Advances in Wound Dressings and Materials

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Pharmaceutical Technology, Manufacturing and Devices".

Deadline for manuscript submissions: closed (10 February 2021) | Viewed by 81331

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Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK
Interests: biopharmaceutics; modified release; dissolution; infection prevention; biopolymers
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Special Issue Information

Dear Colleagues,

Wound healing is an incredibly complex physiological process, with numerous interdependent factors influencing critical events. Although most superficial wounds heal normally, there are instances when they fail to heal properly, leading to infection and/or chronic wounds. Wound management is a major global challenge posing a significant burden to patients and healthcare systems. There have been significant developments in the management of wounds over the last five decades owing to improved insight into the wound healing process and progress in technologies. These include smart systems, such as bioactive dressings, to promote wound healing and advanced textiles for compression or with antimicrobial functionality involving materials with intrinsic bactericidal activity, modified surfaces or incorporating antimicrobial agents. Therapeutic agents, bioactive molecules and cells have been incorporated into controlled-release carriers, including polymeric micro- and nanospheres, lipid nanoparticles, nanofibrous structures, hydrogels and scaffolds. These advances can address many of the challenges associated with wound healing, particularly for chronic wounds, and find application in diagnostics and management.

The aim of this Special Issue is to highlight recent advances in wound dressing materials, manufacture and applications, including their potential to sustain drug delivery and promote wound healing. 

Prof. Dr. Barbara R. Conway
Guest Editor

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Keywords

  • wound healing
  • wound dressing
  • biomaterials
  • chronic wounds
  • skin infection
  • drug delivery

Published Papers (10 papers)

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Research

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9 pages, 411 KiB  
Article
A Prospective Randomized Study: The Usefulness and Efficacy of Negative Pressure Wound Therapy with Lipidocolloid Polyester Mesh Compared to Traditional Negative Pressure Wound Therapy for Treatment of Pressure Ulcers
by Wooyeol Baek, Nara Lee, Eun Jin Han, Tai Suk Roh and Won Jai Lee
Pharmaceutics 2020, 12(9), 813; https://doi.org/10.3390/pharmaceutics12090813 - 27 Aug 2020
Cited by 6 | Viewed by 2852
Abstract
To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or [...] Read more.
To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or causing infection. In this study, we reviewed the efficacy of the lipidocolloid non-adherent dressing (Urgotul®) as a wound contact layer. A total of 38 patients from the same facility who applied NPWT from April 2016 to October 2019 were included and divided into two groups; NPWT with the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only (group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT application, at one week, and again at three weeks after application. No significant differences were found between groups for general characteristics, bacterial culture or photo analysis. However, when comparing groups based on the time of examination, there was a significant reduction of the wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates healing by shrinking the size of the pressure ulcer wound. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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19 pages, 2763 KiB  
Article
Development of a Nonwoven Hemostatic Dressing Based on Unbleached Cotton: A De Novo Design Approach
by J. Vincent Edwards, Elena Graves, Nicolette Prevost, Brian Condon, Dorne Yager, Joseph Dacorta and Alvin Bopp
Pharmaceutics 2020, 12(7), 609; https://doi.org/10.3390/pharmaceutics12070609 - 30 Jun 2020
Cited by 11 | Viewed by 2741
Abstract
Minimally processed greige (unbleached) cotton fibers demonstrate enhanced clotting relative to highly processed United States Pharmacopeia (USP) type 7 bleached cotton gauze. This effect is thought to be due to the material surface polarity. We hypothesized that a textile could be constructed, conserving [...] Read more.
Minimally processed greige (unbleached) cotton fibers demonstrate enhanced clotting relative to highly processed United States Pharmacopeia (USP) type 7 bleached cotton gauze. This effect is thought to be due to the material surface polarity. We hypothesized that a textile could be constructed, conserving the hemostasis-accelerating properties of greige cotton, while maintaining structural integrity and improving absorbance. Spun bond nonwovens of varying surface polarity were designed and prepared based on ratios of greige cotton/bleached cotton/polypropylene fibers. A thromboelastographic analysis was performed on fibrous samples in citrated blood to evaluate the rate of fibrin and clot formation. Lee White clotting times were obtained to assess the material’s clotting activity in platelet fresh blood. An electrokinetic analysis of samples was performed to analyze for material surface polarity. Hemostatic properties varied with composition ratios, fiber density, and fabric fenestration. The determinations of the surface polarity of cotton fabrics with electrokinetic analysis uncovered a range of surface polarities implicated in fabric-initiated clotting; a three-point design approach was employed with the combined use of thromboelastography, thrombin velocity index, Lee White clotting, and absorption capacity determinations applied to fabric structure versus function analysis. The resulting analysis demonstrates that greige cotton may be utilized, along with hydrophilic and hydrophobic fibers, to improve the initiation of fibrin formation and a decrease in clotting time in hemostatic dressings suitable to be commercially developed. Hydroentanglement is an efficient and effective process for imparting structural integrity to cotton-based textiles, while conserving hemostatic function. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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18 pages, 6744 KiB  
Article
A Novel Composite Hydrogel Composed of Formic Acid-Decellularized Pepsin-Soluble Extracellular Matrix Hydrogel and Sacchachitin Hydrogel as Wound Dressing to Synergistically Accelerate Diabetic Wound Healing
by Chien-Ming Hsieh, Weu Wang, Ying-Hsuan Chen, Pu-Sheng Wei, Yu-Hsuan Liu, Ming-Thau Sheu and Hsiu-O Ho
Pharmaceutics 2020, 12(6), 538; https://doi.org/10.3390/pharmaceutics12060538 - 11 Jun 2020
Cited by 24 | Viewed by 3604
Abstract
Extracellular matrix (ECM) hydrogel can create a favorable regenerative microenvironment and act as a promising dressing for accelerating the healing of diabetic wound. In this study, a simple and effective decellularization technique was developed and optimized to obtain acellular extracellular matrix (a [...] Read more.
Extracellular matrix (ECM) hydrogel can create a favorable regenerative microenvironment and act as a promising dressing for accelerating the healing of diabetic wound. In this study, a simple and effective decellularization technique was developed and optimized to obtain acellular extracellular matrix (aECM) from porcine skin. It was found that decellularization at 30% formic acid for 72 h effectively decellularized porcine skin while retaining >75% collagen and ~37% GAG in the aECM with no presence of nuclei of cellular remnants. aECM hydrogel was fabricated by digesting aECM with pepsin in various acidic solutions (0.1 N HCl, glycolic acid (GA) and 2-pyrrolidone-5-carboxylic acid (PCA)) and then treated with a pH-controlled neutralization and temperature-controlled gelation procedure. Based on physical characterizations, including SDS-PAGE, rheological analysis and SEM analysis, aECMHCl hydrogels fabricated at 25 mg/mL in 0.1 N HCl were selected. Four polymeric ECM-mimic hydrogels, including sacchachitin (SC), hyaluronic acid (HA) and chitosan (CS) and three composite hydrogels of combining SC either with aECMHCl,25 (aECMHCl/SC), HA (HA/SC) or CS (SC/CS) were prepared and evaluated for WS-1 cell viability and wound-healing effectiveness. Cell viability study confirmed that no hydrogel dressings possessed any toxicity at all concentrations examined and ECMHCl, HA and ECMHCl/SC at higher concentrations (>0.05%) induced statistically significant proliferation. Diabetic wound healing study and histological examinations revealed that ECMHCl/SC hydrogel was observed to synergistically accelerate wound healing and ultimately stimulated the growth of hair follicles and sweat glands in the healing wound indicating the wound had healed as functional tissues. The results support the great potential of this newly produced ECMHCl/SC composite hydrogel for healing and regeneration of diabetic wounds. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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18 pages, 3278 KiB  
Article
Growth Factors Delivery System for Skin Regeneration: An Advanced Wound Dressing
by Marta Nardini, Sara Perteghella, Luca Mastracci, Federica Grillo, Giorgio Marrubini, Elia Bari, Matteo Formica, Chiara Gentili, Ranieri Cancedda, Maria Luisa Torre and Maddalena Mastrogiacomo
Pharmaceutics 2020, 12(2), 120; https://doi.org/10.3390/pharmaceutics12020120 - 03 Feb 2020
Cited by 40 | Viewed by 4763
Abstract
Standard treatments of chronic skin ulcers based on the direct application of dressings still present several limits with regard to a complete tissue regeneration. Innovative strategies in tissue engineering offer materials that can tune cell behavior and promote growth tissue favoring cell recruitment [...] Read more.
Standard treatments of chronic skin ulcers based on the direct application of dressings still present several limits with regard to a complete tissue regeneration. Innovative strategies in tissue engineering offer materials that can tune cell behavior and promote growth tissue favoring cell recruitment in the early stages of wound healing. A combination of Alginate (Alg), Sericin (SS) with Platelet Lysate (PL), as a freeze-dried sponge, is proposed to generate a bioactive wound dressing to care skin lesions. Biomembranes at different composition were tested for the release of platelet growth factors, cytotoxicity, protective effects against oxidative stress and cell proliferation induction. The highest level of the growth factors release occurred within 48 h, an optimized time to burst a healing process in vivo; the presence of SS differently modulated the release of the factors by interaction with the proteins composing the biomembranes. Any cytotoxicity was registered, whereas a capability to protect cells against oxidative stress and induce proliferation was observed when PL was included in the biomembrane. In a mouse skin lesion model, the biomembranes with PL promoted the healing process, inducing an accelerated and more pronounced burst of inflammation, formation of granulation tissue and new collagen deposition, leading to a more rapid skin regeneration. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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Review

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27 pages, 3101 KiB  
Review
Polymeric Materials for Hemostatic Wound Healing
by Suvash Ghimire, Pritha Sarkar, Kasey Rigby, Aditya Maan, Santanu Mukherjee, Kaitlyn E. Crawford and Kausik Mukhopadhyay
Pharmaceutics 2021, 13(12), 2127; https://doi.org/10.3390/pharmaceutics13122127 - 09 Dec 2021
Cited by 28 | Viewed by 6308
Abstract
Hemorrhage is one of the greatest threats to life on the battlefield, accounting for 50% of total deaths. Nearly 86% of combat deaths occur within the first 30 min after wounding. While external wound injuries can be treated mostly using visual inspection, abdominal [...] Read more.
Hemorrhage is one of the greatest threats to life on the battlefield, accounting for 50% of total deaths. Nearly 86% of combat deaths occur within the first 30 min after wounding. While external wound injuries can be treated mostly using visual inspection, abdominal or internal hemorrhages are more challenging to treat with regular hemostatic dressings because of deep wounds and points of injury that cannot be located properly. The need to treat trauma wounds from limbs, abdomen, liver, stomach, colon, spleen, arterial, venous, and/or parenchymal hemorrhage accompanied by severe bleeding requires an immediate solution that the first responders can apply to reduce rapid exsanguinations from external wounds, including in military operations. This necessitates the development of a unique, easy-to-use, FDA-approved hemostatic treatment that can deliver the agent in less than 30 s and stop bleeding within the first 1 to 2 min at the point of injury without application of manual pressure on the wounded area. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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24 pages, 1669 KiB  
Review
Dermatillomania: Strategies for Developing Protective Biomaterials/Cloth
by Priusha Ravipati, Bice Conti, Enrica Chiesa and Karine Andrieux
Pharmaceutics 2021, 13(3), 341; https://doi.org/10.3390/pharmaceutics13030341 - 05 Mar 2021
Cited by 5 | Viewed by 10452
Abstract
Dermatillomania or skin picking disorder (SPD) is a chronic, recurrent, and treatment resistant neuropsychiatric disorder with an underestimated prevalence that has a concerning negative impact on an individual’s health and quality of life. The current treatment strategies focus on behavioral and pharmacological therapies [...] Read more.
Dermatillomania or skin picking disorder (SPD) is a chronic, recurrent, and treatment resistant neuropsychiatric disorder with an underestimated prevalence that has a concerning negative impact on an individual’s health and quality of life. The current treatment strategies focus on behavioral and pharmacological therapies that are not very effective. Thus, the primary objective of this review is to provide an introduction to SPD and discuss its current treatment strategies as well as to propose biomaterial-based physical barrier strategies as a supporting or alternative treatment. To this end, searches were conducted within the PubMed database and Google Scholar, and the results obtained were organized and presented as per the following categories: prevalence, etiology, consequences, diagnostic criteria, and treatment strategies. Furthermore, special attention was provided to alternative treatment strategies and biomaterial-based physical treatment strategies. A total of six products with the potential to be applied as physical barrier strategies in supporting SPD treatment were shortlisted and discussed. The results indicated that SPD is a complex, underestimated, and underemphasized neuropsychiatric disorder that needs heightened attention, especially with regard to its treatment and care. Moreover, the high synergistic potential of biomaterials and nanosystems in this area remains to be explored. Certain strategies that are already being utilized for wound healing can also be further exploited, particularly as far as the prevention of infections is concerned. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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21 pages, 1242 KiB  
Review
Preclinical and Clinical Applications of Biomaterials in the Enhancement of Wound Healing in Oral Surgery: An Overview of the Available Reviews
by Giacomo Picciolo, Matteo Peditto, Natasha Irrera, Giovanni Pallio, Domenica Altavilla, Mario Vaccaro, Giuseppe Picciolo, Alessandro Scarfone, Francesco Squadrito and Giacomo Oteri
Pharmaceutics 2020, 12(11), 1018; https://doi.org/10.3390/pharmaceutics12111018 - 24 Oct 2020
Cited by 2 | Viewed by 2138
Abstract
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative [...] Read more.
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative wound healing. A search in Medline was performed, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The literature was searched for reviews published up to July 2020. Reviews evaluating the clinical and histological effects of biomaterials on post-operative wound healing in oral surgical procedures were included. Review selection was performed by two independent reviewers. Disagreements were resolved by a third reviewer, and 41 reviews were included in the final selection. The selected papers covered a wide range of biomaterials such as stem cells, bone grafts, and growth factors. Bioengineering and biomaterials development represent one of the most promising perspectives for the future of oral surgery. In particular, stem cells and growth factors are polarizing the focus of this ever-evolving field, continuously improving standard surgical techniques, and granting access to new approaches. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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18 pages, 1661 KiB  
Review
Cellulose/Collagen Dressings for Diabetic Foot Ulcer: A Review
by Ruth Naomi and Mh Busra Fauzi
Pharmaceutics 2020, 12(9), 881; https://doi.org/10.3390/pharmaceutics12090881 - 17 Sep 2020
Cited by 27 | Viewed by 5924
Abstract
Diabetic foot ulcer (DFU) is currently a global concern and it requires urgent attention, as the cost allocation by the government for DFU increases every year. This review was performed to provide scientific evidence on the advanced biomaterials that can be utilised as [...] Read more.
Diabetic foot ulcer (DFU) is currently a global concern and it requires urgent attention, as the cost allocation by the government for DFU increases every year. This review was performed to provide scientific evidence on the advanced biomaterials that can be utilised as a first-line treatment for DFU patients. Cellulose/collagen dressings have a biological property on non-healing wounds, such as DFU. This review aims to analyse scientific-based evidence of cellulose/collagen dressing for DFU. It has been proven that the healing rate of cellulose/collagen dressing for DFU patients demonstrated a significant improvement in wound closure as compared to current standard or conventional dressings. It has been scientifically proven that cellulose/collagen dressing provides a positive effect on non-healing DFU. There is a high tendency for cellulose/collagen dressing to be used, as it highly promotes angiogenesis with a rapid re-epithelisation rate that has been proven effective in clinical trials. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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27 pages, 3417 KiB  
Review
Silver Nanomaterials for Wound Dressing Applications
by Priya Dharshini Krishnan, Dominik Banas, Ramya Devi Durai, Daniil Kabanov, Bozena Hosnedlova, Marta Kepinska, Carlos Fernandez, Branislav Ruttkay-Nedecky, Hoai Viet Nguyen, Awais Farid, Jiri Sochor, Vedha Hari B. Narayanan and Rene Kizek
Pharmaceutics 2020, 12(9), 821; https://doi.org/10.3390/pharmaceutics12090821 - 28 Aug 2020
Cited by 83 | Viewed by 6303
Abstract
Silver nanoparticles (AgNPs) have recently become very attractive for the scientific community due to their broad spectrum of applications in the biomedical field. The main advantages of AgNPs include a simple method of synthesis, a simple way to change their morphology and high [...] Read more.
Silver nanoparticles (AgNPs) have recently become very attractive for the scientific community due to their broad spectrum of applications in the biomedical field. The main advantages of AgNPs include a simple method of synthesis, a simple way to change their morphology and high surface area to volume ratio. Much research has been carried out over the years to evaluate their possible effectivity against microbial organisms. The most important factors which influence the effectivity of AgNPs against microorganisms are the method of their preparation and the type of application. When incorporated into fabric wound dressings and other textiles, AgNPs have shown significant antibacterial activity against both Gram-positive and Gram-negative bacteria and inhibited biofilm formation. In this review, the different routes of synthesizing AgNPs with controlled size and geometry including chemical, green, irradiation and thermal synthesis, as well as the different types of application of AgNPs for wound dressings such as membrane immobilization, topical application, preparation of nanofibers and hydrogels, and the mechanism behind their antimicrobial activity, have been discussed elaborately. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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30 pages, 2285 KiB  
Review
Skin Wound Healing Process and New Emerging Technologies for Skin Wound Care and Regeneration
by Erika Maria Tottoli, Rossella Dorati, Ida Genta, Enrica Chiesa, Silvia Pisani and Bice Conti
Pharmaceutics 2020, 12(8), 735; https://doi.org/10.3390/pharmaceutics12080735 - 05 Aug 2020
Cited by 550 | Viewed by 34336
Abstract
Skin wound healing shows an extraordinary cellular function mechanism, unique in nature and involving the interaction of several cells, growth factors and cytokines. Physiological wound healing restores tissue integrity, but in many cases the process is limited to wound repair. Ongoing studies aim [...] Read more.
Skin wound healing shows an extraordinary cellular function mechanism, unique in nature and involving the interaction of several cells, growth factors and cytokines. Physiological wound healing restores tissue integrity, but in many cases the process is limited to wound repair. Ongoing studies aim to obtain more effective wound therapies with the intention of reducing inpatient costs, providing long-term relief and effective scar healing. The main goal of this comprehensive review is to focus on the progress in wound medication and how it has evolved over the years. The main complications related to the healing process and the clinical management of chronic wounds are described in the review. Moreover, advanced treatment strategies for skin regeneration and experimental techniques for cellular engineering and skin tissue engineering are addressed. Emerging skin regeneration techniques involving scaffolds activated with growth factors, bioactive molecules and genetically modified cells are exploited to overcome wound healing technology limitations and to implement personalized therapy design. Full article
(This article belongs to the Special Issue Advances in Wound Dressings and Materials)
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