Ca-Zn-Ag Alginate Aerogels for Wound Healing Applications: Swelling Behavior in Simulated Human Body Fluids and Effect on Macrophages

Chronic non-healing wounds represent a substantial economic burden to healthcare systems and cause a considerable reduction in quality of life for those affected. Approximately 0.5–2% of the population in developed countries are projected to experience a chronic wound in their lifetime, necessitating further developments in the area of wound care materials. The use of aerogels for wound healing applications has increased due to their high exudate absorbency and ability to incorporate therapeutic substances, amongst them trace metals, to promote wound-healing. This study evaluates the swelling behavior of Ca-Zn-Ag-loaded alginate aerogels and their metal release upon incubation in human sweat or wound fluid substitutes. All aerogels show excellent liquid uptake from any of the formulas and high liquid holding capacities. Calcium is only marginally released into the swelling solvents, thus remaining as alginate bridging component aiding the absorption and fast transfer of liquids into the aerogel network. The zinc transfer quota is similar to those observed for common wound dressings in human and animal injury models. With respect to the immune regulatory function of zinc, cell culture studies show a high availability and anti-inflammatory activity of aerogel released Zn-species in RAW 264.7 macrophages. For silver, the balance between antibacterial effectiveness versus cytotoxicity remains a significant challenge for which the alginate aerogels need to be improved in the future. An increased knowledge of the transformations that alginate aerogels undergo in the course of the fabrication as well as during wound fluid exposure is necessary when aiming to create advanced, tissue-compatible aerogel products.

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Wound dressings: curbing inflammation in chronic wound healing

Emerging Topics in Life Sciences ◽

10.1042/etls20200346 ◽

2021 ◽

Author(s):

Davide Vincenzo Verdolino ◽

Helen A. Thomason ◽

Andrea Fotticchia ◽

Sarah Cartmell

Keyword(s):

Wound Healing ◽

Chronic Wounds ◽

Chronic Wound ◽

Wound Care ◽

Healing Process ◽

Standard Of Care ◽

The Elderly ◽

Wound Dressings ◽

Wound Healing Process

Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.

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Identifying New Pathways and Targets for Wound Healing and Therapeutics from Natural Sources

Current Drug Delivery ◽

10.2174/1567201818666210111101257 ◽

2021 ◽

Vol 18 ◽

Author(s):

Xinchi Feng ◽

Jinsong Hao

Keyword(s):

Wound Healing ◽

Molecular Mechanisms ◽

Chronic Wounds ◽

Wound Care ◽

Healing Process ◽

Unmet Need ◽

Wound Dressings ◽

Wound Healing Process ◽

Natural Sources ◽

Viable Approach

: Chronic wounds remain a significant public problem and the development of wound treatments has been a research focus for the past few decades. Despite advances in the products derived from endogenous substances involved in a wound healing process (e.g. growth factors, stem cells, and extracellular matrix), effective and safe wound therapeutics are still limited. There is an unmet need to develop new therapeutics. Various new pathways and targets have been identified and could become a molecular target in designing novel wound agents. Importantly, many existing drugs that target these newly identified pathways could be repositioned for wound therapy, which will facilitate fast translation of research findings to clinical applications. This review discusses the newly identified pathways/targets and their potential uses in the development of wound therapeutics. Some herbs and amphibian skins have been traditionally used for wound repairs and their active ingredients have been found to act in these new pathways. Hence, screening these natural products for novel wound therapeutics remains a viable approach. The outcomes of wound care using natural wound therapeutics could be improved if we can better understand their cellular and molecular mechanisms and fabricate them in appropriate formulations, such as using novel wound dressings and nano-engineered materials. Therefore, we also provide an update on the advances in the wound therapeutics from natural sources. Overall, this review offers new insights into novel wound therapeutics.

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Assessment of Frailty In Elderly Patients Attending A Multidisciplinary Wound Care Center: A Cohort Study.

10.21203/rs.3.rs-764391/v1 ◽

2021 ◽

Author(s):

Mariona Espaulella-Ferrer ◽

Joan Espaulella-Panicot ◽

Rosa Noell-Boix ◽

Marta Casals-Zorita ◽

Marta Ferrer-Sola ◽

...

Keyword(s):

Wound Healing ◽

Elderly Patients ◽

Healing Rate ◽

Wound Care ◽

Frailty Index ◽

Healing Time ◽

Venous Ulcers ◽

Healing Wounds ◽

Wound Healing Time ◽

The Relationship

Abstract Background: The incidence of frailty and chronic wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods: The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centers (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at six months or upon wound healing. Wounds were followed up every two weeks. To analyze the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyze the evolution of the frailty index during follow-up.Results: A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at six months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p=0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p=0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p=0.637). Wound healing rate is statically significantly higher in non-frail patients (3,26% wound reduction/day, P25-P75 0.8-8.8%/day) in comparison with frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day; p=0.044). Conclusion: Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

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Scaffolds for Wound Healing Applications

Polymers ◽

10.3390/polym12092010 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2010 ◽

Cited By ~ 2

Author(s):

Irina Negut ◽

Gabriela Dorcioman ◽

Valentina Grumezescu

Keyword(s):

Wound Healing ◽

Wound Care ◽

Water Vapor Permeability ◽

Cellular Migration ◽

Wound Dressings ◽

Vapor Permeability ◽

Therapeutic Effects ◽

Microbial Invasion ◽

Polymeric Biomaterials ◽

Hybrid Biomaterials

In order to overcome the shortcomings related to unspecific and partially efficient conventional wound dressings, impressive efforts are oriented in the development and evaluation of new and effective platforms for wound healing applications. In situ formed wound dressings provide several advantages, including proper adaptability for wound bed microstructure and architecture, facile application, patient compliance and enhanced therapeutic effects. Natural or synthetic, composite or hybrid biomaterials represent suitable candidates for accelerated wound healing, by providing proper air and water vapor permeability, structure for macro- and microcirculation, support for cellular migration and proliferation, protection against microbial invasion and external contamination. Besides being the most promising choice for wound care applications, polymeric biomaterials (either from natural or synthetic sources) may exhibit intrinsic wound healing properties. Several nanotechnology-derived biomaterials proved great potential for wound healing applications, including micro- and nanoparticulate systems, fibrous scaffolds, and hydrogels. The present paper comprises the most recent data on modern and performant strategies for effective wound healing.

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An update review of stem cell applications in burns and wound care

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.101285 ◽

2012 ◽

Vol 45 (02) ◽

pp. 229-236 ◽

Cited By ~ 21

Author(s):

Lin Huang ◽

Andrew Burd

Keyword(s):

Stem Cells ◽

Wound Healing ◽

Stem Cell ◽

Cell Therapy ◽

Stem Cell Therapy ◽

Medical Technology ◽

Wound Care ◽

Therapeutic Strategies ◽

Wound Management

ABSTRACTThe ultimate goal of the treatment of cutaneous burns and wounds is to restore the damaged skin both structurally and functionally to its original state. Recent research advances have shown the great potential of stem cells in improving the rate and quality of wound healing and regenerating the skin and its appendages. Stem cell-based therapeutic strategies offer new prospects in the medical technology for burns and wounds care. This review seeks to give an updated overview of the applications of stem cell therapy in burns and wound management since our previous review of the "stem cell strategies in burns care".

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Electrospun PCL/PLA Scaffolds Are More Suitable Carriers of Placental Mesenchymal Stromal Cells Than Collagen/Elastin Scaffolds and Prevent Wound Contraction in a Mouse Model of Wound Healing

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2020.604123 ◽

2020 ◽

Vol 8 ◽

Author(s):

Eva Vonbrunn ◽

Marc Mueller ◽

Melanie Pichlsberger ◽

Monika Sundl ◽

Alexander Helmer ◽

...

Keyword(s):

Wound Healing ◽

Mouse Model ◽

Stromal Cells ◽

Wound Care ◽

Skin Wound ◽

Beneficial Effects ◽

New Therapeutic Approaches

Mesenchymal stem/stromal cells (MSCs) exert beneficial effects during wound healing, and cell-seeded scaffolds are a promising method of application. Here, we compared the suitability of a clinically used collagen/elastin scaffold (Matriderm) with an electrospun Poly(ε-caprolactone)/poly(l-lactide) (PCL/PLA) scaffold as carriers for human amnion-derived MSCs (hAMSCs). We created an epidermal-like PCL/PLA scaffold and evaluated its microstructural, mechanical, and functional properties. Sequential spinning of different PCL/PLA concentrations resulted in a wide-meshed layer designed for cell-seeding and a dense-meshed layer for apical protection. The Matriderm and PCL/PLA scaffolds then were seeded with hAMSCs, with or without Matrigel coating. The quantity and quality of the adherent cells were evaluated in vitro. The results showed that hAMSCs adhered to and infiltrated both scaffold types but on day 3, more cells were observed on PCL/PLA than on Matriderm. Apoptosis and proliferation rates were similar for all carriers except the coated Matriderm, where apoptotic cells were significantly enhanced. On day 8, the number of cells decreased on all carrier types except the coated Matriderm, which had consistently low cell numbers. Uncoated Matriderm had the highest percentage of proliferative cells and lowest apoptosis rate of all carrier types. Each carrier also was topically applied to skin wound sites in a mouse model and analyzed in vivo over 14 days via optical imaging and histological methods, which showed detectable hAMSCs on all carrier types on day 8. On day 14, all wounds exhibited newly formed epidermis, and all carriers were well-integrated into the underlying dermis and showing signs of degradation. However, only wounds treated with uncoated PCL/PLA maintained a round appearance with minimal contraction. Overall, the results support a 3-day in vitro culture of scaffolds with hAMSCs before wound application. The PCL/PLA scaffold showed higher cell adherence than Matriderm, and the effect of the Matrigel coating was negligible, as all carrier types maintained sufficient numbers of transplanted cells in the wound area. The anti-contractive effects of the PCL/PLA scaffold offer potential new therapeutic approaches to wound care.

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Potential of Cyanobacteria in Wound Healing

10.5772/intechopen.98521 ◽

2021 ◽

Author(s):

Laxmi Parwani ◽

Mansi Shrivastava ◽

Jaspreet Singh

Keyword(s):

Wound Healing ◽

Bioactive Compounds ◽

Wound Care ◽

Cost Effective ◽

Wound Dressings ◽

Potential Applications ◽

Healing Agent ◽

The Rich ◽

Immense Potential ◽

Insight Into

The wound care market is rapidly expanding due to the development of innumerable dressings that exhibit specific healing requirements for different wound types. The use of biomaterials as suitable wound dressing material is highly advantageous due to their biocompatibility, biodegradability, and non-toxicity. Cyanobacteria have been widely explored for their potential applications in wound healing, as they are the rich source of bioactive compounds with antibacterial, antitumor, antiviral, antioxidant, and antifungal activities. In recent years this group of organisms has been widely studied due to their immense potential in biomedical applications. Although their different bioactivities can support wound healing in different ways, very few forms have proven utility as a wound-healing agent. This chapter gives an insight into the potential of cyanobacteria in wound healing. Different bioactive compounds present in variable forms of cyanobacteria and their associated activities were reported to support tissue regeneration and wound healing acceleration. As the demand for cost-effective, bioactive wound care products is ever increasing, these organisms have immense potential to be utilized for the development of bioactive wound dressings. Hence, various bioactive compounds of cyanobacteria, their associated activities, and roles in wound healing have been briefly reviewed in this chapter.

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

Journal of Applied Biomaterials & Functional Materials ◽

10.1177/22808000211054930 ◽

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.

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Comparison of Topical Skin Adhesive and Simple Interrupted Nylon Sutures for Wound Closure in Forefoot Surgery: A Prospective Randomised Trial

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00396 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0039

Author(s):

Robbie Ray ◽

Thomas A. Goff ◽

Paul M. Dearden ◽

Peter W. Robinson ◽

Peter Lam ◽

...

Keyword(s):

Wound Healing ◽

Wound Closure ◽

Wound Care ◽

Randomised Trial ◽

Data Set ◽

Prospective Randomised Trial ◽

Forefoot Surgery ◽

High Satisfaction ◽

Patient Reported

Category: Bunion Introduction/Purpose: There are many options for wound closure in forefoot surgery. The purpose of this study was to compare topical skin adhesive (2-Octyl-cyanoacrylate) to standard simple interrupted nylon sutures with attention to the quality of wound healing and the acceptability to the patient. Methods: Patients undergoing elective 1st ray forefoot surgery utilising a medial incision, either Hallux Valgus correction or 1st Metotarsophalangeal joint arthrodesis, were recruited to this study. Patients were randomly allocated during surgery to final layer wound closure with either the intervention topical skin adhesive (TSA) or the control interrupted nylon sutures (INS). Practicality was assessed by time taken for wound closure and subsequent time to perform wound care at 2 weeks postoperatively, wound care pain (VAS) and quality of wound healing was assessed at this point with a dedicated scoring tool, patient satisfaction and acceptability was assessed at 6 weeks postoperative. Results: 70 patients (18 bilateral) were recruited, resulting 42 feet in each study group (after 4 exclusions for incomplete data set). Mean age 61 (29-83). There were no statistical differences in the demographics or surgery performed between groups. Wound closure time was significantly slower for TSA (272 secs (SD 72.2) vs 229 secs (SD 58.8), p=0.0038). At 2 weeks postoperative wound care time was significantly faster for TSA (71 secs (SD 50.8) vs 120 Secs (SD 47.8), p<0.0001), and patient reported pain was significantly less with TSA (VAS 0 vs 2, p=0.025). Significantly more inflammation and wound edge separation was recorded with TSA (17 vs 5 cases, p=0.006) and (12 vs 3 cases, p=0.02) respectively. High satisfaction was reported in both groups with no signifcant difference. Conclusion: Topical skin adhesive and interrupted nylon sutures are both acceptable closure methods for forefoot surgery with high satisfaction rates, low pain scores and low complications. However, the observation of significantly more inflammation and areas of wound separation at the early post-operative period with topical skin adhesive is sufficient to recommend routine use of sutures.

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Wound healing: what is the NICE guidance from the UK?

Journal of Wound Care ◽

10.12968/jowc.2021.30.3.172 ◽

2021 ◽

Vol 30 (3) ◽

pp. 172-182

Author(s):

Katharine Powell ◽

Ojas Jyoti Singh Pujji ◽

Steven Jeffery

Keyword(s):

Wound Healing ◽

Wound Care ◽

Financial Burden ◽

Productivity Loss ◽

Standards Of Care ◽

Index Measurement ◽

Nice Guidance ◽

Health Related ◽

The Uk

Alteration of wound healing increases the risk of a patient's morbidity and mortality. This can lead to scarring, infection, malignant transformation and a reduction in quality of life. Management of wounds costs the UK an estimated £5.3 billion annually which is paid for by the state, with further financial burden due to health related productivity loss. Wound care is managed by a broad spectrum of different health professionals leading to different standards of care. For example, only 16% of lower leg wounds have either an ankle-brachial pressure index measurement or Doppler scan. Due to this variation in wound care, we have summarised all available NICE guidelines and guidance up to February 2021 on the topic of wound healing listed in the National Institute for Health and Care Excellence (NICE) archives. The goal is to provide an easy to access summary of wound care interventions. Our search provided us with 18 technology appraisals related to wound healing which have been summarised.

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