Development and Characterization of Biointeractive Gelatin Wound Dressing Based on Extract of Punica granatum Linn

Medicinal plants used for cutaneous wound healing in Uganda; ethnomedicinal reports and pharmacological evidences

Background

Wounds have become a major health challenge worldwide, presenting marked humanistic and economic burdens such as disabilities and death. Annually, approximately 14 million people suffer from wounds worldwide and 80 % of these occur in developing countries like Uganda. In Uganda, besides many cases of daily wound occurrences, approximately 10 % of surgical procedures become septic wounds and consequently lead to increased morbidity and mortality. Accordingly, several ethnomedicinal studies have identified plants used for wound treatment in different parts of Uganda and the wound healing activities of some plants have been reported. However, at present, these information remain largely separated without an all-inclusive repository containing ethnomedicinal and pharmacological information of the plants used for wound healing in Uganda, thus retarding appropriate evaluation. Therefore, this review focused on extensively exploring the plants used for treating cutaneous wounds in Uganda, along with associated ethnomedicinal information and their globally reported pharmacological potential.

Methods

Electronic data bases including Google Scholar, PubMed, and Science Direct were searched using key terms for required information contained in English peer reviewed articles, books, and dissertations. Additionally, correlations between selected parameters were determined with coefficient of determination (r2).

Results

The literature survey revealed that 165 species belonging to 62 families are traditionally used to treat wounds in Uganda. Most of the species belonged to families of Asteraceae (14 %), Fabaceae (10 %), and Euphorbiaceae (7 %). The commonest plant parts used for wound treatment include leaf (48 %), root (22 %), stembark (11 %), and stem (7 %), which are prepared majorly by poultice (34 %), decoction (13 %), as well as powdering (25 %). Fifty-four (33 %) of the plant species have been investigated for their wound healing activities whereas, one hundred eleven (67 %) have not been scientifically investigated for their wound healing effects. Pearson correlation coefficient between the number of wound healing plant families per part used and percent of each plant part used was 0.97, and between the number of wound healing plant families per method of preparation and percent of each method of preparation was 0.95, showing in both strong positively marked relationships.

Conclusion

The preliminarily investigated plants with positive wound healing properties require further evaluation to possible final phases, with comprehensive identification of constituent bioactive agents. Additionally, the wound healing potential of the scientifically uninvestigated plants with claimed healing effects needs examination. Subsequently, information regarding efficacy, safety, bioactive principles, and mechanism of action could prove valuable in future development of wound healing therapies.

Fabrication and characterization of new levan@CBD biocomposite sponges as potential materials in natural, non-toxic wound dressing applications

Wound healing is a complex process; therefore, new dressings are frequently required to facilitate it. In this study, porous bacterial levan-based sponges containing cannabis oil (Lev@CBDs) were prepared and fully characterized. The sponges exhibited a suitable swelling ratio, proper water vapor transmission rate, sufficient thermal stability, desired mechanical properties, and good antioxidant and anti-inflammatory properties. The obtained Lev@CBD materials were evaluated in terms of their interaction with proteins, human serum albumin and fibrinogen, of which fibrinogen revealed the highest binding effect. Moreover, the obtained biomaterials exhibited antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa, as well as being non-hemolytic material as indicated by hemolysis tests. Furthermore, the sponges were non-toxic and compatible with L929 mouse fibroblasts and HDF cells. Most significantly, the levan sponge with the highest content of cannabis oil, in comparison to others, retained its non-hemolytic, anti-inflammatory, and antimicrobial properties after prolonged storage in a climate chamber at a constant temperature and relative humidity. The designed sponges have conclusively proven their beneficial physicochemical properties and, at the preliminary stage, biocompatibility as well, and therefore can be considered a promising material for wound dressings in future in vivo applications.

UV-polymerizable methacrylated gelatin (GelMA)-based hydrogel containing tannic acids for wound healing

Gelatin-based photopolymerizable methacrylate hydrogel (GelMA) is a promising biomaterial for in situ drug delivery, while aqueous extract of Punica granatum (AEPG) peel fruit rich in gallic acid and ellagic acid is used to improve wound healing. The aim of this study was to develop and analyze the healing properties of GelMA containing AEPG, gallic acid, or ellagic acid in a rodent model. GelMA hydrogels containing 5% AEPG (GelMA-PG), 1.6% gallic acid (GelMA-GA), or 2.1% ellagic acid (GelMA-EA) were produced and their mechanical properties, enzymatic degradation, and thermogravimetric profile determined. Wound closure rates, healing histological grading, and immunohistochemical counts of myofibroblasts were assessed over time. The swelling of hydrogels varied between 50 and 90%, and GelMA exhibited a higher swelling than the other groups. The GPG samples showed higher compression and Young's moduli than GelMA, GGA, and GAE. All samples degraded around 95% in 48 h. GPG and GGA significantly accelerated wound closure, improved collagenization, increased histological grading, and hastened myofibroblast differentiation in comparison to the control, GelMA, and GEA. GelMA containing AEPG (GPG) improved wound healing, and although gallic acid is the major responsible for such biological activity, a potential synergic effect played by other polyphenols present in the extract is evident.

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

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

Chitosan-based films with cannabis oil as a base material for wound dressing application

This study focuses on obtaining and characterizing novel chitosan-based biomaterials containing cannabis oil to potentially promote wound healing. The primary active substance in cannabis oil is the non-psychoactive cannabidiol, which has many beneficial properties. In this study, three chitosan-based films containing different concentrations of cannabis oil were prepared. As the amount of oil increased, the obtained biomaterials became rougher as tested by atomic force microscopy. Such rough surfaces promote protein adsorption, confirmed by experiments assessing the interaction between human albumin with the obtained materials. Increased oil concentration also improved the films' mechanical parameters, swelling capacity, and hydrophilic properties, which were checked by the wetting angle measurement. On the other hand, higher oil content resulted in decreased water vapour permeability, which is essential in wound dressing. Furthermore, the prepared films were subjected to an acute toxicity test using a Microtox. Significantly, the film's increased cannabis oil content enhanced the antimicrobial effect against A. fischeri for films in direct contact with bacteria. More importantly, cell culture studies revealed that the obtained materials are biocompatible and, therefore, they might be potential candidates for application in wound dressing materials.

Cutaneous/Mucocutaneous Leishmaniasis Treatment for Wound Healing: Classical versus New Treatment Approaches

Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (ML) show clinical spectra that can range from a localized lesion (with a spontaneous healing process) to cases that progress to a generalized systemic disease with a risk of death. The treatment of leishmaniasis is complex since most of the available drugs show high toxicity. The development of an effective topical drug formulation for CL and ML treatment offers advantages as it will improve patient’s compliance to the therapy given the possibility for self-administration, as well as overcoming the first pass metabolism and the high costs of currently available alternatives. The most common dosage forms include solid formulations, such as membranes and semi-solid formulations (e.g., ointments, creams, gels, and pastes). Topical treatment has been used as a new route of administration for conventional drugs against leishmaniasis and its combinations, as well as to exploit new substances. In this review, we discuss the advantages and limitations of using topical drug delivery for the treatment of these two forms of leishmaniasis and the relevance of combining this approach with other pharmaceutical dosage forms. Emphasis will also be given to the use of nanomaterials for site-specific delivery.

Hydrophilic Scaffolds Containing Extracts of Stryphnodendron adstringens and Abarema cochliacarpa for Wound Healing: In Vivo Proofs of Concept

The present work aimed to evaluate the healing effect of hydrophilic polymeric resorbable biomembrane scaffolds containing plant extracts obtained from two different species, both popularly known as Stryphnodendron adstringens or Barbatimão. The hydrogel-based scaffolds were characterized and submitted to biological tests using Wistar rats to evaluate their healing capacity. The wound retraction index and the evaluation of the inflammatory process and tissue collagenization were recorded. The extracts showed antioxidant activity with IC50 between 10 and 20 µg/mL (DPPH assay) and 4–6 mmol Trolox/g (FRAP assay). The extract of Stryphnodendron adstringens (SA) presented gallocatechin, epigallocatechin, and O-methylpigalocatechin, while the extract of Abarema cochliacarpa (AC) presented catechin, dimers of procyanidins, di-O-hydroxide, O-deoxyhexosi-hexoside, and epicatechin. The membranes containing SA extract (GELSA) were more rigid, with a more intense color, but less thick, with a more compact structure and few pores. The membranes containing AC extract (GELAC) presented a mechanical profile like the gelatin membrane (GEL), with greater permeability to water vapor. The GELAC and GELSA membranes showed similar thermal degradation profiles. The wounds treated with the membranes containing the extracts obtained high levels of retraction of the wounds with values around 60% and 80% in three and seven days, respectively. These data indicate that the compounds of both species have promising biological activities in the repair process, showing that the extracts accelerated the healing process due to the lower intensity of the inflammatory reaction and the presence of compounds such as catechin and epigallocatechin.

Cold-Pressed Pomegranate Seed Oil: Study of Punicic Acid Properties by Coupling of GC/FID and FTIR

Over the last decades, we have witnessed an increasing interest in food-related products containing vegetable oils. These oils can be obtained either by extraction or by mechanical pressing of different parts of plants (e.g., seeds, fruit, and drupels). Producers of nutraceuticals have ceaselessly searched for unique and effective natural ingredients. The enormous success of argan oil has been followed by discoveries of other interesting vegetable oils (e.g., pomegranate oil) containing several bioactives. This work describes the pomegranate fruit extract and seed oil as a rich source of conjugated linolenic acid as a metabolite of punicic acid (PA), deriving from the omega-5 family (ω-5). Through the chemical characterization of PA, its nutritional and therapeutic properties are highlighted together with the physiological properties that encourage its use in human nutrition. We analyzed the composition of all fatty acids with beneficial properties occurring in pomegranate seed oil using gas chromatography (GC) with flame-ionization detection (FID) analysis combined with Fourier transform infrared spectroscopy (FTIR). Pomegranate seed oil mainly consists of 9,11,13-octadic-trienoic acid (18:3), corresponding to 73 wt % of the total fatty acids. Nine components were identified by GC in PSO, varying between 0.58 and 73.19 wt %. Using midinfrared (MIR) spectroscopy, we compared the composition of pomegranate seed oil with that of meadowfoam seed oil (MSO), which is also becoming increasingly popular in the food industry due to its high content of long chain fatty acids (C20-22), providing increased oil stability. From the results of FTIR and MIR spectroscopy, we found that punicic acid is unique in PSO (73.19 wt %) but not in MSO.

Wet Electrospun Nanofibers-Fortified Gelatin/Alginate-Based Nanocomposite as a Single-Dose Biomimicking Skin Substitute

We report the development and evaluation of a series of well-designed single-dose extracellular matrix (ECM)-mimicking nanofibers (NFs)-reinforced hydrogel (HG)-based skin substitute for wound healing. The HG matrix of the proposed skin substitute is composed of gelatin (GE) and sodium alginate (SA), and incorporates hyaluronic acid (HA) as a key component of the natural ECM, as well as the antimicrobial Punica granatum extract (PE). This HG nanocomposite was cross-linked by the biocompatible N-(3-(dimethylamino)propyl)-N'-ethylcarbodiimide hydrochloride (EDC) cross-linker, and was reinforced with fragmented trans-ferulic acid (FA)-loaded cellulose acetate/polycaprolactone (PCL/CA) NFs. The NFs were obtained via wet electrospinning into a poly(vinyl alcohol) (PVA) coagulating solution to closely resemble the porous structure of the ECM fibers, which facilitates cell migration, attachment, and proliferation. The proposed design of the skin substitute allows adjustable mechanical characteristics and outstanding physical properties (swelling and biodegradability), as well as an excellent porous microstructure. The developed skin substitutes were characterized using Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and electron microscopy. In addition, the biodegradability, biocompatibility, bioactivity, mechanical, and in vitro drug release characteristics were investigated. Moreover, an in vivo excisional full-thickness defect model was conducted to assess skin regeneration and healing effectiveness. The average diameters of the plain and FA-loaded NFs are 210 ± 12 nm and 452 ± 25 nm, respectively. The developed ECM-mimicking skin substitutes demonstrated good antibacterial activity, free-radical scavenging activity, cytocompatibility, porosity, water absorption ability, and good biodegradability. In vivo application of the ECM-mimicking skin substitutes revealed their excellent wound-healing activity and their suitability for single-dose treatment of deep wounds with reducing the wound diameter to 0.95 mm after 15 days of treatment. Moreover, the histological investigation of the wound area demonstrated that the applied skin substitutes have not only enhanced the wound healing progress, but also can participate in improving the quality of the regenerated skin in the treated area via facilitating collagen fibers regeneration and deposition.

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.

Histological Evidence of Wound Healing Improvement in Rats Treated with Oral Administration of Hydroalcoholic Extract of Vitis labrusca

Plant extracts rich in phenolic compounds have been demonstrated to accelerate wound healing, but their use by oral route has been poorly studied. The leaves of Vitis labrusca are rich in phenolic acids and flavonoids. The goal of this study was to assess the healing properties of the oral administration of hydroalcoholic extract of V. labrusca leaves (HEVL) in a murine model. HEVL was obtained by Soxhlet and dynamic maceration, and their yield and phenolic acids and flavonoid contents were determined. For the wound healing assay, 8 mm wounds were performed on the back of 48 Wistar rats, assigned into four groups (n = 12): CTR (distilled water), HEVL100, HEVL200, and HEVL300 (HEVL at 100, 200, and 300 mg/kg, respectively). On days 7 and 14, wound closure rates were assessed, and the healing wounds were subjected to histological analysis. Soxhlet-obtained extract was selected for the wound healing assay because it provided a higher yield and phenolic acid and flavonoid contents. HEVL significantly reduced leukocytosis in the peripheral blood (p < 0.05), accelerated wound closure (p < 0.05), and improved collagenization (p < 0.05) on day 7, as well as enhanced the epidermal tissue thickness (p < 0.001) and elastic fiber deposition on day 14 (p < 0.01). Furthermore, HEVL promoted an increase in the histological grading of wound healing on both days 7 and 14 (p < 0.01). The doses of 200 and 300 mg/kg provided better results than 100 mg/Kg. Our data provide histological evidence that the oral administration of HEVL improves wound healing in rodents. Therefore, the extract can be a potential oral medicine for healing purposes.

Physico-mechanical and biological evaluation of an injectable m-TG cross-linked thrombin loaded amended gelatin hemostat to heal liver trauma

Free flow hemostatic agents are dominating over non-flowable hemostats due to their ability to cover asymmetrical wound surfaces of any depth and easily remove excess materials with irrigation. The objective of this study was to evaluate the activation of a coagulation system both in vitro and in vivo. We assessed detailed physical characteristics of a microbial transglutaminase (m-TG) crosslinked thrombin (TB) laden Gelatin (Gel) hemostat sealant in vitro and its hemostatic efficacy for controlling bleeding caused by liver trauma in rats as well as its efficacy for organ regeneration after making a critical defect. The prepared hemostat gel showed almost seven times higher absorbance behavior than a negative control. Thrombogenicity of the prepared gel was determined based on platelet adhesion, whole blood clotting time, and total blood absorption behavior. In vivo blood absorption and hematological parameters were determined in an animal model after implantation. The prepared gel was able to lead to a fast post-operative recovery with a blood absorption at wound defect. High speed of homeostasis was achieved by a fast clotting time in about 1 min.