The formation of chronicwounds accounts for considerable costs in health care systems. Despite theseveral benefits of decellularized small intestinal submucosa (SIS) as anappropriate scaffold for different tissue regeneration, it has shortcomings such as lack of antibacterial features and inappropriate mechanical properties for skin tissue regeneration. We aimed to examine the efficacy and safety of decellularized SIS scaffold enhanced with cellulose acetate (CA) and silver (Ag) nanoparticles (NPs) for healing full-thickness wounds. The scaffolds wereprepared by decellularizing bovine SIS and electrospinning CA/Ag nanoparticles and characterized using a transmission electron microscope (TEM), scanning electronmicroscope (SEM), tensile testing, and X-ray diffraction. In vivo evaluations were performed using full-thickness excisions covered with sterile gauze as the control group, SIS, SIS/CA, and SIS/CA/Ag scaffolds on the dorsum of twenty male Wistar rats divided into four groups randomly with 21-days follow-up. All in vivo specimens underwent Masson's trichrome (MT) staining for evaluation of collagen deposition, transforming growth factor-β (TGF-β) immunohistochemistry (IHC), and Haematoxylin Eosin (H&E) staining. The IHC and MT data were analyzed with the ImageJ tool by measuring the stained area. The TEM results revealedthat Ag nanoparticles are successfully incorporated into CA nanofibers. Assessment of scaffoldshydrophilicity demonstrated that the contact angle of SIS/CA/Ag scaffold was the lowest. The in vivoresults indicated that the SIS/CA/Ag scaffold had the most significant wound closure. H&E staining of the invivo specimens showed the formation of epidermal layers in the SIS/CA/Ag group on day 21. The percentage of the stained area of MT and TGF-β IHC staining's was highest in the SIS/CA/Ag group. The decellularizedSIS/CA/Ag scaffolds provided the most significant wound closure compared toother groups and caused the formation of epidermal layers and skin appendages. Additionally, the collagen deposition and expression of TGF-β increased significantly in SIS/CA/Ag group.
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