Wound healing generally has four
stages: hemostasis, inflammation,
proliferation, and remolding. Most wound dressings only just take
one or two phases into account. Herein, to develop a novel wound dressing
that works at different stages, the blended alginate sodium/carboxymethyl
chitosan membranes with a hydrogel-like structure are fabricated through
a freeze-drying process together with a dual-ion (Sr2+ and
Zn2+) cross-linking approach. The fabricated membranes
show excellent properties in the swelling ratio, water vapor transmission
rate, tensile strength, sustained release, cell adhesiveness, and
biocompatibility, proving its general performance for application
in wound healing. In particular, the membranes with optimal ion concentrations
of 45 mM Sr2+ and 0.74 mM Zn2+ presented the
antibacterial activity and accelerating function of wound healing.
More specifically, the formation of epithelium and blood vessels is
evidently advanced compared with a commercial dressing in vivo experiment,
and the expression of main growth factors such as epidermal growth
factor, basic fibroblast growth factor, vascular endothelial growth
factor, and transforming growth factor is upregulated which also have
good effects on the remolding of skin. The prepared wound dressings
in this study have good effects on each stage of wound healing, which
is important for the healing of chronic wounds. It provides more choices
for wound healing, especially for chronic wound healing.
Clinical wound management is always a relatively urgent problem. Moreover, wounds, especially severe wounds with excessive tension or excessive movement are prone to tissue infection, necrosis, and other negative effects during healing. Therefore, research has aimed to develop low-cost complementary treatments to address the urgent need for an innovative low-cost dressing that can adapt to high mechanical requirements and complex wound conditions. At present, tissue engineering to produce artificial skin with a structure similar to that of normal skin is one effective method to solve this challenge in the regeneration and repair of serious wounds. The present study hot pressed flat silk cocoons (FSC) with carboxymethyl chitosan (CMCS) to generate a cross-linked binding without enzymes or cross-linking agents that simulated the 3D structural composites of the skin cuticle. This hybrid membrane showed potential to reduce inflammatory cells and promote neovascularization in skin wound repair. After hot pressing at 130°C and 20 Mpa, the FSC/CMCS composite material was denser than FSC, showed strong light transmission, and could be arbitrarily cut. Simulating the normal skin tissue structure, the hybrid membrane overcame the poor mechanical properties of traditional support materials. Moreover, the combination of protein and polysaccharide simulated the extracellular matrix, thus providing better biocompatibility. The results of this study also demonstrated the excellent mechanical properties of the FSC/CMCS composite support material, which also provided a low-cost and environmentally friendly process for making dressings. In addition, the results of this study preliminarily reveal the mechanism by which the scaffolds promoted the healing of full-thickness skin defects on the back of SD rats. In vivo experiments using a full-thickness skin defect model showed that the FSC/CMCS membranes significantly promoted the rate of wound healing and also showed good effects on blood vessel formation and reduced inflammatory reactions. This bionic support structure, with excellent repair efficacy on deep skin defect wounds, showed potential to further improve the available biomaterial systems, such as skin and other soft tissues.
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