation, and MXene-coating. The pore size of the aerogel was adjusted by controlling its CMNC content. When the channel diameter of the aerogel-based evaporator increased from 21.6 to 91.9 μm, the water transport rate of the proposed evaporator increased from 31.94 to 75.84 g min^-1, while its enthalpy increased from 1146.53 to 1791.60 kJ kg^-1. At a pore size of 73.4 μm, the evaporation enthalpy and water transport rate of the aerogel-based evaporator achieved a balance, leading to the best solar evaporation rate (2.86 kg m^-2 h^-1). The evaporator exhibited excellent photothermal conversion efficiency (93.36%) and salt resistance (no salt deposition after three cycles of 8 h). This study could guide the development of efficient solar-driven evaporators for seawater desalination.

Poly β-Cyclodextrin/Quaternary Ammoniated Chitosan Cryogel with a Porous Structure for Effective Hemostasis

Uncontrolled bleeding is one of the most important causes threatening human health, but quick hemostasis remains a challenge. We prepared porous cryogels with poly β-cyclodextrin (Pβ-CD) and quaternary ammoniated chitosan (QCs). Pβ-CD acts as a "water-grabbing agent" to assist QCs' ability to absorb and concentrate blood rapidly. The rat-tail amputation model and liver injury model exhibited that cryogels had excellent hemostatic performance. Moreover, cryogels showed good antibacterial activity and biocompatibility. Therefore, these cryogels can be used as potential hemostatic materials.

3D Printing as a Technological Strategy for the Personalized Treatment of Wound Healing

Wound healing is a dynamic process which involves stages of hemostasis, inflammation, proliferation and remodeling. Any error in this process results in abnormal wound healing, generating financial burdens for health systems and even affecting the physical and mental health of the patient. Traditional dressings do not meet the complexities of ideal treatment in all types of wounds. For this reason, in the last decades, different materials for drug delivery and for the treatment of wounds have been proposed reaching novel level of standards, such as 3D printing techniques. The use of natural or synthetic polymers, and the correct design of these printed products loaded with cells and/or combined with active compounds, can generate an effective system for the treatment of wounds, improving the healing process and generating customized dressings according to the patient needs. This manuscript provides a comprehensive review of different types of 3D printing techniques, as well as its use in wound healing and its different stages, including the advantages and limitations of additive manufacturing and future perspectives.

Collagen Derived from Fish Industry Waste: Progresses and Challenges

Fish collagen garnered significant academic and commercial focus in the last decades featuring prospective applications in a variety of health-related industries, including food, medicine, pharmaceutics, and cosmetics. Due to its distinct advantages over mammalian-based collagen, including the reduced zoonosis transmission risk, the absence of cultural-religious limitations, the cost-effectiveness of manufacturing process, and its superior bioavailability, the use of collagen derived from fish wastes (i.e., skin, scales) quickly expanded. Moreover, by-products are low cost and the need to minimize fish industry waste's environmental impact paved the way for the use of discards in the development of collagen-based products with remarkable added value. This review summarizes the recent advances in the valorization of fish industry wastes for the extraction of collagen used in several applications. Issues related to processing and characterization of collagen were presented. Moreover, an overview of the most relevant applications in food industry, nutraceutical, cosmetics, tissue engineering, and food packaging of the last three years was introduced. Lastly, the fish-collagen market and the open technological challenges to a reliable recovery and exploitation of this biopolymer were discussed.

Agarose/crystalline nanocellulose (CNC) composites promote bone marrow-derived mast cell integrity, degranulation and receptor expression but inhibit production of de novo synthesized mediators

Introduction: Mast cells are highly granulated tissue-resident leukocytes that require a three-dimensional matrix to differentiate and mediate immune responses. However, almost all cultured mast cells rely on two-dimensional suspension or adherent cell culture systems, which do not adequately reflect the complex structure that these cells require for optimal function. Methods: Crystalline nanocellulose (CNC), consisting of rod-like crystals 4-15 nm in diameter and 0.2-1 µm in length, were dispersed in an agarose matrix (12.5% w/v), and bone marrow derived mouse mast cells (BMMC) were cultured on the agarose/CNC composite. BMMC were activated with the calcium ionophore A23187 or immunoglobulin E (IgE) and antigen (Ag) to crosslink high affinity IgE receptors (FcεRI). Results: BMMC cultured on a CNC/agarose matrix remained viable and metabolically active as measured by reduction of sodium 3'-[1-[(phenylamino)-carbony]-3,4-tetrazolium]-bis(4-methoxy-6-nitro) benzene-sulfonic acid hydrate (XTT), and the cells maintained their membrane integrity as analyzed by measuring the release of lactate dehydrogenase (LDH) and propidium iodide exclusion by flow cytometry. Culture on CNC/agarose matrix had no effect on BMMC degranulation in response to IgE/Ag or A23187. However, culture of BMMC on a CNC/agarose matrix inhibited A23187-and IgE/Ag-activated production of tumor necrosis factor (TNF) and other mediators such as IL-1β, IL-4, IL-6, IL-13, MCP-1/CCL2, MMP-9 and RANTES by as much as 95%. RNAseq analysis indicated that BMMC expressed a unique and balanced transcriptome when cultured on CNC/agarose. Discussion: These data demonstrate that culture of BMMCs on a CNC/agarose matrix promotes cell integrity, maintains expression of surface biomarkers such as FcεRI and KIT and preserves the ability of BMMC to release pre-stored mediators in response to IgE/Ag and A23187. However, culture of BMMC on CNC/agarose matrix inhibits BMMC production of de novo synthesized mediators, suggesting that CNC may be altering specific phenotypic characteristics of these cells that are associated with late phase inflammatory responses.

A CS-based composite scaffold with excellent photothermal effect and its application in full-thickness skin wound healing

The development of natural polymer-based scaffolds with excellent biocompatibility, antibacterial activity, and blood compatibility, able to facilitate full-thickness skin wound healing, remains challenging. In this study, we have developed three chitosan (CS)-based porous scaffolds, including CS, CS/CNT (carbon nanotubes) and CS/CNT/HA (nano-hydroxyapatite, n-HA) using a freeze-drying method. All three scaffolds have a high swelling ratio, excellent antibacterial activity, outstanding cytocompatibility and blood compatibility in vitro. The introduction of CNTs exhibited an obvious increase in mechanical properties and exerts excellent photothermal response, which displays excellent healing performance as a wound dressing in mouse full-thickness skin wound model when compared to CS scaffolds. CS/CNT/HA composite scaffolds present the strongest ability to promote full-thickness cutaneous wound closure and skin regeneration, which might be ascribed to the synergistic effect of photothermal response from CNT and excellent bioactivity from n-HA. Overall, the present study indicated that CNT and n-HA can be engineered as effective constituents in wound dressings to facilitate full-thickness skin regeneration.

Inorganic-based biomaterials for rapid hemostasis and wound healing

The challenge for the treatment of severe traumas poses an urgent clinical need for the development of biomaterials to achieve rapid hemostasis and wound healing. In the past few decades, active inorganic components and their derived composites have become potential clinical products owing to their excellent performances in the process of hemorrhage control and tissue repair. In this review, we provide a current overview of the development of inorganic-based biomaterials used for hemostasis and wound healing. We highlight the methods and strategies for the design of inorganic-based biomaterials, including 3D printing, freeze-drying, electrospinning and vacuum filtration. Importantly, inorganic-based biomaterials for rapid hemostasis and wound healing are presented, and we divide them into several categories according to different chemistry and forms and further discuss their properties, therapeutic mechanisms and applications. Finally, the conclusions and future prospects are suggested for the development of novel inorganic-based biomaterials in the field of rapid hemostasis and wound healing.

3D printing of bone and cartilage with polymer materials

Damage and degeneration to bone and articular cartilage are the leading causes of musculoskeletal disability. Commonly used clinical and surgical methods include autologous/allogeneic bone and cartilage transplantation, vascularized bone transplantation, autologous chondrocyte implantation, mosaicplasty, and joint replacement. 3D bio printing technology to construct implants by layer-by-layer printing of biological materials, living cells, and other biologically active substances in vitro, which is expected to replace the repair mentioned above methods. Researchers use cells and biomedical materials as discrete materials. 3D bio printing has largely solved the problem of insufficient organ donors with the ability to prepare different organs and tissue structures. This paper mainly discusses the application of polymer materials, bio printing cell selection, and its application in bone and cartilage repair.

The 3D printed conductive grooved topography hydrogel combined with electrical stimulation for synergistically enhancing wound healing of dermal fibroblast cells

Patients with extensive cutaneous damage resulting from poor wound healing often have other comorbidities such as diabetes that may lead to impaired skin functions and scar formation. Many recent studies have shown that the application of electrical stimulation (ES) to cutaneous lesions significantly improves skin regeneration via activation of AKT intracellular signaling cascades and secretion of regeneration-related growth factors. In this study, we fabricated varying concentrations of gelatin-methacrylate (GelMa) hydrogels with poly(3,4-ethylenedioxythiophene) (PEDOT): polystyrene sulfonate (PSS), which is a conductive material commonly used in tissue engineering due to its efficiency among conductive thermo-elastic materials. The results showed successful modification of PEDOT:PSS with GelMa while retaining the original structural characteristics of the GelMa hydrogels. In addition, the incorporation of PEDOT:PSS increased the interactions between both the materials, thus leading to enhanced mechanical strength, improved swelling ratio, and decreased hydrophilicity of the scaffolds. Our GelMa/PEDOT:PSS scaffolds were designed to have micro-grooves on the surfaces of the scaffolds for the purpose of directional guiding. In addition, our scaffolds were shown to have excellent electrical conductivity, thus leading to enhanced cellular proliferation and directional migration and orientation of human dermal fibroblasts. In vivo studies revealed that the GelMa/PEDOT:PSS scaffolds with electrical stimulation were able to induce full skin thickness regeneration, as seen from the various stainings. These results indicate the potential of GelMa/PEDOT:PSS as an electro-conductive biomaterial for future skin regeneration applications.

3D Bioprinted Chitosan-Based Hydrogel Scaffolds in Tissue Engineering and Localised Drug Delivery

Bioprinting is an emerging technology with various applications in developing functional tissue constructs for the replacement of harmed or damaged tissues and simultaneously controlled drug delivery systems (DDSs) for the administration of several active substances, such as growth factors, proteins, and drug molecules. It is a novel approach that provides high reproducibility and precise control over the fabricated constructs in an automated way. An ideal bioink should possess proper mechanical, rheological, and biological properties essential to ensure proper function. Chitosan is a promising natural-derived polysaccharide to be used as ink because of its attractive properties, such as biodegradability, biocompatibility, low cost, and non-immunogenicity. This review focuses on 3D bioprinting technology for the preparation of chitosan-based hydrogel scaffolds for the regeneration of tissues delivering either cells or active substances to promote restoration.

Computer-Aided Design and 3D Printing of Hemipelvic Endoprosthesis for Personalized Limb-Salvage Reconstruction after Periacetabular Tumor Resection

3D-printed hemipelvic endoprosthesis is an emerging solution for personalized limb-salvage reconstruction after periacetabular tumor resection. Further clinical studies are still required to report its surgical characteristics, outcomes, benefits and drawbacks. Sixteen consecutive patients underwent periacetabular tumor wide resection and pelvic reconstruction with a 3D-printed hemipelvic endoprosthesis from 2018 to 2021. The surgical characteristics and outcomes are described. The mean follow-up duration was 17.75 months (range, 6 to 46 months). Five patients underwent surgery for type I + II resection and reconstruction, seven for type II + III resection and reconstruction, three for type II resection and reconstruction, and one for type I + II + IV resection and reconstruction. The incidence of postoperative complication was 12.5% (2/16) for deep venous thrombosis (DVT), 12.5% (2/16) for pneumonia, and 12.5% (2/16) for would deep or superficial infection. During follow-up, two patients (12.5%) suffered hip dislocation and underwent revision surgery. CT demonstrated an obvious prosthetic porous structure–bone fusion after follow-up of at least 6 months. At the final follow-up, 12 lived with no evidence of disease while four lived with disease; no patients experienced pain; and 15 had independent ambulation, with a mean Musculoskeletal Tumor Society (MSTS) score of 85.8% (range, 26.7% to 100%). 3D-printed hemipelvic endoprosthesis facilitates wide resection of periacetabular tumor and limb-salvage reconstruction, thus resulting in good oncological and functional outcomes. The custom-made nature is able to well mimic the skeletal anatomy and microstructure and promote osseointegration. Perioperative complications and rehabilitation exercise still need to be stressed for this engineering technology-assisted major orthopedic surgery.

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.

Biomaterials-Based Regenerative Strategies for Skin Tissue Wound Healing

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