Search Results (18)

Background: Developing versatile dressings that offer wound protection, maintain a moist environment, and facilitate healing represents an important therapeutic approach for burn patients. Objectives: This study presents the development of new smart pH-sensitive collagen-hydroxyethylcellulose films, incorporating naproxen and phenol red, designed to provide controlled drug release while enabling real-time pH monitoring for burn care. Methods: Biopolymeric films were prepared by the solvent-casting method using ethanol and glycerol as plasticizers. Results: Orange-colored films were thin, flexible, and easily peelable, with uniform, smooth, and nonporous morphology. Tensile strength varied from 0.61 N/mm² to 3.33 N/mm², indicating improved mechanical properties with increasing collagen content, while wetting analysis indicated a hydrophilic surface with contact angle values between 17.61° and 75.51°. Maximum swelling occurred at pH 7.4, ranging from 5.65 g/g to 9.20 g/g and pH 8.5, with values from 4.74 g/g to 7.92 g/g, suggesting effective exudate absorption. In vitro degradation proved structural stability maintenance for at least one day, with more than 40% weight loss. Films presented a biphasic naproxen release profile with more than 75% of the drug released after 24 h, properly managing inflammation and pain on the first-day post-burn. The pH variation mimicking the stages of the healing process demonstrated the color transition from yellow (pH 5.5) to orange (pH 7.4) and finally to bright fuchsia (pH 8.5), enabling easy visual evaluation of the wound environment. Conclusions: New multifunctional films combine diagnostic and therapeutic functions, providing a promising platform for monitoring wound healing, making them suitable for real-time wound assessment. Full article

The human skin is a remarkable organ capable of extensive regeneration, especially after severe injuries such as burns and related wounds. The de-epidermized dermis (DED) model has become a valuable in vitro tool for skin regeneration studies, particularly for testing the mechanism of action and the efficacy of clinical cutaneous cell therapies. To further improve the quality and robustness of these applications, our study focused on optimizing and standardizing DED tissue preparation and storage, enhancing its effectiveness for clinical testing. Therefore, we optimized the air-liquid interfacial culture medium composition by simplifying the historical formulation without compromising keratinocyte (therapeutic cell model) viability or proliferation. Furthermore, we investigated the impacts of adding burn wound exudates in the model by focusing on cell behavior for enhanced translational significance. The results revealed notable differences in keratinocyte adhesion and proliferation between burn wound exudates collected at the early stages and late stages of acute patient treatment, providing new information on a possible therapeutic window to apply cell therapies on burn patients. Generally, this study reported a robust method for the preclinical in vitro assessment of keratinocyte-based cutaneous cell therapies using DED models. Overall, the study underscored the importance of using in vitro models with enhanced translational relevance to better predict the clinical effects of cutaneous cell therapies in burn patient populations. Full article

As antibiotic resistance increasingly undermines traditional infection management strategies, there is a critical demand for innovative wound care solutions that address these emerging challenges. This study introduces a novel antibacterial wound dressing based on Cross-Linked Pullulan (Pul) and Polyhexamethylene Biguanide (PHMB) for enhanced wound management and infection control. The dressing’s adsorption rate reached 200% of its original weight within 30 min, exceeded 300% after 5 h, and exhibited significant non-Newtonian fluid properties. The dressings were able to release the loaded medication completely within 20 min; additionally, the dressing demonstrated significant antibacterial activity against a broad spectrum of bacteria. Significantly, the therapeutic effects of the Pul-PHMB/GP dressing were evaluated in a mouse model. Compared to untreated wounds, wounds treated with Pul-PHMB/GP exhibited a significant gelation process within 5 min post-treatment and showed a significant increase in wound healing rate within 12 days. This powder preparation overcomes the limitations associated with liquid and gel dressings, notably in storage and precise application, preventing the premature expansion or dissolution often caused by PHMB in high-humidity environments. The powder form can transform into a gel upon contact with wound exudate, ensuring accurate coverage of irregular wounds, such as those from burns or pressure sores, and offers excellent chemical and physical stability in a dry state, which facilitates storage and transport. This makes the dressing particularly suitable for emergency medical care and precision therapy, significantly improving the efficiency and adaptability of wound treatment and providing robust support for clinical treatments and emergency responses. Full article

Currently, there are several types of materials for the treatment of wounds, burns, and other topical injuries available on the market. The most used are gauzes and compresses due to their fluid absorption capacity; however, these materials adhere to the surface of the lesions, which can lead to further bleeding and tissue damage upon removal. In the present study, the development of a polymer-based gel that can be applied as a spray provides a new vision in injury protection, respecting the requirements of safety, ease, and quickness of both applicability and removal. The following polymeric sprays were developed to further obtain gels based on different polymers: hydroxypropyl cellulose (HPC), polyvinyl pyrrolidone (PVP) and hydroxypropyl methylcellulose (HPMC) using polyethylene glycol (PEG) as a plasticizer. The developed sprays revealed suitable properties for use in topical injuries. A protective film was obtained when sprayed on a surface through a casting mechanism. The obtained films adhered to the surface of biological tissue (pig muscle), turning into a gel when the exudate was absorbed, and proved to be washable with saline solution and contribute to the clotting process. Moreover, biocompatibility results showed that all materials were biocompatible, as cell viability was over 90% for all the materials. Full article

Hypertrophic scars (HTSs) are pathological structures resulting from chronic inflammation during the wound healing process, particularly in complex injuries like burns. The aim of this work is to propose Biofiber PF (biodegradable fiber loaded with Pirfenidone 1.5 w/w), an electrospun advanced dressing, as a solution for HTSs treatment in complex wounds. Biofiber has a 3-day antifibrotic action to modulate the fibrotic process and enhance physiological healing. Its electrospun structure consists of regular well-interconnected Poly-L-lactide-co-poly-ε-caprolactone (PLA-PCL) fibers (size 2.83 ± 0.46 µm) loaded with Pirfenidone (PF, 1.5% w/w), an antifibrotic agent. The textured matrix promotes the exudate balance through mild hydrophobic wettability behavior (109.3 ± 2.3°), and an appropriate equilibrium between the absorbency % (610.2 ± 171.54%) and the moisture vapor transmission rate (0.027 ± 0.036 g/min). Through its finer mechanical properties, Biofiber PF is conformable to the wound area, promoting movement and tissue oxygenation. These features also enhance the excellent elongation (>500%) and tenacity, both in dry and wet conditions. The ancillary antifibrotic action of PF on hypertrophic scar fibroblast (HSF) for 3 days downregulates the cell proliferation over time and modulates the gene expression of transforming growth factor β1 (TGF-β1) and α-smooth muscle actin (α-SMA) at 48–72 h. After 6 days of treatment, a decrement of α-SMA protein levels was detected, proving the potential of biofiber as a valid therapeutic treatment for HTSs in an established wound healing process. Full article

Following the enzymatic debridement of deep dermal burns, the choice of wound dressing is crucial for providing an adequate environment and suitable conditions for rapid wound healing. As Suprathel^® and fatty gauze (Jelonet^®) are the most commonly used dressings in burn centers, the aim of this study is to compare Suprathel^® and Jelonet^® in the treatment of deep dermal burns after enzymatic debridement with respect to wound healing, patient comfort, and pain. A total of 23 patients with deep dermal burns of the hand or foot (mean total body surface area of 4.31%) were included in this prospective, unicentric, open, comparative, and intra-individual clinical study. After enzymatic debridement, wounds were divided into two areas: one was treated with Suprathel^® and the other with Jelonet^®. Suprathel^® remained on the wounds without dressing changes while Jelonet^® was regularly changed. Wound healing, infection, bleeding, exudation, time for dressing changes, and pain were documented (from days 2 to 48) after injury. Satisfactory results were obtained in 22 cases; only one patient had to undergo a second debridement followed by skin grafting. No significant difference in time to final wound healing could be observed (18–19 d). Patients reported significantly less pain during the dressing changes for Suprathel^® compared to Jelonet^®. Furthermore, the wound areas treated with Suprathel^® showed significantly less exudation and bleeding. Wound infections rarely occurred in both groups. In conclusion, the authors found that both wound dressings could be used to achieve safe and rapid wound healing after the enzymatic debridement of deep dermal burns of the hands and feet. However, compared to Jelonet^®, Suprathel^® showed superior results in terms of patient comfort and pain reduction. Full article

Hydrogels are a favorable alternative to accelerate the burn wound healing process and skin regeneration owing to their capability of absorbing contaminated exudates. The bacterial infections that occur in burn wounds might be treated using different topically applied materials, but bacterial resistance to antibiotics has become a major problem worldwide. Therefore, the use of non-antibiotic treatments represents a major interest in current research. In this study, new antibiocomposite hydrogels with anti-inflammatory and antimicrobial properties based on hyaluronic acid (HA) and sodium alginate (AG) were obtained using 4-(4,6-dimethoxy-1,3,5-triazinyl-2)-4-methylmorpholinium chloride as an activator. The combination of Ibuprofen, a non-steroidal anti-inflammatory drug commonly used to reduce inflammation, fever and pain in the body, with zinc oxide nanoparticles (ZnO NPs) was used in this study aimed at creating a complex hydrogel with anti-inflammatory and antimicrobial action and capable of improving the healing process of wounds caused by burns. FTIR spectra confirmed the cross-linking of AG with HA as well as the successful incorporation of ZnO NPs. Using electronic microscopy, it was noticed that the morphology of hydrogels is influenced by the incorporation of ZnO nanoparticles. Moreover, the incorporation of ZnO nanoparticles into hydrogels also has an influence on the swelling behavior at both pH 7.4 and 5.4. In fact, the swelling rate is lower when the amounts of the activator, HA and ZnO NPs are high. A drug release rate of almost 100% was observed for hydrogels without ZnO NPs, whereas the addition of nanoparticles to hydrogels led to a decrease in the release rate to 68% during 24 h. Cellular viability tests demonstrated the non-cytotoxic behavior of the hydrogels without the ZnO NPs, whereas a weak to moderate cytotoxic effect was noticed for hydrogels with ZnO NPs. The hydrogels containing 4% and 5% ZnO NPs, respectively, showed good antimicrobial activity against the S. aureus strain. These preliminary data prove that these types of hydrogels can be of interest as biomaterials for the treatment of burn wounds. Full article

Current standard wound care involves dressings that provide moisture and protection; however, dressings providing active healing are still scarce and expensive. We aimed to develop an ecologically sustainable 3D printed bioactive hydrogel-based topical wound dressing targeting healing of hard-to-heal wounds, such as chronic or burn wounds, which are low on exudate. To this end, we developed a formulation composed of renewable marine components; purified extract from unfertilized salmon roe (heat-treated X, HTX), alginate from brown seaweed, and nanocellulose from tunicates. HTX is believed to facilitate the wound healing process. The components were successfully formulated into a 3D printable ink that was used to create a hydrogel lattice structure. The 3D printed hydrogel showed a HTX release profile enhancing pro-collagen I alpha 1 production in cell culture with potential of promoting wound closure rates. The dressing has recently been tested on burn wounds in Göttingen minipigs and shows accelerated wound closure and reduced inflammation. This paper describes the dressings development, mechanical properties, bioactivity, and safety. Full article

Several so-called “smart” dressings are available for burn injuries to promote faster wound healing, and this technology has recently reported substantial advancements. However, the selection of an appropriate dressing for partial-thickness burns requires consideration of several crucial elements, including exudate management, conformability, antimicrobial properties, ease of application and removal, patient comfort, and cost-effectiveness. This preliminary feasibility study uses a porcine model to test the INTELIGELS product (Smart Bandage) for partial-thickness burns treatment. Artificially made wounds, mimicking partial-thickness burns, were assessed in two studies with and without antimicrobial additives, where wounds were randomly assigned to the experimental group treated with Smart Bandage and two control groups treated with a simple saline gauze dressing or Aquacel^® products with and without silver additives. In addition, all dressings were evaluated for their ability to reduce wound size, quantified by histological analysis using punch biopsies. This study demonstrates comparable healing properties of Smart Bandage and Aquacel^® dressings that are superior to the simple saline gauze dressing. The superiority is demonstrated by better regeneration, less inflammation of the epidermis and dermis, and better dermis remodeling with more granulation tissue maturation within the wound area when Smart Bandage/Aquacel^® dressings are applied as compared with the simple gauze dressing. Full article

Background: Infections by multidrug-resistant (MDR) microorganisms are associated with increased morbidity and mortality in burn patients. This study aimed to analyze the evolution of MDR bacteria over a five-year period at Coimbra Burns Unit (CBU) in Portugal, seeking to assess the possible associations of specific bacteria with presumed risk factors. Methods: The data obtained consisted of identified bacteria present in any microbiological sample from each patient (including blood, central venous catheter, urine, tracheal aspirate and/or wound exudate). Univariate models and a multivariate model were constructed for each of the MDR bacteria species that infected at least 50 patients or that had five or more MDR strains. Statistical hypothesis tests with a p-value less than 0.05 were considered significant. Results: Of a total of 341 samples obtained, 107 were MDR, corresponding to 10 species. Globally, there was no significant variation in MDR bacteria frequency over the period under analysis. Some risk factors and/or trends were identified for some species, but none was linked to all of them. Conclusions: The risks for the development of MDR in bacteria in burn patients are multifactorial, mainly linked to longer hospital stays, the use of invasive devices and inadequate antimicrobial treatment. However, the influence of these risks regarding specific bacterial species is not straightforward and may rely on individual characteristics, type of treatment and/or local prevalent flora. Due to the severity of multidrug-resistant infections, continued microbiological surveillance with the aid of rapid diagnostic tests and prompt institution of appropriate antimicrobial therapy are crucial to improving outcomes for burn patients. Full article

Background and Objectives: Scar formation after burn trauma has a significant impact on the quality of life of burn patients. Hypertrophic scars or keloids can be very distressing to patients due to potential pain, functional limitations, or hyper- or hypopigmentation. In a previous study comparing Suprathel^® and the new and cheaper dressing epicite^hydro®, we were able to show that pain reduction, exudation, and time until wound-healing of partial-thickness burn wounds were similar, without any documented infections. No study exists that objectively measures and compares skin and scar quality after treatment with Suprathel^® and epicite^hydro® at present. Materials and Methods: In this study, the scar quality of 20 patients who had been treated with Suprathel^® and epicite^hydro® was objectively assessed using the Cutometer^®, Mexameter^®, and Tewameter^®, as well as subjectively with the Patient and Observer Scar Assessment Scale, 3, 6, and 12 months after burn injury. Results: In all performed measurements, no significant differences were detected in scar formation after treatment of partial-thickness burn wounds with the two dressings. Conclusions: Both the newer and less expensive wound-dressing epicite^hydro® and the well-known wound-dressing Suprathel^® resulted in stable wound closure and showed good cosmetic results in the follow-up examinations. Full article

Eliminating or at least lessening the pain is a crucial aspect of burns management, as pain can negatively affect mental health and quality of life, and it can also induce a delay on wound healing. In this context, new amphiphilic chitosan 3D porous membranes were developed and investigated as burns therapeutic systems with analgesic effect for delivery of lidocaine as local anesthetic. The highly porous morphology of the membranes and the structural modifications were evidenced by scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis and infrared spectroscopy (FTIR). Improved compression mechanical properties, long-term hydrolytic degradation (28 days) evaluation and high swelling capacities (ranging from 8 to 22.6 g/g) indicate an increased capacity of the prepared membranes to absorb physiological fluids (burns exudate). Lidocaine in vitro release efficiency was favored by the decreased content of cross-linking agent (reaching maximum value of 95.24%) and the kinetic data modeling, indicating that lidocaine release occurs by quasi-Fickian diffusion. In addition to the in vitro evaluation of analgesic effect, lidocaine-loaded chitosan membranes were successfully investigated and proved antibacterial activity against most common pathogens in burns infections: Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus. Full article

Burn wounds can lead to numerous severe complications including bacterial infections causing patient morbidity and mortality, mostly in low- and middle-income countries. The considerable increase in microbial resistance against traditional antibiotics is leading towards alternative strategies to treat bacterial infections. Nisin Z is an antimicrobial peptide which exhibits a significant antibacterial activity against Gram-positive bacteria. Its efficacy against Gram-negative bacteria is limited, nonetheless it can be improved with the addition of surfactants, such as ethylenediaminetetraacetic acid (EDTA). The incorporation of peptide and other biomolecules within a biopolymer matrix provides protection maintaining their antimicrobial potential. Bacterial nanocellulose (BNC) has been widely used as wound dressings. Its impressive water retention capacity (>99%) and porosity are beneficial to manage wounds due to its potential to absorb exudates, providing a breathable and humid environment. In this work, the functionalization of BNC with Nisin Z (BNC-NZ) via vacuum filtration is reported. The entrapment of the peptide inside the BNC films was confirmed through morphological characterization using attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectrometry. Typical absorbance peaks of Nisin Z are easily identifiable at 1647 cm⁻¹ (amide group) and 1520 cm⁻¹ (bending of primary amines). Thermal gravimetric analysis (TGA) suggested that Nisin Z did not interfere with the BNC matrix. The antimicrobial activity of Nisin Z against five of the most common bacteria found in burn wounds was verified by minimum bactericidal concentration (MBC) ranging 8.0–256.0 µg/mL. Agar diffusion and shake flask methods revealed the potential of BNC-NZ for prospective applications in burn wound dressings. Full article

Electrospun nanofiber materials have been considered as advanced dressing candidates in the perspective of wound healing and skin regeneration, originated from their high porosity and permeability to air and moisture, effective barrier performance of external pathogens, and fantastic extracellular matrix (ECM) fibril mimicking property. Gelatin is one of the most important natural biomaterials for the design and construction of electrospun nanofiber-based dressings, due to its excellent biocompatibility and biodegradability, and great exudate-absorbing capacity. Various crosslinking approaches including physical, chemical, and biological methods have been introduced to improve the mechanical stability of electrospun gelatin-based nanofiber mats. Some innovative electrospinning strategies, including blend electrospinning, emulsion electrospinning, and coaxial electrospinning, have been explored to improve the mechanical, physicochemical, and biological properties of gelatin-based nanofiber mats. Moreover, numerous bioactive components and therapeutic agents have been utilized to impart the electrospun gelatin-based nanofiber dressing materials with multiple functions, such as antimicrobial, anti-inflammation, antioxidation, hemostatic, and vascularization, as well as other healing-promoting capacities. Noticeably, electrospun gelatin-based nanofiber mats integrated with specific functions have been fabricated to treat some hard-healing wound types containing burn and diabetic wounds. This work provides a detailed review of electrospun gelatin-based nanofiber dressing materials without or with therapeutic agents for wound healing and skin regeneration applications. Full article

An active wound dressing should address the main goals in wound treatment, which are improved wound healing and reduced infection rates. We developed novel multifunctional nanofibrous wound dressings with three active ingredients: chloramphenicol (CAM), beta-glucan (βG) and chitosan (CHI), of which βG and CHI are active nanofiber-forming biopolymers isolated from the cell walls of Saccharomyces cerevisiae and from shrimp shells, respectively. To evaluate the effect of each active ingredient on the nanofibers’ morphological features and bioactivity, nanofibers with both βG and CHI, only βG, only CHI and only copolymers, polyethylene oxide (PEO) and hydroxypropylmethylcellulose (HPMC) were fabricated. All four nanofiber formulations were also prepared with 1% CAM. The needle-free Nanospider^TM technique allowed for the successful production of defect-free nanofibers containing all three active ingredients. The CAM-containing nanofibers had a burst CAM-release and a high absorption capacity. Nanofibers with all active ingredients (βG, CHI and CAM) showed a concentration-dependent anti-inflammatory activity, while maintaining the antimicrobial activity of CAM. The promising anti-inflammatory properties, together with the high absorption capacity and antimicrobial effect, make these multifunctional nanofibers promising as dressings in local treatment of infected and exuding wounds, such as burn wounds. Full article