RESUMO
The search for innovative materials for manufacturing skin dressings is constant and high demand. In this context, the present study investigated the effects of a 3D printed skin dressing made of spongin-like collagen (SC) extract from marine sponge (Chondrilla caribensis), used in 3 concentrations of SC and alginate (C1, C2, C3). For this proposal, the physicochemical, morphological andin vitrobiological results were investigated. The results demonstrated that, after immersion, C2 presented a higher mass loss and C3 present a higher pH in experimental periods. Also, a higher porosity was observed for C1 and C2 skin dressings, with a higher swelling ratio for C2. For Fourier transform infrared, peaks of Amide A, -CH2, -COOH and C-O-C were seen. Moreover, the macroscopic image demonstrated a skin dressing with rough surface and grayish color that is naturally observed inChondrilla caribensis. For scanning electron microscopy analysis the presence of pores could be observed for all skin dressings, with fibers disposed in layers. Thein vitroanalyses demonstrated the viability of HFF-1 and L929 cell lines 70% of the values found for cell proliferation compared to Control Group. Furthermore, the cell adhesion analysis demonstrated that both cell lines adhered to the 3 different skin dressings and non-cytotoxicity was observed. Taking together, all the results suggest that the skin dressings are biocompatible and present non-cytotoxicity in thein vitrostudies, being considered a suitable material for tissue engineering proposals.
Assuntos
Materiais Biocompatíveis , Colágeno , Teste de Materiais , Poríferos , Impressão Tridimensional , Animais , Colágeno/química , Poríferos/química , Camundongos , Porosidade , Humanos , Linhagem Celular , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Proliferação de Células/efeitos dos fármacos , Alginatos/química , Bandagens , Sobrevivência Celular/efeitos dos fármacos , Pele/metabolismo , Espectroscopia de Infravermelho com Transformada de Fourier , Fibroblastos/citologia , Microscopia Eletrônica de Varredura , Engenharia Tecidual/métodos , Cicatrização/efeitos dos fármacos , Pele ArtificialRESUMO
Chitosan (CS) is a promising polymeric biomaterial for use in scaffolds forin vitroskin models and wound dressings, owing to its non-antigenic and antimicrobial properties. However, CS often exhibits insufficient physicochemical properties, mechanical strength, and bioactivity, limiting its efficacy in demanding applications. To address these challenges, cotton cellulose nanofibers (CNFs) represent a promising nanomaterial for enhancing CS-based scaffolds in tissue engineering. CNF offers superior stiffness, and mechanical properties that enhance cellular adhesion and proliferation, both crucial for effective tissue regeneration and healing. This study aimed to develop and characterize a scaffold combining cotton CNF and CS, focusing on its cytocompatibility with human fibroblasts and keratinocytes. The cotton CNF/CS scaffold was fabricated using the casting technique, and its physicochemical properties and cellular compatibility were assessedin vitro. The results demonstrated that incorporating cotton CNF significantly enhanced the stability of the CS matrix. The CS scaffold with 1000 µg ml-1of cotton CNF exhibited increased roughness and reduced rupture strain compared to the pure CS scaffold. The cotton CNF/CS scaffold effectively promoted the adhesion, viability, proliferation, migration, and collagen synthesis of skin cells. Notably, increased cell viability was observed in human fibroblasts cultured on scaffolds with higher concentrations of cotton CNF (100 and 1000 µg ml-1). Based on the findings, the cotton CNF/CS scaffold demonstrates enhanced physicochemical properties and bioactivity, making it a promising candidate for the development ofin vitrohuman skin models and wound healing dressings.
Assuntos
Materiais Biocompatíveis , Adesão Celular , Proliferação de Células , Sobrevivência Celular , Celulose , Quitosana , Fibroblastos , Queratinócitos , Nanofibras , Pele , Engenharia Tecidual , Alicerces Teciduais , Cicatrização , Quitosana/química , Cicatrização/efeitos dos fármacos , Humanos , Nanofibras/química , Engenharia Tecidual/métodos , Alicerces Teciduais/química , Fibroblastos/citologia , Celulose/química , Materiais Biocompatíveis/química , Queratinócitos/citologia , Teste de Materiais , Fibra de Algodão , Bandagens , Resistência à Tração , Colágeno/químicaRESUMO
INTRODUCTION: Abdominal binders consist of a wide compression belt that encircles the abdomen, theoretically supporting the abdominal wall. However, their use after ventral hernia repair is debated. Therefore, this meta-analysis evaluates their efficacy. METHODS: We searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing the effects of abdominal binders after ventral hernia repair. Outcomes included postoperative pain using the visual analog scale (VAS), surgical site infection (SSI), seroma formation and size, general well-being, activity limitation, forced expiratory volume in the first second (FEV1), and a 6-min walk test. Statistical analysis was performed with Review Manager 5.4.1 using a random-effects model. RESULTS: We included five RCTs encompassing 297 patients. Overall analysis showed decreased SSI rates (RR 0.21; 95% CI 0.07 to 0.59; p = 0.003; I2 = 0%) and reduced pain two weeks after surgery (MD -0.89; 95% CI -1.41 to -0.37; p = 0.0008; I2 = 0%) using abdominal binders. For patients undergoing open ventral hernia repair, it also demonstrated reduced SSI, pain four weeks after surgery (MD -0.60; 95% CI -0.88 to -0.32; p < 0.0001; I2 = 66%) and increased 6-min walk test performance four weeks after the procedure (MD 32.78 m; 95% CI 15.28 to 50.29 m; p = 0.0002; I2 = 0%). CONCLUSION: Abdominal binders may decrease SSI, postoperative pain, and increase physical condition, particularly in open ventral hernia repair. Further studies are still required to evaluate the role of abdominal binders in minimally invasive techniques.
Assuntos
Hérnia Ventral , Herniorrafia , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Dor Pós-Operatória/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/etiologia , Bandagens , Seroma/etiologia , Seroma/prevenção & controle , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the use of negative pressure wound therapy and hydrofiber dressing with silver in a pediatric patient with a hard-to-heal surgical wound infection. METHOD: This is a descriptive professional experience report on the use of conventional dressings and negative pressure wound therapy in a pediatric patient with a surgical wound infection. It was developed in 2023 at a Public Health Service that is a reference in the care of pediatric patients in the state of Paraná. RESULTS: The surgical wound dehiscence started 12 days after peritoneostomy. Initially, the wound was treated with hydrofiber dressing with silver for 22 days and subsequently, negative pressure wound therapy was used for 15 days, regenerating the wound. CONCLUSION: Negative pressure wound therapy in pediatrics proved to be safe, effective and efficient for the treatment of complex wounds and corroborated the skin regeneration process, as did hydrofiber dressing with silver.
Assuntos
Bandagens , Tratamento de Ferimentos com Pressão Negativa , Infecção da Ferida Cirúrgica , Humanos , Tratamento de Ferimentos com Pressão Negativa/métodos , Infecção da Ferida Cirúrgica/terapia , Criança , Masculino , Prata/administração & dosagem , Deiscência da Ferida Operatória/terapia , FemininoRESUMO
The development of new wound dressings made from biomaterials, which offer a better cost-benefit ratio and accelerate the healing process, is increasing nowadays. Various biopolymers can be electrospun to form functional membranes for wound healing. Therefore, in this study, chitosan and nanochitosan membranes with or without hyaluronic acid were prepared using the electrospinning technique, characterized and evaluated in the healing of skin wounds in rats. Chitosan and nanochitosan solutions, with or without hyaluronic acid, were prepared at concentrations of 1%-4% using PEO (polyethylene oxide) and subjected to the electrospinning process to obtain membranes characterized by scanning electron microscopy (SEM), mechanical tests, and antimicrobial activity. The healing effect of the membranes was evaluated by monitoring the area of the lesions, contraction of the wounds, histologic analysis, and induction of pro-inflammatory cytokine (IL-1 α and TNF-α) production in rats. The nanochitosan and nanochitosan membranes with hyaluronic acid achieved greater fiber diameter and uniformity, resistance, elasticity, and thermal stability, in addition to good adhesion to the wound bed and permeation capacity. Despite not presenting antimicrobial activity in vitro, they contributed to the production of pro-inflammatory interleukins in the animals tested, provided physical protection, reduced the wound area more markedly until the seventh day of the evaluation, with an acceleration of the healing process and especially when functionalized with hyaluronic acid. These results indicate that the membranes may be promising for accelerating the healing process of chronic wounds in humans.
Assuntos
Quitosana , Ácido Hialurônico , Membranas Artificiais , Pele , Cicatrização , Quitosana/química , Quitosana/farmacologia , Animais , Ácido Hialurônico/química , Ácido Hialurônico/farmacologia , Cicatrização/efeitos dos fármacos , Ratos , Pele/lesões , Pele/metabolismo , Masculino , Ratos Wistar , BandagensRESUMO
Dressings should protect wounds, promote healing, absorb fluids, and maintain moisture. Bacterial cellulose is a biopolymer that stands out in biomaterials due to its high biocompatibility in several applications. In the area of dressings, it is already marketed as an alternative to traditional dressings. However, it lacks any intrinsic activity; among these, the need for antimicrobial activity in infected wounds stands out. We developed a cationic cellulose film by modifying cellulose with 1-(5-carboxypentyl)pyridin-1-ium bromide, enhancing its wettability (contact angle: 26.6°) and water retention capacity (2714.37 %). This modified film effectively retained oxacillin compared to the unmodified control. Liposomal encapsulation further prolonged oxacillin release up to 11 days. Both oxacillin-loaded films and liposomal formulations demonstrated antimicrobial activity against Staphylococcus aureus. Our findings demonstrate the potential of chemically modified cellulose as a platform for controlled anionic antibiotics and/or their formulations delivery in wound care.
Assuntos
Antibacterianos , Bandagens , Celulose , Preparações de Ação Retardada , Liberação Controlada de Fármacos , Lipossomos , Oxacilina , Staphylococcus aureus , Celulose/química , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/química , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Oxacilina/administração & dosagem , Oxacilina/farmacologia , Oxacilina/química , Cátions/química , Ânions/química , Cicatrização/efeitos dos fármacos , MolhabilidadeRESUMO
Herein, four different grafted chitosans were synthesized by covalent attachment of glycine, L-arginine, L-glutamic acid, or L-cysteine to the chitosan chains. All products were subsequently permethylated to obtain their corresponding quaternary ammonium salts to enhance the inherent antimicrobial properties of native chitosan. In all cases, transparent hydrogels with the following remarkable characteristics were obtained: i) high-water absorption capacity (32-44 g H2O per g of polymer), ii) viscoelastic behavior at low deformations, iii) flexibility when subjected to deformations and iv) stability over long time scales. All the permethylated derivatives successfully inhibited 100 % of the growth of S. aureus. They also exhibited higher antimicrobial activity against E. coli than native chitosan. The structure of the chemically crosslinked products was more stable under external perturbations than that of the physically crosslinked ones. Between the chemically crosslinked products, the permethylated glutamic acid-grafted chitosan exhibited a noteworthy higher water absorption capacity with respect to that modified with cysteine, which makes it the most promising material for various industrial applications, including biomedical and food industries. Regarding biomedical applications, this derivative met the required physicochemical criteria for wound dressings, which encourages the pursuit of biological studies necessary to ensure the safety of its use for this application.
Assuntos
Bandagens , Quitosana , Hidrogéis , Quitosana/química , Quitosana/farmacologia , Hidrogéis/química , Hidrogéis/farmacologia , Hidrogéis/síntese química , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Antibacterianos/farmacologia , Antibacterianos/química , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento , Água/química , Cicatrização/efeitos dos fármacos , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologiaRESUMO
Chitosan chemical functionalization is a powerful tool to provide novel materials for additive manufacturing strategies. The main aim of this study was the employment of computer-aided wet spinning (CAWS) for the first time to design and fabricate carboxymethyl chitosan (CMCS) scaffolds. For this purpose, the synthesis of a chitosan derivative with a high degree of O-substitution (1.07) and water soluble in a large pH range allowed the fabrication of scaffolds with a 3D interconnected porous structure. In particular, the developed scaffolds were composed of CMCS fibers with a small diameter (< 60 µm) and a hollow structure due to a fast non solvent-induced coagulation. Zn2+ ionotropic crosslinking endowed the CMCS scaffolds with stability in aqueous solutions, pH-sensitive water uptake capability, and antimicrobial activity against Escherichia coli and Staphylococcus aureus. In addition, post-printing functionalization through collagen grafting resulted in a decreased stiffness (1.6 ± 0.3 kPa) and a higher elongation at break (101 ± 9 %) of CMCS scaffolds, as well as in their improved ability to support in vitro fibroblast viability and wound healing process. The obtained results encourage therefore further investigation of the developed scaffolds as antimicrobial wound dressing hydrogels for skin regeneration.
Assuntos
Antibacterianos , Bandagens , Quitosana , Escherichia coli , Staphylococcus aureus , Alicerces Teciduais , Cicatrização , Quitosana/química , Quitosana/análogos & derivados , Quitosana/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Alicerces Teciduais/química , Antibacterianos/farmacologia , Antibacterianos/química , Animais , Camundongos , Fibroblastos/efeitos dos fármacos , Porosidade , Sobrevivência Celular/efeitos dos fármacos , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Materiais Biocompatíveis/síntese química , Reagentes de Ligações Cruzadas/química , HumanosRESUMO
This study reports on the modification of bacterial cellulose (BC) membranes produced by static fermentation of Komagataeibacter xylinus bacterial strains with graphene oxide-silver nanoparticles (GO-Ag) to yield skin wound dressings with improved antibacterial properties. The GO-Ag sheets were synthesized through chemical reduction with sodium citrate and were utilized to functionalize the BC membranes (BC/GO-Ag). The BC/GO-Ag composites were characterized to determine their surface charge, morphology, exudate absorption, antimicrobial activity, and cytotoxicity by using fibroblast cells. The antimicrobial activity of the wound dressings was assessed against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. The results indicate that the BC/GO-Ag dressings can inhibit â¼70% of E. coli cells. Our findings also revealed that the porous BC/GO-Ag antimicrobial dressings can efficiently retain 94% of exudate absorption after exposure to simulated body fluid (SBF) for 24 h. These results suggest that the dressings could absorb excess exudate from the wound during clinical application, maintaining adequate moisture, and promoting the proliferation of epithelial cells. The BC/GO-Ag hybrid materials exhibited excellent mechanical flexibility and low cytotoxicity to fibroblast cells, making excellent wound dressings able to control bacterial infectious processes and promote the fast healing of dermal lesions.
Assuntos
Antibacterianos , Materiais Biocompatíveis , Celulose , Escherichia coli , Grafite , Teste de Materiais , Nanopartículas Metálicas , Testes de Sensibilidade Microbiana , Prata , Staphylococcus aureus , Cicatrização , Grafite/química , Grafite/farmacologia , Prata/química , Prata/farmacologia , Cicatrização/efeitos dos fármacos , Celulose/química , Celulose/farmacologia , Nanopartículas Metálicas/química , Antibacterianos/química , Antibacterianos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Tamanho da Partícula , Pseudomonas aeruginosa/efeitos dos fármacos , Gluconacetobacter xylinus/química , Humanos , Camundongos , Bandagens , AnimaisRESUMO
PURPOSE: To evaluate using a biocellulose-based hydrogel as an adjuvant in the healing process of arterial ulcers. METHODS: A prospective single group quasi-experimental study was carried out with chronic lower limb arterial ulcer patients. These patients received biocellulose-based hydrogel dressings and outpatient guidance on dressing and periodic reassessments. The primary outcomes were the ulcer-healing rate and product safety, which were assessed by ulcer area measured in photographic records of pre-treatment and posttreatment after 7, 30, and 60 days. Secondary outcomes were related to clinical assessment by the quality-of-life scores (SF-36 and EQ-5D) and pain, evaluated by the visual analogue scale (VAS). RESULTS: Seventeen participants were included, and one of them was excluded. Six patients (37%) had complete wound healing, and all patients had a significant reduction in the ulcer area during follow-up (233.6mm2 versus 2.7mm2) and reduction on the score PUSH 3.0 (p < 0.0001). The analysis of the SF-36 and EQ-5D questionnaires showed a statistically significant improvement in almost all parameters analyzed and with a reduction of pain assessed by the VAS. CONCLUSIONS: The biocellulose-based hydrogel was safe and showed a good perspective to promoting the necessary conditions to facilitate partial or complete healing of chronic arterial ulcers within a 60-day follow-up. Quality of life and pain were positively affected by the treatment.
Assuntos
Qualidade de Vida , Cicatrização , Humanos , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Resultado do Tratamento , Doença Crônica , Celulose/uso terapêutico , Celulose/administração & dosagem , Úlcera da Perna/terapia , Bandagens , Idoso de 80 Anos ou mais , Medição da Dor , Hidrogéis/uso terapêuticoRESUMO
Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanofibers embedded with borate glasses of 45B5 composition doped with Co2+, Cu2+, and Zn2 +(46.1 B2O326.9-X CaO24.4 Na2O2.6 P2O5, X CoO/CuO/ZnO mol % (X = 0-5)) were produced by electrospinning for wound healing applications. Prior to their addition, the glasses exhibited two broad halos typical of a vitreous borate network, which were mainly composed of ring-type metaborate structural units. The particle distribution in the PHBV nanofibers embedded with 45B5 borate bioactive glasses is present in isolated and agglomerated states, being partially coated by a polymeric layer-except for the cobalt-doped glass, which resulted in a successful encapsulation with 100% embedding efficiency. The incorporation of the glasses reduced the PHBV crystallinity degree and its decomposition temperature, as well as its mechanical properties, including Young's modulus, tensile strength, and elongation at break. The neat PHBV fibers and those containing the cobalt-doped glasses demonstrated great cytocompatibility with human keratinocytes (HaCat), as suggested by the high cell viability after 7 days of exposure. Further studies are needed to fully understand the wound healing potential of these fibers, but our results significantly contribute to the area.
Assuntos
Bandagens , Boratos , Cobalto , Cobre , Poliésteres , Zinco , Humanos , Cobre/química , Cobalto/química , Poliésteres/química , Boratos/química , Zinco/química , Vidro/química , Teste de Materiais , Cicatrização , Nanofibras/química , Linhagem Celular , Poli-HidroxibutiratosRESUMO
Bacterial cellulose (BC), produced by bacterial fermentation, is a high-purity material. BC can be oxidized (BCOXI), providing aldehyde groups for covalent bonds with drugs. Frutalin (FTL) is a lectin capable of modulating cell proliferation and remodeling, which accelerates wound healing. This study aimed to develop an FTL-incorporated dressing based on BC, and to evaluate its physicochemical properties and biological activity in vitro. An experimental design was employed to maximize FTL loading yield onto the BC and BCOXI, where independent variables were FTL concentration, temperature and immobilization time. BCOXI-FTL 1 (44.96 % ± 1.34) had the highest incorporation yield (IY) at the experimental conditions: 6 h, 5 °C, 20 µg mL-1. The second highest yield was BCOXI-FTL 6 (23.28 % ± 1.43) using 24 h, 5 °C, 100 µg mL-1. Similarly, the same reaction parameters provided higher immobilization yields for native bacterial cellulose: BC-FTL 6 (16.91 % ± 1.05) and BC-FTL 1 (21.71 % ± 1.57). Purified FTL displayed no cytotoxicity to fibroblast cells (<50 µg mL-1 concentration) during 24 h. Furthermore, BCOXI-FTL and BC-FTL were non-cytotoxic during 24 h and stimulated fibroblast migration. BCOXI-FTL demonstrated neutrophil activation in vitro similar to FTL. These promising results indicate that the bacterial cellulose matrices containing FTL at low concentrations, could be used as an innovative biomaterial for developing wound dressings.
Assuntos
Artocarpus , Bandagens , Celulose , Lectinas de Plantas , Artocarpus/química , Celulose/química , Celulose/farmacologia , Lectinas de Plantas/química , Lectinas de Plantas/farmacologia , Animais , Camundongos , Fibroblastos/efeitos dos fármacos , Cicatrização/efeitos dos fármacosRESUMO
Persistent bacterial infections are the leading risk factor that complicates the healing of chronic wounds. In this work, we formulate mixtures of polyvinyl alcohol (P), chitosan (CH), collagen (C), and honey (H) to produce nanofibrous membranes with healing properties. The honey effect at concentrations of 0 % (PCH and PCHC), 5 % (PCHC-5H), 10 % (PCHC-10H), and 15 % (PCHC-15H) on the physicochemical, antibacterial, and biological properties of the developed nanofibers was investigated. Morphological analysis by SEM demonstrated that PCH and PCHC nanofibers had a uniform and homogeneous distribution on their surfaces. However, the increase in honey content increased the fiber diameter (118.11-420.10) and drastically reduced the porosity of the membranes (15.79-92.62 nm). The addition of honey reduces the water vapor transmission rate (WVTR) and the adsorption properties of the membranes. Mechanical tests revealed that nanofibers were more flexible and elastic when honey was added, specifically the PCHC-15H nanofibers with the lowest modulus of elasticity (15 MPa) and the highest elongation at break (220 %). Also, honey significantly improved the antibacterial efficiency of the nanofibers, mainly PCHC-15H nanofibers, which presented the best bacterial reduction rates against Staphylococcus aureus (59.84 %), Pseudomonas aeruginosa (47.27 %), Escherichia coli (65.07 %), and Listeria monocytogenes (49.58 %). In vitro tests with cell cultures suggest that nanofibers were not cytotoxic and exhibited excellent biocompatibility with human fibroblasts (HFb) and keratinocytes (HaCaT), since all treatments showed higher or similar cell viability as opposed to the cell control. Based on the findings, PVA-chitosan-collagen-honey nanofibrous membranes have promise as an antibacterial dressing substitute.
Assuntos
Antibacterianos , Bandagens , Quitosana , Colágeno , Mel , Membranas Artificiais , Nanofibras , Cicatrização , Quitosana/química , Quitosana/farmacologia , Nanofibras/química , Bandagens/microbiologia , Colágeno/química , Antibacterianos/farmacologia , Antibacterianos/química , Humanos , Cicatrização/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Porosidade , Álcool de Polivinil/química , Fibroblastos/efeitos dos fármacosRESUMO
A key strategy in enhancing the efficacy of collagen-based hydrogels involves incorporating polysaccharides, which have shown great promise for wound healing. In this study, semi-interpenetrating polymeric network (semi-IPN) hydrogels comprised of collagen (Col) with the macrocyclic oligosaccharide ß-cyclodextrin (ß-CD) (20-80 wt.%) were synthesised. Fourier-transform infrared (FTIR) spectroscopy confirmed the successful fabrication of these Col/ß-CD hydrogels, evidenced by the presence of characteristic absorption bands, including the urea bond band at â¼1740 cm-1, related with collagen crosslinking. Higher ß-CD content was associated with increased crosslinking, higher swelling, and faster gelation. The ß-CD content directly influenced the morphology and semi-crystallinity. All Col/ß-CD hydrogels displayed superabsorbent properties, enhanced thermal stability, and exhibited slow degradation rates. Mechanical properties were significantly improved with contents higher than ß-CD 40 wt.%. These hydrogels inhibited the growth of Escherichia coli bacteria and facilitated the controlled release of agents, such as malachite green, methylene blue, and ketorolac. The chemical composition of the Col/ß-CD hydrogels did not induce cytotoxic effects on monocytes and fibroblast cells. Instead, they actively promoted cellular metabolic activity, encouraging cell growth and proliferation. Moreover, cell signalling modulation was observed, leading to changes in the expression of TNF-α and IL-10 cytokines. In summary, the results of this research indicate that these novel hydrogels possess multifunctional characteristics, including biocompatibility, super-swelling capacity, good thermal, hydrolytic, and enzymatic degradation resistance, antibacterial activity, inflammation modulation, and the ability to be used for controlled delivery of therapeutic agents, indicating high potential for application in advanced wound dressings.
Assuntos
Antibacterianos , Bandagens , Colágeno , Preparações de Ação Retardada , Liberação Controlada de Fármacos , Escherichia coli , Hidrogéis , beta-Ciclodextrinas , Hidrogéis/química , Hidrogéis/farmacologia , beta-Ciclodextrinas/química , Antibacterianos/farmacologia , Antibacterianos/química , Preparações de Ação Retardada/química , Colágeno/química , Escherichia coli/efeitos dos fármacos , Humanos , Cicatrização/efeitos dos fármacos , Inflamação/tratamento farmacológico , Animais , CamundongosRESUMO
Aim: To Identify and characterize driveline-related injuries among patients with HeartMate II® or HeartMate 3®and assess the dressings used during hospital stay. Method: Observational, cross-sectional study conducted between 2015 and 2023 at a large hospital in São Paulo, Brazil. Results: The sample consisted of 18 patients, with driveline injuries identified in 66.7%, categorized into stages one (83.3%), two (8.3%), and four (8.3%). Of these, 66.6% were diagnosed with driveline infection according to the Utah classification: stages two (50%), three (37.5%), and four (12.5%). A correlation was found between the occurrence of injuries and longer support time (p=0.035) and the presence of a diagnosis of driveline infections (p=0.013). The solutions most frequently used were Chloraprep™ (27.8%), Aqueous Chlorhexidine 0.5% (22.2%), and Saline 0.9% (22.2%), while the dressings were IV3000™ (72.2 %), Excilon™ (44.4%), and Biatain®Ag (33.3%). Conclusion: Driveline dressings are not standardized, indicating the need for new protocols and guidelines based on studies of high methodological quality and presenting robust evidence of the best solutions and dressings to prevent complications and promote better outcomes. (AU)
Objetivos: Identificar y caracterizar lesiones relacionadas con el driveline en pacientes con HeartMate II® o HeartMate 3® y evaluar los apósitos utilizados durante el ingreso hospitalario. Método: Estudio observacional, transversal, realizado entre 2015 y 2023, en un hospital de gran porte de São Paulo, Brasil. Resultados: La muestra estuvo conformada por 18 pacientes, identificándose lesiones de driveline en el 66,7%, categorizadas en estadios uno (83,3%), dos (8,3%) y cuatro (8,3%). De estos, el 66,6% fueron diagnosticados con infección de driveline con la clasificación de Utah en estadios dos (50%), tres (37,5%) y cuatro (12,5%). Hubo correlación entre la aparición de lesiones y el mayor tiempo de soporte (p=0,035) y la presencia del diagnóstico de infección del driveline (p=0,013). Las soluciones más frecuentes fueron Chloraprep™ (27,8%), Clorhexidina acuosa 0,5% (22,2%) y Salino 0,9% (22,2%), y los apósitos fueron IV3000™ (72,2%), Excilon™ (44,4%) y Biatain®Ag. (33,3%). Conclusión: Falta estandarización de los apósitos de drivelines, destacando la necesidad de nuevos protocolos y guías con estudios de alta calidad metodológica y con evidencia sólida sobre las mejores soluciones y coberturas, previniendo complicaciones y promoviendo mejores resultados. (AU)
Objetivos: Identificar e caracterizar as lesões relacionadas ao driveline em usuários de HeartMate II® ou HeartMate 3®e avaliar os curativos utilizados durante a internação hospitalar. Método: Estudo observacional, transversal, com dados analisados entre os anos de 2015 e 2023, em um hospital de grande porte de São Paulo, Brasil. Resultados: A amostra foi composta de 18 pacientes, sendo identificadas lesões de driveline em 66,7%, categorizadas em estágio um (83,3%), dois (8,3%) e quatro (8,3%). Destes, 66,6% apresentavam diagnóstico de infecção de driveline com a classificação de Utah de estágio dois (50%), três (37,5%) e quatro (12,5%). Houve correlação entre a ocorrência de lesões e o maior tempo de suporte (p=0,035) e a presença do diagnóstico de infecção do driveline (p=0,013). As soluções mais frequentes foram Chloraprep™ (27,8%), Clorexidina Aquosa 0,5% (22,2%) e Soro Fisiológico 0,9% (22,2%), e as coberturas IV3000™ (72,2%), Excilon™ (44,4%) e Biatain®Ag (33,3%). Conclusão: Nota-se ausência da padronização de curativos de drivelines, destacando a necessidade de novos protocolos e diretrizes com estudos de alta qualidade metodológica e com evidência robusta das melhores soluções e coberturas, prevenindo complicações e promovendo melhores resultados. (AU)
Assuntos
Humanos , Ferimentos e Lesões , Coração Auxiliar , Bandagens , Estomaterapia , Insuficiência CardíacaRESUMO
BACKGROUND: Diabetic foot ulcers (DFUs) constitute a complication that occurs in 19% to 34% of patients with diabetes mellitus (DM). The aim of this study is to describe median days to healing, average velocity of wound closure, and percentage of wound surface closed at 3, 6, and 12 weeks through the use of homogenized and lyophilized amniotic membrane (hAMpe) dressings for the treatment of DFUs in ambulatory patients. METHODS: An observational, descriptive, longitudinal study was performed. Patients presenting with granulation-based DFU, after proper debridement, were included from August 19, 2021, until July 14, 2023. hAMpe dressings placed every 3 days were used for the treatment of these ulcers. RESULTS: Sixteen patients were included with a mean age of 52.38 (8.07) years. The analyzed lesions were postsurgical ulcers in 15 of the 16 included patients. Median ulcer size was 19.5 cm2 (6.12-36). The median ABI was 1.10 (1-1.14). The median days to healing was 96 (71-170). The median percentage closure of the wound at 3 weeks was 41% (28.9%-55.3%), at 6 weeks it was 68.2% (48.6%-74.2%), and at 12 weeks it was 100% (81%-100%). The average velocity closure was 1.04% per day (95% CI 0.71%-1.31%). It was higher during the closure of the first 50% of the ulcer, 2.12% per day (95% CI 0.16%-4.09%), and decreased from 50% to 25% of the ulcer size to 0.67% per day (95% CI 0.23%-1.10%) and from 25% to closure to 0.47% per day (95% CI 0.14%-0.80%), P < .001. CONCLUSION: These results are difficult to compare to other studies given the higher surface area of the ulcers included in our sample. The development of hAMpe dressings enables patients to apply them without requiring assistance from health care teams and was not associated with any recognized complications.
Assuntos
Âmnio , Pé Diabético , Cicatrização , Humanos , Pé Diabético/terapia , Pessoa de Meia-Idade , Feminino , Masculino , Âmnio/transplante , Estudos Longitudinais , Curativos Biológicos , Adulto , Liofilização , Bandagens , IdosoRESUMO
OBJECTIVE: this study was undertaken to evaluate the efficacy of multilayer polyurethane foam with silicone (MPF) compared to transparent polyurethane film (TPF) dressings in the control of heel skin microclimate (temperature and moisture) of hospitalized patients undergoing elective surgeries. METHOD: the study took of a secondary analysis of a randomized self-controlled trial, involving patients undergoing elective surgical procedure of cardiac and gastrointestinal specialties in a university hospital in southern Brazil, from March 2019 to February 2020. Patients served as their own control, with their heels randomly allocated to either TPF (control) or MPF (intervention). Skin temperature was measured using a digital infrared thermometer; and moisture determined through capacitance, at the beginning and end of surgery. The study was registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5. RESULTS: significant difference in the microclimate variables were observed when the groups (intervention and control) and the timepoint of measurement (beginning and end of surgery) were compared. When assessing temperature, an increase (+3.3 °C) was observed with TPF and a decrease (-7.4 °C) was recorded with MPF. Regarding skin moisture, an increase in moisture (+14.6 AU) was recorded with TPF and a slight decrease (-0.3 AU) with MPF. CONCLUSIONS: The findings of this study suggest that MPF is more effective than TPF in controlling skin microclimate (temperature and moisture) in heels skin of hospitalized patients undergoing elective surgeries. However, this control should be better investigated in other studies.
Assuntos
Calcanhar , Microclima , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Brasil , Idoso , Temperatura Cutânea/fisiologia , Bandagens/normas , Bandagens/estatística & dados numéricos , Poliuretanos , AdultoRESUMO
Oxygen is essential for tissue regeneration, playing a crucial role in several processes, including cell metabolism and immune response. Therefore, the delivery of oxygen to wounds is an active field of research, and recent studies have highlighted the potential use of photosynthetic biomaterials as alternative oxygenation approach. However, while plants have traditionally been used to enhance tissue regeneration, their potential to produce and deliver local oxygen to wounds has not yet been explored. Hence, in this work we studied the oxygen-releasing capacity of Marchantia polymorpha explants, showing their capacity to release oxygen under different illumination settings and temperatures. Moreover, co-culture experiments revealed that the presence of these explants had no adverse effects on the viability and morphology of fibroblasts in vitro, nor on the viability of zebrafish larvae in vivo. Furthermore, oxygraphy assays demonstrate that these explants could fulfill the oxygen metabolic requirements of zebrafish larvae and freshly isolated skin biopsies ex vivo. Finally, the biocompatibility of explants was confirmed through a human skin irritation test conducted in healthy volunteers following the ISO-10993-10-2010. This proof-of-concept study provides valuable scientific insights, proposing the potential use of freshly isolated plants as biocompatible low-cost oxygen delivery systems for wound healing and tissue regeneration.
Assuntos
Bandagens , Oxigênio , Fotossíntese , Peixe-Zebra , Animais , Oxigênio/metabolismo , Estudo de Prova de Conceito , Humanos , Cicatrização/efeitos dos fármacos , Pele/metabolismo , Fibroblastos/citologia , Fibroblastos/metabolismoRESUMO
High expression of MMP-2 and MMP-9 in periapical lesions plays an important role in the degradation of the extracellular matrix. This study aimed to investigate the effect of epigallocatechin-3-gallate (EGCG)-based endodontic paste as an intracanal dressing on the expression of MMP-2 and MMP-9 in periapical lesions. Periapical lesions were experimentally induced in 35 mature beagle dog premolars randomly divided into healthy teeth, untreated periapical lesions, periapical lesions treated in a single session (control groups), and periapical lesions treated in two sessions with EGCG or calcium hydroxide-based pastes (experimental groups). After 120 days, specimens were obtained for histopathologic and immunofluorescence analyses to assess the expression of MMP-2 and MMP-9. The statistical analysis was performed using a p-value of 0.05. Endodontic treatment in two sessions using medication with EGCG and calcium hydroxide-based pastes provided similar repair of the apical and periapical tissues and neoformation of periodontal ligament fibers, cementum, and alveolar bone (p>0.05). The experimental groups treated in two sessions with both medications presented expression of MMP-2 and MMP-9 similar to that in healthy teeth (p>0.05), and significantly lower than teeth treated in a single session or untreated periapical lesions (p <0.001). Expression of MMP-2 and MMP-9 was observed in the cytoplasm of fibroblasts, osteoblasts, cementoblasts, cementocytes, and vascular endothelium. The use of EGCG-based endodontic paste reduced the expression of MMP-2 and MMP-9 and allowed repair of periapical lesions, similar to calcium hydroxide-based paste, and superior to treatment performed in a single session.
Assuntos
Catequina/análogos & derivados , Periodontite Periapical , Cães , Animais , Metaloproteinase 9 da Matriz , Hidróxido de Cálcio/farmacologia , Metaloproteinase 2 da Matriz , BandagensRESUMO
The present study aims to characterize and to evaluate the biological effects of a skin dressing manufactured with the organic part of the Chondrilla caribensis marine sponge (called spongin-like collagen (SC)) associated or not to photobiomodulation (PBM) on the skin wound healing of rats. Skin dressings were manufactured with SC and it was characterized using scanning electron microscopy (SEM) and a tensile assay. In order to evaluate its biological effects, an experimental model of cutaneous wounds was surgically performed. Eighteen rats were randomly distributed into three experimental groups: control group (CG): animals with skin wounds but without any treatment; marine collagen dressing group (DG): animals with skin wounds treated with marine collagen dressing; and the marine collagen dressing + PBM group (DPG): animals with skin wounds treated with marine collagen dressing and PBM. Histopathological, histomorphometric, and immunohistochemical evaluations (qualitative and semiquantitative) of COX2, TGFß, FGF, and VEGF were done. SEM demonstrates that the marine collagen dressing presented pores and interconnected fibers and adequate mechanical strength. Furthermore, in the microscopic analysis, an incomplete reepithelialization and the presence of granulation tissue with inflammatory infiltrate were observed in all experimental groups. In addition, foreign body was identified in the DG and DPG. COX2, TGFß, FGF, and VEGF immunostaining was observed predominantly in the wound area of all experimental groups, with a statistically significant difference for FGF immunostaining score of DPG in relation to CG. The marine collagen dressing presented adequate physical characteristics and its association with PBM presented favorable biological effects to the skin repair process.