Abstract
In chronic wounds, the regeneration process is compromised, which brings complexity to the therapeutic approaches that need to be adopted, while representing an enormous loss in the patients’ quality of life with consequent economical costs. Chronic wounds are highly prone to infection, which can ultimately lead to septicemia and morbidity. Classic therapies are increasing antibiotic resistance, which is becoming a critical problem beyond complex wounds. Therefore, it is essential to study new antimicrobial polymeric systems and compounds that can be effective alternatives to reduce infection, even at lower concentrations. The biological potential of polyphenols allows them to be an efficient alternative to commercial antibiotics, responding to the need to find new options for chronic wound care. Nonetheless, phenolic compounds may have some drawbacks when targeting wound applications, such as low stability and consequent decreased biological performance at the wound site. To overcome these limitations, polymeric-based systems have been developed as carriers of polyphenols for wound healing, improving its stability, controlling the release kinetics, and therefore increasing the performance and effectiveness. This review aims to highlight possible smart and bio-based wound dressings, providing an overview of the biological potential of polyphenolic agents as natural antimicrobial agents and strategies to stabilize and deliver them in the treatment of complex wounds. Polymer-based particulate systems are highlighted here due to their impact as carriers to increase polyphenols bioavailability at the wound site in different types of formulations.
Highlights
Despite all the driven technological advances in the management and treatment of chronic wounds, these remain a challenge for clinicians and researchers worldwide due to the complexity of healing that often fails to progress.The wound healing process consists of a cascade of coordinated events after a skin injury, trauma, or laceration, which is followed by the natural regeneration of the skin’s protective barrier
All these intrinsic and extrinsic factors associated with the impaired healing of chronic wounds negatively affect extracellular matrix deposition, host immune response, and access to antibiotics to the wound site in case of infection [22]
Anjum et al [77] developed a composite material for wound dressing containing nanosilver nanohydrogels with aloe vera and curcumin that promote antimicrobial nature, wound healing, and infection control
Summary
Despite all the driven technological advances in the management and treatment of chronic wounds, these remain a challenge for clinicians and researchers worldwide due to the complexity of healing that often fails to progress. The increase in the elderly population, combined with the risk of comorbidities, such as diabetes and vascular problems, may cause chronic wounds to be a significant contributor to health costs and morbidity [1]. In these cases, blood flow can be injured, which leads to persistent chronic wounds that do not heal and are prominent to infection and septicemia. There are more than 6.5 million patients affected by the chronic wound, and the cost of treatment is estimated to be USD 25 billion per year [2]. This review seeks to bring researchers an updated description of the wound healing process, combining the wide variety of polyphenols-based strategies for accelerating wound healing—from systemic or local dressing to cell-free therapies in nano/microsystems
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