Conventional Wound Research Articles

Tannic acid based multifunctional hydrogels with mechanical stability for wound healing

Conventional wound dressings have poor tissue adhesion and mechanical stability, restricting their applications in dynamic motion environments. Tannic acid (TA) was ideal candidates for current dressing materials due to their well-known antioxidant and anti-inflammatory properties. However, the inevitable polymerization problem of TA limited the one-step synthesis of dressings. Herein, we reported a simple one-pot method to prepare double-network hydrogels containing N-acryloyl glycinamide (NAGA), N-hydroxyethyl acrylamide (HEAA) and TA. The resulting NHT hydrogel exhibited excellent tensile properties, fatigue resistance, and notch insensitivity to ensure mechanical stability under large deformation and stress in vitro. The NHT hydrogel also demonstrated room-temperature self-healing, broad adhesion to various substrates, synergistic swelling ability. In addition, catechol and benzene rings from TA helped shield against UV radiation and acted as free radical scavengers to relieve oxidative stress in wound damage. As a result, full-layer wounds in mice treated with NHT patches showed a higher healing rate, in which epithelialization was completed within 14 days. The integrated function enables hydrogel to maintain mechanical stability in dynamic motion environments with high strain and defects, with great potential for future clinical translation.

Design of Scaffolds Based on Zinc-Modified Marine Collagen and Bilberry Leaves Extract-Loaded Silica Nanoparticles as Wound Dressings.

In this study, wound dressings were designed using zinc-modified marine collagen porous scaffold as host for wild bilberry (WB) leaves extract immobilized in functionalized mesoporous silica nanoparticles (MSN). These new composites were developed as an alternative to conventional wound dressings. In addition to the antibacterial activity of classic antibiotics, a polyphenolic extract could act as an antioxidant and/or an anti-inflammatory agent as well. Wild bilberry leaves extract was prepared by ultrasound-assisted extraction in ethanol and its properties were evaluated by UV-Vis spectroscopy (radical scavenging activity, total amount of polyphenols, flavonoids, anthocyanins, and condensed tannins). The extract components were identified by HPLC, and the antidiabetic properties of the extract were evaluated via α-glucosidase inhibitory activity. Spherical MSN were modified with propionic acid or proline moieties by post-synthesis method and used as carriers for the WB leaves extract. The textural and structural features of functionalized MSN were assessed by nitrogen adsorption/desorption isotherms, small-angle XRD, SEM, TEM, and FTIR spectroscopy. The composite porous scaffolds were prepared by freeze drying of the zinc-modified collagen suspension containing WB extract loaded silica nanoparticles. The properties of the new composites demonstrated enhanced properties in terms of thermal stability of the zinc-collagen scaffold, without altering the protein conformation, and stimulation of NCTC fibroblasts mobility. The results of the scratch assay showed contributions of both zinc ions from collagen and the polyphenolic extract incorporated in functionalized silica in the wound healing process. The extract encapsulated in functionalized MSN proved enhanced biological activities compared to the extract alone: better inhibition of P. aeruginosa and S. aureus strains, higher biocompatibility on HaCaT keratinocytes, and anti-inflammatory potential demonstrated by reduced IL-1β and TNF-α levels. The experimental data shows that the novel composites can be used for the development of effective wound dressings.

Evaluation of nanocellulose-based anthraquinone from marine fungi Penicillium flavidorsum as an alternative therapy for skin wound healing: histopathological and immunohistochemical evidences from a rat model

BackgroundWound healing represents a complex clinical challenge, necessitating the selection of appropriate wound dressings to facilitate an efficient healing process. This study aims to explore an effective approach to enhance wound healing by investigating the therapeutic potential of a nanocellulose-based anthraquinone derived from marine fungi.Forty male Wistar rats were divided into five groups, including a control group and various four treatment groups. The wound healing process was assessed by measuring the wound area at different time points.ResultsThe results showed promising outcomes in terms of wound healing progression. The group treated with anthraquinone and nanocellulose demonstrated the most favorable results, with normal epidermal architecture, marked hyperkeratosis, and minimal dermal edema. This study provides comprehensive evidence supporting the efficacy of this novel alternative therapy through histopathological and immunohistochemical analyses conducted on a rat model.ConclusionBy addressing the limitations associated with conventional wound dressings, our research contributes to the development of innovative strategies for optimizing wound healing outcomes. The findings presented herein underscore the potential of nanocellulose-based anthraquinone as a promising therapeutic option for promoting skin wound healing. Further investigations are warranted to elucidate the underlying mechanisms and establish the clinical viability of this alternative therapy.

Uridine-Loaded Polycaprolactone Nanofiber Mats as a Novel Wound Dressing

In the current study, a novel wound dressing material for an effective wound healing was developed by loading Uridine (URD), an endogenous compound known for its regenerative properties, into polycaprolactone (PCL) nanofibers. Initially, PCL nanofibers without URD were fabricated from different PCL solutions (7, 8, 10 and 11% w/w) by electrospinning and optimum PCL concentration (10% w/w) for URD loading was determined. After loading URD at different concentrations (0.1, 0.5 and 1% w/w) into 10% PCL solution, PCL/URD nanofibers were electrospun. Structural characteristics, release kinetics as well as in vitro and in vivo effects of the PCL/URD nanofibers were studied and in vivo effects were compared with a conventional wound dressing material. Loading URD increased nanofiber diameters from 248 to 509 nm and decreased contact angles from 123.76° to 94.3° with increasing URD concentrations. URD showed a burst release in the first 60 min following a more gradual release up to the 5th day which best fitted with Korsmeyer–Peppas model. PCL/URD mats provided enhanced viability in vitro in MTT assay using mouse L929 fibroblast cell line. Furthermore, in vivo wound closure studies revealed an immediate and robust wound healing in rats treated with PCL/URD mats compared to PCL mats without URD as well as the conventional wound dressing material. These data suggest that URD-loaded PCL nanofiber mats are promising materials as wound dressing.Graphical abstract

Long duration sodium hyaluronate hydrogel with dual functions of both growth prompting and acid-triggered antibacterial activity for bacteria-infected wound healing

Conventional wound dressings are monolithically designed to cover the injured areas as well as absorb the exudates at injured site. Furthermore, antibacterial drugs and growth prompting factors are additionally appended to realize sensible and omnibearing wound management, exhibiting long and tedious treatment process in practice. Consequently, the creation of multifunctional wound dressings that combines wound repair enhancement with antibacterial properties turns out to be significant for simplifying wound managements. In our investigation, electronegative human epidermal growth factor (hEGF) was combined with the positively charged Zn-Al layered double hydroxides (Zn-Al LDHs) via electrostatic interaction while the obtained hEGF/LDH was integrated with sodium hyaluronate hydrogel (SH) hydrogel, forming a composite hydrogel with synergistic benefits for wound management. The innovative hEGF/LDH@SH hydrogel equipped with fine biocompatibility was designed to optimize wound healing in which hEGF stimulates epithelial cell growth while LDH released antibacterial factor Zn2+ against Methicillin-resistant staphylococcus aureus (MRSA) and Escherichia coli (E.coli) under acidic wound environment. Additionally, the SH hydrogel constructed a three-dimensional structure that not only safeguarded the wound area but also maintained a moist environment conducive to recovery. The synthesized hEGF/LDH was confirmed via fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and thermo-gravimetry (TG) measurements. The release of Zn2+ from Zn-Al LDH under acid circumstance was detected via inductively coupled plasma (ICP) and the in vitro bactericidal experiments endowed the antibacterial property of hEGF/LDH@SH hydrogel. In vitro drug release experiments illustrated the controlled-release of hEGF from hEGF/LDH which promoted the long-term affect of hEGF at wound site. In vitro cell experiments verified that the hEGF/LDH@SH hydrogel motivated the promotion on cell proliferation and migration without cytotoxicity. An in vivo study of the repairing of MRSA-infected wound in mice indicated that hEGF/LDH@SH hydrogel serves as a simple and novel, innoxious and efficient wound healing approach. This brand new hydrogel possesses properties of promoting the regeneration of skin tissue, achieving antimicrobial therapy without any accessional antibacterial drugs as well as realizing controlled release of hEGF.

Self-Powered Electrical Bandage Based on Body-Coupled Energy Harvesting.

Self-powered electrical bandages (SEBs), integrated with wearable energy harvesters, can provide an effective and autonomous electrical stimulation (ES) solution for rapid and scarless wound healing. A continuously operating, wireless, and applicable-to-comprehensive-wound ES device is essential for the quick restoration of wounds and convenience. This work illustrates a SEB powered by body-coupled energy harvesting. The SEB continuously treats the wound with 60-Hz sinusoidal electrical potential gained from the coupling of the human body and ambient electrical waves. It is demonstrated that enough level of electrical potential can be applied to the wound, further enhanced by strong capacitive coupling arising from the use of high-permittivity poly(vinylidene fluoride-trifluoroethylene):CaCu3Ti4O12 (P(VDF-TrFE):CCTO) nanocomposite. The potential clinical efficacy of the SEB is illustrated by preclinical analysis of human fibroblasts and mouse wound model, thus confirming the successful expedition of wound recovery. This work suggests a new class of wearable devices to provide ES events and its potential for extension to other conventional wound care materials and device technology.

Rapid-Response Water-Shrink Films with High Output Work Density Based on Polyethylene Oxide and α-Cyclodextrin for Autonomous Wound Closure.

Conventional wound closure methods, including sutures and tissue adhesives, present significant challenges for self-care treatment, particularly in the context of bleeding wounds. Existing stimuli-responsive contractile materials designed for autonomous wound closure frequently lack sufficient output work density to generate the force needed to bring the wound edges into proximity or necessitate stimuli that are not compatible with the human body. Here, semi-transparent, flexible, and water-responsive shrinkable films, composed of poly(ethylene oxide) and α-cyclodextrin, are reported. These films exhibit remarkable stability under ambient conditions and demonstrate significant contraction (≈50%) within 6 s upon exposure to water, generating substantial contractile stress (up to 6MPa) and output work density (≈1028kJ m-3), which is 100 times larger than that of conventional hydrogel and 25 times larger than that of skeletal muscles. Remarkably, upon hydration, these films are capable of lifting objects 10000 times their own weight. Leveraging this technology, water-shrink tapes, which, upon contact with water, effectively constrict human skin and autonomously close bleeding wounds in animal models within 10 seconds, are developed further. This work offers a novel approach to skin wound management, showing significant potential for emergency and self-care scenarios.

Comparison of Conventional and Modern Wound Care in Post-Section Wounds at Cut Mutia Hospital, North Aceh Regency in 2023

The World Health Organization (WHO) sets the average cesarean sections (CS) standard at 5-15% per 1000 births. However, cesarean section rates in private hospitals exceed 30%, compared to 11% in government hospitals. This study investigates the prevalence and complications of surgical wound infections post-cesarean section and the effectiveness of modern wound dressing techniques in reducing these infections. Data analysis reveals cesarean wound infections occur during hospitalization (27%), re-admission (1%), and post-discharge (71%). Surgical wound infections (SWI) significantly increase morbidity, treatment duration, and healthcare costs, with a direct death rate ranging from 3% to 75% globally. The study evaluated modern wound dressings adhering to "moist wound healing" principles, such as hydrocolloids, alginate, and foam, which maintain a moist environment to enhance epithelial cell proliferation, accelerate wound healing, and reduce scarring. Findings indicate that moist wound dressings significantly improve healing outcomes, promoting epithelialization and collagen synthesis, with techniques showing a 30-50% increase in epithelialization and a 2-5 times faster re-epithelialization rate. These results highlight the need for adopting advanced wound care techniques to reduce surgical wound infections and improve patient recovery post-cesarean section. The study implies that healthcare providers should integrate modern wound care practices to enhance maternal health outcomes globally.

Tannic Acid Incorporated Antibacterial Polyethylene Glycol Based Hydrogel Sponges for Management of Wound Infections.

Conventional wound dressings fail to provide features that can assist the healing process of chronic wounds. Multifunctional wound dressings address this issue by incorporating attributes including antibacterial and antioxidant activity, and the ability to enhance wound healing. Herein, polyethylene glycol (PEG)-based antibacterial hydrogel sponge dressings are prepared by a rapid and facile gas foaming method based on an acid chloride/alcohol reaction where tannic acid (TA) is included as a reactant to impart antibacterial efficacy as well as to enhance the mechanical properties of the samples. The results reveal that the TA-integrated sponges possess excellent antibacterial properties against both Escherichia coli and Staphylococcus aureus with approximately 6-8 log reduction in the microbial colony count after 6h, indicating their high potential for management of infection-prone wounds. Compared to the control sample, TA incorporation increases the elastic modulus by twofold. As the samples also exhibit biocompatibility, antioxidant activity, and wound healing capacity, the novel TA-incorporated hydrogels can be an alternative to traditional wound dressings for wounds with low-to-moderate exudate.

PH responsive THPS crosslinked injectable hydrogel with Cu-metformin sustained-release for accelerating wound healing

The utilitarian capacity of hydrogels in fostering a conducive milieu for cellular viability renders them a compelling alternative to conventional wound dressings. Nonetheless, the uncontrolled drug release exhibited by numerous drug-loaded hydrogel dressings often undermines their capacity for sustaining therapeutic efficacy over prolonged periods, while certain hydrogel formulations prove inadequate for addressing deep-seated wounds with low pH caused by chronic bacterial infections. Within the scope of this investigation, a novel pH-responsive injectable sustained-release hydrogel is developed through the crosslinking of tetrakis (hydroxymethyl) phosphonium sulfate (THPS) with carboxymethyl chitosan (CMCS) and Ɛ-poly-L-lysine (EPL). This innovative hydrogel manifests rapid gelation within a span of 30 s sans the requirement of a catalyst, alongside demonstrating commendable antibacterial attributes facilitated by the incorporation of a Cu-metformin complex (CuMet). Furthermore, the lyophilized hydrogel exhibits exceptional water absorbency and hemostatic qualities, effectively addressing exudative concerns and mitigating blood loss. In vitro assessments ascertain the higher drug release under acidic conditions and sustained drug release potential of CMCS/EPL/CuMet for up to 120 h, concomitantly expediting wound healing processes through the attenuation of bacterial colonization and inflammatory responses. In summation, this investigation furnishes novel insights into the viability of the developed formulation as a sustained-release injectable wound dressing.

Synthesis of AgO/CuO/PVA/starch hydrogel by casting method and characterizations to safely overcome skin infections: A possible application in wound healing as a dressing

Wounds are frequently developing resistance to a conventional wound dressing. Therefore, bioactive and biodegradable hydrogel membranes that could serve as wound dressing could be a legitimate strategy for wound healing, Herein, a chemically cross-linking method was used to synthesize polyvinyl alcohol (PVA)/starch hydrogel, which was subsequently loaded, via the solution casting method, with Silver oxide/Copper oxide (AgO/CuO) nanocomposite (NC) tested at various concentrations (i.e., 0.1, 0.3, 0.5, and 0.7 g/L). The prepared hydrogels were physically characterized through standard techniques, including Dynamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), and Fourier Transform Infrared Radiation (FTIR). The influence of the different AgO/CuO NC concentrations was analyzed through tensile strength, swelling behavior, moisture retention capability (MRC), gel fraction, and water vapor transport (WVT) analyses. The relative toxicity (patch test) of hydrogel membranes was also evaluated on the human skin. The antibacterial potential was investigated against common skin pathogens (i.e., Salmonella typhimurium, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and Candida albicans) through the disc diffusion method (DDM). SEM images depicted AgO/CuO/PVA/starch hydrogel membranes as shiny, smooth, and dense. XRD analysis revealed the purity and crystallinity of these hydrogels. FTIR data determined the functional chemical groups and confirmed the successful preparation of AgO/CuO/PVA/starch hydrogels. The increased concentrations of AgO/CuO NC in PVA/starch hydrogel membrane has boosted the tensile strength, swelling behavior, and MRC of the hydrogel membranes, whereas the WVT and gel fraction were decreased. Also, the AgO/CuO/PVA/starch hydrogel exerted enhanced antimicrobial activity against all the tested skin pathogens and no toxicity was observed when applied to the human skin. Taken together, the prepared AgO/CuO/PVA/starch hydrogel is a promising approach for wound dressing due to its desirable mechanical properties, safety, and its excellent barrier against skin pathogen penetration and infection.

Nanozymes for the Therapeutic Treatment of Diabetic Foot Ulcers.

Diabetic foot ulcers (DFU) are chronic, refractory wounds caused by diabetic neuropathy, vascular disease, and bacterial infection, and have become one of the most serious and persistent complications of diabetes mellitus because of their high incidence and difficulty in healing. Its malignancy results from a complex microenvironment that includes a series of unfriendly physiological states secondary to hyperglycemia, such as recurrent infections, excessive oxidative stress, persistent inflammation, and ischemia and hypoxia. However, current common clinical treatments, such as antibiotic therapy, insulin therapy, surgical debridement, and conventional wound dressings all have drawbacks, and suboptimal outcomes exacerbate the financial and physical burdens of diabetic patients. Therefore, development of new, effective and affordable treatments for DFU represents a top priority to improve the quality of life of diabetic patients. In recent years, nanozymes-based diabetic wound therapy systems have been attracting extensive interest by integrating the unique advantages of nanomaterials and natural enzymes. Compared with natural enzymes, nanozymes possess more stable catalytic activity, lower production cost and greater maneuverability. Remarkably, many nanozymes possess multienzyme activities that can cascade multiple enzyme-catalyzed reactions simultaneously throughout the recovery process of DFU. Additionally, their favorable photothermal-acoustic properties can be exploited for further enhancement of the therapeutic effects. In this review we first describe the characteristic pathological microenvironment of DFU, then discuss the therapeutic mechanisms and applications of nanozymes in DFU healing, and finally, highlight the challenges and perspectives of nanozyme development for DFU treatment.

Ceramic Dressings-A New Non-Pharmacological Therapeutic Option in the Management of Chronic Wounds?

In this monocentric, intra-individually controlled, prospective study, patients with conservatively treated refractory chronic wounds were enrolled. One week before the start of the application with ceramic dressing, it was ensured during a screening phase that chronic wounds showed less than a 10% reduction in wound size. During the 4-week ceramic dressing treatment wound size measurements, wound scoring, measurement of wound exudate amount, wound swabs, and ceramic dressing sonication (low-intensity ultrasound) were carried out. The sonication fluid of the removed ceramic dressing was used for analysis of bacterial retention and compared to wound swabs. A total of 20 patients with a mean age of 64.6 years (±26.2) and 21 chronic wounds were included in this study. After a 4-week treatment, a significant reduction of median wound size from 1178 mm2 (range 104-6300) to 751.5 mm2 (range 16-4819) and better total wound scores were observed (p < 0.001). The sensitivity of bacteria detection was 90.7% in the sonication fluid from the ceramic dressings, while only 76.9% in the conventional wound swabs. The new ceramic dressing seems to have a positive impact on wound healing in chronic wounds. Bacteria-binding characteristics of the investigated ceramic dressing, in combination with its debridement, absorption, and detoxification properties, could contribute to its healing abilities. Based on those results, the investigated ceramic dressing seems to be a promising new treatment option for chronic wounds without the use of any active antimicrobial or pharmacological agents. Moreover, ceramic dressings can also be considered for microbiological diagnostic purposes.

Role of Polyphenols, Their Nano-formulations, and Biomaterials in Diabetic Wound Healing.

A diabetic wound is one of the major complications arising from hyperglycemia, neuropathy, and oxidative stress in diabetic patients. Finding effective treatments for diabetic wounds has been difficult owing to the complex pathophysiology of diabetic wound environments. Chronic wounds are notoriously difficult to treat with conventional wound care methods. In recent years, polyphenols found in plants have received much interest as a potential treatment for diabetic wounds. Their key benefits are their safety and the fact that they act through many molecular routes to treat diabetic wounds. However, problems with their formulation development, including lipophilicity, light sensitivity, limited membrane permeability, rapid systemic elimination, and enzymatic degradation, prevented them from gaining clinical attention. This article highlights and discusses the mechanism of polyphenols and various polyphenol-based drug delivery systems used till now to treat diabetic wounds. The consideration that should be taken in polyphenols-based nano-formulations and their prospect for diabetic wounds are also discussed briefly.

Negative Pressure Wound Therapy versus Conventional Dressing in Lower Limb Fractures: Systematic Review and Meta-analysis.

Gustilo 3 lower limb fractures represent a significant challenge because of high complication risk. Two management strategies are commonly used for wound coverage until final closure: negative pressure wound therapy (NPWT) and conventional wound dressing (CWD), also described as standard wound coverage without subatmospheric pressure. Understanding their relative effectiveness is essential to improve patient outcomes. The aim of this systematic review and meta-analysis was to compare the efficacy of NPWT and CWD in Gustilo 3 lower limb fracture management, with a focus on overall rates, superficial infection, and deep infection rates. A systematic review of medical research databases was conducted in accordance with PRISMA guidelines. Studies comparing NPWT with CWD for Gustilo 3 fractures were included. Data extraction and quality assessment were performed. Treatment with CWD was associated with significantly higher rates of overall infection [pooled risk ratio (RR): 0.33; 95% confidence interval (CI): 0.14-0.51] and pooled risk difference (RD: 0.27; 95% CI: 0.15-0.38), superficial infection (pooled RR: 0.35; 95% CI: 0.04-0.66), and deep infection (pooled RR: 0.20; 95% CI: 0.02-0.38) compared with NPWT treatment. Overall infection rate remained significantly higher in the CWD group after analyzing only open tibia fractures (pooled RR: 0.35; 95% CI: 0.21-0.48). Nonunion rate was significant higher in the CWD group (pooled RR: 0.30; 95% CI: 0.00-0.59). Flap failure rate was similar in both groups (pooled RR: 0.09; 95% CI: -0.05 to 0.23). NPWT appears to be a reasonable option for wound management in Gustilo 3 lower limb fractures in terms of infection rates.

Multicomponent Synergistic Antibacterial Hydrogel Based on Gelatin-Oxidized Carboxymethyl Cellulose for Wound Healing of Drug-Resistant Chronic Infection.

Bacterial invasion hinders the healing process of wound, leading to the formation of chronic infected wound; meanwhile, the misuse of antibiotics has resulted in the emergence of numerous drug-resistant bacteria. The application of conventional antimicrobial methods and wound treatment techniques is not appropriate for wound dressings. In this paper, quaternized poly(vinyl alcohol) (QPVA) and pomegranate-like copper uniformly doped polydopamine nanoparticles (PDA@Cu) were introduced into a gelatin-oxidized carboxymethyl cellulose system to form a multicomponent synergistic antibacterial hydrogel (GOQ3P3). Polydopamine improves the biocompatibility and prevents the detachment of Cu nanoparticles. It can achieve synergistic antibacterial effects through quaternary ammonium salt-inorganic nanoparticle photothermal treatment under 808 nm near-infrared (NIR) irradiation. It exhibits highly efficient and rapid bactericidal properties against Escherichia coli, Staphylococcus aureus, and MRSA (methicillin-resistant Staphylococcus aureus) with an antibacterial rate close to 100%. The gel scaffold composed of macromolecules gives the hydrogel excellent mechanical properties, adhesive capabilities, self-healing characteristics, biocompatibility, and pH degradation and promotes cell adhesion and migration. In a full-thickness wound healing model infected with MRSA, GOQ3P3 controls inflammatory responses, accelerates collagen deposition, promotes angiogenesis, and enhances wound closure in the wound healing cascade reaction. This study provides a feasible strategy for constructing dressings targeting chronic infection wounds caused by drug-resistant bacteria.

A commentary on 'A systematic review and meta-analysis comparing negative pressure wound therapy to conventional wound dressings in the treatment of open fractures'.

A commentary on 'A systematic review and meta-analysis comparing negative pressure wound therapy to conventional wound dressings in the treatment of open fractures'.

Film dressings from Thai mango seed kernel extracts versus nanocrystalline silver dressings in antibacterial properties.

Introduction: The extract from the Mango Seed Kernel (MSK) has been documented to exhibit antibacterial activity against Gram-positive and Gram-negative bacteria, including Staphylococcus aureus and Pseudomonas aeruginosa. This suggests that biomaterials containing MSK extract could be a viable alternative to conventional wound treatments, such as nanocrystalline silver dressings. Despite this potential, there is a notable gap in the literature regarding comparing the antibacterial effectiveness of MSK film dressings with nanocrystalline silver dressings. This study aimed to develop film dressings containing MSK extract and evaluate their antibacterial properties compared to nanocrystalline silver dressings. Additionally, the study aimed to assess other vital physical properties of these dressings critical for effective wound care. Materials and methods: We prepared MSK film dressings from two cultivars of mango from Thailand, 'Chokanan' and 'Namdokmai'. The inhibition-zone method was employed to determine the antibacterial property. The morphology and chemical characterization of the prepared MSK film dressings were examined with scanning electron microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR), respectively. The absorption of pseudo-wound exudate and water vapor transmission rate (WVTR) of film dressings were evaluated. Results: The results showed that 40% of MSKC film dressing had the highest inhibition zone (20.00 ± 0.00mm against S. aureus and 17.00 ± 1.00mm against P. aeruginosa) and 20%, 30%, and 40% of MSKC and MSKN film dressings had inhibition zones similar to nanocrystalline silver dressing for both S. aureus and P. aeruginosa (p > 0.05). In addition, all concentrations of the MSK film dressings had low absorption capacity, and Chokanan MSK (MSKC) film dressings had a higher WVTR than Namdokmai MSK (MSKN) film dressings. Conclusion: 20%, 30%, and 40% of MSK film dressing is nearly as effective as nanocrystalline silver dressing. Therefore, it has the potential to be an alternative antibacterial dressing and is suitable for wounds with low exudate levels.

Knotless suture in revision total joint arthroplasty: a prospective randomized controlled trial.

The use of barbed sutures for wound closure in primary total joint arthroplasty (TJA) has been shown to be effective and safe. However, their effectiveness and safety in revision TJA procedures has not been thoroughly studied. This study aims to evaluate the efficacy and safety of using barbed suture closure in revision TJA setting. A total of 80 patients undergoing revision TJA between September 2020 and November 2022 were included in this randomized controlled trial study. Following informed consent, patients were computer-randomized to the treatment arm (barbed suture wound closure) or to the control arm (conventional wound closure). Closure duration, closure rate, number of sutures used and wound related outcomes including complication rates and Patient and Observer Scar Assessment Scale (POSAS) score were compared between groups. The use of barbed sutures decreased closure time by 6min (30.1 vs. 36.1min, P = 0.008) with a higher wound closure rate (6.5 vs. 5.5mm/minute, P = 0.013). Additionally, the number of sutures used for wound closure in the barbed group was significantly lower than in the control group (6.2 vs. 10.1, respectively, P < 0.001). There were no significant differences in the rate of postoperative wound complications (P = 0.556) or patient and observer POSAS scores (P = 0.211, P = 297, respectively) between the two groups at 3-month follow-up. Closure of revision TJA surgical wound utilizing barbed sutures reduced closure time and the number of needles handled by operative staff, with no significant increase in intra- or post-operative complications rate when compared to traditional closure technique. I.

In vitro and in vivo assessment of gallic acid-chitosan/polycaprolactone conjugate electrospun nanofibers for wound healing

The development of innovative multifunctional wound healing materials based on natural bioactives has attracted a great deal of attention in recent years due to their ability to potentiate the healing process and minimize the challenges linked with conventional wound dressings. The current study demonstrates the development and evaluation of a novel nanofibrous wound healing mat made of Gallic acid-chitosan conjugate (GAC) incorporated within a polycaprolactone (PCL) matrix using an electrospinning technique. The GAC conjugate was synthesized by green synthesis using a free radical polymerization reaction to improve the chitosan's free radical scavenging properties. FTIR, DSC, XRD, and UV spectral analysis characterized the formation of GAC conjugate. The red shift observed in the UV spectrum suggested alterations in electronic transitions resulting from the creation of covalent bonds between Chitosan (CA) and Gallic acid (GA). The appearance of broader and weaker peaks in DSC and the reduced crystallinity in XRD spectrum, signify structural modifications, thereby providing valuable insights into the interaction and structural changes occurring in the GAC conjugates.The SEM image revealed a porous flake-like structural network of GAC conjugate due to the reduced intermolecular hydrogen bonding between them. The functional layer of the nanofibrous mat was produced by electrospinning GAC conjugate with polycaprolactone (PCL) to provide mechanical integrity to the nanofibrous mat. The electrospun nanofibers were characterized using FTIR, DSC, and SEM and evaluated for cell cytotoxicity, angiogenesis, and in vivo wound healing potential in female Wistar rats. The FTIR spectra confirmed the presence of GAC conjugate in the nanofibers, validating the conjugation process. The results demonstrated the successful incorporation of GAC conjugate within the PCL nanofibrous mat, thereby confirming the improvement in the biological properties of the mats. The nanofibrous mat showed angiogenesis activity in the yolk sac membrane assay confirming the property of nanofibers to facilitate cellular adhesion, migration and promotion of angiogenesis with no cytotoxic effect on the viability of mouse stromal cells. On the sixteenth day of therapy, wounds dressed with GAC/PCL nanofibrous mat exhibited a significant improvement in the percent wound closure (94.43%) as compared to the control group (p < 0.05). These results supported the application of GAC/PCL as a novel biomaterial for wound dressing to accelerate the process of wound healing.