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.     

Preparation of antimicrobial poly(vinyl alcohol) nanofibers containing silver nanoparticles

Polyvinyl alcohol (PVA) nanofibers containing Ag nanoparticles were prepared by electrospinning PVA/silver nitrate (AgNO₃) aqueous solutions, followed by short heat treatment, and their antimicrobial activity was investigated for wound dressing applications. Since PVA is a water soluble and biocompatible polymer, it is one of the best materials for the preparation of wound dressing nanofibers. After heat treatment at 155 °C for 3 min, the PVA/AgNO₃ nanofibers became insoluble, while the Ag⁺ ions therein were reduced so as to produce a large number of Ag nanoparticles situated preferentially on their surface. The residual Ag⁺ ions were reduced by subsequent UV irradiation for 3 h. The average diameter of the Ag nanoparticles after the heat treatment was 5.9 nm and this value increased slightly to 6.3 nm after UV irradiation. It was found that most of the Ag⁺ ions were reduced by the simple heat treatment. The PVA nanofibers containing Ag nanoparticles showed very strong antimicrobial activity. © 2006 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 44: 2468–2474, 2006     

Poly(n-vinylpyrrolidone) hydrogels: 2.Hydrogel composites as wound dressing for tropical environment

POLY(N-VINYLPYRROLIDONE) HYDROGELS: 2. HYDROGEL COMPOSITES AS WOUND DRESSING FOR TROPICAL ENVIRONMENT. The effects of irradiation on hydration and other properties of poly(vinylpyrrolidone) (PVP) hydrogel composites have been investigated. The aqueous solution of vinylpyrrolidone (VP) 10 wt % was mixed with several additives such as agar and polyethylen glycol (PEG). The solution was then irradiated with gamma rays from Cobalt-60 source at room temperature. Several parameters such as elongation at break (EB), tensile strength (TS), degree of swelling (DS), water vapor transmission rate (WVTR), equilibrium water content (EWC), microbial growth and penetration test, and water activity (Aw) were analysed at room temperature of 29 ±2°C humidity of 80 ± 10%. Results show that elongation at break of hydrogel membranes with initial composition of VP with agar, VP with agar and PEG were 240 % and 250 % kGy, the equilibrium water content of membranes were 96 to 90%, whereas degree of swelling were 55 to 10. The WVTR of hydrogel membranes with initial composition of VP with agar and PEG was 70 g m^-2h^-1, while the water activity was 0.9. Such hydrogel membranes exhibits the following properties: They are elastic, transparent, flexible, impermeable for bacteria. They absopt a high capacity of water, attached to healthy skin but not to the wound and they are easy to remove. These properties of the hydrogel membranes allow for applying as a wound dressings in tropical environment.     

Hemostatic and Absorbent PolyHIPE–Kaolin Composites for 3D Printable Wound Dressing Materials

A novel hemostatic and absorbent wound dressing material compatible with 3D printing is developed to address deficiencies in current wound dressing protocol. The design involves an open celled, microporous hydrogel foam via a high internal phase emulsion (HIPE) template with biocompatible components and tunable hemostatic character by kaolin loading, the viscosity and cure kinetics of which are tailored for 3D printing applications. The use of nontoxic mineral oil organic phase results in cytocompatability with human dermal fibroblasts. Kaolin distribution is shown by X‐ray diffraction and elemental dispersive spectroscopy to be exfoliated and dispersed in the hydrogel dressing. In addition to demonstrating high fluid absorption and noncytotoxicity of relevant cell lines, the high internal phase emulsion polymers (polyHIPEs) also match the hemostatic performance of commercial wound dressing materials. Furthermore, the polyHIPEs display the requisite rheological properties for 3D printing that result in the fabrication of a prototype dressing with hierarchical porosity and a large number of controllable form factors.     

Preparation,characterization, and assessment of cytotoxicity,antioxidant, antibacterial,antifungal, and cutaneous wound healing properties of titanium nanoparticles using aqueous extract of Ziziphora clinopodioides Lam leaves

In recent decades, nanotechnology is growing rapidly owing to its widespread application in science and industry. The aim of the experiment was chemical characterization and evaluation of cytotoxicity, antioxidant, antibacterial, antifungal, and cutaneous wound healing activities of titanium nanoparticles using aqueous extract of Ziziphora clinopodioides Lam leaves (TiNPs@Ziziphora). These nanoparticles were characterized by fourier transformed infrared spectroscopy (FT‐IR), field emission scanning electron microscopy (FE‐SEM), energy dispersive X‐ray spectroscopy (EDS), and UV–visible spectroscopy. The synthesized TiNPs@Ziziphora had great cell viability dose‐dependently (Investigating the effect of the plant on human umbilical vein endothelial cells (HUVECs) cell line) and revealed this method was nontoxic. Then, 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) free radical scavenging test was done to assess the antioxidant properties, which indicated similar antioxidant potentials for TiNPs@Ziziphora and butylated hydroxytoluene. Agar diffusion tests were applied to determine the antibacterial and antifungal characteristics. Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC), and Minimum Fungicidal Concentration (MFC) were specified by macro‐broth dilution assay. The data were analyzed by SPSS 21 software (Duncan post‐hoc test). TiNPs@Ziziphora indicated higher antibacterial and antifungal effects than all standard antibiotics (p ≤ 0.01). Also, TiNPs@Ziziphora inhibited the growth of all bacteria at 2‐16 mg/ml concentrations and removed them at 2‐32 mg/ml concentrations (p ≤ 0.01). In case of antifungal properties of TiNPs@Ziziphora, they prevented the growth of all fungi at 2‐8 mg/ml concentrations and destroyed them at 2‐16 mg/ml concentrations (p ≤ 0.01). In vivo experiment, after creating the cutaneous wound, the rats were randomly divided into six groups: untreated control, treatment with Eucerin basal ointment, treatment with 3% tetracycline ointment, treatment with 0.2% TiO₂ ointment, treatment with 0.2% Z. clinopodioides ointment, and treatment with 0.2% TiNPs@Ziziphora ointment. These groups were treated for 10 days. For histopathological and biochemical analysis of the healing trend, a 3 × 3 cm section was prepared from all dermal thicknesses at day 10. Use of TiNPs@Ziziphora ointment in the treatment groups substantially reduced (p ≤ 0.01) the wound area, total cells, neutrophil, and lymphocyte and remarkably raised (p ≤ 0.01) the wound contracture, hydroxyl proline, hexosamine, hexuronic acid, fibrocyte, and fibrocytes/fibroblast rate compared to other groups. In conclusion, the results revealed the useful non‐cytotoxic, antioxidant, antibacterial, antifungal, and cutaneous wound healing effects of TiNPs@Ziziphora.     

Enzymatic Extraction of Bioactive and Self‐Assembling Wool Keratin for Biomedical Applications

Keratin is widely recognized as a high‐quality renewable protein resource for biomedical applications. Despite their extensive existence, keratin resources such as feathers, wool, and hair exhibit high stability and mechanical properties because of their high disulfide bond content. Consequently, keratin extraction is challenging and its application is greatly hindered. In this work, a biological extraction strategy is proposed for the preparation of bioactive keratin and the fabrication of self‐assembled keratin hydrogels (KHs). Based on moderate and controlled hydrolysis by keratinase, keratin with a high molecular weight of approximately 45 and 28 kDa that retain its intrinsic bioactivities is obtained. The keratin products show excellent ability to promote cell growth and migration and are conferred with significant antioxidant ability because of their intrinsically high cysteine content. In addition, without the presence of any cross‐linking agent, the extracted keratin can self‐assemble into injectable hydrogels. The KHs exhibit a porous network structure and 3D culture ability, showing potential in promoting wound healing. This enzyme‐driven keratin extraction strategy opens up a new approach for the preparation of keratin that can self‐assemble into injectable hydrogels for biomedical engineering.     

Preparation and Characterization of Poly Vinyl Alcohol/Poly Vinyl Pyrrolidone/Clay Based Nanocomposite by Gamma Irradiation

A series of PVA/PVP/clay nanocomposite were prepared by gamma irradiation with different clay contents of (0.15, 0.3, 1, 1.5, 3 and 5 wt%). The gelation content and swelling behavior were investigated. The morphology and structure of PVA/PVP/clay nanocomposite and dispersion of the clay nanoparticles in the polymeric matrix were examined by infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM). The introduction of clay into polymeric matrix was investigated by X-ray diffraction pattern (XRD) and Transmission electron microscope (TEM). It is observed that, the increase of the clay content causes a decrease in the swelling percent. The thermal stability studies confirmed that the introduction of clay lead to an increase in the thermal stability. The TEM results showed that the clay nanoparticles are interchelated or exfoliated in the polymeric matrix. Some desirable characteristics such as relatively good swelling and excellent barrier capability against microbe penetration suggested that PVA/PVP/clay nanocomposite can be a good candidate as a wound dressing.     

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) during NPWT. Twenty-two of 29 consecutive patients who presented at the clinic of Seoul National Universty Hospital between December 2009 and November 2010 who underwent NPWT for diabetic foot infections or skin ulcers were included in this study. Peripheral blood samples were taken before NPWT (pre-NPWT) and 7–14 days after the initiation of NPWT (during-NPWT). Fluorescence-activated cell sorting (FACS) analysis showed that the number of cells in EPC-enriched fractions increased after NPWT, and the numbers of EPC colony forming units (CFUs) significantly increased during NPWT. We believe that NPWT is useful for treating patients with diabetic foot infections and skin ulcers, especially when these conditions are accompanied by peripheral arterial insufficiency. The systemic mobilization of EPCs during NPWT may be a mechanism for healing intractable wounds in diabetic patients with foot infections or skin defects via the formation of increased granulation tissue with numerous small blood vessels.     

L-Glutamic acid loaded collagen chitosan composite scaffold as regenerative medicine for the accelerated healing of diabetic wounds

Diabetic wounds (DWs) are characterized by prolonged inflammation, which poses a significant challenge for clinicians and researchers to promote healing. In this study, we fabricate L-Glutamic acid (LGA) loaded collagen/chitosan (COL-CS) composite scaffold for the accelerated healing of DW. The characterization outcomes of the composite scaffold revealed that a crosslinked scaffold holds optimum porosity, low matrix degradation, and sustained drug release in contrast to a non-crosslinked scaffold. In vitro, LGA composite scaffolds have not exhibited any toxicity on 3T3L1 cell lines. In vivo, the LGA composite scaffold has shown significantly (p < 0.001), higher rates of wound contraction than those in control and COL-CS scaffold treated groups. In addition, MMP-9 levels were also significantly reduced in LGA composite scaffold-treated group compared with those in the control and COL-CS scaffold treated group. Thus, the LGA composite scaffold may serve as a promising therapy in DW due to its unique modulatory effect on inflammatory biomarker MMP-9.