Antimicrobial Peptide‐Based Electrospun Fibers for Wound Healing Applications

Current wound healing treatments such as bandages and gauzes predominantly rely on passively protecting the wound and do not offer properties that increase the rate of wound healing. While these strategies are strong at protecting any infection after application, they are ineffective at treating an already infected wound or assisting in tissue regeneration. Next‐generation wound healing treatments are being developed at a rapid pace and have a variety of advantages over traditional treatments. Features such as gas exchange, moisture balance, active suppression of infection, and increased cell proliferation are all central to developing the next successful wound healing dressing. Electrospinning has already been shown to have the qualities required to be a key technique of next generation polymer‐based wound healing treatments. Combined with antimicrobial peptides (AMPs), electrospun dressings can indeed become a formidable solution for the treatment of both acute and chronic wounds. The literature on combining electrospinning and AMPs is now starting to increase and this review aims to give a comprehensive overview of the current developments that combine electrospinning technology and AMPs in order to make multifunctional fibers effective against infection in wound healing.     

A review on wound dressings with an emphasis on electrospun nanofibrous polymeric bandages

Wound dressings have experienced continuous and significant changes since the ancient times. The development starts with the use of natural materials to simply cover the wounds to the materials of the present time that could be specially made to exhibit various extraordinary functions. The modern bandage materials made of electrospun biopolymers contain various active compounds that are beneficial to the healing of wounds. These materials are fibrous in nature, with the size of fibers segments ranging from tens of nanometers to micrometers. With the right choices of biopolymers used for these fibrous materials, they could enhance the healing of wounds significantly compared with the conventional fibrous dressing materials, such as gauze. These bandages could be made such that they contain bioactive ingredients, such as antimicrobial, antibacterial, and anti‐inflammatory agents, which could be released to the wounds enhancing their healing. In an active wound dressing (AWD), the main purpose is to control the biochemical states of a wound in order to aid its healing process. This review provides an overview of different types of wounds, effective parameters in wound healing and different types of wound dressing materials with a special emphasis paid to those prepared by electrospinning. Copyright © 2009 John Wiley & Sons, Ltd.     

Development of Gelatin‐Alginate Hydrogels for Burn Wound Treatment

Hydrogels are interesting as wound dressing for burn wounds to maintain a moist environment. Especially gelatin and alginate based wound dressings show strong potential. Both polymers are modified by introducing photocrosslinkable functionalities and combined to hydrogel films (gel‐MA/alg‐MA). In one protocol gel‐MA films are incubated in alg‐MA solutions and crosslinked afterward into double networks. Another protocol involves blending both and subsequent photocrosslinking. The introduction of alginate into the gelatin matrix results in phase separation with polysaccharide microdomains in a protein matrix. Addition of alg(‐MA) to gel‐MA leads to an increased swelling compared to 100% gelatin and similar to the commercial Aquacel Ag dressing. In vitro tests show better cell adhesion for films which have a lower alginate content and also have superior mechanical properties. The hydrogel dressings exhibit good biocompatibility with adaptable cell attachment properties. An adequate gelatin‐alginate ratio should allow application of the materials as wound dressings for several days without tissue ingrowth.     

Effect of gamma‐irradiation sterilization on the physical and mechanical properties of a hybrid wound dressing

A wound dressing should ideally provide an optimal healing environment which enables rapid healing. It should maintain a moist environment at the wound surface, allow gas exchange, act as a barrier to microorganisms, remove excess exudates and afford mechanical protection to the wound. A new bioresorbable hybrid wound dressing which combines a poly(DL‐lactic‐co‐glycolic acid) porous top layer with a spongy collagen sublayer was developed and studied. The top layer contained the antibiotic drug gentamicin for controlled release to the wound site. It is of very high importance to use an appropriate sterilization process for this special new wound dressing, which will not have a deleterious effect on its function. Our investigation therefore focused on the effects of gamma‐irradiation sterilization (10, 25, 35 and 50 kGy) on the structure properties of this wound dressing. The physical and mechanical properties were of the wound dressings were affected by the gamma irradiation because of a combination of chain scission and crosslinking of the collagen layer mainly. The weight loss and water vapor transmission rate were increased, while the water uptake was decreased with the increase in the irradiation dose. The changes were small when doses of 10 or 25 kGy were applied at room temperature. The gamma‐irradiation resulted in stronger but more brittle wound dressings. These trends were smaller when the sterilization process was carried out in liquid nitrogen. Our research shows that gamma‐sterilization process is feasible for our new concept of hybrid wound dressings and optimal conditions can be chosen. Copyright © 2016 John Wiley & Sons, Ltd.     

A Spray‐Filming Self‐Healing Hydrogel Fabricated from Modified Sodium Alginate and Gelatin as a Bacterial Barrier

Self‐healing hydrogels as wound dressings still face challenges in infection prevention, especially in the dressing of mass wounds, due to their inflexibility and the slow formation of the protective film on the wound. Therefore, designing a spray‐filming (rapid‐forming) hydrogel that can serve as a bacterial barrier is of particular significance in the development of wound dressings. Here, a self‐healing hydrogel based on adipic acid dihydrazide‐modified gelatin (Gel‐ADH) and monoaldehyde‐modified sodium alginate(SA‐mCHO) is prepared. Using dynamic, Schiff base bonds, the hydrogels exhibit excellent self‐healing properties. Moreover, the gelation time of SA‐mCHO/Gel‐ADH (SG) hydrogels is shortened to 2–21 s, resulting in rapid filming by spraying the two precursor solutions. In addition, the rapid spray‐filming ability might offer sufficient flexibility and rapidity for dealing with mass and irregular wounds. Notably, the bacterial barrier experiments show that the SG hydrogel films could form an effective barrier to Staphylococcus aureus and Candida albicans for 12 h. Therefore, SG hydrogels could be used in wound dressings and they show great promise in applications associated with mass and irregular traumas.     

On‐Demand Dissolution of a Dendritic Hydrogel‐based Dressing for Second‐Degree Burn Wounds through Thiol–Thioester Exchange Reaction

An adhesive yet easily removable burn wound dressing represents a breakthrough in second‐degree burn wound care. Current second‐degree burn wound dressings absorb wound exudate, reduce bacterial infections, and maintain a moist environment for healing, but are surgically or mechanically debrided from the wound, causing additional trauma to the newly formed tissues. We have developed an on‐demand dissolvable dendritic thioester hydrogel burn dressing for second‐degree burn care. The hydrogel is composed of a lysine‐based dendron and a PEG‐based crosslinker, which are synthesized in high yields. The hydrogel burn dressing covers the wound and acts as a barrier to bacterial infection in an in vivo second‐degree burn wound model. A unique feature of the hydrogel is its capability to be dissolved on‐demand, via a thiol–thioester exchange reaction, allowing for a facile burn dressing removal.     

A Bi‐Layer PVA/CMC/PEG Hydrogel with Gradually Changing Pore Sizes for Wound Dressing

Wound dressings are vital for cutaneous wound healing. In this study, a bi‐layer dressing composed of polyvinyl alcohol/carboxymethyl cellulose/polyethylene glycol (PVA/CMC/PEG) hydrogels is produced through a thawing–freezing method based on the study of the pore size of single‐layer hydrogels. Then the physical properties and healing of full‐thickness skin defects treated with hydrogels are inspected. The results show that the pore size of the single‐layer PVA/CMC/PEG hyrogel can be controlled. The obtained non‐adhesive bi‐layer hydrogels show gradually increasing pore sizes from the upper to the lower layer and two layers are well bonded. In addition, bi‐layer dressings with good mechanical properties can effectively prevent bacterial penetration and control the moisture loss of wounds to maintain a humid environment for wounds. A full‐thickness skin defect test shows that bi‐layer hydrogels can significantly accelerate wound closure. The experiment indicates that the bi‐layer PVA/CMC/PEG hydrogels can be used as potential wound dressings.     

Hemocompatibility of Ca2+‐Crosslinked Nanocellulose Hydrogels: Toward Efficient Management of Hemostasis

The present work investigates Ca²⁺‐crosslinked nanofibrillated cellulose hydrogels as potential hemostatic wound dressings by studying core interactions between the materials and a central component of wounds and wound healing—the blood. Hydrogels of wood‐derived anionic nanofibrillated cellulose (NFC) and NFC hydrogels that incorporate kaolin or collagen are studied in an in vitro whole blood model and with platelet‐free plasma assays. The evaluation of thrombin and factor XIIa formation, platelet reduction, and the release of activated complement system proteins, shows that the NFC hydrogel efficiently triggered blood coagulation, with a rapid onset of clot formation, while displaying basal complement system activation. By using the NFC hydrogel as a carrier of kaolin, the onset of hemostasis is further boosted, while the NFC hydrogel containing collagen exhibits blood activating properties comparable to the anionic NFC hydrogel. The herein studied NFC hydrogels demonstrate great potential for being part of advanced wound healing dressings that can be tuned to target certain wounds (e.g., strongly hemorrhaging ones) or specific phases of the wound healing process for optimal wound management.     

Hyaluronic Acid (HA)‐Based Silk Fibroin/Zinc Oxide Core–Shell Electrospun Dressing for Burn Wound Management

Burn injuries represent a major life‐threatening event that impacts the quality of life of patients, and places enormous demands on the global healthcare systems. This study introduces the fabrication and characterization of a novel wound dressing made of core–shell hyaluronic acid–silk fibroin/zinc oxide (ZO) nanofibers for treatment of burn injuries. The core–shell configuration enables loading ZO—an antibacterial agent—in the core of nanofibers, which in return improves the sustained release of the drug and maintains its bioactivity. Successful formation of core–shell nanofibers and loading of zinc oxide are confirmed by transmission electron microscopy, Fourier‐transform infrared spectroscopy, and energy dispersive X‐ray. The antibacterial activity of the dressings are examined against Escherichia coli and Staphylococcus aureus and it is shown that addition of ZO improves the antibacterial property of the dressing in a dose‐dependent fashion. However, in vitro cytotoxicity studies show that high concentration of ZO (>3 wt%) is toxic to the cells. In vivo studies indicate that the wound dressings loaded with ZO (3 wt%) substantially improves the wound healing procedure and significantly reduces the inflammatory response at the wound site. Overall, the dressing introduced herein holds great promise for the management of burn injuries.     

Multifunctional fibrous wound dressings for refractory wound healing

Refractory wounds have always been an important issue to healthcare systems, whose healing process is always delayed by multiple factors, including bacterial infections, chronic inflammation, and excessive exudates, etc. Employing multifunctional wound dressings is recognized as an effective strategy to deal with refractory wounds, which has yielded promising outcomes in recent years. Among these advanced wound dressings, fibrous dressings have gained growing attention due to their unique merits. Such wound dressings have demonstrated great potential in delivering theranostic agents, such as antibacterial agents, anti-inflammatory drugs, growth factors, and diagnostic probes, etc., for the purposes of accelerating wound healing. This paper reviews the development of multifunctional fibrous dressings and their applications in treating refractory wounds. The construction approaches of novel fibrous dressing with capabilities of antibacterial, anti-inflammation, exudate management and diagnosis were also introduced. Furthermore, the existing problems and challenges are also discussed briefly.     

Construction of Antibacterial N‐Halamine Polymer Nanomaterials Capable of Bacterial Membrane Disruption for Efficient Anti‐Infective Wound Therapy

The increasing occurrence of bacterial infection at the wound sites is a serious global problem, demanding the rapid development of new antibacterial materials for wound dressing to avoid the abuse of antibiotics and thereby antibiotic resistance. In this work, the authors first report on antibacterial N‐halamine polymer nanomaterials based on a strategic copolymerization of 3‐allyl‐5,5‐dimethylhydantoin (ADMH) and methyl methacrylate (MMA), which exhibits in vitro and in vivo antimicrobial efficacy against pathogenic bacteria including Staphylococcus aureus and Escherichia coli. Particularly, when a biological evaluation is run for wound therapy, the N‐halamine polymer nanomaterials exhibit a powerful antibacterial efficiency and wound healing ability after a series of histological examination of mouse wound. After the evaluation of biological and chemical surroundings, the proposed four‐stage mechanism suggests that, with unique antibacterial N? Cl bonds, the N‐halamine polymer nanomaterials can disrupt the bacterial membrane, as a result causing intracellular content leaked out and thereby cell death. Based on the synergistic action of antibacterial and wound therapy, the N‐halamine polymer nanomaterials are expected to be promising as wound dressing materials in medical healing and biomaterials.     

Wound healing improvement by curcumin‐loaded electrospun nanofibers and BFP‐MSCs as a bioactive dressing

Wound healing, one of the most complex processes of the body involving the cooperation of several important biomolecules and pathways, is one of the major therapeutic and economic issues in regenerative medicine. The present study aimed to introduce a novel electrospun curcumin (Cur)‐incorporated chitosan/polyvinyl alcohol/carbopol/polycaprolactone nanofibrous composite for concurrent delivery of the buccal fat pad‐derived mesenchymal stem cells (BFP‐MSCs) and Cur to a full‐thickness wound on the mouse model. Scaffolds were characterized structurally using scanning electron microscopy (SEM), fluorescence microscopy imaging and Fourier‐transform infrared spectroscopy, and toxicity of the scaffolds was also evaluated after BFP‐MSC seeding by SEM imaging and 3‐(4,5 dimethyiazol‐2‐1)‐2‐5‐diphenyl tetrazolium bromide (MTT) assay. Then, its influence on the wound‐healing process was investigated as a wound dressing for a full‐thickness skin defect in mouse model. Results demonstrated that the designed composite scaffolds have the capability for cell seeding and support their growth and proliferation. Macroscopic and histopathological characteristics were evaluated at the end of the 7 and 14 days after surgery, and their results showed that our designed scaffold groups accelerated the wound‐healing process compared with the control group. Among those, scaffold/Cur, scaffold/Cur/BFP‐MSC and scaffold/BFP‐MSC groups demonstrated more wound repair efficacy. These results indicated that the combined grafts can be used to improve the wound‐healing process, and therefore, the electrospun nanofibers presented in this study, Cur and BFP‐MSC together, were demonstrated to have promising potential for wound‐dressing applications.     

Dual‐Functional Dextran‐PEG Hydrogel as an Antimicrobial Biomedical Material

Microbial infections continually present a major worldwide public healthcare threat, particularly in instances of impaired wound healing and biomedical implant fouling. The development of new materials with the desired antimicrobial property to avoid and treat wound infection is urgently needed in wound care management. This study reports a novel dual‐functional biodegradable dextran‐poly(ethylene glycol) (PEG) hydrogel covalently conjugated with antibacterial Polymyxin B and Vancomycin (Vanco). The hydrogel is designed as a specialized wound dressing that eradicates existing bacteria and inhibits further bacteria growth, while, ameliorating the side effects of antibiotics and accelerating tissue repair and regeneration. The hydrogel exhibits potent antibacterial activities against both gram‐negative bacteria Escherichia coli (E. coli) and gram‐positive bacteria Staphylococcus aureus (S. aureus) with no observable toxicity to mouse fibroblast cell line NIH 3T3. These results demonstrate the immense potential of dextran‐PEG hydrogel as a wound dressing healthcare material in efficiently controlling bacteria growth in complex biological systems.     

Functional Microneedle Patch for Wound Healing and Biological Diagnosis and Treatment

Wound healing, especially chronic wounds, has been one of the major challenges in the field of biomedicine. Drug therapy alone is not effective, so a variety of functional wound healing dressings have been developed. Microneedles have attracted more and more attentions in the field of wound healing dressings due to their penetration and high drug delivery efficiency. In this review, all the studies on the application of microneedles in wound healing in recent years are summarized, classify different microneedles according to their functions in the process of wound healing, discuss the current challenges in the transformation of microneedle technology toward clinical applications, and finally look forward to the future design and development directions of microneedles in this field.     

Controlled release of antibiotics from poly‐ε‐caprolactone/polyethylene glycol wound dressing fabricated by direct‐writing melt electrospinning

Wound dressing, which can release anti‐infectives in a controlled way, is taking an important role in the treatment and recovery of the open wound. An adequate release of antibiotics can prevent infections from microorganisms effectively. Among the new candidates of fabricating base materials for wound dressing, electrospinning fiber mats are attracting numerous attentions for their excellent performance in controlled drug delivery. The drug release behavior of electrospinning fiber mats can be tuned by changing the chemical components and the geometric structures of the mats. In this study, fiber mats with different geometric structures, which composed of poly‐ε‐caprolactone (PCL), polyethylene glycol (PEG), and ciprofloxacin (Cip) with different blending ratios, were successfully fabricated by direct‐writing melt electrospinning, and the release behavior of Cip were subsequently investigated in vitro. The results showed that the addition of PEG improved the hydrophilicity of the mats, which in turn affected the manner of drug release. The presence of PEG changed the releasing mechanism from a non‐Fickian diffusion into Fickian diffusion, which indicated that the diffusion of Cip from the composite fiber mats became the main factor of drug release instead of polymer degradation. Besides, with the same composition but different geometric structures, the drug release behavior is of significant difference. Therefore, all the Cip‐loaded composite fiber mats showed antibacterial activities but with different efficiency. In summary, the release of the drug could be controlled by adding PEG and changing the geometric structures according to the different requirement of wound dressings.     

Antimicrobial and Wound Treatment Aspects of Micro‐ and Nanoformulations of Carboxymethyl,Dialdehyde, and TEMPO‐Oxidized Derivatives of Cellulose: Recent Advances

The remedy for infected chronic wounds such as diabetic foot ulcers is more complicated particularly in the case of patients with an inefficient immune system. Also, fighting against microbial infections in the wound site by available antibiotics may not be effective because of emerging antibiotic resistance properties among pathogenic bacteria and fungi. Recently, applications of micro‐ and nanoformulations of biomaterials have demonstrated improved therapeutic abilities for wound dressings. In this way, carboxymethyl, dialdehyde, and 2,2,6,6‐tetramethylpiperidine‐1‐oxyl‐oxidized celluloses are common biomaterials having outstanding physicochemical and therapeutic properties compared to unmodified cellulose. Therefore, in this review, recent progress in the field of wound healing and antimicrobial activities of these derivatives are presented and discussed.     

天然高分子外敷材料研究进展

外敷材料能在皮肤受损后起到保护创面、控制感染、促进愈合的作用。本文首先介绍了外敷材料的选择依据与分类。然后,从结构特点与应用角度出发,阐述了天然高分子外敷材料的最新研究进展。可用作外敷材料的多糖包括纤维素、海藻酸盐、甲壳素与壳聚糖、琼脂糖、果胶与树胶、糖胺聚糖等;蛋白类外敷材料分为植物蛋白和动物蛋白外敷材料。随着高分子合成技术和药物控释技术的发展,将会大大推动外敷材料的研究开发,并拓宽其应用领域。     

Novel Poly(vinyl alcohol)/Chitosan/Modified Graphene Oxide Biocomposite for Wound Dressing Application

Rapid absorption of wound exudate and prevention of wound infection are prerequisites for wound dressing to accelerate wound healing. In this study, a novel kind of promising wound dressing is developed by incorporating polyhexamethylene guanidine (PHMG)‐modified graphene oxide (mGO) into the poly(vinyl alcohol)/chitosan (PVA/CS) matrix, conferring the dressing the required mechanical properties, higher water vapor transmission rate (WVTR), less swelling time, improved antibacterial activity, and more cell proliferation compared to the PVA/CS film crosslinked by genipin. In vivo experiments indicate that the PVA/CS/mGO composite film can accelerate wound healing via enhancement of the re‐epithelialization. PVA/CS/mGO composite film with 0.5 wt% mGO sheets displays the best wound healing properties, as manifested by the 50% higher antibacterial rate compared to GO and the wound healing rate of the mouse using this dressing is about 41% faster than the control group and 31% faster than the pure PVA/CS dressing. The underlying mechanism of the accelerated wound healing properties may be a result of the improved antibacterial ability to eradicate pathogenic bacteria on the wound area and maintain an appropriate moist aseptic wound healing environment to accelerate re‐epithelialization. These findings suggest that this novel composite PVA/CS/mGO film may have promising applications in wound dressing.     

Nonwoven Releasing Propolis as a Potential New Wound Healing Method—A Review

Wound healing poses a serious therapeutic problem. Methods which accelerate tissue regeneration and minimize or eliminate complications are constantly being sought. This paper is aimed at evaluation of the potential use of biodegradable polymer nonwovens releasing propolis as wound healing dressings, based on the literature data. Propolis is honeybee product with antioxidant, antibacterial, antifungal, anticancer, anti-inflammatory, analgesic, and regenerative properties. Controlled release of this substance throughout the healing should promote healing process, reduce the risk of wound infection, and improve aesthetic effect. The use of biodegradable aliphatic polyesters and polyester carbonates as a propolis carrier eliminates the problem of local drug administration and dressing changes. Well-known degradation processes and kinetics of the active substance release allows the selection of the material composition appropriate to the therapy. The electrospinning method allows the production of nonwovens that protect the wound against mechanical damage. Moreover, this processing technique enables adjusting product properties by modifying the production parameters. It can be concluded that biodegradable polymer dressings, releasing a propolis, may find potential application in the treatment of complicated wounds, as they may increase the effectiveness of treatment, as well as improve the patient’s life quality.