A moisturizing chitosan-silk fibroin dressing with silver nanoparticles-adsorbed exosomes for repairing infected wounds.

Refractory wounds caused by microbial infection impede wound healing, vascular regeneration, nerve system repair and the regeneration of other skin appendages. In addition, large-area infected wounds cause the appearance of multidrug-resistant (MDR) bacterial strains, which pose a major challenge both in clinical and scientific research. Although many stem cell-derived exosomes have been demonstrated to promote skin repair and regeneration, exosomes are seldom applied in the treatment of infective wounds due to the lack of antimicrobial function. In this study, we fabricated an asymmetric wettable dressing with a composite of exosomes and silver nanoparticles (CTS-SF/SA/Ag-Exo dressing) for promoting angiogenesis, nerve repair and infected wound healing. The CTS-SF/SA/Ag-Exo dressing possesses multifunctional properties including broad-spectrum antimicrobial activity, promoting wound healing, retaining moisture and maintaining electrolyte balance. It can effectively inhibit the growth of bacterial and promote the proliferation of human fibroblasts in vitro. Moreover, the in vivo results show that the CTS-SF/SA/Ag-Exo dressing enhanced wound healing by accelerating collagen deposition, angiogenesis and nerve repair in a P. aeruginosa infected mouse skin wound defect model. We hope that this dressing will provide a solution for the repair of infected wounds for treatments in the clinic.