Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in&amp;nbsp;vitro evaluation of their compatibility with healing processes

Grützner, Verena; Unger, Ronald E.; Baier, Grit; Choritz, Lars; Freese, Christian; Böse, Thomas; Landfester, Katharina; Kirkpatrick, Charles James

doi:10.2147/ijn.s81263

Cited by 19 publications

(7 citation statements)

References 26 publications

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“…Among them, is the use of PHMB associated with nanocarriers, on WDs prepared by additive manufacturing and on smart electronic WD platforms. With the exception of electrospun membranes and of a recent PRM (PRM19) that employed PHMB encapsulated in nanoliposomes, the use of nanocarriers in combination with PHMB has been little explored; a small number of studies with PHMB involving nanocarriers exist [212][213][214][215][216], but the resulting nanosystems are yet to be included in membranes. WDs prepared by 3D printing offer on-demand manufacture of WDs with shapes conforming to a particular body location in a particular patient [217][218][219].…”

Section: Discussionmentioning

confidence: 99%

Novel Polyhexanide-Releasing Membranes for Antimicrobial Wound Dressings: A Critical Review

Guiomar¹,

Urbano²

2022

Preprint

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The prevalence for chronic, non-healing skin wounds in the general population, most notably diabetic foot ulcers, venous leg ulcers and pressure ulcers, is approximately 2% and is expected to increase, driven mostly by an aging population and the steady rise in obesity and diabetes. Non-healing wounds often become infected, increasing the risk of life-threatening complications, which poses a significant socioeconomic burden. Aiming at an improved management of infected wounds, a variety of wound dressings incorporating antimicrobials (AMDs), namely polyhexanide (poly(hexamethylene biguanide); PHMB), have been introduced in the wound care market. However, many wound care professionals agree that none shows comprehensive and optimal antimicrobial activity. This manuscript summarizes and discusses studies on novel PHMB-releasing membranes (PRMs) for wound dressings, detailing their preparation, physical properties relevant in the context of AMDs, drug loading and release, antibacterial activity, biocompatibility, wound healing capacity, and clinical trials conducted. Some of these PRMs were able to improve wound healing in in vivo models, with no associated cytotoxicity, but significant differences in study design make it difficult to compare overall effi-cacies. It is hoped that this review, which includes, whenever available, international standards for testing AMDs, will provide a framework for future studies.their preparation, physical properties relevant in the context of AMDs, drug loading and release, antibacterial activity, biocompatibility, wound healing capacity, and clinical trials conducted. Some of these PRMs were able to improve wound healing in in vivo models, with no associated cytotoxicity, but significant differences in study design make it difficult to compare overall efficacies. It is hoped that this review, which includes, whenever available, international standards for testing AMDs, will provide a framework for future studies.

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Section: Discussionmentioning

confidence: 99%

Novel Polyhexanide-Releasing Membranes for Antimicrobial Wound Dressings: A Critical Review

Guiomar¹,

Urbano²

2022

Preprint

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“…PHMB-based antiseptics introduce low tissue-toxicity, whereas other antiseptics (e.g., PVP-I and octenidine) have significant impact on cell viability 106 (although other studies have shown low cytotoxicity of HOCl to cells 107 ). Laboratory studies have shown that PHMB (or solutions containing PHMB) affect cells in a variety of ways in terms of cytotoxicity: several studies show no or low-level cell cytotoxicity 106,[108][109][110] whilst others show significant levels of toxicity to cells. 111 Kramer al (2019) 104 comparing an extensive number of antiseptics for the antibacterial activity against test organisms and assessing the cytotoxicity on cultured cells found that PHMB was one of the most suitable antimicrobial agents for use wound antisepsis.…”

Section: Broad-spectrum Efficacy Of Phmbmentioning

confidence: 99%

Effectiveness of a polyhexamethylene biguanide-containing wound cleansing solution using experimental biofilm models

Rippon

Rogers

Westgate³

et al. 2023

J Wound Care

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Objective: Antiseptics are widely used in wound management to prevent or treat wound infections, and have been shown to have antibiofilm efficacy. The objective of this study was to assess the effectiveness of a polyhexamethylene biguanide (PHMB)-containing wound cleansing and irrigation solution on model biofilm of pathogens known to cause wound infections compared with a number of other antimicrobial wound cleansing and irrigation solutions. Method: Staphylococcus aureus and Pseudomonas aeruginosa single-species biofilms were cultured using microtitre plate and Centers for Disease Control and Prevention (CDC) biofilm reactor methods. Following a 24-hour incubation period, the biofilms were rinsed to remove planktonic microorganisms and then challenged with wound cleansing and irrigation solutions. Following incubation of the biofilms with a variety of concentrations of the test solutions (50%, 75% or 100%) for 20, 30, 40, 50 or 60 minutes, remaining viable organisms from the treated biofilms were quantified. Results: The six antimicrobial wound cleansing and irrigation solutions used were all effective in eradicating Staphylococcus aureus biofilm bacteria in both test models. However, the results were more variable for the more tolerant Pseudomonas aeruginosa biofilm. Only one of the six solutions (sea salt and oxychlorite/NaOCl-containing solution) was able to eradicate Pseudomonas aeruginosa biofilm using the microtitre plate assay. Of the six solutions, three (a solution containing PHMB and poloxamer 188 surfactant, a solution containing hypochlorous acid (HOCl) and a solution containing NaOCl/HOCl) showed increasing levels of eradication of Pseudomonas aeruginosa biofilm microorganisms with increasing concentration and exposure time. Using the CDC biofilm reactor model, all six cleansing and irrigation solutions, except for the solution containing HOCl, were able to eradicate Pseudomonas aeruginosa biofilms such that no viable microorganisms were recovered. Conclusion: This study demonstrated that a PHMB-containing wound cleansing and irrigation solution was as effective as other antimicrobial wound irrigation solutions for antibiofilm efficacy. Together with the low toxicity, good safety profile and absence of any reported acquisition of bacterial resistance to PHMB, the antibiofilm effectiveness data support the alignment of this cleansing and irrigation solution with antimicrobial stewardship (AMS) strategies.

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“…No cytotoxicity was seen towards 3T3 fibroblasts, while good anti-bacterial and anti-inflammatory effects were observed (the latter due to TA-induced inhibition of NO generation in activated human macrophages). Grützner et al [301] studied the effect of enzyme-sensitive antimicrobial nanoplatforms loaded with polyhexanide biguanide (cationic polymer) and octenidine (cationic surfactant) for prophylaxis against infection in cutaneous burns. The results showed time-dependent cellular uptake, along with no major effect on expression of cytokines and pro-inflammatory molecules by endothelial cells, insignificant cytotoxicity compared to solutions of antiseptic agents, and no inhibition of angiogenesis.…”

Section: Nanotechnology For Treatment Of Burn Infections and Woundmentioning

confidence: 99%

Nanomedicine and advanced technologies for burns: Preventing infection and facilitating wound healing

Jahromi

Zangabad

Basri

et al. 2018

Advanced Drug Delivery Reviews

375

189

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According to the latest report from the World Health Organization, an estimated 265,000 deaths still occur every year as a direct result of burn injuries. A widespread range of these deaths induced by burn wound happens in low- and middle-income countries, where survivors face a lifetime of morbidity. Most of the deaths occur due to infections when a high percentage of the external regions of the body area is affected. Microbial nutrient availability, skin barrier disruption, and vascular supply destruction in burn injuries as well as systemic immunosuppression are important parameters that cause burns to be susceptible to infections. Topical antimicrobials and dressings are generally employed to inhibit burn infections followed by a burn wound therapy, because systemic antibiotics have problems in reaching the infected site, coupled with increasing microbial drug resistance. Nanotechnology has provided a range of molecular designed nanostructures (NS) that can be used in both therapeutic and diagnostic applications in burns. These NSs can be divided into organic and non-organic (such as polymeric nanoparticles (NPs) and silver NPs, respectively), and many have been designed to display multifunctional activity. The present review covers the physiology of skin, burn classification, burn wound pathogenesis, animal models of burn wound infection, and various topical therapeutic approaches designed to combat infection and stimulate healing. These include biological based approaches (e.g. immune-based antimicrobial molecules, therapeutic microorganisms, antimicrobial agents, etc.), antimicrobial photo- and ultrasound-therapy, as well as nanotechnology-based wound healing approaches as a revolutionizing area. Thus, we focus on organic and non-organic NSs designed to deliver growth factors to burned skin, and scaffolds, dressings, etc. for exogenous stem cells to aid skin regeneration. Eventually, recent breakthroughs and technologies with substantial potentials in tissue regeneration and skin wound therapy (that are as the basis of burn wound therapies) are briefly taken into consideration including 3D-printing, cell-imprinted substrates, nano-architectured surfaces, and novel gene-editing tools such as CRISPR-Cas.

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Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes

Cited by 19 publications

References 26 publications

Novel Polyhexanide-Releasing Membranes for Antimicrobial Wound Dressings: A Critical Review

Novel Polyhexanide-Releasing Membranes for Antimicrobial Wound Dressings: A Critical Review

Effectiveness of a polyhexamethylene biguanide-containing wound cleansing solution using experimental biofilm models

Nanomedicine and advanced technologies for burns: Preventing infection and facilitating wound healing

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