Antimicrobial Wound Dressings Research Articles

An open label, single-centric, post market clinical study to evaluate the safety and efficacy of a new antimicrobial wound dressing (VELVERT) as an adjuvant therapy in the treatment of venous leg ulcer.

An open label, single-centric, post market clinical study was undertaken to evaluate the safety and efficacy of a new antimicrobial wound dressing (VELVERT) as an adjuvant therapy in the treatment of venous leg ulcer (VLU). Patients with VLU of grade C-5 according to CEAP classification and above were evaluated using doppler ultra sound. The efficacy of new antimicrobial wound dressing (VELVERT) was assessed in terms of wound area reduction within a time frame of 60 days and surgeon questioners. Patients were evaluated for VELVERT safety and pain level on a scale of 0-10 Numeric Pain Chart. Presence of micro-organism load was monitored at regular time interval. VELVERT treatment was effective as 71.43% reduction in the ulcer area was observed. After 60 days, a total of 9 (45%) patients had complete ulcer closure. A remarkable decrease in the severity of pain was observed with 11 (55%) patients expressing no pain at the EOT. Swab test showed negative result for micro-organism growth. No serious adverse events were observed during the trial. The data indicates that VELVERT is an effective treatment for VLUs and showed the potential in the wound care of VLUs.

Next-generation photodynamic antimicrobial materials made by direct synthesis of functional bacterial cellulose.

Bacterial cellulose (BC) regularly uses chemical or physical modifications to produce antimicrobial wound dressings. However, there is a risk of loss of functional components during application. Moreover, a significant hurdle lies in successfully integrating durable and highly effective bactericidal entities with BC. Herein, we successfully synthesized a photodynamic antibacterial cellulose through direct in situ microbial fermentation, incorporating the photosensitizer protoporphyrin IX-modified glucosamine (PPIX-GlcN) into cellulose to form PIXX-BC biopolymers. Excitingly, the PPIX-BC membrane exhibited robust and uniform red fluorescence, which is crucial for monitoring the bacterial fermentation process. Our results demonstrated that the biocompatibility PPIX-BC membrane possessed potent light-triggered photodynamic bactericidal activity, effectively suppressing the growth of E. coli and S. aureus while also promoting skin wounds repair. Consequently, this research validated the possibility of leveraging microorganisms to bio-functionalize BC, conferring it with photocatalytic antibacterial properties. Furthermore, successfully modification of the microorganisms' glucose carbon source offers valuable insights into biosynthesis of other living materials through microbial metabolism.

Assessment of the Antibiofilm Performance of Silver-Containing Wound Dressings: A Dual-Species Biofilm Model.

Background It is commonly accepted that microorganisms found within hard-to-heal wounds are present in biofilm form. Biofilms are often polymicrobial in nature, which increases their virulence and tolerance to antimicrobial agents. The aim of this study was to compare the antibiofilm activity of silver-containing antimicrobial wound dressings in a dual-species simulated wound biofilm model. Materials and methods Four silver-containing wound dressings were evaluated in vitro: Aquacel® Ag+ Extra™ dressing, KerraContact® Ag dressing, Durafiber* Ag dressing, and UrgoClean Ag dressing. Each dressing was applied to a simulated wound assembly containing biofilm-gauze inoculated with Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA). Each biofilm-inoculated gauze was incubated at 35±3ºC for 6, 24, 48 and 72 hours. Enumeration of surviving biofilm bacteria at each time point was performed in triplicate for each test dressing and its equivalent control. Results Aquacel® Ag+ Extra™ dressing was observed to reduce the biofilm population within 24 hours with a >4 log10 kill observed for K. pneumoniae and >6 log10 for MRSA from an initial biofilm challenge of 4.16×109 CFU/mL. This kill rate was sustained for the duration of the challenge period, with Aquacel®Ag+ Extra™ dressing reducing the biofilm population to non-detectable levels (<30 Colony Forming Units (CFU) per test) by 72 hours for K. pneumoniae and by 48 hours for MRSA. KerraContact® Ag dressing demonstrated an initial reduction at 6 hours of ~2 log10 in both K. pneumoniae and MRSA. Durafiber* Ag dressing exhibited a slight, gradual reduction in biofilm population over the course of the test period, reducing each challenge organism by ~2.5 log10 by 72 hours. UrgoClean Ag was shown to have little to no impact on the dual-species biofilm with levels remaining similar or greater than that recovered prior to dressing application. The no-dressing biofilm-colonised gauze control demonstrated that the biofilm bacteria remained viable throughout the test period and species population proportionality was maintained. Conclusion Using a dual-species simulated wound biofilm model comprising the pathogens K. pneumoniae and MRSA, Aquacel® Ag+ Extra™ dressing demonstrated significantly greater antibiofilm activity than the other silver-containing dressings. The enhanced antibiofilm activity of Aquacel® Ag+ Extra™ dressing in this study may be attributed to the additional antibiofilm agents, ethylenediaminetetraacetic acid and benzethonium chloride, contained within the dressing.

The prospects of application of antimicrobial biodegradable wound dressings for the treatment of purulent wounds

The prospects of application of antimicrobial biodegradable wound dressings for the treatment of purulent wounds

Multifunctional silver nanoparticle embedded eri silk cocoon scaffolds against burn wounds-associated infection.

Antimicrobial wound dressings offer enhanced efficacy compared to conventional dressing platforms by limiting bacterial infections, expediting the healing process, and creating a barrier against additional wound contamination. The use of silk derived from silkworm cocoons in wound healing applications is attributed to its exceptional characteristics. Compared to mulberry silk, sericin from non-mulberry cocoons has higher water exchange mobility and moisture retention. Eri, a non-mulberry silkworm, is an unexplored source of silk with an eco-friendly nature of production where the natural life cycle of silkworms is not disrupted, and no moths are sacrificed. This work reports on an eri silk cocoon-based scaffold decorated with silver nanoparticles as a wound dressing material effective against burn-wound-associated multiple-drug-resistant bacteria. The UV-vis spectroscopy showed maximum absorbance at 448 nm due to the surface plasmon resonance of silver nanoparticles. FT-IR spectra exhibited the functional groups in the eri silk proteins accountable for the reduction of Ag+ to Ag0 in the scaffold. SEM-EDX analysis revealed the presence of elemental silver, and XRD analysis confirmed their particle size of 5.66-8.82 nm. The wound dressing platform showed excellent thermal stability and hydrophobicity, fulfilling the criteria of a standard waterproof dressing material, and anticipating the prevention of bacterial biofilm formation in chronic wounds. The scaffold was found to be effective against both Staphylococcus aureus (MTCC 87) and Pseudomonas aeruginosa (MTCC 1688) multiple-drug-resistant pathogens. Electron microscopy revealed the bacterial cell damage, suggesting its bactericidal property. The results further revealed that the scaffold was both hemocompatible and cytocompatible, suggesting its potential application in chronic wounds such as burns. As an outcome, this study presents a straightforward, cost-effective, and sustainable way of developing a multifunctional wound dressing platform, suggesting its significant therapeutic potential in clinical and biomedical sectors and facile commercialization.

ANTIMICROBIAL WOUND DRESSINGS FOR FULL-THICKNESS INFECTED BURN WOUNDS.

Infection of wounds delays healing, increases treatment costs, and leads to major complications. Current methods to manage such infections include antibiotic ointments and antimicrobial wound dressings, both of which have significant drawbacks, including frequent reapplication and contribution to antimicrobial resistance. In this work, we developed wound dressings fabricated with a medical-grade polyurethane coating composed of natural plant secondary metabolites, cinnamaldehyde, and alpha-terpineol. Our wound dressings are easy to change and do not adhere to the wound bed. They kill gram-positive and -negative microbes in infected wounds due to the Food and Drug Administration-approved for human consumption components. The wound dressings were fabricated by dip coating. Antimicrobial efficacy was determined by quantifying the bacteria colonies after a 24 h of immersion. Wound healing and bacterial reduction were assessed in an in vivo full-thickness porcine burn model. Our antimicrobial wound dressings showed a > 5-log reduction (99.999%) of different gram-positive and gram-negative bacteria, while maintaining absorbency. In the in vivo porcine burn model, our wound dressings were superior to bacitracin in decreasing bacterial burden during daily changes, without interfering with wound healing. Additionally, the dressings had a significantly lower adhesion to the wound bed. Our antimicrobial wound dressings reduced the burden of clinically relevant bacteria more than commercial antimicrobial wound dressings. In an in vivo infected burn wound model, our coatings performed as well or better than bacitracin. We anticipate that our wound dressings would be useful for the treatment of various types of acute and chronic wounds.

Electrospun high hydrophilicity antimicrobial poly (lactic acid)/silk fibroin nanofiber membrane for wound dressings

Antimicrobial wound dressings can aid wound healing by preventing bacterial infection. This is particularly true of electrospun ones, which have a porous structure and can be easily loaded with antimicrobial drugs. Here, Poly lactic acid (PLA), Silk Fibroin (SF) and antimicrobial agents of Silver nanoparticles (Ag NPs) and Silver oxide (Ag2O) to prepare the PLA/SF composites antimicrobial nanofiber membrane by electrospinning. The PLA with 30 % SF nanofiber membrane show the water vapor permeability (WVP) and the liquid absorption of 36 g·mm/(m2·d·kPa) and 1721 %. With the increasing of SF contents, the degradation rate and surface hydrophilicity of the nanofiber membrane increase significantly. The nanofiber membrane exhibited excellent antimicrobial activity against Pseudomonas aeruginosa (P. aeruginosa) with the inhibition circle reach at 18.2 mm. The resultant nanofiber membrane showed high cytosolic activity, good cytocompatibility and strong antimicrobial ability, which laid a theoretical foundation for the construction of a new PLA/SF composites antimicrobial fiber membrane.

Evaluation of living bacterial therapy assisted by pH/reactive oxygen species dual-responsive sodium alginate-based hydrogel for wound infections

The enhancement of antimicrobial wound dressings is of utmost importance in light of the escalating risk of antibiotic resistance caused by excessive antibiotic usage. Conventional antimicrobial materials eradicate pathogenic bacteria while impeding the proliferation of beneficial bacteria during the management of wound infections, thereby disturbing the equilibrium of the skin micro-ecosystem and engendering recurrent cutaneous complications. Lactobacillus rhamnosus (L.rha) is a probiotic that can inhibit the growth of certain pathogenic bacteria by secreting a large number of metabolites. In this paper, we synthesized a cross-linker (SPBA) with a boric acid molecule from succinic acid and 4-(bromomethyl)phenylboronic acid, which formed a boric acid ester bond with a diol on the natural polysaccharide sodium alginate (SA), and obtained a pH/reactive oxygen species (ROS) dual-responsive hydrogel (SA-SPBA) for loading L.rha to treat wound infections. The SA-SPBA@L.rha hydrogel improves the survival of L.rha during storage and has good injectability as well as self-healing properties. The hydrogel showed good biocompatibility, the antimicrobial effect increases in a dose-dependent manner, and it has a certain antioxidant and anti-inflammatory capacity, accelerating wound repair. The use of SA-SPBA@L.rha hydrogel provides a safe and effective strategy for the repair of skin wound infections.

AgNPs-GO Liquid Bandage is antibacterial and accelerates cutaneous wound healing in mouse model

BackgroundThe liquid bandage is a popular choice for superficial wounds due to its convenient application, comfortable feel, attractive appearance, and waterproof properties. It has gained popularity among consumers in recent years. On the other hand, silver-loaded graphene oxide nanoparticles are composite materials that combine carbon and metal. They possess exceptional performance and well-established manufacturing techniques, and have been extensively studied and developed in various areas such as antimicrobial materials, photocatalysis, and semiconductors. These nanoparticles are commonly used as antimicrobial agents in antimicrobial packaging materials, antimicrobial coatings, and antimicrobial wound dressings. ResultsThe study aimed to develop a new type of liquid bandage that has antimicrobial properties. This was achieved by incorporating silver-loaded graphene oxide nanoparticles into the liquid bandage. We measured various physical properties of the liquid bandage, such as film formation time, water resistance, and breathability, to assess its effectiveness as a bandage. We also conducted in vitro antimicrobial experiments to evaluate the antimicrobial efficacy of the liquid bandage. The results showed that the liquid bandages exhibited some antimicrobial activity, indicating their potential for preventing infection. Furthermore, in vitro cytotoxicity experiments demonstrated that the liquid bandage was non-toxic to cells and had good biocompatibility, suggesting its safety for use on wounds. Finally, in vivo wound healing experiments conducted on mice showed that the liquid bandage effectively promoted wound healing. Overall, this study successfully developed a novel liquid bandage with antimicrobial properties, good biocompatibility, and wound healing capabilities. Significance and NoveltyThe AgNPs-GO liquid bandage is expected to be a valuable tool in the medical field for improving wound treatment. It possesses antimicrobial properties. Additionally, it has good biocompatibility, meaning it is well-suited for use in the body and does not cause harm to cells. This liquid bandage also promotes wound healing, which can lead to faster recovery times for patients. Overall, the AgNPs-GO liquid bandage has the potential to greatly enhance the effectiveness of wound treatment.

Improving wound infection management: education and evaluation of an infection management pathway.

To assess the clinical impact and acceptance of an infection management (IM) pathway, designed to improve the consistency of care of wound infection when introduced, and supported by an educational programme. An education and evaluation programme (T3 programme) was-conducted in Portugal, Spain and Italy. This consisted of a two-hour educational, virtual seminar, followed by a four-week evaluation of an IM pathway during which survey data were collected on the impact of this pathway on clinician-selected patients. Finally, all participants reconvened for a virtual meeting during which the combined results were disseminated. The pathway provided guidance to clinicians regarding the targeted use of antimicrobial wound dressings according to the presence and absence of signs and symptoms of wound infection. Responses relating to 259 patients treated according to the IM pathway, 139 (53.7%) of whom had received previous antimicrobial treatment, were captured. Signs and symptoms of infection resolved within four weeks of treatment in >90% of patients. All 25 patients who had received prior antimicrobial treatment for ≥3 months experienced a resolution in the signs and symptoms of infection within four weeks. The majority of participating clinicians agreed that the IM pathway improved decision-making (94.9%) and confidence (97.3%), and helped to determine the correct antimicrobial treatment (91.4%) in the context of wound infection. The T3 programme was an efficient way to deliver a structured educational programme. The use of the IM pathway resulted in >90% of patients achieving resolution of their signs and symptoms of wound infection.

Incorporating silver nanoparticles into electrospun nanofibers of casein/polyvinyl alcohol to develop scaffolds for tissue engineering

Developing novel antimicrobial wound dressings that have the potential to address the challenges associated with chronic wounds is highly imperative in providing effective infection control and wound healing support. Biocompatible electrospun nanofibers with their high porosity and surface area enabling efficient drug loading and delivery have been investigated in this regard as viable candidates for chronic wound care. Here, we design Casein/Polyvinyl alcohol (CAN/PVA) nanofibers reinforced with silver nanoparticles (Ag NPs) by the electrospinning technique to develop diabetic wound healing scaffolds. The prepared samples were characterized using spectroscopic and electron microscopic techniques. The biocompatibility of the polymer samples were assessed using 3 T3 fibroblast cell lines and the maximum cell viability was found to 95 % at a concentration of 50 μg/mL for the prepared nanofibers. Scratch assay tests were also performed to analyze the wound healing activity of the nanofibers wherein they demonstrated increased migration and proliferation of fibroblast 3 T3 cells. Moreover, these nanofibers also exhibit antibacterial efficiency against Gram-negative bacteria, Escherichia coli (E.coli). Therefore, the antimicrobial nature of the electrospun nanofibers coupled with their moisture absorption properties and wound healing ability render them as effective materials for wound dressing applications.

Antibiofilm Efficacy and Mode of Action of Etlingera elatior Extracts Against Staphylococcus aureus

Staphylococcus aureus represents a major bacterial human pathogen that causes a wide variety of clinical manifestations. Various medicinal plants have been used to control its infection, however, the effect of Etlingera elatior on S. aureus biofilm is still uncertain. Thus, the objective of this study was to evaluate the antibacterial and antibiofilm efficacy of E. elatior extracts against S. aureus. Phytochemical screening was carried out to determine the presence of phenols, tannins, saponins, and alkaloids in different extracts (acetone, methanol, ethanol, and aqueous) of E. elatior. Antibacterial activities were determined by disk diffusion assay, minimum inhibitory concentration assay (MIC), and minimum bactericidal concentration assay (MBC) while antibiofilm activities were determined by crystal violet assay and Fourier-transform infrared (FTIR) spectroscopy. All the extracts were found to contain phenols, tannins, saponins, and alkaloids. Only acetone extract showed a high amount of saponins. Among all the extracts, acetone extract showed the widest inhibition zone (21.23±0.2 mm), lowest MIC (20 mg/mL), and lowest MBC (50 mg/mL) values. The acetone extract also showed the highest antibiofilm activities at all biofilm stages (6 hr: 12%-31%; 12 hr: 20%-36%; 18 hr: 27%-32%; 24 hr: 5%-46%). Further analysis with FTIR spectroscopy revealed spectral changes associated with proteins (1700–1400 cm-1), phospholipids, and polysaccharides (1300–700 cm-1) in S. aureus biofilm following the treatment with 200 mg/mL of E. elatior extracts. In conclusion, E. elatior is a potential source of antibacterial and antibiofilm agents to control S. aureus infections. Changes in the composition of proteins, phospholipids, and polysaccharides may mediate the biofilm inhibition by E. elatior extracts. The acetone extract of E. elatior may be useful for various applications such as antimicrobial topical cream and wound dressing.

Chitosan-Based Scaffolds Incorporated with Silver Nanoparticles for the Treatment of Infected Wounds.

Bacterial infections are major problems in wound care due to their impact on the retarded process of wound healing, leading to chronic wounds. Most of the presently utilized wound dressing products exhibit poor antimicrobial properties. Wound dressings formulated from chitosan have been reported to be effective for treating infected wounds, resulting from the antibacterial properties of chitosan. The antibacterial properties of chitosan-based wound dressings can be further enhanced by incorporating metallic nanoparticles into them, such as silver, zinc, titanium, etc. The incorporation of silver nanoparticles into chitosan-based wound dressings has been widely explored in the design of antimicrobial wound dressings. The incorporation of silver nanoparticles into chitosan-based wound dressings promotes accelerated wound-healing processes due to enhanced antimicrobial activity. The accelerated wound healing by these metal-based nanoparticles is via the regulation of re-epithelialization and inflammation without affecting the viability of normal cells. However, there have been few reports that evaluate these wound dressings in infectious animal models to prove their efficacy. The in vivo toxicity of silver nanoparticles still needs to be addressed, revealing the need for further preclinical and clinical trials. The fabrication of wound dressings incorporated with silver nanoparticles has not been fully explored, especially for wounds requiring immediate treatment. The possible interactions between silver nanoparticles and chitosan scaffolds that result in synergistic effects still need to be understood and studied. This review provides a comprehensive report on the preclinical outcomes of chitosan wound dressing materials loaded with silver nanoparticles for managing infected wounds.

Development, characterization, and evaluation of a simple polymicrobial colony biofilm model for testing of antimicrobial wound dressings.

Simple biofilm models are the first step to testing of any antimicrobial and wound dressing; therefore, the aim of this study was to develop and validate a simple polymicrobial colony biofilm wound model comprised of Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans on RPMI-1640 agar. The model was then used to evaluate the topical disinfectant chlorohexidine and four commercially available wound dressings using the polymicrobial model. The model used was as a starting point to mimic debridement in clinical care of wounds and the effectiveness of wound dressings evaluated afterwards. Planktonic assessment using AATCC100-2004 demonstrated that all antimicrobial wound dressings reduced the planktonic microbial burden below the limit of detection; however, when challenged with polymicrobial colony biofilms, silver wound dressings showed limited effectiveness (1-2 log CFU reductions). In contrast, a single iodine releasing wound dressing showed potent antibiofilm activity reducing all species CFUs below the limit of detection (>6-10 log) depending on the species. A disrupted biofilm model challenge was performed to represent the debridement of a wound and wound silver-based wound dressings were found to be marginally more effective than in whole colony biofilm challenges while the iodine containing wound dressing reduced microbial recovery below the limit of detection. In this model, silver dressings were ineffective versus the whole colony biofilms but showed some recovery of activity versus the disrupted colony biofilm. The iodine wound dressing reduced the viability of all species below the level of detection. This suggests that mode of action of wound dressing should be considered for the type of biofilm challenge as should the clinical use, e.g. debridement.

Hydrogels based on lignin extracted from cashew apple bagasse and its application in antimicrobial wound dressings

Hydrogels are versatile materials with a three-dimensional network structure that can retain water and release bioactive compounds. They have found applications in various fields, including agriculture, biomaterial synthesis, and pharmaceuticals. Incorporating natural antimicrobial compounds into hydrogels is a promising approach to developing non-toxic biomedical materials, particularly for wound healing dressings. It was evaluated the extraction and use of cashew apple bagasse lignin (CAB-Lig) due to its healing, anti-inflammatory, and antimicrobial properties for producing a hydrogel-based bandage. The extraction process involved acid and alkali treatments followed by precipitation. The antimicrobial potential of CAB-Lig was evaluated at different concentrations for formulating hydrogels. Hydrogels containing 0.1 % and 3 % lignin showed high swelling and liquid retention abilities. The 3 % lignin hydrogel exhibited effectiveness against Escherichia coli and Staphylococcus aureus. Incorporating CAB-Lig into the hydrogel structure improved its mechanical properties, making it more suitable for application as a bandage. Moreover, the extracted lignin showed low toxicity, indicating its safe use. A bandage was formulated by combining the CAB-Lig-based hydrogel with polyester, which possessed antimicrobial properties and demonstrated biocompatibility (L929 and HaCat cells). The results confirmed the potential of CAB-Lig for synthesizing hydrogels and dressings with antimicrobial properties, offering a sustainable solution for utilizing lignocellulosic biomass.

Nanofibers of N,N,N-trimethyl chitosan capped bimetallic nanoparticles: Preparation, characterization, wound dressing and in vivo treatment of MDR microbial infection and tracking by optical and photoacoustic imaging

Recent advancements in wound care have led to the development of interactive wound dressings utilizing nanotechnology, aimed at enhancing healing and combating bacterial infections while adhering to established protocols. Our novel wound dressings consist of N,N,N-trimethyl chitosan capped gold‑silver nanoparticles (Au-Ag-TMC-NPs), with a mean size of 108.3 ± 8.4 nm and a zeta potential of +54.4 ± 1.8 mV. These optimized nanoparticles exhibit potent antibacterial and antifungal properties, with minimum inhibitory concentrations ranging from 0.390 μg ml−1 to 3.125 μg ml−1 and also exhibited promising zones of inhibition against multi-drug resistant strains of S. aureus, E. coli, P. aeruginosa, and C. albicans. Microbial transmission electron microscopy reveals substantial damage to cell walls and DNA condensation post-treatment. Furthermore, the nanoparticles demonstrate remarkable inhibition of microbial efflux pumps and are non-hemolytic in human blood. Incorporated into polyvinyl alcohol/chitosan nanofibers, they form Au-Ag-TMC-NPs-NFs with diameters of 100–350 nm, facilitating efficient antimicrobial wound dressing. In vivo studies on MDR microbial-infected wounds in mice showed 99.34 % wound healing rate within 12 days, corroborated by analyses of wound marker protein expression levels and advanced imaging techniques such as ultrasound/photoacoustic imaging, providing real-time visualization and blood flow assessment for a comprehensive understanding of the dynamic wound healing processes.

Efficacy and pharmacoeconomic advantages of Fufang Huangbai Fluid hydropathic compress in diabetic foot infections: a comparative clinical study with antimicrobial calcium alginate wound dressing.

Objective: To compare the intervention effects and pharmacoeconomic advantages of Fufang Huangbai Fluid (FFHB) hydropathic compress versus Antimicrobial Calcium Alginate Wound Dressing (ACAWD) in the treatment of diabetic foot infections (DFI). Methods: Patients with DF who were hospitalized in the peripheral vascular Department of Dongzhimen Hospital of Beijing University of Chinese Medicine from December 2020 to February 2022 and met the inclusion and excluding criteria were allocated into the experimental group and control group through minimization randomization. The experimental group was treated with FFHB hydropathic compress for 2weeks, while the control group was treated with ACAWD for the same duration. The wound healing of both groups was monitored for 1month post-discharge. Clinical data from all eligible patients were collected, and differences in various indices between cohorts were analyzed. Results: 22 in the experimental group (including two fell off) and 20 in the control group. After the treatment, the negative rate of wound culture in the experimental group was 30% and that in the control group was 10%, There was no significant difference in the negative rate of wound culture and change trend of minimum inhibitory concentration (MIC) value of drug sensitivity (p > 0.05). The infection control rate of the experimental group was 60%, and that of the control group was 25%. The difference between the two groups was statistically significant (χ2 = 5.013, p = 0.025). The median wound healing rate of the experimental group was 34.4% and that of the control group was 33.3%. There was no significant difference between the two groups (p > 0.05). During the follow-up 1month later, the wound healing rate in the experimental group was higher, and the difference was statistically significant (p = 0.047). Pharmacoeconomic evaluations indicated that the experimental group had greater cost-effectiveness compared to the control group. Conclusion: In the preliminary study, FFHB demonstrated comparable pathogenic and clinical efficacy to ACAWD in the treatment of mild DF infection, and exhibited superior pharmacoeconomic advantages. With the aid of infection control, the wound healing rate in the FFHB group showed notable improvement. Nevertheless, due to the limited sample size, larger-scale studies are warranted to further validate these findings. Clinical Trial Registration: (https://www.chictr.org.cn/showproj.aspx?proj=66175), identifier (ChiCTR2000041443).

Evaluation of antimicrobial photodynamic action of a pluronic and pectin based film loaded with methylene blue against methicillin resistant Staphylococcus aureus

Antimicrobial wound dressings play a crucial role in treatment of wound infections. However, existing commercial options fall short due to antibiotic resistance and the limited spectrum of activity of newly emerging antimicrobials against bacteria that are frequently encountered in wound infections. Antimicrobial photodynamic therapy (aPDT) is very promising alternative therapeutic approach against antibiotic resistant microbes such as methicillin resistant Staphylococcus aureus (MRSA). However, delivery of the photosensitizer (PS) homogeneously to the wound site is a challenge. Though polymeric wound dressings based on synthetic and biopolymers are being explored for aPDT, there is paucity of data regarding their in vivo efficacy. Moreover, there are no studies on use of PS loaded, pluoronic (PL) and pectin (PC) based films for aPDT. We report development of a polymeric film for potential use in aPDT. The film was prepared using PL and PC via solvent casting approach and impregnated with methylene blue (MB) for photodynamic inactivation of MRSA in vitro and in vivo. Atomic force microscopic imaging of the films yielded vivid pictures of surface topography, with rough surfaces, pores, and furrows. The PL:PC ratio (2:3) was optimized that would result in an intact film but exhibit rapid release of MB in time scale suitable for aPDT. The film showed good antibacterial activity against planktonic suspension, biofilm of MRSA upon exposure to red light. Investigations on MRSA infected excisional wounds of mice reveal that topical application of MB loaded film for 30 min followed by red light exposure for 5 min (fluence; ∼30 J cm−2) or 10 min (fluence; ∼60 J cm−2) reduces ∼80% or ∼92% of bioburden, respectively. Importantly, the film elicits no significant cytotoxicity against keratinocytes and human adipose derived mesenchymal stem cells. Taken together, our data demonstrate that PS-loaded PL-PC based films are a promising new tool for treatment of MRSA infected wounds.

Fabrication of bioinspired keratin/sodium alginate based biopolymeric mat loaded with herbal drug and green synthesized zinc oxide nanoparticles as a dual drug antimicrobial wound dressing

Dual drug antibacterial wound dressings with biological materials possess crucial wound healing characteristics including biocompatibility, non-toxicity, degradability, mechanical strength and antibacterial properties. The study focusses on fabricating keratin (K)‑sodium alginate (A) based wound dressings by loading green synthesized zinc oxide nanoparticles (ZnO NPs) using C. roseus (leaf extract) and M. recutita (Chamomile flower part) herbal drug (CH) as a bioactive dual antibacterial wound dressing for the first time. The optimized ZnO NPs and CH exhibits strong physiochemical and electrostatic interactions (FT-IR, XRD and SEM) on the fabricated K-A-CH-ZnO biopolymeric mats. Moreover, the tiny porous network of the biopolymeric mat enhances thermal stability, hydrophilicity, mechanical strength and explores the water vapor transmission (2538.07 g/m2/day) and oxygen permeability (7.38 ± 0.31 g/m2) to maintain moist environment and cell-material interactions. During enzymatic degradation studies, ZnO NPs and CH of biopolymeric mat not only retains structural integrity but also increases the characteristic of swelling with sustained drug release (57 %) in 144 h which accelerates wound healing process. Also, K-A-CH-ZnO mat exhibited excellent antibacterial effects against B. subtilis and E. coli. Furthermore, NIH 3T3 fibroblast cell behavior using MTT assay and in vivo evaluations of biopolymeric mat depicted enhanced biocompatibility with increased collagen deposition at the wound site as a prominent dual drug medicated antimicrobial wound dressing.

Advances of antimicrobial dressings loaded with antimicrobial agents in infected wounds.

Wound healing is a complex process that is critical for maintaining the barrier function of the skin. However, when a large quantity of microorganisms invade damaged skin for an extended period, they can cause local and systemic inflammatory responses. If left untreated, this condition may lead to chronic infected wounds. Infected wounds significantly escalate wound management costs worldwide and impose a substantial burden on patients and healthcare systems. Recent clinical trial results suggest that the utilization of effective antimicrobial wound dressing could represent the simplest and most cost-effective strategy for treating infected wounds, but there has hitherto been no comprehensive evaluation reported on the efficacy of antimicrobial wound dressings in promoting wound healing. Therefore, this review aims to systematically summarize the various types of antimicrobial wound dressings and the current research on antimicrobial agents, thereby providing new insights for the innovative treatment of infected wounds.