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Chronic wound management represents a major challenge in the healthcare sector owing to its delayed wound-healing process progression and huge financial burden. In this regard, wound dressings provide an appropriate platform for facilitating wound healing for several decades. However, adherent traditional wound dressings do not provide effective wo...
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... wound-healing process is affected by various factors, viz., patient age, degree of damage, and nature of the pathological process (autoimmune diseases, metabolic syndromes, vascular diseases) [4]. The healing process in general is mediated by a cascade of precisely orchestrated events that progresses through four distinct physiological phases hemostasis, inflammation, proliferation, and tissue remodeling involving cell migration and proliferation, growth factors action, and extracellular matrix (ECM) components modulation [54,55] (Figure 2). The first hemostasis phase of wound healing process starts immediately after injury to stop the bleeding. ...
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The escalating prevalence of wounds, particularly chronic wounds, poses significant challenges in terms of treatment management and has led to an increase in healthcare expenditure. Hydrogel-based dressings play a crucial role in wound management due to their unique properties. However, there remains a lack of comprehensive reviews on the use of hy...
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... There are several reports on the electrospinning of natural and synthetic polymeric nanofibers. Many researchers have studied the in vitro and in vivo characterization of nanofibers for wound healing applications (Li et al. 2015;Ahmad 2023;Nasir et al. 2023). One of the synthetic polymers widely used in wound healing applications is PVA. ...
In the current study, cupric oxide nanoparticles (CuO NPs) are chemically synthesized and blended with polyvinyl alcohol and chitosan (PVA-CS) solution to produce nanofibrous wound dressing material using an electrospinning technique. The fibrous morphology of CuO-blended nanofibers was studied by SEM, showing smooth beads and uniform nanofibers with an average diameter of around 86.4 nm. The nanofibers are further characterized using XRD to confirm the presence of CuO NPs. The incorporation of CuO NPs with polymer is evident from the peaks obtained from infrared spectrum. The addition of CuO NPs retained the hydrophilic nature of scaffold, as evident from the contact angle measurement. Further, the wound healing properties of scaffold are apparent from the studies such as antioxidant activity, MTT assay, wound scratch assay, and antibacterial studies. These results indicate the greater efficacy of CuO NPs incorporated in PVA/CS for wound healing applications.
Graphical Abstract
... Moreover, these traditional dressings exhibit deficiencies such as subpar mechanical properties, absence of biological activity, limited oxygen permeability, inadequate adhesion and etc. Consequently, traditional wound dressings fall short of providing sufficient protection for the wound and promoting expedited wound healing 9,10 . Currently, flexible material-based dressings have a strong practical application prospect in wound treatment 11 . ...
Wound infection is a worldwide health issue that not only brings large detrimental effects to people's physical and mental health, but also causes substantial economic burdens to society. By using traditional surgical debridement and antibiotic therapy, patients generally suffer more pain and are at risk of recurring infections. Thus, the development of non-antibiotic treatment methods is desperately needed. Currently, the emerging of flexible wound dressings with physiological signal detection, inactivated infectious pathogen, and wound-healing promoting properties has exhibited immense potential for the treatment of infected wound. Among various dressings, MXene-based flexible electronic materials as wound dressings with special electroactive, mechanical, photophysical, and biological performances possess a broad application prospect in healthcare. In this review, the challenges of infected wound management are introduced. Next, the types of MXene-based flexible materials and wound infection features are outlined. Then the recent advance of MXene-based flexible materials for infected wound detection and treatment is summarized. Lastly, the predicaments, prospects, and future directions of MXene-based flexible materials for infected wound management are discussed.
... Traditional dressings have been found to promote fibrosis and create a hypoxic or anaerobic environment that encourages bacterial growth, thus prolonging the inflammatory phase (Shi et al., 2020). Therefore, there is a constant search for new dressings with greater biocompatibility and specific biological activities, such as anti-inflammatory, antioxidant, antibacterial, proangiogenic and tissue adhesion properties (Long et al., 2022;Ahmad, 2022). ...
Silk fibroin is a fibrillar protein obtained from arthropods such as mulberry and non-mulberry silkworms. Silk fibroin has been used as a dressing in wound treatment for its physical, chemical, mechanical, and biological properties. This systematic review analyzed studies from PubMed, Web of Science, and Scopus databases to identify the molecules preferred for functionalizing silk fibroin-based dressings and to describe their mechanisms
of exhibiting anti-inflammatory and antibacterial properties. The analysis of the selected articles allowed us to classify the dressings into different conformations, such as membranes, films, hydrogels, sponges, and bio-adhesives. The incorporation of various molecules, including antibiotics, natural products, peptides, nano-composites, nanoparticles, secondary metabolites, growth factors, and cytokines, has allowed the development of dressings that promote wound healing with antibacterial and immunomodulatory properties. In addition, silk
fibroin-based dressings have been established to have the potential to regenerate wounds such as venous ulcers, arterial ulcers, diabetic foot, third-degree burns, and neoplastic ulcers. Evaluation of the efficacy of silk fibroin-based dressings in tissue engineering is an area of great activity that has shown significant advances in recent years.
... Thereafter, macrophages and lymphocytes release pro-inflammatory cytokines such as interleukins (IL)−6 and IL-1 (the early inflammation phase) and growth factors such as vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β), along with anti-inflammatory cytokines such as IL-10 (the late inflammation phase) to recruit and activate fibroblasts and epithelial cells [26][27][28]. Next, apoptotic neutrophils are removed by physical sloughing or phagocytosed by macrophages and generate specific immune responses to pathogens via B and T lymphocytes, respectively [29]. ...
MXenes, as a new type of two-dimensional nanomaterial, have great potential for biomedical applications due to their unique structural features and excellent physicochemical properties. In recent years, numerous studies have demonstrated that MXenes materials also possess good antibacterial, anti-inflammatory, and antioxidant activities, which has greatly promoted the development of MXenes in the field of tissue engineering and skin regeneration. A series of emerging studies on the introduction of MXenes into wound dressings has significantly advanced the research progress of novel wound dressings. This review provides a brief overview of the application of MXenes in wound healing, focusing on the properties of MXenes in wound healing and the specific applications of MXenes as wound dressings, as well as some suggestions and opinions on their future development.
... Поэтому нужда в разработке инновационных повязок остается. Чтобы преодолеть эти проблемы, в последнее время был разработан и исследован широкий спектр доступных и инновационных повязок для ускорения и улучшения процесса заживления ран [32]. Тем не менее кардинальный успех в лечении пациентов с хроническими ранами с помощью новых раневых повязок пока не достигнут. ...
It is shown that traditional treatment of chronic wounds is a course of daily single procedures of cleansing the wound surface from purulent-necrotic masses by mechanical and medicinal methods, accompanied by regular renewal of wound dressings. In this case, the procedures of medicinal wound cleansing last 10 - 15 minutes between the replacement of "old" wound dressings with "new" wound dressings. According to the established practice, medicinal sanitation of infected and purulent wounds during dressings consists in irrigation of the wound surface with cleansing solutions, solutions of antiseptics and/or antibiotics. In severe cases, the above therapy is supplemented with live larvae of the necrophage fly, which are injected into purulent-necrotic masses and left in them under wound dressings until complete cleansing of wounds from pus. Nevertheless, the effectiveness of the generally accepted course treatment of chronic wounds remains insufficiently high. It is reported that the use of pyolytics and their supplementation with wound dressings made in the form of warm wet compresses, which create a local greenhouse effect in wounds, can accelerate the healing of chronic wounds. It is shown that pyolytics is a group of antiseptics developed in Russia, which are warm alkaline solutions of hydrogen peroxide, which in interaction with purulent-necrotic masses very quickly dissolve and foam them. As a result of interaction with pyolytics, thick purulent immediately turns into fluffy oxygenated foam. It is shown that pyolytics have been developed due to physicochemical repurposing of aqueous solutions of sodium hydrogen carbonate and hydrogen peroxide. To accelerate the healing of chronic wounds it was proposed to irrigate the surface of chronic wounds with a solution of 3% hydrogen peroxide and 2-10% sodium bicarbonate, heated to a temperature of +37 - +45C, having alkaline activity at pH 8.4 - 8.5 and enriched with dissolved carbon dioxide or oxygen (due to excess pressure of 0.2 ATM). The essence of the invented technology of treatment of chronic wounds with the use of pyolytics is indicated and the results of treatment of chronic wounds with pyolytics in combination with warm moist dressings-compresses are given, which confirm the presence of wound-healing effect. Consequently, physical and chemical re-profiling of antiseptics allows turning them into effective pyolytics, and the combination of pyolytics with warm wound dressings made in the form of warm moist compresses, which create a local greenhouse effect in wounds, allows accelerating the healing of chronic wounds.
... Modern wound dressings have recently been used instead of traditional dressings because they provide a moist environment for the wound area and accelerate the relocation of epithelial cells to replace the dead cells and rebuild the damaged tissue [1,2]. The most important advantages of modern wound dressings are their simplicity of application, ease of sterilization, inhibition of bacterial attack, reduction of wound inflammation, biodegradability, and acceptable mechanical properties [3]. ...
Developing a variety of safe and effective functioning wound dressings is a never-ending objective. Due to their exceptional antibacterial activity, biocompatibility, biodegradability, and healing-promoting properties, functionalized chitosan nanocomposites have attracted considerable attention in wound dressing applications. Herein, a novel bio-nanocomposite membrane with a variety of bio-characteristics was created through the incorporation of zinc oxide nanoparticles (ZnONPs) into amine-functionalized chitosan membrane (Am-CS). The developed ZnO@Am-CS bio-nanocomposite membrane was characterized by various analysis tools. Compared to pristine Am-CS, the developed ZnO@Am-CS membrane revealed higher water uptake and adequate mechanical properties. Moreover, increasing the ZnONP content from 0.025 to 0.1% had a positive impact on antibacterial activity against Gram-positive and Gram-negative bacteria. A maximum inhibition of 89.4% was recorded against Escherichia coli, with a maximum inhibition zone of 38 ± 0.17 mm, and was achieved by the ZnO (0.1%)@Am-CS membrane compared to 72.5% and 28 ± 0.23 mm achieved by the native Am-CS membrane. Furthermore, the bio-nanocomposite membrane demonstrated acceptable antioxidant activity, with a maximum radical scavenging value of 46%. In addition, the bio-nanocomposite membrane showed better biocompatibility and reliable biodegradability, while the cytotoxicity assessment emphasized its safety towards normal cells, with the cell viability reaching 95.7%, suggesting its potential use for advanced wound dressing applications.
... This study highlights that this biological macromolecule hydrogel is a promising acute wound-healing dressing for biomedical applications. of wound dressings are deemed promising candidates because of their exceptional advantages [7]. Biological macromolecule hydrogels exhibit excellent biocompatibility, adhesion, wettability, and air permeability [8], factors that provide a suitable microenvironment for the wound [9]. Moreover, biological macromolecule hydrogels formed from natural collagen show inherent bioactivity, excellent biocompatibility, and adhesiveness and are therefore useful for dressings designed to promote wound healing [10][11][12]. ...
... Our final results indicated that this biological macromolecule hydrogel has many desirable functional properties and therefore may be broadly applicable for applications related to wound healing. (CuCl 2 ), and lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) were dissolved at concentrations of 4 wt%, 4 wt%, 8.225 wt%, 10 wt%, and 1 wt%, respectively. ...
... Skin damage causes wound sites to overproduce secretions, which can induce bacterial growth and delay wound healing. Therefore, hydrogels should possess an appropriate swelling ability to absorb excessive exudate produced by the wound [8,54]. Here, the swelling rate of the hydrogel was evaluated using PBS. ...
The development of biological macromolecule hydrogel dressings with fatigue resistance, sufficient mechanical strength, and versatility in clinical treatment is critical for accelerating full-thickness healing of skin wounds. Therefore, in this study, multifunctional, biological macromolecule hydrogels based on a recombinant type I collagen/chitosan scaffold incorporated with a metal–polyphenol structure were fabricated to accelerate wound healing. The resulting biological macromolecule hydrogel possesses sufficient mechanical strength, fatigue resistance, and healing properties, including antibacterial, antioxygenic, self-healing, vascularization, hemostatic, and adhesive abilities. Chitosan and recombinant type I collagen formed the scaffold network, which was the first covalent crosslinking network of the hydrogel. The second physical crosslinking network comprised the coordination of a metal–polyphenol structure, i.e., Cu2+ with the catechol group of dopamine methacrylamide (DMA) and stacking of DMA benzene rings. Double-crosslinked networks are interspersed and intertwined in the hydrogel to reduce the mechanical strength and increase its fatigue resistance, making it more suitable for clinical applications. Moreover, the biological macromolecule hydrogel can continuously release Cu2+, which provides strong antibacterial and vascularization properties. An in vivo full-thickness skin defect model confirmed that multifunctional, biological macromolecule hydrogels based on a recombinant type I collagen/chitosan scaffold incorporated with a metal–polyphenol structure can facilitate the formation of granulation tissue and collagen deposition for a short period to promote wound healing. This study highlights that this biological macromolecule hydrogel is a promising acute wound-healing dressing for biomedical applications.
... However, they are not designed to promote the optimal condition for a suitable recovery in chronic conditions. Indeed, traditional dressings absorb a high amount of blood and exudate especially in hard-to-heal wounds leading to dried surface and formation of clots [16]. Furthermore, the fibers easily stick to the damaged tissue causing a painful removal of the dressing [43]. ...
... Notably, they demonstrated that moist environment speeds the wound healing up to 50% compared to dry, open to air conditions [44]. This is due to the autolytic debridement necessary for the healing progress, that is favored by a limited amount of exudate retained on the wound [16]. ...
Chronic wound is characterized by slow healing time, persistence, and abnormal healing progress. Therefore, serious complications can lead at worst to the tissue removal. In this scenario, there is an urgent need for an ideal dressing capable of high absorbency, moisture retention and antimicrobial properties. Herein we investigate the technical properties of a novel advanced non-woven triple layer gauze imbibed with a cream containing Rigenase, an aqueous extract of Triticum vulgare used for the treatment of skin injuries. To assess the applicability of this system we analyzed the dressing properties by wettability, dehydration, absorbency, Water Vapor Transmission Rate (WVTR), lateral diffusion and microbiological tests. The dressing showed an exudate absorption up to 50%. It created a most environment allowing a proper gaseous exchange as attested by the WVTR and a controlled dehydration rate. The results candidate the new dressing as an ideal medical device for the treatment of the chronic wound repairing process. It acts as a mechanical barrier providing a good management of the bacterial load and proper absorption of abundant wound exudate. Finally, its vertical transmission minimizes horizontal diffusion and side effects on perilesional skin as maceration and bacterial infection.
... When using animal models, researchers should adhere to the 3R (replacement, reduction, and refining) principles to ensure the ethical and compassionate treatment of the animals. Wound healing efficiency is generally influenced by the type of wound dressing, the animal model, the wound location, and the microbiota (Elliot et al., 2018;Ahmad, 2023). ...
... Other aspects to consider are the cost, competence and convenience of handling, sufficiency of biopsy samples, animal husbandry, ethics application, and study duration. Porcine models are appropriate animal models for wound healing (Ahmad, 2023). ...
... Flow cytometry and macrophage polarisation studies are also used to better understand the cellular processes during wound healing. These invasive and noninvasive approaches provide comprehensive information about wound healing progression (Ahmad, 2023). ...
A skin wound or perforation triggers a series of homeostatic reactions to safeguard internal organs from invasion by pathogens or other substances that could damage body tissues. An injury may occasionally heal quickly, leading to the closure of the skin’s structure. Healing from chronic wounds takes a long time. Although many treatment options are available to manage wound healing, an unmet therapy need remains because of the complexity of the processes and the other factors involved. It is crucial to conduct consistent research on novel therapeutic approaches to find an effective healing agent. Therefore, this work aims to cover various in vitro and in vivo methodologies that could be utilised to examine wound recovery. Before deciding on the optimal course of action, several techniques’ benefits, drawbacks, and factors need to be reviewed.
... They are associated with disadvantages like adherent nature, need to change dressings frequently and non-suitability for high secreted wound exudates. Detaching the adhering wound dressings can be very painful and limits their clinical applicability (Ahmad, 2022). Absorption of blood and exudates results in clot formation that does not come off easily and result in the tearing of skin and reopening of the wound. ...
Curcumin loaded solid lipid nanoparticles (CSLNs) and probiotic (Lactobacillus plantarum UBLP-40; L. plantarum) were currently co-incorporated into a wound dressing. The combination with manifold anti-inflammatory, anti-infective, analgesic, and antioxidant properties of both curcumin and L. plantarum will better manage complex healing process. Recent reports indicate that polyphenolics like curcumin improve probiotic effects. Curcumin was nanoencapsulated (CSLNs) to improve its bioprofile and achieve controlled release on the wound bed. Bacteriotherapy (probiotic) is established to promote wound healing via antimicrobial activity, inhibition of pathogenic toxins, immunomodulation, and anti-inflammatory actions. Combination of CSLNs with probiotic enhanced (560%) antimicrobial effects against planktonic cells and biofilms of skin pathogen, Staphylococcus aureus 9144. The sterile dressing was devised with selected polymers, and optimized for polymer concentration, and dressing characteristics using a central composite design. It exhibited a swelling ratio of 412 ± 36%, in vitro degradation time of 3 h, optimal water vapor transmission rate of 1516.81 ± 155.25 g/m2/day, high tensile strength, low-blood clotting index, case II transport, and controlled release of curcumin. XRD indicated strong interaction between employed polymers. FESEM revealed a porous sponge like meshwork embedded with L. plantarum and CSLNs. It degraded and released L. plantarum, which germinated in the wound bed. The sponge was stable under refrigerated conditions for up to six months. No translocation of probiotic from wound to the internal organs confirmed safety. The dressing exhibited faster wound closure and lowered bioburden in the wound area in mice. This was coupled with a decrease in TNF-α, MMP-9, and LPO levels; and an increase in VEGF, TGF-β, and antioxidant enzymes such as catalase and GSH, establishing multiple healing pathways. Results were compared with CSLNs and probiotic-alone dressings. The dressing was as effective as the silver nanoparticle-based marketed hydrogel dressing; however, the cost and risk of developing resistance would be much lower currently.
