Recent advances on the development of wound dressings for diabetic foot ulcer treatment—A review

Abstract

a b s t r a c tDiabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches.

Chitosan as a starting material for wound healing applications

“…Other chitosan derivatives developed for other purposes have also been described in literature in the context of wound healing (Alves & Mano, 2008;Casettari et al, 2012;Francesko & Tzanov, 2011;Park et al, 2010). Specifically, for diabetic wounds, where healing fails, other chitosan derivatives have been proposed (Moura et al 2013) to increase fibroblast migration and collagen deposition in diabetic mice (Moura et al 2014). …”

Alginate–lavender nanofibers with antibacterial and anti-inflammatory activity to effectively promote burn healing

“…The release profile of linalool from SA-PEO/LO nanofibers was investigated by high-resolution LC-MS/MS at different time points (3,6,12,24, and 48 hours), as shown in Figure 3. Together with linalool, caryophillene and caryophillene oxide, which are other characteristic components of lavender oil, were also analysed (Fig.…”

“…3 Among these, alginate-based dressings are attractive for their capability to release bioactive compounds and to maintain a moist environment around the wound, promoting tissue granulation and re-epithelialization. [4][5][6][7][8] Typically they are available in form of freeze-dried foams or non-woven microfibers, though great research interest is nowadays devoted towards nanofibrous matrices. In particular, nanofibers produced by electrostatic spinning have high potentiality in the wound healing field because their porosity promotes nutrient transport and gas permeation, their morphological organization mimics the native tissue, and their mechanical properties can be engineered.…”

Synergistic effect of poly(acrylamide)-incorporated poly(L-ascorbic acid) hydrogels in controlled release and wound dressings

“…[2][3][4][5][6] After intimate contact is established, the rate and duration of drug release depends on the swelling behavior of the hydrogel. [1,7] The usual duration of treatment for fungal or yeast skin infection has been 2-4 weeks (topical therapy) or 3-6 weeks (oral therapy) but shorter courses of topical terbinafine hydrochloride (TER-HCl) (1-2 weeks) were as effective as standard duration therapy in dermatomycose. [16] This TER-HCl is a topically and orally active allylamine antifungal agent that appears to act by preventing fungal ergosterol biosynthesis via specific and selective inhibition of fungal squale oxidase.…”

“…and their respective copolymers. [7,8] A large number of dressings are currently used in the management of burns, split graft donor sites, chronic ulcers, decubitus ulcers, and so on. [9][10][11][12] One of the most important polymeric materials is PAAm-based hydrogels that are blood compatible biomaterials which find applications in coating for catheters, and particularly manufacturing of wound dressings and controlled release devices.…”