Full-thickness Wound Healing Research Articles

An injectable hydrogel dressing for controlled release of hydrogen sulfide pleiotropically mediates the wound microenvironment.

The healing of scalded wounds faces many challenges such as chronic inflammation, oxidative stress, wound infection, and difficulties in vascular and nerve regeneration. Treating a single problem cannot effectively coordinate the complex regenerative microenvironment of scalded wounds, limiting the healing and functional recovery of the skin. Therefore, there is a need to develop a multi-effect treatment plan that can adaptively address the issues at each stage of wound healing. In this study, we propose a scheme for on-demand release of hydrogen sulfide (H2S) based on the concentration of reactive oxygen species (ROS) in the wound microenvironment. This is achieved by encapsulating peroxythiocarbamate (PTCM) in the ROS-responsive polymer poly(ethylene glycol)-poly(L-methionine) (PMet) to form nanoparticles, which are loaded into a thermosensitive injectable hydrogel, F127-poly(L-aspartic acid-N-hydroxysuccinimide) (F127-P(Asp-NHS)), to create a scald dressing. The H2S released by the hydrogel dressing on demand regulates the wound microenvironment by alleviating infection, reducing oxidative stress, and remodeling inflammation, thereby accelerating the healing of full-thickness scalded wounds. This hydrogel dressing for the adaptive release of H2S has great potential in addressing complex scalded wounds associated with infection and chronic inflammation.

Desferrioxamine-Laden Nanofibrous Scaffolds with Efficient Angiogenesis for Accelerating Diabetic Wound Healing.

Delayed diabetic wound healing is one of the clinical difficulties, the main reason is the limited angiogenesis ability. Deferriamine (DFO) is an iron chelating agent that can induce angiogenesis, but its application is limited due to its short half-life. Increasing the load and slow release performance of desferriamine is beneficial to accelerate diabetic wound healing. In this study, we developed collagen (Col)-graphene oxide (GO) and (1% w/w) DFO-loaded nanofiber electrospinning scaffolds (DCG) using the electrospinning technique. We tested the physicochemical properties, drug release performance, and vascularization biological function of the scaffolds, and finally evaluated the promotion of full-thickness wound healing in the diabetic rat models. The results showed that DCG scaffolds have good mechanical properties and water-holding capacity and can release DFO continuously for 14 days. In vitro, the novel DCG scaffold exhibited good biocompatibility, with the up-regulation at the gene level of VEGF and its regulator HIF-1α, promoters of angiogenesis. This was verified in vivo, as the scaffold enhanced granulation tissue formation and improved neovascularization, thereby accelerating wound healing when applied to full-thickness defects on the back of diabetic rats. The DCG nanofiber scaffold prepared in this study has good biocompatibility and vascularization ability, and improves the microenvironment in vivo, and has a good application prospect in diabetic wound repair.

Carboxymethyl chitosan-based hydrogel-Janus nanofiber scaffolds with unidirectional storage-drainage of biofluid for accelerating full-thickness wound healing

Self-pumping wound scaffolds designed for directional biofluid transport are extensively investigated. They efficiently extract excessive biofluids from wounds, while maintaining an optimally humid wound environment, thus facilitating rapid wound healing. However, the existing designed scaffolds are insufficiently focused on stimulating the hydrophobic layer at the wound site, thereby exacerbating inflammation and impeding the wound healing process. Herein, we engineered and fabricated a hydrophilic-hydrophobic-hydrophilic sandwich-structured hydrogel-Janus nanofiber scaffold (NFS) employing a Layer-by-Layer (LbL) method. This scaffold comprises a hydrophilic carboxymethyl chitosan/silver (CMCS-Ag) hydrogel component in conjunction with a poly(caprolactone)/poly(caprolactone)-poly(citric acid)-co-ε-polylysine (PCL/PCL-PCE) Janus NFS. It is noteworthy that the hydrogel-Janus nanofiber scaffold not only demonstrates outstanding water absorption (202.2 %) and unidirectional biofluid transport capability but also possesses high breathability (308.663 m3/m2 h kPa), appropriate pore size (6.7–7.5 μm), excellent tensile performance (270 ± 10 %), and superior mechanical strength (26.36 ± 1.77 MPa). Moreover, in vitro experimentation has convincingly demonstrated the impeccable biocompatibility of hydrogel-Janus NFS. The inherent dual-antibacterial properties in CMCS-Ag and PCE significantly augment fibroblast proliferation and migration. In vivo studies further underscore its capability to expedite wound healing by absorption and expulsion of wound exudates, thereby fostering collagen deposition and vascularization. As such, this work potentially provides fresh insights into the design and fabrication of multifunctional biomimetic scaffolds, holding immense potential in the medical field for efficient wound healing.

Bilayer hydrogel with a protective film and a regenerative hydrogel for effective diabetic wound treatment.

Diabetic foot ulcers (DFUs) are one of the most serious complications of diabetes, often leading to necrosis and amputation. DFU is caused by the intricate diabetic microenvironment, including ischemia, hypoxia, hyperinflammation, reduced angiogenesis, and persistent infection. Traditional wound dressings made of single or mixed materials often struggle to meet all the requirements for effective diabetic wound healing. In contrast, multilayer dressings comprising more than single layers have the potential to address these challenges by combining their diverse chemical and physical properties. In this study, we developed a bilayer hydrogel comprising a GelMA-ALG-nano-ZnO protective film and a COL1-PRP regenerative hydrogel for facilitating diabetic wound healing. We demonstrated the protective properties against bacterial infection of the protective film, while highlighting the regenerative potential of the COL1-PRP hydrogel in promoting fibroblast and MUVEC migration, extracellular matrix secretion and deposition, and angiogenesis. Importantly, the bilayer hydrogel exhibited superior efficacy in promoting full-thickness wound healing in a diabetic rat model compared to its single-layer hydrogel counterparts. This multi-layer approach offers a promising strategy for addressing the complexities of diabetic foot treatment and improving clinical outcomes.

Evaluation of Gelatin Loaded PRP for Full-thickness Wound Healing in Rabbit Model

In this study, gelatin (GE) will be used as a carrier to enhance platelet-rich plasma's (PRP) effects on the wound-healing process. PRP/GE was created by conjugating 20% GE with freshly prepared autologous PRP. Following rabbits with experimentally generated full-thickness skin wounds, the ability of the skin to regenerate was evaluated. Evaluation considered the macroscopic features of wounds, wound healing rate % and histologic findings for specimens collected after 3, 10 and 21 days. The PRP/GE treated wounds revealed noticeably improved and better closure. This improvement may be attributable to the advantages of combining PRP with GE as a bioactive substance that may regulate the release of growth factors and support angiogenesis. It might be concluded that PRP/GE has the ability to quicken the healing process. The therapeutic impact of PRP was boosted by the GE carrier. According to these data, PRP/GE may be suggested as a viable therapy for wound healing.

A tilapia skin-derived gelatin hydrogel combined with the adipose-derived stromal vascular fraction for full-thickness wound healing.

Biomaterials are widely used in regenerative medicine to repair full-thickness skin defect wounds. The adipose-derived stromal vascular fraction (SVF) shows pro-regenerative properties, however, the ex vivo biological activity of SVF is suppressed due to the lack of an external scaffold. Tilapia skin, as a sustained and recyclable biomaterial with low immunogenicity, was applied in the preparation of a hydrogel. The mixture of tilapia skin-derived gelatin and methacrylic anhydride as a scaffold facilitated the paracrine function of SVF and exerted a synergistic effect with SVF to promote wound healing. In this study, 30% (w/v) SVF was added to methacrylate-functionalized tilapia skin gelatin and subsequently exposed to UV irradiation to form a three-dimensional nano-scaffolding composite hydrogel (FG-SVF-3). The effects of paracrine growth factors, neovascularization, and collagen production on wound healing were extensively discussed. FG-SVF-3 displayed a pronounced wound healing ability via in vivo wound models. The FG-SVF-3 hydrogel enhanced the biocompatibility and the expression of EGF, bFGF, and VEGF. FG-SVF-3, as a promising wound dressing, exhibited superior ability to accelerate wound healing, skin regeneration, and wound closure.

Caffeine-reinforced Collagen as Localized Microenvironmental Trans-Browning Bio-Matrix for Soft Tissue Repair and Regeneration in Bariatric Condition.

The wound exudates, hypoperfusion of the subcutaneous fat layer, and poor vasculature worsen wound management in obese subjects. In the current study, a multifunctional Caffeine-reinforced collagen biomaterial is developed that can simultaneously modulate lipid metabolism and angiogenesis in obese wound microenvironments for faster tissue regeneration. The biomaterial is fabricated specialized for obese conditions to initiate simultaneous lipolysis and angiogenesis locally in the hypoxic subcutaneous fat in wound margins of obese subjects. Caffeine-reinforced collagen biomatrix shows better structural integrity, thermal stability, bio-compatibility, and lesser proteolytic susceptibility. Caffeine-collagen biomaterial promote angiogenesis, fibroblast migration, and localized browning of white adipocytes to activate thermogenesis in the subcutaneous fat layer at the wound site. Full-thickness excision wound healing studies performed in obese C57BL6 mice shows faster wound closure within day 9 when compare to control mice. The Caffeine-reinforced collagen biomaterial remodeled the wound site locally by activating fibroblast to secrete collagen, activate endothelial cells to promote angiogenesis, and induce browning in white adipocytes in subcutaneous fat. The study opens a new direction in bariatric tissue regenerative medicine by locally modulating lipid metabolism, angiogenesis, and trans-browning at the injured site for faster complete restoration of the damaged tissue.

Hesperidin-loaded cubogel as a novel therapeutic armamentarium for full-thickness wound healing

Wounds are a physical manifestation of injury to the skin causing it to rupture or tear. The process of wound healing naturally restores skin integrity while minimizing the extent of the damage. Hesperidin (HPN) is a natural polyphenolic flavonoid and is effective in treating wounds due to its ability to reduce inflammation and stimulate angiogenesis. However, its use is limited by its poor physicochemical attributes such as poor solubility in water. Recently, nanoparticles, particularly Cubosomes, are found to be promising candidates for advancing wound-healing therapies, owing to their unique properties. The present study was conducted to develop a hydrogel system based on Cubosomes encapsulating HPN (HPN-Cubogel), with the potential to mitigate full-thickness wounds. The therapeutic efficacy of the formulation assessed in the animal model showed that the HPN-Cubogel formulation group exhibited a wound closure rate of 98.96 ± 1.50% after 14 days post-wounding compared to 89.12 ± 2.6% in the control group suggesting superior wound contraction activity. Collagen synthesis was superior in the formulation compared to the control group, as determined through MT staining. In summary, the HPN-Cubogel formulation was found to be the most effective in enhancing full-thickness wound healing.

Effect of Honey/PVA Hydrogel Loaded by Erythromycin on Full-Thickness Skin Wound Healing in Rats; Stereological Study

Background: Skin wounds are a significant public health risk, and treatment of wound remains a challenging clinical problem for medical teams and researchers.Materials and Methods: In the present study, we aimed to investigate the healing effects of honey/polyvinyl alcohol (PVA) hydrogel loaded with erythromycin  as wound dressing on skin wounds in rats, based on histological studies. In this study, 60 male Wistar rats, with a 1.5 ×1.5 cm2 diameter full-thickness wounds on the backs were divided into four groups: honey/PVA with the erythromycin hydrogel group, honey group, PVA group, and the control group, with no treatment. Skin biopsies were prepared at days 4, 7, and 14 for microscopic analyses. The stereological analysis, including the mean area of the wound, length of vessels, numerical density of fibroblast, macrophage, basal cell and volume of the epidermis, dermis, and fibrous tissue were performed. Result: Wounds area in the honey/PVA hydrogel with the erythromycin group were significantly (P<0.05) smaller than in the other group. The numerical density of fibroblast, macrophage, basal cell and volume of the epidermis in the honey/PVA hydrogel with the erythromycin group were significantly higher than other groups.Conclusion: According to our results, honey/PVA hydrogel with erythromycin may promote early wound healing and has a positive influence on fibroblast proliferation and re-epithelialization, and its administration is recommended after further validation of clinical data. [GMJ. 2019;8:e1362]

Evaluation of the Effectiveness of Medical-Grade Honey and Hypericum Perforatum Ointment on Second-Intention Healing of Full-Thickness Skin Wounds in Cats.

This study aimed to determine the effects of two topical treatments on second-intention wound healing in cats. Eight 2 × 2 cm full-thickness wounds were created, four on each side of the dorsal midline of eight laboratory cats, to receive either medical-grade honey ointment (MGH) and its control (HC), or Hypericum-based ointment (HP) and its control (HPC). MGH or HP ointment was applied to four wounds on the same side, while the remaining four were used as controls, chosen at random. Planimetry, laser Doppler flowmetry, daily physical examinations, and histologic examinations on days 0, 7, 14, and 25 were used to assess the healing of wounds. Tissue perfusion was better in the MGH-treated (2.14 ± 0.18 mm/s) and HP-treated wounds (2.02 ± 0.13 mm/s) than in the untreated controls HC (1.59 ± 0.11 mm/s) and HPC (1.60 ± 0.05 mm/s), respectively (p = 0.001). Histopathology revealed that the median edema score was lower in the MGH-treated (2; range 1-4) compared to the HC-treated wounds (3; range 2-4) on day 7 (p < 0.05). The median angiogenesis score was higher on day 7 in the MGH-treated (2; range 1-3) compared to the HP-treated wounds (2; range 1-2) (p = 0.046). The fibroblast concentration was increased in the MGH-treated wounds (3.5; range 3-4) compared to the HP-treated wounds (3; range 2-4) on day 25 (p = 0.046). MGH and HP increased tissue perfusion compared to the untreated controls. The MGH-treated wounds had histologic parameters superior to the HP-treated wounds regarding angiogenesis and fibroblast concentration in cutaneous wound healing in cats. Topical application of MGH and HP did not accelerate the healing process of feline cutaneous wounds.

Fish Skin Grafts Affect Adenosine and Methionine Metabolism during Burn Wound Healing.

Burn wound healing is a complex process orchestrated through successive biochemical events that span from weeks to months depending on the depth of the wound. Here, we report an untargeted metabolomics discovery approach to capture metabolic changes during the healing of deep partial-thickness (DPT) and full-thickness (FT) burn wounds in a porcine burn wound model. The metabolic changes during healing could be described with six and seven distinct metabolic trajectories for DPT and FT wounds, respectively. Arginine and histidine metabolism were the most affected metabolic pathways during healing, irrespective of burn depth. Metabolic proxies for oxidative stress were different in the wound types, reaching maximum levels at day 14 in DPT burns but at day 7 in FT burns. We examined how acellular fish skin graft (AFSG) influences the wound metabolome compared to other standard-or-care burn wound treatments. We identified changes in metabolites within the methionine salvage pathway, specifically in DPT burn wounds that is novel to the understanding of the wound healing process. Furthermore, we found that AFSGs boost glutamate and adenosine in wounds that is of relevance given the importance of purinergic signaling in regulating oxidative stress and wound healing. Collectively, these results serve to define biomarkers of burn wound healing. These results conclusively contribute to the understanding of the multifactorial mechanism of the action of AFSG that has traditionally been attributed to its structural properties and omega-3 fatty acid content.

Fabricating Composite Cell Sheets for Wound Healing: Cell Sheets Based on the Communication Between BMSCs and HFSCs Facilitate Full-Thickness Cutaneous Wound Healing.

Insufficient angiogenesis and the lack of skin appendages are critical challenges in cutaneous wound healing. Stem cell-fabricated cell sheets have become a promising strategy, but cell sheets constructed by a single cell type are inadequate to provide a comprehensive proregenerative microenvironment for wound tissue. Based on the communication between cells, in this study, bone marrow mesenchymal stem cells (BMSCs) and hair follicle stem cells (HFSCs) were cocultured to fabricate a composite cell sheet (H/M-CS) for the treatment of full-thickness skin wounds in mice. Experiments confirmed that there is cell-cell communication between BMSCs and HFSCs, which enhances the cell proliferation and migration abilities of both cell types. Cell-cell talk also upregulates the gene expression of pro-angiogenic-related cytokines in BMSCs and pro-hair follicle-related cytokines in HFSCs, as well as causing changes in the properties of secreted extracellular matrix components. Therefore, the composite cell sheet is more conducive for cutaneous wound healing and promoting the regeneration of blood vessels and hair follicles.

High-efficiency antibacterial calcium alginate/lysozyme/AgNPs composite sponge for wound healing

Infection poses a significant barrier to effective wound repair, leading to increased inflammatory responses that ultimately result in incomplete and prolonged wound healing. To address this challenge, numerous antibacterial ingredients have been incorporated into dressings to inhibit wound infection. Our previous work demonstrated that lysozyme/silver nanoparticles (LYZ/AgNPs) complexes, prepared using an eco-friendly one-step aqueous method, exhibited excellent antibacterial efficacy with favorable biosafety. To further explore its potential application in advancing wound healing, calcium alginate (CA) with good porosity, water absorption, and water retention capacities was formulated with LYZ/AgNPs to prepare composite sponge (CA/LYZ/AgNPs). As expected, in vivo experiments involving full-thickness skin wound and scald wound healing experiments demonstrated that CA-LYZ-AgNPs composite sponges with excellent biocompatibility exhibited remarkable antibacterial activity against gram-positive bacteria, gram-negative bacteria and fungi, and outperformed the wound healing process efficacy of other commercially available AgNPs-loaded wound dressings. In summary, this work introduces a CA/LYZ/AgNPs sponge featuring exceptional antibacterial efficacy and biocompatibility, thus holding promising potential in wound care applications.

Exploring effect of M2 macrophages on experimental full-thickness wound healing in streptozotocin-induced diabetic rats.

Diabetes mellitus is one of the most prevalent medical conditions, in both humans and animals. People with diabetes mellitus often experience slower than normal wound healing, making it a serious health concern. This study investigates the effect of M2 differentiated macrophages on full-thickness wound healing in white Westar rats exposed to streptozocin 70 mg/kg. A full-thickness skin defect with dimensions of 2 × 2 cm was created on the back of all the animals, and their blood sugar was simultaneously assessed. The monocytes were isolated from blood samples using the plastic adherence method and were exposed to dexamethasone (5-10 μ) for 24 h. Subsequently, they were washed with PBS and incubated in fresh cell culture medium for 5 days. The differentiated M2 cells were injected into four points of the experimental ulcers of the treatment group. Macroscopic and microscopic changes were evaluated and compared over a period of two weeks between the test and control groups. The infusion of these cells a few days after wounding enhances wound healing parameters significantly, as evidenced by an increase in germinating tissue formation, wound contraction, inflammation reduction, and collagen increase in the treated group.

Multicomponent decellularized extracellular matrix of caprine small intestine submucosa based bioactive hydrogel promoting full-thickness burn wound healing in rabbits

Effective treatment for full-thickness burn wounds has remained challenging for clinicians. Among various strategies, extracellular gel-based dressing materials have gained attention to promote effective and rapid wound healing. These gel-based materials are porous and have antioxidant, antibacterial, hydrophilic, biodegradation, and biocompatible properties and hence can be used to alleviate burn wound healing. In concurrence with these findings, the present study evaluates thermo-responsive and self-assembled decellularized extracellular matrix (ECM) of caprine small intestine submucosa (DG-SIS) gel-based dressing material for burn wound healing. To expedite healing and efficiently tackle excessive free radicals and bioburden at the burn wound site, DG-SIS gel is fortified with antibacterial components (zinc oxide nanoparticles; ZnO) and a potent antioxidant agent (Vitamin-C;Vt-C). ZnO- and Vt-C-enriched DG-SIS (DG-SIS/ZnO/Vt-C) gels significantly increased the antioxidant and antibacterial activity of the therapeutic hydrogel. Additionally, the fabricated DG-SIS/ZnO/Vt-C bioactive gel resulted in significant full-thickness burn wound contraction (97.75 % in 14 days), a lower inflammatory effect, and enhanced angiogenesis with the highest collagen synthesis (1.22 μg/mg in 14 days) at the wound site. The outcomes from this study demonstrate a synergistic effect of ZnO/Vt-C in the bioactive gel as an effective and inexpensive therapeutic approach for full-thickness burn wound treatment.

Fabrication of geraniol nanophytosomes loaded into polyvinyl alcohol: A new product for the treatment of wounds infected with methicillin-resistant Staphylococcusaureus

The current study was conducted to evaluate the effectiveness of geraniol nanophytosomes in accelerating the healing process of wounds infected with Methicillin-resistant Staphylococcus aureus (MRSA) in a mouse model. The physicochemical properties confirmed physical properties and successful synthesis of the nanophytosomes. Wounds were induced and mice (n = 90) were treated with a base ointment (negative control group) and/or mupirocin (positive control) and also formulations prepared from geraniol (GNL), geraniol nanophytosomes (NPhs-GNL), and PVA/NPhs-GNL. Wound contraction, total bacterial count, pathological parameters and the expressions of bFGF, CD31 and COL1A were also assessed. The results showed that topical administration of mupirocin and PVA/NPhs/GNL increased wound contraction, fibroblast and epithelization and also the expressions of bFGF, CD31 and COL1A while decreased the expression of total bacterial count and edema compared with negative control mice (P = 0.001). The results also showed that PVA/NPhs-GNL and mupirocin could compete and PVA/NPhs-GNL formulation was safe. In conclusion, the prepared formulations accelerated the wound healing process by modulation in proliferative genes. Geraniol nanophytosomes loaded into PVA could improve the healing in infected full-thickness wounds healing process and can be used for the treatment of infected wounds after future clinical studies.

Adhesivity-tuned bioactive gelatin/gellan hybrid gels drive efficient wound healing

Gelatin-based hydrogels have been widely used for wound healing applications. However, increase in ligand density and reduction in pore size with increasing gelatin concentration may delay wound healing by limiting cell infiltration. In this study, we address this shortcoming by combining gelatin with gellan—which is super hydrophilic and non-adhesive to cells. We show that UV crosslinked hybrid gels composed of methacrylated gelatin (GelMA) and methacrylated gellan gum (mGG), possess considerably larger pores and improved mechanical properties compared to GelMA gels. Reduced spreading and reduced formation of focal adhesions on hybrid gels combined with lower contractility and faster detachment upon trypsin-induced de-adhesion suggests that hybrid gels are less adhesive than GelMA gels. Gradual release of fibroblast growth factor (FGF) and silver nanoparticles (AgNPs) incorporated in hybrid gels not only boosts cell migration, but also confers anti-bacterial activity against gram-positive and gram-negative bacteria at concentrations nontoxic to cells. Full thickness wound healing in Wistar rats revealed increased granulation tissue formation in hybrid gels, fastest epithelialization and highest collagen deposition in rats treated with FGF entrapped hybrid gels. Together, our results demonstrate how adhesive tuning and incorporation of bioactive factors can be synergistically combined for achieving complete wound healing.

Bacteria-responsive hydrogel for on-demand release of antimicrobial peptides that prevent superbug infections and promote wound healing

Various skin infections present a substantial challenge in both patient care and the medical community. A primary obstacle to effective wound healing is the colonization of pathogenic bacteria, which would produce hyaluronidase (HAase). This enzyme degrades hyaluronic acid (HA) at wound sites, facilitating bacterial infection. Herein, we developed a HAase-responsive hydrogel, HA-EPL-PEG, incorporating the antimicrobial peptide ε-Poly-l-lysine (EPL) and Polyethylene glycol diacrylate (PEGDA), chemically crosslinked via a photoinitiator. Following, the in vitro antibacterial and antifouling properties of this hydrogel were evaluated, along with its cytotoxicity to mammalian cells. Subsequently, its bacteria secreted HAase responsive functionality was evaluated. In vivo antibacterial, anti-infectious and wound healing effects were further investigated in a rodent model. All these results demonstrated the multifunctional benefits of HA-EPL-PEG hydrogel, showcasing its HAase-responsive nature, antibacterial and antifouling activities. Importantly, the hydrogel significantly expedited the healing of full-thickness skin wounds, denoting a promising avenue for advancing wound care.

Histopathological Evaluation of the Application of Zinc Nanoparticles in Conjunction With Chitosan Dressing on the Wound Healing of Methicillin-Resistant Staphylococcus aureus Infected Skin Wounds in Rats

Objectives: Wound healing and tissue regeneration have raised serious challenges for healthcare systems worldwide, affecting both aesthetic and health-related aspects of the community well-being. Wound healing is a complex sequence of physical, cellular, and molecular events involving cell recruitment, proliferation, as well as the synthesis and accumulation of the new extracellular matrix components. The present study aimed to histopathologically evaluate the application of zinc nanoparticles in conjunction with chitosan dressing for the wound healing of methicillin-resistant Staphylococcus aureus (MRSA) infected skin wounds in rats. Materials and Methods: In this experimental investigation, 28 healthy male rats were randomly divided into 4 groups, each of which including 7 rats. The wound healing process was evaluated based on histopathological studies and biochemical findings on days 7, 14, and 21. Results: According to the results from the two-way ANOVA analysis, the means of wound area in the study groups were statistically and significantly different on all evaluated days (P&lt;0.001). The highest wound area was associated with group III (i.e., wound with zinc oxide) on days 6, 18, 15, 12, and 9, while the lowest wound area was observed in group IV (i.e., wound with chitosan-nanoparticles-zinc oxide). A statistically significant difference was also found among the study groups in terms of the mean values of hydroxyproline (P&lt;0.001). According to the post hoc Tukey test for pairwise comparisons, a significant difference was observed among all groups regarding the hydroxyproline values (P&lt;0.001). Additionally, the highest collagen density was detected in the chitosan-nanoparticles-zinc oxide group. Conclusions: The application of biodegradable chitosan-nanoparticles-zinc oxide dressing significantly improved the histopathological and biochemical indices of the full-thickness skin wound healing. This study highlighted the effectiveness of chitosan-nanoparticles-zinc oxide dressing in wound healing enhancement, indicating its potential application in wound healing.

An antibacterial nanoclay- and chitosan-based quad composite with controlled drug release for infected skin wound healing

Microbial infections of surgical sites and other wounds represent a major impediment for patients. Multifunctional low-cost dressings promoting tissue reparation while preventing infections are of great interest to medical professionals. Here, clay-based laponite nanodiscs (LAP) were loaded with the antibacterial drug kanamycin (KANA) before being embedded into a poly(lactic-co-glycolic acid) (PLGA) membrane and coated with the biopolymer chitosan (CS). Results indicated that these biocompatible materials combined the excellent capacity of LAP for controlled drug release with the mechanical robustness of PLGA and the antibacterial properties of CS as well as its hydrophilicity to form a composite highly suitable as an infection-preventing wound dressing. In vitro, PLGA/LAP/KANA/CS released drugs in a sustainable manner over 30 d, completely inhibited the growth of infectious bacteria, prompted the adhesion fibroblasts, and accelerated their proliferation 1.3 times. In vivo, the composite enabled the fast healing of infected full-thickness skin wounds with a 96.19 % contraction after 14 d. During the healing process, PLGA/LAP/KANA/CS stimulated re-epithelization, reduced inflammation, and promoted both angiogenesis and the formation of dense collagen fibers with an excellent final collagen volume ratio of 89.27 %. Thus, multifunctional PLGA/LAP/KANA/CS made of low-cost components demonstrated its potential for the treatment of infected skin wounds.