The clinical impact of hydroresponsive dressings in dynamic wound healing: Part I

2021 ◽  
Vol 30 (1) ◽  
pp. 15-24
Author(s):  
Francois Sterpione ◽  
Karine Mas ◽  
Mark Rippon ◽  
Alan Rogers ◽  
Georges Mayeux ◽  
...  
Keyword(s):  
Wound Healing ◽  
Comparative Study ◽  
Wound Dressing ◽  
Wound Closure ◽  
Clinical Effectiveness ◽  
Clinical Impact ◽  
Wound Dressings ◽  
Primary Measurement ◽  
Clinical Healing ◽  
Wound Bed Preparation

Objective: Management of any wound, either acute or hard-to-heal, might involve the use of multiple and different wound dressings in its treatment. This approach is necessary to overcome the myriad of clinical challenges the wound presents, as well as any underlying comorbidities that might affect the clinical outcomes. This article describes the clinical effectiveness of a coordinated wound dressing treatment regimen. Method: This was an open-labelled non-comparative study involving patients with a variety of hard-to-heal and acute wounds of differing levels of severity, but all of which required removal of devitalised tissue to enable wound healing to progress. The first phase used the hydroresponsive wound dressing HydroClean (PAUL HARTMANN AG, Germany). The PUSH score was used as the primary measurement parameter. Results: A total of 86 patients (38 male/48 female), with a mean age of 67.7±21.7 years, took part in the study. The results showed that the hydroresponsive dressing was effective in managing wound exudate production and promoting wound cleansing and debridement, supporting good wound bed preparation. Wound closure was observed in 16/86 (18.6%) wounds at the end of the study (20 weeks). This enabled clinicians to switch to alternative wound dressings to promote subsequent clinical healing outcomes. Conclusion: In this study, the hydroresponsive wound dressing was highly effective in preparing a clean wound bed such that the next stage of wound healing could be supported.

scholarly journals Fabrication of Hybrid Nanofibers from Biopolymers and Poly (Vinyl Alcohol)/Poly (ε-Caprolactone) for Wound Dressing Applications

Polymers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 2104
Author(s):  
Sibusiso Alven ◽  
Blessing Atim Aderibigbe
Keyword(s):  
Mechanical Properties ◽  
Wound Healing ◽  
Vinyl Alcohol ◽  
Wound Dressing ◽  
Chronic Wounds ◽  
Cellular Adhesion ◽  
Wound Dressings ◽  
Poly Vinyl Alcohol ◽  
High Porosity ◽  
Hybrid Nanofibers

The management of chronic wounds is challenging. The factors that impede wound healing include malnutrition, diseases (such as diabetes, cancer), and bacterial infection. Most of the presently utilized wound dressing materials suffer from severe limitations, including poor antibacterial and mechanical properties. Wound dressings formulated from the combination of biopolymers and synthetic polymers (i.e., poly (vinyl alcohol) or poly (ε-caprolactone) display interesting properties, including good biocompatibility, improved biodegradation, good mechanical properties and antimicrobial effects, promote tissue regeneration, etc. Formulation of these wound dressings via electrospinning technique is cost-effective, useful for uniform and continuous nanofibers with controllable pore structure, high porosity, excellent swelling capacity, good gaseous exchange, excellent cellular adhesion, and show a good capability to provide moisture and warmth environment for the accelerated wound healing process. Based on the above-mentioned outstanding properties of nanofibers and the unique properties of hybrid wound dressings prepared from poly (vinyl alcohol) and poly (ε-caprolactone), this review reports the in vitro and in vivo outcomes of the reported hybrid nanofibers.

Preparation of biocompatible wound dressings with dual release of antibiotic and platelet-rich plasma for enhancing infected wound healing

2021 ◽  
pp. 088532822199601
Author(s):  
Linying Shi ◽  
Fang Lin ◽  
Mou Zhou ◽  
Yanhui Li ◽  
Wendan Li ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Wound Dressings ◽  
Inflammatory Factors ◽  
Gelatin Microspheres ◽  
Infected Wounds ◽  
Dual Release

The ever-growing threats of bacterial infection and chronic wound healing have provoked an urgent need for novel antibacterial wound dressings. In this study, we developed a wound dressing for the treatment of infected wounds, which can reduce the inflammatory period (through the use of gentamycin sulfate (GS)) and enhance the granulation stage (through the addition of platelet-rich plasma (PRP)). Herein, the sustained antimicrobial CMC/GMs@GS/PRP wound dressings were developed by using gelatin microspheres (GMs) loading GS and PRP, covalent bonding to carboxymethyl chitosan (CMC). The prepared dressings exhibited high water uptake capability, appropriate porosity, excellent mechanical properties, sustain release of PRP and GS. Meanwhile, the wound dressing showed good biocompatibility and excellent antibacterial ability against Gram-negative and Gram-positive bacteria. Moreover, in vivo experiments further demonstrated that the prepared dressings could accelerate the healing process of E. coli and S. aureus-infected full-thickness wounds i n vivo, reepithelialization, collagen deposition and angiogenesis. In addition, the treatment of CMC/GMs@GS/PRP wound dressing could reduce bacterial count, inhibit pro-inflammatory factors (TNF-α, IL-1β and IL-6), and enhance anti-inflammatory factors (TGF-β1). The findings of this study suggested that biocompatible wound dressings with dual release of GS and PRP have great potential in the treatment of chronic and infected wounds.

Nanofiber Wound Dressing Materials—A Comparative Study of Wound Healing on a Porcine Model

2021 ◽  
Author(s):  
Katerina Menclová ◽  
Petr Svoboda ◽  
Jan Hadač ◽  
Štefan Juhás ◽  
Jana Juhásová ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Blood Count ◽  
Serum Amyloid A ◽  
Porcine Model ◽  
Serum Amyloid ◽  
Wound Dressings ◽  
Amyloid A ◽  
Inflammatory Phase ◽  
Dressing Materials

ABSTRACT Background Nanofiber wound dressings remain the domain of in vitro studies. The purpose of our study was to verify the benefits of chitosan (CTS) and polylactide (PLA)-based nanofiber wound dressings on a porcine model of a naturally contaminated standardized wound and compare them with the conventional dressings, i.e., gauze and Inadine. Material and Methods The study group included 32 pigs randomized into four homogeneous groups according to the wound dressing type. Standardized wounds were created on their backs, and wound dressings were regularly changed. We evaluated difficulty of handling individual dressing materials and macroscopic appearance of the wounds. Wound swabs were taken for bacteriological examination. Blood samples were obtained to determine blood count values and serum levels of acute phase proteins (serum amyloid A, C-reactive protein, and haptoglobin). The crucial point of the study was histological analysis. Microscopic evaluation was focused on the defect depth and tissue reactions, including formation of the fibrin exudate with neutrophil granulocytes, the layer of granulation and cellular connective tissue, and the reepithelialization. Statistical analysis was performed by using SPSS software. The analysis was based on the Kruskal–Wallis H test and Mann–Whitney U test followed by Bonferroni correction. Significance was set at P < .05. Results Macroscopic examination did not show any difference in wound healing among the groups. However, evaluation of histological findings demonstrated that PLA-based nanofiber dressing accelerated the proliferative (P = .025) and reepithelialization (P < .001) healing phases, while chitosan-based nanofiber dressing potentiated and accelerated the inflammatory phase (P = .006). No statistically significant changes were observed in the blood count or acute inflammatory phase proteins during the trial. Different dynamics were noted in serum amyloid A values in the group treated with PLA-based nanofiber dressing (P = .006). Conclusion Based on the microscopic examination, we have documented a positive effect of nanofiber wound dressings on acceleration of individual phases of the healing process. Nanofiber wound dressings have a potential to become in future part of the common wound care practice.

A low-swelling and toughened adhesive hydrogel with anti-microbial and hemostatic capacities for wound healing

2022 ◽  
Author(s):  
Liwei Zhang ◽  
Yajie Zhang ◽  
Fanshu Ma ◽  
Xingzhu Liu ◽  
Yangzhong Liu ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Wound Dressings ◽  
Tissue Adhesion

Hydrogel-based wound dressings with tissue adhesion are widely used for wound closure. However, currently developed hydrogel adhesives are still difficult to continue sealing the wound under the bleeding condition. Herein,...

Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence

2021 ◽  
Vol 30 (12) ◽  
pp. 980-992
Author(s):  
Karen Ousey ◽  
Heather Hodgson ◽  
Mark G Rippon ◽  
Alan A Rogers
Keyword(s):  
Wound Healing ◽  
Clinical Evidence ◽  
Narrative Review ◽  
Wound Dressings ◽  
Fluid Loss ◽  
Subsequent Infection ◽  
First Line ◽  
Wound Healing Response ◽  
Skin Integrity ◽  
Wound Bed Preparation

A break in skin integrity must be repaired as quickly as possible to avoid excess blood and fluid loss, and to minimise the onset of infection. Hard-to-heal wounds, in which the progression of the wound healing response is compromised, present several challenges to healing (for example, the presence of devitalised tissue acting as a physical barrier to healing and as a focus for bacterial contamination with the potential for subsequent infection). The objective of this article is to present, as a narrative review, the clinical evidence supporting the use of a unique hydro-responsive wound dressing (HydroClean, HRWD1, PAUL HARTMANN AG, Germany). The dressing provides a simple treatment option to address a number of clinical challenges clinicians must overcome in order to facilitate wound healing progression. These studies demonstrated that this product supported successful debridement/cleansing of a wide variety of wounds, including hard-to-heal wounds, enabled wound bed preparation, and lead to positive healing outcomes, including in wounds that previously had failed to heal. The simplicity of using HRWD1 as a single dressing can help clinicians overcome a variety of challenges when treating both acute and hard-to-heal wounds, which, with the benefit of proven patient outcomes, could make it an ideal choice for a first-line treatment.

scholarly journals Development and Evaluation of Alginate Membranes with Curcumin-Loaded Nanoparticles for Potential Wound-Healing Applications

Pharmaceutics ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 389 ◽  
Author(s):  
Mónica C. Guadarrama-Acevedo ◽  
Raisa A. Mendoza-Flores ◽  
María L. Del Prado-Audelo ◽  
Zaida Urbán-Morlán ◽  
David M. Giraldo-Gomez ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Clinical Performance ◽  
Ex Vivo ◽  
High Capacity ◽  
Wound Dressings ◽  
In Vivo Studies ◽  
Potential Use

Non-biodegradable materials with a low swelling capacity and which are opaque and occlusive are the main problems associated with the clinical performance of some commercially available wound dressings. In this work, a novel biodegradable wound dressing was developed by means of alginate membrane and polycaprolactone nanoparticles loaded with curcumin for potential use in wound healing. Curcumin was employed as a model drug due to its important properties in wound healing, including antimicrobial, antifungal, and anti-inflammatory effects. To determine the potential use of wound dressing, in vitro, ex vivo, and in vivo studies were carried out. The novel membrane exhibited the diverse functional characteristics required to perform as a substitute for synthetic skin, such as a high capacity for swelling and adherence to the skin, evidence of pores to regulate the loss of transepidermal water, transparency for monitoring the wound, and drug-controlled release by the incorporation of nanoparticles. The incorporation of the nanocarriers aids the drug in permeating into different skin layers, solving the solubility problems of curcumin. The clinical application of this system would cover extensive areas of mixed first- and second-degree wounds, without the need for removal, thus decreasing the patient’s discomfort and the risk of altering the formation of the new epithelium.

scholarly journals Antibacterial-Integrated Collagen Wound Dressing for Diabetes-Related Foot Ulcers: An Evidence-Based Review of Clinical Studies

Polymers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2168
Author(s):  
Ibrahim N. Amirrah ◽  
Mohd Farhanulhakim Mohd Razip Wee ◽  
Yasuhiko Tabata ◽  
Ruszymah Bt Hj Idrus ◽  
Abid Nordin ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Trials ◽  
Clinical Studies ◽  
Wound Dressing ◽  
Chronic Wounds ◽  
Gentian Violet ◽  
Antibacterial Properties ◽  
Small Sample ◽  
Wound Dressings ◽  
Sample Sizes

Diabetic foot ulcer (DFU) is a chronic wound frequently delayed from severe infection. Wound dressing provides an essential barrier between the ulcer and the external environment. This review aimed to analyse the effectiveness of antibacterial collagen-based dressing for DFU treatment in a clinical setting. An electronic search in four databases, namely, Scopus, PubMed, Ovid MEDLINE(R), and ISI Web of Science, was performed to obtain relevant articles published within the last ten years. The published studies were included if they reported evidence of (1) collagen-based antibacterial dressing or (2) wound healing for diabetic ulcers, and (3) were written in English. Both randomised and non-randomised clinical trials were included. The search for relevant clinical studies (n) identified eight related references discussing the effectiveness of collagen-based antibacterial wound dressings for DFU comprising collagen impregnated with polyhexamethylene biguanide (n = 2), gentamicin (n = 3), combined-cellulose and silver (n = 1), gentian violet/methylene blue mixed (n = 1), and silver (n = 1). The clinical data were limited by small sample sizes and multiple aetiologies of chronic wounds. The evidence was not robust enough for a conclusive statement, although most of the studies reported positive outcomes for the use of collagen dressings loaded with antibacterial properties for DFU wound healing. This study emphasises the importance of having standardised clinical trials, larger sample sizes, and accurate reporting for reliable statistical evidence confirming DFU treatment efficiency.

scholarly journals Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing

2021 ◽  
Vol 19 ◽  
pp. 228080002110549
Author(s):  
Michael Rodrigues ◽  
Thilagavati Govindharajan
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Care ◽  
Cost Effective ◽  
Wound Dressings ◽  
Wound Management ◽  
Histopathological Analysis ◽  
Diabetic Wound ◽  
Functional Material ◽  
Diabetic Wound Healing

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study. The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure. The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes. The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

scholarly journals Collagen-Based Nanofibers for Skin Regeneration and Wound Dressing Applications

Polymers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 4368
Author(s):  
Zintle Mbese ◽  
Sibusiso Alven ◽  
Blessing Atim Aderibigbe
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Cellular Proliferation ◽  
Healing Process ◽  
Skin Regeneration ◽  
Wound Dressings ◽  
Wound Management ◽  
Major Constituent ◽  
Wound Healing Process ◽  
Frequent Change

Skin regeneration after an injury is very vital, but this process can be impeded by several factors. Regenerative medicine is a developing biomedical field with the potential to decrease the need for an organ transplant. Wound management is challenging, particularly for chronic injuries, despite the availability of various types of wound dressing scaffolds in the market. Some of the wound dressings that are in clinical practice have various drawbacks such as poor antibacterial and antioxidant efficacy, poor mechanical properties, inability to absorb excess wound exudates, require frequent change of dressing and fails to offer a suitable moist environment to accelerate the wound healing process. Collagen is a biopolymer and a major constituent of the extracellular matrix (ECM), making it an interesting polymer for the development of wound dressings. Collagen-based nanofibers have demonstrated interesting properties that are advantageous both in the arena of skin regeneration and wound dressings, such as low antigenicity, good biocompatibility, hemostatic properties, capability to promote cellular proliferation and adhesion, and non-toxicity. Hence, this review will discuss the outcomes of collagen-based nanofibers reported from the series of preclinical trials of skin regeneration and wound healing.

scholarly journals Collagen Based Sponges for Wound Healing

2019 ◽  
Vol 9 (2S2) ◽  
pp. 916-920
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Repair ◽  
Wound Dressings ◽  
Wound Management ◽  
Repair System ◽  
Tissue Formation ◽  
Fish Scales ◽  
Healing Efficiency ◽  
The Common

Nowadays, wound healing is the common and simple problems occur in our society. Wound healing is the multi factorial process which includes inflammation, reepithelialisation, collagen deposition, and angiogenesis. Wound repair system is indispensable to enhance the proper functioning of skin. Normally, wound dressing is either momentary or lasting, wound dressings has been intended to improve the wound repair. Those wound dressing are required to wrap the large surfaced open wounds such as widespread burns, pressure ulcers, foot sores etc., wound healing substance should have some important features such as, high healing efficiency, anti-scar formation, providing favourable atmosphere for wound management. The collagen plays an important role in tissue formation and has more effect on wound healing. In this work collagen sponge is prepared from fish scales and to increase the antibacterial efficacy need extract has been added.

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