Superior Wound Research Articles

Inclusion of Reduced Graphene Oxide to Silk Fibroin Hydrogels Improve the Conductive, Swelling and Wound Healing Capacity

AbstractDeveloping dressing for wound dressings represents a significant challenge for the scientific community. In this study, a conductive hydrogel was synthesized to promote the wound‐healing process. This hydrogel is composed of silk fibroin (SF), reduced graphene oxide (rGO), and glycerol (G). The impact of modifying the SF:rGO ratio, and the G content (%), on the physicochemical and biological properties. The hydrogels were characterized using FT‐IR, SEM, XRD, TGA, swelling, mechanical resistance, and conductivity. The cytotoxicity of the materials and their wound‐healing capacity in human fibroblasts were also determined. Chemical analysis revealed that the gelation of SF occurs due to the formation of β sheet structures, which was confirmed by the shift from amide I to amide II. An Increase in the SF:rGO ratio favored swelling behavior, although increasing G reduced this effect. The swelling of the hydrogel followed a Fick diffusion mechanism. Furthermore, the increase in the SF:rGO ratio and the percentage G improved the conductivity of the materials. The hydrogels were found to be non‐cytotoxic to human fibroblasts, and those containing rGO exhibited superior wound healing capacity compared to the positive control cell culture medium. Therefore, SF:rGO hydrogels could be considered promising candidates for wound dressing.

Fish collagen sponge with human umbilical cord mesenchymal stem cells for diabetic wound repair in rats.

Stem cell therapy offers a novel approach to treating difbetic foot ulcers. Fish skin decellularized matrix, a type I collagen, provides a promising carrier for stem cells, creating a supportive microenvironment that enhances cell survival and therapeutic potential. This study aims to investigate the effects and mechanisms of human umbilical cord mesenchymal stem cells (HUCMSCs) loaded onto a fish collagen sponge for wound healing in diabetic rats. The study evaluates stem cell-loading efficiency with fish collagen sponge in vitro, assesses material distribution on diabetic rat wounds, and establishes a wound model. Rats are divided into the Self-healing group, Fish collagen sponge group, and Sponge loaded with HUCMSCs group. Therapeutic effects are evaluated through various analyses, including histopathology and reverse transcription polymerase chain reaction for collagen-related gene expression levels. Compared to the self-healing group, both the fish collagen group and the composite group show faster wound repair and improved healing outcomes. The composite group exhibits superior wound healing quality, with fish collagen contributing to enhanced tissue regeneration through collagen regulation at the wound site. Loading HUCMSCs onto a fish collagen sponge shows promise for treating diabetic wounds by addressing nutrient deficiency and cell supply issues, offering potential benefits for patients undergoing treatment.

Amelioration of Full-Thickness Cutaneous Wound Healing Using Stem Cell Exosome and Zinc Oxide Nanoparticles in Rats

BackgroundWound healing is a complex procedure that requires the coordination of several factors, so this study aimed to assess the zinc oxide nanoparticles’ regenerated effect and stem cell exosomes on full-thickness wounds in rats. MethodsSeventy-two Wistar male rats were subjected to a full-thickness skin defect (20 mm2) on the dorsal surface of each rat between two shoulder joints. The rats were randomized into four groups (18/group) according to wound treatments. The wounds were irrigated with normal saline (Control group), or the wound’s edges were subcutaneously injected daily with 0.3 ml of exosome (Exo-group), or 1 ml of zinc oxide nanoparticles (ZnO2-NPs group), or 0.3 ml of exosome in combined with 1 ml of zinc oxide nanoparticles (Exo/ZnO2-NPs group). On the 7th, 14th, and 21st days post-wounding, the weight of the rats, the wound healing breaking strength, the wound size, and the contraction percent were evaluated. Six rats in each group were euthanized at each time point for histopathological, immunohistochemical examination of collagen, the levels of alpha-smooth muscle actin (α-SMA), and epidermal growth factor receptor (EGFR). additionally, the gene expression analysis of the relative renal nuclear factor erythroid 2-related factor2 (Nrf2 mRNA), Transforming growth factor beta-1 (TGFβ1), fibroblast growth factor-7 (FGF7), Transforming growth factor beta-1 (TGFβ1), Lysyl oxidase (LOX), and Vascular endothelial growth factor (VEGF) were applied. ResultsThe Exo-group exhibited a significant decrease in wound size and a significant increase in wound contraction compared with other groups. Histopathologically evaluation during the three intervals revealed that the Exo-group had the highest collagen deposition area with a significant reduction of the granulation tissue. Moreover, upregulated gene expression profiles of the growth factors genes at all time points post-wounding. DiscussionThe exosomes-treated group revealed superior wound healing and contraction, with minimal inflammatory signs, higher angiogenesis, and myofibroblasts, and associated with higher growth factor expression genes compared to the other groups. ConclusionsExosome-based therapy demonstrates potential as a treatment method to promote and accelerate wound healing by modulating angiogenesis, re-epithelialization, collagen deposition, and gene expression profiles.

Combination therapy of negative pressure wound therapy and antibiotic-loaded bone cement for accelerating diabetic foot ulcer healing: A prospective randomised controlled trial.

Negative pressure wound therapy (NPWT) and antibiotic-loaded bone cement (ALBC) are commonly used treatments for diabetic foot ulcers (DFUs). However, the combined efficacy of these two modalities remains unclear. This clinical study aimed to assess the effectiveness and underlying mechanisms of NPWT&ALBC in the management of DFUs. A total of 28 patients were recruited, 16 of whom served as controls and received only NPWT, whilst 12 received NPWT&ALBC. Both groups underwent wound repair surgery following the treatments. Blood samples were obtained to detect infections and inflammation. Wound tissue samples were also collected before and after the intervention to observe changes in inflammation, vascular structure and collagen through tissue staining. Compared with the NPWT group, the NPWT&ALBC group exhibited a superior wound bed, which was characterised by reduced inflammation infiltration and enhanced collagen expression. Immunostaining revealed a decrease in IL-6 levels and an increase in α-SMA, CD68, CD206 and collagen I expression. Western blot analysis demonstrated that NPWT&ALBC led to a decrease in inflammation levels and an increase in vascularization and collagen content. NPWT&ALBC therapy tends to form a wound bed with increased vascularization and M2 macrophage polarisation, which may contribute to DFUs wound healing.

Tailor-made curdlan based nanofibrous dressings enable diabetic wound healing

The development and application of novel polysaccharides that can improve diabetic wound healing is crucial. Dressings containing curdlan have the potential to promote healing in diabetic wounds, but the underlying mechanism remain unclear. In addition, the functional modifications that could further enhance the activity of curdlan in promoting diabetic wound healing have not been explored. Herein, we investigated the capabilities of curdlan (CU) and its four derivatives i.e., sulfated curdlan (SC), amino-curdlan (AC) carboxymethyl curdlan (CMC) and CMC/ZnO nanocomposites for diabetic wound healing. Pristine CU and its derivatives were blended with polyvinyl alcohol (PVA) to fabricate electrospun nanofiber dressings (ENDs) with uniform appearances. The PVA/CU, PVA/CMC and PVA/CMC-ZnO ENDs were more compatible with keratinocytes, fibroblasts, and macrophages than that of PVA/AC ENDs. Notably, PVA/CMC ENDs and PVA/CMC-ZnO ENDs exhibited superior wound healing efficiencies than other ENDs. Among various dressings, PVA/CU, PVA/SC, PVA/CMC ENDs effectively reduced M1 macrophages and facilitated M2 phenotype at early stage of diabetic wound healing. Collectively, the PVA/CMC ENDs demonstrated greater therapeutic potential against diabetic wounds compared to other modified scaffolds via regulating macrophage polarization.

Polyvinyl alcohol-chitosan based oleanolic acid nanofibers against bacterial infection: In vitro studies and in vivo evaluation by optical and laser Doppler imaging modalities

The present work focuses on the fabrication of polyvinyl alcohol-chitosan-loaded oleanolic acid-nanofibers (PVA-CS-OLA-NFs) for bacterial infection. The prepared PVA-CS-OLA-NFs were characterized for contact angle, SEM, AFM, XRD, FTIR, and TGA. The solid-state characterization and in vitro performance evaluation of nanofibers reveal consistent interconnection and diameters ranging from 102 ± 9.5 to 386 ± 11.6 nm. The nanofibers have a flat surface topography and exhibit efficient drug entrapment. Moreover, the in vitro release profile of PVA-CS-OLA-NFs was found to be 51.82 ± 1.49 % at 24 h. Furthermore, the hemocompatibility study showed that the developed PVA-CS-OLA-NFs are non-hemolytic to human blood. The PVA-CS-OLA-NFs demonstrate remarkable antibacterial capabilities, as evidenced by their MBC and MIC values, which range from 128 and 32 μg/mL, against the strains of S. aureus. The in-vivo fluorescence optical imaging showed the sustained PVA-CS-OLA-NFs release at the wound site infected with S. aureus for a longer duration of time. Moreover, the PVA-CS-OLA-NFs showed superior wound healing performance against S. aureus infected wounds compared to the marketed formulation. Further, the laser Doppler imaging system improved oxygen saturation, blood supply, and wound healing by providing real-time blood flow and oxygen saturation information.

Enhancing Wound Healing With Sprayable Hydrogel Releasing Multi Metallic Ions: Inspired by the Body's Endogenous Healing Mechanism.

In the pursuit of new wound care products, researchers are exploring methods to improve wound healing through exogenous wound healing products. However, diverging from this conventional approach, this work has developed an endogenous support system for wound healing, drawing inspiration from the body's innate healing mechanisms governed by the sequential release of metal ions by body at wound site to promote different stages of wound healing. This work engineers a multi-ion-releasing sprayable hydrogel system, to mimic this intricate process, representing the next evolutionary step in wound care products. It comprises Alginate (Alg) and Fibrin (Fib) hydrogel infused with Polylactic acid (PLA) polymeric microcarriers encapsulating multi (calcium, copper, and zinc) nanoparticles (Alg-Fib-PLA-nCMB). Developed sprayable Alg-Fib-PLA-nCMB hydrogel show sustained release of beneficial multi metallic ions at wound site, offering a range of advantages including enhanced cellular function, antibacterial properties, and promotion of crucial wound healing processes like cell migration, ROS mitigation, macrophage polarization, collagen deposition, and vascular regeneration. In a comparative study with a commercial product (Midstress spray), developed Alg-Fib-PLA-nCMB hydrogel demonstrates superior wound healing outcomes in a rat model, indicating its potential for next generation wound care product, addressing critical challenges and offering a promising avenue for future advancements in the wound management.

Curcumin-loaded gold nanoparticles with enhanced antibacterial efficacy and wound healing properties in diabetic rats

Diabetic wounds pose a significant global health challenge. Although curcumin exhibits promising wound healing and antibacterial properties, its clinical potential is limited by low aqueous solubility, and poor tissue penetration. This study aimed to address these challenges and enhance the wound healing efficacy of curcumin by loading it onto gold nanoparticles (AuNPs). The properties of the AuNPs, including particle size, polydispersity index (PDI), zeta potential, percent drug entrapment efficiency (%EE) and UV–Vis spectra were significantly influenced by the curcumin/gold chloride molar ratio used in the synthesis of AuNPs. The optimal formulation (F2) exhibited the smallest particle size (41.77 ± 6.8 nm), reasonable PDI (0.59 ± 0.17), high %EE (94.43 ± 0.25 %), a moderate zeta potential (−8.44 ± 1.69 mV), and a well-defined surface Plasmon resonance peak at 526 nm. Formulation F2 was incorporated into Pluronic® F127 gel to facilitate its application to the skin. Both curcumin AuNPs solution and gel showed sustained drug release and higher skin permeation parameters compared with the free drug solution. AuNPs significantly enhanced curcumin’s antibacterial efficacy by lowering the minimum inhibitory concentrations and enhancing antibacterial biofilm activity against various Gram-positive and Gram-negative bacterial strains. In a diabetic wound rat model, AuNPs-loaded curcumin exhibited superior wound healing attributes compared to the free drug. Specifically, it demonstrated improved wound healing percentage, reduced wound oxidative stress, increased wound collagen deposition, heightened anti-inflammatory effects, and enhanced angiogenesis. These findings underscore the potential of AuNPs as efficacious delivery systems of curcumin for improved wound healing applications.

Shatadhauta Ghrita and Panchavalkala Prevent Wound Healing In Vivo

Background: Wounds disrupt the integrity of skin or mucosa, causing significant cellular and vascular damage. Historical and modern research aims to improve wound healing through effective management strategies and therapeutic applications, particularly within traditional systems like Ayurveda. This study evaluates the efficacy of Shatadhauta Ghrita (SDG) combined with Panchavalkala Siddha Ghrita (PSSG) for wound healing, assessing their potential as modern treatments. Methods: Thirty mature Wistar strain albino rats were divided into five groups, including a control and treatment groups receiving SDG, Go-Ghrita (GH), and PSSG. Standardized excision wounds were created, and healing was monitored through wound contraction measurements over 21 days. Results: The control group showed a wound contraction of 91.53% after 15 days, increasing to 95.23% by day 21. The GH group exhibited 93.67%, while the SDG group had 87.95%. Notably, the SDG group demonstrated a contraction of 98.67% by day 21, outperforming both control and GH groups. Conclusion: SDG’s superior wound healing efficacy suggests it may serve as an effective topical treatment, supported by traditional Ayurvedic practices. This research emphasizes the importance of integrating traditional knowledge with scientific validation, advocating for further studies on SDG's biological properties and potential applications in modern medicine.

The Application of Photobiomodulation and Stem Cells Seeded on the Scaffold Accelerates the Wound Healing Process in Mice.

Introduction: The purpose of this research was to test the impact of seeding a hydrogel chitosan scaffold (HCS) with human adipose-derived stem cells (hADSCs) under the influence of photobiomodulation (PBM) on the remodeling step on the wound repairing process in mice. Methods: Thirty mice were randomly assigned to five groups (n=6 per group ): The control group (group 1) consisted of mice without any intervention. In group 2, an HCS was implanted into the wound. In group 3, a combination of HCS+hADSC was inserted into the wound. In group 4, an HCS was inserted into the wound and PBM was applied. In group 5, a combination of HCS+hADSCs was inserted into the wound, followed by PBM treatment. Results: Improvements in the injury closing rate (WCR) and microbial flora were observed in all groups. However, the highest WCRs were observed in group s 5, 4, 3, and 2 (all P values were 0.000). Groups 3-5 showed increased wound strength compared to group s 1 and 2, with group 2 demonstrating better results than group 1 (P values ranged from 0.000 to 0.013). Although group s 3-5 showed increases in certain stereological elements compared to group s 1 and 2, group 2 exhibited superior results in comparison with group 1 (P values ranged from 0.000 to 0.049). Conclusion: The joined use of HCS+hADSCs+PBM significantly accelerated the wound healing process during the maturation phase in healthy mice. This approach demonstrated superior wound healing compared to the use of HCS alone, hADSCs+HCS, or PBM+HCS. The findings suggest an additive effect when HCS+hADSCs+PBM are combined.

Zn@TA assisted dual cross-linked 3D printable glycol grafted chitosan hydrogels for robust antibiofilm and wound healing

Rapid regeneration of the injured tissue or organs is necessary to achieve the usual functionalities of the damaged parts. However, bacterial infections delay the regeneration process, a severe challenge in the personalized healthcare sector. To overcome these challenges, 3D-printable multifunctional hydrogels of Zn/tannic acid-reinforced glycol functionalized chitosan for rapid wound healing were developed. Polyphenol strengthened intermolecular connections, while glutaraldehyde stabilized 3D-printed structures. The hydrogel exhibited enhanced viscoelasticity (G′; 1.96 × 104 Pa) and adhesiveness (210 kPa). The dual-crosslinked scaffolds showed remarkable antibacterial activity against Bacillus subtilis (∼81 %) and Escherichia coli (92.75 %). The hydrogels showed no adverse effects on human dermal fibroblasts (HDFs) and macrophages (RAW 264.7), indicating their superior biocompatibility. The Zn/TA-reinforced hydrogels accelerate M2 polarization of macrophages through the activation of anti-inflammatory transcription factors (Arg-1, VEGF, CD163, and IL-10), suggesting better immunomodulatory effects, which is favorable for rapid wound regeneration. Higher collagen deposition and rapid re-epithelialization occurred in scaffold-treated rat groups vis-à-vis controls, demonstrating superior wound healing. Taken together, the developed multifunctional hydrogels have great potential for rapidly regenerating bacteria-infected wounds in the personalized healthcare sector.

Enhanced healing of burn wounds by multifunctional alginate-chitosan hydrogel enclosing silymarin and zinc ‎oxide ‎nanoparticles

Multifunctional wound dressings have been applied for burn injuries to avoid complications and promote tissue regeneration. In the present study, we fabricated a natural alginate-chitosan hydrogel comprising silymarin and green-synthesized zinc ‎oxide ‎nanoparticles (ZnO NPs). Then, the physicochemical attributes of ZnO NPs and loaded hydrogels were analyzed. Afterward, wound healing efficacy was evaluated in a rat model of full-thickness dermal burn wounds. The findings indicated that ZnO NPs were synthesized via reduction with phytochemicals from Elettaria cardamomum seeds extract. The microscopic images exhibited fairly spherical ZnO NPs (35-45nm), and elemental analysis verified the relevant composition. The hydrogel, containing silymarin and biosynthesized ZnO NPs, displayed a uniform appearance, smooth surfaces, and a porous structure. Moreover, infrared spectroscopy ‎identified functional groups, confirming the successful loading without adverse interactions. The obtained hydrogel exhibited great water absorption, high porosity, sustainable degradation for several days, and enhanced antioxidant capability of the combined loaded component. In vivo studies revealed faster and superior wound healing, achieving nearly complete closure by day 21. Histopathology confirmed improved cell growth, tissue regeneration, collagen deposition, and neovascularization. It is believed that this multifunctional hydrogel-based wound dressing can be applied for effective burn wound treatment.

Collagen Synthesis During Wound Repair in Infected Albino Rats Using Ciprofloxacin-Loaded Gelatin Microspheres Incorporated into a Collagen Scaffold: A Histological Approach Using Masson’s Trichrome Staining

The production of collagen fibers is essential for wound healing because it creates a scaffold of collagen on which new cells may move and proliferate. It indicates cellular activity and improves strength and flexibility. Collagen synthesis is influenced by a number of factors, including age, health, infection, and diet. Collagen dressings often have the ability to increase the production of collagen. Collagen production can be adversely affected by infected cutaneous wounds, which can result in a delayed healing process, a higher risk of scarring, weakened tissue, and functional impairment. For this reason, in order to speed up wound healing, antimicrobial agents have been added to the collagen scaffold. Furthermore, the prolonged delivery of antimicrobial agent-loaded gelatin microspheres to infected wounds promotes quicker wound healing and effective collagen synthesis in the granulated tissue. These scaffolds may make superior wound dressings in clinical settings in light of this relationship.

Incisional negative pressure wound therapy (PrevenaTM) vs. conventional post-operative dressing after immediate breast reconstruction: a randomized controlled clinical trial

BackgroundSurgical complications following breast reconstruction remain a significant concern. This study aimed to investigate if incisional negative pressure wound therapy (iNPWT) using Prevena™ provides superior wound treatment for patients undergoing immediate breast reconstruction (IBR) compared to conventional postoperative dressing. Additionally, we investigated whether intraoperative indocyanine green angiography (ICG-A) could predict and prevent postoperative complications.MethodsA randomized controlled study (RCT) comprising 39 patients was conducted. The primary outcome was time until surgical drain removal. ICG-A was applied to evaluate tissue perfusion and compared to rate of postoperative complications. Patients were followed for one year, including postoperative complications, quality of life (QoL), scar evaluation, incidence of lymphedema and timely administration of adjuvant therapy.ResultsNo significant differences were observed in time to surgical drain removal, hospitalization or incidence of postoperative complications between the two groups. Analysis revealed no significant association between ICG-A results and postoperative complications. After one year, both groups exhibited similar QoL and satisfaction with scars. One patient developed lymphedema during follow-up, and adjuvant treatment was timely administered in 82%.ConclusionsThis RCT investigated iNPWT by Prevena™ compared to conventional postoperative dressing in IBR using implants or tissue expanders. ICG-A was applied to assess tissue perfusion and compared to postoperative complications. We did not find any significant differences in recovery time, hospitalization duration, postoperative complication rates, QoL, or scar satisfaction between the two groups within a one-year follow-up. Additionally, there were no significant association between ICG-A and postoperative complications. Larger randomized studies incorporating intraoperative ICG-A are needed to obtain higher quality data.Level of Evidence: Level I, Risk/Prognostic

Systematic Review of Cellular, Acellular, and Matrix-like Products and Indirect Treatment Comparison Between Cellular/Acellular and Amniotic/Nonamniotic Grafts in the Management of Diabetic Foot Ulcers.

Significance: This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant review focuses on the efficacy of cellular, acellular, and matrix-like products (CAMPs) in the management of diabetic foot ulcers (DFUs) based on published randomized controlled trials (RCTs). Recent Advances: Although CAMPs have been incorporated into the clinical algorithm for chronic wounds, evidence is lacking to comparatively evaluate the efficacy of these products. Critical Issues: Level 1 RCT studies are the gold standard to evaluate the efficacy of different treatment approaches; however, due to differences in surgical techniques, patient demographics, and compliance, standard-of-care (SOC) outcomes in the wound care space can vary significantly between different RCTs, making it difficult to compare them against each other. Future Directions: To mitigate variability between different RCTs, wound closure outcomes can be reported as risk ratios (RRs). This review of all the currently published RCTs (with a similar trial design) in patients with DFU and RRs confirms that CAMPs adjunct to SOC result in statistically superior wound closure outcomes in DFUs, when compared with SOC alone, with a RR of 1.72 [1.56, 1.90], p < 0.00001. Enough evidence is still lacking to determine a statistical difference between broad categories of cellular/acellular and amniotic/nonamniotic CAMPs, and hence, decision makers should consider published head-to-head comparative studies, real-world evidence, and cost-effectiveness evidence between individual CAMPs to decide on which to use in practice.

Integrated In Vivo and In Vitro Evaluation of a Powder-to-Hydrogel, Film-Forming Polymer Complex Base with Tissue-Protective and Microbiome-Supportive Properties.

The study aimed to perform a comprehensive in vitro and in vivo evaluation of a newly developed, patent-pending, powder-to-hydrogel, film-forming polymer complex base, which possesses tissue-protective and microbiome-supportive properties, and to compare its characteristics with poloxamer 407. The study used a combination of in vitro assays, including tissue viability and cell migration, and in vivo wound healing evaluations in male diabetic mice. Microbiome dynamics at wound sites were also analyzed. The in vitro assays demonstrated that the polymer complex base was non-cytotoxic and that it enhanced cell migration over poloxamer 407. In vivo, the polymer complex base demonstrated superior wound healing capabilities, particularly in combination with misoprostol and phenytoin, as evidenced by the reduced wound area and inflammation scores. Microbiome analysis revealed favorable shifts in bacterial populations associated with the polymer complex base-treated wounds. The polymer complex base demonstrates clinical significance in wound care, potentially offering improved healing, safety and microbiome support. Its transformative properties and efficacy in drug delivery make it a promising candidate for advanced wound care applications, particularly in chronic wound management.

The role of TENS therapy in reducing the incidence of post-Caesarean section wound infection.

The occurrence of wound infection following a Caesarean section procedure poses a substantial clinical obstacle. Transcutaneous Electrical Nerve Stimulation (TENS) has been identified as a promising supplementary treatment option for improving the healing process and decreasing the incidence of infections. This study assessed the efficacy of TENS therapy in the postoperative care of patients who have had Caesarean section. We randomly assigned a total of 108 women who had Caesarean sections to either a TENS group (n = 54) or control (n = 54). The TENS therapy was provided twice daily for a duration of 30 min for the period of 14 days following the surgery. The main measure of interest in this study was the occurrence of wound infection during 30-day period. Additionally, secondary measures included the rate of wound healing, levels of pain experienced and level of patient satisfaction. In comparison to the control (22.2%, p < 0.05), the TENS group had notably reduced occurrence of wound infection, with the rate of 7.4%. TENS group had superior wound healing results, as measured by REEDA scale, at 7 days (2.1 ± 0.8 vs. 2.5 ± 1.0, p < 0.04), 14 days (1.2 ± 0.5 vs. 1.9 ± 0.7, p < 0.05) and 30 days (0.3 ± 0.5 vs. 0.7 ± 0.6, p < 0.05). Furthermore, TENS group had reduced pain levels on the Visual Analog Scale (VAS) at all evaluation intervals (p < 0.05). TENS group exhibited significantly higher levels of patient satisfaction, as evidenced by 64.8% of participants rating high satisfaction, in contrast to 40.7% in the control group (p < 0.05). The incidence of adverse effects was found to be minor, as indicated by a skin irritation rate of 3.7% and reported discomfort rate of 1.9% at the electrode location. TENS therapy effectively decreased the occurrence of post-Caesarean wound infections, expedited the healing process and enhanced pain control. This treatment was well-received by patients and had little negative consequences. The aforementioned results provided evidence in favour of incorporating TENS into post-Caesarean care regimens, which may have significant consequences for improving patient outcomes and maximizing healthcare resources.

Multifunctional skin dressings synthesized via one‐pot photopolymerization: Advancing wound healing and infection prevention strategies

AbstractIn the field of wound healing treatment, the development of new materials is essential to cover multiple functions, such as acceleration of the healing process, prevention of infection and response to stimuli, especially if they present lower costs or are easier to manufacture. These properties are of great importance to prompt skin cicatrization. In this work, new multifunctional skin dressings for wound healing and infection prevention are developed based on new hydrogel materials. The dressings are produced via a straightforward and environmentally friendly one‐pot photopolymerization manufacturing process utilizing vitamin B2 aqueous solutions as sensitizer, and energy‐efficient blue light sources. These dressings exhibit a high swelling capacity, pH and temperature responsiveness, biocompatibility, antimicrobial activity in the absence of conventional antibiotics, and are capable of promoting wound healing. The formulation is based on the combination of three monomers: 2‐((methacryloyloxy)ethyl)trimethylammonium chloride, methacrylic acid and N‐vinyl caprolactam. Collagen, hyaluronic acid, and essential oil of hop are added to enhance antimicrobial properties and stimulate regenerative cellular processes. In vivo experiments have demonstrated that pristine dressings are superior in promoting collagen and fibroblast regeneration and accelerating cicatrization as compared to dressings containing natural products. The dressing embedded with hop also displayed antimicrobial characteristics. The preparation and testing of these new efficient wound dressings are described. This study is distinctive in its integration of environmentally conscious manufacturing techniques with innovative material formulations, resulting in superior wound dressings that are both cost‐effective and highly functional. By achieving enhanced healing and infection prevention without the employment of conventional antibiotics, this work represents a substantial advancement in sustainable and effective wound care management.

Potential of hybrid lecithin-chitosan kaempferol ethosomes for the treatment of diabetic foot ulcer: In vitro and In vivo investigation

Hybrid lecithin-chitosan (LC) ethosomes were developed for maximizing encapsulation efficiency and release of Kaempferol (KMP) in controlled effect for topical delivery. The hybrid lecithin–chitosan offers the benefits of both components: enhanced lipophilicity and mucoadhesive, respectively. In this work, hybrid lecithin-chitosan KMP ethosomes (Eth) were prepared via a cold technique and assesses its physicochemical properties, in vitro and in vivo studies. The synthesized LC-Eth-vesicles of KMP reported vesicle size of 186.8 nm with polydispersity index of 0.285 and 31.9 mV of zeta-potential. The encapsulation efficiency was 96.2 %. In vitro drug release profile has shown prolonged release of KMP in a controlled manner over a period of 24 h. Around 80.3 % KMP was released from LC-KMP-Eth gel while only 46.9 % of KMP was released from the plain KMP-gel in 24 h. The release kinetic investigation the release of KMP followed the “Korsmeyer-Peppas model” with Fickian-diffusion mechanism. The LC-KMP-Eth has shown increased antimicrobial activity as compared plain KMP gel against multiple strains of MRSA. The histopathological analysis of skin samples revealed an increased re-epithelization with reduced wound ulcer which was also observed by the visual examination of the skin conditions. The in vivo results on Wistar albino rat models demonstrated superior wound closure efficacy of LC-KMP-Eth gel as compared to plain KMP gel. Around 2-fold overall increased pharmacokinetic parameters of KMP from LC-KMP-Eth gel after topical application, displayed a higher concentration of KMP in rat plasma, reveling a potent effect at the wound site and the gel also provide the moist environment and influencing cell adhesion, thus stimulating restorative action in diabetic foot ulcers.

Bone marrow derived mesenchymal stem cells enriched PCL-gelatin nanofiber scaffold for improved wound healing

Electrospun nanofibers exhibit a significant potential in the synthesis of nanostructured materials, thereby offering a promising avenue for enhancing the efficacy of wound care. The present study aimed to investigate the wound-healing potential of two biomacromolecules, PCL-Gelatin nanofiber adhered with bone marrow-derived mesenchymal stem cells (BMSCs). Characterisation of the nanofiber revealed a mean fiber diameter ranging from 200 to 300 nm, with distinctive elemental peaks corresponding to polycaprolactone (PCL) and gelatin. Additionally, BMSCs derived from bone marrow were integrated into nanofibers, and their wound-regenerative potential was systematically evaluated through both in-vitro and in-vivo methodologies. In-vitro assessments substantiated that BMSC-incorporated nanofibers enhanced cell viability and crucial cellular processes such as adhesion, and proliferation. Subsequently, in-vivo studies were performed to demonstrate the wound-healing efficacy of nanofibers. It was observed that the rate of wound healing of BMSCs incorporated nanofibers surpassed both, nanofiber and BMSCs alone. Furthermore, histomorphological analysis revealed accelerated re-epithelization and improved wound contraction in BMSCs incorporated nanofiber group. The fabricated nanofiber incorporated with BMSCs exhibited superior wound regeneration in animal model and may be utilised as a wound healing patch.