Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, People's Republic of China.
Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Int J Nanomedicine. 2024 Nov 15;19:11883-11921. doi: 10.2147/IJN.S484473. eCollection 2024.
Chronic wound infection has become a global health problem, with bacterial biofilms, which are difficult to penetrate using traditional antibiotics, considered the primary cause of recurrent infection and delayed healing in chronic wounds. In recent years, the outstanding performance of nanomaterials in controlling biofilm infections has been widely acknowledged, and these materials are regarded as highly promising for chronic wound infection management. The formation and structure of chronic wound biofilms undergo complex dynamic changes. Therefore, a deep understanding of the underlying causes of repeated wound infections and the specific antibacterial mechanisms of nanomaterials at different stages of biofilm formation is crucial for effective "chronic wound infection management". This review first reveals the relationship between biofilms, wound chronicity, and recurrent infections. Secondly, it focuses on the four stages of chronic wound biofilm formation: (1) adhesion stage, (2) aggregation and promotion stage, (3) maturation stage, and (4) regeneration and dissemination stage. It also comprehensively summarizes the specific antibacterial mechanisms of nanomaterials. This study analyzes essential factors affecting the control of chronic wound biofilms by nanoparticles from various perspectives, such as the material itself, the local wound environment, and the systemic host response. Finally, the limitations and potential future trends in current research are discussed. In summary, nanoparticles represent a promising strategy for combating chronic wound biofilm infections, and this review provides new insights for alternative adjuvant therapies in managing bacterial biofilm infections in chronic wounds.
慢性伤口感染已成为全球性健康问题,细菌生物膜被认为是导致慢性伤口反复感染和愈合延迟的主要原因,而传统抗生素难以穿透生物膜。近年来,纳米材料在控制生物膜感染方面的优异表现已得到广泛认可,被认为是慢性伤口感染管理极具前景的方法。慢性伤口生物膜的形成和结构会发生复杂的动态变化。因此,深入了解反复发生伤口感染的根本原因以及纳米材料在生物膜形成的不同阶段的具体抗菌机制,对于有效“管理慢性伤口感染”至关重要。本综述首先揭示了生物膜、伤口慢性化和反复感染之间的关系。其次,重点关注慢性伤口生物膜形成的四个阶段:(1)黏附阶段,(2)聚集和促进阶段,(3)成熟阶段,以及(4)再生和传播阶段。还全面总结了纳米材料的具体抗菌机制。本研究从纳米颗粒本身、局部伤口环境和全身宿主反应等多个角度分析了影响慢性伤口生物膜控制的关键因素。最后,讨论了当前研究的局限性和潜在的未来趋势。总之,纳米颗粒是一种有前途的治疗慢性伤口生物膜感染的策略,本综述为管理慢性伤口细菌生物膜感染的替代辅助治疗提供了新的见解。