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1.
J Surg Case Rep ; 2024(8): rjae529, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39183786

ABSTRACT

The care of skin grafts in the penile shaft is challenging because of its cylindrical shape and constantly changing length and lie, which makes it difficult to apply uniform compression and ensure immobilization during the critical period of skin graft take. These challenges are difficult to overcome with conventional dressings. The authors describe a technique of applying a double-opposing negative pressure dressing to sandwich the penile shaft following reconstruction with a skin graft, which is simple to apply and addresses these issues. Adoption of this technique may allow the reconstructive surgeon to manage skin grafts on the penile shaft with greater ease and confidence of optimum graft take.

2.
Burns ; 2024 Jul 20.
Article in English | MEDLINE | ID: mdl-39181767

ABSTRACT

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 (35-45 nm), 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.

3.
Expert Opin Drug Deliv ; 21(7): 1115-1141, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39095934

ABSTRACT

INTRODUCTION: Wound healing is an intricate and continual process influenced by numerous factors that necessitate suitable environments to attain healing. The natural ability of wound healing often gets altered by several external and intrinsic factors, leading to chronic wound occurrence. Numerous wound dressings have been developed; however, the currently available alternatives fail to coalesce in all conditions obligatory for rapid skin regeneration. AREA COVERED: An extensive review of articles on herbal nano-composite wound dressings was conducted using PubMed, Scopus, and Google Scholar databases, from 2006 to 2024. This review entails the pathophysiology and factors leading to non-healing wounds, wound dressing types, the role of herbal bio-actives for wound healing, and the advantages of employing nanotechnology to deliver herbal actives. Numerous nano-composite wound dressings incorporated with phytoconstituents, herbal extracts, and essential oils are discussed. EXPERT OPINION: There is a strong substantiation that several herbal bio-actives possess anti-inflammatory, antimicrobial, antioxidant, analgesic, and angiogenesis promoter activities that accelerate the wound healing process. Nanotechnology is a promising strategy to deliver herbal bio-actives as it ascertains their controlled release, enhances bioavailability, improves permeability to underlying skin layers, and promotes wound healing. A combination of herbal actives and nano-based dressings offers a novel arena for wound management.


Subject(s)
Bandages , Drug Delivery Systems , Nanotechnology , Wound Healing , Wound Healing/drug effects , Humans , Animals , Plant Extracts/administration & dosage , Plant Extracts/pharmacology , Plant Preparations/administration & dosage , Plant Preparations/therapeutic use , Oils, Volatile/administration & dosage , Oils, Volatile/therapeutic use , Nanocomposites/chemistry , Wounds and Injuries/drug therapy , Wounds and Injuries/therapy
4.
Front Bioeng Biotechnol ; 12: 1406336, 2024.
Article in English | MEDLINE | ID: mdl-39165402

ABSTRACT

Introduction: PVA hydrogels present many characteristics of the ideal dressing, although without antimicrobial properties. The present work aims to study the physical, mechanical and release characteristics of hydrogel wound dressings loaded with either of two natural herbal products, sage extract and dragon's blood. Methods: Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC) and tensile mechanical testing were used to investigate the structure and properties of the gels. Swelling and degradation tests were conducted according to ISO 10993-9. Release characteristics were studied using UV Spectrophotometry. Results: PVA matrices incorporating sage extract or dragon's blood (DB) present hydrogen bonding between these components. PVA-CMC hydrogels containing sage present similar spectra to PVA-CMC alone, probably indicating low miscibility or interaction between the matrix and sage. The opposite is found for DB, which exhibits more pronounced interference with crystallinity than sage. DB and NaCMC negatively affect Young's modulus and failure strength. All samples appear to reach equilibrium swelling degree (ESD) in 24 h. The addition of DB and sage to PVA increases the gels' swelling capacity, indicating that the substances likely separate PVA chains. The inclusion of CMC contributes to high media uptake. The kinetics profile of media uptake for 4 days is described by a power-law model, which is correlated to the drug delivery mechanism. Discussion: A PVA-CMC gel incorporating 15% DB, the highest amount tested, shows the most favorable characteristics for flavonoid delivery, as well as flexibility and swelling capacity.

5.
Heliyon ; 10(15): e35389, 2024 Aug 15.
Article in English | MEDLINE | ID: mdl-39165973

ABSTRACT

Given the growing interest in non-toxic materials with good anti-inflammatory and antimicrobial mechanical properties, this work focuses on preparing chitosan sponges with violacein and cannabis oil crosslinked with dialdehyde chitosan. The sponge was tested for its physicochemical and biological properties, presenting a high swelling rate, good thermal stability, and satisfactory mechanical properties. The obtained sponge's water vapor transmission rate was 2101 g/m2/day and is within the recommended values for ideal wound dressings. Notably, adding violacein favorably affected the material's porosity, which is essential for dressing materials. In addition, studies have shown that the designed material interacts with human serum albumin and exhibits good antioxidant and anti-inflammatory properties. The antibacterial properties of the prepared biomaterial were assessed using the Microtox test against A. fisherii (Gram-negative bacterium) and S. aureus (Gram-positive bacterium). The investigated material provides potential therapeutic benefits due to the synergistic action of chitosan, violacein, and cannabis oil so that it could be used as a dressing material. The natural origin of the substances could provide an attractive and sustainable alternative to traditional commercially available dressings.

6.
J Biomater Sci Polym Ed ; : 1-22, 2024 Aug 21.
Article in English | MEDLINE | ID: mdl-39167543

ABSTRACT

Chitosan based films endowed with antibacterial features have witnessed remarkable progress as potential wound dressings. The current study aimed at appraising the effects of the molar mass of chitosan (MM) and the film casting acids on the properties of unplasticized chitosan films and plasticized MSO-embedded chitosan films in order to provide best suited film formulation as a potential candidate for wound dressing application. The prepared films were functionally characterized in terms of their qualitative assessment, thickness, density, swelling behavior, water vapor barrier, mechanical and antibacterial properties. Overall, all chitosan films displayed thickness lower than the human dermis even though thicker and denser films were produced with lactic acid. Assessment of the swelling behavior revealed that only high molar mass (HMM) chitosan films may be regarded as absorbent dressings. Moreover, unplasticized HMM lactate (HMM-LA) films furnished lower stiffness and higher percent strain break as compared to acetate films, due to the plasticizing effect of the remaining lactic acid as alluded by the FTIR analysis. Meanwhile, they provided suitable level of moisture and indicated substantial antibacterial activity against S. aureus and E. coli, the most commonly opportunistic bacteria found in infected skin wound. Plasticized chitosan films doped with MSO were significantly thicker and more permeable to water compared to unplasticized films. Furthermore, MSO significantly potentiate the antibacterial effect of chitosan-based films. Therefore, plasticized HMM-LA/MSO chitosan film flashing good swelling behavior, adequate WVTR and WVP, suitable mechanical properties and antibacterial performances substantiated to be a promising antibacterial dressing material for moderately exuding wounds.

7.
J Wound Care ; 33(8): 560-568, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39137251

ABSTRACT

OBJECTIVE: This work explores concurrent optical and magnetic stimulation (COMS) effects on hard-to-heal wounds in real-world settings. METHOD: In this case series, participants received COMS 1-3 times per week for up to 12 weeks alongside standard wound care. RESULTS: A total of 27 patients (18 female and nine male) were included. Mean age was 72 years. Participants' wounds that were unresponsive to standard wound care included: venous leg ulcers (VLUs, n=13); mixed leg ulcers (MLUs, n=4); diabetic foot ulcers (DFUs, n=1); pressure ulcers (PUs, n=5); and traumatic wounds (TWs, n=4). On average, COMS was applied twice a week, resulting in an overall mean wound area reduction of 69%. In 24 participants, COMS was used primarily to achieve wound closure by the end of the 12-week period, of which: 12 were classified as complete wound closure (50%; VLUs=8, PUs=3 and TW=1); four as likely-to-heal (17%; VLUs=2 and MLUs=2); four as 'improved' (17%; MLU=1, DFU=1 and TWs=2); and four as 'non-responding' (17%; VLUs=3 and MLU=1). The best results were achieved in PUs and VLUs (respectively 100% and 62% categorised as completely healed). When used in participants where its purpose was other than that of achieving wound closure, COMS was successfully used to debride two PUs, and for wound bed preparation in one TW. CONCLUSION: In this case series, COMS showed positive effects and appeared to be beneficial in healing different types of hard-to-heal wounds in community health and homecare settings. Novel COMS therapy aspects emerged: (1) positive outcomes for PU and VLU treatment; (2) COMS as a potential debridement tool when sharp debridement is unfeasible; and (3) COMS as a promising method to prepare wound beds for subsequent skin grafting or skin replacement procedures.


Subject(s)
Wound Healing , Humans , Female , Male , Aged , Aged, 80 and over , Middle Aged , Magnetic Field Therapy/methods , Leg Ulcer/therapy , Treatment Outcome , Pressure Ulcer/therapy , Varicose Ulcer/therapy , Diabetic Foot/therapy
8.
J Wound Care ; 33(8): 570-576, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39137253

ABSTRACT

OBJECTIVE: Acute laceration wound (ALW) is one of the most common injuries in Indonesia with potential significant morbidities. In rural areas, povidone-iodine and honey are commonly used as wound dressings. This study aimed to identify the effectiveness of honey compared to paraffin gauze and the commonly used povidone-iodine in improving ALW healing time. METHOD: This study was a single-blind, pilot randomised controlled trial (RCT) with three intervention groups (honey, povidone-iodine, and paraffin). The outcomes were wound healing time, slow healing, secondary healing, signs of infection, wound dehiscence, oedema, maceration, necrosis, exudate and cost. RESULTS: A total of 35 patients (male to female ratio: 4:1), with a mean age of 22.5 (range: 6-47) years, were included and randomised to treatment groups using predetermined randomisation according to wound location and wound dressing selection: honey group, n=12; povidone-iodine group, n=11; paraffin group, n=12 with one patient lost to follow-up. All groups achieved timely healing, with a mean healing time of 9.45±5.31 days and 11.09±5.14 days for the povidone-iodine and paraffin groups, respectively, and a median healing time of 10 (3-19) days for the honey group (p>0.05). More wounds in the honey group achieved healing in ≤10 days compared with the other groups. Both povidone-iodine and honey groups had fewer adverse events, with the latter having the lowest cost. CONCLUSION: In this study, honey was clinically effective in accelerating healing time with a lower cost compared to paraffin, and was comparable to povidone-iodine. Future RCTs with a larger sample size should be pursued to determine honey's role in ALW treatment.


Subject(s)
Anti-Infective Agents, Local , Honey , Lacerations , Povidone-Iodine , Wound Healing , Humans , Povidone-Iodine/therapeutic use , Wound Healing/drug effects , Male , Female , Adult , Pilot Projects , Middle Aged , Adolescent , Single-Blind Method , Anti-Infective Agents, Local/therapeutic use , Lacerations/therapy , Young Adult , Child , Indonesia , Bandages , Paraffin/therapeutic use , Treatment Outcome
9.
J Wound Care ; 33(8): 612-616, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39140406

ABSTRACT

There are several reasons for skin damage, including genetic factors, disorders, acute trauma, hard-to-heal wounds, or surgical interventions. Whatever the cause, wounds have a substantial impact on people who experience them, their caregivers and the healthcare system. Advanced wound care products have been researched and developed, providing an opportunity for faster and more complete healing. Tissue engineering (TE) is a promising strategy that can overcome limitations when choosing a graft for a wound. Amniotic membrane is a highly abundant, readily available, and inexpensive biological tissue that does not raise ethical concerns, with many applications in different fields of TE and regenerative medicine. It has attractive physical characteristics, such as elasticity, rigidity and mechanical strength, among others. The effects can also be potentiated by association with other substances, such as hyaluronic acid and growth factors. This paper describes new perspectives involving the use of amniotic membranes.


Subject(s)
Amnion , Tissue Engineering , Wound Healing , Humans , Amnion/transplantation , Wounds and Injuries/therapy , Regenerative Medicine/methods
10.
J Wound Care ; 33(8): 542-553, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39140478

ABSTRACT

OBJECTIVE: Managing the gap between the dressing and the wound bed can facilitate the healing of exuding wounds. A silicone foam dressing (Biatain Silicone; Coloplast A/S, Denmark) was developed for application to exuding wounds. A sub-analysis of the real-world, prospective, observational VIPES (Observatoire en Ville des Plaies ExSudatives) study was conducted to investigate the use and performance of the silicone foam dressing in a community nursing setting in France. METHOD: The sub-analysis included patients from the VIPES study who received the silicone foam dressing as a primary dressing for an acute or hard-to-heal (chronic) wound. Epidemiological and wound healing outcomes were reported via a smartphone application. RESULTS: Overall, 64 patients were included in the sub-analysis. At baseline, most wounds (n=33/40; 82.5%) were in treatment failure (i.e., were stagnant, non-healing or had poor exudate management). At the last follow-up visit, a median of 22.5 (range: 3-151) days post baseline, 48.4% of wounds had healed and 25.0% were progressing towards healing. From baseline to the last follow-up visit, significant reductions in exudate level (p<0.0001) and exudate pooling (p<0.0001), and significant improvements in wound edges (p≤0.0001) and periwound skin (p<0.01) were observed. A total of 62.3% of patients had re-epithelialising wounds at the last follow-up visit. The majority of nurses (88.3%) and patients (85.0%) reported that the wound had improved and, at most dressing removals (93.5%), nurses reported that the dressing conformed closely to the wound bed. CONCLUSION: Overall, the data suggest that use of the silicone foam dressing in community practice supported the healing of wounds, illustrating the importance of exudate and gap management.


Subject(s)
Silicones , Wound Healing , Humans , Female , Male , Middle Aged , Prospective Studies , Aged , Adult , Aged, 80 and over , Wounds and Injuries/therapy , Exudates and Transudates , France , Bandages
11.
J Wound Care ; 33(Sup8): S17-S26, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39140710

ABSTRACT

OBJECTIVE: Orthopaedic surgery is an effective intervention for treating the symptoms of degenerative joint disease or osteoarthritis (OA). Frequent wound dressing changes, unless clinically indicated, can disrupt the healing process and increase the occurrence of incision site contamination. Protection from contamination is critical for surgical incisions and, therefore, undisturbed wound healing (UWH) in surgical wound management is vital. This article describes a retrospective study reporting the clinical performance of a self-adherent, absorbent postoperative dressing, with a focus on dressing wear time. METHOD: A single-centre, retrospective electronic medical record review of a convenience sample of adult patients treated with a dressing (Mepilex Border Post Op; Mölnlycke, Sweden) following elective hip or knee replacement was undertaken. Data relating to dressing wear time, rationale for dressing changes and patient-reported outcomes were extracted from a mobile health application moveUP Therapy (moveUP NV, Belgium). Health-related quality of life assessment was conducted using the EQ-5D-5L questionnaire and orthopaedic-specific quality of life (QoL) indicator tools. RESULTS: Of the 558 records reviewed, 151 respondents (27.1%) reported outcomes relating to dressing wear time and frequency of dressing change. The average wear time of the first dressing was 13.6 days (second dressing: 5.3 days). The proportion of patients who wore the first dressing for 1-7 days, 8-13 days and for ≥14 days was 17.2%, 13.2% and 69.5%, respectively. Data from the completed questionnaires revealed improvement in QoL over time. CONCLUSION: The results of this study are a good indicator of the suitability of the postoperative dressing for a 14-day wear time, in line with the principles of UWH.


Subject(s)
Bandages , Patient Reported Outcome Measures , Wound Healing , Humans , Retrospective Studies , Male , Female , Aged , Middle Aged , Aged, 80 and over , Time Factors , Quality of Life , Arthroplasty, Replacement, Hip , Adult , Surgical Wound Infection/prevention & control , Arthroplasty, Replacement, Knee , Surveys and Questionnaires
12.
J Wound Care ; 33(Sup8): S10-S16, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39140711

ABSTRACT

OBJECTIVE: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Its treatment often requires a surgical approach. The aim of our study was to evaluate the occurrence of post-surgical complications following a new standard of surgical management. This included presurgical lesion mapping by ultra-high frequency ultrasound (UHFUS) with a 70MHz probe. Postoperative management was based on the principles of HS-TIME (time, inflammation/infection, moisture, edges). METHOD: A single-centre, retrospective study was conducted by the Department of Dermatology of the University of Pisa. Patients with moderate and severe HS, refractory to previous medical and surgical therapies, were enrolled. All of the patients were treated with wide surgical excision of lesions, previously explored through a UHFUS evaluation with VEVO MD (Fujifilm VisualSonics, Inc., Canada) using a 48MHz and a 70MHz ultrasound probe. Following surgery, all patients were treated with secondary intention healing following the principles of HS-TIME. For each patient, we assessed the occurrence of post-surgical complications at follow-up visit six months after surgery. For each patient we assessed the occurrence of early post-surgical complications at every follow-up visit after surgery until complete wound healing. The occurrence of delayed complications was then assessed in all patients with an observation time after complete healing of >3 months (n=23). RESULTS: A total of 26 patients were enrolled in the study. There were no reported cases of post-surgical bleeding or haematoma occurrence, while three (11.5%) patients developed minor surgical site infection. The average severity of pain decreased from a numerical rating scale of 5.3 immediately after surgery to 1.3 after four weeks. The average healing time was 33.3±16.8 days, and only five (19.2%) patients reported a complete wound healing time of >6 weeks. Focusing on delayed complications: 1/23 (4.3%) patient had hypertrophic scarring; 2/23 (8.7%) patients reported dysaesthesia; and 2/23 (8.7%) cases of clinical relapse were reported. No cases of limited mobility at the surgery site were registered. CONCLUSION: The findings of the study demonstrated the efficacy of a novel surgical protocol, including a preoperative ultrasound evaluation and appropriate postoperative wound management. Further prospective studies are needed to validate the observed results; however, we conclude that the low recurrence rates and post-surgical complications confirmed that our proposed protocol would represent an effective strategy for the management of patients with HS eligible for surgical therapy.


Subject(s)
Hidradenitis Suppurativa , Postoperative Complications , Ultrasonography , Humans , Hidradenitis Suppurativa/surgery , Hidradenitis Suppurativa/diagnostic imaging , Retrospective Studies , Male , Female , Adult , Postoperative Complications/epidemiology , Middle Aged , Wound Healing , Preoperative Care
13.
J Wound Care ; 33(Sup8): S4-S8, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39140712

ABSTRACT

OBJECTIVE: The objective of the scoping review will be to understand and describe risk factors associated with surgical site infection (SSI) in an orthopaedic surgery population in Sub-Saharan Africa and South Africa. This paper describes the protocol that will be used for the scoping review. METHOD: A comprehensive literature search will be conducted using MEDLINE (PubMed), CINAHL (EBSCO), Embase and Cochrane Libraries to identify articles meeting the inclusion criteria, including both published and grey literature, in order to provide a broad overview of the reported risk factors associated with patients who have undergone an orthopaedic surgery with an outcome of SSI within 90 days of a procedure. Additional studies will be sourced by exploring the reference list of included eligible studies. By using a combination of the Population, Exposure, Outcome framework, terms and synonyms related to each category, in different variations, along with Boolean operators (AND, OR, NOT) in the search strategy, identified comprehensive and relevant literature for the scoping review. RESULTS: It is anticipated the results will provide a baseline of risk factors that will inform the development of a risk assessment tool for clinical use. CONCLUSION: This protocol will inform the development of a scoping review to describe factors associated with SSIs following orthopaedic surgery in Sub-Saharan Africa and South Africa.


Subject(s)
Orthopedic Procedures , Surgical Wound Infection , Humans , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Risk Factors , South Africa , Orthopedic Procedures/adverse effects , Africa South of the Sahara
14.
Biomed Pharmacother ; 179: 117307, 2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39153435

ABSTRACT

Wound healing requires interplay between cells and molecules. Recent evidence has demonstrated that liquid bandages promote wound healing by forming a protective barrier against contamination, attenuating inflammation, and enhancing re-epithelialization and angiogenesis. In this study, we evaluated the wound healing activity of pyroxylin-based liquid bandage (LiQuiPlast®) in eight-week-old C57BL/6 male mice by generating a single 4 mm diameter full-thickness excisional skin wound on the dorsum. In the LiQuiPlast® group, the liquid bandage was applied on day 0 and was replaced every four days. Wound size was monitored every day for two weeks. The results showed that LiQuiPlast® was mechanically active (induced wound contraction), which promoted a significant wound size reduction (27 %-39 %, compared to the control group) on days 1-4 postinjury. In addition, a significant reduction in wound size was observed again in the LiQuiPlast® group (25 %-29 %, compared to the controls) on days 8-9 postinjury. LiQuiPlast®-treated wounds showed no scab. Immunohistochemistry analyses displayed a reduction in neutrophils and tumor necrosis factor-α levels in LiQuiPlast®-treated wounds, compared to the control group on day 4 postinjury (the inflammatory phase). In addition, LiQuiPlast®-treated mice had enhanced keratinocyte proliferation than control mice during this time. On day 13 postinjury, LiQuiPlast® significantly reduced hypertrophic scarring and enhanced expression and reorganization of collagen fiber compared to control mice. In conclusion, we show that LiQuiPlast® acts as a mechanically active protective film, which promotes moist wound healing by promoting wound contraction, no scab formation, attenuated inflammation, enhanced keratinocyte proliferation, and decreased scarring.

15.
J Wound Care ; 33(8): 554-559, 2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39149927

ABSTRACT

OBJECTIVE: The aim was to evaluate the effectiveness of a marine omega fatty acid-containing multimodal wound matrix (MWM) in reducing bacterial contamination and supporting wound area reduction (WAR) in patients with hard-to-heal wounds of varying aetiologies. METHOD: A prospective, single-site, pilot case series of patients with hard-to-heal wounds. All wounds were considered non-healing prior to inclusion as they had failed to achieve at least 50% WAR after at least four weeks of standard of care (SoC) treatments. Patients were seen once weekly for wound assessments, matrix application and dressing changes. Baseline and weekly fluorescence images, standard wound images and wound measurements were obtained. RESULTS: A total of three patients, two with venous leg ulcers (VLUs) and one with a diabetic foot ulcer (DFU) were enrolled in this pilot study. The mean baseline wound age prior to study enrolment was 24 weeks, with a mean baseline wound size of 8.61cm2. The two VLUs went on to complete closure. The DFU displayed a total WAR of 53% by six weeks, when the patient was lost to follow-up due to a geographical relocation. The mean percentage area reduction of all wounds combined was 82% upon study completion. CONCLUSION: The use of MWM proved to be effective and safe in this patient cohort. The wounds included in this case series failed to enter a healing trajectory with SoC wound therapies. The MWM supported wound closure and reduced bacterial loads in this patient cohort.


Subject(s)
Diabetic Foot , Varicose Ulcer , Wound Healing , Humans , Pilot Projects , Male , Female , Diabetic Foot/therapy , Diabetic Foot/microbiology , Prospective Studies , Aged , Middle Aged , Varicose Ulcer/therapy , Varicose Ulcer/microbiology , Leg Ulcer/microbiology , Leg Ulcer/therapy , Wound Infection/drug therapy , Wound Infection/microbiology , Aged, 80 and over , Treatment Outcome
16.
ACS Appl Bio Mater ; 7(8): 5662-5678, 2024 Aug 19.
Article in English | MEDLINE | ID: mdl-39097904

ABSTRACT

Quercetin, recognized for its antioxidant, anti-inflammatory, and antibacterial properties, faces limited biomedical application due to its low solubility. Cotton, a preferred wound dressing material over synthetic ones, lacks inherent antibacterial and wound-healing attributes and can benefit from quercetin features. This study explores the potential of overcoming these challenges through the inclusion complexation of quercetin with cyclodextrins (CDs) and the development of a nanofibrous coating on a cotton nonwoven textile. Hydroxypropyl-beta-cyclodextrin (HP-ß-CD) and hydroxypropyl-gamma-cyclodextrin (HP-γ-CD) formed inclusion complexes of quercetin, with chitosan added to enhance antibacterial properties. Phase solubility results showed that inclusion complexation can enhance quercetin solubility up to 20 times, with HP-γ-CD forming a more stable inclusion complexation compared with HP-ß-CD. Electrospinning of the nanofibers from HP-ß-CD/Quercetin and HP-γ-CD/Quercetin aqueous solutions without the use of a polymeric matrix yielded a uniform, smooth fiber morphology. The structural and thermal analyses of the HP-ß-CD/Quercetin and HP-γ-CD/Quercetin nanofibers confirmed the presence of inclusion complexes between quercetin and each of the CDs (HP-ß-CD and HP-γ-CD). Moreover, HP-ß-CD/Quercetin and HP-γ-CD/Quercetin nanofibers showed a near-complete loading efficiency of quercetin and followed a fast-releasing profile of quercetin. Both HP-ß-CD/Quercetin and HP-γ-CD/Quercetin nanofibers showed significantly higher antioxidant activity compared to pristine quercetin. The HP-ß-CD/Quercetin and HP-γ-CD/Quercetin nanofibers also showed antibacterial activity, and with the addition of chitosan in the HP-γ-CD/Quercetin system, the Chitosan/HP-γ-CD/Quercetin nanofibers completely eliminated the investigated bacteria species. The nanofibers were nontoxic and well-tolerated by cells, and exploiting the quercetin and chitosan anti-inflammatory activities resulted in the downregulation of IL-6 and NO secretion in both immune as well as regenerative cells. Overall, CD inclusion complexation markedly enhances quercetin solubility, resulting in a biofunctional antioxidant, antibacterial, and anti-inflammatory wound dressing through a nanofibrous coating on cotton textiles.


Subject(s)
Anti-Bacterial Agents , Anti-Inflammatory Agents , Antioxidants , Bandages , Chitosan , Cyclodextrins , Materials Testing , Nanofibers , Quercetin , Quercetin/pharmacology , Quercetin/chemistry , Antioxidants/pharmacology , Antioxidants/chemistry , Nanofibers/chemistry , Chitosan/chemistry , Chitosan/pharmacology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/chemistry , Cyclodextrins/chemistry , Cyclodextrins/pharmacology , Particle Size , Biocompatible Materials/chemistry , Biocompatible Materials/pharmacology , Microbial Sensitivity Tests , Cotton Fiber , Wound Healing/drug effects , Humans , Picrates/antagonists & inhibitors , Cell Survival/drug effects , Biphenyl Compounds
17.
J Biomater Sci Polym Ed ; : 1-22, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39088278

ABSTRACT

This investigation examined the potential antibacterial and antidiabetic effects of wound dressings created using electrospun nanofibers containing Ziziphus jujuba fruit extract (ZJ). These nanofibers were composed of a combination of Polycaprolactone (PCL), Polyvinyl Alcohol (PVA), and Polyhexamethylene Biguanide (PHMB). The process of creating these nanofibers involved electrospinning. The nanofiber products, which included PCL, PCL/PVA, PCL/PVA/ZJ, PCL/PVA/PHMB, and PCL/PVA/PHMB/ZJ, underwent a morphology, physicochemical, and biological assessment. Incorporating PHMB into the nanofibers enhanced the antibacterial properties, effectively preventing bacterial infections in wounds. Furthermore, including ZJ fruit extract in the nanofibers provided antidiabetic properties, making these dressings suitable for diabetic patients. The PCL/PVA/PHMB/ZJ combination exhibited exceptional healing capabilities and superior antibacterial efficiency in MRSA-infected wounds. The histological assay confirmed complete wound healing by day 14, accompanied by reduced inflammation. Based on these findings, using PCL/PVA/PHMB/ZJ as innovative wound dressings is recommended, as they can expedite wound healing while offering significant antidiabetic and antibacterial features. Ultimately, these electrospun nanofibers possess the potential to serve as advanced wound dressings with enhanced antibacterial and anti-diabetes properties.

18.
Int J Biol Macromol ; 277(Pt 3): 134384, 2024 Aug 05.
Article in English | MEDLINE | ID: mdl-39098683

ABSTRACT

This study aimed to develop hydrogel dressings for wound healing composed of gum tragacanth (TG) and polyvinyl alcohol (PVA) loaded with Graphene oxide (GO) and Cinnamon oil (CMO) using electron beam irradiation. The impact of the preparation conditions and the incorporation of GO and CMO on the characteristic properties of the prepared CMO-(PVA/TG)-GO wound dressings was evaluated. The healing-related characteristics were assessed, including fluid absorption and retention, water vapor transmission rate (WVTR), hemolytic assay, and antimicrobial potential. Wound healing efficacy was evaluated using a scratch wound healing assay. FTIR analysis verified the chemical structure, whereas scanning electron microscopy demonstrated an appropriate porosity structure necessary for optimal wound healing. The gel content increases with the initial total polymer concentration and the irradiation dose increases. Higher GO and CMO content improve the gel content and decreases swelling. WVTR decreases with the rise in CMO content. In vitro, cytotoxicity and hemolytic potency assessments confirmed their biocompatibility. The incorporation of GO and CMO enhances the antimicrobial activity and wound-healing capability. Based on the above findings, CMO-(PVA/TG)-GO dressings show promising potential as candidates for wound care.

19.
Skin Res Technol ; 30(8): e13888, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39099447

ABSTRACT

BACKGROUND: Incontinence-associated dermatitis (IAD) is a tough problem in clinical settings, not only increasing the risk of complications like catheter-related urinary tract infections and pressure ulcers in elderly and critically ill patients, but also prolonging hospital stays, raising hospital costs, and possibly leading to medical disputes. This study is aimed to evaluate the therapeutic effect of silicone dressing combined with topical oxygen therapy on IAD in a rat model. METHODS: An IAD rat model induced by synthetic urine with trypsin was established. Hematoxylin & eosin staining was carried out to examine skin histology. Using immunofluorescence, the microvessel density in the affected skin tissues was determined. ELISA was performed to measure the concentrations of inflammatory cytokines and angiogenic factors in serum. The mRNA expression of EGF, PDGF, and VEGF was detected via qRT-PCR. Western blotting was employed to determine NF-κB p65/STAT1 pathway-related protein levels. RESULTS: Compared to single therapy, silicone dressing combined with topical oxygen therapy could significantly reduce the severity of IAD, improve skin histology, inhibit inflammation, and promote angiogenesis in IAD rat models. Additionally, the results showed that relatively speaking, the combined therapy suppressed the NF-κB p65/STAT1 signaling pathway more effectively. CONCLUSION: These findings indicated that silicone dressing combined with topical oxygen therapy can alleviate IAD through promoting wound healing and inhibiting inflammation via NF-κB p65/STAT1 signaling pathway in a rat model, which provided a theoretical basis for the prevention and treatment of IAD in clinic.


Subject(s)
Bandages , Dermatitis , Disease Models, Animal , Oxygen , Rats, Sprague-Dawley , STAT1 Transcription Factor , Signal Transduction , Silicones , Transcription Factor RelA , Urinary Incontinence , Animals , Rats , Signal Transduction/drug effects , Oxygen/administration & dosage , STAT1 Transcription Factor/metabolism , Dermatitis/therapy , Dermatitis/etiology , Transcription Factor RelA/metabolism , Urinary Incontinence/therapy , Urinary Incontinence/etiology , Male
20.
Int J Nanomedicine ; 19: 7895-7926, 2024.
Article in English | MEDLINE | ID: mdl-39108405

ABSTRACT

Pseudomonas aeruginosa (P. aeruginosa) is a common nosocomial pathogen that can cause severe infections in critically ill patients. Due to its resistance to multiple drugs, it is challenging to treat, which can result in serious illness and death. Conventional treatments for infected wounds often involve the topical or systemic application of antibiotics, which can lead to systemic toxicity and the development of drug resistance. The combination of wound dressings that promote wound healing with nanoparticles (NPs) represents a revolutionary strategy for optimizing the safety and efficacy of antibiotics. This review assesses a systematic search to identify the latest approaches where the evaluation of wound dressings loaded with antibiotic NPs is conducted. The properties of NPs, the features of wound dressings, the antimicrobial activity and biocompatibility of the different strategies are analyzed. The results indicate that most research in this field is focused on dressings loaded with silver NPs (57.1%) or other inorganic materials (22.4%). Wound dressings loaded with polymeric NPs and carbon-based NPs represent 14.3% and 6.1% of the evaluated studies, respectively. Nevertheless, there are no clinical trials that have evaluated the efficacy of NPs-loaded wound dressings in patients. Further research is required to ensure the safety of these treatments and to translate the findings from the bench to the bedside.


Subject(s)
Anti-Bacterial Agents , Bandages , Pseudomonas Infections , Pseudomonas aeruginosa , Humans , Pseudomonas aeruginosa/drug effects , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/administration & dosage , Pseudomonas Infections/drug therapy , Nanoparticles/chemistry , Wound Healing/drug effects , Animals , Metal Nanoparticles/chemistry , Silver/chemistry , Silver/pharmacology , Silver/administration & dosage
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