Medical Tourism Research Articles

A Review on Post Pandemic Cardiac Arrests

Abstract: The COVID-19 pandemic has profoundly impacted global healthcare systems, with a significant increase in cardiac arrests reported during and following the peak phases of infection. This review examines the epidemiology, pathophysiology, clinical characteristics, and outcomes of post-pandemic cardiac arrest. It explores the complex interplay between viral infection, systemic inflammation, and cardiovascular complications, highlighting key risk factors such as pre-existing comorbidities and delayed medical interventions. Furthermore, the review discusses the challenges faced by healthcare providers in managing cardiac arrest cases amidst pandemic-related disruptions in healthcare delivery and emphasizes the importance of tailored resuscitation protocols and post-resuscitative care strategies. Insights from this review underscore the need for proactive public health measures, robust healthcare infrastructure, and ongoing research to mitigate the long-term impact of pandemics on cardiovascular health.

Identifying and Ranking Critical Motivational Dimensions for the Choice of Wellness Tourism: An Analytic Hierarchy Process (AHP) Approach

This exploratory study aims to determine the elements that impact travellers' decisions to choose wellness tourism. Motivation criteria have been prioritized to determine the most influential reason tourists decide to engage in wellness tourism. This study investigates the motivational factors that influence the decision to choose wellness tourism. These factors were ascertained by conducting an extensive review of the relevant literature and considering the preferences articulated by wellness tourism-seeking visitors. The Analytic Hierarchy Process (AHP) was employed to assess seven identified criteria and thirty-three sub-criteria, to determine their relative importance in motivating tourists to choose wellness tourism. The findings indicate, in accordance with the proposed hierarchical model, that motivational factors including “the desire to challenge myself physically,” “the desire to find peace for myself”, “the desire to look and feel better”, “the desire to maintain a balanced diet”, and "the desire to focus on one's inner self” - are the critical factors that motivates tourist to choose wellness tourism.

Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages

Currently, health tourists primarily rely on independent facilitators to manage and book their medical appointments and vacation plans. There is a notable absence of dedicated booking applications for health tourism packages. This paper proposes HealthTourismHub, an application designed to provide personalized packages that include medical appointments, accommodation options, and recommended tourism activities. It also serves as a platform for medical experts and accommodation providers, allowing health tourists to discover and connect with them, promoting local resources, and contributing to the sustainable growth of health tourism destinations. To incorporate personalization, HealthTourismHub uses an ontology that organizes medical and tourism data, along with a reasoner that generates new knowledge. This approach enables the application to offer customized packages and identify the most suitable providers for each user. Providers are strategically paired and located in close proximity, encouraging shorter travel distances and more efficient travel planning, with the package also including personalized tourism recommendations that benefit the local economy and contribute to a conscious tourism industry. A survey was conducted to assess the usability of the application and general perspectives towards health tourism, including motivations, concerns, and preferences. The results revealed an above-average SUS score, indicating that users found the application user-friendly and effective. Some areas for improvement were identified, such as error handling and additional functionalities. Nonetheless, HealthTourismHub shows great potential as a pioneer in the field of sustainable health tourism applications.

제주방문 관광자의 인구통계적 특성에 따른 위험지각과 선택속성 차이와 만족도 간의 영향 관계

This study analyzed how tourists who visited Jeju during the COVID-19 pandemic differed in their behaviors and satisfaction based on demographic characteristics. Data (n=600) were collected through an online survey from February 22 to March 4, 2023. Analyses included independent sample t-tests, one-way ANOVA, and multiple regression analysis. Results showed variations in risk perceptions: the perceived risk of COVID-19 infection was higher among women than men and was highest among those in their 40s and 50s. Tourists who made more than four visits to Jeju perceived greater economic risk than others. In terms of selection attributes, tourists in their 20s and 30s or with frequent visits rated healing factors highly. Those vaccinated more than four times or with more than four visits to Jeju also rated COVID-19 safety factors highly. Economic risk negatively impacted satisfaction, while COVID-19 infection risk had a positive impact. Both healing and safety factors positively influenced satisfaction. The findings suggest that Jeju needs to prioritize hygiene and sanitation in tourism facilities and services in the 'New Normal Tourism (NNT)' era and develop segmented healing resources and wellness tourism products to be recognized as a leading healing tourism island in Korea. Additionally, to prevent potential tourists from choosing other destinations over Jeju, Jeju's image as an expensive destination needs to be addressed.

Modern approaches to understanding pathogenetic link between arterial hypertension and renal failure from the point of view of evidence based medicine

Background: Renal failure and arterial hypertension are critical global health issues affecting millions worldwide. Hypertension, affecting over 1.13 billion individuals, is a significant risk factor for cardiovascular and renal diseases. Chronic kidney disease (CKD), affecting approximately 10% of the global population, significantly impacts morbidity, mortality, and socioeconomic wellbeing. The reciprocal relationship between hypertension and renal failure exacerbates these conditions, creating a detrimental cycle of worsening health. Methods and Materials: This study employs a comprehensive review of epidemiological data, pathophysiological mechanisms, and evidence-based management strategies. The research focuses on the bidirectional link between arterial hypertension and renal failure, analyzing the shared pathophysiological pathways such as endothelial dysfunction, inflammation, oxidative stress, and the activation of the renin-angiotensin-aldosterone system (RAAS). Data from various clinical trials and epidemiological studies are synthesized to propose effective treatment and management plans. Results: The findings indicate a strong reciprocal correlation between arterial hypertension and renal failure. Hypertension is prevalent in over 85% of CKD patients, and individuals with hypertension have a significantly higher risk of developing CKD. Shared pathophysiological mechanisms, such as endothelial dysfunction, inflammation, oxidative stress, and RAAS activation, contribute to the progression and worsening of both conditions. Effective management requires addressing these common mechanisms through evidence-based treatments like RAAS inhibitors and lifestyle modifications. Conclusion: The study underscores the need for integrated management strategies targeting both arterial hypertension and renal failure. Early detection, prevention, and comprehensive treatment approaches are crucial for mitigating the health and socioeconomic impacts of these interrelated diseases. Future research should focus on novel therapeutic strategies and personalized medicine to improve patient outcomes and reduce the global healthcare burden.

Tourism Crisis Events Affecting Intention towards Forest-Based Health Tourism: A Structural Equation Model

Since the beginning of the 21st century, various tourism crisis events have negatively impacted the global tourism industry. This study proposes a research model grounded in the Stimulus–Organism–Response theory to explore how external stimuli influence individuals and help identify factors influencing elderly individuals’ willingness to participate in forest-based health tourism during and after tourism crisis events, considering the global aging trend. From 20 December 2023 to 15 January 2024, we collected 429 valid questionnaires from Chinese older adult participants engaged in forest-based health tourism in Guizhou Province. Structural equation modelling (SEM) and bootstrapping techniques were employed to analyze data. The results indicate that tourism crisis events, primarily in the form of geological disasters, are significant antecedent variables influencing the willingness of Chinese older adults to engage in forest-based health tourism. Furthermore, destination image and perceived value serve as individual mediators and function as chained mediators. The results enhance our understanding of the complex relationship between tourism crisis events and the willingness of older Chinese adults to travel while also revealing deeper underlying mechanisms.

The impact of mobile health interventions on service users’ health outcomes and the role of health professions: a systematic review of systematic reviews—protocol

BackgroundMobile health tools have gained prominence in global health care in recent years. Mobile health (mHealth) interventions have demonstrated their impact on managing healthcare service users’ health. A pilot search revealed many systematic reviews on the effectiveness of mobile health tools on service users’ health outcomes. However, how the role of healthcare professionals in promoting the adoption of mobile health may lead to improved outcomes needs to be clarified. Therefore, this systematic review aims to synthesise existing systematic reviews that examine both the impact of mobile health interventions on service users’ outcomes and the role of healthcare professionals in facilitating the adoption of mobile health solutions.MethodsFive electronic databases will be searched: EMBASE, CINHAL Plus, MEDLINE, Web of Science, and the Cochrane Library for systematic reviews exploring the impact of mobile health interventions on service users’ outcomes and the role of healthcare professionals in facilitating the adoption of mobile health solutions. Systematic reviews published in English dated from January 2015 to June 2024 will be included. Screening and selection of the reviews against inclusion and exclusion criteria will be performed by three independent reviewers, as well as data extraction and quality assessment.DiscussionCurrent systematic reviews in mHealth have primarily focused on assessing the effectiveness of mHealth interventions for managing a range of conditions. While these reviews provide valuable input into the outcomes for mHealth, more is needed to know about the impact of the involvement of health professions on service users’ outcomes when adopting mHealth. This systematic review of systematic reviews aims to bridge this critical gap in the literature by critically appraising and synthesising the evidence of mHealth interventions’ impact on service user outcomes and the level of involvement of health professionals.Systematic review registrationPROSPERO CRD 42023414435.

Risk of Pediatric Bipolar Disorder After General Anesthesia in Infants and Toddlers: A Propensity Score-Matched Population-Based Cohort Study.

The potential role of anesthesia as an independent risk factor for childhood bipolar disorder (BD) remains unclear. To address this, we conducted a population-based cohort study employing propensity score matching to compare BD incidence between pediatric patients undergoing surgery with and without general anesthesia. Our study included patients aged 0-3 years who received at least 1 episode of general anesthesia and were hospitalized for over 1 day in Taiwan between January 2004 and December 2014. They were matched 1:1 with a population not receiving general anesthesia to assess pediatric BD incidence. The study cohort comprised 15 070 patients, equally distributed between the general anesthesia and nongeneral anesthesia groups (7535 each). Multivariate Cox regression analysis revealed adjusted hazard ratios (aHRs; 95% CIs) for pediatric BD in the general anesthesia group as 1.26 (1.04-1.54; P = .021) compared to the nongeneral anesthesia group. Moreover, the incidence rate ratio (95% CI) for the general anesthesia group was 1.26 (1.03-1.53) compared to the nongeneral anesthesia group. Early childhood exposure to general anesthesia is significantly associated with an increased risk of pediatric BD. This expands understanding of pediatric BD's complex development, informing preventive strategies, and enhancing mental health outcomes for vulnerable young patients and global pediatric healthcare.

Factors influencing multiple non-utilized healthcare appointments from patients' and healthcare providers' perspectives: a qualitative systematic review of the global literature.

The term "non-utilised appointments" emerged in 2019 but lacks a clear definition. We focus on multiple non-utilised appointments due to recent advances in understanding 'missingness' in UK healthcare. Studies on missed appointments show conflicting results regarding interventions like text messaging due to oversight of occasional versus repeated missed appointments. Understanding patient and healthcare-related factors in multiple non-utilised appointments is crucial for improving interventions and patient engagement. To identify factors influencing multiple non-utilised appointments from patients' and healthcare providers' perspectives. A systematic review of qualitative research identifying factors that influence multiple non-utilised appointments across diverse global health care settings. The review employed a qualitative systematic approach, encompassing diverse papers from multiple databases, irrespective of patient or healthcare provider age, location, or setting. Data analysis followed Thomas and Harden's thematic synthesis method. Themes are presented in alignment with both the health service and patient perspective aspects of the Levesque access model. Ten thousand and eighty-six records were retrieved. Five studies met the inclusion criteria and were analysed. Six key themes influenced appointment utilisation. Healthcare system determinants highlighted provider-patient relationship and professionalism, and healthcare organisation factors role in appointments utilisation. Patient experience and decision-making explored personal factors. Additionally, communication, support, and engagement delved into challenges with communication and language, family and social support, and socio-familial barriers to appointment utilisation. Health and well-being factors encompassed medical conditions, mental and emotional factors, and psychosocial determinants affecting appointment utilisation. Moreover, financial constraints and socioeconomic factors were identified as significant contributors. Lastly, healthcare access and barriers addressed transportation challenges, accessibility issues, and geographical barriers impacting healthcare access. The analysis reveals complex factors influencing multiple non-utilised appointments. Strong provider-patient relationships improve care accessibility. Flexible scheduling and patient-centred approaches are pivotal, alongside addressing workplace discrimination. Tailored healthcare services and overcoming geographical barriers are essential. Ensuring safety, accessibility, and communication, while supporting vulnerable groups and mental health needs, are necessary. Equitable access to services and alternative transportation solutions are essential for comprehensive healthcare delivery. PROSPERO CRD42023429465.

An investigation into resilience strategies in the medical tourism supply chain

An investigation into resilience strategies in the medical tourism supply chain

Unveiling the Potential: Remote Monitoring and Telemedicine in Shaping the Future of Heart Failure Management.

Heart failure (HF) remains a significant burden on global healthcare systems, necessitating innovative approaches for its management. This manuscript critically evaluates the role of remote monitoring and telemedicine in revolutionizing HF care delivery. Drawing upon a synthesis of current literature and clinical practices, it delineates the pivotal benefits, challenges, and personalized strategies associated with these technologies in HF management. The analysis highlights the potential of remote monitoring and telemedicine in facilitating timely interventions, enhancing patient engagement, and optimizing treatment adherence, thereby ameliorating clinical outcomes. However, technical intricacies, regulatory frameworks, and socioeconomic factors pose formidable hurdles to widespread adoption. The manuscript emphasizes the imperative of tailored interventions, leveraging advancements in artificial intelligence and machine learning, to address individual patient needs effectively. Looking forward, sustained innovation, interdisciplinary collaboration, and strategic investment are advocated to realize the transformative potential of remote monitoring and telemedicine in HF management, thereby advancing patient-centric care paradigms and optimizing healthcare resource allocation.

Anti-TNF therapy impairs both short- and long-term IgG responses after repeated vaccination.

Recently, it has been questioned whether vaccination of patients with inflammatory (auto)immune diseases under anti-tumor necrosis factor (TNF) treatment leads to impaired vaccine-induced immune responses and protection against breakthrough infections. However, the effects of TNF blockade on short- and long-term immune responses after repeated vaccination remain unclear. Vaccination studies have shown that initial short-term IgG antibodies (Abs) carry highly galactosylated and sialylated Fc glycans, whilst long-term IgG Abs have low levels of galactosylation and sialylation and are most likely generated by long-lived plasma cells (PCs) derived primarily from the germinal center (GC) response. Thus, IgG Fc glycosylation patterns may be applicable to distinguish short- and long-term vaccine responses after repeated vaccination under the influence of anti-TNF treatment. We used COVID-19 vaccination as a model to investigate vaccine-induced IgG subclass levels and Fc glycosylation patterns, B cell subsets, and effector functions of short- and long-term Ab responses after up to three vaccinations in patients on anti-TNF or other immunosuppressive treatments and in healthy individuals. Using TriNetX, a global healthcare database, we determined the risk of SARS-CoV-2 breakthrough infections in vaccinated patients treated with anti-TNF or other immunosuppressive drugs. Anti-TNF treatment reduced the long-term abundance of all anti-S IgG subclasses with low levels of galactosylation and sialylation. Re-activation of potential memory B cells initially generated highly galactosylated and sialylated IgG antibodies, which were progressively reduced after each booster dose in anti-TNF-treated patients, especially in the elderly. The reduced short- and long-term IgG (1) levels in anti-TNF-treated patients correlated with diminished functional activity and an increased risk for the development of COVID-19. The data suggest that anti-TNF treatment reduces both GC-dependent long-lived PCs and GC-dependent memory B cell-derived short-lived PCs, hence both the long- and short-term IgG subclass responses, respectively, after repeated vaccination. We propose that anti-TNF therapy, especially in the elderly, reduces the benefit of booster vaccination.

Bacteriophage-driven emergence and expansion of Staphylococcus aureus in rodent populations.

Human activities such as agriculturalization and domestication have led to the emergence of many new pathogens via host-switching events between humans, domesticated and wild animals. Staphylococcus aureus is a multi-host opportunistic pathogen with a global healthcare and economic burden. Recently, it was discovered that laboratory and wild rodents can be colonised and infected with S. aureus, but the origins and zoonotic potential of rodent S. aureus is unknown. In order to trace their evolutionary history, we employed a dataset of 1249 S. aureus genome sequences including 393 of isolates from rodents and other small mammals (including newly determined sequences for 305 isolates from 7 countries). Among laboratory mouse populations, we identified multiple widespread rodent-specific S. aureus clones that likely originated in humans. Phylogeographic analysis of the most common murine lineage CC88 suggests that it emerged in the 1980s in laboratory mouse facilities most likely in North America, from where it spread to institutions around the world, via the distribution of mice for research. In contrast, wild rodents (mice, voles, squirrels) were colonized with a unique complement of S. aureus lineages that are widely disseminated across Europe. In order to investigate the molecular basis for S. aureus adaptation to rodent hosts, genome-wide association analysis was carried out revealing a unique complement of bacteriophages associated with a rodent host ecology. Of note, we identified novel prophages and pathogenicity islands in rodent-derived S. aureus that conferred the potential for coagulation of rodent plasma, a key phenotype of abscess formation and persistence. Our findings highlight the remarkable capacity of S. aureus to expand into new host populations, driven by the acquisition of genes promoting survival in new host-species.

A two-stage framework for a resilient medical tourism supply chain considering social aspects and supplier evaluation under uncertainty: a real-case study

A two-stage framework for a resilient medical tourism supply chain considering social aspects and supplier evaluation under uncertainty: a real-case study

Mechanosensitive Channels: Utilising the Bacterial Cell’s Defence Mechanism against It

Mechanosensitive channels are integral membrane proteins in bacterial cell membranes as well as archaea, and eukaryotes. The role of these bacterial mechanosensitive channels is essential for protecting cells from structural damage during hypoosmotic shock. Mechanosensitive channel of small conductance (MscS) and mechanosensitive channels of large conductance (MscL) are the predominant channels in E. coli. Activation of mechanosensitive channels typically occurs when the bacterial membrane senses tension or distortion. Overall, the ecological niche of bacteria shapes the selective pressures acting on mechanosensitive channels, leading to their adaptation to specific environmental conditions. Bacterial mechanosensitive channels contribute to the ability of bacterial pathogens to adapt to and survive within the host environment, as well as to modulate interactions with host cells and tissues during infection. They could also act as entrance gates for specific antibiotic classes into bacterial cells. Accordingly, it was discovered that nitrofuran nifuroxazide and tuberactinomycin viomycin depended on both Ec-MscS and Ec-MscL for enhanced efficacy. Several compounds have been identified that directly target mechanosensitive channels. For example, ramizol has been shown to reduce the gating threshold of MscL and MscS channels, while styrylbenzene inhibits MscL channels in S. aureus, Streptococcus pneumoniae, and Clostridium difficile. Bacterial mechanosensitive channels are versatile drug targets due to their role in promoting bacterial virulence and host colonization, serving as entry points for antibiotics, and being structurally distinct from mammalian counterparts. These special structures which are meant to protect the cell can also be harnessed as drug targets, thereby increasing the susceptibility of the bacterial cell to target antibiotics. This feature has been harnessed to reduce the burden of antibiotics resistance and its attendant effect on global healthcare complications. The aim of this review is to examine the various physiological, drug resistance and pathogenicity roles of these mechanosensitive channels as well as their usefulness as potential drug targets.

Defensins: Exploring Their Opposing Roles in Colorectal Cancer Progression.

Colorectal cancer (CRC) represents a significant global healthcare burden, with a particularly concerning rising incidence among younger adults. This trend may highlight potential links between diet, gut microbiome, and CRC risk. Novel therapeutic options have been increasingly based on the understanding of molecular mechanisms and pathways. The PI3K/AKT/mTOR pathway, a crucial cell growth regulator, offers a promising target for CRC therapy. mTOR, a key component within this pathway, controls cell growth, survival, and metabolism. Understanding the specific roles of defensins, particularly human β-Defensin 1 (HBD-1), in CRC is crucial. HBD-1 exhibits potent antimicrobial activity and may influence CRC development. Deciphering defensin expression patterns in CRC holds the promise of improved understanding of tumorigenesis, which may pave the way for improved diagnostics and therapies. This article reviews recent advances in understanding regarding how HBD-1 influences CRC initiation and progression, highlighting the molecular mechanisms by which it impacts CRC. Further, we describe the interaction between defensins and mTOR pathway in CRC.

Factors Affecting Foreign Patients’ Satisfaction towards Medical Tourism Services in Jordan

Governments invest a great deal of time, resources, and money in promoting medical tourism, which seeks to satisfy patients by offering them medical care. This study examined the impact of various factors, including quality of care, cost, medical staff services, and hospital environment, on foreign patients' satisfaction with Jordanian medical tourism services. To collect data, a questionnaire was distributed to a sample of 320 foreign patients in the public and private hospitals in Amman, Jordan. To analyze the data, the Social Statistical Package for Social Sciences (SPSS) was used. The findings of the study were that of the environment of the hospital and the service of medical staff had the most significant impact factors. Overall, the findings supported a positive effect quality of medical care, cost of medical care, services of medical staff, and the environment of the hospital on the level of satisfaction among foreign patients about Jordanian medical tourism. Lastly, the study recommends that have the capacity of the Ministry of Tourism, the Ministry of Health, and practitioners to uphold the standard of care and attract a sizable influx of international medical patients to Jordan.

Effect of occupational therapy on the occurrence of delirium in critically ill patients: a systematic review and meta-analysis.

Delirium poses a major challenge to global health care, yet there is currently a dearth of single effective interventions or medications. Particularly, addressing delirium induced by critical illness is a complex process. Occupational therapy is considered to have a high potential for use in the prevention of delirium, as it involves both cognitive training and training in ADL. To comprehensively analyze the effect of occupational therapy on delirium prevention, we evaluated the effects of occupational therapy vs. standard non-pharmacological prevention on incidence and duration of delirium, clinical outcomes and rehabilitation outcomes in critically ill patients. The data sources, including PubMed/Medline, Web of Science, EMBASE, and Cochrane Library, were comprehensively searched from their inception until 15 October 2023. Following the PICOS principle, a systematic screening of literature was conducted to identify relevant studies. Subsequently, the quality assessment was performed to evaluate the risk of bias in the included literature. Finally, outcome measures from each study were extracted and comprehensive analysis was conducted using Review Manager 5.4. A total of four clinical trials met the selection criteria. The pooled analysis indicated no significant difference in the incidence and duration of delirium between the OT group and standard non-pharmacological interventions. A comprehensive analysis of clinical outcomes revealed that OT did not significantly reduce the length of hospital stay or ICU stay. Meanwhile, there was no significant difference in mortality rates between the two groups. It is noteworthy that although grip strength levels did not exhibit significant improvement following OT intervention, there were obvious enhancements observed in ADL and MMSE scores. Although occupational therapy may not be the most effective in preventing delirium, it has been shown to significantly improve ADL and cognitive function among critically ill patients. Therefore, we contend that occupational therapy is a valuable component of a comprehensive multidisciplinary approach to managing delirium. In the future, high-quality researches are warranted to optimize the implementation of occupational therapy interventions for delirium prevention and further enhance their benefits for patients.

Comparison of dynamic compression system versus multiple cancellous screws in the treatment of femoral neck fractures in young adults

IntroductionFemoral neck fractures have posed a significant global healthcare challenge and had notable impacts on the quality of life. Current treatment strategies for femoral neck fractures in young individuals have varied, emphasizing the need for optimal fixation methods. This study compared the clinical and radiological outcomes of the dynamic compression system (DCS) and multiple cancellous screws (MCS) methods.MethodsThis retrospective study included a total of 275 young adults with fresh femoral neck fractures treated with DCS and MCS. A matching analysis with a 1:1 ratio based on age, gender, fracture classification, and reduction quality was conducted. Demographic data were recorded, and comparisons were made according to follow-up time (FUT), hospitalization period, operation duration, femoral neck shortening, caput-collum-diaphysis (CCD) angle, Harris Hip Score (HHS), and post-operative complications.ResultsA total of 42 fractures were matched with a median age of 42 years (range, 22–48). In the DCS group, vertical neck shortening (median 1.92) was significantly lower than that in the MCS group (median 4.53) (P < 0.05). In the DCS group, horizontal femoral neck shortening, resultant femoral neck shortening, the amount of change in CCD angle, and HHS were 0.57 mm (0.43, 4.74 mm), 1.82 mm (0.40, 3.53 mm), 0.13° (-0.78°, 1.80°), and 91 (85–93), respectively. They were all non-significant than 1.00 mm (0.56, 6.23 mm), 2.74 mm (1.59, 6.71 mm), -0.18° (-1.11°,1.85°), and 91 (75, 93) in the MCS group, respectively (P > 0.05). There was no statistical difference in FUT, hospitalization period, operation time, and post-operative complications at the latest follow-up (P > 0.05). There were no complications such as pulmonary embolism, deep vein thrombosis, and incision infection reported.ConclusionDCS and MCS demonstrated effectiveness in treating femoral neck fractures in young adults. The DCS implant provides additional stability in the vertical axis. A prospective randomized controlled study with a large sample size was needed to validate these findings.

A bioactive xyloglucan polysaccharide hydrogel mechanically enhanced by Pluronic F127 micelles for promoting chronic wound healing

Chronic wounds represent a formidable global healthcare challenge due to the bacteria infections and uncontrollable inflammation responses, while developing wound healing materials capable of resolving these issues remains a challenge. In this study, we integrated xyloglucan (XG) with Pluronic F127 diacrylate (F127DA)to develop a composite hydrogel for wound healing, where the XG introduced anti-inflammation and anti-bacterial properties to the construct, and F127DA provides the photocurable properties essential for hydrogel formation and robust mechanical characteristics to achieve physical strength that matches tissue regeneration. The material characterizations suggested that XG/F127DA hydrogels had great biostability, blood compatibility and antibacterial effects, which was suitable to be used as a wound healing material. The in vitro analysis by culturing L929 fibroblasts on the hydrogel surface demonstrated that the inclusion of XG could promote the cellular proliferation rate, migration rate, and re-epithelialization-related marker expression, while downregulate the inflammation process. The XG/F127DA hydrogel was further used for the full-thickness skin wound healing test on mice, where the inclusion of XG significantly increased the wound closure rate through reducing the inflammation responses, and promote re-epithelialization and angiogenesis. These results indicated that XG/F127DA hydrogel has great potential to be used for wound healing in future clinical translation.