Search Results (1,247)

Biomaterials modified by antibacterial substances, including nanoparticles, open new opportunities for the effective treatment of infected wounds. Unfortunately, most publications focused only on experiments in vitro, with limited understanding of their potential for the clinic. This study evaluates the effectiveness in vivo of electrospun chitosan/polylactic acid (Ch/PLA) membranes enriched with silver nanoparticles (AgNPs) for purulent wound treatment. The composite biomaterial integrates chitosan’s biocompatibility and antimicrobial activity with PLA’s structural integrity, while AgNPs enhance antibacterial efficacy against major wound pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia aureus. A full-thickness purulent wound model was established in a rat model, and the animals were divided into three treatment groups: (i) Ch/PLA, (ii) Ch/PLA-AgNPs, and (iii) PLA-chlorhexidine (control). Wound healing was monitored over 21 days through macroscopic evaluation, histology, immunohistochemistry, and microbiological analysis. The Ch/PLA-AgNPs membranes significantly reduced bacterial colonization within 4–6 days, promoted granulation tissue formation, and accelerated epithelialization compared to the non-modified Ch/PLA scaffold. By day 15, complete wound closure was observed in the Ch/PLA-AgNPs group, comparable to PLA-chlorhexidine-treated wounds. Immunohistochemical analysis revealed a controlled inflammatory response with a balanced macrophage M1/M2 transition, supporting efficient tissue regeneration. Furthermore, systemic toxicity assessments indicated no significant adverse effects on internal organs. These findings demonstrate that electrospun Ch/PLA-AgNPs membranes effectively accelerate purulent wound healing by combining antimicrobial protection with biocompatible tissue support. This innovative approach presents a promising alternative to conventional wound dressings and paves the way for clinical applications in managing infected wounds. Full article

Diabetic wounds are characterized by a refractory healing cycle resulting from the synergistic effects of hyperglycemic microenvironment, oxidative stress, bacterial infection, and impaired angiogenesis. Conventional hydrogel dressings, with limited functionality, struggle to address the complexities of chronic diabetic ulcers. Smart hydrogels, possessing biocompatibility, porous architectures mimicking extracellular matrix, and environmental responsiveness, have emerged as promising biomaterials for diabetic wound management. This review systematically elucidates the specific response mechanisms of smart hydrogels to wound microenvironmental stimuli, including pH, matrix metalloproteinase-9 (MMP-9), reactive oxygen species (ROS), and glucose levels, enabling on-demand release of antimicrobial agents and growth factors through dynamic bond modulation or structural transformations. Subsequently, the review highlights recent advances in novel hydrogel-based sensors fabricated via optical (photonic crystal, fluorescence) and electrochemical principles for real-time monitoring of glucose levels and wound pH. Finally, critical challenges in material development and scalable manufacturing of multifunctional hydrogel components are discussed, alongside prospects for precision diagnostics and therapeutics in diabetic wound care. Full article

Background: Urethral strictures impact millions, causing significant morbidity and millions in healthcare costs. Testing new interventions is limited by the lack of inexpensive urethral healing models. We developed an ex vivo model of early urethral wound healing using explanted rabbit urethral tissue. This was used to test the impact of six growth factors (GFs). Methods: The rabbit urethra was detubularized by cutting it between the corpora cavernosa, and then it was stitched flat using a custom 3D-printed platform. The tissue was carefully scratched to produce a visible wound, and the specimens were placed in media containing growth factors at 100 ng/mL and 10 ng/mL. Images were taken at 0, 24, 48, 72, and 96 h, and the wound area was measured by blinded reviewers to determine the rate of wound contraction. Results: Specimens with IGF at 100 ng/mL showed a statistically significant difference in wound contraction when compared to those with GF-free control medium, showing that IGF-1 supports early urethral epithelization and may improve healing. Conclusions: The developed protocol provides a simple explant platform that can be used to investigate methods of enhancing early phases of urethral healing or used to investigate other areas of urethral health, including drug delivery, infection, and mechanical properties. Full article

We describe the first use of phage therapy in Canada for the treatment of a life-threatening periprosthetic joint infection (PJI), with successful outcome. PJI is a devastating complication of joint replacement surgery, with high morbidity and mortality. Our patient presented with early sepsis from a chronic recalcitrant multidrug-resistant (MDR) Staphylococcus epidermidis hip PJI which had repeatedly failed standard therapy. She had previously undergone 10 operations of the right hip, and only three weeks after completing a prolonged course of daptomycin following her most recent hip revision, she developed a draining sinus tract. Given the high burden of disease, inability to achieve surgical source control, and lack of antibiotic treatment options for long-term suppressive therapy, bacteriophage (phage) therapy was pursued. The patient underwent irrigation and debridement with complex flap reconstruction: intraoperative tissue cultures again yielded MDR S. epidermidis. We developed a novel phage therapy protocol for this patient, with twice daily, intra-articular and intravenous (7 × 10⁹ PFU/dose) phage delivery over a planned 14-day course. Complete healing of the wound with cessation of drainage occurred within one month after treatment. A marked improvement in right hip pain and mobility occurred within three months after treatment. Twelve months following phage treatment, there is normalization of serum inflammatory markers with diminished pain, increased mobility, and no recurrent surgery. Our patient continues to improve and is currently living independently at home, with sustained clinical control of infection. Full article

The accelerating threat of antimicrobial resistance (AMR) demands transformative strategies that go beyond conventional antibiotic therapies. Nanoparticles (NPs) have emerged as versatile antimicrobial agents, offering a combination of physical, chemical, and immunological mechanisms to combat multidrug-resistant (MDR) pathogens. Their small size, surface tunability, and ability to disrupt microbial membranes, generate reactive oxygen species (ROS), and deliver antibiotics directly to infection sites position them as powerful tools for infection control. This narrative review explores the major classes, mechanisms of action, and biomedical applications of antimicrobial NPs—including their roles in wound healing, implant coatings, targeted drug delivery, inhalation-based therapies, and the treatment of intracellular infections. We also highlight the current landscape of clinical trials and evolving regulatory frameworks that govern the translation of these technologies into clinical practice. A distinctive feature of this review is its focus on the interplay between NPs and the human microbiota—an emerging frontier with significant implications for therapeutic efficacy and safety. Addressing this bidirectional interaction is essential for developing microbiota-informed, safe-by-design nanomedicines. Despite promising advances, challenges such as scalability, regulatory standardization, and long-term biosafety remain. With interdisciplinary collaboration and continued innovation, antimicrobial NPs could reshape the future of infectious disease treatment and help curb the growing tide of AMR. Full article

Bacterial infection is a cause of life-threatening diseases. The emergence of antimicrobial-resistant bacteria exacerbates this situation, highlighting the need for the discovery of new antimicrobial agents. Our previous study identified a novel antimicrobial peptide, BrSPR20-P1 (P1), which showed potential activity against MRSA. Additionally, silver nanoparticles (AgNPs) exhibit broad-spectrum antibacterial activity, capable of killing multidrug-resistant bacteria. The combination of antimicrobial agents presents a novel strategy for combating these pathogens. This study aimed to evaluate the antibacterial activity of the combination of P1 and AgNPs. It revealed that the combinations showed synergy. The P1 and AgNP mixture at a concentration of 1 and 8 µg/mL (1:8) doubled the activity against S. aureus and MRSA, while that combination of 64 and 64 µg/mL (64:64) exhibited broad-spectrum activity, expanding to E. coli with a 32-fold increase. These combinations exhibited a bactericidal effect, showing the rapid killing of tested bacteria at 10× MIC, with killing rates during the first 3 h ranging from 4.04 ± 0.01 to 4.31 ± 0.03 h⁻¹. The P1 and AgNP mixtures caused a low risk of antibacterial resistance up to 30 passages. It was demonstrated that the synergistic activity of P1 and AgNPs occurred through the disruption of cell walls and membranes, leakage of intracellular materials, and cell lysis. Additionally, the mixtures appeared to interact with bacterial genomic DNA, as indicated by a gel retardation assay. These activities of the combinations were concentration-dependent. The 1:8 µg/mL mixture caused low hemolysis and cytotoxicity and did not impede the wound healing process. In contrast, although the 64:64 µg/mL mixture showed excellent antibacterial efficacy, it was toxic to erythrocytes and mammalian cells. It implies that dose optimization is required to balance its efficacy and toxicity. Therefore, the P1 and AgNP combinations exhibit synergistic antimicrobial activity and have the potential to resolve bacterial infections. Full article

Wound healing is a physiological process including haemostasis, inflammation, proliferation, and remodelling. Acute wounds typically follow a predictable healing process, whereas chronic wounds cause prolonged inflammation and infection, failing to progress through typical healing phases and presenting significant clinical challenges. A combination of wound care techniques and therapeutic agents is required to manage chronic wounds effectively. Curcumin is a bioactive compound derived from Curcuma longa and has gained attention for its potent antioxidant, anti-inflammatory, and antibacterial properties. The first part of this review aims to provide a comprehensive overview of the physiology of wound healing, focusing on the pathophysiology and management of acute and chronic wounds, followed by the biological activity of curcumin in wound healing, emphasising its impact on promoting tissue repair. Finally, this review explores curcumin-loaded dressings, such as hydrogels, nanofibrous membranes, polymeric micelles, and films, offering controlled drug release and targeted curcumin delivery to enhance wound healing. Full article

Chronic wounds pose a great challenge due to their slow healing and susceptibility to infections, hence the need for innovative alternatives to conventional antibiotics, as increasing bacterial resistance limits the efficacy of current treatments. This paper addresses the development of novel electrospun membranes based on polyvinyl alcohol (PVA) and sodium alginate, incorporating therapeutic ZnO and bioglass (54SiO₂:40CaO:6P₂O₅) nanoparticles. While nanocomposites presented smaller fiber diameters than pure polymers, ternary nanocomposites displayed higher values, e.g., in porous areas, values were in the ca. 80–240 nm range and 0.06–0.60 μm², respectively. The Young’s modulus of the PVA/SA membrane, initially 15.9 ± 2.0 MPa, decreased by 65% with 10 wt.% ZnO NPs, whereas 10 wt.% BG NPs increased it by 100%. The membranes demonstrated efficacy against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) isolated from a human wound secretion, as well as two ATCC strains: Staphylococcus aureus and Staphylococcus epidermidis. A cell viability assay conducted with HaCaT cells demonstrated nearly complete survival following 72 h of membrane exposure. Their combined Gram-positive antibacterial activity and cytocompatibility support their potential application as biofunctional dressings for the management of chronic and hospital-acquired topical infections, while also contributing to the global effort to combat antibiotic resistance. Full article

Background: Larval debridement therapy is used to cleanse necrotic tissue wounds and/or decontaminate wounds that are not amenable to standard therapies. Methods: A patient was diagnosed with septic shock and multiple organ failure caused by Streptococcus pyogenes after thyroidectomy (the patient had experienced contact with a child with scarlet fever six days before admission to the hospital). As a result of systemic infection, numerous necrotic skin lesions appeared, which involved the surgical site, chest and scalp. A tracheocutaneous fistula was confirmed. Due to the ineffectiveness of typical therapy and the patient’s severe clinical condition, she qualified for unconventional therapy (larval debridement therapy). Results: Larval wound debridement therapy and negative-pressure wound therapy were used for the tracheocutaneous fistula; this is the first case of this alternative therapy being described in the English-language literature. In this case, based on an analysis of the health benefits for the patient and the uncertain prognosis, larval therapy was used for a postoperative wound after strumectomy with the presence of a tracheocutaneous fistula, and negative-pressure wound therapy ultimately led to complete wound healing. Conclusions: Sepsis caused by Streptococcus pyogenes can be fulminant and often leads to complications or death, especially if it develops in the perioperative period. Larval therapy can be effectively used in cases of fistulas, such as tracheocutaneous fistulas, to prepare the wound bed for the next stage of healing using negative-pressure therapy, which ultimately leads to complete wound healing. Full article

Oral infections and tissue defects remain significant clinical challenges, often requiring localized, sustained, and multifunctional therapeutic solutions. In this study, baicalein-loaded chitosan films were developed and comprehensively characterized as novel biomaterials for oral and maxillofacial applications. Using a 3² factorial design, nine film formulations were prepared via solvent casting, varying chitosan molecular weight and composition. Physicochemical and structural analyses (microscopy, SEM, FTIR, and XRPD) confirmed uniform drug distribution and matrix compatibility. Mechanical testing and dissolution studies demonstrated zero-order baicalein release kinetics, with controlled, sustained delivery influenced by chitosan content and molecular weight. The optimal formulation (F5: CS MMW 2%, Gel 2%) combined favorable mechanical integrity, drug release, and potent antioxidant and anti-inflammatory activities. Further evaluation on 3D anatomical models simulating bone and soft tissue defects highlighted excellent membrane adaptability, stability, and ease of handling under conditions mimicking clinical surgery. The films acted as effective barriers in guided tissue regeneration and donor site protection, with improved surgical visibility due to their baicalein-induced coloration. Biocompatibility assays confirmed the safety of the materials, while antibacterial testing demonstrated activity against Streptococcus mutans. These results support the potential of baicalein-loaded chitosan films as multifunctional membranes for regenerative dentistry, periodontal therapy, and peri-implant care. The modular formulation design provides a platform for future integration of additional bioactive agents, paving the way for personalized, advanced wound healing solutions. Full article

Infection control and bleeding management in deep wounds remain urgent and unmet clinical challenges that demand innovative, multifunctional, and sustainable solutions. Unlike previously reported sodium alginate and silk fibroin-based gel formulations, the present work introduces a dual-functional system combining antimicrobial and haemostatic activity in the form of conformable aerogel beads. This dual-functional formulation is designed to absorb exudate, promote clotting, and provide localized antimicrobial action, all essential for accelerating wound repair in high-risk scenarios within a single biocompatible system. Aerogel beads were obtained by supercritical drying of a silk fibroin–sodium alginate blend, resulting in highly porous, spherical structures measuring 3–4 mm in diameter. The formulations demonstrated efficient ciprofloxacin encapsulation (42.75–49.05%) and sustained drug release for up to 12 h. Fluid absorption reached up to four times their weight in simulated wound fluid and was accompanied by significantly enhanced blood clotting, outperforming a commercial haemostatic dressing. These findings highlight the potential of silk-based aerogel beads as a multifunctional wound healing platform that combines localized antimicrobial delivery, efficient fluid and exudate management, biodegradability, and superior haemostatic performance in a single formulation. This work also shows for the first time how the prilling encapsulation technique with supercritical drying is able to successfully produce silk fibroin and sodium alginate composite aerogel beads. Full article

Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article

Wound care in military and combat environments poses distinct challenges that set it apart from conventional medical practice in civilian settings. The nature of injuries sustained on the battlefield—often complex, contaminated, and involving extensive tissue damage—combined with limited access to immediate medical intervention, significantly increases the risk of infection, delayed healing, and adverse outcomes. Traditional wound dressings frequently prove inadequate under such extreme conditions, as they have not been designed to address the specific physiological and logistical constraints present during armed conflicts. This review provides a comprehensive overview of recent progress in the development of advanced wound dressings tailored for use in military scenarios. Special attention has been given to multifunctional dressings that go beyond basic wound coverage by incorporating biologically active macromolecules such as collagen, chitosan, thrombin, alginate, therapeutic peptides, and growth factors. These compounds contribute to properties including moisture balance control, exudate absorption, microbial entrapment, and protection against secondary infection. This review highlights the critical role of advanced wound dressings in improving medical outcomes for injured military personnel. The potential of these technologies to reduce complications, enhance healing rates, and ultimately save lives underscores their growing importance in modern battlefield medicine. Full article

Gingival recession is a common problem, particularly affecting oral health and esthetics, and its treatment involves surgical root coverage procedures. The aim of this narrative review is to evaluate the role of systemic antibiotic therapy in mucogingival surgery for recession treatment. The available literature does not support routine antibiotic use in systemically healthy patients undergoing recession coverage surgery. Indications for prophylactic antibiotics are restricted to individuals at high risk of infective endocarditis and immunocompromised patients with elevated susceptibility to surgical site infections. Although mucogingival surgeries are performed in a non-sterile environment, the risk of infection remains low when proper aseptic techniques and good preoperative tissue preparation are applied. The review emphasizes the importance of making clinical decisions that consider the patient’s health status and are aligned with current recommendations. It also emphasizes the necessity for prospective studies to evaluate antibiotics’ effect on recession coverage procedures outcome. To bridge the gap between contemporary evidence and clinical practice and to foster responsible use of antibiotics in periodontal plastic surgery, the authors of this review integrate current evidence and clinical guidelines into a practical tool designed to assist clinicians in making reasoned, evidence-based decisions. Full article

This review explores the emerging role of functionalized hydrogels in modulating the microbiome for therapeutic applications in tissue regeneration and infection control. The skin and gut microbiomes play crucial roles in maintaining tissue homeostasis, regulating immune responses, and influencing the healing process. Disruptions in microbial balance—such as those observed in chronic wounds, autoimmune conditions, or post-surgical environments—can impair regeneration and increase susceptibility to infection. Hydrogels, due to their tunable physical and chemical properties, serve as versatile platforms for delivering probiotics, prebiotics, antimicrobials, and immune-modulatory agents. The encapsulation of beneficial bacteria, such as Lactobacillus plantarum or Prevotella histicola, within hydrogels could enhance bacterial viability, targeted delivery, and immune tolerance. Additionally, hydrogels functionalized with silver nanoparticles, nitric oxide donors, and bacteriocins have demonstrated effective biofilm disruption and pathogen clearance. These systems also promote favorable immune responses, such as M2 macrophage polarization and the induction of regulatory T cells, which are essential for tissue repair. Innovative approaches, including 3D bioprinting, self-healing materials, and photothermal-responsive hydrogels, expand the clinical versatility of these systems. Full article