Production of Hypericum perforatum oil-loaded membranes for wound dressing material and in vitro tests

A Cutting-Edge Multilayer Nanofiber Wound Dressing: Design, Synthesis, and Investigation for Enhanced Wound Healing In Vitro and In Vivo

Wounds, disruptions in normal anatomy, are classified as acute or chronic. The choice of wound treatment relies significantly on dressing materials. Electrospun nanofibrous materials offer promising applications in wound healing, featuring a substantial surface area, close mimicry of the natural extracellular matrix, and adjustable water resistance, air permeability, and drug release. This research endeavors to formulate an innovative three-layered nanofibrous wound dressing using the electrospinning technique with the primary objectives of enhancing patient well-being, exhibiting antimicrobial characteristics, and expediting wound healing. The designed dressing comprises nanofibers of polyurethane (PU), quercetin (Q)-loaded polyethylene glycol (PEG), polyvinyl alcohol (PVA), and gelatin. Characterization of individual layers and the integrated wound dressing was conducted through SEM and FT-IR analyses. The efficacy of the nanofibrous wound dressing was assessed through in vitro human cell culture and in vivo rat wound models. The anti-toxic effects of nanofiber wound dressing on human epithelial and keratin cells have been proven. In vitro wound models in 24-well plates were utilized to assess the impact on wound healing rates. Photographic documentation of wound closure was performed at the different treatment hours, revealing complete closure of the wounds by the end of the 48th hour. Rats with 2 × 1 cm wounds were treated with the nanofibrous dressings, and wound healing progress was observed over a 14-day period. qRT-PCR was employed to analyze MMP-9, TIMP1, COL1A1, PDGFA, and VEGFC mRNA expressions. With its contemporary design surpassing existing treatments, the nanofiber wound dressing stands out for its wound-healing acceleration and antibacterial properties.

Study of the synergistic properties of copaiba oil co-electrospun with poly(L-co-D,L lactic acid) and natural rubber latex for application in bioactive wound dressings

Wound healing is a complex process involving a sequence of factors that can be disrupted, negatively impacting the quality of life for patients and overburdening healthcare systems. Advanced dressings obtained by electrospinning are highlighted by the optimization of this process, allowing air exchange and protection against microorganisms. Aiming to develop bioactive dressings, this study investigated the physicochemical, mechanical, microbiological, and in vitro biological properties of membranes containing 25 %, 50 %, 75 %, and 90 % copaiba oil (CO) co-electrospun with poly(L-co-D,L-lactic acid) (PLDLA) and natural rubber latex (NR). CO, with antimicrobial and anti-inflammatory properties, was co-electrospun with the system, which integrates the bioactivity and elasticity of NR with the mechanical strength of PLDLA. FTIR analysis indicated a physical interaction between CO and PLDLA/NR, promoting its efficient and sustained release. Scanning electron microscopy (SEM) revealed a fibrous and porous morphological structure. The mechanical tensile test revealed the plasticizing effect of CO. The low Young's modulus (26.6 MPa) for 25 % CO indicated its elastic capacity under low stress. In vitro tests have demonstrated efficacy in preventing bacterial infections against Staphylococcus aureus, due to its bacteriostatic effect and air-filtering capacity, allowing gas exchange while preventing the entry of microorganisms. The system composed of PLDLA/NR/25 % CO also exhibited cell viability of 93 % and 80 % after 24 and 72 h, respectively. The scratch assay using PLDLA/NR/25 % CO demonstrated efficacy in promoting cell migration. These results suggest that co-electrospun membranes hold promise as advanced wound dressings, with the potential to accelerate the wound healing process.

Production and Characterization of H. perforatum Oil-Loaded, Semi-Resorbable, Tri-Layered Hernia Mesh

Hernia repair is the most common surgical operation applied worldwide. Mesh prostheses are used to support weakened or damaged tissue to decrease the risk of hernia recurrence. However, the patches currently used in clinic applications have significant short-term and long-term risks. This study aimed to design, produce, and characterize a three-layered semi-resorbable composite hernia mesh using the electrospinning technique, where the upper layer (parietal side) was made of non-resorbable polypropylene (PP-Cl) fibers, the partially resorbable middle layer was made of PP-Cl and polycaprolactone (PCL) fibers, and the fully resorbable lower layer (visceral side) was made of H. perforatum oil-loaded polyethylene glycol (PEG) fibers. The extracellular matrix-like fibrous structure of the patches provided low density and high porosity, minimizing the risk of long-term foreign body reactions, and the hydrophilic/hydrophobic character of the surfaces and the detected swelling rates supported biocompatibility. The patches exhibited mechanical properties comparable to commercially available products. Controlled release of therapeutic oil could be achieved from the oil-integrated patches due to the dissolution of PEG in the acute process. In vitro cell culture studies with the L929 mouse fibroblast cell line revealed that the meshes do not have a cytotoxic nor a biomaterial-induced necrotic effect that will induce apoptosis of the cells. The visceral side of the meshes exhibited non-adherence of cell-like structures to the surface due to the dissolution of PEG. The composite hernia patches were concluded to reduce the risk of adhering to internal organs in the hernia area, have the potential to be used in in vivo biomedical applications, and will support the search for an ideal hernia mesh that can be used in the treatment of abdominal hernias.

Assessing the Impact of Irrigation and Biostimulants on the Yield and Quality Characteristics of Two Different St. John's Wort Cultivars in Their Second Growing Season

The perennial species Hypericum perforatum, commonly known as St. John's Wort, is well regarded for its medicinal attributes, particularly its strong anti-inflammatory and antidepressant effects. Hypericum perforatum L., commonly known as balsam, is extensively employed in both traditional and contemporary medicine due to its biological properties, although the plant's medicine distribution is limited to Europe and Asia. This study pioneers the investigation of Hypericum perforatum cultivation in a Mediterranean country, specifically Greece, focusing on the effects of irrigation and biostimulants of two distinct genotypes on quantitative (height, drug yield, essential oil yield) and qualitative (essential oil content and composition) characteristics. A field trial was conducted at the experimental farm of the Agrotechnology Department at the University of Thessaly, located in the Larissa region. This study investigated various testing varieties under different irrigation levels and biostimulant applications. The results underscore the importance of customized irrigation and biostimulant strategies in improving yield and quality during the second growing season, establishing a foundation for sustainable agricultural progress. Notably, irrigated treatments significantly increased plant height, dry biomass yield, and essential oil production per hectare. Specifically, the essential oil yields for irrigated treatments were nearly double those of rainfed treatments, with 219 kg/ha for rainfed and 407 kg/ha for irrigated. The genotype played a crucial role in influencing production potential, height, flowering, and essential oil composition, with one variety demonstrating biennial blooming and modified essential oil compounds. While irrigation positively impacted yield, it also reduced certain essential oil compounds while increasing β-pinene content. The effects of biostimulants varied based on their composition, with some enhancing and others diminishing essential oil content. Notably, the biostimulant containing algae with auxin and cytokinin (B2) proved to be the most effective in improving the therapeutic profile. This study offers valuable insights into the cultivation of H. perforatum in a Mediterranean climate, highlighting the necessity for ongoing research into native populations, irrigation levels, biostimulants, fertilization, and other factors that affect crop yield and quality characteristics.

Sodium alginate-based multifunctional sandwich-like system for treating wound infections

Microbial colonization and development of infections in wounds is a sign of chronicity. The prevailing approach to manage and treat these wounds involves dressings. However, these often fail in effectively addressing infections, as they struggle to both absorb exudates and maintain optimal local moisture. The system here presented was conceptualized with a three-layer design: the outer layer made of a fibrous polycaprolactone (PCL) film, to act as a barrier for preventing microorganisms and impurities from reaching the wound; the intermediate layer formed of a sodium alginate (SA) hydrogel loaded with ampicillin (Amp) for fighting infections; and the inner layer comprised of a fibrous film of PCL and polyethylene glycol (PEG) for facilitating cell recognition and preventing wound adhesion. Thermal evaluations, degradation, wettability and release behavior testing confirmed the system resistance overtime. The sandwich demonstrated the capability for absorbing exudates (≈70 %) and exhibited a controlled release of Amp for up to 24 h. Antimicrobial testing was performed against Staphylococcus aureus and Escherichia coli, as representatives of Gram-positive and Gram-negative bacteria: >99 % elimination of bacteria. Cell cytotoxicity assessments showed high cytocompatibility levels, confirming the safety of the proposed sandwich system. Adhesion assays confirmed the system ease of detaching without mechanical effort (0.37 N). Data established the efficiency of the sandwich-like system, suggesting promising applications in infected wound care.

Inhibition of Enzyme and Bacteria Activities in Diabetic Ulcer-like Scenarios via WAAPV-Loaded Electrospun Fibers

In diabetic ulcers, an increased secretion of human neutrophil elastase (HNE) and bacterial infections play crucial roles in hindering healing. Considering that, the present study proposed the development of multi-action polycaprolactone (PCL)/polyethylene glycol (PEG) electrospun fibers incorporating elastase-targeting peptides, AAPV and WAAPV, via blending. Characterization confirmed WAAPV's efficacy in regulating proteolytic enzymes by inhibiting HNE. The engineered fibers, particularly those containing PEG, exhibited optimal wettability but an accelerated degradation that was mitigated with the peptide's inclusion, thus promoting a sustained peptide release over 24 h. Peptide loading was verified indirectly through thermal stability and hydration capacity studies (hydrophobic bonding between PCL and WAAPV and hydrophilic affinities between PCL/PEG and AAPV) and determined at ≈51.1 µg/cm2 and ≈46.0 µg/cm2 for AAPV and ≈48.5 µg/cm2 and ≈51.3 µg/cm2 for WAAPV, respectively, for PCL and PCL/PEG. Both AAPV and WAAPV effectively inhibited HNE, with PEG potentially enhancing this effect by interacting with the peptides and generating detectable peptide-PEG complexes (≈10% inhibition with PCL + peptide fibers after 6 h of incubation, and ≈20% with PCL/PEG + peptide fibers after 4 h incubation). Peptide-loaded fibers demonstrated antibacterial efficacy against Staphylococcus aureus (up to ≈78% inhibition) and Escherichia coli (up to ≈66% inhibition), with peak effectiveness observed after 4 and 2 h of incubation, respectively. This study provides initial insights into the WAAPV's potential for inhibiting HNE and bacteria activities, showing promise for applications in diabetic ulcer management.

Polymer-Based Wound Dressings Loaded with Essential Oil for the Treatment of Wounds: A Review

Wound healing can result in complex problems, and discovering an effective method to improve the healing process is essential. Polymeric biomaterials have structures similar to those identified in the extracellular matrix of the tissue to be regenerated and also avoid chronic inflammation, and immunological reactions. To obtain smart and effective dressings, bioactive agents, such as essential oils, are also used to promote a wide range of biological properties, which can accelerate the healing process. Therefore, we intend to explore advances in the potential for applying hybrid materials in wound healing. For this, fifty scientific articles dated from 2010 to 2023 were investigated using the Web of Science, Scopus, Science Direct, and PubMed databases. The principles of the healing process, use of polymers, type and properties of essential oils and processing techniques, and characteristics of dressings were identified. Thus, the plants Syzygium romanticum or Eugenia caryophyllata, Origanum vulgare, and Cinnamomum zeylanicum present prospects for application in clinical trials due to their proven effects on wound healing and reducing the incidence of inflammatory cells in the site of injury. The antimicrobial effect of essential oils is mainly due to polyphenols and terpenes such as eugenol, cinnamaldehyde, carvacrol, and thymol.

Biologically active sodium pentaborate pentahydrate and Hypericum perforatum oil loaded polyvinyl alcohol: chitosan membranes

In this study, sodium pentaborate pentahydrate (NaB) and Hypericum perforatum (HP) oil were incorporated into polyvinyl alcohol (PVA) and chitosan (CH) polymer blend to obtain membranes by solution casting method. In order to see the synergistic effects of NaB and HP oil on the biological and physical properties of the membranes NaB and HP oil were incorporated into membrane matrix in different ratios. Fourier-transform infrared spectroscopy (FTIR) results showed that no significant bond formation between the bioactive components and the PVA:CH matrix. According to mechanical test results, Young's Modulus and elongation at break decreased from 426 MPa to 346 MPa and 52.23 % to 15.11 % for neat PVA:CH membranes and NaB and HP oil incorporated PVA:CH (PVA:CH@35NaB:HP) membranes, respectively. Antimicrobial activity tests have shown the membranes were over 99 % effective against Escherichia coli, Staphylococcus aureus, and Candida albicans, underlining their potential for infection control. Cytocompatibility assay performed with Human Dermal Fibroblast (HDFa) cells highlight the biocompatibility of the membranes, revealing 74.84 % cell viability after 72 h. The properties of NaB and HP oil doped PVA:CH based membranes obtained from these experiments reveal the promise of a versatile membrane for applications in wound healing, tissue engineering and other biomedical fields.

Incorporation of essential oils in polymeric films for biomedical applications

Natural and synthetic biodegradable polymers are widely used to obtain more sustainable films with biological, physicochemical, and mechanical properties for biomedical purposes. The incorporation of essential oils (EOs) in polymeric films can optimize the biological activities of these EOs, protect them from degradation, and serve as a prototype for new biotechnological products. This article aims to discuss updates over the last 10 years on incorporating EOs into natural and synthetic biodegradable polymer films for biomedical applications. Chitosan, alginates, cellulose, and proteins such as gelatine, silk, and zein are among the natural polymers most commonly used to prepare biodegradable films for release EOs. In addition to these, the most cited synthetic biodegradable polymers are poly(L-lactide) (PLA), poly(vinyl alcohol) (PVA), and poly(ε-caprolactone) (PCL). The EOs of clove, cinnamon, tea tree, eucalyptus, frankincense, lavender, thyme and oregano incorporated into polymeric films have been the most studied EOs in recent years in the biomedical field. Biomedical applications include antimicrobial activity against pathogenic bacteria and fungi, anticancer activity, potential for tissue engineering and regeneration with scaffolds and wound healing as dressings. Thus, this article reports on the importance of incorporating EOs into biodegradable polymer films, making these systems especially attractive for various biomedical applications.

Hypericum perforatum: a comprehensive review on pharmacognosy, preclinical studies, putative molecular mechanism, and clinical studies in neurodegenerative diseases

The herb Hypericum perforatum, also referred to as St. John's wort, has drawn a lot of interest because of its potential therapeutic benefits in treating neurodegenerative illnesses. Due to the absence of effective therapies, illnesses like Alzheimer's and Parkinson's disease pose an increasing worldwide health concern. Because of its wide variety of phytochemicals, especially hyperforin, and hypericin, Hypericum perforatum is well known for its neuroprotective properties. These substances have proven to be able to affect different cellular processes linked to neurodegeneration. They can act as anti-inflammatory, antioxidant, and neurotransmitter system regulators, which may help halt neurodegenerative illnesses' progression. The use of Hypericum perforatum extracts and its contents has shown encouraging results in research on animal models of neurodegenerative disorders. These advantages include higher nerve cell survival, lowered oxidative stress, and higher cognitive performance. Underscoring its versatile potential to combat neurodegeneration, Hypericum perforatum has neuroprotective mechanisms that modulate neuroinflammation and prevent apoptotic pathways. In conclusion, Hypericum perforatum shows tremendous promise as a potential treatment for neurological illnesses due to its wide variety of phytochemicals. To completely comprehend its specific mechanisms of action and turn these discoveries into efficient clinical therapies, additional research is needed. Investigating Hypericum perforatum's function in neurodegenerative disorders may present new opportunities for the advancement of ground-breaking therapeutic strategies.

Electrospun wound dressings with antibacterial function: a critical review of plant extract and essential oil incorporation

Among the many different types of wound dressings, nanofiber-based materials produced through electrospinning are claimed to be ideal because of their advantageous intrinsic properties and the feasibility of employing several strategies to load bioactive compounds into their structure. Bioactive compounds with antimicrobial properties have been incorporated into different wound dressings to promote healing as well as prevent and treat bacterial infections. Among these, natural products, such as medicinal plant extracts and essential oils (EOs), have proven particularly attractive thanks to their nontoxic nature, minor side effects, desirable bioactive properties, and favorable effects on the healing process. To this end, the present review provides an exhaustive and up-to-date revision of the most prominent medicinal plant extracts and EOs with antimicrobial properties that have been incorporated into nanofiber-based wound dressings. The most common methods used for incorporating bioactive compounds into electrospun nanofibers include: pre-electrospinning (blend, encapsulation, coaxial, and emulsion electrospinning), post-electrospinning (physical adsorption, chemical immobilization, and layer-by-layer assembly), and nanoparticle loading. Furthermore, a general overview of the benefits of EOs and medicinal plant extracts is presented, describing their intrinsic properties and biotechniques for their incorporation into wound dressings. Finally, the current challenges and safety issues that need to be adequately clarified and addressed are discussed.

Innovative Multilayer Electrospun Patches for the Slow Release of Natural Oily Extracts as Dressings to Boost Wound Healing

Electrospinning is an advanced manufacturing strategy used to create innovative medical devices from continuous nanoscale fibers that is endowed with tunable biological, chemical, and physical properties. Innovative medical patches manufactured entirely by electrospinning are discussed in this paper, using a specific plant-derived formulation "1 Primary Wound Dressing©" (1-PWD) as an active pharmaceutical ingredient (API). 1-PWD is composed of neem oil (Azadirachta indica A. Juss.) and the oily extracts of Hypericum perforatum (L.) flowers, according to the formulation patented by the ENEA of proven therapeutic efficacy as wound dressings. The goal of this work is to encapsulate this API and demonstrate that its slow release from an engineered electrospun patch can increase the therapeutic efficacy for wound healing. The prototyped patch is a three-layer core-shell membrane, with a core made of fibers from a 1-PWD-PEO blend, enveloped within two external layers made of medical-grade polycaprolactone (PCL), ensuring mechanical strength and integrity during manipulation. The system was characterized via electron microscopy (SEM) and chemical and contact angle tests. The encapsulation, release, and efficacy of the API were confirmed by FTIR and LC-HRMS and were validated via in vitro toxicology and scratch assays.

Methyl cellulose/okra mucilage composite films, functionalized with Hypericum perforatum oil and gentamicin, as a potential wound dressing

There is a growing demand for the development of functional wound dressings enriched with bioactive natural compounds to improve the quality of life of the population by accelerating the healing process of chronic wounds. In this regard, a functional composite film of okra mucilage (OM) and methylcellulose (MC) incorporated with Hypericum perforatum oil (Hp) and gentamicin (G) was prepared and characterized as a wound dressing. Increasing Hp resulted in improved film properties with a more porous structure, higher WVTR, and lower surface hydrophobicity. Furthermore, incorporating Hp into OM:MC films led to increased elongation at the break while reducing the tensile strength of the films. The highest values of total antioxidant capacity (1.09-1.16 mM trolox equivalent) and total phenolic content (13.76-16.94 μg GA equivalent mL-1) were measured in the composite films containing the highest Hp concentration (1.5 %). In addition, OM:MC/HpG composite films exhibited significant antibacterial activity against both E. coli and S. aureus and prevented the transmission of these bacteria through the films. Hp incorporation reduced the cytotoxic effects of OM:MC films on BJ cells and increased the wound closure rate in vitro. In conclusion, the developed OM:MC/HpG composite film can be a promising candidate as a novel wound dressing with its superior properties.

In vitro assessment of Momordica charantia/Hypericum perforatum oils loaded PCL/Collagen fibers: Novel scaffold for tissue engineering

The research on tissue engineering applications has been progressing to manufacture ideal tissue scaffold biomaterials. In this study, a double-layered electrospun biofiber scaffold biomaterial including Polycaprolactone (PCL)/Collagen (COL) fibrous inner layer and PCL/ Momordica charantia (MC) and Hypericum perforatum (HP) oils fibrous outer layer was developed to manufacture a functional, novel tissue scaffold with the advantageous mechanical and biological properties. The main approach was to combine the natural perspective using medicinal oils with an engineering point of view to fabricate a potential functional scaffold for tissue engineering. Medicinal plants MC and HP are rich in functional oils and incorporation of them in a tissue scaffold will unveil their potential to augment both new tissue formation and wound healing. In this study, a novel double-layered scaffold prototype was fabricated using electrospinning technique with two PCL fiber layers, first is composed of collagen, and second is composed of oils extracted from medicinal plants. Initially, the composition of plant oils was analyzed. Thereafter the biofiber scaffold layers were fabricated and were evaluated in terms of morphology, physicochemistry, thermal and mechanical features, wettability, in vitro bio-degradability. Double-layered scaffold prototype was further analyzed in terms of in vitro biocompatibility and antibacterial effect. The medicinal oils blend provided antioxidant and antibacterial properties to the novel PCL/Oils layer. The results signify that inner PCL/COL layer exhibited advanced biodegradability of 8.5% compared to PCL and enhanced wettability with 11.7° contact angle. Strength of scaffold prototype was 5.98 N/mm2 thanks to the elastic PCL fibrous matrix. The double-layered functional biofiber scaffold enabled 92% viability after 72 h contact with fibroblast cells and furthermore provided feasible attachment sites for the cells. The functional scaffold prototype's noteworthy mechanical, chemical, and biological features enable it to be suggested as a different novel biomaterial with the potential to be utilized in tissue engineering applications.

Therapeutic Potential of Nanocarrier-Mediated Delivery of Phytoconstituents for Wound Healing: Their Current Status and Future Perspective

The treatment of wounds is a serious problem all over the world and imposes a huge financial burden on each and every nation. For a long time, researchers have explored wound dressing that speeds up wound healing. Traditional wound dressing does not respond effectively to the wound-healing process as expected. Therapeutic active derived from plant extracts and extracted bioactive components have been employed in various regions of the globe since ancient times for the purpose of illness, prevention, and therapy. About 200 years ago, most medical treatments were based on herbal remedies. Especially in the West, the usage of herbal treatments began to wane in the 1960s as a result of the rise of allopathic medicine. In recent years, however, there has been a resurgence of interest in and demand for herbal medicines for a number of reasons, including claims about their efficacy, shifting consumer preferences toward natural medicines, high costs and negative side effects of modern medicines, and advancements in herbal medicines brought about by scientific research and technological innovation. The exploration of medicinal plants and their typical uses could potentially result in advanced pharmaceuticals that exhibit reduced adverse effects. This review aims to present an overview of the utilization of nanocarriers in plant-based therapeutics, including its current status, recent advancements, challenges, and future prospects. The objective is to equip researchers with a comprehensive understanding of the historical background, current state, and potential future developments in this emerging field. In light of this, the advantages of nanocarriers based delivery of natural wound healing treatments have been discussed, with a focus on nanofibers, nanoparticles, nano-emulsion, and nanogels.

Hypericum perforatum Oil and Vitamin A Palmitate-Loaded Gelatin Nanofibers Cross-Linked by Tannic Acid as Wound Dressings

Recent studies in wound dressing applications offer new therapies to promote the wound healing process. The main strategy of this study is to combine the traditional perspective of using medicinal oils with polymeric scaffolds manufactured by an engineering approach to fabricate a potential tissue engineering product that provides both new tissue formation and wound healing. Thus, Hypericum perforatum oil (HPO) and vitamin A palmitate (VAP) incorporated gelatin (Gt) nanofibrous scaffolds were successfully prepared by the electrospinning method. Tannic acid (TA) was used as the cross-linking agent. The amounts of VAP and HPO loaded in the base Gt solution [15% w/v in 4:6 v/v acetic acid/deionized water] were 5 and 50 wt % (based on the weight of Gt), respectively. The obtained scaffolds were studied regarding their microstructure, chemical structure, thermal stability, antibacterial activity, in vitro release study, and cellular proliferation assay. In the light of these studies, it was determined that VAP and HPO were incorporated successfully in Gt nanofibers cross-linked with TA. Release kinetic tests confirmed that the patterns of TA and VAP release were consistent with the Higuchi model, whereas HPO release was consistent with the first-order kinetic model. In addition, this membrane was biocompatible with L929 fibroblast cells and had antibacterial activity and thermal stability. This preliminary study suggests potential applicability of the proposed dressing to treat skin wounds in clinics.

Recent Advances in Using Natural Antibacterial Additives in Bioactive Wound Dressings

Wound care is a global health issue with a financial burden of up to US $96.8 billion annually in the USA alone. Chronic non-healing wounds which show delayed and incomplete healing are especially problematic. Although there are more than 3000 dressing types in the wound management market, new developments in more efficient wound dressings will require innovative approaches such as embedding antibacterial additives into wound-dressing materials. The lack of novel antibacterial agents and the misuse of current antibiotics have caused an increase in antimicrobial resistance (AMR) which is estimated to cause 10 million deaths by 2050 worldwide. These ongoing challenges clearly indicate an urgent need for developing new antibacterial additives in wound dressings targeting microbial pathogens. Natural products and their derivatives have long been a significant source of pharmaceuticals against AMR. Scrutinising the data of newly approved drugs has identified plants as one of the biggest and most important sources in the development of novel antibacterial drugs. Some of the plant-based antibacterial additives, such as essential oils and plant extracts, have been previously used in wound dressings; however, there is another source of plant-derived antibacterial additives, i.e., those produced by symbiotic endophytic fungi, that show great potential in wound dressing applications. Endophytes represent a novel, natural, and sustainable source of bioactive compounds for therapeutic applications, including as efficient antibacterial additives for chronic wound dressings. This review examines and appraises recent developments in bioactive wound dressings that incorporate natural products as antibacterial agents as well as advances in endophyte research that show great potential in treating chronic wounds.

The efficacy of St John's wort oil macerates on intractable skin lesions of patients with idiopathic granulomatous mastitis: preliminary results

Objective:

St John's wort (SJW, Hypericum perforatum) has a long history of medicinal use, mainly for its antidepressive effects and for wound healing. However, to the best of our knowledge, this is the first clinical study evaluating the effects of topical SJW oil macerates on the intractable skin lesions of idiopathic granulomatous mastitis (IGM).

Method:

SJW oil massage (twice daily for two minutes) was recommended between 2016 and 2019, only for patients with persistent or intractable skin lesions, after complete regression of granulomatous mass with two cycles of high-dose oral steroid and empiric antibiotics. Skin lesions were assessed and graded, before and after treatment, as clear, mild, moderate and severe. A questionnaire was also completed for each patient at the end of the six-week treatment.

Results:

A total of 21 patients with persistent IGM lesions used SJW oil after completion of the standard treatment protocol. All patients were women, and the mean age was 36.6 years. Hyperaemia (100%), scaling (61%), induration (52%) and ulcers (28%) were the predominant skin lesions. Distribution of the lesions according to the degree of severity were graded mild, moderate and severe, and seen in 35%, 41% and 23% of the patients, respectively. When compared with pre-treatment scores, there were very significant regressions (clear: 76.4%, mild: 17.6%, moderate: 3.9%, severe: 1.9%; p<0.001 for each). The overall success rate (total clearance or decrease/decline in lesions) of treatment was 94%.

Conclusion:

SJW oil massage seems to be very effective in patients with IGM-related persistent skin lesions.

Production of alginate films containing Hypericum perforatum extract as an antibacterial and antioxidant wound dressing material

The incorporation of herbal extracts in wound dressing materials is an important concept that has been researched recently. In this study, alginate films incorporated in the various ratio (0.25–1% v/v) of Hypericum perforatum extract (HPE) for potential applications of wound dressing were successfully prepared by solvent-casting method. The obtained films were examined for cytotoxicity, in vitro wound healing potential, swelling behavior, antioxidant, and antibacterial properties. When compared to the alginate film (Al) alone, HPE incorporated alginate films (HPE/Al) exhibit improved antioxidant properties according to the results of CUPRAC assay and antioxidant activity increases with the rate of HPE. Also, HPE/Al films exhibited antibacterial activity against E. coli and S. aureus, and addition with the HPE extract into films significantly increased the antibacterial activity against S. aureus. All film samples had no cytotoxic effects on fibroblast cell line and HPE/Al films showed a proliferative effect with high extract concentrations (1%) compared to extract free-films. Also, scratch assay results show that films containing 0.5% (v/v) HPE may have a positive effect on wound healing. The results have shown that the newly developed HPE incorporated alginate films are a candidate as antibacterial, and antioxidant wound dressing for use on burn or excision wounds.

An In Vitro Study of Antibacterial Properties of Electrospun Hypericum perforatum Oil-Loaded Poly(lactic Acid) Nonwovens for Potential Biomedical Applications

The growth of population and increase in diseases that cause an enormous demand for biomedical material consumption is a pointer to the pressing need to develop new sustainable biomaterials. Electrospun materials derived from green polymers have gained popularity in recent years for biomedical applications such as tissue engineering, wound dressings, and drug delivery. Among the various bioengineering materials used in the synthesis of a biodegradable polymer, poly(lactic acid) (PLA) has received the most attention from researchers. Hypericum perforatum oil (HPO) has antimicrobial activity against a variety of bacteria. This study aimed to investigate the development of an antibacterial sustainable material based on PLA by incorporating HPO via a simple, low-cost electrospinning method. Chemical, morphological, thermal, thickness and, air permeability properties, and in vitro antibacterial activity of the electrospun nonwoven fabric were investigated. Scanning electron microscopy (SEM) was used to examine the morphology of the electrospun nonwoven fabric, which had bead-free morphology ultrafine fibers. Antibacterial tests revealed that the Hypericum perforatum oil-loaded poly(lactic acid) nonwoven fabrics obtained had high antibacterial efficiency against Escherichia coli and Staphylococcus aureus, indicating a strong potential for use in biomedical applications.

Perspective on the application of medicinal plants and natural products in wound healing: A mechanistic review

Wound is defined as any injury to the body such as damage to the epidermis of the skin and disturbance to its normal anatomy and function. Since ancient times, the importance of wound healing has been recognized, and many efforts have been made to develop novel wound dressings made of the best material for rapid and effective wound healing. Medicinal plants play a great role in the wound healing process. In recent decades, many studies have focused on the development of novel wound dressings that incorporate medicinal plant extracts or their purified active compounds, which are potential alternatives to conventional wound dressings. Several studies have also investigated the mechanism of action of various herbal medicines in wound healing process. This paper attempts to highlight and review the mechanistic perspective of wound healing mediated by plant-based natural products. The findings showed that herbal medicines act through multiple mechanisms and are involved in various stages of wound healing. Some herbal medicines increase the expression of vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) which play important role in stimulation of re-epithelialization, angiogenesis, formation of granulation tissue, and collagen fiber deposition. Some other wound dressing containing herbal medicines act as inhibitor of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and inducible nitric oxide synthase (iNOS) protein expression thereby inducing antioxidant and anti-inflammatory properties in various phases of the wound healing process. Besides the growing public interest in traditional and alternative medicine, the use of herbal medicine and natural products for wound healing has many advantages over conventional medicines, including greater effectiveness due to diverse mechanisms of action, antibacterial activity, and safety in long-term wound dressing usage.

Preparation and Characterization of Electrospun Double-layered Nanocomposites Membranes as a Carrier for Centella asiatica (L.)

A wide range of naturally derived and synthetic biodegradable and biocompatible polymers are today regarded as promising materials for improving skin regeneration. Alongside this, these materials have been explored in conjunction with different types of antimicrobial and bioactive agents, especially natural-derived compounds, to enhance their biological properties. Herein, a double-layered nanocomposite dressing membrane was fabricated with two distinct layers. A bottom layer from Chitosan-Sodium tripolyphosphate (CS-TPP) and Poly(vinyl alcohol) (PVA) containing Centella asiatica (L.) (CA) was electrospun directly over a Polycaprolactone (PCL) layer to improve the biologic performance of the electrospun nanofibers. In turn, the PCL layer was designed to provide mechanical support to the damaged tissue. The results revealed that the produced double-layered nanocomposite membrane closely resembles the mechanical, porosity, and wettability features required for skin tissue engineering. On the other hand, the in vitro drug release profile of the PCL/PVA_CS-TPP containing CA exhibited a controlled release for 10 days. Moreover, the PVA_CS-TPP_CA's bottom layer displayed the highest antibacterial activity against Staphylococcus aureus (S. aureus) (99.96 ± 6.04%) and Pseudomonas aeruginosa (P. aeruginosa) (99.94 ± 0.67%), which is responsible for avoiding bacterial penetration while endowing bioactive properties. Finally, the 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay showed that this nanocomposite membrane was not cytotoxic for normal human dermal fibroblasts (NHDF) cells. Therefore, these findings suggest the potential use of the double-layered PCL/PVA_CS-TPP_CA as an efficient bionanocomposite dressing material.

Recent trends on wound management: New therapeutic choices based on polymeric carriers

Wound healing is an unmet therapeutic challenge among medical society since wound assessment and management is a complex procedure including several factors playing major role in healing process. Wounds can mainly be categorized as acute or chronic. It is well referred that the acute wound displays normal wound physiology while healing, in most cases, is seemed to progress through the normal phases of wound healing. On the other hand, a chronic wound is physiologically impaired. The main problem in wound management is that the majority of wounds are colonized with microbes, whereas this does not mean that all wounds will be infected. In this review, we address the problems that clinicians face to manage while treat acute and chronic wounds. Moreover, we demonstrate the pathophysiology, etiology, prognosis and microbiology of wounds. We further introduce the state of art in pharmaceutical technology field as part of wound management aiming to assist health professionals to overcome the current implications on wound assessment. In addition, authors review researches which included the use of gels and dermal films as wound healing agents. It can be said that natural and synthetic drugs or carriers provide promising solutions in order to meet the wound management standards. However, are the current strategies as desirable as medical society wish?

Development of Hypericum perforatum oil incorporated antimicrobial and antioxidant chitosan cryogel as a wound dressing material

In this study, a herbal infused oil (Hypericum perforatum, HP) incorporated chitosan (CS) cryogel as a wound dressing material was produced in order to be used in wound healing process. The main strategy is to combine the traditional perspective of using medicinal oils with polymeric scaffolds manufactured by an engineering approach to fabricate a potential tissue engineering product that provides both new tissue formation and wound healing. The scaffolds manufactured by cryogelation were soft, spongy, highly porous, physically stable, elastic and could be easily cut in any desired shape. Physicochemical, mechanical and morphological analyzes were used to characterize the produced cryogels. Young modulus of the plain chitosan cryogel was about 21 kPa whereas it increased with increasing HP oil content and became 61 kPa for 20% HP oil ratio. Further, the antimicrobial studies, antioxidant and DNA cleavage effects were investigated. Samples including the highest ratio of oil (CS4) showed the highest DPPH scavenging activity as 69.9%. In addition, 20% HP oil loaded chitosan cryogel demonstrated single strain DNA cleavage activitiy at 500 μg/mL concentration. Antimicrobial studies were applied against seven strains. The lowest activities were obtained against E. hirae and B. cereus, the highest against E. coli and L. pneumophila. This study concluded that the newly developed HP oil loaded chitosan cryogel scaffolds with unique antimicrobial and antioxidant properties are promising candidates to be used in tissue engineering applications as wound dressing for exudative and long-term healing wounds.

A novel bilayer zein/MMT nanocomposite incorporated with H. perforatum oil for wound healing

Recently, layered structures composed of nanofibers have gained attention as a novel material to mimic skin tissue in wound healing applications. The aim of this study is to develop a novel hybrid bilayer material composed of zein based composite film and nanofiber layers as a wound dressing material. The upper layer was composed of H. perforatum oil incorporated zein film including MMT and the bottom layer was comprised of 3D electrospun zein/MMT nanofibers to induce wound healing with the controlled release of H. perforatum oil. The bilayer composites were characterized in terms of mechanical test, WVP, water uptake and surface wettability. Antimicrobial activity of the wound dressings against microorganisms were investigated by disc diffusion method. In vitro cytotoxicity of monolayer film and bilayer structure was performed using WST-1 assay on HS2 keratinocyte and 3T3 cell lines. Results indicated that the prepared monolayer films showed appropriate mechanical and gas barrier properties and surface wettability for wound healing. Controlled release of H. perforatum oil was obtained from fabricated membranes up to 48 h. Bilayer membranes showed antimicrobial activity against E. coli, S. aureus, and C. albicans and did not show any toxic effect on NIH3T3 mouse fibroblast and HS2 keratinocyte cell lines. In vitro scratch assay results indicated that H. perforatum oil had a wound healing effect by inducing fibroblast migration. The proliferation study supported these results by increasing fibroblast proliferation on H. perforatum oil loaded bilayer membranes.