Abstract
Recent data have reported that the burden of infections related to antibiotic-resistant bacteria in the European Union and European Economic Area (EEA) can be estimated as the cumulative burden of tuberculosis, influenza, and human immunodeficiency virus (HIV). In wound management, the control of infections represents a crucial issue and a multi-billion dollar industry worldwide. For diabetic wounds ulcers, in particular, infections are related to the majority of amputations in diabetic patients, which today represent an increasing number of the elderly. The greatest barrier to healing is represented by the biofilm, an organized consortium of bacteria encapsulated in a self-produced extracellular polymeric substance with high resistance to conventional antimicrobial therapies. There is an urgent need for novel anti-biofilm strategies and novel antimicrobial agents and, in this scenario, silver nanotechnology has received tremendous attention in recent years in therapeutically enhanced healthcare. Due to its intrinsic therapeutic properties and the broad-spectrum antimicrobial efficacy, silver nanoparticles have opened new horizons towards novel approaches in the control of infections in wound healing. This review aims at providing the reader with an overview of the most recent progress in silver nanotechnology, with a special focus on the role of silver in the wound healing process.
Highlights
The Wound Healing ProcessThe skin, the largest organ of the body, has a crucial role in sensory functions, homeostasis, control of temperature, and protection against pathogens, toxins, and trauma [1]
Recent data have reported that the burden of infections related to antibiotic-resistant bacteria in the European Union and European Economic Area (EEA) can be estimated as the cumulative burden of tuberculosis, influenza, and human immunodeficiency virus (HIV)
In the United States, 20 million people are affected by diabetes, and this number is expected to double by the year 2030; 15% of these patients are affected by diabetic foot ulcers, which are related to most cases of amputations [9]
Summary
The skin, the largest organ of the body, has a crucial role in sensory functions, homeostasis, control of temperature, and protection against pathogens, toxins, and trauma [1]. In the United States, 20 million people are affected by diabetes, and this number is expected to double by the year 2030; 15% of these patients are affected by diabetic foot ulcers, which are related to most cases of amputations [9] Underlying conditions, such as diabetes and neuropathy, can have an effect on the nature of the wound fluid, varying considerably during the healing process as a consequence of changes in the microenvironment and tissue remodeling progresses. An ideal dressing should mimic the extracellular matrix and should be characterized by biological stability, flexibility, and capability to remove the wound exudate while providing a moist environment at the wound site It should protect the wound from external hazards and bacterial infections, should enhance epidermal migration, and promote angiogenesis and connective tissue synthesis [20,21]. Wound dressings with antimicrobial agents have been considered as a valuable chance to control bacterial colonization and infection in wound healing [23]
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