Papain incorporated chitin dressings for wound debridement sterilized by gamma radiation

Wound debridement is essential for the removal of necrotic or nonviable tissue from the wound surface to create an environment conducive to healing. Nonsurgical enzymatic debridement is an attractive method due to its effectiveness and ease of use. Papain is a proteolytic enzyme derived from the fruit of Carica papaya and is capable of breaking down a variety of necrotic tissue substrates. The present study was focused on the use of gamma radiation for sterilization of papain dressing with wound debriding activity. Membranes with papain were prepared using 0.5% chitin in lithium chloride/dimethylacetamide solvent and sterilized by gamma radiation. Fluid absorption capacity of chitin–papain membranes without glycerol was 14.30±6.57% in 6 h. Incorporation of glycerol resulted in significant (p<0.001) increase in the absorption capacity. Moisture vapour transmission rate of the membranes was 4285.77±455.61 g/m²/24 h at 24 h. Gamma irradiation at 25 kGy was found suitable for sterilization of the dressings. Infrared (IR) spectral scanning has shown that papain was stable on gamma irradiation at 25–35 kGy. The irradiated chitin–papain membranes were impermeable to different bacterial strains and also exhibited strong bactericidal action against both Gram-positive and Gram-negative bacteria. The fluid handling characteristics and the antimicrobial properties of chitin–papain membranes sterilized by gamma radiation were found suitable for use as wound dressing with debriding activity.     

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.     

Recent advances on herb‐derived constituents‐incorporated wound‐dressing materials: A review

Since ancient times, wound dressings have evolved with persistent and substantial changes. Several efforts have been made toward the development of new dressing materials, which can meet the demanding conditions for the treatment of skin wounds. Currently, many studies have been focused on the production and designing of herb‐incorporated wound dressings. Herb‐derived constituents are more effective than conventional medicines because of their nontoxic nature and can be administered over long periods. Herbal medicines in wound healing provide a suitable environment for aiding the natural course of healing. This review mainly focuses on the diverse approaches that have been developed to produce a wound dressing material, which can deliver herb‐derived bioactive constituents in a controlled manner. This review also discusses the common wound‐dressing materials available, basic principles of wound healing, and wound‐healing agents from medicinal plants.     

同轴静电纺丝法制备具有核-壳纤维结构的多功能敷料

利用同轴静电纺丝制备了具有核壳结构纳米纤维的未交联敷料,其中纤维内核为载有抗菌药物莫匹罗星的聚己内酯(PCL),外壳则由载有麻醉剂利多卡因的胶原构成;通过京尼平将胶原外壳交联后得到交联敷料.用扫描电子显微镜(SEM)和透射电子显微镜(TEM)观察了未交联敷料的表面形貌和纤维的核壳结构.体外药物释放实验结果表明,在2种敷料中,2种药物在1 h内均出现了突释现象,而在随后的60 h中,2种药物均能从敷料中缓慢释放出来,说明2种敷料均具有较好的持续止痛与抗菌性能.二辛可宁酸(Bicinchonininc acid,BCA)蛋白测试结果表明,未交联敷料外壳上的胶原蛋白能够持续地释放出来.体外细胞培养结果表明,与交联敷料相比,未交联敷料能够更好地促进成纤维细胞L929的黏附和生长,具有更好的促进伤口愈合作用.体外抗菌实验结果显示,负载了莫匹罗星的2种敷料的抗菌性能均明显高于对照组,具有良好的抗菌性能.     

Hydrogel Complex Containing the Antimicrobial Peptide HX-12C Accelerates Healing of Infected Wounds

Bacterial infections of the wound surface can be painful for patients, and traditional dressings do not effectively address this problem. In this study, an antimicrobial wound dressing is prepared using a novel antimicrobial peptide, HX-12C. This hydrogel system is based on the natural biomaterials sodium alginate and gelatin, utilizing calcium carbonate as a source of Ca²⁺, and ionic cross-linking is facilitated by lowering the solution pH. The resulting sodium alginate/gelatin HX-12C-loaded hydrogel (CaAGEAM) has good mechanical and adhesion properties, biocompatibility and in vitro degradability. Its extraordinary antibacterial efficacy (>98%) is verified by an antibacterial experiment. More importantly, in vivo experiments further demonstrate its healing-promotion effect, with a 95% wound healing rate by day 9. Tissue staining demonstrates that the hydrogel containing antimicrobial peptides is effective in suppressing inflammation. The dressing promotes wound healing by stimulating the deposition of skin appendages and collagen. The results of this study suggest that composite hydrogels containing antimicrobial peptides are a promising new type of dressing to promote the healing of infected wounds.     

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

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

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

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

Bioactive peptides grafted silicone dressings: A simple and specific method

The need for bioactive dressings increases with the population aging and the prevalence of chronic diseases. In contrast, there are very few dressings on the market which are designed to display a chosen bioactivity. In this context, we investigated the surface-functionalization of silicone wound dressing with bioactive peptides. One of the challenges was to avoid multistep grafting reactions involving catalysts, solvents or toxic reagents, which are not suitable for the fabrication of medical devices at an industrial scale. In the other hand, a covalent bonding was necessary to avoid the loss of the biological effect by progressive removal of the peptide in biological fluids generated by the wound. To solve these limitations, we developed a strategy allowing an easy and direct functionalization of silicone. This strategy relies on hybrid silylated bioactive peptides, which chemoselectively react with plasma-activated silicone surfaces. We synthesized three hybrid peptides with wound healing properties, which were grafted on commercially available silicone dressings Cerederm^® and Mepitel^®. Grafted dressings were evaluated in vitro and enabled a quicker scare recovery and extracellular matrix deposition with human dermal fibroblasts. These results were confirmed by in vivo studies showing an enhanced wound-healing of the pig skin. By this simple method, we transformed inert dressing into bioactive dressing which showed properties of wound healing.     

Electrospun cellulose acetate wound dressings loaded with Pramipexole for diabetic wound healing: an in vitro and in vivo study

In the current study, a Pramipexole-loaded wound dressing was produced via electrospinning of cellulose acetate solution. Pramipexole was added to cellulose acetate solution at 3, 5, and 10% w/w concentrations and then electrospun. The produced wound dressings were studied regarding their physicochemical and biological properties. Results of cell viability assay and cytoprotection studies showed that cellulose acetate wound dressings containing 3% w/w Pramipexole had significantly higher cell viability compared with other concentrations. The wound healing potential of dressings incorporated with 3% drug was studied in a rat model of diabetic wound. Study showed that the cellulose acetate/3% Pramipexole scaffolds had significantly higher percentage of wound closure, epithelial thickness, and collagen deposition compared with drug-free dressings and control group. Gene expression study showed that the drug-loaded wound dressings could reduce oxidative stress and alleviate inflammation at significantly higher extent compared with other groups.

     

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

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

Study of new cellulosic dressing with enhanced antibacterial performance grafted with a biopolymer of chitosan and myrrh polysaccharide extract

The treatment of chronic wounds represents a major interest for public health both medically and economically. Hence the need for a modern wound dressing that actively promotes the physiological process specific to healing. In this perspective we have studied the development of a new dressing able to offer a serious contribution to the dilemma of the various chronic wounds. A dressing grafted with two natural polysaccharides known for their multiple biological effects, chitosan and a carbohydrate polymer extracted from Commiphora myrrha (CMP). We began by studying the grafting of the two natural biopolymers onto cellulose dressings, via a polyacrylic acid as a crosslinking agent. An optimization study, revealed the different grafting parameters, the polymer concentration as well as the heat-setting time and temperature. After, different characterization techniques were carried out in order to evaluate the effectiveness of our grafting. The swelling test revealed a hydrophilicity enhancement which increased with the degree of grafting, a desired property for effective dressings. Infrared characterization as well as thermogravimetric analysis (TGA and DTA) confirmed the binding mode and the permanence of our grafting. XRD and mechanical characterization showed no change in the crystallinity or in the original mechanical properties of the functionalized dressings. Morphological SEM study, confirmed the presence of our grafting as well as its mode of distribution. Finally, a bacteriological study conducted, showed a clear improvement of the antimicrobial behavior of cellulosic wound dressings functionalized by our combined natural biopolymers.     

A Self-Pumping Dressing with Multiple Liquid Transport Channels for Wound Microclimate Management

A microclimate with ventilation and proper wettability near the wound is vital for wound healing. In the case of pressure or absorption of large amounts of wound exudate, maintaining air circulation around the wound is currently a challenge for wound dressings. In this study, a novel self-pumping dressing (FAED) with multiple liquid transport channels is designed by combining a 3D spacer fabric, sodium alginate aerogel, and electrospun membrane. This unique structural design allows FAED to unidirectionally rapidly remove excess biofluid from the wound and transfer it through a special liquid transport channel to a liquid storage layer with a high absorption ratio. Importantly, the air circulation layer of FAED composed of liquid transport channels and spacer yarns provides excellent air permeability in both the horizontal (12.3 L min⁻¹) and vertical (272.02 mm s⁻¹) directions. Additionally, a lower compression modulus (0.14 MPa) and higher compression strength (0.15 MPa) enable the novel dressing to adapt to body contours and provide good supporting performance, as compared to foam dressings. Combined with its high biocompatibility, this unique dressing has significant potential for wound treatment and intensive care.     

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

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

Irradiation of Crosslinked, Poly(Vinyl Alcohol) Blended Hydrogel for Wound Dressing

In order to obtain a more ideal hydrogel wound dressing, crosslinked hydrogel films blended with polyvinyl alcohol (PVA), polyvinyl pyrrolidone, kappa-carrageenan (KC), and powder silk were prepared by electron beam, and their physiochemical properties were investigated as a combination of function factors. The experimental results showed that the gel fraction of the hydrogel films depended mainly on irradiation dose and the monomer concentration of the polymers, the properties of hydrogel could be greatly extended or improved by blending homopolymers. The rate of gel formation of the hydrogel was raised, and the water evaporation from hydrogel could be retarded after mixing with KC, while the tensile strength of hydrogel films were obviously increased after mixing with silk. Toxicity and healing effect of PVA/PVP/KC/silk blended hydrogel films as wound dressings were evaluated. The irradiated blended hydrogel showed satisfactory properties for wound dressing, the hydrogel did not induceany acute general toxic effects, and it is effective for fast healing of wound.     

Synthesis and characterization of a microsphere‐based coating for textiles with potential as an in situ bioactive delivery system

Proteinaceous microspheres have a wide range of biomedical applications, including their use as drug delivery systems. On the other hand, bioactive and antimicrobial textiles are promising substrates for medical care, in particular, as wound‐dressings. This work relates the development of a new process for the functionalization of textiles through the simultaneous formation and linkage of protein‐based microspheres onto textile fibers by sonochemical techniques. The microspheres developed by this process possess antimicrobial properties by themselves, but other may be incorporated by the encapsulation of various pharmaceutical formulations. This new type of microspheres and particularly their fixation onto textile materials encourage the development of textiles that can be used as delivery systems in a simple, fast, and non‐toxic process. Here it is reported the production of microspheres with a combination of bovine serum albumin (BSA), L ‐Cysteine (L ‐Cys), and n‐dodecane, using the ultrasound technology. The size distribution and morphology of the microspheres was determined as a function of several parameters such as irradiation time and BSA and L ‐Cys concentrations. The produced microspheres were analyzed using a laser light scattering size analyzer, an optical microscope and a scanning electron microscope. The new coating of BSA + L ‐Cys microspheres revealed a high stability and excellent antibacterial properties being a promising alternative to design textile‐based bioactive delivery systems with potential application in the development of textile‐based wound‐dressings. Copyright © 2011 John Wiley & Sons, Ltd.     

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.     

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

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

Development of Gelatin‐Alginate Hydrogels for Burn Wound Treatment

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

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.     

Gamma irradiation of electrospun poly(ε‐caprolactone) fibers affects material properties but not cell response

Fabrication of electrospun fibrous scaffolds as future medical devices is being widely researched, with particular emphasis given to their material properties and effect on cell response and differentiation. However, the vast majority of these scaffolds are sterilized via nonmedically approved methods, including submersion in ethanol and exposure to UV light. Although these techniques are adequate for laboratory‐based research, they are not sufficient for human implantation. In this case, regulatory approved, medical grade sterilization is required. In this study, we report the effects of gamma irradiation, a regulatory approved technique, on electrospun poly(ε‐caprolactone) fibers. Fabricated fibers were separately subjected to different dosages of irradiation ranging from 0 to 45 kGy and then assessed for their physicochemical properties. Gamma irradiation affected fiber properties irrespective of dosage. A dose‐dependent decrease in polymer molecular weight was observed and an increase in melting point and crystallinity reported. Similarly, irradiation had a significant effect on mechanical properties with greatest decrease in tensile strength (68%) for fibers exposed to 40 kGy. The method of sterilization had no effect on cell response. Seeded tenocytes attached to all fibers and elongated parallel to the underlying fiber direction. The results demonstrate the importance of incorporating medical grade sterilization procedures early in the research projects time line to assist translation from bench to clinic. © 2012 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys, 2012