Biomedical applications of functional hydrogels: Innovative developments, relevant clinical trials and advanced products.

Functional hydrogels are used for numerous biomedical applications such as tissue engineering, wound dressings, lubricants, contact lenses and advanced drug delivery systems. Most of them are based on synthetic or natural polymers forming a three-dimensional network that contains aqueous media. Among synthetic polymers, poly(meth)acrylates, polyethyleneglycols, poly(vinylalcohols), poly(vinylpyrrolidones), PLGA and poly(urethanes) are of high relevance, whereas natural polymers are mainly polysaccharides such as hyaluronic acid, alginate or chitosan and proteins such as albumin, collagen or elastin. In contrast to most synthetic polymers, natural polymers are biodegradable. Both synthetic and natural polymers are often chemically modified in order to improve or induce favorable properties and functions like high mechanical strength, stiffness, elasticity, high porosity, adhesive properties, in situ gelling properties, high water binding capacity or drug release controlling properties. Within this review we provide an overview about the broad spectrum of biomedical applications of functional hydrogels, summarize innovative approaches, discuss the concept of relevant functional hydrogels that are in clinical trials and highlight advanced products as examples for successful developments.

Integrating an antimicrobial nanocomposite to bioactive electrospun fibers for improved wound dressing materials.

This study investigates the fabrication and characterization of electrospun poly (ε-caprolactone)/poly (vinyl pyrrolidone) (PCL/PVP) fibers integrated with a nanocomposite of chitosan, silver nanocrystals, and graphene oxide (ChAgG), aimed at developing advanced wound dressing materials. The ChAgG nanocomposite, recognized for its antimicrobial and biocompatible properties, was incorporated into PCL/PVP fibers through electrospinning techniques. We assessed the resultant fibers' morphological, physicochemical, and mechanical properties, which exhibited significant enhancements in mechanical strength and demonstrated effective antimicrobial activity against common bacterial pathogens. The findings suggest that the PCL/PVP-ChAgG fibers maintain biocompatibility and facilitate controlled therapeutic delivery, positioning them as a promising solution for managing chronic and burn-related wounds. This study underscores the potential of these advanced materials to improve healing outcomes cost-effectively, particularly in settings plagued by high incidences of burn injuries. Further clinical investigations are recommended to explore these innovative fibers' full potential and real-world applicability.

Fabrication and Properties of Hydrogel Dressings Based on Genipin Crosslinked Chondroitin Sulfate and Chitosan.

Multifunctional hydrogel dressings remain highly sought after for the promotion of skin wound regeneration. In the present study, multifunctional CHS-DA/HACC (CH) hydrogels with an interpenetrated network were constructed using hydroxypropyl trimethyl ammonium chloride modified chitosan (HACC) and dopamine-modified chondroitin sulfate (CHS-DA), using genipin as crosslinker. The synthesis of HACC and CHS-DA was effectively confirmed using Fourier transform infrared (FT-IR) analysis and 1H nuclear magnetic resonance (1H NMR) spectroscopy. The prepared CH hydrogels exhibited a network of interconnected pores within the microstructure. Furthermore, rheological testing demonstrated that CH hydrogels exhibited strong mechanical properties, stability, and injectability. Further characterization investigations showed that the CH hydrogels showed favorable self-healing and self-adhesion properties. It was also shown that increasing HACC concentration ratio was positively correlated with the antibacterial activity of CH hydrogels, as evidenced by their resistance to Escherichia coli and Staphylococcus aureus. Additionally, Cell Counting Kit-8 (CCK-8) tests, fluorescent images, and a cell scratch assay demonstrated that CH hydrogels had good biocompatibility and cell migration ability. The multifunctional interpenetrated network hydrogels were shown to have good antibacterial properties, antioxidant properties, stable storage modulus and loss modulus, injectable properties, self-healing properties, and biocompatibility, highlighting their potential as wound dressings in wound healing applications.

Evaluation of the Feasibility of Using Commercial Wound Coatings as a Carrier Matrix for Bacteriophages.

The aim of the investigation is to study the possibility of applying commercial wound coatings for treating infected wounds as a carrier matrix for bacteriophages. Materials and Methods: Twelve varieties of commercial wound coverings based on biopolymers of natural and synthetic origin, a biological preparation Staphylophag produced by scientific-industrial association Microgen (Russia), registration certificate P N001973/01, and the S. aureus 3196 test strain (GenBank JARQZO000000000) isolated from a patient with a burn wound have been used in our work. The ability of commercial biological wound coatings to absorb solutions was examined by immersing them in a physiological solution (pH 7.0-7.2) followed by weighing. The lytic activity of three bacteriophage series against the test strain was studied using the Appelman method and a spot test. The lytic activity of the bacteriophage in the wound samples was studied within 7 days after its absorption by the wound coatings. Results: The greatest volume of fluid was absorbed by the LycoSorb, NEOFIX FibroSorb Ag, Biatravm, and Chitocol-S wound coatings. All bacteriophage series have been found to have a high lytic activity against the test strain. It has also been shown that Chitocol-S, Collachit-FA, Algipran, and Aquacel Ag Extra possessed their own inherent antibacterial activity under in vitro conditions stable for 7 days; moreover, the lysis zones of the test strain increased after their saturation with bacteriophage. On day 0, a high level of bacteriophage lytic activity with the maximum size of the test strain lysis zones from 49 to 59 mm have been found to remain in all samples of the wound coverings. The bacteriophage activity persisted for 1 day in the samples of Hydrofilm, Polypran, and NEOFIX FibroCold Ag coatings, up to 4 days in Algipran, Nano-Aseptica, and Biatravm coatings; and for 7 days in the Chitocol-S, Collachit-FA, Opsite Post-Op Visible, NEOFIX FibroSorb Ag, Aquacel Ag Extra, and LycoSorb samples. Conclusion: Modern commercial wound dressings based on chitosan-collagen complex (Chitocol-S, Collachit-FA), polyurethane (Opsite Post-Op Visible, LycoSorb, NEOFIX FibroSorb Ag), and Hydrofiber (Aquacel Ag Extra) have a sufficient level of bacteriophage solution absorption, provide a stable preservation of the bacteriophage lytic activity under in vitro conditions up to 7 days. Thus, the in vitro studies prove the possibility of their use as a carrier matrix for bacteriophages.

Freestanding Hydrogen-Bonded Organic Framework Membrane for Efficient Wound Healing.

Hydrogen-bonded organic frameworks (HOFs) are emerging as multifunctional materials with exceptional biocompatibility, abundant active sites, and tunable porosity, which are highly beneficial for advanced wound care. However, a significant challenge involves transforming pristine HOFs powders into lightweight, ultrathin, freestanding membranes compatible with soft biological systems. Herein, the study successfully develops shape-adaptive HOF-based matrix membranes (HMMs) using a polymer-assisted liquid-air interface technique. The HMMs conform seamlessly to tissues of different sizes and shapes, effectively stopping bleeding, and provide high water-vapor permeability. Notably, both in vitro and in vivo studies with mice wound models demonstrated that these tissue-conformable HMMs significantly accelerate wound healing by modulating the inflammatory environment of the injured tissue and promoting rapid re-epithelialization. Furthermore, RNA-seq analysis and mechanistic studies revealed that HMMs effectively reduce inflammation and facilitate the tissue transition from the proliferative stage to the remodeling stage of skin development. This work not only opens up new avenues for advanced wound care materials but also establishes a foundation for hybridizing HOFs with polymers for a wide range of potential applications.

Stimulus-responsive biomacromolecule wound dressings for enhanced drug delivery in chronic wound healing: A review.

Addressing the challenge of poor wound healing in chronic wounds remains complex, as the underlying physiological mechanisms are still not fully understood. Traditional wound dressings often fail to meet the specific needs of the chronic wound healing process. Recently, considerable interest has shifted toward employing biomacromolecule-based smart wound dressings to facilitate wound healing. These stimuli-responsive dressings have undergone substantial development to manage local drug delivery, demonstrating promising therapeutic effects in treating chronic wound defects. They have displayed improved drug release profiles both in vitro and in vivo. Recently, there have been advancements in the development of innovative dual and multi-stimuli responsive dressings that react to combinations of signals including pH-temperature, pH-enzyme, pH-ROS, pH-glucose, pH-NIR, and multiple stimuli. This paper offers an in-depth review of recent progress in responsive wound dressings based on biomacromolecules, with a specific focus on their design, drug release capabilities, and therapeutic advantages.

Construction and Performance Study of an Injectable Dual-Network Hydrogel Dressing with Inherent Drainage Function.

With the widespread utilization of moist wound dressings, the extended healing time and increased risk of wound infection caused by excessively moist environments have garnered significant attention. The development of hydrogel dressings that can effectively control the wound moisture level and promote healing is very important. Inspired by the pore-opening perspiration effect of the skin, this study constructed an injectable dual-network hydrogel, CMCS-OSA/AG/MXene, by the composition of a dynamic covalent network of carboxymethyl chitosan and oxidized sodium alginate based on the Schiff base and hydrogen bond network of the thermosensitive low-melting-point agar with the advantage of the upper critical solution temperature (UCST) effect. Under near-infrared (NIR) light stimulation, the CMCS-OSA/AG/MXene hydrogel shows characteristics conducive to rapid removal of wound exudate while maintaining an appropriate moist environment for the wound and excellent antibacterial effects with its photothermal responses. The excellent conductivity of the hydrogel can also promote cell proliferation under external electrical stimulation (ES). Further validation through animal experiments on a full-thickness skin defect model demonstrates the excellent capability of CMCS-OSA/AG/MXene in accelerating wound healing. This work provides an innovative approach to the development of injectable hydrogel dressing materials with inherent drainage functionality and shows a new avenue to wound moisture control and wound healing promotion.

Design and Characterization of an Antimicrobial Biocomposite for Wound Dressings.

Skin wounds, due to their high vulnerability to infections, represent a significant public health issue. These wounds are not only disabling but also entail costly treatments and slow recovery. Consequently, it is crucial to implement new treatments based on bioactive and natural antimicrobial compounds utilizing fibers, polymers, hydrocolloids, and hydrogels to control potential infections and promote wound healing. This study aimed to develop a biocomposite with antimicrobial activity for the treatment of skin wounds, using sodium alginate, bamboo fiber, and a natural antimicrobial as ingredients. The physico-mechanical properties (Young's modulus, tensile strength, elongation at break, moisture absorption, and water vapor permeability) and antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Staphylococcus hominis were determined. The results demonstrated that the designed biocomposite possesses adequate physico-mechanical properties, such as flexibility, strength, and water absorption capacity, in addition to exhibiting antibacterial activity, making it suitable to be used as a dressing in wound treatment.

Rare Breast Emergency: A Case of Necrotizing Fasciitis of the Breast in a Lactating Patient.

Necrotizing fasciitis is a rare but potentially lethal infection of the skin and soft tissue, commonly seen in the perianal and gluteal regions. Concomitant diabetes is a predisposing factor. Primary necrotizing fasciitis of the breast is rare in healthy women. In this article, we present a very rare case of breast necrotizing fasciitis in the context of the literature. We report the case of a 35-year-old female patient who had given birth two months prior to admission and developed necrotizing fasciitis of the breast during lactation. The patient presented to the emergency department with sepsis. Examination revealed widespread erythema, dark discoloration, edema, and necrotic areas indicative of wet gangrene and crepitation in the left breast. Necrotizing fasciitis is a rapid and aggressive disease that can be fatal, and delayed diagnosis may unfortunately result in death. Therefore, careful evaluation of all suspected cases, especially for patients with risk factors, is crucial for early diagnosis and timely treatment. This case highlights the importance of recognizing necrotizing fasciitis of the breast in lactating women to ensure prompt and appropriate management, potentially saving lives.

Computational Designed and Optimized Liposomal Curcumin-Embedded Bifunctional Cross-Linked Hydrogels for Wound Healing.

Curcumin (CUR) bifunctional cross-linked nanocomposite hydrogels are presented as an efficient method for CUR delivery in wound healing. CUR-loaded liposomes (CUR-Ls) were optimized using the Box-Behnken design to augment particle size, size distribution, zeta potential, and CUR concentration. The antioxidant activity and cytotoxicity of CUR-Ls were assessed. Hyaluronic acid (HA)/poly(vinyl alcohol) (PVA) hydrogels were optimized with a central composite design; then, poly(N-vinylpyrrolidone-co-itaconic acid) (PNVP-ITA) was synthesized to enrich the properties of the hydrogels. The drug release kinetics of the CUR-L@HA/PVA/PNVP-ITA hydrogels were studied. Skin recovery was investigated in vivo on rat dorsal skin. The optimized CUR-Ls were constructed from 2.7% Tween® 20, 0.04% oleic acid, and 8.1% CUR, yielding nano-CUR-L with a narrow size distribution, negative surface charge, and CUR content of 19.92 ± 0.54 µg/mg. CUR-Ls improved the antioxidant effects of CUR. The optimized hydrogel contained 5% HA and 10% PVA. PNVP-ITA improved the properties of the hydrogels via enhanced cross-linking. CUR-Ls exhibited a more rapid release than CUR, whereas the hydrogels enhanced CUR release via a diffusion-controlled mechanism. CUR-L@HA/PVA/PNVP-ITA hydrogels improved the skin recovery rate compared to the commercial patch after 5 days. Therefore, the optimized CUR-L@HA/PVA/PNVP-ITA hydrogels facilitated skin recovery and could be a promising nanocomposite for wound dressings.

Sodium alginate/polyacrylic acid hydrogel composite, potential carrier for fibroblast growth factor1 (FGF1) delivery.

Fibroblast growth factor1 is a powerful signaling molecule that plays a critical role in injury repair of diverse tissue by stimulating cell growth and angiogenesis. FGF1 has significant role in the cell fate and regulating inflammation with short half-life and poor in vivo stability. The encapsulation of the growth factor in the hydrogel led to peptide protect from the degradation and/or immune recognition and enable controlled drug delivery over a longer period of time. The aim of this study is to develop and evaluate a hydrogel carrier with adjustable release rate while maintaining bioactivity of FGF1. Here we describe an optimal ratio of sodium alginate and polyacrylic acid without additional cross linker containing FGF1 with the potential of sustained release to be used as a therapeutic agent. The carrier was characterized by FTIR, contact angel and swelling ratio and then variety of FGF1 concentration tested to find the optimum release. The activity of FGF1 after release from the hydrogel was confirmed by ELISA and Western blot. This hydrogel is able to deliver growth factors by restricting the essential proteins within the matrix to prevent rapid proteolysis and explosive release and is therefore widely applicable.

Development of Thyme-Infused Polydimethylsiloxane Composites for Enhanced Antibacterial Wound Dressings.

Polydimethylsiloxane (PDMS) is widely used in biomedical applications due to its biocompatibility and flexibility but faces challenges due to its hydrophobicity and limited mechanical strength. This study explores the incorporation of thyme (Thymus vulgaris L.) into PDMS to enhance its properties for wound dressing applications. PDMS composites containing 2.5 wt.% and 5 wt.% of thyme were prepared and evaluated for physical, chemical, mechanical, and biological properties. Scanning electron microscopy, contact angle measurements, absorption tests, Fourier-transform infrared spectroscopy, differential scanning calorimetry, hardness, tensile testing, antibacterial activity, and cell viability assays were conducted. Thyme integration improved mechanical properties with increased absorption and preserved hydrophobicity. FTIR and DSC analyses indicated minimally altered crystallinity and chemical interactions. Hardness decreased with higher thyme content due to terpene-induced polymerization inhibition. Tensile testing showed reduced stress at break but increased elongation, suitable for wound dressings. Enhanced antibacterial activity was observed, with composites meeting bacteriostatic standards. Cell viability exceeded 70%, with optimal results at 2.5 wt.% thyme, attributed to cytokine-inducing compounds. Thyme-incorporated PDMS composites exhibit improved antibacterial and mechanical properties, demonstrating the potential for advanced wound dressings.

Exploring the Antibacterial and Regenerative Properties of a Two-Stage Alginate Wound Dressing in a Rat Model of Purulent Wounds.

Chronic wounds complicated by infection pose significant clinical challenges, necessitating comprehensive treatment approaches. The widespread use of antibiotics has led to resistant microorganisms, complicating traditional therapies. This study aims to develop and evaluate modified alginate wound dressings with enhanced antimicrobial and regenerative properties. Alginate dressings were synthesized with silver nanoparticles, cefepime, and fibroblast growth factor-2 (FGF-2). The two-stage therapy involved an initial antibacterial dressing followed by a regenerative dressing. In vitro tests demonstrated high antibacterial activity, with maximum inhibition zones for P. aeruginosa (41.3 ± 0.4 mm) and S. aureus (36.6 ± 1.8 mm). In vivo studies on rats with purulent wounds showed significant healing progression in the experimental group. Histological analysis revealed complete re-epithelialization, thicker neoepithelium, dense collagen deposition, and minimal inflammation in treated wounds. These findings suggest that the modified alginate dressings significantly enhance the reparative process and are promising for treating chronic infected wounds in both veterinary and medical practices.

An Overview of Wound Dressing Materials.

Wounds are an increasing global concern, mainly due to a sedentary lifestyle, frequently associated with the occidental way of life. The current prevalence of obesity in Western societies, leading to an increase in type II diabetes, and an elderly population, is also a key factor associated with the problem of wound healing. Therefore, it stands essential to find wound dressing systems that allow for reestablishing the skin integrity in the shortest possible time and with the lowest cost, avoiding further damage and promoting patients' well-being. Wounds can be classified into acute or chronic, depending essentially on the duration of the healing process, which is associated withextent and depth of the wound, localization, the level of infection, and the patient's health status. For each kind of wound and respective healing stage, there is a more suitable dressing. The aim of this review was to focus on the possible wound dressing management, aiming for a more adequate healing approach for each kind of wound.

Harnessing the Interactions of Wound Exudate Cells with Dressings Biomaterials for the Control and Prognosis of Healing Pathways.

The global socioeconomic challenge generated by wounds requires an understanding of healing and non-healing pathways in patients. Also, the interactions occurring between the wound dressing biomaterials with cells relevant to the healing process have not been sufficiently investigated, thus neglecting the role that wound dressing composition can play in healing. Through the study of six cases of acute surgical wounds, the present work analyses the early (24 h post-surgery) interactions of biochemical and cellular components with (i) Atrauman, a device made of knitted woven synthetic polymeric fibre when used as a primary dressing, and (ii) Melolin, a hydrocolloid engineered as two layers of synthetic and cellulose non-woven fibres when used as a secondary dressing. A pathway towards healing could be observed in those cases where endoglin-expressing cells and M2 macrophages were retained by Atrauman fibres at the interface with the wound bed. On the contrary, cases where the secondary dressing Melolin absorbed these cell phenotypes in its mesh resulted in a slower or deteriorating healing process. The data obtained indicate that a subtraction of progenitor cells by Melolin may impair the healing process and that the analysis of the retrieved wound dressings for biomarkers expressed by cells relevant to wound healing may become an additional tool to determine the patient's prognosis.

The emerging role of nanoscaffolds in chronic diabetic wound healing: a new horizon for advanced therapeutics.

Non-healing or chronic wounds in extremities that lead to amputations in patients with Type II diabetes (hyperglycemia) are among the most serious and common health problems in the modern world. Over the past decade, more efficient solutions for diabetic ulcers have been developed. Nanofibers and/or composite materials capable of drug delivery, moisture control, and antibacterial effectiveness are increasingly utilized in the formulation of wound dressings, with a particular focus on the biofunctionalization of polymeric and hydrogel materials. Natural products, including plant extracts, honey, antibacterial agents, nanozymes, and metal nanoparticles, are now commonly and effectively implemented to enhance the functionality of wound dressings. Due to the complicated and dysfunctional physiological structure of the chronic wound sites in the extremities of diabetic patients, formulated nanoscaffold or hydrogel components are becoming more intricate and versatile. This study aimed to investigate the development of wound dressing materials over the years while demonstrating their progressively enhanced complexity in effectively targeting, treating, and managing chronic wounds. The mechanisms of action and bio-functionality of wound dressing technologies were elucidated based on findings from 290 studies conducted over the last decade. A notable observation that emerged from these studies is the evolution of wound dressing development technology, which has led to significant advancements in the operational range of smart systems. These include, but are not limited to, self-healing, self-oxygenation, and adaptable mimicry of human tissue.

Assessing polylactic acid nanofibers with cellulose and chitosan nanocapsules loaded with chamomile extract for treating gram-negative infections.

This study presents the development and characterization of a novel nanocomposite wound dressing material based on polylactic acid (PLA) nanofibers incorporating chitosan nanocapsules loaded with chamomile extract and cellulose nanoparticles. The nanofibers were fabricated using a three-step synthesis and electrospinning techniques, resulting in uniform, bead-free fibers with an average diameter of 186 ± 56 nm. Fourier-transform infrared spectroscopy confirmed the successful incorporation of all components, while tensile strength tests demonstrated improved mechanical properties by adding nanoparticles. Water contact angle measurements revealed enhanced surface wettability of the PLA-Cellulose-Chitosan complex compared to pure PLA nanofibers. In vitro biocompatibility assessments using MTT assays showed excellent cell viability and proliferation, with the optimized composite exhibiting the best performance. Scanning electron microscopy imaging confirmed robust cell adhesion and interaction with the nanofibers. The nanocomposite demonstrated significant antimicrobial activity against Escherichia coli, with a 20 mm inhibition zone observed for chamomile extract-loaded samples. Additionally, the material showed superior hemostatic ability compared to commercial gauze and high hemocompatibility. These comprehensive results indicate that the developed nanocomposite is a promising candidate for advanced wound management applications, offering a multifunctional approach to wound healing by combining antimicrobial activity, cell compatibility, and hemostatic properties.

Biocompatible Electrospun Hydrogel Fibers for Advanced Wound Healing Therapies.

Wound healing is a complex cascade and is governed through a number of crucial factors. Conventional wound dressing possesses numerous limitations which hinder wound healing process and may result in serious infections and even mortality. A lot of effort have been put in through researchers to develop a multifaceted dressing which can address these limitations and facilitate accelerated wound healing. Among various newly developed dressings, electrospun hydrogel nanofibers have emerged as a promising class of biomaterials for advanced wound care and tissue engineering applications. These biomimetic fibers closely mimic the architect of the native extracellular matrix, providing an optimal environment that facilitates cellular proliferation and fast generation required for effective wound healing. Electrospinning offers versatility in precisely controlling fiber attributes such as diameter, alignment, and surface morphology and can entrap a variety of drugs with high efficacy. Recently, such dressings have advanced through the incorporation of smart features such as stimuli-responsive components, real-time wound monitoring sensors, and smart closed-loop systems. The electrospun hydrogels are bestowed with extreme porosity, water-retention attribute, biocompatibility, and modified drug release which make them superior over other wound dressings. The review gives an insight of electrospun hydrogel fibers and their application in wound healing and the studies assessing wound healing potential with underlying mechanisms have been critically analysed. Electrospun hydrogel fibers have significant potential to revolutionize wound care through their biomimetic structure, versatile customization, and capacity for integrating therapeutic and sensing capabilities, outlining future research directions toward next-generation wound care products.

Evaluation of Negative Pressure Dressings for Closed Surgical Incisions in Decreasing Surgical Site Infections After Emergency Laparotomy: A Randomized Controlled Study.

Objectives The aim of this study is to compare the effectiveness of negative pressure dressings (NPDs) versus conventional dressings for closed surgical incisions after emergency midline laparotomy, focusing on their impact on surgical site infection (SSI) rates, wound dehiscence, hospital stay duration, and cosmetic outcomes. Methods The randomized controlled study was conducted over 24 months, involving 80 patients aged 18-65 years who had peritonitis and underwent emergency midline laparotomies. Patients with diabetes mellitus, a BMI >35 kg/m², immunocompromised conditions, or those requiring re-exploration within 30 days of surgery were excluded. The participants were randomly assigned into two groups using a computer-generated randomization table: Group A, the case group, consisted of 40 patients who received NPDs, while Group B, the control group, included 40 patients who received conventional dressings. Data were recorded in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA), with a p-value of <0.05 considered statistically significant. Results The overall occurrence of SSIs within the 30-day follow-up period was significantly lower in the NPD group compared to the conventional dressing group (30% vs. 70%, p < 0.05). The mean duration of hospital stay was 14.85 ± 10.43 days for the NPD group and 15.4 ± 9.75 days for the control group, with no statistically significant difference (p = 0.712). The mean Vancouver Scar Scale score was 5.3 ± 2.47 in the NPD group and 6.5 ± 2.14 in the control group, also showing no statistically significant difference (p = 0.11). Conclusions NPDs significantly reduced the incidence of SSIs compared to conventional dressings, but they did not have a significant impact on scar cosmesis or the duration of hospital stay.

The use of PICO™ single-use negative pressure wound therapy in the community settings.

The prevalence and incidence of wounds is predicted to rise due to an ageing population, that is also likely to have an increasing number of comorbidities (Dowsett et al, 2017). This trend will invariably result in increased costs to the NHS. The estimated annual cost of wound management in 2017/2018 was £8.3 billion. The cost of managing 70% of wounds which healed was £2.7 billion while it cost £5.6 billion managing only 30% of unhealed wounds (Guest et al, 2020). In view of these figures, it is important that health professionals (HPs) recognise wounds that are not progressing to healing at an early stage and implement all available treatment modalities to ensure that the wound does not become non-healing or stalled. Therefore, this article defines non-healing wounds, how to identify wounds at risk of becoming non-healing and the timely implementation of advanced treatment modalities, such as single use negative pressure wound therapy (sNPWT).