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构建多功能伤口敷料及其在慢性伤口治疗中的应用。

Construction of multifunctional wound dressings with their application in chronic wound treatment.

机构信息

National Engineering Research Center for Biomaterials, Chuanda-Jinbo Joint Research Center, Sichuan University, Chengdu, 610064, China.

出版信息

Biomater Sci. 2022 Jul 26;10(15):4058-4076. doi: 10.1039/d2bm00620k.

Abstract

As the prevalence of diabetes increases year by year and the aging population continues to intensify in the world, chronic wounds such as diabetic foot ulcers and pressure ulcers have become serious problems that threaten people's health, and have brought an enormous burden to the world healthcare system. Conventional clinical treatment of chronic wounds relies on non-specific topical care (including debridement, infection/inflammation control, and frequent wound dressing changes), which can alleviate disease progression and reduce patient suffering to a certain extent, but the overall cure rate is less than 50% and the recurrence rate is high. Traditional wound dressings such as gauze, hydrocolloids, films and foams are single-function, acting as a physical barrier or absorbing exudates, and cannot meet all the needs of the entire chronic wound healing process. Recently, a large number of novel functional dressings have been reported for chronic wound repair. Based on the progress on wound dressings in recent years and the relevant research experience of our group, the review summarizes and discusses the progress on multifunctional wound dressings (such as microneedles, sponges and hydrogels) with anti-inflammatory, antioxidant, antibacterial, pro-angiogenic and tissue adhesive functions in detail. At the same time, the various responsive mechanisms ( microenvironment or stimulation) of the smart multifunctional wound dressing are also analyzed in detail. It is expected that the review could provide some inspiration and suggestions for research on dressings for chronic wound treatment.

摘要

随着糖尿病患病率的逐年上升以及世界人口老龄化的不断加剧,糖尿病足溃疡和压疮等慢性创面已成为威胁人类健康的严重问题,给全球医疗体系带来了巨大负担。传统的慢性创面临床治疗主要依赖于非特异性的局部护理(包括清创、感染/炎症控制和频繁的创面敷料更换),这种方法在一定程度上可以缓解疾病进展,减轻患者痛苦,但总体治愈率低于 50%,且复发率较高。传统的创面敷料,如纱布、水胶体、薄膜和泡沫敷料等,功能单一,仅作为物理屏障或吸收渗出物,无法满足整个慢性创面愈合过程的所有需求。最近,大量新型功能性敷料被报道用于慢性创面修复。基于近年来创面敷料的进展以及我们课题组的相关研究经验,本文详细综述和讨论了具有抗炎、抗氧化、抗菌、促血管生成和组织黏附功能的多功能创面敷料(如微针、海绵和水凝胶)的研究进展。同时,还详细分析了智能多功能创面敷料的各种响应机制(微环境或刺激)。期望本文的综述能够为慢性创面治疗用敷料的研究提供一些启示和建议。

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