Excessive Exudate Research Articles

Alpha-ketoglutarate supramolecular network accelerates diabetic wound healing through exudates management and neovascularization

Healing of chronic wounds such as diabetic foot ulcers is a critical clinical challenge due to the failure management of excess exudates, persistent inflammatory responses, and vascular microcirculatory disturbances by most traditional wound dressings. To promote the wound healing under diabetic pathological environment, a supramolecular network, polyethyleneimine/polyacrylic acid/alpha-ketoglutarate (PEI/PAA/αKG) with bioactive and metabolic αKG was developed herein for exudates management and vascular microcirculatory reconstruction. Once deposited onto the wound area, the PEI/PAA/αKG supramolecular powder would quickly adsorb the exudates and in-situ gel to form a robust protective barrier for sustainably managing the wound exudates during the healing process. Owing to the reversible H-bonding and electrostatic interactions in the network, bioactive αKG monomer could responsively dissociate from the supramolecular network in a pH-dependent manner to promote the chronic diabetic wound healing. The collagen deposition, soft tissue regeneration, and neovascularization of the healing wound were all obviously enhanced under the mediation of PEI/PAA/αKG supramolecular hydrogel. It was further confirmed that the outstanding effect of PEI/PAA/αKG on angiogenesis under diabetic condition results from the function of αKG on cellular oxidative stress regulation. The present method of materializing therapeutic molecules provides a potential strategy to solve the problem of metabolic molecules in biomedical application.

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

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

Molecular Characterization of a Clade 2.3.4.4b H5N1 High Pathogenicity Avian Influenza Virus from a 2022 Outbreak in Layer Chickens in the Philippines.

H5 subtype high-pathogenicity avian influenza (HPAI) viruses continue to devastate the poultry industry and threaten food security and public health. The first outbreak of H5 HPAI in the Philippines was reported in 2017. Since then, H5 HPAI outbreaks have been reported in 2020, 2022, and 2023. Here, we report the first publicly available complete whole-genome sequence of an H5N1 high-pathogenicity avian influenza virus from a case in Central Luzon. Samples were collected from a flock of layer chickens exhibiting signs of lethargy, droopy wings, and ecchymotic hemorrhages in trachea with excessive mucus exudates. A high mortality rate of 96-100% was observed within the week. Days prior to the high mortality event, migratory birds were observed around the chicken farm. Lungs, spleen, cloacal swabs, and oropharyngeal-tracheal swabs were taken from two chickens from this flock. These samples were positive in quantitative RT-PCR assays for influenza matrix and H5 hemagglutinin (HA) genes. To further characterize the virus, the same samples were subjected to whole-virus-genome amplification and sequencing using the Oxford Nanopore method with mean coverages of 19,190 and 2984, respectively. A phylogenetic analysis of the HA genes revealed that the H5N1 HPAI virus from Central Luzon belongs to the Goose/Guangdong lineage clade 2.3.4.4b viruses. Other segments also have high sequence identity and the same genetic lineages as other clade 2.3.4.4b viruses from Asia. Collectively, these data indicate that wild migratory birds are the likely source of H5N1 viruses from the 2022 outbreaks in the Philippines. Thus, biosecurity practices and surveillance for HPAI viruses in both domestic and wild birds should be increased to prevent and mitigate HPAI outbreaks.

MANAGEMENT OF HAND ECZEMA (VICHARCHIKA) THROUGH AYURVEDA: A CASE STUDY

Eczema is referred to as "atopic dermatitis." It's a chronic inflammatory skin condition characterised by itchy, red, and dry skin and sometimes scaly patches of skin. These patches may become thickened, cracked, or scaly and can occur anywhere on the body. Eczema often involves periods of flare-ups and remissions and can vary from mild to severe. It is considered a type of allergic or atopic condition, and it's commonly associated with other allergic conditions such as asthma and hay fever. Eczema resembles Vicharchika in Ayurveda. The signs and symptoms of Vicharchika are kandu (itching), pidika (papule), shyava varna (blackish-brown discolouration), and bahusrava (excessive exudation). Case summary: A 29-year-old female patient approached Kayachikitsa Skin OPD with complaints of dry, scaly skin lesions over bilateral palms with redness, cracking, and occasional discharge from lesions associated with severe itching for 10 years; symptoms have aggravated for 15 days. Based on signs and symptoms, an Ayurvedic diagnosis was made as Vicharchika (hand eczema). The subject was given deepana (appetiser)-pachana (carminative), bahya rukshana karma (external dehydrating therapy), then snehapana (internal oleation), followed by Virechana (purgation therapy), and shamana aushadhis (oral medications). The subject showed improvement in signs and symptoms, EASI and DLQI scores.

Bacteria-Derived Cellulose Membranes Modified with Graphene Oxide-Silver Nanoparticles for Accelerating Wound Healing.

This study reports on the modification of bacterial cellulose (BC) membranes produced by static fermentation of Komagataeibacter xylinus bacterial strains with graphene oxide-silver nanoparticles (GO-Ag) to yield skin wound dressings with improved antibacterial properties. The GO-Ag sheets were synthesized through chemical reduction with sodium citrate and were utilized to functionalize the BC membranes (BC/GO-Ag). The BC/GO-Ag composites were characterized to determine their surface charge, morphology, exudate absorption, antimicrobial activity, and cytotoxicity by using fibroblast cells. The antimicrobial activity of the wound dressings was assessed against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. The results indicate that the BC/GO-Ag dressings can inhibit ∼70% of E. coli cells. Our findings also revealed that the porous BC/GO-Ag antimicrobial dressings can efficiently retain 94% of exudate absorption after exposure to simulated body fluid (SBF) for 24 h. These results suggest that the dressings could absorb excess exudate from the wound during clinical application, maintaining adequate moisture, and promoting the proliferation of epithelial cells. The BC/GO-Ag hybrid materials exhibited excellent mechanical flexibility and low cytotoxicity to fibroblast cells, making excellent wound dressings able to control bacterial infectious processes and promote the fast healing of dermal lesions.

Anthocyanidin-Loaded Superabsorbent Self-Pumping Dressings for Macrophage Immunomodulation and Diabetic Wound Healing.

Management of diabetic chronic wound exudate is a serious challenge in healthcare worldwide since it is related to the speed of diabetic wound healing. However, current foam dressings not only absorb fluid to generate swelling and compress the wound to hinder wound healing but also are very thick and less comfortable to use. Herein, a superabsorbent self-pumping ultrathin dressing is reported to accelerate diabetic wound healing by achieving superior exudate absorption and management in an ultrathin state. The self-pumping dressing is composed of a drainage layer loaded with anthocyanidin and a thermoplastic polyurethane absorbent layer embedded with superabsorbent particles. The dressing realizes the self-pumping process of unidirectional exudate draining to the absorption layer through the drainage layer without significant dressing swelling to compress the diabetic wound. The dressing is experimentally proven to unidirectionally drain excessive exudate with inflammatory factors and modulate the conversion of macrophages from M1 to M2 in diabetic wounds, thereby promoting the healing of diabetic skin ulcers faster than commercial foam dressings. Therefore, the dressing provides a new idea and novel method for accelerating diabetic skin ulcer healing.

Sodium alginate-based nanofibers loaded with Capparis Sepiaria plant extract for wound healing

Burn wounds are associated with infections, drug resistance, allergic reactions, odour, bleeding, excess exudates, and scars, requiring prolonged hospital stay. It is crucial to develop wound dressings that can effectively combat allergic reactions and drug resistance, inhibit infections, and absorb excess exudates to accelerate wound healing. To overcome the above-mentioned problems associated with burn wounds, SA/PVA/PLGA/Capparis sepiaria and SA/PVA/Capparis sepiaria nanofibers incorporated with Capparis sepiaria plant extract were prepared using an electrospinning technique. Fourier-transform infrared spectroscopy confirmed the successful incorporation of the extract into the nanofibers without any interaction between the extract and the polymers. The nanofibers displayed porous morphology and a rough surface suitable for cellular adhesion and proliferation. SA/PVA/PLGA/Capparis sepiaria and SA/PVA/Capparis sepiaria nanofibers demonstrated significant antibacterial effects against wound infection-associated bacterial strains: Pseudomonas aeruginosa, Enterococcus faecalis, Mycobaterium smegmatis, Escherichia coli, Enterobacter cloacae, Proteus vulgaris, and Staphylococcus aureus. Cytocompatibility studies using HaCaT cells revealed the non-toxicity of the nanofibers. SA/PVA/PLGA/Capparis sepiaria and SA/PVA/Capparis sepiaria nanofibers exhibited hemostatic properties, resulting from the synergistic effect of the plant extract and polymers. The in vitro scratch wound healing assay showed that the SA/PVA/Capparis sepiaria nanofiber wound-healing capability is more than the plant extract and a commercially available wound dressing. The wound-healing potential of SA/PVA/Capparis sepiaria nanofiber is attributed to the synergistic effect of the phytochemicals present in the extract, their porosity, and the ECM-mimicking structure of the nanofibers. The findings suggest that the electrospun nanofibers loaded with Capparis sepiaria extract are promising wound dressings that should be explored for burn wounds.

Comparison of "Semiocclusive Dressing" Treatment Using Plastic Wrap or Low-Adherent Absorbent Wound Dressings Versus Occlusive Dressing Treatment for Stage III/IV Pressure Injuries in the Inflammatory Phase: A Randomized Controlled Trial.

Objective: To compare the effectiveness of "semiocclusive dressing (SOD)" treatment using plastic wrap or low-adherent absorbent wound dressings with that of occlusive dressing (OD) treatment for National Pressure Injury Advisory Panel stage III/IV pressure injuries in the inflammatory phase. Approach: This 12-week, open-label, randomized controlled trial was conducted at one hospital and three care facilities. Seventy-seven participants were enrolled; 40 comprised the SOD group and 37 comprised the OD group. The primary outcome was the surface area reduction. Secondary outcomes included the Bates-Jensen Wound Assessment Tool (BWAT) score reductions, incidence of adverse events, and material cost. This trial met the recommendations of the CONSORT 2010 statement. Results: The surface area reduction of the SOD group was greater than that of the OD group throughout the study period. The significant interaction was revealed between treatment and time course (p < 0.0001). The 95% confidence interval of the difference at 12 weeks was 3.4 to 21.9. The median BWAT score reduction of the SOD group at 12 weeks was 23, and that of the OD group was 18.5 (p = 0.0077). The incidence of adverse events was comparable between groups. The OD treatment cost was 3.0 times higher than the SOD treatment cost (p = 0.0012). Innovation: Because the SOD does not completely occlude the wound, excess exudate drains from the wound. Therefore, SOD can treat the wound with abundant exudate effectively and safely. Conclusion: SOD treatment is more effective and less expensive than OD treatment for stage III/IV pressure injuries. Clinical Trial Registration: UMIN Clinical Trials Registry [UMIN000023412]. Registered on July 31, 2016.

A Highly Stable, Multifunctional Janus Dressing for Treating Infected Wounds.

The limited and unstable absorption of excess exudate is a major challenge during the healing of infected wounds. In this study, a highly stable, multifunctional Janus dressing with unidirectional exudate transfer capacity is fabricated based on a single poly(lactide caprolactone) (PLCL). The success of this method relies on an acid hydrolysis reaction that transforms PLCL fibers from hydrophobic to hydrophilic in situ. The resulting interfacial affinity between the hydrophilic/phobic PLCL fibers endows the Janus structure with excellent unidirectional liquid transfer and high structural stability against repeated stretching, bending, and twisting. Various other functions, including wound status detection, antibacterial, antioxidant, and anti-inflammatory properties, are also integrated into the dressing by incorporating phenol red and epigallocatechin gallate. An in vivo methicillin-resistant Staphylococcus aureus-infected wound model confirms that the Janus dressing, with the capability to remove exudate from the infected site, not only facilitates epithelialization and collagen deposition, but also ensures low inflammation and high angiogenesis, thus reaching an ideal closure rate up to 98.4% on day 14. The simple structure, multiple functions, and easy fabrication of the dressing may offer a promising strategy for treating chronic wounds, rooted in the challenges of bacterial infection, excessive exudate, and persistent inflammation.

A poly (lactic-co-glycolic acid) self-pumping Janus dressing with bidirectional biofluid transport for diabetic wound healing via anti-bacteria and pro-angiogenesis

Diabetic wound healing poses a substantial challenge owing to bacterial infections, insufficient angiogenesis, and excessive exudates. Currently, most of the clinical dressings used for diabetic wounds are still conventional dressings such as gauze. In this study, a three-layer Janus dressing was developed via continuous electrostatic spinning. The top-layer was composed of polylactic acid-glycolic acid and hydroxyapatite doped with silver ions and silicate. The hydrophobic top-layer prevented the adhesion of foreign bacteria. The mid-layer was composed of polyethylene glycol, polylactic acid-glycolic acid and hydroxyapatite doped with silver ions and silicate facilitated exudate absorption and bioactive ion release. The modified sub-layer containing polylactic acid-glycolic acid, hydroxyapatite doped with silver ions and silicate and sodium alginate microspheres enabled both the transport of wound exudate from the wound bed to dressing and the backflow of bioactive silver ions and silicate to the wound bed, thereby reducing infection and stimulating angiogenesis. Through in vivo and in vivo experiments, the Janus dressing showed to have antimicrobial, angiogenic, and exudate-control properties that accelerate healing in diabetic wounds. As a novel dressing, the multifunctional, self-pumping Janus wound dressing with bi-directional biofluidic transport offers a new approach to diabetic wound healing.

Electrospun Self-Pumping dressing with gastrodin for immunomodulation and rapid healing of diabetic wounds

The diabetic wound is often associated with excessive inflammatory exudate, scant neovascularization, and imbalanced macrophage immunomodulation. However, the inflammatory exudate is absorbed by gauze to come into contact with the diabetic wound, which hinders the separation of the inflammatory exudate from the wound without creating effective separation protection. Hence, an electrospun multifunctional self-pumping dressing loading with gastrodin is designed to attenuate inflammation, improve immunomodulation, and promote neovascularization. The absorbent layer and drainage layer of the self-pumping dressing are integrated using electrospinning. The inflammatory exudate in the diabetic wound is unidirectionally drained from the drainage layer to the absorbent layer via the self-pumping structure. In addition, the synergistic effect of the immunomodulatory and anti-inflammatory properties of gastrodin and the self-pumping properties of the self-pumping dressing further promote the rapid healing of diabetic wounds. The diabetic wound healing experiment confirms that the self-pumping dressing loading with gastrodin exhibits the ability to rapidly promote diabetic wound healing within 15 days. The self-pumping dressing with gastrodin can regulate inflammatory exudate in diabetic wounds and promote extremely rapid healing of diabetic wounds, which expands the novel application of gastrodin and self-pumping dressing in the field of biomedical materials.

A clinical observational case series evaluation of a superabsorbent dressing on exudating wounds.

The annual cost to the NHS of managing 3.8 million patients with a wound was estimated in 2020 to be £8.3 billion, of which £5.6 billion was spent on the 30% of wounds that did not heal and £2.7 billion on the 70% of wounds that healed (Guest, 2020). One of the main symptoms associated with chronic 'hard-to-heal' wounds is the production of excess exudate (Atkin et al, 2019). This is due to a prolonged chronic inflammatory response stimulated by a physiological cause. This article describes what exudate is and its importance in the wound healing process, highlighting the consequences of too little or excessive wound exudate associated with any wound. The article goes on to describe a case series observational study involving a range of patients (n=47; 33 male/14 female), aged between 33 and 91 years (mean 67.4 years), with a variety of acute (n=11) and chronic exuding wounds (n=44). In total, 55 wounds of various aetiologies were managed with DryMax Super (a dressing whose design includes superabsorbent polymers) in order to evaluate and report on the absorption and fluid-handling properties of the product.

USING OF NEGATIVE WOUND PRESSURE THERAPY (NPWT): A CASE SERIES OF WOUND DISRUPTION AS A COMPLICATION OF A CAESAREAN SECTION

Highlights: Surgical site infection during caesarean section can cause complications, thereby increasing maternal mortality and morbidity, especially in groups at risk. VAC therapy can stimulate granulation tissue formation so that primary wound junctions occur. VAC shows its ability to close wounds entirely within 3-4 weeks. Abstract: Introduction: Wound disruption following caesarean sections is a common issue that can increase maternal mortality and morbidity. Several factors have been identified, including maternal, procedural, and antibiotic factors. The re-suturing method, primer, and secondary suture often fail, causing recurrent and delayed healing. Case Illustration: CASE 1: A 26-year-old woman, 7 days post-caesarean section, presented with a wet wound and yellowish serous fluid. Three weeks later, wound dehiscence occurred despite re-debridement and re-suturing. Subsequent installation of VAC resulted in granulation tissue and re-epithelialization. CASE 2: A 32-year-old woman, 14 days post-caesarean section, complained of weakness and pus in the surgical wound. Upon examination, a red-yellowish fluid was found, indicating wound dehiscence. Re-debridement and VAC installation led to the formation of granulation tissue and re-epithelialization. Discussion: VAC is the new wound care technique that suctions or collects excess exudate that absorbent gauze cannot accommodate. In comparison, absorbent gauze is limited in its capacity to absorb the fluid that produced in wounds. An innovation where the use of VAC, which has a negative pressure function, can stimulate granulation tissue to form and can bind the edges of the wound so that it can close naturally. Conclusion: In instances of wound disruption following surgery, such as in the case of a caesarean section, it may be prudent to contemplate re-debridement followed by re-suturing. VAC presents itself as a viable alternative for managing wound dehiscence until the formation of granulation tissue.

Immunometabolic checkpoint-mediated macrophage metabolic reprogramming accelerates infected wound healing

Immunometabolic disorders, triggered by excessive oxidative stress, lead to macrophage dysfunction, consequently impeding the healing of infected wounds. The uncontrolled accumulation of reactive oxygen species (ROS) in infected wounds is primarily attributed to persistent bacterial infections, excess exudate, and hypoxia. Herein, an immunometabolic checkpoint-mediated macrophage metabolic reprogramming strategy based on a nanofiber aerogel loaded with catalase (CAT) and tannic acid (TA) is proposed. The three-dimensional porous network of the nanofiber aerogel effectively absorbs exudates, maintains wound dryness, and prevents tissue saturation. CAT catalyzes oxygen generation, alleviates hypoxia, and reduces ROS, while TA acts as a natural antioxidant and antibacterial agent, collaboratively mitigating oxidative stress and bacterial infections. More importantly, the CAT-TA nanofiber aerogel, as an immunometabolic checkpoint regulator, can reshape the glutathione (GSH) metabolic pathway, enhancing intrinsic antioxidative capacity, allowing the reversion of macrophage functions, and ultimately promoting wound healing. This macrophage metabolism therapy (MMT), centered on the modulation of immunometabolic checkpoint, effectively enhances the regenerative capacity of infected wounds and provides a pioneering perspective for the treatment of regeneration disorders in infected tissues.

The importance of the simulated wound fluid composition and properties in the determination of the fluid handling performance of wound dressings.

Effective fluid handling by wound dressings is crucial in the management of exuding wounds through maintaining a clean, moist environment, facilitating healing by removing excess exudate and promoting tissue regeneration. In this context, the availability of reliable and clinically relevant standardised testing methods for wound dressings are critical for informed decision making by clinicians, healthcare administrators, regulatory/reimbursement bodies and product developers. The widely used standard EN 13726 specifies the use of Solution A, an aqueous protein-free salt solution, for determining fluid-handling capacity (FHC). However, a simulated wound fluid (SWF) with a more complex composition, resembling the protein, salt, and buffer concentrations found in real-world clinical exudate, would provide a more clinically relevant dressing performance assessment. This study compared selected physicochemical parameters of Solution A, an alternative, novel simulated wound fluid (SWF A), and a benchmark reference serum-containing solution (SCS) simulating chronic wound exudate. Additionally, FHC values for eight advanced bordered and non-bordered foam dressings were determined for all three test fluids, following EN 13726. Our findings demonstrate a close resemblance between SWF A and SCS. This study highlights the critical importance of selecting a physiochemically appropriate test fluid for accurate FHC testing resulting in clinically meaningful evaluation of dressing performance.

Ayurvedic Management of Refractory Atopic Dermatitis - Case Report

The term 'eczema' refers to inflammation of the skin and makes the skin irritated. Most common type is atopic dermatitis or atopic eczema. Vicharchika (skin disease with excessive exudation) in ayurveda can be compared to atopic dermatitis (AD). It manifests as erythema, vesiculation and oozing in the acute stage, scaling, and crusting in the subacute stage and lichenification (hyperpigmentation, accentuation of skin markings and thickening of the skin) in the chronic stage. The current condition known as atopic dermatitis leads to eager, aroused skin. Most often, it takes the form of patches on the face, neck, trunk, or extremities. This article presents a case study of a child who is having signs and symptoms of vicharchika. According to ayurvedic etiopathogenesis (samprapti) patient was diagnosed with vicharchika and is treated accordingly by internal and external therapies. Assessment was conducted using subjective as well as objective criteria. Oral ayurvedic medications along with udvartanachurna for local applications as part of the treatment was given. This case was successfully treated using the chikitsasiddhanta of vicharchika. After treatment, there was noticeable improvement in both signs and symptoms. The course of treatment revealed no complications. The study's goals and objectives were to assess the efficacy of simple ayurvedic formulations for the treatment. This single case report highlights thatthis ayurvedic intervention generated beneficial results and raised the quality of life of the patient.

Engineered composite dressing with exudate management capabilities for the process of entire wound healing

A timely antibacterial dressing that can adapt to dynamic wound environments poses a significant challenge in burn research and management. Herein, a four-layered composite dressing is reported. At its core, it features a modified micropore arrayed Janus membrane with a super-hydrophobic polyurethane layer on one side and a super-hydrophilic hydrogel on the other. This unique design enables the dressing to maintain stable and durable self-pumping capabilities, effectively transferring wound exudate to the upper foam layer. The self-pumping rate exceeds that of traditional foam dressings, being approximately 1.39 times more efficient in absorbing excess wound exudate. The composite dressing demonstrates an impressive water donation capacity when tested on 45% gelatin-simulated skin, achieving a water donation rate of (59.20 ± 2.66)%. Furthermore, the water vapor permeability of the composite dressing outperforms hydrocolloids by approximately 3.66 times. Additionally, the composite dressing, when loaded with super-hydrophilic nanometer zinc oxide, exhibits a potent antibacterial effect. The dressing's surface reduces cellular, platelet, fibrinogen, and bovine serum albumin adhesion, reducing the risk of tissue adhesion. During a 20-day trial covering deep II-degree burn wounds, the dressing demonstrated excellent biocompatibility. It effectively compresses the inflammatory phase, promotes vascularization, and significantly accelerates the regeneration of skin accessory organs. This innovative dressing exhibits great potential for use throughout the entire wound-healing process in future burn treatments.

Localized trans-browning and pro-angiogenesis inductive self-assembled collagen resveratrol bio-matrix for tissue repair and regeneration in obese conditions

The present study probes into the complexities of wound management in obesity by proposing a novel biomaterial designed to reprogram the altered skin physiology prevalent in obese conditions. The strategy involves the development of a multifunctional biomaterial addressing issues such as excessive exudate, pressure ulcers, and reduced vascularity. The bio-matrix demonstrates the localized transformation of white adipocytes through trans-browning, coupled with the simultaneous induction of angiogenesis at obese wound sites, resulting in expedited wound closure. The collagen bio-matrices, stabilized with Resveratrol (Rsv), exhibit remarkable thermal, mechanical, and biological stability. The porous 3D microstructure of the Rsv-stabilized collagen bio-matrix closely resembled the natural extracellular matrix, facilitating effective cell adhesion. The bio-matrix exhibited the unique capability to induce localized thermogenesis in the subcutaneous fat layer while concurrently activating angiogenesis. In vivo wound healing studies conducted on DIO-C57BL6 mice demonstrated complete healing within 10 days, showcasing accelerated tissue regeneration, blood vessel formation, robust collagen deposition, and significant activation of browning in the subcutaneous adipose layer. This study introduces the concept of tailored regenerative biomaterials with the ability to reprogram the challenging wound environment associated with obesity. This innovative approach opens up new avenues for enhanced wound care strategies, particularly for bariatric patients.

Apigenin Self-Assembled Collagen Biomatrix for Reprogramming the Obese Wound Microenvironment for Its Management and Repair.

Wound management in obesity is complicated by excessive exudates from wounded areas, pressure ulcerations due to stacking of the fat layer, and vascular rarefaction. The current study explored the development of biomaterials for reprogramming the altered wound microenvironment under obese conditions. Self-assembled collagen biomatrix with trans and de novo browning activator, apigenin, was fabricated as a soft tissue regenerative wound dressing material. The as-synthesized self-assembled collagen biomatrix exhibited excellent thermal, mechanical, and biological stability with a superior wound exudate absorption capacity. The apigenin self-assembled collagen biomatrix exhibited porous 3-D microstructure that mimicked the extracellular matrix that promoted cell adhesion and proliferation. The apigenin self-assembled collagen multifunctional biomatrix triggered adaptive localized thermogenesis in the subcutaneous fat layer, resulting in the activation of angiogenesis and fibroblast spreading and migration. The in vivo wound healing assay performed in DIO-C57BL6 mice showed faster tissue regeneration within 9 days, with well-defined neo-epidermis, blood vessel formation, thick collagen deposition, minimal inflammation, and significant activation of browning in the subcutaneous adipose layer. This study paves the way forward for the development of specialized regenerative biomatrices that reprogram the obese wound bed for faster tissue regeneration.

Surface Wrinkled Microsphere Enhanced Irregular Wound Healing Through Synergistic Hygroscopicity, Reversible Wet‐Adhesion and Antibacterial Properties

Rapid and effective healing of irregular wounds caused by burns, lacerations, and blast injuries remains a persistent challenge in wound care. Hydrogel microsphere dressings that can adaptively fill and adhere to the wounds without external force are desired to treat irregular wounds, providing an external barrier and accelerating healing. Herein, we created multifunctional cellulose‐based surface‐wrinkled microspheres with antioxidant, antibacterial, hygroscopicity, wet‐adhesion and shape‐adaptive capabilities to relieve inflammation, bacteria and excess exudate situations in healing irregular wounds. This dressing rapidly adsorbs exudate and reversibly adheres wetly to the wounds upon being filled, effectively inhibiting bacterial infection and reducing the flooded exudate to accelerate wound healing. Polydopamine (PDA) provides catechol‐based tissue bioadhesion to microspheres through π–π stacking or hydrogen bond interaction, and also establishes a bond bridge with an antimicrobial component (thymol), which not only enables the microspheres to stably adhere to the wound to maintain hygroscopicity, but also improves the release of the introduced antimicrobial component (thymol). In vivo assays, as well as histopathological and immunofluorescence studies have shown that multifunctional cellulose‐based microspheres have excellent pro‐healing abilities and are promising candidates for dehumidification and healing of irregular wound in clinical applications.