Conventional Wound Dressings Research Articles

Evaluation of a new low-cost negative pressure wound therapy in the treatment of diabetic foot ulcers.

To investigate the effectiveness of a new and low-cost negative pressure wound therapy (LC-NPWT) in the treatment of diabetic foot ulcers (DFUs). In this retrospective cohort study, patients from our inpatient clinic with Wagner grade 3 DFUs were given LC-NPWT or conventional wound dressings. The primary outcome was the wound healing rates. Complete wound healing, defined as complete re-epithelialisation of the wound, was recorded during the two months of follow-up. The definition of complete epidermis of the wound was that the skin was closed (100% re-epithelialisation), with no drainage or dressing. The secondary outcomes were the number of inpatient days and surgical procedures, and outcomes after hospital discharge. The wound score from the Bates-Jensen wound assessment tool and the levels of the inflammation factors procalcitonin (PCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were compared between the two groups. The Kaplan-Meier survival estimate was used to examine the cumulative wound healing rate. The study cohort comprised 41 patients. The two-month wound healing rate was higher in patients in the LC-NPWT group than in the control group (15/21 (71.4%) versus 8/20 (40.0%), respectively; p=0.043). At the end of the two-month follow-up period, the cumulative wound healing rate was higher in the LC-NPWT group than in the control group (p=0.032). Patients in the LC-NPWT group had fewer inpatient days (19.3±3.84 versus 25.05±4.81; p<0.001) and shorter duration of antibiotic use (32.14±3.89 days versus 36.10±5.80 days; p=0.014) than those who received conventional wound dressings. There were significant improvements in mean wound score between the LC-NPWT group and the control group (p<0.001). After one week of treatment, the blood levels of PCT (0.03±0.30ng/ml versus 0.07±0.08ng/ml; p=0.039), CRP (14.55±13.40mg/l versus 24.71±18.10mg/l; p=0.047) and ESR (42.05±29.29mm/h versus 61.65±22.42mm/h; p=0.021) were lower in patients who received LC-NPWT than those who received conventional wound dressings. LC-NPWT is effective in the treatment of DFUs and provides a cheaper alternative for patients with DFUs that could potentially alleviate the economic distress these patients endure.

Asymmetric adhesive SIS-based wound dressings for therapeutically targeting wound repair

Severe tissue injuries pose a significant risk to human health. Conventional wound dressings fall short in achieving effective tissue regeneration, resulting in suboptimal postoperative healing outcomes. In this study, an asymmetric adhesive wound dressing (marked as SIS/PAA/LAP) was developed, originating from acrylate acid (AA) solution with laponite (LAP) nanoparticles polymerization and photo-crosslinked on the decellularized extracellular matrix small intestinal submucosa (SIS) patch. Extensive studies demonstrated that the SIS/PAA/LAP exhibited higher tissue adhesion strength (~ 33 kPa) and burst strength (~ 22 kPa) compared to conventional wound dressings like Tegaderm and tissue adhesive products. Importantly, it maintained favorable cell viability and demonstrated robust angiogenic capacity. In animal models of full-thickness skin injuries in rats and skin injuries in Bama miniature pigs, the SIS/PAA/LAP could be precisely applied to wound sites. By accelerating the formation of tissue vascularization, it displayed superior tissue repair outcomes. This asymmetrically adhesive SIS-based patch would hold promising applications in the field of wound dressings.

Advances in Chronic Wound Management: From Conventional Treatment to Novel Therapies and Biological Dressings.

Chronic wounds can be classified as diabetic foot ulcers, pressure ulcers, or venous leg ulcers. Chronic wound management has become a threat to clinicians and constitutes a major healthcare burden. The healing process of chronic wounds requires many factors to work in concert to achieve optimal healing. Various treatment options, ranging from hypoxia to infection, have evolved considerably to address the challenges associated with chronic wound healing. The conventional and accelerating treatments for chronic wounds still represent an unmet medical need due to the complex pathophysiology of the chronic wound microenvironment. In clinical settings, traditional chronic wound care practices rely on nonspecific topical treatment, which can reduce pain and alleviate disease progression with varying levels of success but fail to completely cure the wounds. Conventional wound dressings, such as hydrocolloids, gauze, foams, and films, have also shown limited success for the treatment of chronic wounds and only act as a physical barrier and absorb wound exudates. Emerging advances in treatment approaches, including novel therapies (stem cells, microRNAs, and nanocarrier-based delivery systems) and multifunctional biological dressings, have been reported for chronic wound repair. This review summarizes the challenges offered by chronic wounds and discusses recent advancements in chronic wound treatment.

Development and biological evaluation of smart powder bandage for wound healing and dressing applications

Cutaneous wounds are one of the pressing concerns for healthcare systems globally. With large amounts of water, conventional hydrogels encounter obstacles in effectively delivering small molecules and peptides for wound healing. The surplus water content challenges the stability and sustained release of small molecules and peptides, diminishing their therapeutic efficacy. Our pioneering smart powder bandage, fabricated through freeze-drying, ensures a water content of <1 % during storage. Upon contact with wound exudate, it forms hydrogel layers, thereby optimizing the delivery of peptides. Tailored for thermosensitive peptides such as EGF, this strategy surmounts the limitations of conventional hydrogels, providing a robust platform for efficacious therapeutic delivery in wound healing applications. Developing multifunctional wound dressings with antibacterial, anti-inflammatory, hemostatic, and healing properties is essential to promote wound healing. Therefore, the current investigation reports the development of multifunctional EGF@Silnanom SPB with the above-mentioned properties to promote wound healing using silver nanomix (Silnanom) and bioactive epidermal growth factors (EGF) as active therapeutics. The characterization of smart powder bandage (SPB) revealed that Silnanom were homogeneously dispersed in the entangled polymer network. The multifunctional smart powder bandage exhibited high bacterial inhibition rates against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), and rigorous hemocompatibility, cell compatibility, and in vivo studies also confirmed its biocompatibility. Furthermore, multifunctional EGF@Silnanom SPB effectively reduced pro-inflammatory markers, enhanced collagen deposition, promoted angiogenesis, and accelerated wound healing in a full-thickness mouse wound model through the sustained release of Silnanom and EGF. Additionally, the results of hemostasis analysis on the tail amputation mouse model confirmed the hemostasis properties of the EGF@Silnanom SPB. Overall, the multifunctional EGF@Silnanom SPB shows promising potential for skin wound repair, offering a potent and effective solution to the challenges posed by conventional wound dressings.

Multifunctional Drugs-Loaded Carbomol Hydrogel Promotes Diabetic Wound Healing via Antimicrobial and Immunoregulation.

Diabetic wound healing poses a significant clinical dilemma. Bacterial infection and immune dysregulation are the predominant reasons. However, conventional wound dressings with a single treatment approach often limit therapeutic efficacy and continue working with difficulty. These limitations cause high treatment failure for diabetic wounds. In this study, we developed a multiple drug-loaded carbomer hydrogel containing Que/Van/Rif (QVR-CBMG) for the simultaneous treatment of infection and immune dysregulation. Honeycomb-like QVR-CBMG hydrogel exhibits excellent abilities to eliminate bacterial infection and biofilms in vitro. Moreover, QVR-CBMG hydrogel possesses an immunomodulatory capacity via affecting the Sirt3/SOD2 signaling pathway to promote M2 macrophages. Furthermore, QVR-CBMG hydrogel effectively promotes wound healing in diabetic rats through several mechanisms. The multidrug-loaded wound dressing not only eliminates bacterial infection and facilitated angiogenesis but also promotes collagen deposition and remodulates the local immune microenvironment in the areas of wounds. In summary, this synthetic strategy to eliminate infection and regulate immune disorders has potential translational value for the prevention and management of diabetic wounds.

Multifunctional xyloglucan-containing electrospun nanofibrous dressings for accelerating infected wound healing

Preventing wound infection is a major challenge in biomedicine. Conventional wound dressings often have poor moisturizing and antimicrobial properties unfavorable for wound healing. In this study, we prepared a multifunctional electrospun nanofiber dressing (PCQX-M) containing xyloglucan, quaternized chitosan, Polyvinyl alcohol, and collagen. By applying the concept of wet healing, xyloglucan and quaternized chitosan polysaccharides with excellent water solubility were employed to improve the absorption and moisturizing properties and maintain a moist microenvironment for the wound healing process. PCQX-M demonstrated high mechanical, thermodynamic, and biocompatible properties, providing suitable healing conditions for wounds. In addition, PCQX-M showed exceptional antibacterial properties and a potential inhibitory effect on the growth of microorganisms in infected wounds. More intriguingly, the restorative healing effect was investigated on a mouse model of whole skin injury infected with Staphylococcus aureus. Wound healing, collagen deposition, and immunofluorescence results showed that PCQX-M significantly promoted cell proliferation and angiogenesis at the injury site and facilitated the healing of the infected wound. Our study suggests that PCQX-M has excellent potential for clinical application in infected wound healing.

Mussel-Inspired PEDOT-Incorporated Gelatin-Based Conductive Hydrogel with Flexibility and Electroactivity to Accelerate Wound Healing In Vitro

Chronic wounds are associated with a metabolically imbalanced physiological microenvironment. However, conventional wound dressings are inadequate for treating chronic wounds due to their weak bioactivity. Electroactive wound dressings are essential for modulating a myriad of biological processes, particularly antioxidant activity and cell migration. Herein, we designed a conductive hydrogel with flexible, biodegradable, and electroactive properties using a mussel-inspired method. This conductive hydrogel was prepared by inducing poly(3,4-ethylenedioxythiophene) (PEDOT) in situ polymerization in the Hofmeister effect-assisted polydopamine-functionalized gelatin hydrogel (Gel-PDA/PEDOT). The hydrogel demonstrated robust mechanical properties with compressive and tensile strengths of 3.8 and 0.13 MPa, respectively, and a conductivity of 68.7 S/m. The addition of PDA and PEDOT to the Gel hydrogel endowed the hydrogel with exceptional antioxidant properties to maintain an intracellular redox balance. Additionally, the Gel-PDA/PEDOT hydrogel, which had favorable biocompatibility, significantly increased the migration and proliferation of fibroblasts due to its electroactive properties. A cell migration experiment was performed to assess whether the flexible and electroactive Gel-PDA/PEDOT hydrogel may be a promising wound dressing in skin wound regeneration. These findings provide a strategy for fabricating a multifunctional hydrogel with potential application in bioelectronics and wound dressings.

Negative pressure wound therapy and conventional wound management at a rural tertiary care center – A comparative study

Background: Wounds are a major source of morbidity and sometimes, mortality and there are several ways to treat them. Negative pressure wound therapy (NPWT) is one way, and this involves the use of a suction device to aspirate and remove fluids, debris, and infectious materials from the wound bed to promote the formation of granulation tissue and wound healing. Another way is with the use of conventional wound dressings. Aims and Objectives: The aim was to compare NPWT and conventional wound dressings for the poor in a rural setting. Materials and Methods: Sixty consecutive cases clinically presenting with wounds between March 2018 and August 2019 were examined and divided into NPWT or conventional wound dressing groups. Outcome was measured by recording wound scores on day 7 or thereafter. Cases and controls were studied from admission until complete healing. Outcome and complications of NPWT and conventional wound dressings were noted. Results were tabulated in MS excel and evaluated using Graphpad Prism 9 software (San Diego, CA, USA). Results: Many patients (33.33%) were in the 5th and 6th decades of life and most (77%) were male. Many wounds were located on the foot (40%). Those patients younger than 40 years of age with a wound &lt;10 days old had a better median wound score in both the groups. The majority of wounds (43.33%) were traumatic. Wound healing was better in non-diabetics and non-smokers. There was a considerable reduction in the organism load in the NPWT group (P=0.0078). Complications were minor. The NPWT group had a significantly shorter mean hospital stay (P=0.0001). Conclusion: NPWT enhanced granulation tissue formation leading to earlier wound healing and faster recovery compared to conventional wound dressings.

Evaluation of biogenic nanosilver-acticoat for wound healing: A tri-modal in silico, in vitro and in vivo study

Wound healing is a complex process that involves numerous biological and physiological events and is influenced by various local and systemic factors. Chronic wounds affect around 6 million people and pose a significant clinical challenge for healthcare professionals, particularly in light of the increasing difficulty in treating wound infections with conventional antibiotics. Conventional wound dressings have several limitations, including insufficient antibacterial potency, toxicity, failure to deliver adequate moisture to the wound, and poor mechanical properties. Silver nanoparticles (AgNPs) have shown great promise in wound healing due to their exceptional antibacterial properties. In this study, AgNPs were synthesized via green synthesis using Camellia sinensis and Ocimum sanctum and characterized by various techniques. The AgNPs were incorporated into carrageenan to develop nanosilver acticoat for wound healing applications. The anti-bacterial property of the acticoat was tested against S. aureus and E. coli bacteria, and in vivo studies showed that dressing with Carrageenan silver nanoparticles (CAgNPs) acticoat promoted wound healing and had good reepithelialization and dense collagen deposition capabilities. With a significance level of < 0.05, we used one-way ANOVA to analyze the means between groups. In silico analysis with pkCSM and SwissADME provided information on the drug-likeness and human health hazard-related predictions for the prepared formulations. The study highlights the potential of the prepared CAgNPs acticoat for dressing applications in the burn, accidental, and diabetic wound infections. These results suggest that the use of CAgNPs acticoat can provide a safe and effective alternative to conventional wound dressings in promoting wound healing.

Essential Oils Infused Poly-ε-Caprolactone/Gelatin Electrospun Nanofibrous Mats: Biocompatibility and Antibacterial Study.

Infections caused by antibiotic-resistant pathogens result in a delayed wound-healing process. As an approach to prevent infections, alternatives in the form of natural antimicrobial products have become public interest. Essential oils derived from plants are used as antimicrobials owing to their broad-spectrum activity against pathogenic organisms. In this study, essential oil from seeds of watermelon, jackfruit, and papaya was incorporated into poly-ε-caprolactone/gelatin nanofibers using an electrospinning technique. The synthesized nanofibers were smooth, continuous, and bead-free. The nanofibers were found to be mechanically competent as confirmed by the universal tensile tester. The antibacterial activity of the various essential oil-loaded nanofibrous mats was determined by disc diffusion assay. Furthermore, they were found to be non-toxic and biocompatible by MTT and CMFDA assays on fibroblast cells. The obtained results have demonstrated that essential oil-loaded nanofiber mats are promising alternatives to conventional antibacterial wound dressings.

Gene liposome nanocomplex-loaded dermal substitute promotes diabetic chronic wound healing and angiogenesis in rat

The incidence of chronic diabetic wounds is increasing with the growing number of diabetic patients, and conventional wound dressings have proven to be ineffective in treating them. To address this challenge, researchers have developed artificial dermal substitutes using collagen and hyaluronic acid, which are crucial extracellular matrices. However, these subsitiues lack precision and targeted treatment. To overcome this limitation, a gene liposome nanocomplex-loaded dermal substitute (GDS) has been developed as a potential solution. This innovative biomaterial combines the benefits of liposome nanocomplexes with dermal substitutes to offer a more accurate and effective treatment option for chronic diabetic wounds. The GDS has the ability to deliver genes and therapeutic agents specifically to the wound site, promoting angiogenesis and accelerating the wound healing process. Overall, the GDS presents a promising new approach for the clinical treatment of chronic diabetic wounds, offering a targeted and effective solution for this growing problem.

Multifunctional Bletilla striata polysaccharide/copper/peony leaf sponge for the full-stage wound healing

Conventional wound dressings fail to satisfy the requirements and needs of wounds in various stages. It is challenging to develop a multifunctional dressing that is hemostatic, antibacterial, anti-inflammatory, and promotes wound healing. Therefore, this study aimed to develop a multifunctional sponge dressing for the full-stage wound healing based on copper and two natural products, Bletilla striata polysaccharide (BSP) and peony leaf extract (PLE). The developed BSP-Cu-PLE sponges were characterized by SEM, XRD, FTIR, and XPS to assess micromorphology and elemental composition. Their properties and bioactivities were also verified by the further experiments, whereby the findings revealed that the BSP-Cu-PLE sponges had improved water absorption and porosity while exhibiting excellent antioxidative, biocompatible, and biodegradable properties. Moreover, the antibacterial test revealed that BSP-Cu-PLE sponges had superior antibacterial activity against S. aureus and E. coli. Furthermore, the hemostatic activity of BSP-Cu-PLE sponges was significantly enhanced in a rat liver trauma model. Most notably, further studies have demonstrated that the BSP-Cu-PLE sponges could significantly (p < 0.05) accelerate the healing process of skin wounds by stimulating collagen deposition, promoting angiogenesis, and decreasing inflammatory cells. In summary, the BSP-Cu-PLE sponges could provide a new strategy for application in clinical setting for full-stage wound healing.

PCL/gelatin nanofibers incorporated with starfish polydeoxyribonucleotides for potential wound healing applications

Conventional wound dressings have several shortcomings because they are unspecific and partially effective for wound healing. To enhance the therapeutic efficiency of wound dressings, we extracted polydeoxyribonucleotides (PDRN) from Patiria pectinifera, and characterized using absorbance-based analysis, chemical composition analysis, and electrophoresis. We evaluated their cytotoxicity and wound healing activity on human dermal fibroblast (HDF) and human keratinocytes (HaCaT). Next, we used electrospinning to fabricate polycaprolactone (PCL)/gelatin (Gel)/PDRN nanofibers for wound dressing application. The average fiber diameters of PCL (P), PCL/Gel (PG), and PCL/Gel/PDRN (PGP) nanofibers were 582.88 ± 202.65, 435.65 ± 149.87, and 334.63 ± 98.09 nm, respectively. The biocompatibility of the nanofibers was assessed using MTT assay and FDA/PI staining on HDF and HaCaT, no cytotoxicity was observed. In vivo experiments with full-thickness skin defect mouse models confirmed that the PGP nanofiber accelerated the initial wound healing process, as shown by wound closure analysis and histological analysis. Our results suggest that the PGP nanofiber has potential as a biomaterial for wound dressing applications and skin tissue engineering.

Bioinspired multifunctional injectable hydrogel for hemostasis and infected wound management.

Routine wound management faces significant challenges including rebleeding and bacterial infection that affect millions of people each year. However, conventional wound dressings (e.g., gauze, bandage) are limited to simply cover the injured surfaces and rarely show special functionality to promote the wound recovery. Currently, injectable hydrogels have been widely designed as multifunctional wound dressings to manage the hemostatic and wound healing process. Nevertheless, the integration of multiple functions through simple composition and easy construction is still difficult and hardly achieved. Herein, we reported a bioinspired multifunctional injectable hydrogel (CQCS@gel) consisted of only two components, catechol-functionalized quaternized chitosan (CQCS) and dibenzaldehyde-terminated poly(ethylene glycol) (DB-PEG2000). The building blocks endowed CQCS@gel with tissue-adhesive, antibacterial, antioxidant, self-healing and pH-responsive properties. Based on the in vivo hemostatic study, quick hemostasis for acute tissue injuries such as liver and carotid wounds was realized owing to the rapid gelation rate and strong tissue-adhesiveness of CQCS@gel. Moreover, CQCS@gel remarkably boosted the chronic recovery process of MRSA-infected cutaneous wounds by promoting collagen deposition, hair follicles regeneration and angiogenesis. Overall, this multifunctional injectable hydrogel shows potentials as a universal wound dressing in clinical applications, enabling both hemostasis and infected wound management. STATEMENT OF SIGNIFICANCE: This is the first report showing the multifunctional injectable hydrogel (CQCS@gel) consisted of catechol-functionalized quaternized chitosan and dibenzaldehyde-terminated poly(ethylene glycol). The incorporation of quaternary ammonium groups imparted the CQCS@gel with outstanding contact-active bacterial killing efficiency and the catechol moieties enhanced its tissue adhesive and antioxidant properties. Moreover, the reversible imine crosslinks endowed the CQCS@gel with self-healing and pH-responsive drug release capabilities. These multiple functions were integrated into a single injectable hydrogel system with easy availability and low cost. In vitro and in vivo results showed that the newly designed hydrogel was biocompatible, realized successful sealing hemostasis under multiple bleeding scenarios and enabled accelerated healing of infected skin wounds.

Nanofibrous Scaffolds for Diabetic Wound Healing

Chronic wounds are one of the secondary health complications that develop in individuals who have poorly managed diabetes mellitus. This is often associated with delays in the wound healing process, resulting from long-term uncontrolled blood glucose levels. As such, an appropriate therapeutic approach would be maintaining blood glucose concentration within normal ranges, but this can be quite challenging to achieve. Consequently, diabetic ulcers usually require special medical care to prevent complications such as sepsis, amputation, and deformities, which often develop in these patients. Although several conventional wound dressings, such as hydrogels, gauze, films, and foams, are employed in the treatment of such chronic wounds, nanofibrous scaffolds have gained the attention of researchers because of their flexibility, ability to load a variety of bioactive compounds as single entities or combinations, and large surface area to volume ratio, which provides a biomimetic environment for cell proliferation relative to conventional dressings. Here, we present the current trends on the versatility of nanofibrous scaffolds as novel platforms for the incorporation of bioactive agents suitable for the enhancement of diabetic wound healing.

Recent Developments in Electrospun Nanofibers as Delivery of Phytoconstituents for Wound Healing

Wound healing is an unresolved therapeutic challenge for the medical community, as wound assessment and management is a complex procedure involving numerous factors that play a significant role in the healing process. Several factors, including bacterial infections, underlying conditions, malnutrition, obesity, aging, and smoking are the most frequent causes of a delayed wound-healing process. The shortcomings related to the currently used wound dressings include poor antimicrobial properties, weak mechanical features, poor biodegradability, biocompatibility, etc. Modern medicine has expanded the use of phytoconstituents based on nanotechnology to regenerate and repair soft and hard tissues. Electrospun nanofiber platforms are the most recent and promising among many types of conventional wound dressings due to their distinct characteristics. Many plant extracts and their phytoconstituents are well-known as adequate substitutes for wound healing agents because of their wide range of active ingredients, accessibility, and limited side effects. Incorporating these phytoconstituents into electrospun nanofibers combines the structural properties of the nanofibers with the antibacterial and therapeutic properties of the plants, making the nanofibers ideal for use as wound dressings. This review focuses on the antibacterial and therapeutic applications of nanofiber wound dressings containing phytoconstituents and their potential to revolutionize wound healing.

Three dimensional printed wound dressings: recent progresses.

Three dimensional printed wound dressings: recent progresses.

Recent advances in responsive hydrogels for diabetic wound healing.

Poor wound healing after diabetes mellitus remains a challenging problem, and its pathophysiological mechanisms have not yet been fully elucidated. Persistent bleeding, disturbed regulation of inflammation, blocked cell proliferation, susceptible infection and impaired tissue remodeling are the main features of diabetic wound healing. Conventional wound dressings, including gauze, films and bandages, have a limited function. They generally act as physical barriers and absorbers of exudates, which fail to meet the requirements of the whol diabetic wound healing process. Wounds in diabetic patients typically heal slowly and are susceptible to infection due to hyperglycemia within the wound bed. Once bacterial cells develop into biofilms, diabetic wounds will exhibit robust drug resistance. Recently, the application of stimuli-responsive hydrogels, also known as "smart hydrogels", for diabetic wound healing has attracted particular attention. The basic feature of this system is its capacities to change mechanical properties, swelling ability, hydrophilicity, permeability of biologically active molecules, etc., in response to various stimuli, including temperature, potential of hydrogen (pH), protease and other biological factors. Smart hydrogels can improve therapeutic efficacy and limit total toxicity according to the characteristics of diabetic wounds. In this review, we summarized the mechanism and application of stimuli-responsive hydrogels for diabetic wound healing. It is hoped that this work will provide some inspiration and suggestions for research in this field.

Does the use of epicutaneous vacuum-assisted closure after revision surgery on the spine reduce further wound revision surgery?

PurposeThis study aimed to investigate the effect of epicutaneous vacuum therapy on the rate of unplanned spinal wound revisions compared with conventional wound dressing.MethodsThis retrospective study included patients who underwent unplanned revision spine surgery after primary aseptic spine surgery who were treated at a level I spine centre between December 2011 and December 2019. Patients with revision surgery who required a further unplanned revision surgery during the inpatient stay were considered a treatment failure. The epicutaneous vacuum-assisted closure (Epi-VAC) therapy was the standard treatment method beginning in 2017 (the epi-VAC group). Before, conventional wound dressing was used (the control group (CG)). In addition, a one-to-one matched-pair comparison analysis was performed between both groups.ResultsOf 218 patients, 48 were in the epi-VAC group. The mean age was 65.1 years (epi-VAC 68.2 to CG 64.3 years (P = 0.085)), and the mean body mass index (BMI) was 28.2 kg/m2 (epi-VAC 29.4 to CG 27.9 kg/m2 (P = 0.16)). No significant differences in the treatment failure rate could be detected between the two groups (epi-VAC 25% to CG 22.4% (P = 0.7)). There was also no significant difference for the matched-pair analysis (epi-VAC 26.1% to CG 15.2% (P = 0.3)). An elevated CRP level (C-reactive protein) immediately before the first wound revision was a significant risk factor for further revision surgery (treatment failure: 135.2 ± 128.6; no treatment failure: 79.7 ± 86.1 mg/l (P < 0.05)).ConclusionConcerning repeat unplanned wound revision after spinal revision surgery, we cannot demonstrate an advantage of the epicutaneous vacuum therapy over conventional wound dressing.

Metal mediated high performance antimicrobial hydrogel films for wound infection management: Zn, Cu, and Mg versus Ag and Au

Wound infection impedes wound healing and thus poses serious health risks in humans. Wound healing conventionally relies on gauze, lint, plasters, bandages, and cotton wool, with heavy doses of antibiotics in some of them. While silver-based materials have emerged as potential alternatives to antibiotics in wound care management, they are expensive (gold is an even more expensive antimicrobial agent), and their excessive use may promote silver-resistant microbial strains, and skin argyrosis. Furthermore, excessive wound exudate causes conventional wound dressings to become moistened and painful to remove due to adhesion to the wound. We present non-traditional yet high-performance hydrogel (HG)-based wound films based on polyvinyl alcohol (PVA), chitosan (CS), polyethylene glycol (PEG), and effective antibacterial metal ions (Zn2+, Cu2+, Ag+, Au3+, and Mg2+) for wound infection management. The resulting HG_Cu, HG_Zn, HG_Ag, and HG_Au films demonstrated excellent antibacterial efficacy against S. aureus, A. baumanni, and C. albicans, as well as high water absorption (213%, 169.50%, 338.62%, and 241.22%, respectively), swellability (3.21, 2.69, 4.38, and 3.41, respectively), and outstanding thermal stability. Strikingly, the Cu and Zn integrated hydrogels demonstrated broad-spectrum antimicrobial properties. The findings of this work thus reveal a more cost-effective, sustainable, and environmentally friendly approach to designing high-value-added wound care products.