Wound care is a multifaceted and collaborative process, and chronic wounds can have significant repercussions on a patient's well-being and impose a financial burden on the healthcare industry. While traditional wound dressings can effectively facilitate healing, their limitations in addressing the intricacies of the wound healing process remain a formidable obstacle. Smart wound dressings have emerged as a promising solution to tackle this challenge, offering numerous advantages over conventional dressings, such as real-time monitoring of wound healing and enhanced wound care management. These advanced medical dressings incorporate microelectronic sensors that can monitor the wound environment and provide timely interventions for accelerated and comprehensive healing. Furthermore, advancements in drug delivery systems have enabled real-time monitoring, targeted therapy, and controlled release of medications. Smart wound dressings exhibit versatility, as they are available in various forms and can be utilised for treating different types of acute or chronic wounds. Ultimately, the development of innovative wound care technologies and treatments plays a vital role in addressing the complexities presented by wounds and enhancing patients' quality of life. This review sheds light on the diverse types of smart dressings and their distinctive features, emphasising their potential in advancing the field of wound care.

Granulation tissue formation and tracheitis are common pediatric tracheostomy complications. Ciprofloxacin/dexamethasone is frequently prescribed, but the influence of social determinants on this topic is unexplored.

This study extends a prior cohort study of pediatric tracheostomy patients at a single academic institution from 2016 to 2020. Social determinants of health, including race, insurance status, and residence characteristics, including Area Deprivation Index (ADI), were evaluated. Logistic regression, Wilcoxon rank-sum, and log-rank tests (α = .05) analyzed relationships between these determinants and prescriptions and post-tracheostomy outcomes.

This cohort included 182 patients; 98/182 (53.9%) were male, and 140/182 (76.9%) were White, non-Hispanic. Non-White race was associated with increased odds of receiving nebulized ciprofloxacin/dexamethasone (OR = 2.80, 95% CI = 1.25-6.29). In those with tracheal culture results available (n = 63), Staphylococcus aureus was more common with public insurance (29/47, 7 with MRSA, 61.7%) compared with private (5/16, 3 with MRSA, 31.3%; OR = 3.54, 95% CI = 1.05-11.9). ADI was greater in the 7 patients with Streptococcus pneumoniae (median = 95, IQR = 88-99) compared to without (median = 77, IQR = 65-81, P = .003). Patients with tracheitis lived further from our center (median = 44.7 miles, IQR = 27.7-91.4 miles) compared with those who did not develop tracheitis (median = 33.4 miles, IQR = 12.0-85.2 miles, P = .02). Antibiotic resistance was more prevalent in children discharged home (14/35, 40.0%) than to transitional care (3/28, 10.7%; OR = 5.56, 95% CI = 1.40-22.0) and was associated with longer hospital stays (median = 70 days, range = 34-152 vs median = 35 days, range = 15-75 days, P = .02). Non-White patients experience increased odds of decannulation over time compared with White patients (HR = 2.85, 95% CI = 1.21-6.70). Discharge locations and ADI were associated with dressing choice post-tracheostomy.

This study revealed racial disparities in ciprofloxacin/dexamethasone usage, residence-related differences in tracheal culture results, and ADI-related dressing choices, which highlight the need for tailored, equitable care to optimize outcomes.

4.

The use of mastoid pressure dressings (MPDs) after otologic surgery has been a standard practice for decades, believed to minimize complications such as hematoma and wound infection. However, the efficacy of MPDs in improving patient outcomes has been questioned. This study aimed to evaluate the necessity and impact of MPDs on postoperative pain, complications, and overall patient comfort.

In this prospective, randomized, controlled trial, 200 patients undergoing major ear surgeries were randomly assigned to receive either a MPD group or a non-MPD (NMPD) group. Postoperative pain was assessed using the Visual Analog Scale at the 3rd, 6th, and 24th hour. Complications, including hematoma, wound infection, and skin erythema, were systematically recorded.

Patients in the MPD group reported significantly-higher pain levels at all measured intervals than in the NMPD group (P < .05). Complications such as skin erythema and auricular bruising were more prevalent in the MPD group. Importantly, there was no significant difference between the two groups in the incidence of hematomas or wound infections.

The findings suggest that MPDs may contribute to increased postoperative pain and discomfort without offering significant benefits in preventing complications. Given the lack of significant benefit and the increased patient discomfort observed with MPDs, their routine use in otologic surgery may warrant reconsideration. Future research should further explore optimal postoperative care strategies to enhance patient comfort and outcomes.

Wound is a disruption in the epithelial integrity of the skin or mucosa, which is caused by internal or external pathological processes. In this study, a nanofiber as wound dressing loaded with Duloxetine was produced by electrospinning technique. The diameter of nanofibers containing 20% and 40% Duloxetine was around 236 nm and 272 nm, respectively. Tensile testing results showed that elongation at break percentage soared from 11.5% for drug-free nanofibers to 40.01% for nanofibers containing 40% Duloxetine. All nanofibers had uniform bead-free structure. Contact angle of nanofibers with and without drug was 84.3° and 99.3°, respectively. The drug release profile revealed that after the burst release over the first 8 h, the curve witnessed a slow sustained release for a longer period. The nanofibers had antibacterial activity against gram-positive and gram-negative bacteria and the crosslinked nanofibers with 40% duloxetine had the largest diameter of inhibition zone at roughly 43 mm for Staphylococcus aureus, 40 mm for Escherichia coli, and 30 mm for Pseudomonas aeruginosa. Clinical studies showed that the percentage of wound area reduction was approximately 96.41% for nanofibers containing 40% duloxetine which was higher than positive control containing phenytoin at around 92.24% and also the other group with 20% duloxetine at 81.68%.

A growing body of research is dedicated to developing new therapeutic agents for wound healing with fewer adverse effects. One of the proceedings being taken today in wound healing research is to identify promising biological materials that not only heal wounds but also vanish scarring. The effectiveness of nanofibers like polyvinyl alcohol (PVA), in improving wound healing can be related to their unique properties. Pistacia atlantica Desf. subsp. kurdica (Zohary) Rech. f. (PAK) [Anacardiaceae], also known as "Baneh" in traditional Iranian medicine, is one of the most effective herbal remedies for the treatment of different diseases like skin injuries due to its numerous pharmacological and biological properties, including anti-inflammatory, antioxidant, and anti-bacterial effects.

Our study aimed to evaluate the wound-healing activity of nanofibers containing PVA/PAK oleo-gum-resin in two rat models of burn and excision wound repair.

PVA/PKA nanofibers were prepared using the electrospinning method. Scanning electron microscope (SEM) images and mechanical properties of nanofibers were explored. Diffusion and releasing experiments of nanofibers were performed by the UV visible method at different time intervals and up to 72 h. The animal models were induced by excision and burn in Wistar rat's skin and the wound surface area was measured during the experiment for 10 and 21 days, respectively. On the last day, the wound tissue was removed for histological studies, and serum oxidative factors were measured to evaluate the antioxidant properties of the PVA/PKA. Data analysis was performed using ImageJ, Expert Design, and statistical analysis methods.

PVA/PKA nanofibers were electrospun at different voltages (15, 18, and 20 kV). The most suitable fibers were obtained when the nozzle was positioned 15 cm away from the collector, with a working voltage of 15 kV, and an injection rate of 0.5 mm per hour, using the 30:70 w/v PKA gum. In the SEM images, it was found that the surface tension of the polymer solution decreased by adding the gum and yield thinner and longer fibers at a voltage of 15 kV with an average diameter of 96 ± 24 nm. The mechanical properties of PVA/PKA nanofibers showed that the presence of gum increased the tensile strength and decreased the tensile strength of the fibers simultaneously. In vivo results showed that PVA/PKA nanofibers led to a significant reduction in wound size and tissue damage (regeneration of the epidermal layer, higher density of dermal collagen fibers, and lower presence of inflammatory cells) compared to the positive (phenytoin and silver sulfadiazine) and negative control (untreated) groups. Wound contraction was higher in rats treated with PVA/PKA nanofibers. Additionally, antioxidative serum levels of catalase and glutathione were higher in the PVA/PKA nanofiber groups even in comparison to positive control groups.

Pistacia atlantica oleo-gum-resin-loaded electrospun nanofibers potentially improve excision and burn models of skin scars in rats through antioxidative and tissue regeneration mechanisms.

Wound healing remains a critical challenge in healthcare, requiring advanced wound dressings with superior properties like transparency, absorbency, and biocompatibility. However, gaps exist in the use of marine-derived biopolymers for sustainable dressings. This study addresses this gap by combining κ-carrageenan (KC) with polyvinyl pyrrolidone (PVP) to develop transparent and absorbent biodegradable films through solvent casting and lyophilization techniques. Lyophilized films exhibited superior absorbency (9.17 g/cm2) and moisture management, with a water vapour transmission rate of 3990.67 g/m2/24 h, while solvent-cast films showed 78 % transmittance, enabling wound visualization. Mechanical testing revealed high tensile strength (31.5 MPa) and folding endurance (410 folds), ensuring durability. In vitro bactericidal assays confirmed efficacy against MRSA and E. coli, and in vivo tests on Wistar rats showed complete wound healing within 16 days with 91.1 % closure, outperforming untreated controls (76.7 %). This is the first study to explore lyophilized KC-PVP films for wound dressing applications, demonstrating potential for drug release, absorbency, and biodegradability. The innovative combination of biopolymers and fabrication techniques offers a sustainable, high-performance solution for wound care.

Effective wound management presents a substantial financial and time-related obstacle for healthcare institutions. Enhancing healthcare involves implementing innovative wound treatment methods to minimize healing time and expenses. This study is centered on the development of a non-toxic wound dressing using only two natural polymers and an enzyme. By adding 10 % wt microbial transglutaminase, the mechanical properties of the dressing were improved. This formulation increased the swelling rate by 70 %, deswelling rate by 15 %, conversion rate by 9 %, and networking rate by 20 %. Additionally, the non-toxic dressing showed a cell viability rate of 106 %. In drug delivery tests, explosive release behavior was observed, which is advantageous for open wounds. Cell staining experiments were also carried out to evaluate wound behavior in terms of collagen formation, granulation, and inflammation. The results suggest that the optimized hydrogel has great potential as a wound dressing. Its excellent absorption, antioxidant, and biocompatibility characteristics enhance tissue granulation rate and reduce wound treatment time by half compared to conventional methods, while also minimizing scarring risk. This innovative treatment, which eliminates the need for frequent changes, is beneficial for both secondary intentions and severe open wounds requiring bottom-up healing.

Gelatin-based biomaterials are widely acknowledged as a promising choice for wound dressings, given their similarity to the extracellular matrix and biocompatibility. However, the challenge of cross-linking gelatin while preserving its biocompatibility and cost-effectiveness persists. This study aimed to enhance the properties of gelatin by incorporating the oxidized lignosulfonate (OLS) biopolymer as an inexpensive and biocompatible natural material. The polyphenolic structure of OLS acts as both a cross-linking agent and an antibacterial component. The OLS/gelatin films were prepared using a casting method with varying weight ratios (0.1, 0.2, 0.3, 0.4, and 0.5 w/w). FTIR analysis confirmed the formation of Schiff-base and hydrogen bonds between gelatin and OLS. The resulting films exhibited enhanced mechanical properties (Young's modulus ∼40 MPa), no cytotoxicity, and excellent cell adhesion and morphology. Antimicrobial tests showed significant activity against Escherichia coli and Staphylococcus aureus, with higher activity against S. aureus (17 mm inhibition zone and 99 % bactericidal rate). In vivo studies in a mouse model demonstrated that the gelatin/0.2OLS dressing significantly improved wound healing, including re-epithelialization, collagen formation, inflammation reduction, and blood vessel density, compared to untreated wounds. These findings suggest that the synthesized novel gelatin/OLS wound dressing has promising healing and antibacterial properties.

In clinical practice, a large variety of medical devices adhere to skin to perform their function. The repeated application and removal of these devices can lead to skin damage or medical adhesive-related skin injury. Awareness of this problem has increased in the past decade, and this adverse event can be prevented with appropriate selection of adhesive products and the appropriate techniques for application and removal. A wide variety of adhesives and backing systems have been developed to create medical devices with an array of attributes, so they can accomplish many different indications in the clinical setting and meet various needs, including doing the clinical job without damaging the skin and causing further patient complications. The selection of an adhesive product should take into consideration a patient's skin assessment and history of medical adhesive-related skin injury, and using only the minimal adhesive strength needed to perform the function while protecting the skin from damage.

Chronic wounds are becoming an increasing burden on healthcare services, as they have extended healing times and are susceptible to infection, with many failing to heal, which can lead ultimately to amputation. Due to the additional rise in antimicrobial resistance and emergence of difficult-to-treat Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE pathogens), novel treatments will soon be required asides from traditional antibiotics. Many natural substances have been identified as having the potential to aid in both preventing infection and increasing the speed of wound closure processes. Manuka honey is already in some cases used as a topical treatment in the form of ointments, which in conjunction with dressings and fish skin grafts are an existing US Food and Drug Administration-approved treatment option. These existing treatment options indicate that fatty acids from fish oil and manuka honey are well tolerated by the body, and if the active components of the treatments were better understood, they could make valuable additions to topical treatment options. This review considers two prominent natural substances with established manufacturing and global distribution-marine based fatty acids (including their metabolites) and manuka honey-their function as antimicrobials and how they can aid in wound repair, two important aspects leading to resolution of chronic wounds.

Chitosan (CS) composite gels have emerged as promising materials with diverse applications in biomedicine. This review provides a concise overview of recent advancements and key aspects in the development of CS composite gels. The unique properties of CS, such as biocompatibility, biodegradability, and antimicrobial activity, make it an attractive candidate for gel-based composites. Incorporating various additives, such as nanoparticles, polymers, and bioactive compounds, enhances the mechanical, thermal, and biological and other functional properties of CS gels. This review discusses the fabrication methods employed for CS composite gels, including blending and crosslinking, highlighting their influence on the final properties of the gels. Furthermore, the uses of CS composite gels in tissue engineering, wound healing, drug delivery, and 3D printing highlight their potential to overcome a number of the present issues with drug delivery. The biocompatibility, antimicrobial properties, electroactive, thermosensitive and pH responsive behavior and controlled release capabilities of these gels make them particularly suitable for biomedical applications. In conclusion, CS composite gels represent a versatile class of materials with significant potential for a wide range of applications. Further research and development efforts are necessary to optimize their properties and expand their utility in pharmaceutical and biomedical fields.

In this article, a method to develop 3D printable hybrid sodium alginate and albumin foam, crosslinked with calcium chloride mist is introduced. Using this method, highly porous structures are produced without the need of further postprocessing (such as freeze drying). The proposed method is particularly beneficial in the development of wound dressing as the printed foams show excellent lift-off and water absorption properties. Compared with methods that use liquid crosslinker, the use of mist prevents the leaching of biocompounds into the liquid crosslinker. 3D printing technique was chosen to provide more versatility over the wound dressing geometry. Calcium chloride and rhodamine B were used as the crosslinking material and the model drug, respectively. Various biomaterial inks were prepared by different concentrations of sodium alginate and albumin, and the fabricated scaffolds were crosslinked in mist, liquid, or kept without crosslinking. The effects of biomaterial composition and the crosslinking density on the wound dressing properties were assessed through printability studies. The mist-crosslinked biomaterial ink composed of 1% (w/v) sodium alginate and 12% (w/v) albumin showed the superior printability. The fabricated scaffolds were also characterized through porosity, mechanical, degradation, and drug release tests. The mist-crosslinked scaffolds showed superior mechanical properties and provided relatively prolonged drug release.

This review investigates the most recent advances in personalized 3D-printed wound dressings and skin scaffolding. Skin is the largest and most vulnerable organ in the human body. The human body has natural mechanisms to restore damaged skin through several overlapping stages. However, the natural wound healing process can be rendered insufficient due to severe wounds or disturbances in the healing process. Wound dressings are crucial in providing a protective barrier against the external environment, accelerating healing. Although used for many years, conventional wound dressings are neither tailored to individual circumstances nor specific to wound conditions. To address the shortcomings of conventional dressings, skin scaffolding can be used for skin regeneration and wound healing. This review thoroughly investigates polysaccharides (e.g., chitosan, Hyaluronic acid (HA)), proteins (e.g., collagen, silk), synthetic polymers (e.g., Polycaprolactone (PCL), Poly lactide-co-glycolic acid (PLGA), Polylactic acid (PLA)), as well as nanocomposites (e.g., silver nano particles and clay materials) for wound healing applications and successfully 3D printed wound dressings. It discusses the importance of combining various biomaterials to enhance their beneficial characteristics and mitigate their drawbacks. Different 3D printing fabrication techniques used in developing personalized wound dressings are reviewed, highlighting the advantages and limitations of each method. This paper emphasizes the exceptional versatility of 3D printing techniques in advancing wound healing treatments. Finally, the review provides recommendations and future directions for further research in wound dressings.

A composite silicone skin adhesive material was designed to improve its water vapor permeability to offer advantages to wearer comfort compared to existing skin adhesive dressings available (including perforated silicone and hydrocolloid products). The chemical and mechanical properties of this novel dressing were analyzed to show that it has a high creep compliance, offering anisotropic elasticity that is likely to place less stress on the skin. A participant study was carried out in which 31 participants wore a novel silicone skin adhesive (Sil2) and a hydrocolloid competitor and were monitored for physiological response to the dressings. Trans-epidermal water loss (TEWL) was measured pre- and postwear to determine impairment of skin barrier function. Sil2 exhibited a higher vapor permeability than the hydrocolloid dressings during wear. Peel strength measurements and dye counter staining of the removed dressings showed that the hydrocolloid had a higher adhesion to the participants' skin, resulting in a greater removal of proteins from the stratum corneum and a higher pain rating from participants on removal. Once the dressings were removed, TEWL of the participants skin beneath the Sil2 was close to normal in comparison to the hydrocolloid dressings that showed an increase in skin TEWL, indicating that the skin had been highly occluded. Analysis of the skin immediately after removal showed a higher incidence of erythema following application of hydrocolloid dressings (>60%) compared to Sil2, (<30%). In summary, this modified silicone formulation demonstrates superior skin protection properties compared to hydrocolloid dressings and is more suitable for use as a skin adhesive.

This study determined the influence and ideal ratios of various coconut oil (CO) amounts in gelatin (G) based-films as wound dressings since there are limited comparative studies to evaluate the sole effect of increasing CO on protein-based biomaterials. Homogenous films at G:CO ratio of 4:0,4:2,4:3,4:4 (w:w) corresponding to CO-0, CO-2, CO-3, CO-4, respectively, were obtained using solution casting. SEM showed CO caused rougher surfaces decreasing mechanical strength. However, no pores were observed in CO-4 due to bigger clusters of oil improving stretchability compared to CO-3; and durability since aging of CO-4 was >10% lower than CO-0 in aqueous media. FTIR showed triglycerides' band only in CO films with increasing amplitude. Moreover, amide-I of CO-2 was involved in more hydrogen bonding, therefore, CO-2 had the highest melt-like transition temperatures (Tmax) at ∼163 °C while others' were at ∼133 °C; and had more ideal mechanical properties among CO films. XTT showed that increased CO improved 3T3 cell viability as CO-0 significantly decreased viability at 10,50,75,100 μg/mL (p < 0.05), whereas CO-2 and CO-3 within 5-75 μg/mL and CO-4 within 5-100 μg/mL range increased viability ≥100% suggesting proliferation. All CO samples at 25 μg/mL stimulated 3T3 cell migration in Scratch Assay indicating wound healing. CO amounts mainly improved thermal and healing properties of gelatin-based biomaterial. CO-2 was more thermally stable and CO-4 had better influence on cell viability and wound healing than CO-0. Therefore, increased CO ratios, specifically 4:2 and 4:4, G:CO (w:w), in gelatin-based films can be ideal candidates for wound dressing materials.

In this research, a novel double-layer film based on polycaprolactone and cress seed mucilage containing zinc oxide nanoparticles (0.5-2 %) was synthesized using solution casting technique, as an interactive multi-functional wound dressing. The bilayer films were characterized by measuring moisture content, contact angle parameter, porosity, water vapor transmission rate (WVTR), color attributes and opacity, swelling, degradation, mechanical properties, cell viability, and antimicrobial activity, as well as using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). The results indicated that the film containing 1.5 % zinc oxide nanoparticles had the best performance, with high swelling ability (3600 %) and 25 % degradation within 24 h of placement in a wound simulator solution. Its mechanical properties, including tensile strength and elongation at break, were 9 MPa and 5.53 %, respectively. In investigating the antimicrobial activity of the optimal film against Escherichia coli and Staphylococcus aureus, the diameter of the inhibition zone was observed to be 39.33 and 42 mm, respectively. Moreover, increasing the number of ZnO-NPs hindered the growth of NIH/3T3 cells, but the 1.5 % ZnO-NP loaded film showed a high percentage of cell viability in 1 day (90 %) and 3 days (93 %), which is suitable for biomedical applications.

Malignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternatives for better malignant wound management. The last decade screened literature evidenced an increasing interest in developing natural treatment alternatives based on beehive, plant extracts, pure vegetal compounds, and bacteriocins. Promising therapeutics can also be envisaged by involving nanotechnology due to either intrinsic biological activities or drug delivery properties of nanomaterials. Despite recent progress in the field of malignant wound care, the literature is still mainly based on in vitro and in vivo studies on small animal models, while the case reports and clinical trials (less than 10 and only one providing public results) remain scarce. Some innovative treatment approaches are used in clinical practice without prior extensive testing in fungating wound patients. Extensive research is urgently needed to fill this knowledge gap and translate the identified promising therapeutic approaches to more advanced testing stages toward creating multidimensional wound care strategies.

Burns can result in infection, disability, psychosocial and economic issues. Advanced wound dressings like hydrogel absorb exudate and maintain moisture. Considering the antimicrobial properties of silver nanoparticles and iron oxide nanoparticles, the efficiency of cross-linked hydrogel loaded with chitosan-supported iron oxide and silver nanoparticles for burn wounds repair was investigated in animal model. Cellulose hydrogel dressing made from carboxymethylcellulose and hydroxyethylcellulose crosslinked with different concentrations of citric acid (10, 15, 20, and 30%) was produced. The physicochemical characteristics of the synthetized hydrogels including Fourier-Transform Infrared spectroscopy, Thermal behavior, Swelling properties, and Scanning Electron Microscope (SEM) were evaluated. The silver nanoparticles and iron nanoparticles were produced and the characteristics, cytotoxicity, antimicrobial activities and their synergistic effect were investigated. After adding nanoparticles to hydrogels, the effects of the prepared wound dressings were investigated in a 14-day animal model of burn wound. The results showed that the mixture comprising 12.5 ppm AgNps, and IONPs at a concentration ≤100 ppm was non-cytotoxic. Moreover, the formulations with 20% CA had a swelling ratio of almost 250, 340, and 500 g/g at pHs of 5, 6.2, and 7.4 after one hour, which are lower than those of formulations with 5 and 10% CA. The total mass loss (59.31%) and the exothermic degradation happened in the range of 273-335 °C and its Tm was observed at 318.52 °C for hydrogels with 20% CA. Thus, the dressing comprising 20% CA which was loaded with 12.5 ppm silver nanoparticles (AgNPs) and 100 ppm iron oxide nanoparticles (IONPs) indicated better physicochemical, microbial and non-cytotoxic characteristics, and accelerated the process of wound healing after 14 days. It was concluded that the crosslinked hydrogel loaded with 12.5 ppm AgNPs and 100 ppm IONPs possesses great wound healing activity and could be regarded as an effective topical burn wound healing treatment.

Chronic wounds that fail to progress through normal phases of healing present a significant healthcare burden owing to prolonged treatment and associated costs. Traditional wound care typically involves regular dressing changes, which can be painful. Recent approaches have explored the use of lidocaine to manage pain and red-light irradiation (RLI), known for its anti-inflammatory and cell proliferation effects, to potentially enhance wound healing.

To investigate the therapeutic efficacy of lidocaine wet compression (LWC) combined with RLI for chronic wounds.

We enrolled 150 patients with chronic wounds from the Wound and Ostomy Outpatient Clinic of the Second Hospital of Anhui Medical University from April to September 2022. The wounds were treated with dressing changes. The patients were randomly assigned to the control and experimental groups using a random number table and given the same first dressing change (2% LWC for 5 min and routine dressing change). From the second dressing change, in addition to 2% LWC for 5 min and routine dressing change, the experimental group received RLI, whereas the control group continued to receive the same LWC and dressing change. The first and second dressing changes were performed on days 1 and 2, respectively. The third dressing change was performed 3 d after the second change. The frequency of subsequent dressing changes was determined based on wound exudation and pain. Pain during the first three dressing changes was evaluated in both groups. The average number of dressing changes within 28 d and the degree of wound healing on day 28 were also recorded.

During the initial dressing change, no noticeable differences were observed in the pain levels experienced by the two groups, indicating similar pain tolerance. However, during the second and third dressing changes, the experimental group reported significantly less pain than the control group. Furthermore, over 28 d, the experimental group required fewer dressing changes than the control group.

Notably, the effectiveness of wound healing on the 28th day was significantly higher in the experimental group than that of in the control group. The combination of LWC and RLI was effective in reducing early-stage pain, promoting wound healing, decreasing the frequency of dressing changes, and enhancing patients' overall quality of life with chronic wounds.

The complications associated with diabetic wounds make their healing process prolonged. Hydrogels could be ideal wound dressings therefore present research was conducted to prepare silk sericin (an adhesive protein polymer) based hydrogels in combination with plant extracts and to evaluate its effectiveness against wound healing process in mice with alloxan induced diabetes. Excision wounds were formed via a biopsy puncture (6 mm). Experimental hydrogels were prepared and applied topically on the diabetic wounds. All the hydrogel treatment groups showed significantly higher (P < 0.001) percent wound contraction from day 3 to day 11 as compared to the negative diabetic control group. The serum level of anti-inflammatory cytokine (Interleukin-10) and tissue inhibitor metalloproteinase (TIMP) was significantly higher (P < 0.001), while the level of pro-inflammatory cytokines (tumor necrosis factor-α, Interleukin-6) and matrix metalloproteinases (MMP-2, MMP-9) was significantly lower (P < 0.001) in hydrogels treatment groups as compared to diabetic control group. Although all the hydrogels showed effective results, however the best results were shown by 4 % sericin+4 % banyan+4 % onion based hydrogel. It can be concluded that Sericin based hydrogel enriched with banyan and onion extracts can be used as an effective remedy for the treatment of diabetic wounds due to their high healing and regenerative properties.

In this study, a simple and scalable mechanical pretreatment was evaluated as means to increase the cellulose accessibility of cellulose fibers, with the aim of improving the efficiency of enzymatic reactions for the production of cellulose nanoparticles (CNs). In addition, the effects of enzyme type (endoglucanase - EG, endoxylanase - EX, and a cellulase preparation - CB), composition ratio (0-200UEG:0-200UEX or EG, EX, and CB alone), and loading (0 U-200 U) were investigated in relation to CN yield, morphology, and properties. The combination of mechanical pretreatment and specific conditions for enzymatic hydrolysis substantially improved CN production yield, reaching up to 83 %. The production of rod-like or spherical nanoparticles and their chemical composition were highly dependent on the type of enzyme, composition ratio, and loading. However, these enzymatic conditions minimally affected the crystallinity index (approximately 80 %) and thermal stability (T_max within 330-355 °C). Collectively, these results demonstrate that mechanical pretreatment followed by enzymatic hydrolysis under specific conditions is a suitable method to produce nanocellulose with a high yield and tunable properties such as purity, rod-like or spherical forms, high thermal stability, and high crystallinity. Therefore, this production route is a promising approach to produce tailored CNs with the potential to offer superior performance in a variety of sophisticated applications, including, but not limited to, wound dressings, drug delivery, thermoplastic composites, 3D (bio)printing, and smart packaging.

Biopolymers play a significant role in tissue engineering, including in the formulation of bioinks that require careful selection of the biopolymers having properties ideal for printability and supporting biological entities such as cells. Alginate is one of the most widely explored natural biopolymers for tissue engineering applications due to its biocompatibility, cross-linking ability, hydrophilic nature, and easy incorporation with other polymers. Here, a succinoglycan-like exopolysaccharide (EPS-R17) produced by a bacterial strain Rhizobium sp. PRIM17 was incorporated with alginate for the development of a bioink. The physicochemical characterization of EPS-R17 was performed before formulating the bioink with alginate. The bioink formulation was prepared by mixing different concentrations of EPS with an alginate solution at room temperature under sterile atmosphere. The prepared bioink was characterized for rheological properties, biocompatibility, and a bioplotting experiment was also conducted to mimick the extrusion bioprinting. The EPS-R17 was composed of glucose, galactose, and rhamnose with a molecular weight of 69.98 kDa. It was thermally stable up to 260 °C and showed characteristic FT-IR peaks (1723.3 cm^-1) for succinyl groups. The EPS-R17 showed biocompatibility with keratinocytes (HaCaT), and fibroblasts (HDF) in vitro. The rheological properties of EPS-R17-alginate bioink at different combinations showed shear thinning behavior at 25 and 37 °C. Amplitude sweep measurements showed the gel-like nature of the polymer combinations in the solution system superior to alginate or EPS-R17 alone. The combination of 1 % EPS-R17 and 1.5 % alginate showed good compressive strength and swelling behavior. Extrusion bioprinting mimicked using a bioplotting experiment showed the sustained cell viability in the polymer matrix of EPS-R17-alginate bioink. The results indicate that the EPS-R17 can be used in combination with alginate for bioinks for bioprinting applications for providing physical properties and favorable bioactivities.

A major challenge in chronic wound treatment is maintaining an appropriate wound moisture balance throughout the healing process. Wound dehydration hinders wound healing due to impeded molecule transport and cell migration with associated tissue necrosis. In contrast, wounds that produce excess fluid contain high levels of reactive oxygen species and matrix metalloproteases that impede cell recruitment, extracellular matrix reconstruction, and angiogenesis. Dressings are currently selected based on the relative amount of wound exudate with no universal dressing available that can maintain appropriate wound moisture balance to enhance healing. This work aimed to develop a high porosity poly(ethylene glycol) diacrylate hydrogel foam that can both rapidly remove exudate and provide self-tuning moisture control to prevent wound dehydration. A custom foaming device was used to vary hydrogel foam porosity from 25% to 75% by adjusting the initial air-to-solution volume ratio. Hydrogel foams demonstrated substantial improvements in water uptake volume and rate as compared to bulk hydrogels while maintaining similar hydration benefits with slow dehydration rates. The hydrogel foam with the highest porosity (~75%) demonstrated the greatest water uptake and rate, which outperformed commercial dressing products, Curafoam® and Silvercel®, in water absorption, moisture retention, and exudate management. Investigation of the water vapor transmission rates of each dressing at varied hydration levels was characterized and demonstrated the dynamic moisture-controlling capability of the hydrogel foam dressing. Overall, the self-tuning moisture control of this hydrogel foam dressing holds great promise to improve healing outcomes for both dry and exudative chronic wounds.

Comparative investigations on environmentally triggered drug delivery and wound healing characteristics of flexible hydrogel composites, Chitosan-Gelatin (C/G) and 2-Hydroxyethyl Methacrylate-Gelatin (H/G); are presented here. These composites, prepared through facile synthesis and curing methods, indicate the potential to smartly respond to the pH changes in wounds by releasing drug simultaneously and aiding in faster healing. An in-vitro investigation of the composite characteristics were included testing for Equilibrium Water Capacity Studies, Fourier Transform Infrared Spectroscopy (FTIR) investigations as well as UV based drug release and gravimetric hydrogel degradation profiles. This was followed by cutaneous application testing of the hydrogel systems in balb-c mice. Observations and testing results indicated the potential applicability of the hydrogel systems as dressings for topical/transdermal applications, provided that further detailed in-vivo characteristics are accounted for.

This study aimed to investigate the wound-healing activity of animal platelet-rich plasma (PRP) in wounds infected with methicillin-resistant Staphylococcus aureus (MRSA) in rats. After wound induction, the rats were divided into three groups: noninfected animals treated with PRP (PRP group), MRSA-infected animals treated with mupirocin (standard control group), and MRSA-infected animals treated with PRP (MRSA+PRP group). Scratch assays, MTT test, and live/dead cells were also investigated. Total bacterial count, parameters of wound area, histopathological assessment, and expressions of IL-1β, TNF-α, iNOS, PDGF, FGF-2, and TGF-β mRNA levels and immunofluorescent staining of CD31 and collagen type 1 were assessed. The results showed that culture with PRP increased migration. PRP only showed cytotoxicity in a concentration of 100%. Topical application of PRP (50 µL) reduced the wound area and total bacterial count compared with the control group (P<0.05). The mRNA levels of IL-1β, TNF-α, and iNOS expression on days 7 and 14 (P<0.05) decreased in the treated groups compared with control rats. The mRNA levels of PDGF and TGF-β expression (P<0.05) increased in the treatment groups compared with control rats on days 3 and 7 (P<0.05). FGF-2 expression was significantly higher in the treated groups compared with the control group on days 7 and 14 (P<0.05). Moreover, positive expressions of macrophage colony-stimulating factor (M-CSF), CD31, collagen type 1 and cytokeratin proteins keratinocyte proliferation, and re-epithelization were significantly (P<0.05) increased in both PRP and MRSA+PRP-treated groups compared with the control groups on days 7 and 14. Topical administration of PRP accelerated the wound healing in MRSA-infected wound by decreasing the inflammation and improving the proliferative phase.

Regenerative medicine is an active research sphere that focuses on the repair, regeneration, and replacement of damaged tissues and organs. A plethora of innovative wound dressings and skin substitutes have been developed to treat cutaneous wounds and are aimed at reducing the length or need for a hospital stay. The inception of biomaterials with the ability to interact with cells and direct them toward desired lineages has brought about innovative designs in wound healing and tissue engineering. This cellular engagement is achieved by cell cues that can be biochemical or biophysical in nature. In effect, these cues seep into innate repair pathways, cause downstream cell behaviours and, ultimately, lead to advantageous healing. This review will focus on biomolecules with encoded biomimetic, instructive prompts that elicit desired cellular domino effects to achieve advanced wound repair. The wound healing dressings covered in this review are based on functionalized biopolymeric materials. While both biophysical and biochemical cues are vital for advanced wound healing applications, focus will be placed on biochemical cues and in vivo or clinical trial applications. The biochemical cues aforementioned will include peptide therapy, collagen matrices, cell-based therapy, decellularized matrices, platelet-rich plasma, and biometals.

Pectin is a heterogeneous hydrocolloid present in the primary cell wall and middle lamella in all dicotyledonous plants, more commonly in the outer fruit coat or peel as compared to the inner matrix. Presently, citrus fruits and apple fruits are the main sources for commercial extraction of pectin, but ongoing research on pectin extraction from alternate fruit sources and fruit wastes from processing industries will be of great help in waste product reduction and enhancing the production of pectin. Pectin shows multifunctional applications including in the food industry, the health and pharmaceutical sector, and in packaging regimes. Pectin is commonly utilized in the food industry as an additive in foods such as jams, jellies, low calorie foods, stabilizing acidified milk products, thickener and emulsifier. Pectin is widely used in the pharmaceutical industry for the preparation of medicines that reduce blood cholesterol level and cure gastrointestinal disorders, as well as in cancer treatment. Pectin also finds use in numerous other industries, such as in the preparation of edible films and coatings, paper substitutes and foams. Due to these varied uses of pectin in different applications, there is a great necessity to explore other non-conventional sources or modify existing sources to obtain pectin with desired quality attributes to some extent by rational modifications of pectin with chemical and enzymatic treatments.

Incomplete contact between a pre-formed hydrogel and irregular wound limits the therapeutic effect of the dressing and increases the risk of infection; while great concerns have remained regarding the potential toxicity of the residual additives of chemical crosslinking for in situ forming hydrogels. Therefore, it is desirable to develop a self-adaptive hydrogel in response to skin temperature with shape adaptability and efficient antibacterial properties to prevent microbial invasion. Herein, a dually-thermoresponsive hydrogel composed of poly(N-isopropylacrylamide) (PNIPAm) and methacrylated κ-carrageenan (MA-κ-CA) is designed with compliance at physiological temperature to realize shape adaptability for completely covering irregular wounds. Furthermore, the hydrogel with near-infrared (NIR)-responsive polypyrrole-polydopamine nanoparticles (PPy-PDA NPs) and Zn²⁺ -derived zeolitic imidazolate framework (ZIF-8) can generate localized heat and gradually release Zn²⁺ to realize safe, effective synergetic photothermal-chemical bactericidal capability. In addition, the release rate of Zn²⁺ can be accelerated by NIR-induced heating, and thus a more efficient sterilization can be provided to severely infected wounds. Therefore, the proposed hydrogel would serve as a promising wound dressing for the full course of wound healing, with the abilities of perfectly covering the wound and adapting to regenerating tissue, and controllable photothermal-chemical antibacterial capability to reach high bactericidal efficiency and long-term release of antibacterial agents.

Skin tissue wound healing proceeds through four major stages, including hematoma formation, inflammation, and neo-tissue formation, and culminates with tissue remodeling. These four steps significantly overlap with each other and are aided by various factors such as cells, cytokines (both anti- and pro-inflammatory), and growth factors that aid in the neo-tissue formation. In all these stages, advanced biomaterials provide several functional advantages, such as removing wound exudates, providing cover, transporting oxygen to the wound site, and preventing infection from microbes. In addition, advanced biomaterials serve as vehicles to carry proteins/drug molecules/growth factors and/or antimicrobial agents to the target wound site. In this review, we report recent advancements in biomaterials-based regenerative strategies that augment the skin tissue wound healing process. In conjunction with other medical sciences, designing nanoengineered biomaterials is gaining significant attention for providing numerous functionalities to trigger wound repair. In this regard, we highlight the advent of nanomaterial-based constructs for wound healing, especially those that are being evaluated in clinical settings. Herein, we also emphasize the competence and versatility of the three-dimensional (3D) bioprinting technique for advanced wound management. Finally, we discuss the challenges and clinical perspective of various biomaterial-based wound dressings, along with prospective future directions. With regenerative strategies that utilize a cocktail of cell sources, antimicrobial agents, drugs, and/or growth factors, it is expected that significant patient-specific strategies will be developed in the near future, resulting in complete wound healing with no scar tissue formation.

The influence of coconut oil (CO) on a gelatin-based film was investigated when used as a potential wound dressing material. There is limited study on CO in protein-based wound dressing materials. Therefore, in this study a self-supporting, continuous and homogenous CO incorporated gelatin-based film was formulated and obtained by solution casting method. The influence of CO on physicochemical and thermal properties of gelatin-based film was also determined. Moreover, the effect CO in gelatin films on cell viability and cell migration was analysed with a preliminary cell culture study. Homogenous dispersion of 10% (w/w) CO was obtained in films when 3% (v/w) Tween 80, a surfactant, was incorporated to 20% (w/w) plasticized gelatin film forming solution. Effect of CO on gelatin-based film was observed via phase separation by SEM analysis. Water uptake of gelatin film with no CO, GE film; and 10% (w/w) CO incorporated GE film, GE-CO, were 320% and 210%, respectively, after 3 hours in water. FTIR analysis showed triglyceride component of CO and increased hydrogen bonding between NH groups of gelatin in GE-CO films. DSC results suggested a more ordered structure of GE-CO film due to an increase in melt-like transition temperature and melting enthalpy of GE-CO film. CO content also increased cell viability, assessed by XTT Assay since cell viability was approximately 100% when L929 cell culture was incubated with GE-CO of 5-100 μg/mL. Moreover, GE-CO samples within 5-25 μg/mL concentration range, increased proliferation of L929 cells since cell viability was significantly higher than the 100% viable cell culture control (P < 0.05) which is also an indication of efficient healing. However, GE decreased viability of L929 cells significantly at 100-10 μg/mL concentration range (P < 0.05) and were toxic at concentrations of 100, 75 and 50 μg/mL which decreased ∿50% of the viability of the cells. Scratch Assay to assess in vitro wound healing showed cell migration towards scratch after 24 h as an indication of wound healing only in GE-CO samples. This study showed that, CO could efficiently be added to gelatin-based films for preparation of a primary wound dressing biomaterial which is also demonstrated to have a promising wound healing effect for minor wounds.

Hydrocolloid dressings are an important method for accelerating wound healing. A combination of a hydrocolloid and nanoparticles (NPs), such as gold (Au), improves the wound healing rate, but Au-NPs are expensive and unable to block ultraviolet (UV) light. Herein, we combined zinc oxide nanoparticles (ZnO-NPs) with hydrocolloids for a less expensive and more effective UV-blocking treatment of wounds. Using Sprague-Dawley rat models, we showed that, during 10-day treatment, a hydrocolloid patch covered with ZnO-NPs (ZnO-NPs-HC) macroscopically and microscopically stimulated the wound healing rate and improved wound healing in the inflammation phase as shown by reducing of pro-inflammatory cytokines (CD68, IL-8, TNF-α, MCP-1, IL-6, IL-1β, and M1) up to 50%. The results from the in vitro models (RAW264.7 cells) also supported these in vivo results: ZnO-NPs-HCs improved wound healing in the inflammation phase by expressing a similar level of pro-inflammatory mediators (TNF-α and IL-6) as the negative control group. ZnO-NPs-HCs also encouraged the proliferation phase of the healing process, which was displayed by increasing expression of fibroblast biomarkers (α-SMA, TGF-β3, vimentin, collagen, and M2) up to 60%. This study provides a comprehensive analysis of wound healing by measuring the biomarkers in each phase and suggests a cheaper method for wound dressing.

The increased antibiotic resistance of pathogenic bacteria requires intense research of new wound healing agents. Novel wound dressings should be designed to provide wound disinfection, good moisture, and fast epithelization. In this study, bacterial cellulose (BC) was impregnated with graphene quantum dots (GQDs) for potential use in wound healing treatment. The BC was successfully loaded with approximately 11.7 wt% of GQDs. The actual release of GQDs from new designed composite hydrogels were 13%. Novel GQDs-BC hydrogel composites are biocompatible and showed significant inhibition towards Staphylococcus aureus and Streptococcus agalactiae and bactericidal effect towards Methicillin-resistant Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. The in vitro healing analysis showed significant migration of human fibroblasts after the GQDs-BC hydrogels application. Furthermore, after 72 h exposure to GQDs-BC, endothelial nitric oxide synthase, vascular endothelial growth factor A, matrix metallopeptidase 9, and Vimentin gene expression in fibroblast were significantly upregulated promoting angiogenesis. GQDs-BC hydrogel composites showed very good wound fluid absorption and water retention, which satisfies good dressing properties. All obtained results propose new designed GQDs-BC hydrogels as potential wound dressings.

Recently, functional dressings that can protect the wound area from dehydration and bacterial infection and support healing have gained importance in place of passive dressings. This study aimed to develop temporary and regenerative xanthan/gelatin (XGH) and keratin/xanthan/gelatin hydrogels (KXGHs) that have high absorption capacity and applicability as a wound dressing that can provide local delivery of Vitamin C (VC). Firstly, xanthan/gelatin hydrogels were produced by crosslinking with different glycerol concentrations and characterized to determine the hydrogel composition. According to their weight ratios, xanthan, gelatin, and glycerol hydrogels are named. If their weight ratio is 1:1:2 (w/w/w), the group name is selected as X1:GEL1:GLY2. X1:GEL1:GLY2 hydrogel was selected for biocompatibility, mechanical property, water vapor transmission rate (WVTR), and porosity. The addition of keratin to X1:GEL1:GLY2 improved L929 fibroblasts viability and increased protein release. Water vapor transmission of XGHs and KXGHs was between 3059.09 ± 126 and 4523 ± 133 g m^-2 d^-1; therefore, they can be suitable for granulating, low to moderate exudate wounds. XGH and KXGHs loaded with VC had higher water uptake, making it more convenient for exudate wounds. VC was released for 100 h, and VC containing XGHs and KXGHs increased the collagen synthesis of L929 fibroblasts. All of the hydrogels (XGH, KXGH, and VC-KXGHs) inhibited the bacteria transmission. In conclusion, our results suggest that VC-XGH and VC-KXGH can be candidates for temporary wound dressing materials for skin wounds.

Presently, notwithstanding the progress regarding wound-healing management, the treatment of the majority of skin lesions still represents a serious challenge for biomedical and pharmaceutical industries. Thus, the attention of the researchers has turned to the development of novel materials based on cellulose derivatives. Cellulose derivatives are semi-synthetic biopolymers, which exhibit high solubility in water and represent an advantageous alternative to water-insoluble cellulose. These biopolymers possess excellent properties, such as biocompatibility, biodegradability, sustainability, non-toxicity, non-immunogenicity, thermo-gelling behavior, mechanical strength, abundance, low costs, antibacterial effect, and high hydrophilicity. They have an efficient ability to absorb and retain a large quantity of wound exudates in the interstitial sites of their networks and can maintain optimal local moisture. Cellulose derivatives also represent a proper scaffold to incorporate various bioactive agents with beneficial therapeutic effects on skin tissue restoration. Due to these suitable and versatile characteristics, cellulose derivatives are attractive and captivating materials for wound-healing applications. This review presents an extensive overview of recent research regarding promising cellulose derivatives-based materials for the development of multiple biomedical and pharmaceutical applications, such as wound dressings, drug delivery devices, and tissue engineering.

The treatment of unhealable and chronic cutaneous wounds is a significant challenge for the healthcare system. Hence, there has been heightened interest in the development of innovative therapeutic approaches for the acceleration of wound healing. Regenerative medicine based on mesenchymal stem cells (MSCs) has shown appropriate potential in skin repair. The regenerative properties of stem cells are mainly attributed to paracrine effects of secreted products, including exosomes. There are advantages to using exosomes as a cell-free approach instead of direct application of stem cells. Exosomes have nanoscale dimension and are immune-tolerant, Exosomes have the nanoscale dimension and are immune-tolerant. They can easily endocytose, and transfer the cargo content to recipient cells. They contribute to the regulation of the wound healing process by activating specific signaling pathways. To preserve exosome bioactivity and controlled release of effective concentration during prolonged wound care, the design of an optimized delivery system is necessary. Accordingly, hydrogels with their unique properties are promising candidates as exosome delivery and wound management products. This article investigates the characteristics of exosomes, their molecular mechanism in wound healing, and the advantages of the hydrogel delivery system. Also, published reports on the potential of exosome-loaded hydrogels in skin regeneration have been reviewed.

To relief the severe economic and social burdens and patient suffering caused by the increasing incidence of chronic wounds, more effective treatments are urgently needed. In this study, we focused on developing a novel sprayable wound dressing with the active ingredient β-1,3/1,6-glucan (βG). Since βG is already available as the active ingredient in a commercial wound healing product provided as a hydrogel in a tube (βG-Gel), the sprayable format should bring clinical benefit by being easily sprayed onto wounds; whilst retaining βG-Gel's physical stability, biological safety and wound healing efficacy. Potentially sprayable βG hydrogels were therefore formulated, based on an experimental design setup. One spray formulation, named βG-Spray, was selected for further investigation, as it showed favorable rheological and spraying properties. The βG-Spray was furthermore found to be stable at room temperature for more than a year, retaining its rheological properties and sprayability. The cytotoxicity of βG-Spray in keratinocytes in vitro, was shown to be promising even at the highest tested concentration of 100 μg/ml. The βG-Spray also displayed favorable fluid affinity characteristics, with a capacity to both donate and absorb close to 10% fluid relative to its own weight. Finally, the βG-Spray was proven comparably effective to the commercial product, βG-Gel, and superior to both the water and the carrier controls (NoβG-Spray), in terms of its ability to promote wound healing in healing-impaired animals. Contraction was found to be the main wound closure mechanism responsible for the improvement seen in the βG-treatment groups (βG-Spray and βG-Gel). In conclusion, the novel sprayable βG formulation, confirmed its potential to expand the clinical use of βG as wound dressing.

Chronic wounds are highly susceptible to bacterial infections. Previously, we loaded a natural antimicrobial peptide of low cost and high safety, ε-polylysine (EPL), into the electrospun nanofiber mat of starch. The mat showed comparable antibacterial activity but markedly better biocompatibility than the commercial silver-containing dressing. To further optimize material property, in this paper, we use hyaluronic acid (HA) to replace starch. Results show that EPL-loaded HA nanofiber mats (OHA-EPL) have suitable water vapor permeability, good biocompatibility and broad-spectrum antibacterial property similar to that of EPL-loaded starch nanofiber mat (Starch-EPL). Differently, the content of EPL in OHA-EPL nanofiber mats increases from 19.2% to 27.9%, the tensile strength rises from 0.3 MPa to 0.6 MPa, the elongation grows from 62.0% to 130.0%, and the fiber degradation and EPL release accelerates. In addition, OHA-EPL can absorb up to 26.3-times exudate, which is much higher than Starch-EPL (15.1 times). Combined with the excellent biological activity of HA, OHA-EPL may produce better therapeutic effects than Starch-EPL.

Surgical site infection (SSI) is one of the most common and debilitating complications of surgery. The risk of SSI rises if the patient has underlying health-related risk factors. This article reports on the complicated case of 61-year-old female with a history of obesity and diabetes. She was diagnosed with end-stage renal disease (ESRD) and had been receiving haemodialysis since 2012. She underwent a kidney transplant and developed a multidrug-resistant Pseudomonas aeruginosa SSI following surgery. She experienced delayed wound healing with a partially dehisced incision. Despite conventional wound care, there was no progress in wound healing. The authors combined sharp debridement, irrigation and antibiotic therapy with a silver-containing antimicrobial dressing for 1 month. Her SSI improved significantly and she returned to theatre for wound closure. The patient recovered well and was discharged from the hospital after suture removal. Wound care professionals can use combination therapies to manage SSIs effectively and reduce patient and healthcare costs.

The aim of this study was to evaluate a bioactive multilayer wound dressing, based on chitosan and alginate. To enhance healing potential, Dracaena Cinnabari and Aloe Vera were loaded as separate layers into the scaffold. The bare and bioactive multilayered scaffolds were fabricated by an iterative layering freeze-drying technique. Following of topographical, chemical, and physical assessment, the performance of the scaffolds was evaluated in vitro and in vivo. The results revealed adequate attachment, and proliferation of human foreskin fibroblasts, indicating excellent biocompatibility of the bioactive scaffold. In vivo, the performance of the multi-layered scaffold loaded with the bioactive materials was comparable with Comfeel plus®. The wounds treated with the bioactive scaffold exhibited superior hypergranulation, fibroblast maturation, epithelization, and collagen deposition, with minimal inflammation, and crust formation. It is concluded that the synergism of extracellular matrix-mimicking multi-layered scaffolding with Aloe Vera and Dracaena Cinnabari could be considered as a supportive wound dressing.

Wound healing is a dynamic and well-orchestrated process that can be promoted by creating an optimal environment with wound dressing. An ideal wound dressing material should possess a suitable matrix, structure and bioactive components, functioning synergistically to accelerate wound healing. Wound dressings that allow reproducibility and customizability are highly desirable in clinical practice. In this study, using chitosan (CS) as the matrix and bioglass (BG) as the biological component, a spatially designed dressing scaffold was fabricated from a home-made cryogenic printing system. The micro- and macro-structures of the scaffold were highly controllable and reproducible. The printed scaffold exhibited interconnected and hierarchical pore structures, as well as good flexibility and water absorption capacity, and these properties were not affected by the content of BG. Nevertheless, when the content of BGs exceeded 20% that of CS, the tension strength and elongation rate reduced, but in vitro antibacterial, cell proliferation and migration performance were enhanced. In vivo examinations revealed that the composite scaffold significantly promoted wound healing process, with the group having 30% bioglass showing better wound closure, neovascularization and collagen deposition than other groups. These results indicate that the 3D printed CS/BG composite scaffold is a promising dressing material that accelerates wound healing.

Wound dressings play an indispensable role in wound healing. However, traditional wound dressings have several disadvantages, such as poor mechanical properties and small pore diameters, which do not allow sufficient gas exchange. To overcome these shortcomings, this paper reports a polyvinyl alcohol (PVA)-based hydrogel physically crosslinked at -20 °C and containing polyethylene glycol (PEG) and nanohydroxyapatite (HAP). The physical and chemical properties of the hydrogels formed by different stirring methods (stirring with a glass rod or a hand-held homogenizer) were compared. The average roughness of Gel 1 (prepared using a hand-held homogenizer) is 112.6 nm, which is much lower than the average surface roughness of Gel 2 (1222 nm, prepared using a glass rod). Moreover, the hydrogel made by the unconventional mixing method (with a homogenizer) showed better performance, including a more interconnected open-pore microstructure and better mechanical properties. Finally, a full-thickness skin defect test was performed. The experimental results demonstrated that the hydrogel has considerable potential for applications in wound dressings.