Conventional Dressings Research Articles

Collagen-Based Nanoparticles as Drug Delivery System in Wound Healing Applications.

Conventional wound dressings often adhere to wounds and can cause secondary injury due to their lack of anti-inflammatory and antibacterial properties. In contrast, collagen-based nanoparticles (NPs) as drug delivery systems exhibit both biocompatibility and biodegradability, presenting a promising avenue for accelerating wound healing processes. This review aims to provide a comprehensive overview of the mechanisms involved in wound healing, description of the attributes of ideal wound dressings, understanding of wound healing efficacy of collagen, exploring NPs-mediated drug delivery mechanisms in wound therapy, detailing the synthesis and fabrication techniques of collagen-based NPs, and delineating the applications of various collagen-based NPs infused wound dressings on wound healing. This review synthesizes relevant literature from reputable databases such as Scopus, Science Direct, Google Scholar, and PubMed. A diverse array of collagen-based NPs, including nanopolymers, metal NPs, nanoemulsions, nanoliposomes, and nanofibers, demonstrate pronounced efficacy in promoting wound closure and tissue regeneration. The incorporation of collagen-based NPs has not only become an agent for the delivery of therapeutics but also actively contributes to the wound healing cascade. In conclusion, In brief, the use of collagen-based NPs presents a compelling strategy for expediting wound healing processes.

Defining critical quality attributes and composition parameters for burn wound dressings: Antibiotic-anesthetic films as a model

The management of wounds primarily revolves around pain relief, effective infection control and the promotion of tissue regeneration to prevent complications like chronic skin wounds. While polymeric bioactive films are innovative alternatives to conventional wound dressings, there exists a dearth of guidance regarding their quality control. This underscores the imperative need to establish precise critical quality attributes, a task undertaken within this study using an antibiotic-anesthetic film as a model. The aim was to establish the influence of critical composition and process parameters and optimize the formula.First, the quality target product profile was defined, and critical quality attributes were identified. Our material selection included ciprofloxacin hydrochloride (an antimicrobial), lidocaine hydrochloride (an anesthetic), as well as excipients, such as sodium alginate, sodium hyaluronate, carbomer and glycerol. The critical components were identified through a risk assessment matrix, and their influence on film composition was determined by experimental verification using Design-Expert® software. A full factorial design was employed to assess the effects of sodium hyaluronate, carbomer and glycerol (as independent variables) on transparency, homogeneity, folding capacity and handling. Following this, an optimized formulation was achieved and subjected to further characterization.These optimized antibiotic-anesthetic films exhibited uniform micro-distribution of components, ensuring dosage uniformity. Both ciprofloxacin hydrochloride and lidocaine hydrochloride displayed sustained release profiles, suggesting potential therapeutic benefits for skin wounds. Furthermore, the resistance and elongation properties were similar to those of human skin.Utilizing a QbD approach, we successfully developed an optimized antibiotic-anesthetic film that adhered to the essential critical quality attributes. This films exhibits potential utility as a wound dressing. The findings presented in this study establish a fundamental framework for delineating the critical quality attributes of dressing films and refining their formulation to optimize wound treatment.

Hydrogen‐Bonded Organic Frameworks as a Carrier for Nanodrugs with Host–Guest Interaction for Smart Wound Dressing Applications

AbstractThis study introduces surface modification to conventional dressings utilizing adducts of a hydrogen‐bonded organic framework (HOF) with curcumin, curcumin–silver, curcumin‐zinc oxide nanoparticles, and citric acid drugs. Accordingly, eight HOF‐AMs and dressings modified with them were studied. The synthesized structures underwent characterization using various methods, including IR, 1H NMR, XRD, FE‐SEM, and EDX. FE‐SEM results show that the hexagonal morphology is maintained along with the crystal growth in the form of hexagonal tubes. In order to confirm the nanoscale nature of the structures, TEM analysis was conducted specifically for curcumin‐Ag nanoparticles and curcumin–ZnO nanoparticles which confirms the particle size smaller than 50 nm. Knowing the sensitivity of the release of the incorporated substances to temperature and pH, the controlled release of the drugs at two different temperatures (37 °C and 40 °C) and pH levels of 5.5, 7.4, and 9 at the modified dressings was investigated. Investigating the release of HOF‐AMs particles and modified dressings indicates that these products in both cases provide the possibility of drug release in alkaline and acidic pHs. Also, the results showed that increasing the temperature increases the release of curcumin particles in all its types. The modified dressings showed a loading capacity of more than 50 mg g−1.

A comparative analysis of vacuum assisted closure therapy and conventional dressings: outcomes in chronic diabetic foot ulcers among Indian patients

Background: India faces a growing diabetes epidemic, with approximately 77 million individuals affected. Chronic non-healing diabetic foot ulcers (DFUs) are a common complication of diabetes and a major healthcare challenge in Conventional wound care methods often result in prolonged healing times, increasing the risk of infection, hospitalization, and amputations. Vacuum-assisted closure (VAC) therapy, a modern treatment modality, offers a potentially more effective approach to managing these ulcers. Methods: This prospective, observational study was conducted at a tertiary care hospital in India from March 2022 to March 2024. One hundred patients with chronic non-healing DFUs were randomized into VAC therapy or conventional dressing groups. The primary outcomes included wound size reduction and healing time, while secondary outcomes involved patient satisfaction and cost-effectiveness. Results: VAC therapy significantly reduced wound size (65.2% vs. 40.5%) and shortened healing time (6.2 vs. 10.9 weeks) compared to conventional dressings. Additionally, VAC therapy led to higher patient satisfaction and proved more cost-effective due to fewer dressing changes and shorter hospital stays. Conclusions: VAC therapy outperforms conventional dressings in managing DFUs, offering faster healing, better patient satisfaction, and cost-effectiveness. Expanding its use in India could greatly improve diabetic foot care outcomes.

The Negative Pressure Wound Therapy for Flap Salvage

Negative Pressure Wound Therapy (NPWT) effectively manages complex wounds by promoting fluid drainage, stabilizing the wound environment, and reducing bacterial load. It aids in granulation tissue formation and modulation of inflammatory reactions. NPWT is increasingly used in reconstructive surgery, particularly in flap procedures, enhancing wound healing and cosmetic outcomes while reducing flap complications. Despite concerns about flap compromise, clinical trials demonstrate low flap loss rates with NPWT. Strategies like observation windows and implantable Doppler devices help overcome monitoring challenges. However, conclusive evidence regarding NPWT's safety and impact on flap vascularity is limited due to scarce studies. The study involved 40 healthy adult patients, mostly male, with soft tissue defects primarily caused by road traffic accidents. They were split into two groups: NPWT (25 patients) and conventional dressing (15 patients). The NPWT group was further categorized into high pressure (8 patients) and low pressure (17 patients) subgroups. Results showed lower flap edema in NPWT groups compared to controls, but high pressure NPWT led to higher flap ischemia and infection rates. Overall, low pressure NPWT yielded the best clinical and aesthetic outcomes with fewer complications. The study suggests a delayed NPWT approach and low-pressure settings for optimal vascular perfusion in Fasciocutaneous flaps, emphasizing the need for further trials to establish its efficacy and determine ideal pressure settings for different flap types.

Combined local flap placement and negative-pressure wound therapy for the management of critical peritracheostomal pharyngocutaneous fistula

ObjectivePeritracheostomal pharyngocutaneous fistula (PCF), a direct connection between the PCF and tracheal stoma due to a skin defect, is among the most problematic complications after total laryngectomy or pharyngolaryngectomy. Peritracheostomal PCFs can cause lethal complications, including severe pneumonia or carotid blowout, secondary to salivary leakage directly into the tracheal stoma, and their management is challenging without early invasive surgical closure. We aimed to evaluate the utility of our novel and minimally invasive combined local skin flap placement and negative-pressure wound therapy (NPWT) method for the management and conservative closure of peritracheostomal PCFs. MethodsWe retrospectively enrolled patients who developed a peritracheostomal PCF from July 2015 to September 2021 at our institution and affiliated hospitals. Postoperative PCFs were all initially managed with appropriate wound bed preparation. Subsequently, a small local flap of healthy, lower neck skin was elevated and transferred anterior to the PCF to replace the peritracheostomal skin defect. The flap served to provide a sufficient surface for film dressing attachment and facilitated airtight sealing during NPWT. We initiated NPWT after confirming the local skin flap was firmly sutured to the tracheal mucosa. A flexible hydrocolloid dressing was applied to the peritracheostomal skin flap, and a film dressing was placed on the flexible hydrocolloid dressing and surrounding cervical skin. We inserted the NPWT foam shallowly into the fistula tract and applied negative pressure (73.5–125 mmHg). NPWT was continued until the PCF was closed or became so small that salivary leakage was minimal and could be managed by conventional compression dressings. ResultsWe enrolled six patients [male, n = 6; mean age, 66.5 years (range, 57–80 years)]. NPWT was applied for an average of 18.2 days (range, 2–28 days). During NPWT, air leakage occurred once (2 cases), only a few times (2 cases), or not at all (2 cases). In all patients, complete fistula closure was achieved in an average of 28.2 days (range, 15–55 days) after the start of NPWT, and no patient required further surgical intervention. There were no lethal complications (e.g., severe pneumonia) during treatment. ConclusionOur method of combined local flap placement and NPWT enabled effective management of salivary aspiration and accelerated wound healing, which allowed conservative fistula closure in all patients. We believe combined local flap placement and NPWT should be considered a first-line treatment for intractable peritracheostomal PCF.

Closed-incision negative-pressure wound therapy after Bascom's cleft lift surgery for pilonidal sinus disease: A randomized study comparing healing.

Despite favourable outcomes in recurrence after off-midline closure techniques in pilonidal surgery, between 18% and 40% of patients suffer from prolonged postoperative wound healing. The aim of this work was to investigate if closed-incision negative-pressure wound therapy (NPWT) promotes wound healing after Bascom's cleft lift (BCL) surgery for complicated pilonidal sinus disease compared with conventional drainage and dressing. Patients were randomized to either NPWT for 4-7 days or loop-vessel drain for 24 h and a dry dressing postoperatively. Healing was evaluated by a wound care nurse blinded for randomization at 2 and 12 weeks postoperatively (primary endpoint). Healing was defined as one or no closing defects of ≤5 mm and with no undermining. Although we had wanted to recruit 200 patients, the study was terminated at 118 patients (NPWT group, n = 60; control group, n = 58) after interim analysis. Patients were comparable by age, sex, body mass index, previous smoking status and indication for BCL surgery. At 2 weeks 12% of patients were healed in both the NPWT and control groups [risk difference = 0.00(95% CI -0.12 to 0.11), p = 1.00]. After 12 weeks, 68% of patients were healed in the NPWT group and 72% in the control group [risk difference = -0.03 (95% CI 0.19 to 0.13), p = 0.82]. There was no significant difference in pain experienced postsurgery. In a symptom-based questionnaire, the control group reported self-esteem to be less affected (p = 0.015). Closed-incision negative-pressure wound therapy did not significantly improve healing after BCL surgery for complicated pilonidal sinus disease.

N-succinyl chitosan-oxidized hyaluronic acid-calcium chloride hydrogel as hemostatic agent.

This study aims to develop an effective hemostatic agent in the management of irregular and deep wounds that can accelerate the hemostatic process. The background revealed the importance of rapid treatment of bleeding, with data showing a significant risk of death from blood loss. Current treatments use conventional hemostatic dressings, but they are less effective on irregular surgical wounds. Several studies have developed chitosan, hyaluronic acid, and CaCl2-based hydrogels that have hemostatic, regenerative, and antibacterial potential. However, there is still a need to develop hydrogels that are thermally stable, biocompatible, and able to accelerate the hemostatic process. This research will synthesize self-healing hydrogels by modifying the structure of chitosan and hyaluronic acid, using a certain ratio of ingredients. The research procedure was carried out with the preparation of N-succinyl chitosan (NSC) and oxidized hyaluronic acid (OHA) as the main ingredients which were then added with CaCl2 to produce self-healing injectable hydrogel. First, NSC and OHA were dissolved in phosphate buffer solution (pH = 7.4 PBS) to obtain 60 mg/mL NSC and OHA solution respectively. Calcium chloride was then dissolved in water to obtain 120 mg/mL CaCl2 solution. Then NSC-OHA-CaCl2-based hydrogels were synthesized through rapid and full solution mixing above room temperature with the composition of (1-1-0.1; 1-1-0.2; and 1-1-0.3). The targeted findings of this research are sample characterization results that explain and prove the best NSC-OHA-CaCl2 composition variation that can be used as a hemostatic agent for irregular and deep wounds. The results of the analysis obtained FTIR test data with the formation of C = N functional groups in the four samples; blood clotting time test for sample K0, K1, K2, and K3 with time 4.6, 3.33, 2.66, and 1 s; MTT assay with cell viability percentage of 77.82% for sample K0, 84.18% for sample K1, 89.30% for sample K2, and 89.50% for sample K3; hemolysis index percentage of 0.373% for sample K0, 0.555% for sample K1, 0.625% for sample K2, and 0.201% for sample K3; Viscosity test obtained data of 13 dPa s for sample K0, 15 dPa s for sample K1, 16 dPa s for sample K2, and 18 dPa. The injectability test yielded an injectability percentage of 96.84% for sample K0, 95.03% for sample K1, 94.78% dPa s for sample K2, and 94.61% for sample K3; the DSC test results of the four samples obtained a transition peak at the exothermic peak of 62.27°C for sample K0, 70.23°C for sample K1, 73.77°C for sample K2, and 74.49°C for sample K3; and the characteristic graph of the TGA test results, the weight profile of the hydrogel during heating which showed a mass change of 21.64 mg in sample K0, 16.89 mg in sample K1, 15.37 mg in sample K2, and 11.43 mg in sample K3 (°C).

The Efficacy of Negative Pressure Wound Therapy (NPWT) on Healing of Diabetic Foot Ulcers: A Literature Review.

Diabetes mellitus is a complex disorder that requires continuous management to control blood sugar levels and prevent complications. Diabetic foot ulcers (DFU) are the most common complication in diabetic patients. A popular therapy modality with considerable advantages in the management of diabetic foot ulcers today is negative pressure wound therapy (NPWT). This study aimed to review related articles about the efficacy as well as the complications or adverse effects of using NPWT on the healing of DFUs. Searching English databases from PubMed, Ebscohost, Proquest and Science Direct was done to identify relevant citations published between January 2017 and January 2022. A combination of terms was used with the boolean formulation of "negative pressure wound therapy OR NPWT" OR "vacuum-assisted closure or VAC" AND "diabetic foot ulcers OR diabetic foot wound" AND "wound healing" AND "Conventional dressings" and map terms were also used for the subject heading. Some potentially relevant citations of articles from the bibliographies are also reviewed. This study included 8 related articles consisting of 6 RCTs, 1 cohort study and 1 Quasy experimental study. There were various methodological techniques for using NPWT and outcome measures among studies. The results of this literature review showed that NPWT was more efficacious than the other conventional or advanced moist dressings. This therapy revealed a faster healing time with complete wound healing and formation of granulation tissue and reduction in wound size. The complications or adverse effects of NPWT, such as amputation rate, bleeding and pain, were not different from conventional or advanced moist dressings, though. NPWT was more efficacious than other conventional or advanced moist dressings for the healing of DFUs. However, complications or adverse effects of using this therapy showed no significant difference with other conventional or advanced moist dressings.

Recombinant Keratin-Chitosan Cryogel Decorated with Gallic Acid-Reduced Silver Nanoparticles for Wound Healing.

Wound healing is a complex physiological process that can be roughly divided into four stages: hemostasis, inflammation, proliferation, and remodeling. Conventional wound dressings often fail to meet the diverse needs of these healing stages due to their limited functionality. Cryogels, however, possess several attractive properties, such as large, interconnected pores, good mechanical strength, and ease of modification, making them suitable for developing advanced dressings with multiple functions. In this study, we developed a multifunctional cryogel dressing, with biocompatible polysaccharides as the main component, designed to provide a breathable, moist, and antibacterial microenvironment for chronic infected wounds, thereby promoting wound healing. Recombinant keratin 31 (RK31) was combined with chitosan (CS) to produce a CS/RK31 cryogel, referred to as CK. Gallic acid-reduced silver nanoparticles (GA/Ag NPs) were incorporated as the active antibacterial component to create the CS/K31@GA/Ag cryogel, known as CKGA. The cryogel was characterized using scanning electron microscopy (SEM) and a universal testing machine, and its biocompatibility was assessed in vitro. The dynamic hemostatic performance of the cryogel was evaluated with a rat tail amputation bleeding model. Additionally, the antibacterial effects of the cryogel against Staphylococcus aureus and Escherichia coli were tested using agar diffusion assays and turbidimetry. The antioxidant capacity of the CKGA cryogel was also measured in vitro. Finally, the cryogel's ability to promote wound healing was tested in an SD rat model of infected wounds. Characterization results showed that the CKGA cryogel features an interpenetrating porous network structure and exhibits excellent mechanical properties, with a swelling rate of up to 1800%. Both in vitro and in vivo experiments confirmed that the cryogel has good biocompatibility, effectively absorbs exudates, and rapidly stops bleeding. The addition of GA/Ag NPs provided significant antibacterial effects, achieving an inhibition rate of over 99.9% against both S. aureus and E. coli. Furthermore, CKGA cryogels demonstrated a strong scavenging capacity for ROS in a dose-dependent manner. Studies using the SD rat infected wound model showed that the cryogel effectively inhibited bacterial proliferation on wound surfaces, reduced local tissue inflammation, and promoted the healing of infected wounds. The multifunctional cryogel, with its rapid hemostatic, antibacterial, and antioxidant properties, as well as its ability to promote cell proliferation, could be widely used as a wound dressing for the healing of bacterial infections.

Multifunctional poloxamer-based thermo-responsive hydrogel loaded with human lactoferricin niosomes: In vitro study on anti-bacterial activity, accelerate wound healing, and anti-inflammation

Chronic wound infections are attributed to delayed tissue repair, which remains a major clinical challenge in long-term health care. Particularly, infections with antibiotic resistance have more serious effects on health, often resulting in unsuccessful treatments. Thus, antimicrobial peptide (AMP)-based therapy holds promise as a potential therapeutic approach to overcoming drug resistance. Conventional wound dressing is a passive strategy for wound care that is not capable of eradicating pathogens and promoting tissue repair. In this study, we aim to construct an advanced wound dressing; a thermo-responsive hydrogel incorporated with lactoferricin (Lfcin) niosome (Lfcin-Nio/hydrogel) for bacterial pathogen treatment. The Lfcin-loaded niosome (Lfcin-Nio) has a particle size of 396.91 ± 20.96 nm, 0.38 ± 0.01 of PdI, −10.5 ± 0.3 mV of ζ potential, and 72.30 ± 7.05 % Lfcin entrapment efficiency. Lfcin-Nio exhibited broad antibacterial activity on both drug-susceptible and drug-resistant strains, and also on bacteria residing in the biofilm matrix. The Lfcin-Nio/hydrogel was fabricated from 0.5 % w/v poloxamer 188–20 % w/v poloxamer 407, and supplemented with Lfcin-Nio and epidermal growth factor (EGF). The physical properties of Lfcin-Nio/hydrogels showed elasticity, swelling ability, and strong injectability with responsiveness to 33–37 °C temperatures. The biological properties of Lfcin-Nio/hydrogels exhibited a bactericidal effect against drug-resistant strains of S. aureus and P. aeruginosa, and showed less toxicity to the human skin fibroblast. It also promoted the healing of scratches by 55 % within 6 h, compared to the wound closure rate of 20 % in the cell control. The inflammatory response of the Lfcin-Nio/hydrogel-treated cells was reduced via suppression of IL-1β and COX-2 mRNA expressions. From this study, Lfcin-Nio/hydrogels can be suggested as a modern wound dressing that possesses multifunctional and beneficial properties for the management of chronic wound infections.

Wireless Micro Current Stimulation (WMCS) therapy to enhance burn wound healing: A randomized clinical trial

BackgroundPediatric burn injuries are often associated with significant morbidity, and require specialized care. The primary advantage of Wireless Micro Current Stimulation (WMCS) is the ability to deliver electric current without direct contact with the wound, which is particularly advantages in the pediatric population, wounds over multiple areas, and over sensitive regions. MethodsA prospective, randomized trial was performed. Patients with partial thickness burns were recruited into the study over a 5-year period, and randomly assigned to one of two groups – Conventional dressings group and WMCS therapy group. Time to wound healing, adverse effects and risk of burn wound conversion were evaluated. ResultsAverage percentage of total body surface area (TBSA%) of burn injuries for patients in both groups were 1.39% and 2.78% respectively.Median time to healing was 2 days faster in WMCS group (6 days vs 8 days; p=0.0057). 1 burn (5.9%) from WMCS group and 5 (20.8%) from conventional dressings group progressed to deeper injuries (p=0.261). Most common symptoms reported during therapy in both groups were pain and itch. ConclusionOur study shows statistically significant improvement in healing time with WMCS therapy. This is despite two times higher average TBSA% noted in the WMCS group.

Comparative efficacy of autologous platelet rich plasma and conventional dressing in the management of chronic ulcers

Background: Chronic ulcers pose a major global healthcare challenge. The use of platelet-rich plasma (PRP) for treating these wounds has garnered interest because of its potential healing benefits. Objective were to determine the effect of autologous PRP therapy on the percentage of surface area reduction/healing in chronic ulcers. Methods: This randomized controlled trial was conducted at the department of general surgery of M.M. institute of medical sciences and research (M.M.I.M.S.R.) Mullana, Ambala from May 1, 2023, to April 30, 2024. Patients aged 18-80 years of either gender with chronic ulcers were enrolled. Patients were randomly allocated to the PRP group and control group. PRP group was administered autologous PRP once in two weeks for 6 weeks after debridement, while for the control group conventional saline dressings were done after debridement. Final assessment was done at 8 weeks. Results: Of the 60 patients, the mean age was 53.90±11.23 years. There were 49 (82%) males and 11 (18%) females. At 8 weeks, the PRP group achieved 83.78% (SD=2.99) reduction in surface area of ulcers, whereas the control group had a 57.78% (SD=1.32) reduction in surface area of ulcers, with a p=0.0000 indicating a significant difference. The small sample size and 56-day follow-up period are insufficient to assess long-term treatment effects. Conclusions: A better outcome of PRP was observed compared to conventional dressing in patients with chronic non-healing ulcers.

A Prospective, Interventional, Comparative Study to Evaluate the Efficacy of Using Combined Platelet-Rich Plasma and Platelet-Rich Fibrin Over Standard Cleaning and Dressing in Chronic Wounds.

Chronic wounds are defined as wounds that have failed to proceed through the orderly process that produces satisfactory anatomic and functional integrity or that have proceeded through the repair process without producing an adequate anatomic and functional result. The majority of wounds that have not healed in three months are considered chronic, although a duration as low as four weeks has been used to indicate chronicity.Our study aimed to compare the efficacy of autologous platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) versus standard cleaning and dressing as a regenerative medicine strategy to promote healing in chronic wounds. A prospective randomized controlled trial was undertaken to test the efficacy of autologous PRPand PRFin the healing of chronic wounds. A series of 60 cases was compiled from patients attending the outpatient department regularly for the management of chronic wounds. A total of 30 cases were randomly chosen for study with autologous PRP and PRF and 30 cases received conventional dressing. The average healing duration in the study was significantly shorter for the PRP & PRF group. The mean healing time for this group was 4.45 weeks (31.2 ± 3.07 days) compared to 9.61 weeks (67.27 ± 9.19 days) for the conventional dressing group. PRP and PRF belong to a new generation of platelet concentrates that help efficaciously for enhanced healing and functional recovery, safely and cost-effectively. They help by shortening the recovery period overall, improving the quality of life of patients, and altogether eliminating the additional morbidity of operative procedures.

Near-Infrared Stimuli-Responsive Hydrogel Promotes Cell Migration for Accelerated Diabetic Wound Healing.

Diabetic wound healing including diabetic foot ulcers is a major clinical challenge, which could bring an increased level of mortality and morbidity. However, conventional wound dressings exhibit limited healing efficacy due to their lack of active modulation for the healing process. Here, a near-infrared (NIR) stimuli-responsive composite hydrogel dressing with the synergistic effect of both mechanical contraction and epithelial-mesenchymal transition (EMT) was developed to facilitate cell migration and vascularization for diabetic wound healing. In the methacrylated gelatin-based composite hydrogel, N-isopropylacrylamide and polydopamine nanoparticles were incorporated to endow the composite hydrogel with thermosensitive and photothermal properties. Linagliptin (LIN) was loaded into the composite hydrogel, and the drug release rate could be controlled by NIR laser irradiation. NIR-triggered on-demand active contraction of wound area and LIN release for biological stimulation were potentially realized in this responsive system due to the thermally induced sol-gel transition of the composite hydrogel. The release of loaded LIN could effectively promote cell migration by activating EMT and enhancing angiogenesis. In the full-thickness skin defect model, the LIN-loaded composite hydrogel with NIR laser irradiation had the highest wound closure rate as compared with the pure hydrogel and LIN-loaded hydrogel groups. Therefore, this composite hydrogel can serve as an excellent platform for promoting wound healing and will find more practical value in clinical treatment.

Early experience using vacuum-assisted closure for managing soft tissue injuries in open type IIIB tibial fractures, a non-randomised controlled trial from a North African level one trauma centre

Purpose: The primary objective was to investigate our early results of using vacuum-assisted closure (VAC) for wound management in patients with open IIIB tibial fractures and compare the results with a group subjected to conventional daily dressing. Methods: A prospective non-randomised clinical trial (NRCT) with a parallel design and allocation ratio of 1:1 was conducted after obtaining ethical committee approval. Forty skeletally mature patients with unilateral type IIIB open tibia fractures were included over two years, starting from April 2019. In group A, patients were treated with VAC, which was changed every four days if needed, and in group B, patients had daily conventional dressings. Results: Both groups had no differences in the basic demographic, comorbidities, injury mechanism, and associated injuries. The need for secondary debridement surgeries was significantly lower in Group A than in Group B, 1 ± 0.50 versus 2.50 ± 0.85, respectively ( P < 0.001). The time till definitive coverage was significantly lower in Group A than in Group B, 12.22 ± 2.90 versus 23.56 ± 8.68 (days); P < 0.001. All coverage procedures succeeded in Group A, while four (20%) failed in Group B, P = 0.04. Infection was higher in Group B, with six (30%) patients compared to one (5%) in Group A, P = 0.01. Conclusion: Reports on VAC's role in managing severe open fracture wounds are rare in our area, and the initial results we obtained are encouraging, with lower infection rates and less cumbersome reconstruction procedures; however, further evaluation of the procedure's cost-effectiveness is mandatory.

Pressure makes diamonds? The impact of closed incision negative pressure wound therapy on complications following abdominoplasty in patients with massive weight loss—results from a case controlled trial

BackgroundThe effectiveness of closed incision negative pressure wound therapy (ciNPWT) has been shown across various studies. However, studies with large patient cohorts comprising post-bariatric patient populations are missing. The objective of this research was to assess the influence of ciNPWT on post-operative wound complications in this demanding patient collective. MethodsWe conducted a retrospective case-control study. Between 1 January 2013 and 31 December 2023, a total of 251 abdominoplasty procedures following massive weight loss were identified. Patients were matched based on resection weights. We matched 118 patients separated into two groups depending on post-surgical wound management (conventional wound dressings vs ciNPWT). The primary outcomes were wound-related disorders and secondary outcomes were the number of readmissions or reoperations within 30 days after the initial surgery. ResultsThe study revealed equal incidence of seroma formation (15 vs 15, p = 1.0), rates of wound dehiscence (23 vs 20, p = 0.56), surgical site infection (11 vs 6, p = 0.18), hematoma (17 vs 9, p = 0.07), complete removal of all drainages (6.7 vs 6.1 days, p = 0.34) and total number of readmission (12 vs 11, p = 0.77) or reoperations (12 vs 10, p = 0.63) within 30 days. The second hospital stay caused by revision was significantly shorter in the ciNPWT group (5.8 days vs 12.0 days, p = 0.02). ConclusionConsequently, we did not find evidence to support the hypothesis that ciNPWT reduces complications after abdominoplasty in patients with massive weight loss.

A multifunctional polyacrylonitrile fibers/alginate-based hydrogel loaded with chamomile extract and silver sulfadiazine for full-thickness wound healing

Most conventional wound dressings do not meet the clinical requisites owing to their limited multifunctionality. Herein, a bilayer wound dressing containing both hydrogel and fibrous structures with multifunctional features was developed for effective skin rehabilitation. Sodium alginate (SA)/gelatin (Gel) hydrogel comprising Matricaria chamomilla L extract and silver sulfadiazine (AgSD) drug as antibacterial agents was cross-linked using genipin and CaCl2. Then, the surface of the hydrogel was covered by electrospun polyacrylonitrile (PAN) nanofibers to fabricate a bilayer dressing. FESEM images revealed formation of continuous, smooth, and bead-free PAN nanofibers with excellent compatibility between hydrogel and fibers. The bilayer wound dressing exhibited satisfactory mechanical virtues including elastic modulus (2.4 ± 0.2 MPa), tensile strength (6.2 ± 0.5 MPa) and elongation at break (21.8 ± 1 %) as well as suitable swelling ratio. Such bilayer dressing revealed biodegradability, cytocompatibility and effective antibacterial performance against gram positive and gram negative strains. Release kinetics of AgSD drug followed a Fickian diffusion mechanism, ensuring sustained drug release. In vivo studies demonstrated bilayer dressing could promote rate of wound closure, re-epithelialization and collagen deposition, facilitating the replacement of damaged skin with healthy tissue. Such engineered wound dressing has a high potency for inducing skin repair and could be used in skin tissue engineering.

NIR-driven intense UV upconversion films for non-contact high-efficiency prevention of bacterial infections

Bacterial infections on wounds imposes a significant limitation to the wound healing. Although the conventional drug antibacterial dressing is employed for hindering bacterial infection, the inevitable microbial resistance and secondary damage severely limit the quality and speed of wound healing. Herein, the NIR-driven intense UV upconversion (UC) BaLu2F8:80%Yb3+/0.5%Tm3+ microcrystals are, for the first time, designed and fabricated into solid sterilization film to protect the wounds from infections. Equipped with excessive Yb3+ sensitizers, the emission of Yb3+/Tm3+ co-doped monoclinic BaLu2F8 matrix achieve a 175-fold enhancement at the UV band. The UV UC microcrystals was further fabricated into a NIR-to-UV sterilization film with a diameter of 1.5 cm and a thickness of 150 μm using solution casting method, which can efficiently destroy 97 % of E. coli with a NIR irradiation of 5 minutes. Due to the outstanding penetrability of NIR irradiation, the sterilization film under 4 layers gauze dressing can be activated to produce UV photons. The in-vivo mouse tests demonstrate the well-designed NIR-to-UV sterilization film can speed up the wound healing by high-efficient inhibiting E. coli infection under the irradiation of 980 nm NIR laser. The non-contact NIR-driven UV sterilization film require no more drugs and dressing exchange, thus entirely eliminating the effect of microbial resistance and secondary damage from conventional drug dressing. Our work provides a new alternative for constructing highly-efficiency sterilization dressing through the utilization of NIR-to-UV optical conversion materials.

The Effectiveness of Silicon Wound Dressing for the Healing Process of Contaminated Abrasions

Wounds are skin disorders caused by pathological processes. Abrasion wounds are a type of acute injury. One of the contributing factors is traffic accidents. More than 1.2 million people died as a result of traffic accidents, while 20-50 million others suffered injuries. Choosing the proper dressing can determine wound healing. This case study aims to determine the effectiveness of silicone wound dressing in the healing process of contaminated abrasion wounds. Contaminated abrasion wounds are contaminated by dirty materials, which potentially cause infection. This case report describes four patients, Mrs. W, Mrs. K, Mr. Y, and Mr. M., who suffered abrasions on the face. Their wounds were cleaned in the operating room under general anesthesia. A silicone wound dressing is applied as the primary dressing. The secondary dressing depends on the amount of the exudate. On the 3rd day after the surgery, the wounds looked dry, so they were cleaned and reapplied with the silicone dressing. On the 7th day, after applying silicone wound dressing, the wound had epithelialized. Silicone wound dressing is a modern type of dressing that is effective for acute wounds as it provides a barrier against external contamination. Our sample shows that wound are abrasion contaminated. The result of silicone wound dressings applied was shown accelerate the wound healing process. Modern dressings accelerate wound healing 20% to 40% faster than conventional dressings, such as gauze, tulle, or gauze.