Medical Wound Dressings Research Articles

High strength “breathable” glycosilicone/Aloe vera polysaccharide-based gel dressing for efficient wound repair

Medical wound dressings are effective in protecting wounds, maintaining moisture, creating an optimal healing environment and accelerating wound healing. However, their deficiencies in mechanical properties, adhesion and prevention of adhesion to the wound bed have been identified as limiting factors for their therapeutic efficacy in wound healing. To address these issues, we prepared glycosilicone gel dressings consisting of hydrophobic polysiloxanes and highly hydrophilic polysaccharides via ester exchange and silicone hydrogen addition reactions. Silicone gel dressings exhibit skin-like “respiratory” properties, with good permeability to O2 and CO2. Additionally, elongation and other important parameters are similar to those of the skin, which provides a foundation for the application of silicone gels in the field of wound dressings. The introduction of Aloe vera polysaccharide (AP) results in the glycosilicone gel exhibiting certain mechanical properties, including a tensile strength of 0.35 MPa and an adhesion force of 10 N/m. Furthermore, a mouse model of total skin defect demonstrated that the wound healing rate of the mice on the 12th day was 98 %, which effectively promotes wound healing. Consequently, the glycosilicone gel is anticipated to be an optimal wound dressing.

Large-scale production of a “skin-like” self-pumping fabric for personal sweat management

Fabrics designed for personal sweat management, capable of efficiently transporting sweat away from the skin, are highly sought after for enhancing thermal comfort and conserving energy. However, the fabrication processes for these functional garments require intricate physical and chemical modifications, resulting in poor durability and limited suitability for mass production. In this study, a “skin-like” self-pumping fabric, consisting of hydrophobic polyester coils and hydrophilic microfiber polyester coils arranged on a bi-layer knitting fabric, is presented. This configuration allows for unidirectional wicking of sweat away from the skin. The accumulative one-way transport index increased to 717.18% when spandex filaments were introduced into the polyester fabric, which was greater than that of the pristine polyester fabric (393.71%). This exceptional property is achieved by creating differential capillary effects across a predominant combination of microfiber polyester and ordinary hydrophobic polyester. In addition to functional clothing, this “skin-like” self-pumping fabric has great potential for various applications, including industrial textiles, medical wound dressings, geotechnical engineering, and device diaphragms. Overall, this work presents an effective design to achieve large-scale manufacturing of personal sweat management fabrics, which is expected to guide material design for future innovations in functional textiles.

Current Status of Wound Dressing Research in Biomaterials

Skin is the body's first defense against external injuries, in daily production life, skin as an organ is easily injured, forming surface trauma. Wound dressings play a pivotal role in the process of skin wound repair. In order to meet the clinical demand for wound dressings, functional wound dressings with excellent biocompatibility, excellent antimicrobial activity, absorption of wound exudate and promotion of wound tissue repair have been developed. We categorize wound dressings into traditional medical dressings and novel medical wound dressings, and review the wound dressings included in the latter in terms of types, preparation methods, and effects. In future treatments for chronic wounds, researchers will integrate and utilize the antimicrobial activity, biocompatibility, and mechanical properties of wound dressings to investigate advanced wound dressings with multiple functions.

Wound Healing Performance in a Moist Environment of Crystalline Glucose/Mannose Film as a New Dressing Material Using a Rat Model: Comparing with Medical-Grade Wound Dressing and Alginate.

Although medical wound dressings produced using hydrocolloids and alginate were effective in wound healing, adhesion at the wound site and the resulting delayed healing have been a problem. As a new wound dressing material, crystalline wound dressings produced from glucose/mannose were used in this study, which aimed to clarify the properties, adhesion reduction, and wound healing performance of a new wound dressing. Crystalline glucose/mannose films were obtained via alkali treatment using the solution casting method. The structure of the crystalline glucose/mannose films was analogous to the cellulose II polymorph, and the crystallinity decreased with time in hydrated conditions. The crystalline glucose/mannose films had adequate water absorption of 34 × 10-4 g/mm3 for 5 min. These allowed crystalline glucose/mannose films to remove excess wound exudates while maintaining a moist wound healing condition. This in vivo study demonstrated the healing effects of three groups, which were crystalline glucose/mannose group > alginate group > hydrocolloid group. At 1 week, the crystalline glucose/mannose group was also found to be non-adhesive to the portion of wound healing. This was evidenced by the earlier onset of the healing process, which assisted in re-epithelization and promotion of collagen formation and maturation. These results implied that crystalline glucose/mannose films were a promising candidate that could accelerate the wound healing process, compared with medical-grade wound dressing and alginate.

Combinatorial wound dressings loaded with synergistic antibiotics in the treatment of chronic infected wounds

Advanced medicated wound dressings fabricated by electrospinning and electrospraying were prepared for the eradication of topical bacterial infections potentially applied in the management of infected acute and chronic non-healing wounds. Two different antibiotics (ciprofloxacin and rifampicin), with different aqueous solubilities and different mechanisms of antimicrobial action, were loaded within electrosprayed polymer microparticles and within electrospun nanofibers, respectively, to provide the resulting wound dressing with dually controlled antibiotic release kinetics. Due to the large surface area per volume ratio of the electrosprayed microparticles containing ciprofloxacin, an initial burst release was obtained. Simultaneously, the reduced surface area per volume ratio for the electrospun nanofibers together with the reduced aqueous solubility of rifampicin produced an extended rifampicin release over time. More importantly, a synergistic antimicrobial effect against Gram-positive and Gram-negative bacteria was observed when both antibiotics were combined. Biofilm formation prevention and the elimination of already formed mature bacterial biofilms were also successfully achieved using our advanced dressings. The lack of cytotoxicity of the advanced wound dressings here reported against eukaryotic cells at antimicrobial doses was also demonstrated using three different mammalian cell lines. Moreover, the advanced wound dressings successfully eliminated a Staphylococcus aureus mediated experimental infection in a chronic wound murine model showing their efficacy for the treatment of these complicated non-healing wounds. The strategy of advanced medicated wound dressings developed here may be used as a potential methodology for the fabrication of functional combinatorial materials that offer the ability to eradicate bacterial infections.

Centrifugally spun hybrid polyhydroxyalkanoate/dextran nanocapsule fiber matrix for the delivery of hydrophilic payloads

Biopolymeric micro- and nanofibers with active ingredients have gained significant attention for biological applications. However, the incorporation of hydrophilic compounds into hydrophobic matrices via spinning techniques remain rather unexplored. Here we report the incorporation of dextran nanocapsules (Dex-NCs) in centrifugally spun poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) fibers for the release of hydrophilic payloads. Inverse miniemulsion polymerization was employed to synthesize hydrophilic Dex-NCs with an average size of 0.25 µm. The Dex-NCs were embedded into PHBHHx via dual solvent centrifugal spinning at 0–7 wt% loading, resulting in beaded fibers with average fiber diameters of 4–6 µm. The effect of Dex-NC loading on the melting and crystallization behavior of PHBHHx was limited, while the strength and stiffness of the hybrid fibers was retained. The elongation of the hybrid fiber mats is reduced with increasing Dex-NC loading, but remains suitable for biological applications. Further, the in vitro release measurements showed a time dependent release of embedded Dex-NCs and the payload from the hybrid fibers. We anticipate this hybrid fiber matrix to be a starting point for the development of non-woven mats for slow release of hydrophilic payloads for biological applications, especially for medical wound dressings.

Well-ordered and visual poly(ε-caprolactone) composite fibrous membranes for the treatment of skin wounds

Three dimensional (3D) printing near-field electrospinning (NFES) process is a robust method to fabricate fibrous membranes by depositing solid nanofibers in a direct, continuous and controlled manner. In this study, poly(ε-caprolactone) (PCL) solutions were electrospun into composite fibrous membranes with an ordered geometric pore structure by the 3D printing NFES technique. The bioceramic hardystonite (Ca2ZnSi2O7, ZnCS) was added to the PCL fibrous membranes to stimulate epithelial cell and fibroblast proliferation, and adhesion. Meanwhile, the fluorescent material of tetraphenylene (TPE) with easy identification, high sensitivity, and real-time response was added to the PCL fibrous membrane to better observe the wound healing process. The magnitude of the electric field strength and distribution of a single-needle near-field electrospinning system is studied based on the size of the actual device. Furthermore, we analyzed the effect of voltage, distance, and position on the electric field strength based on the simulation results. The results indicated that the composite scaffold was nontoxic, and the cells could adhere, proliferate and differentiate effectively on the composite fibrous membrane scaffold, which could effectively promote wound healing. This PCL/ZnCS/TPE composite fibrous membrane with a controllable structure and pore size is suitable for tissue engineering and medical wound dressing.

DRY GAUZE AND IODINE TULLE DRESSINGS FOR THE PREVENTION OF INFECTION IN PATIENTS WITH A LOWER LIMB EXTERNAL FIXATOR: A RETROSPECTIVE OBSERVATIONAL STUDY

DRY GAUZE AND IODINE TULLE DRESSINGS FOR THE PREVENTION OF INFECTION IN PATIENTS WITH A LOWER LIMB EXTERNAL FIXATOR: A RETROSPECTIVE OBSERVATIONAL STUDY

“Effectiveness of Planned Demonstration on Aseptic Medical Wound Dressing in Terms of Practice among Staff Nurses in Selected Hospitals of Gwalior”

Background: Wound dressing procedures are very common and if wound contamination is limited, then there is a less chance of infection. The investigator felt a strong need to conduct a planned demonstration on aseptic wound dressing technique which would help the staff nurses to develop proper practice and skill in aseptic wound dressing. The aim of the study was to determine the practice on aseptic medical wound dressing technique among staff nurses before planned demonstration as measured by an observation checklist and evaluate the effectiveness of planned demonstration in terms of practice of aseptic medical wound dressing technique among staff nurses.Materials and Method: A quasi experimental, time series design was adapted for the study. The conceptual framework of the present study was developed by the investigator based on the Weidenbach’s Prescriptive Theory. Purposive sampling technique was used to select the XI samples consisted of 30 staff nurses based on their inclusion criteria. A structured observational checklist consisted of 51 items was used to evaluate the effectiveness of planned demonstration on aseptic medical wound dressing technique.Results: In pre- test majority (66.7%) of the staff nurses have an average practice on aseptic medical wound dressing where as in post test 1, majority (96.7%) of the staff nurses have good practice and in post test 2 (100%) and post test 3 all (100%) the staff nurses have good practice on aseptic medical wound dressing. The mean post-test 1 (44.5±4.2), post test 2 (48.7±0.93) and post test 3 (48.7±0.93) practice scores are higher than pre-test practice score (21.5±5.5). The calculated t value (33.3) is greater than table value (t 29=2.262) at 0.05 level of significance. There is a significant association of source of knowledge of staff nurses with pre-test practice scores and there is no significant association found between age, sex, education, years of experience and present area of working with pre- test practice scores. Also there is no significant association found between age, sex, education, years of experience, present area of working and source of knowledge with post- test practice scores.Conclusion: The findings of the study proved that the planned demonstration on aseptic medical wound dressing is an effective measure to improve the staff nurses level of practice. The nurses can learn about the aseptic measures maintained during dressing preparation phase, dressing execution phase and post procedure phase.

Particles-based medicated wound dressings: a comprehensive review.

Wound healing is a dynamic process that is controlled by many factors. The interest in developing wound dressings capable of providing the required environment for the proper wound healing process is ever expanding, and particles occupy a sizable share of the research area. This comprehensive review reports 10 years of research in terms of current advances, delivery system evaluation, outcomesand future directions. The review follows a clearly defined method of article search and screening. Retrieved papers are reviewed regarding the materials, formulation development, and in vitro/in vivo testing of particles-based wound dressings. The review summarized the current status of medicated wound dressing research, identifies gaps to be addressed, and represents a reference for researchers working on wound dressings.

Scalable Electrospinning Methods to Produce High Basis Weight and Uniform Drug Eluting Fibrous Biomaterials

Electrospinning is a process for fabricating nonwoven fibrous materials of versatile composition and form that has shown enormous promise as medical wound dressings, tissue engineered scaffolds, and for pharmaceutical delivery. However, pharmaceutical application and clinical translation of electrospun fibers requires a scalable process to control mass deposition and uniformity in the finished materials. Here, we show that free-surface electrospinning using a stationary wire electrode can generate fiber materials with high productivity and controllable deposition to achieve uniform area density (basis weight) that is relevant for scalable pharmaceutical dosage form production. Using a production-scale instrument, we performed statistically designed optimization experiments to identify a combination of parameters that improved productivity up to 13 g/h. By combining this optimization with process controls for dynamic movement of the electrospinning substrate, we also demonstrate the production of uniform and high area density materials of 50–120 G per square meter. We verified our process by fabricating a triple drug solid dosage form at a high area target density (100 g/m2) that largely showed less than a 10% coefficient of variation in mass or drug content. The process developed here provides a general approach for optimizing different material compositions for high productivity and uniformity, and advances the use of free-surface electrospinning for manufacturing fiber-based biomedical materials.

Wound dressing products: A translational investigation from the bench to the market

Chronic skin wounds affect more than 40 million patients globally and represent a severe growing burden for the healthcare systems, with annual costs expected to exceed $15 billions by 2022. To satisfy the huge demand for effective wound care products, different types of wound dressings have been introduced on the market during the last decades. Based on “the moist wound healing theory” postulated by Prof Winter in 1962, bandages were initially designed to recreate the optimal wound environment to favor the healing process. Then, thanks to the advancements achieved in biomaterial design and processing, biotechnology, imaging and electronic fields, great effort has been devoted to the development of formulations able to actively participate to tissue healing. Indeed, both the literature and the market report the design of medicated wound dressings, i.e., wound care products releasing anti-microbial agents, anti-inflammatory drugs, or bioactive molecules. In this scenario, this review aims at critically describing the currently available wound care products, highlighting their proved effectiveness in wound management. Moreover, an overview of the main strategies exploited to design personalized wound dressings has been reported. Lastly, concerns on regulatory affairs and practical issues limiting the clinical translation of advanced research platforms have also been discussed.

Antibacterial and superhydrophobic hemostatic properties of fluorinated random copolymer composite nanocoatings

Hemorrhage is the main obstacle to wound healing and can trigger microbial infections, delay the healing process, and seriously threaten human life. Many multifunctional antibacterial hemostatic surfaces have been explored to prevent bacterial attachment, biofilm formation and uncontrolled hemorrhage; however, unnecessary blood loss and tissue adhesion still need to be solved. Here, a fluorinated, biocompatible, superhydrophobic coating that can be used in medical wound dressings to improve their antibacterial and hemostasis function is introduced. The coating is formed by multifunctional antibacterial composite nanoparticles, which are generated from acrylic acid (AA) and 1H,1H,2H,2H-perfluorododecyl acrylate (PFDA) and poly (hexamethylene biguanide) hydrochloride (PHMB). The PAA-co-PFDA/PHMB composite nanoparticles can be used for various substrate materials and form transparent coatings. It has been proven that PAA-co-PFDA/PHMB composite nanocoatings not only have good antibacterial adhesion but also have bactericidal properties. In vitro and in vivo hemostatic experiments show that PAA-co-PFDA/PHMB composite nanocoated gauze has good hemostatic and antiadhesion properties. Comprehensive anti-adhesive, bactericidal and hemostatic properties are the best when the fluorine content is 5.0 wt%. The multifunctional fluoropolymer coating with antifouling, antibacterial and hemostatic properties may have a great potential in biomedical applications.

Bioactive Collagen Hydrolysate-Chitosan/Essential Oil Electrospun Nanofibers Designed for Medical Wound Dressings.

In this study, lemon balm (Melissa officinalis L.) and dill (Anethum graveolens L.) essential oils (EOs) were encapsulated into collagen hydrolysates extracted from bovine tendons and rabbit skins, both mixed with chitosan (CS) by using the coaxial electrospinning technique for potential wound dressing applications. The morphology and chemical composition of the electrospun nanofibers were investigated using scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). The antimicrobial activity of the dill EO and lemon EO, as well as the electrospun samples loaded with essential oils was determined by disk diffusion assay against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Enterococcus faecalis ATCC 29212, and Salmonella typhimurium ATCC 14028 bacterial strains; Candida albicans ATCC 10231 and Candida glabrata ATCC 90028 yeast strains; and Aspergillus brasiliensis ATCC 9642 fungal strain. In vivo biocompatibility testing of the collagen hydrolysate-chitosan/essential oil electrospun nanofibers was based on the determination of the hematological, biochemical, and immunological profile and the evaluation of the influence produced on the oxidative stress in white Swiss mice. The synergetic effect of dill and lemon balm EOs can improve the antimicrobial activity of collagen hydrolysate-chitosan nanofibers against the most important bacterial strains. The in vivo test results suggested a good biocompatibility of electrospun samples based on collagen hydrolysate extracted from bovine tendons or rabbit skin mixed with chitosan and containing dill and/or lemon balm essential oils as encapsulated bioactive compounds.

Sustainable Coated Nanostructures Based on Alginate and Electrospun Collagen Loaded with Antimicrobial Agents

In this study, sodium alginate film (Alg) was coated with electrospun collagen glue (Col) extracted from rabbit skin waste, loaded with different commercial antimicrobial agents (chitosan, AG425K and ZnONPs) and investigated in terms of morphological, structural and biological properties. The coated nanostructures were characterized using scanning electron microscopy coupled with the energy-dispersive X-ray (SEM/EDS), Attenuated Total Reflectance Fourier-Transform Infrared spectroscopy (ATR FT-IR), and Atomic Force Microscopy (AFM) tests. The cytotoxicity was investigated on murine L929 fibroblasts using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide salt (MTT) and lactate dehydrogenase (LDH) assays. Microbiological tests were performed against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853 and Candida albicans ATCC 27853 standard strains. In vitro cell culture tests showed a good cytocompatibility of the coated nanostructured systems, except the sample loaded with ZnONPs, which exhibited a highly cytotoxic effect. Alg-Col-ZnONPs nanostructure inhibited the growth and multiplication of the Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922 bacterial strains. The results of new coated nanostructures may be useful for the development of sustainable biomaterials in a circular economy, with bioactive properties for medical wound dressings.

Polyglutamic acid grafted dopamine modified collagen-polyvinyl alcohol hydrogel for a potential wound dressing

ABSTRACT Natural collagen has good biocompatibility and ability to promote tissue regeneration and repair, but the poor mechanical properties and intolerance of degradation of natural collagen limit its applications in the biomedical field. In this research, we synthesized a skin wound repair hydrogel with good biological activity, high strength and excellent water absorption properties. Inspired by the theory of wet healing, dopamine was introduced into the side chain of the water-absorbing polymer polyglutamic acid to synthesize a cross-linking agent (PGAD) with both water absorption and cell adhesion ablities, and then it was introduced into collagen/polyvinyl alcohol (PVA-COL) system to form a double network hydrogel. Scanning electron microscope observation of the morphological characteristics of the hydrogel showed that after the introduction of PGAD, the hydrogel formed an obvious pore structure, and the swelling rate showed that the introduction of PGAD significantly improved the water absorption rate of the hydrogel.In addition, PVA-COL-PGAD hydrogel has good mechanical properties and water absorption behavior.In vitro experimental results revealed that the hydrogel has good biocompatibility. In vivo wound healing experiments showed that hydrogel can promote wound healing process.These results indicated that our hydrogel has great potential as a medical wound dressing.

Binary Structured Polypropylene/Polyethylene Glycol Micro-nanofibrous Membranes with Enhanced Water and Air Permeability

As a stable chemical material, polypropylene (PP) micro-nanofibrous membranes are widely used in medical and health care. However, PP fibrous membranes with single nano scale diameter are conducive to high packing density, which results in large flow resistance across the membrane. Therefore, to improve the material’s water and air permeability, polyethylene glycol (PEG), an incompatible polymer with PP, was introduced by blending in a modified method using a melt blowing process. This proposed approach allows large 10 um diameter fibers to be entangled with fine 300 nm diameter fibers to produce highly porous binary structured fibrous membranes with small pore size. Because of its binary structure, the air permeability in the material reached 569.56 mm/s and the water vertical velocity was 70.15 mm/s. Additionally, the three-dimensional numerical calculations suggested that the high porosity and binary structure were key to enhancing water permeability in the fibrous membranes. These binary structured micro-nanofibrous membranes are expected to be used for filtration, separation, health care, oil/water separation, medical wound dressings, and other applications.

МОДЕЛЮВАННЯ ПРОЦЕСІВ ВОЛОГОПЕРЕНОСУ В БАГАТОШАРОВИХ АПЛІКАЦІЙНИХ МАТЕРІАЛАХ МЕДИЧНОГО ПРИЗНАЧЕННЯ

To carry out modeling of moisture transfer processes in multilayer medical application materials for forecasting of targeted transport of drugs of a certain effective concentration into the lesion center, based on the geometric parameters of the wounds. Using digital image processing techniques in a computer environment have developed methods for designing three-dimensional fluid propagation effects in multilayer medical wound dressings. Modern wound dressings have been found to be multilayer multidimensional compositions with complex fluid kinetics. Additionally, the wounds on the human body itself have a complex space geometric shape. This requires taking into account the volumetric effects when analyzing and forecasting the processes of wetting and fluid flow in such systems. An algorithm for ordering the boundary of a wound by digital photography with the subsequent processing of a wound image in a computer environment is proposed. To evaluate the moisture transport properties for the controlled release of medicinal substances at the desired concentration in different layers of wound dressings, an experiment was made with wetting from two and three sources, followed by three-dimensional modeling. It has been experimentally found that the parameters of the layered distribution of liquid moisture in multilayer dressings vary significantly.. The results of the simulation are suitable for making prompt decisions about the type, the required geometric parameters of medical materials and wound dressings. The proposed method of establishing the real geometry of the wound, together with three-dimensional modeling, allows to predict the exact boundaries of the application of the drug, to calculate its required amount and time of movement to the wound. Using 3D computer graphics of discrete objects, methods have been developed to predict the conditions for the reliable functioning of multilayer dressings. Investigated processes of transport and distribution of liquid moisture can be used in the selection of components of the raw material composition, structure and number of layers of multilayer wound dressings, taking into account the real geometric profile of the wound.

A study on artemisia argyi oil/sodium alginate/PVA nanofibrous membranes: micro-structure, breathability, moisture permeability, and antibacterial efficacy

Medical wound dressing with natural antibacterial efficacy is an important issue. However, few studies on Artemisia argyi oil based wound dressing have been studied because of the volatility of the Artemisia argyi oil. In this study, Artemisia argyi oil -microcapsules (AAO-MC)/PVC fibrous membrane were fabricated through emulsification-internal gelation and electrospinning method. The membranes were characterized by SEM, Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and particle diameter, hydrophilicity, breathability, water vapor transmission rate (WVTR), and antibacterial performance were evaluated. The results show that AAO-MC microcapsules excellent stability, and the slow-release property. Moreover, the prepared AAO-MC/PVC fibrous membrane indicated good WVT (72.47 g/(m²·h)), high hydrophilicity (30.5°), and outstanding antibacterial rate (94.3%). This study provides a new strategy to prepare microcapsule nanofibrous membrane with excellent performance and is suggested to be a promising candidate for medical wound dressings.

Cell response to PLA scaffolds functionalized with various seaweed polysaccharides

The porous polylactic acid matrix has been particularly developed as a scaffold in tissue engineering, drug loading, and wound dressing. However, the loading of active chemical compounds is challenging due to its highly hydrophobic nature and lack of functional groups for chemical bonding. Plasma treatment is a fast, heat and chemical-free solution to increase its hydrophilicity by oxidative functional groups and physical etching. In this study, a highly porous PLA scaffold was obtained by polyethylene glycol pore formation agent and treated by radiofrequency (RF) air plasma. Fucoidan from Fucus vesiculosus, Macrocystis pyrifera, and Undaria pinnatifida were used to immobilize onto the activated porous PLA surface for use as medicated wound dressings. The chemical composition and morphology were investigated by FTIR, SEM-EDS analysis, and cytocompatibility assay was studied mouse embryonic fibroblast cells (NIH/3T3).