Saberianpour Shirin, Melotto Gianluca, Forss Rachel, Redhead Lucy, Sandeman Susan, Terrazzini Nadia, Sarker Dipak, Santin Matteo
Centre for Regenerative Medicine and Devices, University of Brighton, Brighton, United Kingdom.
School of Applied Sciences, Brighton, United Kingdom.
PLoS One. 2025 Jan 24;20(1):e0317258. doi: 10.1371/journal.pone.0317258. eCollection 2025.
Diabetic foot, leg ulcers and decubitus ulcers affect millions of individuals worldwide leading to poor quality of life, pain and in several cases to limb amputations. Despite the global dimension of this clinical problem, limited progress has been made in developing more efficacious wound dressings, the design of which currently focusses on wound protection and control of its exudate volume. The present in vitro study systematically analysed seven types of clinically-available wound dressings made of different biomaterial composition and engineering. Their physicochemical properties were analysed by infrared spectroscopy, swelling and evaporation tests and variable pressure scanning electron microscopy. These properties were linked to the interactions with inflammatory cells in simulated normoglycaemic and hyperglycaemic conditions. It was observed that the swelling behaviour and evaporation prevention at different glucose levels depended more on the engineering of the fibres than on the hydrophilicity and hydrophobicity of their biomaterials. Likewise, the data show that the engineering of the dressings as either non-woven or woven or knitted fibres seems to determine the swelling behaviour and interactions with inflammatory cells more than their polymer composition. Dressings presenting absorbent layers made of synthetic, non-woven fibres supported the adhesion of monocytes macrophages and stimulate the release of factors known to play a role in the chronic inflammation. Non-woven absorbent layers based on carboxymethyl cellulose mainly stimulating the iNOS, an enzyme producing free radicals; in the case of Kerracel this was combined with a swelling of fibres preventing the penetration of cells. Kaltostat, an alginate-based wound dressing, showed the higher level of swelling and supporte the adhesion of inflammatory cells with limited activation. Knitted dressings showed a limited adhesion of inflammatory cells. In conclusion, this work offers insights about the interactions of these wound dressings with inflammatory cells upon exudate changes thus providing further criteria of choice to clinicians.
糖尿病足、腿部溃疡和褥疮影响着全球数百万人,导致生活质量下降、疼痛,在某些情况下还会导致肢体截肢。尽管这一临床问题具有全球性,但在开发更有效的伤口敷料方面进展有限,目前伤口敷料的设计主要集中在伤口保护和渗出液量的控制上。本体外研究系统分析了七种临床上可用的、由不同生物材料组成和工艺制成的伤口敷料。通过红外光谱、膨胀和蒸发试验以及可变压力扫描电子显微镜对其物理化学性质进行了分析。这些性质与在模拟正常血糖和高血糖条件下与炎症细胞的相互作用有关。研究发现,不同葡萄糖水平下的膨胀行为和防蒸发性能更多地取决于纤维的工艺,而非生物材料的亲水性和疏水性。同样,数据表明,敷料作为非织造、织造或针织纤维的工艺似乎比其聚合物组成更能决定膨胀行为和与炎症细胞的相互作用。具有合成非织造纤维制成的吸收层的敷料支持单核细胞巨噬细胞的黏附,并刺激已知在慢性炎症中起作用的因子的释放。基于羧甲基纤维素的非织造吸收层主要刺激诱导型一氧化氮合酶(iNOS),一种产生自由基的酶;就Kerracel而言,这与纤维膨胀相结合,可防止细胞渗透。藻酸盐基伤口敷料Kaltostat表现出较高的膨胀水平,并在有限激活的情况下支持炎症细胞的黏附。针织敷料显示出炎症细胞的黏附有限。总之,这项工作提供了关于这些伤口敷料在渗出液变化时与炎症细胞相互作用的见解,从而为临床医生提供了进一步的选择标准。
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