Luo Ruizeng, Liang Yi, Yang Jinrui, Feng Hongqing, Chen Ying, Jiang Xupin, Zhang Ze, Liu Jie, Bai Yuan, Xue Jiangtao, Chao Shengyu, Xi Yi, Liu Xiaoqiang, Wang Engui, Luo Dan, Li Zhou, Zhang Jiaping
Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, China.
Adv Mater. 2023 Apr;35(16):e2208395. doi: 10.1002/adma.202208395. Epub 2023 Mar 9.
The endogenous electric field (EF) generated by transepithelial potential difference plays a decisive role in wound reepithelialization. For patients with large or chronic wounds, negative-pressure wound therapy (NPWT) is the most effective clinical method in inflammation control by continuously removing the necrotic tissues or infected substances, thus creating a proproliferative microenvironment beneficial for wound reepithelialization. However, continuous negative-pressure drainage causes electrolyte loss and weakens the endogenous EF, which in turn hinders wound reepithelialization. Here, an electrogenerative dressing (EGD) is developed by integrating triboelectric nanogenerators with NPWT. By converting the negative-pressure-induced mechanical deformation into electricity, EGD produces a stable and high-safety EF that can trigger a robust epithelial electrotactic response and drive the macrophages toward a reparative M2 phenotype in vitro. Translational medicine studies confirm that EGD completely reshapes the wound EF weakened by NPWT, and promotes wound closure by facilitating an earlier transition of inflammation/proliferation and guiding epithelial migration and proliferation to accelerate reepithelialization. Long-term EGD therapy remarkably advances tissue remodeling with mature epithelium, orderly extracellular matrix, and less scar formation. Compared with the golden standard of NPWT, EGD orchestrates all the essential wound stages in a noninvasive manner, presenting an excellent prospect in clinical wound therapy.
经上皮电位差产生的内源性电场（EF）在伤口再上皮化过程中起决定性作用。对于大面积或慢性伤口患者，负压伤口治疗（NPWT）是通过持续清除坏死组织或感染物质来控制炎症的最有效临床方法，从而创造有利于伤口再上皮化的促增殖微环境。然而，持续的负压引流会导致电解质流失并削弱内源性EF，进而阻碍伤口再上皮化。在此，通过将摩擦纳米发电机与NPWT相结合开发了一种发电敷料（EGD）。通过将负压引起的机械变形转化为电能，EGD产生稳定且安全性高的EF，该EF可触发强大的上皮电趋化反应，并在体外驱动巨噬细胞向修复性M2表型转变。转化医学研究证实，EGD完全重塑了因NPWT而减弱的伤口EF，并通过促进炎症/增殖的更早转变以及引导上皮迁移和增殖以加速再上皮化来促进伤口闭合。长期的EGD治疗显著促进了具有成熟上皮、有序细胞外基质和较少瘢痕形成的组织重塑。与NPWT的黄金标准相比，EGD以非侵入性方式协调伤口的所有关键阶段，在临床伤口治疗中展现出极佳的前景。
