Modern Wound Dressings Research Articles

Comparison of different modern wound dressings on full-thickness murine cutaneous wound healing with wild-type and type-2 diabetes db/db mice

BackgroundTo evaluate the process of cutaneous wound healing, experiments have been conducted. However, to date, what modern wound dressings are suitable remains unclear. Therefore, this study aimed to compare the healing process in different modern wound dressings to determine their suitability in experimental acute wound and chronic diabetic wound. Materials and methodsTwelve C57BL/6J mice and eleven db/db mice were subjected to full-thickness wound injuries. The mice were divided into the following four groups: hydrocolloid, form, film, and gauze groups in both wild-type and db/db mice. Wound healing was assessed until day 14. ResultsIn the wild-type groups, all wounds were healed and completed re-epithelialization by day 14. However, the wound surface was dry, and the periwound was hypercontracted in the wild-type–form and wild-type–gauze groups. In the db/db groups, wounds were not healed until day 14. Wound exudates in the db/db- hydrocolloid group were abundant and gradually increased until day 14. Wound exudates in the db/db-film group were present until day 14. Conversely, in the db/db-form and db/db-gauze groups, the wound surface was dry, and the periwound was hypercontracted. ConclusionThese results showed that hydrocolloid and film dressings are suitable modern wound dressings for the mice wound models of acute wound and chronic diabetic wound. Moreover, using either hydrocolloid or film dressing depending on the purpose of the study on cutaneous wound healing in diabetes is necessary.

Hydroentangled waste cotton non-woven based alginate hydrogel wound dressing for high wound exudates

Hydrogels are used in modern wound dressings due to their ability to provide comfort with quick healing. However, poor mechanical properties of hydrogels limit their availability in commercial wound dressings. Nonwovens are highly porous, strong, and flexible structures that can provide support to hydrogels without compromising their properties. In this study, a cost-effective and sustainable hydroentangled nonwoven from industrial cotton waste was prepared and incorporated into alginate hydrogel for wound dressings. The novel composite of hydroentangled cotton nonwoven and alginate hydrogel was synthesized by a simple sol-gel technique. The effect of concentration of alginate hydrogel (0.5 wt%, 1 wt%, 1.5 wt %) and drying temperature (20 °C, 40 °C, 60 °C) of composite was analyzed for high wound exudates. The properties of prepared composite samples were characterized by scanning electron microscopy (SEM), XRD, tensile strength, tear strength, Air permeability, moisture management wound exudate test, and quantitative antimicrobial testing. Moreover, the comfort performance of these samples was evaluated by air permeability and moisture management testing. The properties of developed composites are highly dependent on the concentration of alginate and drying temperature. The results showed that maximum fluid absorbency (%) of 650 was achieved with good comfort properties. This study can help to increase the commercial availability of hydrogel-based wound dressings.

DEVELOPMENT OF ZINC-LOADED HYDROGEL INFUSED WITH ALOE BARBADENSIS MUCILAGE FOR WOUND HEALING

This study aims to formulate and characterize zinc-loaded hydrogel infused with Aloe barbadensis mucilage for wound dressing. Five formulations containing varying proportions of carbopol, zinc, aloe and water (as vehicle) were developed via physical crosslinking using triethanolamine. All formulations had a translucent off-white colour while the control gave a transparent gel. The viscosity was highest in the control, 30000.00 ± 2.07 PaS. The pH of the formulations was between 5.7 and 5.8. Formulation 2 which is composed of 30 mg of Zinc and 1.4 mg of Aloe barbadensis incorporated into 1% w/v Carbopol Ultrez hydrogel polymer had the lowest swelling index of 79.2 ± 1.95% implying that it had the fastest drug release rate. The wounds treated with Formulation 2 had the most rapid wound healing with no sign of scars in the wound area. Histomorphometric evaluation reflected a high re-epithelisation rate of 70%, a significant percentage occupied by collagen in granulation tissue of 85%. The thickness of the tissue's central region was 10 mm. The inflammatory cells /mm2 tissue was 200 cells/mm2 while the number of microvessels in granulation tissue was 1.0 microvessels/mm2. Zinc-loaded hydrogel infused with Aloe barbadensis mucilage shows great potential as a modern wound dressing.

Preliminary Study: Antimicrobial Permeation and Release Rates of Biocellulose Wound Dressing Produced Using Acetobacter Xylinum 0416 in Pineapple Peel Waste Culture

Modern wound dressings are employed to hasten the healing of damaged skin. Alginate, foam, hydrogel, hydrocolloid and film are contemporary wound dressings. These contemporary wound dressings are effective for treating wounds because they keep moisture in the wound to help the skin of the damaged tissue heal. Another application for biocellulose (BC) is as a material for treating wounds. This is because biocellulose can absorb exudates from skin wounds and has a considerable water-holding capacity. Because pineapple peel waste has a high concentration of glucose and fructose, it can be used as a fermentation medium to make biocellulose. The manufacture of biocellulose also makes use of the bacterium Acetobacter xylinum 0416. The biocellulose fermentation process lasts five days at 30 °C in an incubator with static conditions. Utilising antimicrobial agents such as silver nanoparticle compounds, Moringa oleifera, or Melastoma malabathricum leaf extract will improve the antibacterial capabilities of biocellulose. The growth of A. xylinum 0416 indicates an exponential phase at 48 hours, where the number of bacterial cells increases, and the process of transferring 20% of the inoculum to the fermentation medium is carried out. BC fermentation in 6-well plates with 3 ml of pineapple peel extract volume at 30°C and pH 5.15 recorded the highest BC wet weight reading at 1.740g and an average of 1.393g. Low concentrations of silver nanoparticles and Moringa leaf extract at 0.02mg/ml, 5mg/l and 0.0125mg/l showed a good effect against the pathogen. The water absorption capacity of the raw BC shows a good absorption value of 144.84.

The Diels-Alder Cross-Linked Gelatin/Dextran Nanocomposite Hydrogels with Silver Nanoparticles for Wound Healing Applications: Synthesis, Characterization, and In Vitro Evaluation.

Wound healing involves a sophisticated biological process that relies on ideal conditions to advance through various stages of repair. Modern wound dressings are designed to imitate the natural surroundings around cells and offer properties such as moisture regulation, strength, and antimicrobial defense to boost healing. A recent research project unveiled a new type of gelatin (Gel)/dextran (Dex) hydrogels, linked through Diels-Alder (D-A) reactions, loaded with silver nanoparticles (Ag-NPs) for cutting-edge wound treatment. Gel and Dex were chemically modified to form the hydrogels via the D-A reaction. The hydrogels were enriched with Ag-NPs at varying levels. Thorough analyses of the hydrogels using methods like NMR, FT-IR, and SEM were carried out to assess their structure and nanoparticle integration. Rheological tests displayed that the hydrogels had favorable mechanical attributes, particularly when Ag-NPs were included. The hydrogels demonstrated controlled swelling, responsiveness to pH changes, and were non-toxic. Testing against E. coli showcased the strong antibacterial activity of the nanocomposite hydrogels in a concentration-dependent manner. This investigation showcased the promise of these bioactive nanocomposite hydrogels in promoting speedy wound healing by maintaining a moist environment, offering an antimicrobial shield, and ensuring mechanical support at the wound site.

Comparison of Conventional and Modern Wound Care in Post-Section Wounds at Cut Mutia Hospital, North Aceh Regency in 2023

The World Health Organization (WHO) sets the average cesarean sections (CS) standard at 5-15% per 1000 births. However, cesarean section rates in private hospitals exceed 30%, compared to 11% in government hospitals. This study investigates the prevalence and complications of surgical wound infections post-cesarean section and the effectiveness of modern wound dressing techniques in reducing these infections. Data analysis reveals cesarean wound infections occur during hospitalization (27%), re-admission (1%), and post-discharge (71%). Surgical wound infections (SWI) significantly increase morbidity, treatment duration, and healthcare costs, with a direct death rate ranging from 3% to 75% globally. The study evaluated modern wound dressings adhering to "moist wound healing" principles, such as hydrocolloids, alginate, and foam, which maintain a moist environment to enhance epithelial cell proliferation, accelerate wound healing, and reduce scarring. Findings indicate that moist wound dressings significantly improve healing outcomes, promoting epithelialization and collagen synthesis, with techniques showing a 30-50% increase in epithelialization and a 2-5 times faster re-epithelialization rate. These results highlight the need for adopting advanced wound care techniques to reduce surgical wound infections and improve patient recovery post-cesarean section. The study implies that healthcare providers should integrate modern wound care practices to enhance maternal health outcomes globally.

Antibacterial wound dressing with cross-linked electrospun surface from reduced graphene oxide doped polyvinyl alcohol/sodium caseinate blends.

In this study, a new biomaterial with polyvinyl alcohol (PVA)/sodium caseinate (SodCa)/reduced graphene oxide (rGO) structure was developed. Antibacterial effective nanofibers were successfully produced by electrospinning method from 1%, 3%, 5%, and 7% rGO added PVA/SodCa (60:40, w:w) solution mixtures prepared for use as modern wound dressings. To create a usage area, especially in exuding wounds, hydrophilic PVA/SodCa/rGO electrospun mats were cross-linked by dipping them in a glutaraldehyde (GLA) bath. The surface micrographs of all nanofibers were homogeneous and smooth. rGO-doped biomaterials were obtained as thin nanofibers in the range of 301-348 nm. Nanofibers, which were completely soluble in water, after cross-linking preserved their existence in the range of 87%-81% at the end of the 24th hour in distilled water. It was reported that these biomaterials that persist in an aqueous environment show swelling behavior in the range of 275%-608%. The porosity of uncross-linked pure PVA/SodCa nanofibers increased by 46.75% after cross-linking. Moreover, the tensile strength of cross-linked PVA/SodCa electrospun mats increased in the presence of rGO. Provided that wound dressing is done every 24 h with 3% rGO-doped PVA/SodCa nanofiber and provided that wound dressing is done every 48 h with 5% rGO-doped PVA/SodCa nanofiber showed antibacterial activity against S. aureus as 99.38% and 99.55%, respectively.

Potential Wound Dressing with Antibacterial Effect from Cross‐Linked Polyvinyl Alcohol/Sodium Caseinate/CuO NP Electrospun Mat

AbstractIn this study, nanofibers were produced from Polyvinyl alcohol (PVA)/Sodium Caseinate (SoCAS)/Copper Oxide nanoparticle (CuO NP) mixtures by electrospinning method. Nano surfaces were cross‐linked by immersion in a Glutaraldehyde (GLA) bath. Electrospun mats are designed as modern wound dressings with antibacterial effects for exuding wounds. The cross‐linking process by dipping has thickened a bit of nanofiber diameter by creating a coating effect on fiber surface. The increase of acetal bonds and decrease of hydroxyl groups in structure by cross‐linking have improved thermal properties of nanofibers. The increase in melting enthalpy has also improved mechanical properties of mats. The mixture of semicrystalline PVA and SoCAS has increased breaking stress of nanostructure. Besides, the CuO NP additive improved the breaking strength and elongation behavior of mats. It was stated that cross‐linked nanofibers swelled without dissolving in distilled water and contained water‐repellent groups. The CuO NP supplementation delayed the growth of Escherichia coli (E. coli). However, it was observed that antibacterial effect against Staphylococcus aureus (S. aureus) was higher than against E. coli. It was reported that 5 % CuO NP‐doped nanofiber can be used as a wound dressing, owing to its high fibroblast cell viability at 24th and 48th hours and 99.48 % antibacterial activity against S. aureus.

Bacterial cellulose as an ideal potential treatment for burn wounds: A comprehensive review.

Burn wound regeneration is a complex process, which has many serious challenges such as slow wound healing, secondary infection, and inflammation. Therefore, it is essential to utilise appropriate biomaterials to accelerate and guide the wound healing process. Bacterial cellulose (BC), a natural polymer synthesised by some bacteria, has attracted much attention for wound healing applications due to its unique properties including excellent physicochemical and mechanical properties, simple purification process, three-dimensional (3D) network structure similar to extracellular matrix, high purity, high water holding capacity and significant permeability to gas and liquid. BC's lack of antibacterial activity significantly limits its biomedical and tissue engineering application, but adding antimicrobial agents to it remarkably improves its performance in tissue regeneration applications. Burn wound healing is a complex long-lasting process. Using biomaterials in wound treatment has shown that they can satisfactorily accelerate wound healing. The purpose of this review is to elaborate on the importance of BC-based structures as one of the most widely used modern wound dressings in the treatment of burn wounds. In addition, the combination of various drugs, agents, cells and biomolecules with BC to expand its application in burn injury regeneration is discussed. Finally, the main challenges and future development direction of BC-based structures for burn wound repair are considered. The four most popular search engines PubMed/MEDLINE, Science Direct, Scopus and Google Scholar were used to help us find relevant papers. The most frequently used keywords were bacterial cellulose, BC-based biocomposite, wound healing, burn wound and vascular graft.

A Swine Burn Model for Investigating the Healing Process in Multiple Depth Burn Wounds.

Burn wound healing is a complex and long process. Despite extensive experience, plastic surgeons and specialized teams in burn centers still face significant challenges. Among these challenges, the extent of the burned soft tissue can evolve in the early phase, creating a delicate balance between conservative treatments and necrosing tissue removal. Thermal burns are the most common type, and burn depth varies depending on multiple parameters, such as temperature and exposure time. Burn depth also varies in time, and the secondary aggravation of the "shadow zone" remains a poorly understood phenomenon. In response to these challenges, several innovative treatments have been studied, and more are in the early development phase. Nanoparticles in modern wound dressings and artificial skin are examples of these modern therapies still under evaluation. Taken together, both burn diagnosis and burn treatments need substantial advancements, and research teams need a reliable and relevant model to test new tools and therapies. Among animal models, swine are the most relevant because of their strong similarities in skin structure with humans. More specifically, Yucatan minipigs show interesting features such as melanin pigmentation and slow growth, allowing for studying high phototypes and long-term healing. This article aims to describe a reliable and reproducible protocol to study multi-depth burn wounds in Yucatan minipigs, enabling long-term follow-up and providing a relevant model for diagnosis and therapeutic studies.

Surgical management of burn injury patients : Comments on the guidelines on treatment of thermal injuries in adults

The treatment of burn injury patients is aunique challenge for clinicians. The extent of thermal injuries ranges from very small burns to life-threatening burn injuries. Insufficient treatment can result in a substantial impairment in the quality of life. In order to avoid such sequelae a targeted treatment must be carried out. A precise diagnosis determines the necessary treatment. Superficial second-degree burns (2a) not involving the face, hand or joints with atotal body surface area smaller than 10% can usually be treated with modern wound dressings in an outpatient setting. Deep second-degree burns (2b) are an indication for debridement. In addition to the classical surgical procedures with tangential excision, enzymatic debridement can also be employed. Similarly, indeterminate burns (2a/2b) are also considered to be an indication for enzymatic debridement. Third-degree burns are treated with early debridement and skin grafting. These patients can also benefit from special dermal replacement procedures for an improvement of the functional and esthetic results. Due to the long-term visible sequelae of burns, aftercare of these patients is indicated.

Electrospun Antimicrobial Drug Delivery Systems and Hydrogels Used for Wound Dressings.

Wounds and chronic wounds can be caused by bacterial infections and lead to discomfort in patients. To solve this problem, scientists are working to create modern wound dressings with antibacterial additives, mainly because traditional materials cannot meet the general requirements for complex wounds and cannot promote wound healing. This demand is met by material engineering, through which we can create electrospun wound dressings. Electrospun wound dressings, as well as those based on hydrogels with incorporated antibacterial compounds, can meet these requirements. This manuscript reviews recent materials used as wound dressings, discussing their formation, application, and functionalization. The focus is on presenting dressings based on electrospun materials and hydrogels. In contrast, recent advancements in wound care have highlighted the potential of thermoresponsive hydrogels as dynamic and antibacterial wound dressings. These hydrogels contain adaptable polymers that offer targeted drug delivery and show promise in managing various wound types while addressing bacterial infections. In this way, the article is intended to serve as a compendium of knowledge for researchers, medical practitioners, and biomaterials engineers, providing up-to-date information on the state of the art, possibilities of innovative solutions, and potential challenges in the area of materials used in dressings.

Principles for the use of modern wound dressings
 for local treatment of limited borderline burns

Aim of the review to analyze the principles of the use of wound dressings for limited borderline burns.
 We have made an attempt to systematize the use of wound dressings depending on the state of the wound surface, the stage of the wound process. The proposed system simplifies the selection of the dressing and increases the chance for optimal treatment leading to positive clinical results.

Surgical management of burn injury patients : Comments on the guidelines on treatment of thermal injuries in adults

The treatment of burn injury patients is aunique challenge for clinicians. The extent of thermal injuries ranges from very small burns to life-threatening burn injuries. Insufficient treatment can result in a substantial impairment in the quality of life. In order to avoid such sequelae a targeted treatment must be carried out. A precise diagnosis determines the necessary treatment. Superficial second-degree burns (2a) not involving the face, hand or joints with atotal body surface area smaller than 10% can usually be treated with modern wound dressings in an outpatient setting. Deep second-degree burns (2b) are an indication for debridement. In addition to the classical surgical procedures with tangential excision, enzymatic debridement can also be employed. Similarly, indeterminate burns (2a/2b) are also considered to be an indication for enzymatic debridement. Third-degree burns are treated with early debridement and skin grafting. These patients can also benefit from special dermal replacement procedures for an improvement of the functional and esthetic results. Due to the long-term visible sequelae of burns, aftercare of these patients is indicated.

Controlled Delivery of Amoxicillin and Rifampicin by Three‐Dimensional Polyvinyl alcohol/Bismuth Ferrite Scaffolds

AbstractSkin is a protective barrier that can protect against environmental influences and renew itself. However, in some cases, this regenerative property is lost, and this causes delays in wound healing. Wound healing is a complex and long‐lasting phase. Any bacterial infection during the wound healing process delays wound healing. The therapeutic efficacy can be increased by using nanocarrier drug delivery systems to the target tissue with modern wound dressings. Controlled nano drug delivery systems increase the therapeutic efficacy in the treatment of diseases and provide a faster recovery process. In this study, amoxicillin (AMX) and rifampicin (RIF) were loaded into the bismuth ferrite (BFO) particles which were synthesized with the co‐precipitation method. Then, these drug‐loaded BFO particles (0.075 %) were added separately to 13 % polyvinyl alcohol (PVA) solution and the solutions were printed three‐dimensionally to obtain three dimensional scaffolds. With these designed scaffolds, it is aimed to reduce the risk of inflammation in wound tissues and increase therapeutic efficacy with controlled release. The SEM images proved that homogeneous pore distributions could be achieved with these combinations. The tensile test results showed that drug‐loaded BFO addition increased the mechanical strength of the 13 % PVA scaffold. The biocompatibility test results demonstrated that the highest viability values of the human adipose tissue‐derived mesenchymal stem cells were obtained for AMX‐added 13 % PVA scaffolds.

Clinical manifestations of allergic reactions and immunoglobulin E levels on allogeneic freeze-dried platelet-rich plasma (PRP) application

Link of Video Abstract: https://youtu.be/yS431sCL3VQ Background: Several studies have reported that modern wound dressings offer better results. Allogeneic PRP products in the form of injections and gels are available in the market, which helps accelerate wound healing without triggering an immunological reaction. Meanwhile, this study was carried out to investigate the Allogeneic Freeze-Dried PRP form, which is more practical, efficient, and safer. This study aims to determine the effect of Allogeneic Freeze-Dried PRP on human split-thickness skin graft donor wounds on clinical manifestations of allergic reactions and levels of Immunoglobulin E (IgE). Methods: A randomized Pre- and Post-test Control-Trial Group Design was conducted on patients with split-thickness skin graft donor wounds using Allogeneic Freeze-Dried PRP dressings at Dr. Soetomo General Hospital, Surabaya. Allergic manifestations were reviewed during the observation period of up to 4 days, and IgE levels were measured pre-test and 60 minutes post-application. A statistical comparison of results was carried out between the trial and control groups that used paraffin dressings. Results: A total of 36 patients were used as subjects, with 19 (52.78%) in the trial group and 17 (47.22%) in the control group, and their parameters were generally homogeneous. There were no clinical manifestations of allergic, changes in vital signs, and significant differences in IgE levels before and after application statistically in all study subjects (p>0.05). Conclusion: Application of Allogeneic Freeze-Dried PRP to human split-thickness skin graft donor wounds did not generate clinical manifestations of allergic reactions and an increase in IgE.

Alginate-Based Materials Loaded with Nanoparticles in Wound Healing.

Alginate is a naturally derived polysaccharide widely applied in drug delivery, as well as regenerative medicine, tissue engineering and wound care. Due to its excellent biocompatibility, low toxicity, and the ability to absorb a high amount of exudate, it is widely used in modern wound dressings. Numerous studies indicate that alginate applied in wound care can be enhanced with the incorporation of nanoparticles, revealing additional properties beneficial in the healing process. Among the most extensively explored materials, composite dressings with alginate loaded with antimicrobial inorganic nanoparticles can be mentioned. However, other types of nanoparticles with antibiotics, growth factors, and other active ingredients are also investigated. This review article focuses on the most recent findings regarding novel alginate-based materials loaded with nanoparticles and their applicability as wound dressings, with special attention paid to the materials of potential use in the treatment of chronic wounds.

Dressing Materials: A Comprehensive Review.

Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of events involved in wound healing can be affected by numerous disease processes, resulting in chronic, non-healing wounds that give significant discomfort and distress to the patients while draining the medical fraternity of enormous resources. Wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. There is a growing concern about the usage of correct materials for wound dressings. The development of new and effective treatments in wound care still remains an area of intense research. There are a number of wound dressings available in the market. The objective of the article is to enhance knowledge about characteristics of an ideal wound dressing and guide in finding the correct dressing material. It also provides a detailed classification of traditional and modern wound dressings.

A bio-polymeric scaffold incorporated with p-Coumaric acid enhances diabetic wound healing by modulating MMP-9 and TGF-β3 expression

Diabetic wounds lead to severe health complications as the tissue regeneration process fails predominantly due to prolonged inflammation, reactive oxygen species generation, and imbalance in collagen turnover. Modern wound dressings that can aid in wound management thus improving the public healthcare system, is the present need. This study aims to fabricate an effective wound dressing using plant polyphenol to treat chronic wounds as polyphenols possess excellent wound-healing ability. The collagen scaffold enriched with the polyphenol, p-Coumaric acid, was fabricated by freeze-drying method (Col-OxP3-Ca) and examined for its wound-healing ability by in vitro and in vivo analyses. Col-OxP3-Ca scaffold exhibited 85% antioxidant activity, biocompatibility in fibroblast cells, enhanced cell proliferation and migration rate. The diabetic excision wound treated with Col-OxP3-Ca scaffold healed within 21 days and a well-developed epidermis, blood vessels, hair follicle formation, fewer inflammatory cells and collagen deposition was observed in histological analysis. The immunohistochemical results depicted the enhanced expression of TGF-β3 and lessened expression of the MMP-9 in Col-OxP3-Ca scaffold treatment group. p-Coumaric acid shortened the inflammatory stage, enhanced angiogenesis, tissue regeneration and balanced collagen turnover during healing. From this, we can accomplish that the Col-OxP3-Ca wound dressing could be an outstanding alternative to treat chronic wounds.

Phytoconstituent-Loaded Nanofibrous Meshes as Wound Dressings: A Concise Review.

In the past, wounds were treated with natural materials, but modern wound dressings include functional elements to expedite the process of healing and to improve skin recovery. Due to their exceptional properties, nanofibrous wound dressings are now the most cutting-edge and desirable option. Similar in structure to the skin's own extracellular matrix (ECM), these dressings can promote tissue regeneration, wound fluid transportation, and air ductility for cellular proliferation and regeneration owing to their nanostructured fibrous meshes or scaffolds. Many academic search engines and databases, such as Google Scholar, PubMed, and Sciencedirect, were used to conduct a comprehensive evaluation of the literature for the purposes of this investigation. Using the term "nanofibrous meshes" as a keyword, this paper focuses on the importance of phytoconstituents. This review article summarizes the most recent developments and conclusions from studies on bioactive nanofibrous wound dressings infused with medicinal plants. Several wound-healing methods, wound-dressing materials, and wound-healing components derived from medicinal plants were also discussed.