Injectable hydrogel with antimicrobial and anti-inflammatory properties for postoperative tumor wound care.

Clinically, tumor removal surgery leaves irregularly shaped wounds that are susceptible to bacterial infection and further lead to excessive inflammation. Injectable hydrogel dressings with antimicrobial and anti-inflammatory properties have been recognized as an effective strategy to care for postoperative tumor wounds and prevent recurrence in recent years. In this work, we constructed a hydrogel network by ionic bonding interactions between quaternized chitosan (QCS) and epigallocatechin gallate (EGCG)-Zn complexes which were coordinated by EGCG and zinc ions. Because of the synergistic effect of QCS and EGCG-Zn, the hydrogel exhibited outstanding antimicrobial capacity (>99.9% inhibition), which could prevent infections caused byEscherichia coli and Staphylococcus aureus. In addition, the hydrogel was able to inhibit the growth of mice breast cancer cells (56.81% survival rate within 72 h) and reduce inflammation, which was attributed to the sustained release of EGCG. The results showed that the hydrogel was effective in inhibiting tumor recurrence and accelerating wound closure when applied to the postoperative tumor wounds. This study provided a simple and reliable strategy for postoperative tumor wound care using antimicrobial and anti-inflammatory injectable dressings, confirming their great potential in the field of postoperative wound dressings.

Metallic-Polyphenolic Nanoparticles Reinforced Cationic Guar Gum Hydrogel for Effectively Treating Burn Wound.

The development of injectable hydrogel dressings which are long-term moisturizing, easy-to-apply, and effectively inhibiting infection and inflammatory is essential to promote burn wound repairing. Herein, an injectable hydrogel with moisturizing, antibacterial, and anti-inflammation abilities via multiple reversible interactions between cation guar gum (CG) and metallic-polyphenolic nanoparticles (PA-ZnII NPs) is developed. Specifically, PA-ZnII NPs is formed by synergistic complexation of protocatechualdehyde (PA) and zinc ion (Zn2+ ), provides CGPZ hydrogel with plentiful reversible interactions to inhibit the loss of moist. By interacting with PA-ZnII NPs, the CGPZ hydrogel can provide enhanced moisturization for more than 3 days. Moreover, the CGPZ hydrogel can maintain good adhesion for a period of time with injection and self-healing capabilities due to reversible interactions between CG and PA-ZnII NPs. In addition, CGPZ hydrogel exhibits outstanding broad spectrum antibacterial performance, as its killing efficiency against Escherichia coli and Staphylococcus aureus is all greater than 99.99%. Importantly, compared with commercial dressing, the CGPZ hydrogel can promote wound healing faster by inhibiting tissue damage from dysregulated inflammation and accelerating neovascularization. It is believed that the moisturizing CGPZ hydrogel with antibacterial and anti-inflammation performance can serve as a promising dressing for the effective treatment of burn wound.

A zwitterionic silver nanoparticle-incorporating injectable hydrogel with a durable and efficient antibacterial effect for accelerated wound healing.

Antibacterial wound dressing is essential for inflammation control and accelerated wound healing. This study investigates polyzwitterion-functionalized silver nanoparticles (AgNPs) with enhanced antibacterial performance in an injectable wound dressing hydrogel. A mussel-inspired poly(sulfobetaine methacrylate-co-dopamine methacrylamide) (PSBDA) copolymer consisting of sulfobetaine and catechol moieties is developed and used in the stabilizing strategy for a facile one-step synthesis of AgNPs. The catechol moieties in PSBDA reduce AgNO3 in an alkaline solution and anchor PSBDA onto the surface of AgNPs. The zwitterionic AgNPs exhibit a uniform size profile and significantly improved stability, which are critical for maintaining antibacterial efficiency in a physiological environment. An injectable wound dressing hydrogel is developed by incorporating zwitterionic AgNPs into the mixed precursors of gelatin methacryloyl (GelMA) and poly(vinyl alcohol) (PVA). The hydrogel precursors exhibit good injectability and rapidly respond to UV-induced in situ gelation. The zwitterionic AgNP-incorporating hydrogel demonstrates significantly improved antibacterial efficiency compared to the non-zwitterionic counterpart both in vitro and in vivo. The zwitterionic modification also provides enhanced hemocompatibility and biocompatibility. The as-developed hydrogel dressing facilitates the resolution of inflammation and results in a rapid re-epithelization for the accelerated wound healing process in a rat full-thickness wound model.

Evaluation of a wearable wireless device with artificial intelligence, iThermonitor WT705, for continuous temperature monitoring for patients in surgical wards: a prospective comparative study.

OBJECTIVES: To evaluate a new-generation, non-invasive, wireless axillary thermometer with artificial intelligence, iThermonitor (WT705, Raiing Medical, Beijing, China), and to ascertain its feasibility for perioperative continuous body temperature monitoring in surgical patients. SETTING: Departments of Biliary Surgery and Operating Room and the post-anaesthesia care unit of a university teaching hospital in Chengdu, China. PARTICIPANTS: A total of 526 adult surgical patients were consecutively enrolled. DESIGN: This was a prospective observational study. Axillary temperatures were continuously recorded with iThermonitor throughout the whole perioperative period. The temperatures of the contralateral armpit were measured with mercury thermometers at 8:00, 12:00, 16:00 and 20:00 every day and were used as references. OUTCOME MEASURES: The outcomes were the accuracy and precision of the temperatures measured with iThermonitor, the validity to detect fever and the feasibility of continuous wear. Pairs of temperatures were evaluated with Student's t-test, Pearson's correlation and repeated-measures Bland-Altman plot. RESULTS: A total of 3621 pairs of body temperatures were obtained. The temperatures measured with iThermonitor agreed with those measured with the mercury thermometers overall, with a mean difference of 0.03°C±0.35°C and a moderate correlation (r=0.755, p<0.001). The 95% limits of agreement (LoA) ranged from -0.63°C to 0.73°C, with 5.11% of the differences outside the 95% LoA. The intraclass correlation coefficient was 0.753. Continuous temperature monitoring captured more fevers than intermittent observation (117/526 vs 91/526, p<0.001), detected fever up to 4.35 hours earlier, and captured a higher peak temperature (0.29°C±0.27°C, 95% CI: 0.26-0.31). All subjects felt that wearing iThermonitor was more or less comfortable and did not affect their daily activities. CONCLUSIONS: iThermonitor is promising for continuous remote temperature monitoring in surgical patients. However, further developments are still needed to improve the precision of this device, especially for temperature detection in underweight patients and those with lower body temperature. TRIAL REGISTRATION NUMBER: ChiCTR1900024549; Results (registered on 5 July 2019).