Chronic Wounds Research Articles

Self-Growing Hydrogel Bioadhesives for Chronic Wound Management.

Hydrogel bioadhesives have emerged as a promising alternative to wound dressings for chronic wound management. However, many existing bioadhesives do not meet the functional requirements for efficient wound management through dynamically mechanical modulation, due to the reduced wound contractibility, frequent wound recurrence, incapability to actively adapt to external microenvironment variation, especially for those gradually-expanded chronic wounds. Here, a self-growing hydrogel bioadhesive (sGHB) patch that exhibits instant adhesion to biological tissues but also a gradual increase in mechanical strength and interfacial adhesive strength within a 120-h application is presented. The gradually increased mechanics of the sGHB patch could effectively mitigate the stress concentration at the wound edge, and also resist the wound expansion at various stages, thus mechanically contracting the chronic wounds in a programmable manner. The self-growing hydrogel patch demonstrated enhanced wound healing efficacy in a mouse diabetic wound model, by regulating the inflammatory response, promoting the faster re-epithelialization and angiogenesis through mechanical modulation. Such kind of self-growing hydrogel bioadhesives have potential clinical utility for a variety of wound management where dynamic mechanical modulation is indispensable.

Preparing the soil: Adjusting the metabolic health of patients with chronic wounds and musculoskeletal diseases.

In recent years, systemic inflammation has emerged as a pivotal player in the development and progression of various degenerative diseases. This complex, chronic inflammatory state, often undetected, can have far-reaching consequences for the body's physiology. At the molecular level, markers such as C-reactive protein, cytokines and other inflammatory mediators serve as indicators of systemic inflammation and often act as predictors of numerous musculoskeletal diseases and even certain forms of cancer. The concept of 'meta-inflammation', specifically referring to metabolically triggered inflammation, allows healthcare professionals to understand inflammatory responses in patients with metabolic syndrome. Driven by nutrient excess and the expansion of adipose tissue, meta-inflammation is closely associated with insulin resistance, further propagating the metabolic dysfunction observed in many Western societies. Wound persistence, on the other hand, exacerbates the detrimental effects of prolonged inflammation at the local level. Acute inflammation is a beneficial and essential process for wound healing and infection control. However, when inflammation fails to resolve, it can impede the healing process, leading to chronic wounds, excessive scarring and even the activation of fibrotic pathways. This approach significantly reduces the efficacy of regenerative biological therapies. Our review focuses on the vital role of proteins, vitamins and minerals in collagen synthesis and cell proliferation for tissue healing. We also examine hormonal influences on regeneration, noting the negative effects of imbalances, and emphasize glucose regulation's importance in creating a stable environment for chronic wound healing.

Development of multifunctional H2S-releasing gold nanoparticles for chronic wound treatment

Chronic wounds, characterized by prolonged inflammation, require new therapies to improve healing. Hydrogen sulfide (H2S), a key neurotransmitter, supports critical factors in wound healing but is often deficient in chronic wounds. Despite its potential, the toxicity of direct H2S delivery and the unsustainable release from current systems hinder its therapeutic use. This study introduces H2S-releasing gold nanoparticles synthesized by reducing chloroauric acid (HAuCl4) with diallyl trisulfides (DATS), a naturally derived H2S donor. These nanoparticles are hypothesized to be biocompatible and multifunctional, combining H2S release with the beneficial properties of gold. Results show that DATS does not impair H2S release, and higher DATS concentrations enhance H2S output. The sustained H2S release promotes endothelial cell proliferation, migration, and angiogenesis while retaining the antimicrobial properties of gold nanoparticles, making this material promising for chronic wound treatment.

Multifunctional Janus nanofibrous membrane with unidirectional water transport and pH-responsive color-changing for wound dressing

Chronic wounds often produce a significant volume of exudate, posing a substantial obstacle to healing. Consequently, there is a pressing demand for a versatile dressing capable of effectively managing exudate in chronic wounds. In this context, a Janus smart dressing is proposed, featuring unidirectional water transport and a pH-responsive color-changing for exudate management and wound monitoring. The dressing’s mechanisms for unidirectional water transport and color changing are elucidated. The Janus dressing consists of a polyacrylonitrile (PAN)/sodium polyacrylate (SPA)/anthocyanin (An) hydrophilic layer with antioxidant and pH-sensitive functions and a poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) hydrophobic layer, enabling unidirectional exudate drainage without reverse osmosis. Studies indicate that the Janus dressing exhibits excellent air permeability, moisture permeability, mechanical properties, cytocompatibility, and antioxidant performance while promptly responding to color variations in solutions of varying pH levels. In vivo studies demonstrated the excellent wound healing ability of Janus PHBV-PAN/SPA/An membrane. Consequently, this study provides a promising solution to develop wound dressings that can effectively manage excessive wound exudate and dressing changes.

A Comparative Analysis of Patient-Reported Outcomes Following Free Tissue Transfer, Partial Foot Amputation, and Below-Knee Amputation in High-Risk Limb Salvage Patients.

The surgical decision for limb-salvage with free tissue transfer (FTT), partial foot amputation (PFA), or below-knee amputation (BKA) for complex lower extremity (LE) wounds hinges on several factors, including patient choice and baseline function. However, patient-reported outcome measures (PROMs) on LE function, pain, and QoL for chronic LE wound interventions are limited. Thus, the study aim was to compare PROMs in patients who underwent FTT, PFA, or BKA for chronic LE wounds. PROMs were collected via QR code for all adult chronic LE wound patients who presented to a tertiary wound center between June 2022 and June 2023. A cross-sectional analysis of patients who underwent FTT, PFA, or BKA was conducted. The 12-Item Short Survey (SF-12), PROM Information System Pain Intensity (PROMIS-3a), and Lower Extremity Functional Scale (LEFS) were completed at 1, 3, and 6 months and 1, 3, and 5 years postoperatively. Patient demographics, comorbidities, preoperative characteristics, and amputation details were collected. Of 200 survey sets, 71 (35.5%) underwent FTT, 51 (25.5%) underwent PFA, and 78 (39.0%) underwent BKA. Median postoperative time points of survey completion between FTT (6.2 months, IQR: 23.1), PFA (6.8 months, IQR: 15.5), and BKA (11.1 months, IQR: 21.3) patients were comparable (P = 0.8672). Most patients were male (n = 92, 76.0%) with an average age and body mass index (BMI) of 61.8 ± 12.6 years and 30.3 ± 7.0 kg/m2, respectively. Comorbidities for FTT, PFA, and BKA patients included diabetes mellitus (DM; 60.6% vs 84.2% vs 69.2%; P = 0.165), peripheral vascular disease (PVD; 48.5% vs 47.4% vs 42.3%; P = 0.790), and chronic kidney disease (CKD; 12.1% vs 42.1% vs 30.8%; P = 0.084). No significant differences were observed between FTT, PFA, and BKA patients in mean overall PROMIS-3a T-scores (49.6 ± 14.8 vs 54.2 ± 11.8 vs 49.6 ± 13.7; P = 0.098), LEFS scores (37.5 ± 18.0 vs 34.6 ± 18.3 vs 38.5 ± 19.4; P = 0.457), or SF-12 scores (29.6 ± 4.1 vs 29.5 ± 2.9 vs 29.0 ± 4.0; P = 0.298). Patients receiving FTT, PFA, or BKA for chronic LE wounds achieve comparable levels of LE function, pain, and QoL postoperatively. Patient-centered functionally based surgical management for chronic LE wounds using interdisciplinary care, preoperative medical optimization, and proper patient selection optimizes postoperative PROMs.

Nanocomposite conductive r(GO/BSA) hydrogel as an effective dressing for rapid chronic diabetic wound healing

Conductive hydrogels, with their soft, hydrated interface and superior electrical conductivity, represent a groundbreaking solution for diabetic wound healing. However, developing a conductive hydrogel with excellent biocompatibility has proven to be challenging. This study presents the synthesis of a novel conductive hydrogel composed of bovine serum albumin (BSA) protein and graphene oxide (GO) for the treatment of diabetic wounds. The prepared hydrogel is mildly reduced by ascorbic acid to facilitate charge-transfer and enhance its conductivity. Hydrogel is optimized for enhanced mechanical and electrical properties by changing the concentration of GO within the BSA matrix. The nanocomposite hydrogel demonstrates superior antibacterial properties and enhanced biocompatibility compared to the BSA hydrogel. The prepared hydrogel is investigated for wound healing capacity in a rat model, where it demonstrates rapid healing of chronic diabetic wound. The improved therapeutic outcomes are attributed to the hydrogel's ability to facilitate cellular activities through enhanced electrical conductivity by maintaining continuous electrical signal at the wound site. The presented findings suggest that nanocomposite protein-based conductive hydrogel not only hold great potential for advanced diabetic wound care and have potential for future innovation in tissue engineering, regenerative medicine and beyond.

Co-creation and evaluation of an algorithm for the development of a mobile application for wound care among new graduate nurses: A mixed methods study.

Chronic wounds are a growing concern due to aging populations, sedentary lifestyles and increasing rates of obesity and chronic diseases. The impact of such wounds is felt worldwide, posing a considerable clinical, environmental and socioeconomic challenge and impacting the quality of life. The increasing complexity of care requires a holistic approach, along with extensive knowledge and skills. The challenge experienced by health-care professionals is particularly significant for newly graduate nurses, who face a gap between theory and practice. Digital tools, such as mobile applications, can support wound care by facilitating more precise assessments, early treatment, complication prevention and better outcomes. They also aid in clinical decision-making and improve healthcare delivery in remote areas. Several mobile applications have emerged to enhance wound care. However, there are no applications dedicated to newly graduate nurses. The aim of this study was to co-create and evaluate an algorithm for the development of a wound care mobile application supporting clinical decisions for new graduate nurses. The development of this mobile application is envisioned to improve knowledge application and facilitate evidence-based practice. This study is part of a multiphase project that adopted a pragmatic epistemological approach, using the 'Knowledge-to-Action' conceptual model and Duchscher's Stages of Transition Theory. Following a scoping review, an expert consensus, and stakeholder meetings, this study was pursued through a sequential exploratory mixed methods design carried out in two phases. In the initial phase, 21 participants engaged in semi-structured focus groups to explore their needs regarding clinical decision support in wound care, explore their perceptions of the future mobile application's content and identify and categorize essential components. Through descriptive analysis, five overarching themes emerged, serving as guiding principles for conceptual data model development and refinement. These findings confirmed the significance of integrating a comprehensive glossary complemented by photos, ensuring compatibility between the mobile application and existing documentation systems, and providing quick access to information to avoid burdening work routines. Subsequently, the algorithm was created from the qualitative data collected. The second phase involved presenting an online SurveyMonkey® questionnaire to 34 participants who were not part of the initial phase to quantitatively measure the usability of this algorithm among future users. This phase revealed very positive feedback regarding the usability [score of 6.33 (±0.19) on a scale of 1-7], which reinforces its quality. The technology maturation process can now continue with the development of a prototype and subsequent validation in a laboratory setting.

CAPE derivatives: Multifaceted agents for chronic wound healing.

Chronic wounds significantly impact the patients' quality of life, creating an urgent interdisciplinary clinical challenge. The development of novel agents capable of accelerating the healing process is essential. Caffeic acid phenethyl ester (CAPE) has demonstrated positive effects on skin regeneration. However, its susceptibility to degradation limits its pharmaceutical application. Chemical modification of the structure improves the pharmacokinetics of this bioactive phenol. Hence, two novel series of CAPE hybrids were designed, synthesized, and investigated as potential skin regenerative agents. To enhance the stability and therapeutic efficacy, a caffeic acid frame was combined with quinolines or isoquinolines by an ester (1a-f) or an amide linkage (2a-f). The effects on cell viability of human gingival fibroblasts (HGFs) and HaCaT cells were evaluated at different concentrations; they are not cytotoxic, and some proved to stimulate cell proliferation. The most promising compounds underwent a wound-healing assay in HGFs and HaCaT at the lowest concentrations. Antimicrobial antioxidant properties were also explored. The chemical and thermal stabilities of the best compounds were assessed. In silico predictions were employed to anticipate skin penetration capabilities. Our findings highlight the therapeutic potential of caffeic acid phenethyl ester (CAPE) derivatives 1a and 1d as skin regenerative agents, being able to stimulate cell proliferation, control bacterial growth, regulate ROS levels, and being thermally and chemically stable. An interesting structure-activity relationship was discussed to suggest a promising multitargeted approach for enhanced wound healing.

High-Quality Dietary Protein: The Key to Healthy Granulation Tissue.

To review the role of nutrition and high-quality dietary protein intake in creating healthy granulation tissue and optimize wound healing in patients with chronic wounds. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Summarize the structure and composition of proteins. 2. Specify the role of proteins in generating healthy granulation tissue and wound healing. 3. Explain the physiologic pathways involved in the wound healing process. 4. Describe evidence-based interventions to support nutrition in wound healing.

Polycaprolactone/gelatin-QAS/bioglass nanofibres accelerate diabetic chronic wound healing by improving dysfunction of fibroblasts

Worldwide, more than 25 % of patients with diabetes develop chronic diabetic wounds in their lifetime. Infection and dysfunctional fibroblasts represent two significant etiological factors contributing to impaired wound healing in patients with diabetes. It is therefore evident that the development of wound dressings with both anti-infective and DM fibroblast modulating functions has the potential for clinical applications. In this study, a PCL/gelatine-quaternary ammonium salts (QAS)/bioglass (BG) electrospun nanofibrous membrane was developed with physico-chemical and biological properties that not only meet the clinical requirements for wound dressings but also exhibit remarkable moisturising (water adsorption rate of 382.39 ± 4.36 %) and tear-resistance properties (a tear strength of ~5.5 MPa). The incorporation of QAS and BG has enhanced the biocompatibility and bioactivity of the nanofibres, while also imparting remarkable antimicrobial properties. The antibacterial efficacy of PGQ-BG against E. coli and S. aureus was found to be 92.8 ± 0.78 % and 99.3 ± 0.55 %, respectively. Moreover, it was demonstrated that PGQ-BG nanofibers exerted a promoting effect on the extracellular matrix (ECM) in dysfunctional fibroblasts and upregulated the expression level of α-smooth muscle actin (α-SMA), a marker of their differentiation to myofibroblasts in vitro and in vivo. Furthermore, the COL-III/COL-I ratio was significantly increased, indicating that PGQ-BG may also accelerate wound healing. The nanofibrous dressing reduced scar formation by increasing the COL-III/COL-I ratio. This is the first report of BG improving fibroblast dysfunction via COL-III and COL-I promotion in fibroblasts, both in vitro and in vivo. Therefore, this novel bioactive nanofibrous dressing represents an effective and safe therapeutic strategy for improving chronic wound healing in patients with diabetes.

Simvastatin and adenosine-co-loaded nanostructured lipid carriers for wound healing: Development, characterization and cell-based investigation

Chronic wounds represent a significant global health burden, characterized by delayed skin healing and associated comorbidities. The present study aimed to develop nanostructured lipid carriers (NLCs) as a topical delivery system for the co-administration of simvastatin and adenosine to address chronic wound management. The rationale behind the co-delivery approach was to mitigate the cytotoxicity associated with high-dose simvastatin, while preserving its therapeutic benefits through a potential synergistic or additive effect. A significant challenge in the development of these NLCs was the encapsulation of the highly hydrophilic adenosine within the hydrophobic lipid matrix. The NLCs were prepared using a hot homogenization-sonication method with a double emulsion technique and optimized through a series of formulation trials, employing various surfactants, solid and liquid lipids, to achieve efficient drug encapsulation, particularly for the hydrophilic adenosine. Optimized formulations F5- and F10-S/A 0.6 %/2 % (containing 0.6 % simvastatin and 2 % adenosine), exhibited promising physicochemical properties. The main difference was the liquid lipid used: F5 containing Miglyol 810 N, while F10 Capmul MCM C-8. Both formulations displayed a mean particle size below 230 nm, a polydispersity index (PDI) of approximately 0.2, and a zeta potential of around –22 mV. While simvastatin association efficiency (AE) was nearly 100 %, adenosine AE was higher for F10 (24 %), compared to F5 (13.5 %). F5 demonstrated superior stability compared to F10, maintaining consistent particle size and PDI over a 60-day period. Formulation F5 also demonstrated superior cell-based in vitro performance compared to F10, with higher cell viability (MTT assay), greater cell proliferation induction (SRB assay), and enhanced cell proliferation and migration in the wound-scratch assay. While F10 displayed higher adenosine AE, F5 excelled in terms of stability and biological activity. The slightly increase in intracellular reactive oxygen species levels observed with F5 may contribute to its enhanced proliferative effects. In-depth characterization revealed that F5 comprised spherical nanoparticles, and thermal analysis indicated no significant changes in the nanocarrier structure upon drug encapsulation. Additionally, ex vivo permeability study demonstrated superior skin retention of both simvastatin and adenosine for F5 compared to an emulsion control. Overall, the F5 nanocarrier demonstrated suitable physicochemical properties, cellular biocompatibility, induction of cell proliferation and migration events, and drug retention capacity in the skin layers, indicating its potential as a promising topical treatment for difficult-to-heal wounds.

Inflammatory regulation of squid cartilage gelatin with different molecular weights for treatment of chronic wounds in diabetes

Squid, as a very important economic marine species, accounts for 5 % of the total catch of fish and cephalopods. The waste from the processing process of squid can be used for collagen extraction, which has great application value in the field of biomedical materials. Here, we obtained squid cartilage gelatin (SCG) with different molecular weights by adjusti.ng the reaction conditions and used for the treatment of chronic wounds in diabetes. SCG extracted at low temperatures and short heating times demonstrated a more intact structure, higher molecular weight, and superior gel stability. Based on cell study and transcriptome analysis, SCG with high molecular weight significantly promoted cell adhesion, because it provided more contact sites for cells, whereas small molecules of SCG could directly reduce inflammation. Animal studies have demonstrated that SCG significantly promotes diabetic wound healing as evidenced by reducing inflammation, inducing vascular regeneration, promoting tissue growth, re-epithelialization, collagen deposition and remodeling. This study elucidated the immunoregulatory mechanisms of SCG with different molecular weights, and validated its potential application in chronic wound healing in diabetes.

Exudate Unidirectional Pump to Promote Glucose Catabolism Triggering Fenton-Like Reaction for Chronic Diabetic Wounds Therapy.

The massive accumulation of exudate containing high concentrations of glucose causes wound infection and triggers the release of inflammatory factors, which in turn delays the closure of diabetic wounds. In this study, a Janus membrane is constructed by combining glucose oxidase (GOx) and copper ions (Cu2+) for the treatment of diabetic wounds, which is named as Janus@GOx/Cu2+. It consists of hydrophobic, transitional, and superhydrophilic layers in a three-layer structure with gradient hydrophilicity for self-pumping properties. The Janus@GOx/Cu2+ membrane triggers a series of cascading reactions while pumping out diabetic wound exudates. First, glucose oxidase loaded onto the hydrophilic layer of the Janus@GOx/Cu2+ membrane decomposes glucose into hydrogen peroxide (H2O2) and glucuronic acid, reducing the local glucose level. The generated glucuronic acid neutralizes the local alkaline environment of chronic wounds. Simultaneously, the H2O2 interacts with the Cu2+ contained in the hydrophobic layers of the Janus@GOx/Cu2+ membrane via a Fenton-like reaction, generating hydroxyl radicals with excellent bactericidal properties. Cu2+ promotes angiogenesis and wound healing in diabetic wounds. Under the action of multiple responses, the Janus@GOx/Cu2+ membrane promotes wound healing in diabetic infections.

Unveiling the Various Analytical Techniques of Polyphenols for Pharmacological Activity and Nanotechnological Delivery in Wound Healing

Polyphenols are a diverse group of molecules known for their broad range of biological activities, making them valuable in therapeutic applications, including wound healing. Chronic wounds, which are often complicated by persistent infections and the rise of antibiotic resistance, present a significant challenge in the treatment. Traditional antibiotics are becoming less effective, necessitating the exploration of new antimicrobial agents. Polyphenols like hesperidin, chlorogenic acid, quercetin, and curcumin are promising candidates due to their natural antibacterial properties, offering an effective alternative to conventional antibiotics for treating chronic wounds. However, polyphenols face challenges such as limited stability, which can reduce their effectiveness at the wound site. Furthermore, to overcome these limitations, polymer-based systems have been developed as carriers to stabilize polyphenols and control their release over time, thereby enhancing their therapeutic efficacy. This article explores the potential of polyphenols as natural antibacterial agents and highlights various nanoparticulate systems as effective carriers for treating chronic wounds.

Homology-based identification and structural analysis of Pangasius hypophthalmus Annexins and Serine proteases to search molecules for wound healing applications

Chronic wounds and burns are a worldwide healthcare problem that erodes patients’ well-being and healthcare systems. This silent and costly epidemic requires new, cost-efficient solutions to improve patients’ physical and economic welfare. Eschar-degrading vegetal and bacterial proteases have been utilized as a solution. However, these proteins are evolutionarily far from those present in human wound healing. Serine protease (SP) and annexin (ANX) proteins interact within the skin healing process. A homology-based identification pipeline can help in discovering selective human SP and ANX analogs in the epithelial tissue of the fast-healing species, Pangasius hypophthalmus. In the present work, we found 14 candidates for RT-PCR in P. hypophthalmus using homology inference. The genetically detected candidates were then structurally and sequentially analyzed to understand their possible relation to SPs and ANXs involved in human wound healing. A total of six TBLASTN/BLASTX candidates (four SPs and two ANXs) were detected in P. hypophthalmus skin. Structural analysis revealed that all SP candidates resembled human KLK4, KLK5, KLK6, and KLK8, whereas all ANX only resembled human ANXA4. Structure and sequence analysis revealed high conservation of ANX Ca2+ binding sites (GDXD) and SP catalytic triad (HDS) motifs. In addition, structural analysis revealed that SP substrate selectivity position 186 was the main difference between human KLK5 and P. hypophthalmus SPs. These findings may allow the proposal and testing of more selective formulations, broadening treatments beyond debridement.

Essential Oils of Some Potential Medicinal Plants and their Wound Healing Activities.

The wound has been recognised as a deep cut or tearing of the epidermis, which is also referred to as trauma and harm to the body tissues. Healing of wounds requires a coordinated series of cellular processes, including cell attraction, proliferation, differentiation, and angiogenesis. These processes involve interactions between various cells, such as macrophages, endothelial cells, keratinocytes, fibroblasts, growth hormones, and proteases. The outcome of wounds can be fatal if not treated properly, resulting in chronic wounds, chronic pain, and even death. Wound healing is replacing missing tissue with tissue repairs and regeneration. Some local variables are the presence of tissue maceration, foreign objects, biofilm, hypoxia, ischemia, and wound infection. Sustained growth factor delivery, siRNA delivery, micro-RNA targeting, and stem cell therapy are all emerging possible therapeutic approaches for wound healing. Traditional approaches, such as Ayurveda, Siddha, and Unani medicines, are also being used for treatment. The therapeutic application of nanoformulations in wound infections has shown various beneficial effects. Several herbal medicines, especially essential oils have shown potential wound healing activities, such as lavender, tea tree, sesame, olive, etc. Various nanoparticles and their nanoformulations have been explored in wound healing therapy. The present review article highlights several aspects of essential oils for wound healing activity through a novel drug delivery system. Further, some patents on wound healing through herbal medicine have been listed.

A multi-purpose dressing based on resveratrol-loaded ionic liquids/gelatin methacryloyl hydrogel for enhancing diabetic wound healing

Diabetic wound (DW) is a multifaceted challenge, characterized by persistent bacterial infections and compromised angiogenesis. To address these issues and enhance DW healing, we developed a novel strategy using a photo-crosslinked hydrogel system composed of ionic liquids (ILs) and gelatin methacryloyl (GelMA) loaded with resveratrol (Res). The ILs/GelMA hydrogel was fabricated via a simple photo-crosslinking process, resulting in desirable mechanical properties, biocompatibility, and controlled release kinetics. Res was incorporated into the hydrogel matrix (ILs/GelMA@Res) to ensure sustained release, facilitating angiogenesis and accelerating wound healing. In vitro studies demonstrated that the ILs/GelMA@Res hydrogel exhibited potent antibacterial activity against Staphylococcus aureus and Escherichia coli, inhibiting bacterial growth and biofilm formation. Furthermore, the sustained release of Res from the hydrogel promoted angiogenesis by activating the PI3K/AKT signaling pathways associated with VEGF and FGF, enhancing endothelial cell proliferation, migration, and tube formation. In a DW mice model, the ILs/GelMA@Res hydrogel demonstrated accelerated wound closure, reduced inflammation, and robust neovascularization. This multifunctional hydrogel-based delivery system holds considerable potential for clinical translation, offering a safe and effective treatment modality for diabetic patients with chronic wounds.

Wireless matrix metalloproteinase-9 sensing by smart wound dressing with controlled antibacterial nanoparticles release toward chronic wound management

Chronic wounds cause serious health and economic burdens on patients and society. Herein, a wireless and flexible smart wound dressing was developed for matrix metalloproteinase-9 (MMP-9) monitoring and antimicrobial treatment toward chronic wound management. The highly sensitive radio frequency MMP-9 sensor was realized based on a bioresponsive hydrogel with bioactive sequences of the arginyl-glycyl-aspartic acid peptide. Taking advantage of the flexible inductive-capacitive (LC) circuit and bioresponsive hydrogel, the wireless and wearable smart wound dressing offered an efficient strategy for in-situ wound analysis. Besides, the controlled release of silver nanoparticles (AgNPs) from the degradable hydrogel exhibited significant antimicrobial efficacy against typical bacteria in wound infection including Escherichia coli and Staphylococcus aureus. The analysis of MMP-9 in wound exudate from diabetic foot ulcer (DFU) patients demonstrated good accuracy cross-validated with gold-standard fluorescent measurements, providing great potential for personalized wound management.

Role of Piezoelectricity in Disease Diagnosis and Treatment: A Review.

Because of their unique electromechanical coupling response, piezoelectric smart biomaterials demonstrated distinctive capability toward effective, efficient, and quick diagnosis and treatment of a wide range of diseases. Such materials have potentiality to be utilized as wireless therapeutic methods with ultrasonic stimulation, which can be used as self-powered biomedical devices. An emerging advancement in the realm of personalized healthcare involves the utilization of piezoelectric biosensors for a range of therapeutic diagnosis such as diverse physiological signals in the human body, viruses, pathogens, and diseases like neurodegenerative ones, cancer, etc. The combination of piezoelectric nanoparticles with ultrasound has been established as a promising approach in sonodynamic therapy and piezocatalytic therapeutics and provides appealing alternatives for noninvasive treatments for cancer, chronic wounds, neurological diseases, etc. Innovations in implantable medical devices (IMDs), such as implantable piezoelectric energy generator (iPEG), offer significant advantages in improving physiological functioning and ability to power a cardiac pacemaker and restore the heart function. This comprehensive review critically evaluates the role of piezoelectricity in disease diagnosis and treatment, highlighting the implication of piezoelectric smart biomaterials for biomedical devices. It also discusses the potential of piezoelectric materials in healthcare monitoring, tissue engineering, and other medical applications while emphasizing future trends and challenges in the field.

Nutrition intake and physical activity in patients with chronic wounds

Nutrition intake and physical activity in patients with chronic wounds