Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, 91058 Erlangen, Germany.
Acta Biomater. 2020 Apr 15;107:25-49. doi: 10.1016/j.actbio.2020.02.022. Epub 2020 Feb 19.
Globally, chronic wounds impose a notable burden to patients and healthcare systems. Such skin wounds are readily subjected to bacteria that provoke inflammation and hence challenge the healing process. Furthermore, bacteria induce infection impeding re-epithelialization and collagen synthesis. With an estimated global market of $20.4 billion by 2021, appropriate wound dressing materials e.g. those composed of biopolymers originating from nature, are capable of alleviating the infection incidence and of accelerating the healing process. Particularly, biopolymeric nanofibrous dressings are biocompatible and mostly biodegradable and biomimic the extracellular matrix structure. Such nanofibrous dressings provide a high surface area and the ability to deliver antibiotics and antibacterial agents locally into the wound milieu to control infection. In this regard, with the dangerous evolution of antibiotic resistant bacteria, antibiotic delivery systems are being gradually replaced with antibacterial biohybrid nanofibrous wound dressings. This emerging class of wound dressings comprises biopolymeric nanofibers containing antibacterial nanoparticles, nature-derived compounds and biofunctional agents. Here, the most recent (since 2015) developments of antibacterial biopolymeric nanofibrous wound dressings, particularly those made of biohybrids, are reviewed and their antibacterial efficiency is evaluated based on a comprehensive literature analysis. Lastly, the prospects and challenges are discussed to draw a roadmap for further progresses and to open up future research avenues in this area. STATEMENT OF SIGNIFICANCE: With a global market of $20.4 billion by 2021, skin wound dressings are a crucial segment of the wound care industry. As an advanced class of bioactive wound dressing materials, natural polymeric nanofibers loaded with antibacterial agents, e.g. antimicrobial nanoparticles/ions, nature-derived compounds and biofunctional agents, have shown a remarkable potential for replacement of their classic counterparts. Also, given the expanding concern regarding antibiotic resistant bacteria, such biohybrid nanofibrous wound dressings can outperform classical drug delivery systems. Here, an updated overview of the most recent (since 2015) developments of antibacterial biopolymeric nanofibrous wound dressings is presented. In this review, while discussing about the antibacterial efficiency of such systems, the prospects and challenges are highlighted to draw a roadmap for further progresses in this area.
全球范围内，慢性伤口给患者和医疗系统带来了显著负担。这种皮肤伤口很容易受到细菌的感染，从而引发炎症，进而影响愈合过程。此外，细菌感染会阻碍上皮细胞的再形成和胶原蛋白的合成。预计到 2021 年，全球市场规模将达到 204 亿美元，因此，合适的伤口敷料材料，例如那些由天然来源的生物聚合物组成的材料，能够降低感染发生率并加速愈合过程。特别是，生物聚合物纳米纤维敷料具有生物相容性，大多可生物降解，并模仿细胞外基质的结构。这种纳米纤维敷料提供了较大的表面积，并能够将抗生素和抗菌剂局部递送到伤口环境中，以控制感染。在这方面，随着抗生素耐药菌的危险演变，抗生素递送系统正逐渐被具有抗菌作用的生物杂交纳米纤维伤口敷料所取代。这种新兴的伤口敷料类别包括含有抗菌纳米粒子、天然衍生化合物和生物功能制剂的生物聚合物纳米纤维。在此，综述了自 2015 年以来具有抗菌作用的生物聚合物纳米纤维伤口敷料的最新（自 2015 年以来）发展，并通过全面的文献分析评估了它们的抗菌效率。最后，讨论了前景和挑战，为进一步发展制定了路线图，并为该领域的未来研究开辟了新途径。意义声明：预计到 2021 年，全球市场规模将达到 204 亿美元，皮肤伤口敷料是伤口护理行业的一个重要组成部分。作为一种先进的生物活性伤口敷料材料，天然聚合物纳米纤维负载抗菌剂，例如抗菌纳米粒子/离子、天然衍生化合物和生物功能制剂，已显示出取代其经典对应物的巨大潜力。此外，鉴于人们对抗生素耐药菌的担忧不断扩大，这种生物杂交纳米纤维伤口敷料的性能优于传统的药物递送系统。本文综述了自 2015 年以来具有抗菌作用的生物聚合物纳米纤维伤口敷料的最新发展。在讨论这些系统的抗菌效率时，强调了前景和挑战，为该领域的进一步发展制定了路线图。
