In vitro and in vivo evaluation of chitosan-alginate/gentamicin wound dressing nanofibrous with high antibacterial performance

Wound dressings based on nanofiber polymer scaffolds with good antimicrobial performance and skin reconstruction ability are promising options to thwart wound infection and accelerate wound healing. This paper reports on the synthesis via electrospinning of chitosan-alginate (CS-Alg) nanofiber dressings with various amounts of gentamicin (Gn; 0–10 wt%) as a drug delivery system. Smooth and continuous nanofibers with no obvious beads were created, with increases in the amount of Gn resulting in reduced fiber diameter. Antimicrobial tests showed the Gn-loaded nanofibers had good antibacterial performance as indicated by the inhibition of bacterial growth. CS-Alg nanofibers loaded with higher Gn concentrations exhibited greater antibacterial performance than those with lower Gn concentrations. In vitro cell culture studies demonstrated that CS-Alg wound dressings with 1–3% Gn improved L929 cell attachment and proliferation more than wound dressings with higher Gn concentrations. In vivo experiments revealed that Cs-Alg nanofibers loaded with 3% Gn significantly enhanced skin regeneration in a Balb/C mice model by stimulating the formation of a thicker dermis, increasing collagen deposition, and increasing the formation of new blood vessels and hair follicles. Collectively, Gn-loaded CS-Alg wound dressings can be considered a good candidate for drug delivery systems and skin regeneration applications.     

Positively and negatively charged ionic modifications to cellulose assessed as cotton-based protease-lowering and hemostatic wound agents

Recent developments in cellulose wound dressings targeted to different stages of wound healing have been based on structural and charge modifications that function to modulate events in the complex inflammatory and hemostatic phases of wound healing. Hemostasis and inflammation comprise two overlapping but distinct phases of wound healing wherein different dressing material properties are required to bring pathological events under control when they present as a result of trauma or chronic wounds. Thus, we have designed cellulose wound dressings with properties that function through modified fiber surface properties to lower protease levels in the chronic wound and promote clotting in hemorrhaging wounds. With this in mind three finishing chemistries utilizing traditional pad-dry-cure approaches were explored for their potential to confer charged properties to cotton dressings. Cellulose dressings designed to remove cationic serine proteases from highly exudative chronic wounds were created to present negatively charged fibers as an ion exchange mechanism of protease-lowering. Phosphorylated cotton and polycarboxylic acid crosslinked cotton were prepared to examine their ability to remove human neutrophil elastase (HNE) from surrogate wound fluid. A cellulose phosphorylation reaction utilizing sodium hexametaphosphate: urea was explored to optimize cellulose phosphorylation as a function of HNE sequestration efficacy. Acid catalyzed cross linking of cellulose with butane-tetracarboxylic acid also resulted in a negatively charged dressing that removed HNE from solution more effectively than phosphorylated cellulose. Collagenase sequestration was also assessed with phosphorylated cellulose and polycarboxylic acid cross linked cellulose derivatives. Butanetetracarboxylic acid and phosphorylated cellulose functioned to remove collagenase from solution most effectively. Cellulose dressings designed to accelerate thrombosis and aggregation of blood platelets were prepared with a view to examining derivatized cotton fibers bearing a net positive charge to promote hemostasis. Cellulose and chitosan dressings bearing an aminoglucan functionality were created by grafting chitosan on cotton and preparing aminized cotton. The preparation of chitosan-grafted cotton dressings was completed with a citric acid grafting onto cellulose. Aminized cotton was functionalized as an ethylamino-ether cellulose derivative. The chitosan-grafted and aminized cotton demonstrated a dose response gelling of citrated sheep blood.     

Preparation and characterization of wool fiber reinforced nonwoven alginate hydrogel for wound dressing

Wound healing is a complex process which requires an appropriate environment for quick healing. Recently, biodegradable hydrogel-based wound dressings have been seen to have high potential owing to their biodegradability and hydrated molecular structure. In this work, a novel biodegradable composite of sodium alginate hydrogel with wool needle-punched nonwoven fabric was produced for wound dressing by sol–gel technique. The wool nonwoven was dipped in the sodium alginate-water solution and then soaked in calcium chloride solution which resulted in hydrogel formation. FTIR analysis and SEM images confirm the presence of alginate hydrogel inside the needle-punched wool nonwoven fabric. The wound exudate absorbing capacity of hydrogel based wool nonwoven was increased 30 times as compared to pure wool nonwoven. Moreover, the tensile strength and moisture management properties of hydrogel based nonwoven were also enhanced. The unique combination of alginate hydrogel with biocompatible wool nonwoven fabric provides moist environment and can help in cell proliferation during wound healing process.

     

Application of micellar electrokinetic chromatography for detection of silver nanoparticles released from wound dressing

The recent emergence of nanotechnology has provided a new therapeutic modality in case of silver nanoparticles. Dressings containing silver form the basis for the treatment of burns and wounds, either acute or chronic ones. The aim of the study was to examine silver release from the different wound dressings: commercially available (Atrauman Ag, Aquacel Ag) and experimental (FKDP‐AgNPs) using MEKC. In order to characterize prepared keratin based wound dressing before and after its modification with AgNPs, a compositional analysis was conducted using energy dispersive X‐ray spectroscopy. Nanosilver toxicity was evaluated with the 3‐(4,5‐dimethylthiazol‐2‐yl)‐5‐(3‐carboxymethoxyphenyl)‐2‐(4 sulfophenyl)‐2H‐tetrazolium test. Silver release from wound dressings was assessed using MEKC. The best separation was observed for MEKC in 20 mM borate buffer at pH 9 with 20 mM SDS addition. In vitro studies showed silver at higher concentration than 10 ppm exerted a toxic effect on fibroblasts isolated from diabetic mice versus. NIH/3T3 and BJ cell lines (p < 0.05). We observed silver was released more gradually from experimental FKDP‐AgNPs wound dressing, in compare to commercially available wound dressings. The fast and low‐cost method utilizing MEKC can be used in clinical practice to detect silver release from the wound dressings.     

Antimicrobial and wound healing activities of electrospun nanofibers based on functionalized carbohydrates and proteins

The anti-adhesion, anti-growth and the anti-penetration of bacteria, specifically multidrug-resistant bacteria, should be taken into consideration when designing promising wound dressings for infected wounds such as diabetic foot ulcers. Wound dressings composed of natural polymeric nanofibers such as functionalized cellulose, chitosan, alginate, hyaluronic acid, dextrin and cyclodextrin with appropriate antimicrobial and skin reconstruction properties are suitable alternatives that can accelerate wound healing and remove microbial infections. For instance, to improve the release profile of antibacterial agents such as metal nanoparticles and antibiotics, water-soluble polymers like polyethylene oxide and polyvinylpyrrolidone may be incorporated into polymeric nanofiber scaffolds. This review, therefore, addresses the current status and future challenges of antibacterial activities of nanofiber scaffolds composed of some of the natural occurring polymers.

     

Antibacterial and wound healing properties of cellulose acetate electrospun nanofibers loaded with bioactive glass nanoparticles; in-vivo study

Bioactive glasses (BGs) have gained great attention owing to their versatile biological properties. Combining BG nanoparticles (BGNPs) with polymeric nanofibers produced nanocomposites of great performance in various biomedical applications especially in regenerative medicine. In this study, a novel nanocomposite nanofibrous system was developed and optimized from cellulose acetate (CA) electrospun nanofibers containing different concentrations of BGNPs. Morphology, IR and elemental analysis of the prepared electrospun nanofibers were determined using SEM, FT-IR and EDX respectively. Electrical conductivity and viscosity were also studied. Antibacterial properties were then investigated using agar well diffusion method. Moreover, biological wound healing capabilities for the prepared nanofiber dressing were assessed using in-vivo diabetic rat model with induced wounds. The fully characterized CA electrospun uniform nanofiber (100–200 nm) with incorporated BGNPs exhibited broad range of antimicrobial activity against gram negative and positive bacteria. The BGNP loaded CA nanofiber accelerated wound closure efficiently by the 10th day. The remaining wound areas for treated rats were 95.7?±?1.8, 36.4?±?3.2, 6.3?±?1.5 and 0.8?±?0.9 on 1st, 5th, 10th and 15th days respectively. Therefore, the newly prepared BGNP CA nanocomposite nanofiber could be used as a promising antibacterial and wound healing dressing for rapid and efficient recovery.

     

The effects of cotton gauze coating with microbial cellulose

Microbial cellulose is a pure form of cellulose with widespread applications. It is very applicable for medical usage specially wound dressings due to its high liquid absorbency and hygienic nature. In this study, microbial cellulose formed/coated on cotton gauze samples during its biosynthesis in a static medium (Hestrin & Scharm) for 6 days by Acetobacter Xylinium. Some essential factors of treated gauze samples, like water absorbency, drying time (water holding time), and amount of vertical wicking were determined and compared with untreated samples. Results showed that cotton gauze coating with microbial cellulose increases water absorbency and wicking ability over 30%, and reduces drying time about 33%. It can be concluded that covering of cotton gauze with microbial cellulose can promote some important characteristics of it specially for wound dressings.     

Engineering quaternized chitosan in the 3D bacterial cellulose structure for antibacterial wound dressings

Balancing antibacterial properties with biocompatibility is of paramount importance for wound dressings loaded with antibacterial agents. In this work, a water soluble antibacterial agent, quaternized chitosan (hydroxypropyltrimethyl ammonium chloride chitosan, HACC) with an appropriate degree of substitution was introduced into the bacterial cellulose (BC) network by adding it into the BC culture medium. Results indicated that the addition of HACC could affect the yield of BC, porous structure, thermal stability, water absorption and antibacterial properties. HBC-1 with a low content of HACC (13.65 ± 0.30%) cannot inhibit the biofilm formation of bacteria, while HBC-3 with a high content of HACC (62.05 ± 0.90%) has a low yield of BC and confused structure. HBC-2 with an optimum concentration of HACC (37.33 ± 0.80%) possessed a typical porous structure, acceptable thermal stability, good water absorption and favorable antibacterial properties against Staphylococcus aureus (S. aureus, ATCC 25923) and methicillin-resistant S. aureus (ATCC 43300). Most importantly, none of the HACC/BC films exhibited cytotoxicity to NIH3T3 cells. We believe that obtained HACC/BC films with favorable bactericidal properties and biocompatibility could be potential candidates for wound dressings in clinical applications.     

Evaluation of Chitosan-Based Films Containing Gelatin,Chondroitin 4-Sulfate and ZnO for Wound Healing

In this work, chitosan-based films containing gelatin and chondroitin-4-sulfate (C4S) with and without ZnO particles were produced and tested in vitro to investigate their potential wound healing properties. Chitosans were produced from shrimp-head processing waste by alkaline deacetylation of chitin to obtain chitosans differing in molecular weight and degree of deacetylation (80 ± 0.5%). The film-forming solutions (chitosan, C4S and gelatin) and ZnO suspension showed no toxicity towards fibroblasts or keratinocytes. Chitosan was able to agglutinate red blood cells, and film-forming solutions induced no hemolysis. Film components were released into solution when incubated in PBS as demonstrated by protein and sugar determination. These data suggest that a stable, chitosan-based film with low toxicity and an ability to release components would be able to establish a biocompatible microenvironment for cell growth. Chitosan-based films significantly increased the percentage of wound healing (wound contraction from 65 to 86%) in skin with full-thickness excision when compared with control (51%), after 6 days. Moreover, histological analysis showed increased granulation tissue in chitosan and chitosan/gelatin/C4S/ZnO films. Chitosan-based biopolymer composites could be used for improved biomedical applications such as wound dressings, giving them enhanced properties.     

Gallic acid‐loaded electrospun cellulose acetate nanofibers as potential wound dressing materials

Gallic acid (GA)–loaded cellulose acetate (CA) nanofiber mats with 10 to 40 wt.% GA contents (based on the weight of CA) were fabricated by electrospinning. The effects of GA contents and applied potential on the morphology and the average diameters of fibers were studied. The electrospun fiber mats containing 20 and 40 wt.% GA were investigated for their potential use as carrier of GA in wound dressing application. The GA‐loaded CA films were prepared by solvent casting technique for use in comparative studies. Determination of the release characteristics of GA from the GA‐loaded fiber mats and films was carried out by the total immersion and the transdermal diffusion through a pig skin method in acetate buffer solution (pH 5.5) or normal saline (pH 7.0) at either 32 or 37°C, respectively. In the total immersion method, the maximum amounts of the GA released from the fiber mats containing 20 and 40 wt.% GA in the acetate buffer were approximately 97% and 71% (based on the weight of initial GA), while those of the GA released into the normal saline were approximately 96% and 81%, respectively. Lower values were observed in the experiments of the transdermal diffusion through a pig skin method. The corresponding GA‐loaded CA films showed the lower amounts of GA released into media. The as‐loaded and the as‐released GA remained its antioxidant activity as investigated by 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) assay. Lastly, the GA‐loaded CA fiber mats exhibited antibacterial activity against Staphylococcus aureus, which showed the potential for use as wound dressing materials.     

In situ wound sprayable double-network hydrogel: Preparation and characterization

In clinical settings the wound-dressing was required easy to use and can match the wound area immediately, at the same time they need to have the properties of hemostats, anti-inflammation and promoting wound healing. To get an ideal wound dressing, we developed a type of gel-like wound adhesive patch from spraying double-network hydrogel, which own the properties of self-antibacterial and can promote wound healing. By spraying, the gel-like wound adhesive patch can match the wound area immediat...     

Biocompatible hydrogels based on chitosan,cellulose/starch,PVA and PEDOT:PSS with high flexibility and high mechanical strength

Fabricating mechanically strong hydrogels that can withstand the conditions in internal tissues is a challenging task. We have designed hydrogels based on multicomponent systems by combining chitosan, starch/cellulose, PVA, and PEDOT:PSS via one-pot synthesis. The starch-based hydrogels were homogeneous, while the cellulose-based hydrogels showed the presence of cellulose micro- and nanofibers. The cellulose-based hydrogels demonstrated a swelling ratio between 121 and 156%, while the starch-based hydrogels showed higher values, from 234 to 280%. Tensile tests indicated that the presence of starch in the hydrogels provided high flexibility (strain at break?>?300%), while combination with cellulose led to the formation of stiffer hydrogels (elastic moduli 3.9–6.6 MPa). The ultimate tensile strength for both types of hydrogels was similar (2.8–3.9 MPa). The adhesion and growth of human osteoblast-like SAOS-2 cells was higher on hydrogels with cellulose than on hydrogels with starch, and was higher on hydrogels with PEDOT:PSS than on hydrogels without this polymer. The metabolic activity of cells cultivated for 3 days in the hydrogel infusions indicated that no acutely toxic compounds were released. This is promising for further possible applications of these hydrogels in tissue engineering or in wound dressings.

Graphical abstract

     

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

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

The gel swelling properties of alginate fibers and their applications in wound management

Calcium alginate fibers have a novel gel‐forming capability in that, upon the ion exchange between sodium ions in the contact solution and calcium ions in the fiber, the fiber slowly transforms into a fibrous gel. This paper reviews the principles of the gel‐forming process for alginate fibers and analyzed the gelling behavior of various types of alginate fibers. The absorption characteristics of alginate wound dressings were analyzed and it was found that alginate wound dressings absorb a large quantity of liquid into the fiber structure, in addition to those held between the fibers in the textile structure. This gives rise to the unique gel blocking properties of alginate wound dressings. In addition, alginate wound dressings also have novel hemostatic and antimicrobial properties as well as the ability to promote wound healing. They are now widely used in the management of highly exuding wounds such as leg ulcers, pressure sores, and surgical wounds. Copyright © 2007 John Wiley & Sons, Ltd.     

Natural okra-based hydrogel for chronic diabetic wound healing

As a representative of chronic wounds, the long-term high levels of oxidative stress and blood sugar in chronic diabetic wounds lead to serious complications, making them the biggest challenge in the research on wound healing. Many edible natural biomaterials rich in terpenes, phenols, and flavonoids can act as efficient antioxidants. In this study, okra extract was selected as the main component of a wound dressing. The okra extracts obtained via different methods comprehensively maintained the bioactivity of multiple molecules. The robust antioxidant properties of okra significantly reduced intracellular reactive oxygen species production, thereby accelerating the wound healing process. The results showed that okra extracts and their hydrogel dressings increased cell migration, angiogenesis, and re-epithelization of the chronic wound area, considerably promoting wound remodeling in diabetic rats. Therefore, okra-based hydrogels are promising candidates for skin regeneration and wider tissue engineering applications.     

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.     

Cellulose–halloysite nanotube composite hydrogels for curcumin delivery

Halloysite nanotubes (HNTs) were added to cellulose NaOH/urea solution to prepare composite hydrogels using epichlorhydrine crosslinking at an elevated temperature. The shear viscosity, mechanical properties, microstructure, swelling properties, cytocompatibility, and drug delivery behavior of the cellulose/HNT composite hydrogels were investigated. The viscosity of the composite solution increases with the addition of HNT. The compressive mechanical properties of composite hydrogels are significantly improved compared with pure cellulose hydrogel. The compressive strength of the composite hydrogels with 66.7% HNTs is 128 kPa, while that of pure cellulose hydrogel is only 29.8 kPa in compressive strength. Rheological measurement suggests the resistance to deformation is improved for composite hydrogels. X-ray diffraction and Fourier transform infrared spectroscopy show that the crystal structure and chemical structure of HNT are not changed in the composite hydrogels. Hydrogen bonding interactions between HNT and cellulose exist in the composites. A porous structure of the composite hydrogels with pore size of 200–400 μm was found by scanning electron microscopy. The addition of HNT leads to decreased swelling ratios in NaCl solution and pure water for the composite hydrogels. Cytotoxicity assays show that the cellulose/HNT composite hydrogels have a good biocompatibility with MC3T3-E1 cells and MCF-7 cells. Curcumin is further loaded into the composite hydrogel via physical adsorption. The curcumin-loaded composite hydrogels show a strong inhibition effect on the cancer cells. All the results illustrate that the cellulose/HNT composite hydrogels have promising applications such as anticancer drug delivery systems and anti-inflammatory wound dressings.     

Formation of cellulose acetate membranes using a supercritical fluid assisted process

Microporous cellulose acetate membranes have been prepared from polymer–acetone solutions using a supercritical fluid phase inversion process in which CO₂ acts as the non-solvent. Series of experiments were performed at various polymer concentrations, temperatures and pressures. The structure of the resulting membranes was analysed using scanning electron microscopy. We operated with polymer concentrations ranging between 5 and 40% (w/w) in acetone obtaining different pore dimensions and membrane structures. Increasing the percentage of polymer in the solution, the structure of the membranes changed from beads-like structure to cellular structure. Polymer concentration also influenced the mean diameter of the pores that ranged from 2 to 50 μm for polymer concentrations from 40 to 5% (w/w). We also tested membrane formation pressures between 100 and 200 bar and at temperature between 45 and 65 °C. Pressure influences the change in membrane structure from cellular to beads-like, whereas temperature has a minor influence on pore size: both the effects can be partially related to CO₂ density. Cellulose acetate membrane formation mechanisms have also been discussed.     

Biodegradable Sodium Alginate/Carrageenan/Cellulose Composite Hydrogel Wound Dressings Containing Herbal Extracts for Promoting Blood Coagulation and Wound Healing

Accelerating the coagulation process and preventing wound infection are major challenges in the wound care process. Therefore, new multifunctional wound dressings with procoagulant, antibacterial, and antioxidant properties have enormous potential for clinical application. In this work, biodegradable hydrogels containing herbal extracts are prepared for wound dressings. First, the active ingredients are extracted from Amaranthus spinosus (A. spinosus) and Rubia cordifolia (R. cordifolia) and added to the hydrogels prepared from microcrystalline cellulose (MCC), carrageenan, and sodium alginate. Then the composite hydrogels are air-dried to obtain the wound dressings. The wound dressings prepared in this work have good biocompatibility and moisture retention. The mechanical properties of the wound dressings are further improved with the addition of MCC. Besides, the wound dressings have excellent procoagulant, antibacterial, and antioxidant properties due to the presence of R. cordifolia extract. Overall, the most effective group of wound dressings with different ingredient formulations reduces clotting time by 75% and largely inhibits bacterial growth. The wound dressings perform well in the animal wound models to promote wound healing. These results indicate that the hydrogel wound dressings prepared in this work have great potential for medical applications.     

Microfluidic fabrication of calcium alginate helical microfibers for highly stretchable wound dressing

Due to suitable biocompatibility and biodegradability, natural polymers have a wide range of applications in the biomedical field, but the defects of mechanical properties limit their performance in some practical scenarios. Here, the microfluidic method was used to spin alginate into helical fibers, and then the gaps of packed microfibers were filled with polyacrylamide (PAM) to obtain a calcium alginate/PAM composite polymer membrane. Compared with pure calcium alginate, this composite film greatly improved the flexibility and stretchability, and could be stretched up to 14 times of its original length, and not deform significantly under 300% strain for 8 cycles. It also had good transparency and skin adhesion, further guaranteeing the application potential in the field of wound dressings. The loading and release experiments showed that the calcium alginate fibers maintained a dense morphology, and could achieve higher loading efficiency and more controllable release than pure PAM. Above all, this film has great application potential in joint wound dressings, especially when loading with antibacterial substances or healing-promoting drugs is needed. In addition, our research of achieving substantial optimization of elasticity and stretchability through the introduction of helical shape also has certain reference significance for other natural polymers limited by mechanical properties.