Abstract
Novel antimicrobial wound dressings impregnated with copper oxide micro-particles have been cleared for treatment of acute and chronic wounds. Our objective is to provide preliminary data regarding the potential benefit of using these novel wound dressings including in non-infected wounds. Methods involved the treatment of wounds that responded partially or poorly to conventional wound healing treatments with copper oxide impregnated wound dressings in patients with a range of etiologies. Ten cases of patients with etiologies such as diabetes mellitus, sickle cell disease, renal failure, and necrotizing fasciitis, in which the application of copper oxide impregnated wound dressings in infected and non-infected wounds, which resulted in significant enhanced wound healing, are presented. This was exemplified by clearing of the wound infections, reduction of the fibrous and/or necrotic tissue and by intense granulation, epithelialization, and wound closure. The described 10 case reports support our hypothesis that the copper oxide-containing wound dressing not only confers protection to the wound and the dressing from microbial contamination, and in some cases may help clear the wound infections, but in addition and more importantly, stimulate skin regeneration and wound healing. Our findings are in line with previous animal and in vitro studies showing that copper plays a key role in angiogenesis and skin regeneration. These case reports support the notion that the use of copper oxide impregnated wound dressings may be an important intervention in the arsenal of wound treatment modalities, especially in hard to heal wounds.
Highlights
Copper is a trace mineral essential for many wound healing-related processes [1,2]
We demonstrated the capacity of the copper oxide impregnated wound dressings to enhance wound closure in a diabetic animal model [4]
By using a platform technology that introduces copper oxide into fibers [36,37], wound dressings impregnated with copper oxide microparticles (COD, Figure 1) are produced
Summary
Copper is a trace mineral essential for many wound healing-related processes [1,2]. Copper stimulates (a) angiogenesis [3] by upregulating Hypoxia Induced Factor 1alpha (HIF-1α) [4], vascular endothelial growth factor (VEGF) [5], and Cu-dependent transcription factor Atox1 [6]; (b) expression of integrin [7]; (c) stimulation of secretion of fibrinogen, elastin, and collagen by dermal fibroblasts [8,9] and their stabilization [10,11]; (d) upregulation of copper-dependent enzymes and polysaccharides, such as lysyl oxidase, metalloproteinases, glycosaminoglycans, and small proteoglycans, important for matrix remodeling, cell proliferation, and re-epithelization [12,13,14,15], and (e) migration of skin and stem cells [16,17].Copper has potent wide spectrum biocidal properties [18,19]. Copper stimulates (a) angiogenesis [3] by upregulating Hypoxia Induced Factor 1alpha (HIF-1α) [4], vascular endothelial growth factor (VEGF) [5], and Cu-dependent transcription factor Atox1 [6]; (b) expression of integrin [7]; (c) stimulation of secretion of fibrinogen, elastin, and collagen by dermal fibroblasts [8,9] and their stabilization [10,11]; (d) upregulation of copper-dependent enzymes and polysaccharides, such as lysyl oxidase, metalloproteinases, glycosaminoglycans, and small proteoglycans, important for matrix remodeling, cell proliferation, and re-epithelization [12,13,14,15], and (e) migration of skin and stem cells [16,17]. The mechanisms of copper’s biocidal activity include alteration of microbial proteins and inhibition of their biological assembly and activity; plasma membrane permeabilization; and membrane lipid peroxidation [18]. In contrast to the antibiotic-resistant microbes that have evolved in less than 50 years of antibiotic use, coppertolerant microbes are extremely rare due to the non-specific and parallel damage caused by copper to many key components of microorganisms [18]
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