壳聚糖基多功能氧合抗生素水凝胶敷料用于治疗糖尿病伤口慢性感染。
Chitosan-based multifunctional oxygenating antibiotic hydrogel dressings for managing chronic infection in diabetic wounds.
机构信息
Department of Chemical, Biomolecular, and Corrosion Engineering, The University of Akron, Akron, Ohio 44325, USA.
Integrated Biosciences Program, Department of Biology, The University of Akron, Akron, Ohio 44325, USA.
出版信息
Biomater Sci. 2024 Jun 25;12(13):3458-3470. doi: 10.1039/d4bm00355a.
Current treatment strategies for infection of chronic wounds often result in compromised healing and necrosis due to antibiotic toxicity, and underlying biomarkers affected by treatments are not fully known. Here, a multifunctional dressing was developed leveraging the unique wound-healing properties of chitosan, a natural polysaccharide known for its numerous benefits in wound care. The dressing consists of an oxygenating perfluorocarbon functionalized methacrylic chitosan (MACF) hydrogel incorporated with antibacterial polyhexamethylene biguanide (PHMB). A non-healing diabetic infected wound model with emerging metabolomics tools was used to explore the anti-infective and wound healing properties of the resultant multifunctional dressing. Direct bacterial bioburden assessment demonstrated superior antibacterial properties of hydrogels over a commercial dressing. However, wound tissue quality analyses confirmed that sustained PHMB for 21 days resulted in tissue necrosis and disturbed healing. Therefore, a follow-up comparative study investigated the best treatment course for antiseptic application ranging from 7 to 21 days, followed by the oxygenating chitosan-based MACF treatment for the remainder of the 21 days. Bacterial counts, tissue assessments, and lipidomics studies showed that 14 days of application of MACF-PHMB dressings followed by 7 days of MACF dressings provides a promising treatment for managing infected non-healing diabetic skin ulcers.
目前慢性伤口感染的治疗策略往往由于抗生素毒性而导致愈合受损和坏死,并且受治疗影响的潜在生物标志物尚未完全清楚。在这里,利用壳聚糖的独特伤口愈合特性开发了一种多功能敷料,壳聚糖是一种天然多糖,在伤口护理方面具有许多益处。该敷料由含氧全氟碳功能化甲基丙烯酰化壳聚糖(MACF)水凝胶与具有抗菌作用的聚六亚甲基双胍(PHMB)组成。使用具有新兴代谢组学工具的非愈合糖尿病感染性伤口模型来探索所得多功能敷料的抗感染和伤口愈合特性。直接细菌生物负荷评估表明水凝胶具有比商业敷料更好的抗菌性能。然而,伤口组织质量分析证实,持续 21 天使用 PHMB 会导致组织坏死和愈合受到干扰。因此,后续的对比研究调查了最佳的防腐剂应用疗程,从 7 天到 21 天不等,然后再用含氧壳聚糖基 MACF 治疗 21 天的剩余时间。细菌计数、组织评估和脂质组学研究表明,应用 MACF-PHMB 敷料 14 天,然后再应用 MACF 敷料 7 天,为治疗非愈合性糖尿病皮肤溃疡提供了一种有前途的方法。