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由负载藻酸盐的天然乳胶制成的高吸收性敷料,用于控制糖尿病伤口的渗出液并促进愈合。

Highly absorptive dressing composed of natural latex loaded with alginate for exudate control and healing of diabetic wounds.

作者信息

Barros Natan Roberto, Ahadian Samad, Tebon Peyton, Rudge Marilza Vieira Cunha, Barbosa Angélica Mércia Pascon, Herculano Rondinelli Donizetti

机构信息

Department of Bioprocess and Biotechnology Engineering, São Paulo State University (Unesp), School of Pharmaceutical Sciences, Araraquara, SP 14801-902, Brazil; Department of Biochemistry and Organic Chemistry, São Paulo State University (Unesp), Institute of Chemistry, Araraquara, SP 14800-060, Brazil; Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA.

Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA; Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, Los Angeles, CA 90095, USA; Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, University of California-Los Angeles, Los Angeles, CA 90095, USA.

出版信息

Mater Sci Eng C Mater Biol Appl. 2021 Feb;119:111589. doi: 10.1016/j.msec.2020.111589. Epub 2020 Sep 30.

Abstract

Wounds can take longer to heal in diabetic patients, increasing the risk of infections and other complications. The most common wounds in diabetic patients are diabetic foot ulcers, a severe complication associated with diabetes mellitus. The United States alone spends $18.7 billion annually on care for these wounds including pain and infection management. If improperly managed, infected lesions may require amputation. The enormous cost associated with wound care and the dire consequences if not cared for properly, emphasize the need to develop strategies to accelerate the healing of diabetic foot wounds. Natural rubber latex (NRL), extracted from Hevea brasiliensis (the rubber tree), has been widely applied as a carrier system for several pharmacologically active compounds. Furthermore, it has been shown to encourage angiogenesis, facilitate cell adhesion, and accelerate wound healing. When NRL dressings are applied to wounds of diabetic patients, exudate release is upregulated. The production of exudate is essential to wound healing as it provides the nutrients, proteins, cells, and environment required for regeneration. Despite its benefits, it is necessary to control excess exudate to avoid prolonged healing resulting from dermatitis, maceration of the wound edges, and lesion growth. In order to solve the problem of excessive exudate release induced by NRL membrane application, we aimed to regulate humidity by absorbing excess exudate and increase water vapor transmission. We developed a highly absorptive, permeable, alginate loaded NRL dressing. Adding alginate to NRL membranes, swelling was increased up to 80-fold, absorbing 4.80 g of water per gram of dry membrane. Moreover, water vapor transmission was improved drastically as the material transmitted 480% more water vapor than pure NRL membranes. Furthermore, in vitro tests demonstrated not only that the membranes are biocompatible, but that they also enhance cell proliferation. Through a cell proliferation assay, we observed that fibroblast proliferation was improved by the presence of NRL while the keratinocytes benefit from the presence of alginate. The NRL-alginate dressings have great potential to improve diabetic wound care by accelerating the healing process.

摘要

糖尿病患者的伤口愈合时间可能更长,这增加了感染和其他并发症的风险。糖尿病患者最常见的伤口是糖尿病足溃疡,这是一种与糖尿病相关的严重并发症。仅在美国,每年就花费187亿美元用于这些伤口的护理,包括疼痛和感染管理。如果处理不当,感染的伤口可能需要截肢。伤口护理的巨大成本以及处理不当的严重后果,凸显了制定加速糖尿病足伤口愈合策略的必要性。天然橡胶乳胶(NRL),从巴西橡胶树(橡胶树)中提取,已被广泛用作几种药理活性化合物的载体系统。此外,它已被证明能促进血管生成、促进细胞粘附并加速伤口愈合。当NRL敷料应用于糖尿病患者的伤口时,渗出物释放会上调。渗出物的产生对伤口愈合至关重要,因为它提供了再生所需的物质、细胞和环境。尽管有这些益处,但有必要控制过多的渗出物,以避免因皮炎、伤口边缘浸渍和病变生长导致愈合时间延长。为了解决应用NRL膜引起的渗出物过度释放问题,我们旨在通过吸收多余的渗出物来调节湿度并增加水蒸气透过率。我们开发了一种高吸收性、渗透性的载藻酸盐NRL敷料。向NRL膜中添加藻酸盐后,肿胀增加了80倍,每克干膜可吸收4.80克水。此外,水蒸气透过率大幅提高,因为该材料传输的水蒸气比纯NRL膜多480%。此外,体外测试表明,这些膜不仅具有生物相容性,而且还能促进细胞增殖。通过细胞增殖试验,我们观察到NRL的存在促进了成纤维细胞的增殖,而角质形成细胞则受益于藻酸盐的存在。NRL-藻酸盐敷料在加速愈合过程以改善糖尿病伤口护理方面具有巨大潜力。

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