Traditional Dressings Research Articles

Efficacy of Oxidized Regenerated Cellulose/Collagen Dressing for Management of Skin Wounds: A Systematic Review and Meta-Analysis.

Objective The purpose of this study was to evaluate the wound healing efficacy of oxidized regenerated cellulose (ORC)/collagen dressing and ORC/collagen/silver-ORC dressings compared to standard of care or control in treatment of chronic skin wounds such as diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), and pressure injuries sore ulcers (PISUs). Methods An electronic search was carried out in four popular databases PubMed, Scopus, Embase, and CENTRAL to identify thirteen included studies, comparing the clinical efficacy of ORC/collagen dressings when compared to control in management of chronic skin wounds, especially DFUs, VLUs, and PISUs, and skin graft donor site wounds. Results Consolidated data from thirteen comparative clinical studies undertaken for management of DFUs, VLUs, and PISUs showed favorable outcomes towards use of ORC/collagen compared to other traditional and hydrocolloid foam dressings in terms of wound healing rate (P=0.02) and percentage wound relative reduction (P=0.003). The time taken to achieve complete wound healing in the included studies did not show any statistical significant difference (P=0.24). There was no significant difference in adverse events between ORC/collagen-treated group and comparative group (P=0.19). Conclusion ORC/collagen wound dressings are beneficial in terms of improved wound healing rate and percentage wound relative reduction compared to already existing traditional standard of care with non-MMP, inhibiting biomaterials such as moistened gauze, autologous growth factors, hydrocolloid foam dressings, or ovine extracellular matrix.

Study on scar repair and wound nursing of chitosan-based composite electrospun nanofibers in first aid of burn

Bacterial infection and oxidative stress are serious complications in emergency burn patients, as the increase of oxygen free radicals in burn wounds can aggravate vascular endothelial cell injury, make the wounds ischemic and hypoxic, and delay wound healing. Traditional dressings cannot meet the first-aid needs of burn patients. In this study, polycaprolactone/chitosan (PCL/CS) was used as an electrospun nanofiber matrix, and curcumin (CUR), a molecule with excellent anti-inflammatory and antioxidant properties, was introduced to construct polycaprolactone/ chitosan graft copolymer-zein-curcumin electrospun nanofibers (PCL/CS-ZE-CUR). The results of clinical experiments suggest that compared with traditional dressings, based on the excellent mechanical properties and antibacterial activity of PCL/CS, the new dressing can exhibit oxygen free radical-scavenging abilities of CUR to accelerate wound healing and is expected to provide a beneficial upgrade for wound emergency care.

Experimental Substantiation of Antimicrobial Efficiency of a New Composite Polymeric Material Based on Poly(2-Hydroxyethyl Methacrylate) under the Action of Low-Intensity Current without External Power Supplies

Active use of polymeric materials has become an integral part of all areas of modern medicine. Wound dressings capable of prolonged release of drugs directly into the lesion occupy a special place among them. The possibility of using such materials in the presence of low-intensity currents without external power supplies in a comprehensive treatment program for patients with burn injuries remains promising. The aim of the work is to study experimentally the antimicrobial efficacy of a new composite polymeric material based on poly(2-hydroxyethyl methacrylate), saturated with the antiseptic decamethoxine, under conditions of low-intensity current without external power supplies. The method of free radical thermal polymerization of a mixture of liquid monomer 2-hydroxyethyl methacrylate, crosslinking agent triethylene glycol dimethacrylate, polymerization initiator azobisisobutyronitrile was used for the synthesis of composite polymeric material. In addition, fourfold volume of distilled water as a pore-forming agent and decamethoxine as an antimicrobial component were administered. Known dressings of synthetic and biological origin were selected for comparison, some of which were pre-soaked in a 0.02% solution of decamethoxine. The study of conductivity of the materials without external power supplies was performed on the surface of a dense nutrient medium in a Petri dish using VITA-01M measuring device. Determination of antibacterial properties was performed by diffusion into agar. The obtained results allowed to establish the ability of the suggested polymeric material to conduct low-intensity currents without external power supplies, exceeding the duration of other traditional dressings. Comparison of antimicrobial activity of the studied samples confirmed the synergism of the action of physical factors and a new polymer-based composite material with the addition of antimicrobial substance to inhibit the growth of the test museum and clinical strains of Staphylococcus aureus. The ability of low-intensity currents without external power supplies to potentiate the antimicrobial properties of a new composite polymeric material based on poly(2-hydroxyethyl methacrylate), modified with a pore-forming agent, with the addition of decamethoxine was experimentally established.

Fluorescent Light Energy and Chronic Lesions: A Winning Association.

Background:Chronic ulcers represent a challenge for healthcare professionals and a large expense for national health care systems for their difficulty in achieving complete healing and for their high incidence of recurrence. With the progressive aging of the general population, the incidence of these injuries will only increase, further affecting the public health budget, hence the need to find new strategies for their management. The purpose of this study was to share the experience of the Complex Operational Unit of Plastic Surgery of the University Hospital of Padua with fluorescent light energy therapy, outlining its role in the treatment of chronic ulcers in the daily use outside the previous EUREKA study.Methods:In this case series study, we enrolled 15 patients with chronic ulcers of any etiology between January 2018 and July 2019 and we treated them using fluorescence light energy. We evaluated efficacy and safety endpoints reporting data in excel files completed by medical staff during the study.Results:The study confirms the effectiveness of fluorescent light energy inducing chronic ulcer healing, regardless of etiology, or at least preparing the lesions for a skin graft closure surgery. The system showed a low rate of complications established by patient adherence to treatment. Patients also reported a reduction in pain both at home and during outpatient dressings.Conclusion:Based on our experience, fluorescent light energy shows an excellent safety and efficacy profile in chronic ulcers no more responsive to traditional dressings and/or surgery.

Could intermittent change of conventional dressing affect risk of periprosthetic joint infection after primary total joint arthroplasty?

Periprosthetic joint infection (PJI) is one of the most dreaded and challenging complications after total joint arthroplasty (TJA). The aim of this study was to evaluate the effect of keeping the dressing without change on the occurrence of PJI in patients undergoing TJA. 4877 Patients with a minimum follow-up of 90days were included to investigate the effect of dressing on the PJI occurring within 3months of surgery. Patients were divided into two consecutive groups as the intermittent change of traditional dressing (group 1-before 2019) and keeping dressing for 5days without change (group 2-after 2019). A backward stepwise logistic regression model was used to estimate independent risk factors for PJI. Group 1 and group 2 consisted of 4172 and 705 patients, and the numbers of diagnosed PJI cases in the groups were 40 (1.0%) and 10 (1.4%), respectively (p = 0.1). The backward stepwise logistic regression model analysis revealed that keeping the dressing unchanged and removing it after the first week postoperatively was not an independent risk factor for the occurrence of PJI. Older age, diabetes mellitus and coronary artery diseases were independent risk factors for PJI (p < 0.05). Our study results present, that intermittent change of conventional dressing is unnecessary, because it does not decrease the risk of PJI after TJA. Level III Therapeutic.

Wound Dressings for Hip and Knee Total Joint Arthroplasty: A Narrative Review.

Dressing choice following lower-extremity total joint arthroplasty has substantial ramifications for postoperative outcomes and should be carefully made to prevent complications such as periprosthetic joint infection. Patient risk factors are essential components in the selection of wound dressings in total joint arthroplasty. Traditional dressings are inexpensive per unit; nevertheless, the associated higher complication profile in patients at a high risk for poor wound healing and sequelae-associated costs may outweigh the up-front savings. Modern dressings have the potential to yield better safety outcomes and increased patient satisfaction; however, there is a paucity of evidence regarding the ideal interactive dressing. Active dressings, such as silver-ion dressings and closed-incisional negative-pressure wound therapy, have shown promising results to reduce surgical site and periprosthetic joint infection, especially in patients at a high risk for poor wound healing following hip and knee total joint arthroplasty.

Preparation and Application of Quaternized Chitosan- and AgNPs-Base Synergistic Antibacterial Hydrogel for Burn Wound Healing.

Infection is the major reason that people die from burns; however, traditional medical dressings such as gauze cannot restrain bacterial growth and enhance the healing process. Herein, an organic- and inorganic-base hydrogel with antibacterial activities was designed and prepared to treat burn wounds. Oxidized dextran (ODex) and adipic dihydrazide grafted hyaluronic acid (HA-ADH) were prepared, mixed with quaternized chitosan (HACC) and silver nanoparticles to fabricate Ag@ODex/HA-ADH/HACC hydrogel. The hydrogel, composed of nature biomaterials, has a good cytocompatibility and biodegradability. Moreover, the hydrogel has an excellent antibacterial ability and presents fast healing for burn wounds compared with commercial Ag dressings. The Ag@ODex/HA-ADH/HACC hydrogel will be a promising wound dressing to repair burn wounds and will significantly decrease the possibility of bacterial infection.

Wound Healing: From Passive to Smart Dressings.

The universal increase in the number of patients with nonhealing skin wounds imposes a huge social and economic burden on the patients and healthcare systems. Although, the application of traditional wound dressings contributes to an effective wound healing outcome, yet, the complexity of the healing process remains a major health challenge. Recent advances in materials and fabrication technologies have led to the fabrication of dressings that provide proper conditions for effective wound healing. The 3D-printed wound dressings, biomolecule-loaded dressings, as well as smart and flexible bandages are among the recent alternatives that have been developed to accelerate wound healing. Additionally, the new generation of wound dressings contains a variety of microelectronic sensors for real-time monitoring of the wound environment and is able to apply required actions to support the healing progress. Moreover, advances in manufacturing flexible microelectronic sensors enable the development of the next generation of wound dressing substrates, known as electronic skin, for real-time monitoring of the whole physiochemical markers in the wound environment in a single platform. The current study reviews the importance of smart wound dressings as an emerging strategy for wound care management and highlights different types of smart dressings for promoting the wound healing process.

A Pilot Study of Negative Pressure Therapy with Autologous Skin Cell Suspensions in a Porcine Model

Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in the treatment of burn injuries in conjunction with mSTSGs.To date, limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT would not negatively impact wound healing of ASCS+mSTSG. A burn, excision, mSTSG, ASCS ± NPWT model was used. Two Duroc pigs were utilized in this experiment, each with 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Cellular viability was characterized prior to spraying. Percent re-epithelialization, graft-adherence, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks. All wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT, and non-NPWT wounds were observed. Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. NPWT treated wounds had less graft loss and improved elasticity, with elasticity being statistically different. These data suggest the positive attributes of the cellular suspension delivered are retained following the application of negative pressure. Re-epithelialization, revascularization, and repigmentation are not adversely impacted. The use of NPWT may be considered as an option when using ASCS with mSTSGs for the treatment of full-thickness burns.

Impact of Previous Irradiation on Wound Healing after Negative Pressure Wound Therapy in Head and Neck Cancer Patients-A Systematic Review.

Simple SummaryThe study has focused on the use of Negative Pressure Wound Therapy (NPWT) specifically in head and neck cancer patients. The sole purpose of using NPWT is to expedite the process of healing as most of the head and neck cancer patients are bound to get post-operative radiotherapy and any delay would further lengthen the treatment and affect the outcome. Previous irradiation and Diabetes Mellitus have detrimental impact on wound healing after NPWT. (1) Background: Negative pressure wound therapy (NPWT) has been effectively used for wound management in comparison to traditional dressings. The purpose of this study was to provide an evidence-based review of NPWT in head and neck cancer patients, as well as the impact of previous irradiation and other risk factors on wound healing. (2) Material and Methods: We conducted a comprehensive search in PubMed, Medline, Embase, Web of Science, and Cochrane Library databases for relevant literature. (3) Results: 15 studies fulfilled the inclusion criteria. The most common etiologies requiring NPWT were defects post tumor resection and flap reconstruction and oro/pharyngo-cutaneous fistulas. The neck was found to be the most common site of involvement (47.3%). The overall wound healing response rate was 87.5%. The median negative pressure recorded was 125 mm of Hg, with a median dressing change time of three days. Previous irradiation (p = 0.01; OR = 4.07) and diabetes mellitus (DM) (p = 0.001; OR = 5.62) were found to be significantly associated with delayed wound healing after NPWT. (4) Conclusion: NPWT treats complex wounds in head and neck cancer patients and should represent a significant armamentarium in head and neck cancers. Previous irradiation and DM have detrimental effects on wound healing after NPWT.

A Nanoporous Graphene/Nitrocellulose Membrane Beneficial to Wound Healing.

Adequate treatment of skin wounds is vital to health. Nitrocellulose bandage as a traditional wound dressing is widely used for wound healing, but its limited air permeability and poor sterilization need to be improved for enhancing the actual efficacy. Here, nanoporous graphene (NPG) is used to mix into nitrocellulose for preparing a composite membrane, which exhibits a moderate transmission rate of water vapor, excellent toughness performance, and good biocompatibility. Moreover, the membrane shows an excellent broad-spectrum antibacterial property (>98%, Escherichia coli; >90%, Staphylococcus aureus) and can reduce the risk of microbial infection for the body after trauma. Importantly, after using the nanoporous graphene/nitrocellulose membrane, the wound closure percentage reaches 93.03 ± 1.08% at 7 days after the trauma, and the degree of skin tissue recovery is also improved significantly. Therefore, this study develops a highly efficient wound healing dressing, which is expected to be used directly in clinics.

Acellular fish skin enhances wound healing by promoting angiogenesis and collagen deposition

Acellular matrix is a type of promising biomaterial for wound healing promotion. Although acellular bovine and porcine tissues have proven effective, religious restrictions and risks of disease transmission remain barriers to their clinical use. Acellular fish skin (AFS), given its similarity to human skin structure and without the aforementioned disadvantages, is thus seen as an attractive alternative. This study aims to fabricate AFS from the skin of black carp (Mylopharyngodon piceus), evaluate its physical and mechanical properties and assess its impact on wound healing. The results showed that AFS has a highly porous structure, along with high levels of hydrophilicity, water-absorption property and permeability. Furthermore, physical characterization showed the high tensile strength of AFS in dry and wet states, and high stitch tear resistance, indicating great potential in clinical applications. Cell Counting Kit-8 was used to test the viability of L929 cells when culturing in the extracts of AFS. Compared with the control group, there is no significant difference in optical density value when culturing in the extracts of AFS at days 1, 3 and 7 (*p > 0.05). In vivo wound healing evaluation then highlighted its promotion of angiogenesis and collagen synthesis, its function in anti-inflammation and acceleration in wound healing. Therefore, this study suggests that AFS has potential as a promising alternative to mammal-derived or traditional wound dressing.

VAC Therapy versus Traditional Wound Dressing: Comparative Effects of Nursing Training Program on Patients' Outcomes

Abstract: Background: Nurses should have adequate training about appropriate dressing selection to enhance the quality of life for patients with chronic wound. Aim; To assess the effects of Nursing Program about Vacuum-Assisted Closure Therapy versus Traditional Wound Dressing, on Patients' Outcomes. Method: Design; Quasi-experimental (Preposttest), a comparative research design between both groups. Setting: The trauma departments and outpatients' clinic at Assiut University Hospital. Subjects: Total coverage of nurses (N.= 40) and a randomized 60 patients with (chronic wound), both groups nurses and patients were divided into two equal groups. Tools: (I) Nurses' interview questionnaire (demographic characteristics, knowledge, and observation checklist), (II): Patients' assessment (personnel and clinical data) and (III): Patients' outcomes sheet; Bates-jensen wound assessment scale and WoundQuality of life scale. Results: A statistically significant difference between nurses' knowledge and practice pre and post-test. Also, between the traditional wound dressing and VAC therapy groups regarding their outcomes (wound healing and wound quality of life) with a positive correlation between them. Conclusion: The nursing program had a positive effect on nurses` knowledge, practice and on patients' outcomes who managed with VAC therapy were better than the other group who managed with the traditional wound dressing. Recommendations: Continuous instructions and in-service training programs in the trauma departments to improve nurses' knowledge and practice. Apply VAC therapy in managing chronic wound for a better healing and high quality of life.

Investigation into the physical properties, antioxidant and antibacterial activity of Bletilla striata polysaccharide/chitosan membranes

Traditional wound dressings and formulations, such as cream, gauze, cotton wool and gel, are disadvantaged by short residence time, poor leakage and air permeability, poor patient compliance, and the minimal preservation in wet environment. This study is purposed to develop new biodegradable, antioxidant, and antimicrobial membranes based on two natural polysaccharides, Bletilla striata polysaccharide (BSP) and chitosan (CS). The developed films were characterized by SEM, FTIR spectroscopy, NMR spectroscopy and X-ray diffraction to examine surface morphology and internal structure, while TG analysis was conducted to explore the thermal properties of the films. The physical properties of the films were also improved significantly after the introduction of BSP. The biological activity of developed films was assessed by means of antioxidant and antibacterial assay for the further research as a potential wound dressing. The CCK-8 assay revealed that the developed films showed a significant improvement of cell viability, biocompatibility and non-toxicity. These researches demonstrated that BSP/CS films can be applied as suitable materials for the development of biomaterial matrix in novel wound dressing.

138 Evaluation of Healing Outcomes Combining Negative Pressure Wound Therapy with Autologous Skin Cell Suspension and Meshed Autografts: Pre-Clinical and Clinical Evidence

Abstract Introduction Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence, working by minimizing disruption by shear forces and promoting the continual removal of wound bed drainage. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in treating full-thickness burn injuries in conjunction with mSTSGs. Limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT in conjunction with ASCS+mSTSGs would aid in skin graft adherence without compromise to healing outcomes. Methods In this study, a Duroc pig model of burn, excision, mSTSG, ASCS + NPWT was used (n=2), where each animal had 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Percent re-epithelialization was measured using digital planimetry and Image J. Graft-adherence was evaluated using a scale with blinded reviewers (0=no graft loss, 4= &amp;gt;50% graft loss). Histological architecture, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks. After the evaluation of its effectiveness in animal models, the same surgical technique, including NPWT, was used in patients with full-thickness burns (n=9), and wound healing trajectories were described. Results In the Duroc pig study, all wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT and non-NPWT wounds were observed (61.09 ± 9.01 and 61.15 ± 0.82% at Day 7). Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. Overall, the non-NPWT group had higher amounts of graft loss (1.0 ± 1.41 vs. 0 ± 0). NPWT-treated wounds had significantly improved elasticity (NPWT=109.5 ± 21.23 vs. non-NPWT=177.5 ± 35.4, p&amp;lt; 0.05). There were no differences in histological architecture between treatment groups. Patients had a median age of 53 (37–69), and median TBSA of 12.5 (8–18) resulting primarily from scald burns (67%). There were no reported morbidities, and all wounds were re-epithelialized within an expected time period. The use of NPWT promoted graft adherence, and was useful as a bolster dressing in wounds that crossed joints. Conclusions These data suggest the positive attributes of the cellular suspension delivered are retained following the application of NPWT. Re-epithelialization, revascularization, and repigmentation are not adversely impacted.

Safety of Silk-elastin Sponges in Patients with Chronic Skin Ulcers: A Phase I/II, Single-center, Open-label, Single-arm Clinical Trial.

Background:Although traditional wound dressings such as collagen scaffolds promote granulation tissue formation, the efficacy of these dressings in chronic wounds is limited because of high susceptibility to bacterial growth. Biomaterials that can be applied to chronic wounds should have an anti-bacterial function. We previously reported that administering a silk-elastin solution that forms moisturizing hydrogels to wound surfaces of diabetic mice reduced bacterial growth and promoted granulation tissue formation compared with control or carboxymethyl cellulose hydrogels. We hypothesized that silk-elastin promotes wound healing in human chronic wounds by suppressing bacterial growth.Methods:An open-label, clinical case series was conducted with a prospective, single-arm design at Kyoto University Hospital in Kyoto, Japan. In this study, 6 patients with chronic skin ulcers of any origin (2 < ulcer area (cm2) < 25) on their lower extremities were included; patients with critical ischemia were excluded. Silk-elastin sponges were applied and covered with a polyurethane film without changing the dressing for 14 days. Inflammation triggered treatment discontinuation due to fear of infection. The primary study endpoint was adverse events, including inflammation and infection.Results:Poor hydrogel formation, possibly due to continuous exudation, was observed. No serious adverse events were noted. Two patients discontinued treatment on day 6 and day 7, respectively, due to inflammation, but they were not infected. The other 4 patients completed the 14-day silk-elastin sponge treatment without infection.Conclusion:Silk-elastin sponge is safe for chronic skin ulcers, and its ability to promote wound healing should be determined by confirmatory clinical trials.

Use of a negative pressure wound therapy system over closed incisions option in preventing post-sternotomy wound complications.

Post-sternotomy surgical site infections may be serious complications responsible for increased morbidity, mortality and length of hospital stay. A variety of wound-healing strategies can be used over closed surgical incisions, including negative pressure wound therapy (NPWT). The aim of the study is to assess sternal wound complications after heart surgery using NPWT in patients at risk for surgical site complication. Considered risk factors affecting wound healing were type 2 diabetes, Body Mass Index (BMI) >30, chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and myocardial revascularization by double mammary artery harvesting. With these premises, 90 patients were selected: 30 patients received traditional gauze dressings, 30 advanced dressings (hydrocolloid and carboxymethyl cellulose) and 30 patients NPWT. Thirty-four patients (37.7%) had two risk factors, 41 patients (45.5%) were affected by three risk factors and 15 patients (16.6%) by four risk factors. The NPWT group had lower rates of diabetes and CRF and only one patient presented four risk factors. With regard to surgical times and types of surgical procedure, no significant differences were observed within the three groups. The patients who received NPWT over closed incision experimented a significantly lower rate of deep sternal complication over traditional gauze and hydrocolloid and carboxymethyl cellulose dressings.

Therapeutic effect of continuous diffusion of oxygen therapy combined with traditional moist wound dressing therapy in the treatment of diabetic foot ulcers

AimsTo investigate the therapeutic effect of continuous diffusion of oxygen (CDO) combined with traditional moist wound dressing (MWD) on the diabetic foot ulcers (DFUs) inpatients. MethodsThe inpatients from May 2016 to April 2018 were enrolled and randomly divided into MWD, CDO and combination treatment groups (n = 40 each group). The moist dressing was used in the MWD group while a micro-oxygen supply device was used in the CDO group. The combination treatment group was given both MWD and CDO. All patients were treated for 8 weeks. The wound healing, amputation rate, and inflammatory control were evaluated. ResultsCompared with MWD and CDO groups, the combination group showed a higher wound healing rate (P < 0.05), lower white blood cell count (P < 0.05) and lower high-sensitivity C-reactive protein level (P < 0.05). During 1-year follow-up, the amputation rate was 0% in combination group, which was significantly lower than that in other two groups (P < 0.05). ConclusionsThe combination of MWD and CDO was effective in promoting healing and preventing infection of DFUs, which holds a potential to be a new strategy for the treatment of this critical clinical condition.

The Utility of Novel Fish-Skin Derived Acellular Dermal Matrix (Kerecis) as a Wound Dressing Material

Background: The newly-approved Kerecis is a piscine acellular dermal xenograft. This piscine acellular dermal matrix (ADM) has specific bioactive lipid mediators, omega-3 polyunsaturated fatty acids, and has a positive effect on the process of wound healing. This study aimed to explore the utility of this novel material by comparing healing rates, and suggest the proper timing for applying Kerecis.&lt;br/&gt;Methods: Patients who visited the hospital with acute or chronic deep dermal wounds from June 2019 to May 2020 were enrolled in the study. A total of 48 patients were assessed. All wounds in the experimental group (n=16) were treated only once with Kerecis and a non-adherent absorptive foam material (Therasorb) to cover the ADM. In the control group, daily conventional dressings were provided. All wounds sizes were measured with mass-market computer software in a method suggested by the authors for the first time.&lt;br/&gt;Results: The mean healing rate proved to be faster in the Kerecis group (P&lt;0.05) versus the control group, and no complications were observed. It was statistically proved that treating burn wounds with the ADM showed better healing rates than the conventional method (P&lt;0.05).&lt;br/&gt;Conclusion: This study establishes that managing wounds with the ADM is likely to heal wounds faster than traditional dressings. In addition, for burn wounds, a prolonged application (10 days vs. 5 days after the onset) showed a better wound healing rate (98.8%±2.5% vs. 67.0%±14.3%, respectively, P=0.029).

Polydopamine nanoparticle-dotted food gum hydrogel with excellent antibacterial activity and rapid shape adaptability for accelerated bacteria-infected wound healing

Most commonly used wound dressings have severe problems, such as an inability to adapt to wound shape or a lack of antibacterial capacity, affecting their ability to meet the requirements of clinical applications. Here, a nanocomposite hydrogel (XKP) is developed by introducing polydopamine nanoparticles (PDA NPs) into a food gum matrix (XK, consisting of xanthan gum and konjac glucomannan, both FDA-approved food thickening agents) for skin wound healing. In this system, the embedded PDA NPs not only interact with the food gum matrix to form a hydrogel with excellent mechanical strength, but also act as photothermal transduction agents to convert near-infrared laser radiation to heat, thereby triggering bacterial death. Moreover, the XKP hydrogel has high elasticity and tunable water content, enabling it to adapt to the shape of the wound and insulate it, providing a moist environment suitable for healing. In-vivo skin wound healing results clearly demonstrate that XKP can significantly accelerate the healing of wounds by reducing the inflammatory response and promoting vascular reconstruction. In summary, this strategy provides a simple and practical method to overcome the drawbacks of traditional wound dressings, and provides further options when choosing suitable wound healing materials for clinical applications.