Alginate Dressings Research Articles

Exploring the Antibacterial and Regenerative Properties of a Two-Stage Alginate Wound Dressing in a Rat Model of Purulent Wounds.

Chronic wounds complicated by infection pose significant clinical challenges, necessitating comprehensive treatment approaches. The widespread use of antibiotics has led to resistant microorganisms, complicating traditional therapies. This study aims to develop and evaluate modified alginate wound dressings with enhanced antimicrobial and regenerative properties. Alginate dressings were synthesized with silver nanoparticles, cefepime, and fibroblast growth factor-2 (FGF-2). The two-stage therapy involved an initial antibacterial dressing followed by a regenerative dressing. In vitro tests demonstrated high antibacterial activity, with maximum inhibition zones for P. aeruginosa (41.3 ± 0.4 mm) and S. aureus (36.6 ± 1.8 mm). In vivo studies on rats with purulent wounds showed significant healing progression in the experimental group. Histological analysis revealed complete re-epithelialization, thicker neoepithelium, dense collagen deposition, and minimal inflammation in treated wounds. These findings suggest that the modified alginate dressings significantly enhance the reparative process and are promising for treating chronic infected wounds in both veterinary and medical practices.

Observation of the Therapeutic Effect of Hydrogel Combined with Alginate Dressings for a Patient with Grade 4 Acute Radiation Dermatitis: A Case Report.

In this case report, the authors summarize their experience of using hydrogel combined with alginate dressings in the wound care of a patient with grade 4 acute radiation dermatitis. With the combination of hydrogel and alginate dressings, the authors achieved autolytic debridement of the wound and created a moist healing environment to facilitate wound closure. Hydrogel helps the dressing adhere better to the wound bed, ensuring that it does not easily detach during the wound healing process. It also eliminates the need for traditional adhesive tapes for fixation, thus avoiding damage to the fragile skin in the radiation field.The wound gradually decreased in size from an area of 10 × 12 cm, and exudate decreased continuously. The wound completely healed in 20 days with a total of 17 dressing changes. As the wound gradually healed, the patient's psychological burden decreased and comfort level increased. The patient expressed satisfaction and hope for the gradual healing of the wound.Thus, the treatment of severe acute radiation dermatitis with hydrogel combined with alginate dressings yields remarkable results, aligning the noninvasive, low-adhesive, absorbent, conformable, and comfortable attributes of optimized wound care. This experience provides a practical foundation for wound management in acute radiation dermatitis and supports clinical application and promotion of the approach.

A Comparison of Incisional Dressings and Negative-Pressure Wound Therapy for the Prevention of Infection and Wound Complications After Primary Total Hip and Knee Arthroplasty: A Network Meta-Analysis of Randomized Controlled Trials.

Incisional dressings may decrease wound complications and joint infection after total hip and knee arthroplasties (THA; TKA). However, there is no consensus on the superiority of a particular product. This study compared infection and wound complications among randomized controlled trials (RCTs) across various dressing types after primary THA and TKA. Scopus, Ovid/MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were queried in May 2024. A frequentist model network meta-analysis of eligible prospective RCTs compared minor and major wound complications and dressing changes using P-scores. Of 3,067 compiled studies, 12 RCTs of 1,939 patients with median (interquartile range) follow-up of 42 (382) days undergoing primary THA (n = 880, 45.4%) or TKA (n = 1,059, 54.6%) with alginate (n = 208; 10.7%), absorbent (n = 236; 12.2%), gauze (n = 474; 24.4%), or hydrofiber (n = 683; 35.2%) dressings or negative-pressure wound therapy (NPWT; n = 338; 17.4%) were included for meta-analysis. Compared with gauze, alginate and hydrofiber dressings were associated with fewer postoperative changes (mean difference [MD], -12.1; 95% confidence interval [CI], -15.08 to -9.09, p < 0.001; MD, -3.5; 95% CI, -6.30 to -0.74, p = 0.013, respectively). In a subanalysis, silver-ion hydrofiber also was associated with fewer changes (MD, -5.0; 95% CI, -5.70 to -4.39; p < 0.001). Overall, there was no statistically significant risk of increased minor nor major wound complications including superficial and deep infections among all dressing types and NPWT compared with gauze. Despite no association between wound complications nor infection risk among various incisional dressings and NPWT vs. gauze, the alginate, hydrofiber, and silver hydrofiber dressings had statistically fewer mean postoperative changes. Future studies are required to assess whether these dressings confer reduced infection risk. Therapeutic, Level I. See Instructions for Authors for a complete description of levels of evidence.

REGECEL (an Oxidized Regenerated Cellulose) Provides Superior Bioactivity Effect on Microorganisms.

Patients who need to be readmitted to the hospital because of complications from infections or require long-term care and rehabilitation face substantial financial hardships. To ensure the safety of patients undergoing surgery, it is crucial to implement measures that prevent wound infections before and after the procedure. Antibacterial wound dressings are essential to prevent infections during surgical procedures. There are various types of antibacterial wound dressings available on the market, such as silver-based dressings, hydrocolloid dressings, polyhexamethylene biguanide, alginate dressings, collagen-based dressings, and iodine-based dressings. We used each type (standard, knit, fibril, and non-woven) of a commercial brand of oxidized regenerated cellulose (ORC) called Regecel to test bacterial growth. The choice of antibacterial wound dressing depends on the type of wound being treated. Different bacterial strains require specific culture conditions to thrive and grow in laboratory settings. To obtain accurate and reliable results, it is vital to follow the precise culture conditions required for each bacterial strain. The evaluation of ORC highlighted its potential to inhibit bacterial growth, showing promising results against various bacterial strains and Candida albicans. Different variants of ORC, such as Regecel, have demonstrated impressive capacity to hinder the growth of 32 distinct bacterial strains, with inhibition rates ranging from 40-100%. These bacteria include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and penicillin-resistant Streptococcus pneumoniae. This study supports the usage and development of ORC (Regecel) as an innovative approach to treating bacterial infections.

Study the effect of different concentrations of polydopamine as a secure and bioactive crosslinker on dual crosslinking of oxidized alginate and gelatin wound dressings

Alginate hydrogels are commonly used in wound care due to their ability to maintain a moist environment, absorb fluids, and aid wound healing. However, their stability and mechanical properties can sometimes limit their effectiveness. This study explores a new approach by creating a dual network system of oxidized alginate and gelatin hydrogel crosslinked with polydopamine in a single step, with the goal of improving the mechanical properties of these hydrogels. The unique aspect of this research is the comprehensive examination of different polydopamine concentrations in dual crosslinking systems. First, alginate was modified with sodium periodate to create additional active groups on its backbone, and various polydopamine concentrations were then tested to assess their impact on the dual crosslinking network and hydrogel properties. The study involved a range of tests, including FTIR, H-NMR, SEM, gelation time, rheology, adhesion, antioxidant activity, swelling ratio, weight loss, drug release, and cell viability. The addition of polydopamine was found to enhance the crosslinking density (0.859 × 109 mol.cm−3). Additionally, the results indicated improvements in properties such as reduced weight loss, enhanced antioxidant and adhesive qualities, and better mechanical properties (2240 kPa). However, the optimal concentration of polydopamine must be determined to achieve the best properties for a wound dressing. Excessive polydopamine can increase the space between polymer chains, leading to a reduction in crosslinking density and storage modulus. Nevertheless, it can also increase the swelling ratio, degradation rate, pore size, porosity, antioxidant activity, and dopamine release. Therefore, identifying the optimal concentration for a functional hydrogel is crucial. Notably, the hydrogel containing 0.5 mg.mL−1 polydopamine exhibited outstanding cell viability (108 % on the third day), swelling capacity (480 %), storage modulus (2240 kPa), gelation time (3 min), antioxidant activity (42.27 %), and skin adherence (11 kPa), making it an optimal choice for advanced wound management. According to the findings, it is emphasized that the application of this particular hydrogel expedites wound healing, as indicated by wound closure and histological studies. AbbreviationsUnlabelled TableOALoxidized alginateGELgelatinPDApolydopamineEDCsodium meta periodate 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide hydrochlorideNHSN-hydroxysuccinimide

Perianal Ulcers from Antihemorrhoidal Ointment: A Case Report and Literature Review.

Perianal ulcers (PAUs) related to antihemorrhoidal product use have been recently reported in the literature through a few case reports. However, other etiologies of PAU must be ruled out, including infectious disease, inflammatory disease, malignancy, pressure injuries, radiotherapy, and other topical drugs. In this report, the authors describe two cases of PAUs due to an antihemorrhoidal ointment. In case 1, a 68-year-old woman with a history of hemorrhoids presented with PAUs after using an antihemorrhoidal ointment for 2 months. The ulcers were assessed through a histopathologic study and treated with calcium alginate dressings, with complete re-epithelialization occurring after 2 months. In case 2, a 58-year-old woman with a history of hemorrhoids developed painful PAUs while using an antihemorrhoidal ointment for 2 months. No other probable cause was found, and the ulcers were treated by discontinuing the ointment. The ulcers showed marked improvement, and complete re-epithelialization occurred after 6 weeks without additional treatment.

Optimizing alginate dressings with allantoin and chemical modifiers to promote wound healing

Wound healing requires diverse functionalities in dressings, and conventional materials often fall short in water absorption and moisture regulation. Natural sodium alginate is popular in wound dressings due to its excellent film-forming ability, biocompatibility, ionic crosslinking, and pH responsiveness. However, it has limitations in physical stability and solubility in aqueous environments. This study enhanced alginate dressings by incorporating allantoin and treating with calcium chloride and citric acid to improve physicochemical properties and mechanical performance. Treatments for S2 to S5 prevented dissociation and maintained integrity, with suitable water absorption (363 %–442 %) and water vapor transmission rates (612.53–715.39 g × m2 × day−1). The treatments also improved tensile strength (44.90–55.19 MPa). S2 had the highest migration ratio (52.71 %) of L929 cells and wound healing rates for mice skin (86.6 %), indicating that calcium chloride treatment is beneficial. All dressings (S1 to S5) exhibited low cytotoxicity against L929 cells and low hemolysis ratios, indicating good biocompatibility. Higher allantoin content improved wound healing efficacy. This study provides valuable insights for the design and development of alginate dressings in wound repair, expanding allantoin's application in wound healing.

Effect of electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen for diabetic foot ulcers

Diabetic foot ulcers were a significant complication of diabetes and were accompanied by delayed wound healing. To compare the effect of topical application electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen (PLCL/Fg) dressing with alginate dressing when treating diabetic foot ulcers (DFUs). A single-center, prospective, randomized, patient-blinded clinical trial was conducted from July 1, 2023, to December 26, 2023. The clinical trial registration was completed on August 28, 2023 (ClinicalTrials.gov Identifier: NCT06014437). The eligible patients with DFUs of 1–20 cm2 present for at least 1 month and with Wagner grade 1 or 2. They were randomized 1:1 to receive PLCL/Fg or alginate dressing. Participants received PLCL/Fg dressing 1–3 times per week or alginate dressing 3 times per week for 12 weeks. A total of 52 patients (33 men [63.5 %]; mean [SD] age, 63.1 [11.9] years; mean [SD] diabetes time, 8.3 [4.6] years) with DFUs were assessed for this study. The DFUs classified as Wagner grade 1 or 2 (mean [SD] ulcer area, 3.8 [3.2] cm2) were randomized to receive either the PLCL/Fg dressing (n = 26) or the alginate dressing (n = 26) for as long as 12 weeks. In this study, the incidence of complete healing included 22 patients (91.7 %) in the PLCL/Fg group and 14 (63.6 %) in the alginate group during the 12-week treatment period (P = 0.003). The treatment-related adverse events that occurred were 5 (20.8 %) in the PLCL/Fg group and 4 (18.1 %) in the comparator group.In this randomized clinical trial, PLCL/Fg dressing showed beneficial effects in DFUs treatment of wound surface reduction and regulating the wound microenvironment.

3D printed and smart alginate wound dressings with pH-responsive drug and nanoparticle release

The pH of a wound site can undergo a significant change from its normal range of 5.4–5.6 to a more alkaline environment of 7.2–8.9 after being infected by microorganisms. Therefore, the development of a smart material that can respond to this shift in pH and release antimicrobial agents for effective treatment of wound infections holds great promise for the future of wound care. In the present work, we produced 3D printed alginate wound dressings doped with calcium phosphate nanoparticles (CaP NPs), referred to as alginate-CaP nanocomposites hereafter. The CaP NPs enabled pH-responsive switching of the degradation and drug release of 3D-printed alginate-based wound dressings. Three sizes of rod-shaped CaP NPs were synthesised, including small NPs (62 × 18 nm), medium NPs (197 × 49 nm), and large NPs (496 × 143 nm). The addition of CaP NPs significantly increased both the tensile strength and elongation at the break of the alginate dressings. Additionally, the degradation rate of the alginate-CaP nanocomposite dressings increased with pH, potentiating pH responsive drug delivery from the dressing. Alginate nanocomposites with 1 mg/mL of medium-sized CaP NPs were found to elicit the strongest pH responsiveness. The release rates of rhodamine B, the antibiotic peptide bacitracin, and antimicrobial selenium nanoparticles were assessed, and showed faster release at higher pHs. These results illustrate that CaP NPs can be easily used as a pH-responsive switch to effectively control the degradation and drug release of alginate based wound dressings, enabling increased antimicrobial release at the pH of infected wounds.

Porous and Dense Alginate/Chitosan Composite Films Loaded with Simvastatin for Dressing Applications

Alginate is a biocompatible polysaccharide matrix used for bioactive dressings with inherent healing properties. Most alginate dressings are produced as single-layer dressings. This study explores the potential of bilayer membranes to modulate drug release and enhance antimicrobial properties. We used alginate and chitosan loaded with simvastatin, an anti-inflammatory drug. One membrane comprised dense layers of both alginate and chitosan, while the other featured a dense alginate upper layer and a porous chitosan lower layer. The current study introduces a new approach in which a bilayer membrane is modeled instead of creating a polymeric blend between alginate and chitosan. The upper layer of the membrane contains only alginate loaded with simvastatin, while the bottom layer contains only chitosan. Another innovation is the study of the use of a porous lower layer of chitosan. Therefore, the association of these polymers in a bilayer and porous membrane gives advanced therapeutic dressings (with anti-inflammatory and antimicrobial properties intrinsic to the membrane) that are more efficient in the healing of complex wounds. Comprehensive characterization encompassed physicochemical, thermal, morphological, and mechanical properties. Microbiological tests were conducted using chitosan extract, and cytotoxicity evaluations were performed on fibroblast and keratinocyte cells. The results showed interlayer adhesion due to ionic interactions between alginate and chitosan surfaces. The drying process influenced the morphological and physicochemical features of the membranes. Simvastatin release profiles demonstrated sustained release over an extended period (approximately 60%–70% of the drug after 96 h). Storage assessments revealed that after six months, the membranes maintained around 98% of the initial simvastatin content. The antimicrobial activity test underscored the bacteriostatic efficacy of the chitosan porous layer, making it well-suited for infected wounds. Cell viability tests confirmed the non-cytotoxic nature of the films, highlighting their promising characteristics for treating diverse skin lesion types.

Bioactive glass enhanced alginate / carboxymethyl cellulose funcional dressings Li2O–ZrO2–SiO2

The healing of skin injuries is crucial for the human body, but the presence of harmful bacteria can be detrimental. Conventional dressings provide protection but do not promote active healing. In contrast, functional dressings can enhance regeneration by regulating moisture, facilitating gas exchange, preventing infection, and may even contain therapeutic compounds. Li2O–ZrO2–SiO2 (LZS) bioactive glasses possess antibacterial and regenerative properties but have not yet been explored in wound dressings. Therefore, this work aims to evaluate the potential of LZS glass to be used as an antibacterial biomaterial to obtain functional dressings. The antibacterial activity against Staphylococcus aureus and Escherichia coli was considered for this purpose. In-vitro biological studies were assessed by MTT (3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide), and DNA damage. Alginate and carboxymethyl cellulose (CMC) dressings were prepared with the addition of LZS in a minimum bactericidal concentration (MBC). The dressings' bioactivity was assessed by exposing them to a simulated body fluid (SBF) and analyzing their structure and microstructure. The glass efficiently inhibited the tested microorganisms, with an MBC of 100 mg/mL. LZS glasses exhibited no cytotoxicity. The bioactive glass-incorporated dressings demonstrated appropriate thickness and fluid absorption capacity for application in wound treatment. The deposition of a calcium phosphate layer on the surface of the dressings proved its bioactivity. The optimized design exhibited a tensile strength of 0.28 MPa and an elongation of 15.63 %. The functional dressings obtained have potential for applications in tissue repair where bacterial proliferation is a concern.

Comparative efficacy of silver alginate dressings versus standard gauze in enhancing wound healing post-mastectomy for triple-negative breast cancer: A systematic review and meta-analysis.

This meta-analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post-mastectomy in patients with triple-negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post-mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I2 = 85%; Random: SMD: -7.08, 95% CI: -8.26 to -5.98, p < 0.01), compared to SG. Additionally, long-term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post-mastectomy showed a notable reduction in scar formation (I2 = 95%; Random: SMD: -12.97, 95% CI: -16.20 to -9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post-mastectomy care for triple-negative breast cancer patients but highlight the need for further research on long-term safety and cost-effectiveness.

The safety and effectiveness of a self-made negative pressure suction device in the treatment of chronic wounds.

Chronic wounds are wounds that are not healed or have no healing tendency for more than 1 month due to various factors. In clinical nursing, chronic wounds are often not properly treated, and the treatment efficiency is low. Therefore, it is very important to explore effective methods to deal with chronic wounds. To explore the effect of a self-made negative pressure suction device (NPSD) in the nursing of chronic wounds in the elderly. A total of 50 elderly patients with chronic wounds who were hospitalised in our hospital from January 2020 to December 2022 were selected as participants by convenient sampling. According to the random number table method, they were divided into a control group and an observation group, with 25 people in each group. The control group was treated with chloroplast foam dressing, debridement gel and alginate dressing. The observation group was treated with a self-made NPSD on the basis of the control group. The wound healing of the two groups was observed. After the intervention of the self-made NPSD, the granulation tissue coverage rate and wound volume reduction rate of the observation group were significantly increased (p<0.05), and the positive rate of bacterial infection was significantly decreased (p<0.05). After 3 months of intervention, the total effective rate of the observation group was significantly higher than that of the control group (χ2 =3.869, p=0.0492). The self-made NPSD can effectively promote the healing of a chronic wound.

Thyroxine incorporated commercially available alginate dressings to stimulate angiogenesis for wound healing applications

Thyroxine incorporated commercially available alginate dressings to stimulate angiogenesis for wound healing applications

Clinical Evaluation of Medical Ozone Use in Domestic Feline Cutaneous Wounds-A Short Case Series.

Support and management of second-intention wound healing involves frequent dressing changes having different properties. Dressings can range from simple ones, such as nonadherent dressings, to more complex options, such as foam, hydrocolloid, alginate or negative pressure dressings. Seven cats were enrolled in the study with a total of nine wounds of various sizes with different etiology sizes and localizations. Three methods of local ozone administration were used to cover more of the ozone properties in the treatment of wounds: bagging, perilesional subcutaneous infiltrations and lavages with ozonated saline. Evaluation of the healing process was performed by clinical observation and wound area measurements every seven days until the complete recovery of the patients. The results of this study should encourage clinicians to consider medical ozone as a new therapeutic approach with regenerative properties in the second-intention healing of cats presenting cutaneous wounds.

Green chemistry production of biopolymeric film-derived biomaterial prepared using natural alginate and vanillin compounds for application as a biocurative.

The present work presents the results obtained in the production of vanillin-doped alginate biopolymeric film using green chemistry methodology. Alginate dressings are already a therapeutic reality, but they act only by maintaining the appropriate environment for healing. In order to improve their properties, the incorporation of vanillin was proposed due to its antioxidant and antimicrobial potential. Different biopolymeric films were produced employing the experiment planning through response surface analysis, which allowed determining the best region for a medium value of solubility and high degree of swelling. This region refers to values above 0.07g of CaCl2 and concentrations above 0.024g of vanillin, triggering solubility between 25 and 30% and a degree of swelling above 100% and with fixed values of alginate (0.85g). Such data are related to experiments (A), (B), and (C) listed in Table 1. Regarding the optimization of the process, the normal boundary intersection (NBI) method allowed the analysis of concave regions, predicting the optimal points and generating the Pareto chart with equidistant limits. The antimicrobial test allowed observing the antimicrobial activity against Escherichia coli and Pseudomonas aeruginosa microorganisms from the biopolymeric films, as well as a solution of vanillin with calcium chloride and glycerol obtaining a halo of inhibition only in the presence of vanillin, and there was no significant difference between the results obtained in the experiments (A) and (B). The thermal analyses showed that the material has thermal stability in the ideal temperature range (~ 25°C) for application as a biocurative. We preliminarily concluded that the alginate biopolymeric film doped with vanillin prepared using green chemical methodology presents antimicrobial properties and thermal stability that indicate its potential use as biocurative.

The Efficacy of Nano-Silver Alginate Dressing Combined with Tibial Transverse Transport for Stage III–IV Diabetic Foot Treatment

To effectively treat severe diabetic foot (DF) and reduce amputation risk, we explored nano-silver alginate (Ag/Alg) dressings and tibial transverse transport (TTT) to improve circulation and suppress inflammatory responses in lower limbs. First, Ag/Alg dressings were biocompatible without affecting L-929 cell activity, and they had better hygroscopic properties when compared with conventional dressings. Ag/Alg dressing also markedly inhibited Gram+/Gram− bacterial activity. We also retrospectively analyzed clinical data from DF patients at our hospital and divided them into control and TTT groups according to treatment modality; the latter group was treated with TTT and Ag/Alg dressings as conventional therapy. We then compared cytokines, inflammatory responses, blood supply to the foot, and ulcer healing characteristics between pre- and post-treatments. TTT patients displayed significantly higher angiogenesis-related cytokine levels and more effective inflammation control after treatment when compared with patients receiving conventional therapy. Additionally, more significant increases in ankle-brachial index and skin temperature, and a greater decrease in the visual analog scale were observed in TTT patients. In terms of surface ulcer healing, TTT patients showed better healing, with healing times, amputation rates, and ulcer recurrence rates significantly reduced. Therefore, Ag/Alg dressings combined with TTT showed great potential for severe DF therapy.

Mechanism of wound repair in diabetic rats using nanosilver-free alginate dressing.

Nanosilver-alginate dressing can effectively promote the healing of diabetic wounds in rats. However, due to the potential toxicity of nanosilver, its widespread application in hard-to-heal wound healing is limited. In the present study, the role and potential mechanism of nanosilver-free alginate gel (NSFAG) in the healing process of diabetic wounds were explored. A diabetic rat skin wound model was established, and wounds were treated with saline (NC group), nanosilver gel (NSG group) or nanosilver-free alginate gel (NSFAG group) for seven consecutive days. NSFAG significantly promoted wound healing and increased the content of protein and hydroxyproline in granulation tissues, and was superior to NSG (p<0.05). Immunohistochemical analyses revealed that the skin wound tissue structure of the NSFAG group was intact, and the number of skin appendages in the dermis layer was significantly higher compared with the NC group and the NSG group (p<0.05). Western blot analysis found that the protein expression of the epidermal stem cell marker molecules CK19 and CK14 as well the proliferation marker of keratinocytes Ki67 in the NSFAG group was significantly higher compared with the NC group or NSG group (p<0.05). Additionally, the proliferation marker of keratinocytes Ki67 in the NSFAG group was significantly higher compared with the NC or NSG group (p<0.05). Immunofluorescence staining analyses indicated that the CK19- and CK14-positive cells were mainly distributed around the epidermis and the newly formed appendages in the NSFAG group, and this result was not observed in the NC or NSG groups. The present findings demonstrate that NSFAG can effectively accelerate wound healing in diabetic rats by promoting epidermal stem cell proliferation and differentiation into skin cells, as well as formation of granulation tissue, suggesting that it can be a potential dressing for diabetic wounds.

Experience in complex therapy of lower limb trophic ulcers of venous and diabetic origin

Trophic ulcers (TU) associated with venous circulation pathology or diabetes mellitus are considered chronic wounds with all the attributes of the complex extracellular matrix (ECM) reorganization and tissue remodelling of the edges and bed of these wounds. It was therefore determined that only a comprehensive step-wise approach to the treatment of TU can produce a stable clinical result. The article presents the experience of comprehensive management of venous and diabetic TUs. Three clinical cases of management of patients with lower limb TUs are described. The treatment of patients was planned taking into account the accepted algorithms for the management of TU associated venous circulation pathology or diabetes mellitus. The topical therapy included advanced wound coverings. The choice of dressing was determined by the clinical course of wound process. Alginate dressings were used on stages I and II wounds; hydrocolloid dressings were used on stages II and III wounds. Effects resulting from treatment included almost complete healing or readiness of a TU for skin grafting. The topical therapy of venous and diabetic TUs is part of the comprehensive treatment. During phase 1 wound process, the topical drugs should have antimicrobial, necrolytic, draining, osmotic and analgesic action. During phase 2, the granulation tissue should be induced and the balanced moist environment should be created to promote tissue regeneration. The wound coverings specified in the above clinical examples are fully consistent with the principles of the TIME concept, their ease of use and comfort for the patient are pointed out.

Assessment framework for the selection of a potential interactive dressing material for diabetic foot ulcer

Diabetic foot ulcer is a chronic health issue leading to lower leg amputations in approximately 15% of patients with diabetics. There are many factors directly or indirectly involved in the physiology of wound healing but being a multisystem disorder, wound healing in diabetic patients retard or worsen with heavy exudates and severe microbial infections. Wound management is of prime importance and is an emerging area to incorporate wound regenerative materials in natural or synthetic dressing materials along with proper microbial control. The article aim to identify suitable dressing materials which exhibit inherent wound healing properties at the same time flexible to be used as drug carriers for slow, consistent and effective delivery of ‘functional drugs’ to the wound environment. The authors selected nine materials from the popular and well accepted dressings of patient choice, analyzed them using graph theoretic approach and ranked them on the basis of graph index values obtained. A critical review has also been done on the basis of their ranking, providing insights to the advantages, disadvantage and potential of top 5 ranked candidate materials. Alginate, Honey, Medifoam, Saline, and Hydrogel dressings were the top five candidate materials ranked respectively, even then, the authors suggests that ‘modified hydrogels’ can have the potential to be used as a future candidate in DFU treatment as it is the only material (among the top ranked ones) which can effectively used as regenerative drug carrier, while providing all other wound healing properties in relative proportions. The proposed framework can be modified and applied in the selection and ranking of materials for any kind of applications both in industry and medical fields by identifying factors influencing the final outcome of study and by listing the characteristics of the materials selected.