Search Results (1,394)

Background: Chronic diabetic wounds, particularly diabetic foot ulcers (DFUs), are prone to recurrent infection and delayed healing, resulting in substantial morbidity, mortality, and economic burden. Multifunctional wound dressings that combine antibacterial, antioxidant, conductive, and self-healing properties may help to address the complex microenvironment of chronic diabetic wounds. Methods: In this study, ε-poly-L-lysine and amino-terminated polyethylene glycol were grafted onto carboxylated single-walled carbon nanotubes (SWCNTs) via amide coupling to obtain ε-PL-CNT-PEG. Aminated chondroitin sulfate (CS-ADH) and a catechol–metal coordination complex of protocatechualdehyde and Fe³⁺ (PA@Fe) were then used to construct a dynamic covalently cross-linked hydrogel network through Schiff-base chemistry. The obtained hydrogels (Gel0–3, Gel4) were characterized for photothermal performance, rheological behavior, microstructure, swelling/degradation, adhesiveness, antioxidant capacity, electrical conductivity, cytocompatibility, hemocompatibility, and antibacterial activity in the presence and absence of near-infrared (NIR, 808 nm) irradiation. Results: ε-PL-CNT-PEG showed good aqueous dispersibility, NIR-induced photothermal conversion, and improved cytocompatibility after surface modification. Incorporation of ε-PL-CNT-PEG into the PA@Fe/CS-ADH network yielded conductive hydrogels with porous microstructures and storage modulus (G′) higher than loss modulus (G′′) over the tested frequency range, indicating stable gel-like behavior. The hydrogels exhibited self-healing under alternating strain and macroscopic rejoining after cutting. Swelling and degradation studies demonstrated pH-dependent degradation, with faster degradation in mildly acidic conditions (pH 5.0), mimicking infected chronic diabetic wounds. The hydrogels adhered to diverse substrates and tolerated joint movements. Gel4 showed notable DPPH• and H₂O₂ scavenging (≈65% and ≈60%, respectively, within several hours). The electrical conductivity was 0.19 ± 0.0X mS/cm for Gel0–3 and 0.21 ± 0.0Y mS/cm for Gel4 (mean ± SD, n = 3), falling within the range reported for human skin. In vitro, NIH3T3 cells maintained >90% viability in the presence of hydrogel extracts, and hemolysis ratios remained below 5%. Hydrogels containing ε-PL-CNT-PEG displayed enhanced antibacterial effects against Escherichia coli and Staphylococcus aureus, and NIR irradiation further reduced bacterial survival, with some formulations achieving near-complete inhibition under low-power (0.2–0.3 W/cm²) 808 nm irradiation. Conclusions: A dynamic, conductive hydrogel based on PA@Fe, CS-ADH, and ε-PL-CNT-PEG was successfully developed. The hydrogel combines photothermal antibacterial activity, antioxidant capacity, electrical conductivity, self-healing behavior, adhesiveness, cytocompatibility, and hemocompatibility. These properties suggest potential for application as a wound dressing for chronic diabetic wounds, including diabetic foot ulcers, although further in vivo studies are required to validate therapeutic efficacy. Full article

Background: Chitosan-based hydrogels exhibit excellent temperature-sensitive properties and are widely used as skin dressings. However, several challenges remain, such as long gelation times and difficulties releasing insoluble drugs, which limit their application in skin wound healing. In this study, we developed a novel sulfobutyl-β-cyclodextrin/quercetin@chitosan/hyaluronic acid hydrogel (Qe/SBE@CS/HA Gel). In this gel, SBE not only encapsulates Qe to form inclusion complexes, thereby enhancing the solubility of Qe, but also shortens the gelation time of thermosensitive gels through electrostatic adsorption with chitosan. Methods: Qe/SBE was prepared using the saturated solution method, while Qe/SBE@CS/HA gel was fabricated via electrostatic adsorption. The performance of the gels was evaluated using antibacterial, antioxidant, compatibility, and skin infection damage models. Results: The Qe/SBE@CS/HA Gel exhibits both thermosensitivity and acid sensitivity, releasing 91.9% of Qe in a medium with a pH of 5.0. This gel displays notable antibacterial activity and antioxidant characteristics. Furthermore, it shows excellent biocompatibility, as evidenced by hemolytic and in vivo degradation tests. The gel has the capacity to modulate chronic inflammation and facilitate angiogenesis and collagen synthesis, thereby significantly accelerating wound healing in wound and infection models. Conclusions: This multi-responsive and multifunctional gel shows potential as a therapeutic strategy for bacterial infection wounds. Full article

Background/Objectives: This study aimed to identify risk factors for postoperative wound infections and healing disorders in patients with brain tumors, based on a large, single-center analysis, and to establish an evidence-based foundation for prevention. Methods: A retrospective analysis was conducted on 1480 patients who underwent intracranial tumor resection in our department over a ten-year period, without the influence of anticoagulant or antiplatelet medication. Potential predictors of wound healing disorders were evaluated, focusing on demographic variables and pre-existing conditions. Results: Among the 1480 patients, postoperative wound infections occurred in 47 cases, corresponding to a cumulative incidence of 3.17%. Platelet count (p = 0.018) and partial thromboplastin time (p = 0.011) emerged as potential risk factors for postoperative wound infections. Length of hospital stay appeared as a distinct outcome-associated marker in cases of postoperative wound infection (p = 0.018). In contrast, demographic characteristics (age, sex, blood type), comorbidities (hypertension, diabetes mellitus, cardiovascular disease, kidney disease, chronic inflammatory conditions), and other surgical or laboratory parameters showed no significant association with wound healing disorders. Conclusions: In patients with brain tumors undergoing surgery without the influence of anticoagulant or antiplatelet therapy, most demographic factors, common comorbidities, and selected laboratory parameters were not associated with an increased risk of postoperative wound infections. Awareness of the identified risk factors may help guide preventive strategies and nursing care. Full article

Background/Objectives: Wound infections caused by multidrug-resistant Gram-negative bacteria, such as Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii, pose a major clinical challenge. This study evaluated the interactions between gamma-polyglutamic acid (γ-PGA), cefiderocol, and silver nanoparticles (AgNPs) within multilayer wound dressing configurations. The primary goal was to clarify the dual role of γ-PGA as a healing promoter and a potential protector of bacterial cells against antimicrobial agents. Methods: Multilayer dressing models were assembled in 96-well plates to simulate vertical stratification of antimicrobial layers4. Bacterial viability was assessed through relative OD₆₀₀ measurements following incubation with varying concentrations and spatial arrangements of cefiderocol, AgNPs, and γ-PGA. Data were analyzed using generalized linear modeling (GLM) with a gamma distribution and random forest regression to determine the relative importance of each factor in modulating bacterial survival. Results: γ-PGA concentration emerged as the dominant factor influencing bacterial viability, accounting for nearly 100% of variable importance in random forest analysis. Despite high antimicrobial pressure from cefiderocol and AgNPs, bacterial viability stabilized at approximately 40% in the presence of γ-PGA. The vertical positioning of γ-PGA significantly impacted survival; direct physical contact between the polymer and bacteria, particularly at high concentrations, enhanced bacterial persistence in P. aeruginosa and E. coli. Cefiderocol showed strain-specific potency, while AgNPs provided consistent growth inhibition. Conclusions: γ-PGA plays a paradoxical role in wound care by providing moisture retention while simultaneously acting as a cytoprotective agent that reduces antimicrobial efficacy, likely by facilitating biofilm formation. These findings underscore the necessity of optimizing the spatial layering and concentration of biopolymers in advanced dressings. Strategic design is crucial to balance regenerative benefits with maximal antimicrobial control to improve clinical outcomes in chronic wound management. Full article

Diabetic foot complications represent a major global health burden and arise from a multifactorial interaction between neuropathy, ischemia, infection, and impaired wound repair. Increasing evidence suggests that, beyond traditional vascular and metabolic risk factors, endocrine dysregulation plays a central role in shaping vascular dysfunction and tissue vulnerability in patients with diabetes. This narrative review provides an updated overview of the endocrine–vascular axis in the development, progression, and healing of diabetic foot ulcers (DFUs), integrating evidence from experimental and clinical studies identified through targeted searches of PubMed, Embase, and Scopus. We examine how alterations in insulin signaling, relative glucagon excess, adipokine imbalance, dysregulation of stress hormones, and thyroid dysfunction interact with chronic hyperglycemia, dyslipidemia, mitochondrial dysfunction, and low-grade inflammation to impair endothelial homeostasis. These disturbances promote oxidative stress, reduce nitric oxide bioavailability, and compromise microvascular perfusion, thereby creating a pro-ischemic and pro-inflammatory tissue environment that limits angiogenesis, extracellular matrix (ECM) remodeling, immune coordination, and effective wound repair. By linking pathophysiological mechanisms to clinical relevance, this review highlights potential biomarkers of endocrine–vascular dysfunction, implications for risk stratification, and emerging therapeutic perspectives targeting metabolic optimization, endothelial protection, and hormonal modulation. Finally, key knowledge gaps and priority areas for future translational and clinical research are discussed, supporting the development of integrated endocrine-based strategies aimed at improving DFU prevention, healing outcomes, and long-term limb preservation in patients with diabetes. Full article

Background: Elastic stable intramedullary nailing (ESIN) is widely used in pediatric trauma surgery for benefits such as early limb loading, short hospital stays, and easy implant removal. Perioperative antibiotic prophylaxis (PAP) is used to reduce surgical site infections (SSIs). However, the necessity of PAP in minimally invasive pediatric procedures like ESIN remains unclear. Methods: This retrospective analysis reviewed all pediatric fractures treated with ESIN osteosynthesis at a pediatric trauma center over a time span of 10 years. Focus was set on the use of PAP during implantation and complications in the period between osteosynthesis and implant removal, which was used as follow-up. Results: Between January 2013 and December 2023, a total of 979 ESIN osteosyntheses were performed. In total, 4.1% were lost to follow-up resulting in 939 eligible cases. Complications occurred in 14.7% of all cases. However, complications such as wound healing disorders, wound infections, and osteomyelitis were rare, at 1.7%. Between the different subgroups regarding the application of PAP, type of reduction, openness of the fractures, or localization, no significant differences were found. Conclusions: Besides the most minor complications, ESIN osteosynthesis in children and adolescents is safe treatment. No increased risk for complications was observed when closed reduction was performed without the administration of PAP. Full article

Background/Objectives: Calcinosis cutis universalis is a rare and severe manifestation of dystrophic calcification, most associated with connective tissue diseases such as dermatomyositis, systemic sclerosis, and systemic lupus erythematosus. It is characterized by widespread deposition of calcium salts throughout the soft tissues, leading to pain, recurrent infections, restricted mobility, and significant impairment in daily functioning and quality of life. Management remains challenging due to the absence of standardized treatment guidelines with risks including delayed wound healing and recurrence. Adjunctive therapies may support symptom control in refractory cases. Conclusions: Management of calcinosis cutis universalis requires an individualized, multimodal strategy. Based on available evidence and expert opinion, a stepwise therapeutic decision-making algorithm integrating medical, minimally invasive, and surgical approaches is proposed to guide clinical practice and the variable efficacy of available therapies. This review aims to summarize current therapeutic strategies and to propose a pragmatic approach to clinical decision-making. Methods: A narrative review of the literature was conducted using PubMed and Google Scholar. The review focused primarily on calcinosis cutis universalis and severe or extensive forms of calcinosis cutis, with particular emphasis on surgical management and its integration with medical and minimally invasive treatments. Results: Pharmacological treatments—including bisphosphonates, calcium-channel blockers, tetracyclines, phosphate binders, probenecid, immunomodulatory agents, biologics, colchicine, sodium thiosulfate and JAK inhibitors—show heterogeneous and often partial efficacy, with more favorable responses in early or localized disease. Surgical interventions such as excision, curettage, CO₂ laser ablation, and reconstructive procedures provide meaningful symptomatic relief in selected patients but are associated. Full article

Wound healing is a complex process essential for maintaining skin integrity; however, the rise of antibiotic-resistant bacteria limits therapeutic options, highlighting the critical need for new antimicrobial agents. In this context, this research focused on the synthesis of new azole derivatives and their biological evaluation, specifically targeting antimicrobial, antioxidant, and biocompatible properties relevant to wound infections. In the present work, ketoconazole derivatives were obtained through an initial reaction with an excess of hydrazine hydrate, followed by condensation with benzaldehydes and cyclization with chloroacetyl chloride to form a β-lactam ring. These compounds were evaluated in vitro for antioxidant activity using FRAP, DPPH, and TAC assays, and for antimicrobial activity against a variety of microorganisms. Additionally, the cytotoxicity was assessed using the MTT assay on a normal mouse fibroblast cell line (NCTC, clone L929) for evaluating the biocompatibility of the obtained compounds. Derivative K1 exhibited the highest antioxidant activity, a finding confirmed by all three assays. Regarding antimicrobial properties, all compounds demonstrated notable activity, with K1, K4 and K5 displaying superior efficacy. Significantly, the MTT assay revealed that the derivatives exhibit dose-dependent cytotoxicity but maintain favorable safety profiles at therapeutic concentrations, supporting their suitability for topical application. In conclusion, these findings suggest that the synthesized derivatives may serve as promising leads for infected wound therapy. Future research will further explore the therapeutical potential of these compounds, together with their incorporation into polymeric films designed for chronic wound treatment. Full article

A retrospective study on 135 cases of teat and udder surgical conditions in 129 small ruminants is described. On 19 repairs of teat lacerations, a primary- and a secondary-intention healing in 13 (68%) and in 4 (21%) cases, respectively, was observed; 2 (11%) had poor response and consequent mastitis. Good outcome and first-intention healing in 100% of the fistula repairs (2 cases), thelectomies (5 cases), teat neoplasm removals (14), and mastectomies (2 cases) were observed. Among 26 teat curettage cases, all 18 (69%) unilateral lesions treatment had a good outcome versus the 8 (31%) with bilateral lesion that suffered definitive relapse. In 67 skin udder neoplasm removals, a primary- and a secondary-intention healing in 59 (88%) and in 8 (12%) cases, respectively, was observed; however, 2 of the latter suffered mastitis. These procedures are associated with a good prognosis, and the percentage of favorable outcomes was high. Wound infections and dehiscence were the main complications observed. More interest in teat and udder surgery on small ruminants should be encouraged, and farmers should be made aware that the animal can often return into production at a reasonable cost; however, their post-operative care is the key to success. Full article

Background: Combating antimicrobial resistance and developing dressings that match all aspects of wound healing will always be challenging. Methods: In this study, hydrogel membranes composed of sodium alginate (SA), polyvinyl alcohol (PVA), and Pluronic-f-127 (F-127) loaded with colistin (C) were formulated. The formulations were divided into two groups: group 1 (SA-PVA-C) and group 2 (SA-PVA-F127-C). Results: The membranes were characterized using multiple techniques, which confirmed component compatibility, physical cross-linking, an amorphous structure, and suitable surface morphology with acceptable porosity. Mechanical testing showed that both groups were suitable for wound-dressing applications. Differences in drug release across media (water, normal saline, and phosphate) were non-significant (p value > 0.05). Drug-loaded membranes (n = 3) from both groups showed antibacterial activity against multidrug-resistant Gram-negative Pseudomonas aeruginosa (ZOI = 20.33 ± 2.51 mm, 21.66 ± 2.08 mm). Conclusions: Overall, the developed hydrogel membranes (both group 1 and group 2) demonstrated promising in vitro potential as colistin delivery systems for wound infection management. Full article

Pine needles are traditional herbal remedies used for centuries to treat various ailments, including rheumatism, bronchitis, burns, inflammation, and infections. This study aimed to evaluate the antioxidant, analgesic (peripheral and central), and wound-healing activities of Pinus pinaster (PPN) and Pinus halepensis (PAN) needles while identifying the bioactive compounds responsible for these effects. Phytochemical analysis revealed several phenolic compounds, including p-coumaroylquinic acid, quercetin, narcissin, and myricetin-3-O-glucoside. Both extracts showed strong antioxidant activity, with high total phenolic content (TPC: 384.84 ± 0.84 and 524.46 mg GAE/g DM for PPN and PAN, respectively) and flavonoid content (TFC: 109.44 ± 0.62 and 111.64 ± 0.62 mg QE/g DM, respectively). Peripheral analgesic activity, assessed using the acetic acid-induced writhing test, revealed that PAN (300 mg/kg) significantly reduced pain by 72.3%, while central analgesic effects, evaluated by the tail immersion test, were comparable to the reference drug for both extracts. In vivo wound-healing tests showed accelerated wound contraction and complete closure by day 21, indicating strong regenerative potential. Overall, this study demonstrates that PPN and PAN needle extracts possess significant antioxidant, analgesic, and wound-healing activities, supporting their traditional use and highlighting their potential as natural therapeutic agents for managing oxidative stress, pain, and skin injuries. Full article

Healthcare-associated infections remain an ongoing concern across medical and dental practice, prompting continuous evaluation of infection prevention measures. In dental extractions, the necessity of sterile gloves is debated, as the oral cavity represents an inherently contaminated environment. This systematic review and meta-analysis evaluated whether the use of sterile gloves reduces postoperative socket infections compared with non-sterile gloves. A search of MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Google Scholar identified randomized controlled trials, clinically controlled trials, and observational trials directly comparing sterile versus non-sterile glove use during dental extractions. The primary outcome of this study was extraction socket infection at day 7 post-surgery. A meta-analysis using relative risk (RR) was performed for dichotomous data. Of the initial 7170 publications found, seven articles met inclusion criteria. Infection rates ranged from 0% to 3.9%, with an overall infection rate of 0.3% in the sterile glove group (672 patients) and 1.3% in the non-sterile glove group (758 patients). Three studies qualified for meta-analysis, resulting in an RR of 0.30 (95% CI 0.07–1.24), indicating no significant difference in postoperative infections between sterile and non-sterile glove usage. Given the limitations of small sample sizes, low event rates, incomplete reporting, and lack of subgroup data for surgical versus non-surgical extractions, no difference in postoperative infection was found between sterile and non-sterile glove use. Additional research is needed to determine whether glove sterility influences infection risk, particularly in surgical procedures. Full article

Wound healing has been studied extensively in humans and lab animals, but not in dolphins. Severe human wounds require extensive medical intervention to avoid infection. Yet severe wounds on free-ranging dolphins heal without infection in microbial-infested seas, a compelling distinction. An eye-witnessed shark attack on a yearling bottlenose dolphin yielded 8 years of macroscopic markers on a live recuperating dolphin by known days of healing. In total, 106 healing histories were generated from the author’s 20-year ethological study of free-ranging bottlenose dolphins (Tursiops truncatus) in St. Petersburg, FL, USA. Results show that unaided wound healing at sea involves two consecutive macroscopic pigment patterns, wounds form preliminary seals by 4–8 weeks, and most heal to atrophic scars that remodel for years. Macroscopic markers in live recuperating dolphins show strong matches with macroscopic wound patterns in stranded Fraser’s dolphins (Lagenodelphis hosei), demonstrating links between macroscopic markers and immune activities. This is the first study to link macroscopic markers visible as healing-related pigment patterns to immunity. Macroscopic markers are conservation tools for tracking anthropogenic impacts on increased susceptibility to infection at sea and could lead to novel therapies in veterinary and human regenerative medicine. Full article

Bacterial infections remain a major challenge to human health, especially in wound healing, where they can cause prolonged inflammation, delayed recovery, and severe complications. Current research is increasingly focused on developing innovative antimicrobial materials capable of overcoming the limitations of conventional antibiotics, whose effectiveness has declined due to the rise in bacterial resistance. Among the various alternatives, silver nanoparticles have gained particular attention for their broad-spectrum antibacterial properties and have already been successfully applied in the functionalization of commercial wound dressings. The aim of this study was to optimize the functionalization of commercial cotton gauzes based on in situ UV-assisted reduction of silver nanoparticles, reducing methanol usage and identifying the minimal silver nitrate precursor concentration to achieve antimicrobial efficacy while maintaining biocompatibility. Different precursor concentrations were then evaluated through cytocompatibility assays (MTT, Live/Dead, and scratch tests on fibroblasts) and antimicrobial analyses against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus (including an antibiotic-resistant strain), and Candida albicans. The results demonstrated that a 0.5% w/w silver nitrate concentration provided strong antimicrobial and antibiofilm activity without compromising textile properties or cytocompatibility. Furthermore, this optimized process reduced material waste, highlighting its potential for scalable production of antimicrobial wound dressings. Full article

This study addresses the critical need for advanced biomedical materials that possess both potent antimicrobial properties and high biocompatibility to prevent device-related infections and promote healing. To this end, we demonstrate the successful development and comprehensive characterization of functional composite materials based on a photopolymerizable acrylate resin modified with laser-ablated copper nanoparticles (Cu NPs). The synthesized Cu NPs exhibited a monomodal size distribution with a peak at 47 nm, a high zeta potential of −33 mV, and a spherical morphology. Incorporation of Cu NPs into the polymer matrix via Masked Stereolithography (MSLA) enabled the fabrication of complex structures that maintained high surface quality and optical transparency after polishing. Modification of photopolymer resin with Cu NPs significantly increased the strength of the resulting products and caused dose-dependent formation of reactive oxygen species (ROS). The resulting composite materials exhibited strong antibacterial activity against E. coli. Crucially, despite their potent antimicrobial efficacy, the materials showed no cytotoxicity towards human fibroblast cultures. These results highlight the potential of these composites for a new generation of biomedical applications, such as implantable devices and wound coatings, which combine programmable antimicrobial activity with high biocompatibility. Full article