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用于慢性伤口管理的基于聚合物的生物材料:前景与挑战。

Polymer-based biomaterials for chronic wound management: Promises and challenges.

机构信息

Department of Community Health Sciences, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan.

Department of Polymer Engineering & Technology, University of the Punjab Lahore, Pakistan.

出版信息

Int J Pharm. 2021 Apr 1;598:120270. doi: 10.1016/j.ijpharm.2021.120270. Epub 2021 Jan 21.

Abstract

Chronic non-healing wounds tender a great challenge to patients, physicians, and wound care professionals. In view of the increasing prevalence of chronic wounds due to ischemia, diabetic foot, venous, and pressure ulcers, their appropriate management requires significant attention. Along with the basic techniques of medical and surgical treatments; an ideal dressing is essential for a speedy recovery and rapid healing of such wounds. Mechanistic understanding of chronic wound pathology will not only help towards future directions for an ideal dressing model but also to resonant advance research related to specific dressings for various wound types. This review provides key insights into causes, pathophysiology, and critical issues pertaining to chronic wounds and their management. It also summarizes the challenges faced for chronic wound treatment and specified factors responsible for delayed healing. Moreover, this review delivers a detailed discussion on available polymeric materials (alginate, chitosan, hyaluronic acid, collagen, polyurethane, cellulose, dextran, gelatin, silk, and polyaniline), their functional characteristics, and usage as chronic wound healing agents for polymeric wound dressing development. Incorporation and comparison of the research studies for their thermal behavior, structural analysis, and microscopic studies by Fourier transform infrared spectroscopy, thermogravimetric analysis and scanning electron microscopy, respectively and swelling studies of different polymeric materials are discussed. Additionally, studies of anatomy cum physiology of wound healing, pathophysiology, tissue engineering and advance healing management approaches makes the content of this review a significant tool for future studies on chronic wounds healing by polymeric wound dressings. In this review, polymeric wound dressings have been explained in terms of their structures, function, chemistry, and key characteristics. These features are directly linked to the polymeric systems' potential in the management of chronic wounds. These polymeric systems have gained promising success in solving real word global health problems. More recently, innovative approaches to fabricate the polymer dressings have been introduced, but their commercial, sustainable, and high-scale production largely remains unexplored. This review also summarizes the promises of polymeric wound dressings and provides a future perspective on how the clinical and commercial landscape could potentially be propelled by utilizing polymers in wound care management.

摘要

慢性不愈合的伤口给患者、医生和伤口护理专业人员带来了巨大的挑战。鉴于缺血性、糖尿病足、静脉和压力性溃疡等慢性伤口的患病率不断增加,对其进行适当的治疗需要高度关注。除了医疗和手术治疗的基本技术外,对于此类伤口的快速康复和快速愈合,理想的敷料也是必不可少的。对慢性伤口病理学的机制理解不仅有助于为理想的敷料模型指明未来方向,也有助于促进与各种伤口类型特定敷料相关的研究进展。本综述提供了有关慢性伤口的原因、病理生理学和关键问题及其治疗的关键见解。它还总结了慢性伤口治疗面临的挑战和导致愈合延迟的特定因素。此外,本综述详细讨论了可用的聚合物材料(海藻酸盐、壳聚糖、透明质酸、胶原、聚氨酯、纤维素、葡聚糖、明胶、丝、聚苯胺)及其作为慢性伤口愈合剂用于聚合物伤口敷料开发的功能特性和用途。讨论了不同聚合物材料的热行为、结构分析和微观研究(分别通过傅里叶变换红外光谱、热重分析和扫描电子显微镜)以及溶胀研究的合并和比较研究。此外,伤口愈合的解剖学和生理学、病理生理学、组织工程和先进的愈合管理方法的研究也使得本综述的内容成为未来通过聚合物伤口敷料治疗慢性伤口的重要工具。在本综述中,聚合物伤口敷料是根据其结构、功能、化学性质和关键特性来解释的。这些特性与聚合物系统在慢性伤口管理中的潜力直接相关。这些聚合物系统在解决现实世界中的全球性健康问题方面取得了有希望的成功。最近,已经引入了制造聚合物敷料的创新方法,但它们的商业、可持续和大规模生产在很大程度上仍未得到探索。本综述还总结了聚合物伤口敷料的前景,并就如何利用聚合物在伤口护理管理中推动临床和商业前景提供了未来展望。

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