Clinical efficacy of wet dressing combined with chitosan wound dressing in the treatment of deep second-degree burn wounds: A prospective, randomised, single-blind, positive control clinical trial

Emerging trends in chitosan based colloidal drug delivery systems: A translational journey from research to practice

Chitosan, a natural polymer derived from chitin, has garnered significant interest in pharmaceutical and biomedical applications due to its distinctive properties, such as controlled drug release, mucoadhesive capabilities, in situ gelling property, enhancement of permeation, and efflux pump inhibitory effect. In this review, various types of chitosan based colloidal drug delivery systems such as vesicular, and particulate systems were discussed along with their role in pre-clinical biomedical applications. Some important clinical applications of chitosan-based drug delivery systems in treating major chronic diseases were also discussed. Using Chitosan in delivery of drugs and gene therapy had many beneficial outcomes, however, obtaining clinical acceptance and regulatory approval requires a careful approach for proving efficacy and safety. In order to present the current status of chitosan-based drug delivery systems, filled patents employing chitosan derivatives were also part of this review. This will help forward the use of chitosan-based drug delivery system from research to practice. Finally, the future prospects for chitosan-based delivery systems were discussed.

Engineered polyvinyl alcohol/chitosan/carrageenan nanofibrous membrane loaded with Aloe vera for accelerating third-degree burn wound healing

This study introduces an innovative nanofibrous membrane included polyvinyl alcohol (PVA), chitosan (CS), carrageenan (CG), and Aloe vera (AV), designed to enhance burn wound healing through a coaxial electrospinning technique. The PVA/AV@PVA/CS/CG membrane exhibited smooth surface, well-defined layered structure, and uniform nanofibers with a diameter of 180 ± 49 nm, as confirmed by SEM, TEM images. AV was efficiently incorporated into the membrane system, achieving encapsulation efficiency exceeding 80 % and loading efficiency of ∼3 %. The release profile of AV followed the Fickian diffusion mechanism, described by the Peppas-Sahlin model, with the membrane demonstrating ∼85 % delivery performance. The membrane exhibited favorable blood coagulation properties and a sufficient water vapor transmission rate. The membrane's balanced performance in boosting cell survival while also demonstrating antibacterial activity as well as anti-inflammatory effect, made it a suitable setting for wound healing. The synergistic interaction between the components significantly accelerated burn wound recovery and histological evaluation showed that less inflammation, fibroblast proliferation, and collagen deposition without formation of hypertrophic scars. The PVA/AV@PVA/CS/CG membrane showed statistically superior performance (p-values) in various experiments compared to the remaining samples. Conclusively, PVA/AV@PVA/CS/CG membrane exhibited numerous positive biochemical features, making it an excellent choice for third-degree burn wound dressing.

Potential Applications of Chitosan in Seborrheic Dermatitis and Other Skin Diseases: A Comprehensive Review

This review article explores the potential applications of chitosan, a natural polysaccharide derived from crustacean shells, in the treatment of seborrheic dermatitis (SD) and other skin diseases. SD is a common chronic inflammatory skin condition characterized by erythema, scaling, itching, and an oily appearance, predominantly affecting areas rich in sebaceous glands. Current treatments, including antifungal agents, corticosteroids, and calcineurin inhibitors, offer symptomatic relief but have limitations in long-term use due to side effects and resistance issues. Chitosan exhibits excellent biocompatibility, biodegradability, and broad-spectrum antibacterial properties, making it a promising candidate for SD treatment. This review highlights chitosan's multifunctional properties such as antimicrobial, anti-inflammatory, sebum-regulating, and barrier-enhancing effects, which are closely related to the pathogenesis of SD. Additionally, the article summarizes the applications of chitosan in other skin conditions, including wound healing, infectious skin diseases, and atopic dermatitis, demonstrating its broad therapeutic potential. Through this comprehensive evaluation, the review aims to provide a theoretical foundation for clinical research on chitosan in SD and support the development of new, safer, and more effective treatment options for various skin conditions.

Risk factors for poor outcomes in adult patients with lip through-and-through wounds

BACKGROUND

Risk factors associated with infection and traumatic lacerations affecting the face are still not fully understood. This study investigated risk factors for poor outcomes in adult patients with through-and-through lip wounds who underwent debridement and suturing.

METHODS

Patients with through-and-through lip wounds who underwent debridement in our emergency department between January 1, 2017, and December 31, 2021, were included. The effects of gender, age, wound age (time from injury to wound closure), antibiotic application, injury mechanism, diabetes, wound length, wound cleanliness, peripheral tissue damage, and postoperative wound blood scab on the poor outcome rate were assessed for all patients. Poor outcome was analyzed based on atraumatic wound dehiscence before suture removal, pus in the wound, and unhealed oral wounds with a length >1 cm or deeper than the muscle layer 5-6 days after surgery.

RESULTS

A total of 728 cases were included, with a poor outcome rate of 20.88 %. The univariable analysis showed that the proportion of poor outcomes was significantly associated with male gender, age (65-79 years old), bicycle/electric bicyble, antibiotic use, wound length of 4-8 cm, wound contamination, peripheral tissue damage, and scabs. Binary logistic analysis showed that the proportion of poor outcomes was significantly associated with older age (65-79 years old), wound length of 4-8 cm, peripheral tissue damage and wounds covered by scabs. In the binary logistic regression analysis, poor outcomes were not associated with gender, injury mechanism, wound contamination or the use of antibiotics.

CONCLUSION

Our findings provide valuable information on the risk factors for poor outcomes in adult patients with lip through-and-through wounds who underwent debridement and suturing.

Levofloxacin loaded poly (ethylene oxide)-chitosan/quercetin loaded poly (D,L-lactide-co-glycolide) core-shell electrospun nanofibers for burn wound healing

This study developed a new burn wound dressing based on core-shell nanofibers that co-deliver antibiotic and antioxidant drugs. For this purpose, poly(ethylene oxide) (PEO)-chitosan (CS)/poly(D,L-lactide-co-glycolide) (PLGA) core-shell nanofibers were fabricated through co-axial electrospinning technique. Antibiotic levofloxacin (LEV) and antioxidant quercetin (QS) were incorporated into the core and shell parts of PEO-CS/PLGA nanofibers, respectively. The drugs could bond to the polymer chains through hydrogen bonding, leading to their steady release for 168 h. An in vitro drug release study showed a burst effect followed by sustained release of LEV and QS from the nanofibers due to the Fickian diffusion. The NIH 3T3 fibroblast cell viability of the drug loaded core-shell nanofibers was comparable to that in the control (tissue culture polystyrene) implying biocompatibility of the nanofibers and their cell supportive role. However, there was no significant difference in cell viability between the drug loaded and drug free core-shell nanofibers. According to in vivo experiments, PEO-CS-LEV/PLGA-QS core-shell nanofibers could accelerate the healing process of a burn wound compared to a sterile gauze. Thanks to the synergistic therapeutic effect of LEV and QS, a significantly higher wound closure rate was recorded for the drug loaded core-shell nanofibrous dressing than the drug free nanofibers and control. Conclusively, PEO-CS-LEV/PLGA-QS core-shell nanofibers were shown to be a promising wound healing material that could drive the healing cascade through local co-delivery of LEV and QS to burn wounds.