scholarly journals Novel Chronic Wound Healing by Anti-biofilm Peptides and Protease

2021 ◽  
Author(s):  
Fatemeh Sadat Ghoreishi ◽  
Rasoul Roghanian ◽  
Giti Emtiazi
Keyword(s):  
Wound Healing ◽  
Antimicrobial Agents ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Antibacterial Properties ◽  
Paenibacillus Polymyxa ◽  
Bacterial Strains ◽  
Biofilm Production ◽  
Bacterial Protease ◽  
Biofilm Destruction

Chronic wounds have made a challenge in medical healthcare due to their biofilm infections, which reduce the penetrance of the antibacterial agents in the injury site. In infected wounds, the most common bacterial strains are Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa). Biofilm disruption in chronic wounds is crucial in wound healing. Due to their broad-spectrum antibacterial properties and fewer side effects, anti-biofilm peptides, especially bacteriocins, are promising in the healing of chronic wounds by biofilm destruction. This study reviews the effects of antimicrobial and anti-biofilm agents, including bacteriocins and protease enzymes as a novel approach, on wound healing, along with analyzing the molecular docking between a bacterial protease and biofilm components. Among a large number of anti-biofilm bacteriocins identified up to now, seven types have been registered in the antimicrobial peptides (AMPs) database. Although it is believed that bacterial proteases are harmful in wound healing, it has recently been demonstrated that these proteases like the human serine protease, in combination with AMPs, can improve wound healing by biofilm destruction. In this work, docking results between metalloprotease from Paenibacillus polymyxa (P. polymyxa) and proteins of S. aureus and P. aeruginosa involved in biofilm production, showed that this bacterial protease could efficiently interact with biofilm components. Infected wound healing is an important challenge in clinical trials due to biofilm production by bacterial pathogens. Therefore, simultaneous use of proteases or anti-biofilm peptides with antimicrobial agents could be a promising method for chronic wound healing.

scholarly journals Electrospun Antibacterial Nanomaterials for Wound Dressings Applications

Membranes ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 908
Author(s):  
Aysegul Gul ◽  
Izabela Gallus ◽  
Akshat Tegginamath ◽  
Jiri Maryska ◽  
Fatma Yalcinkaya
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Chronic Wounds ◽  
Antibacterial Properties ◽  
Electrospun Nanofibers ◽  
Electrospinning Process ◽  
Wound Dressings ◽  
Promising Solution

Chronic wounds are caused by bacterial infections and create major healthcare discomforts; to overcome this issue, wound dressings with antibacterial properties are to be utilized. The requirements of antibacterial wound dressings cannot be fulfilled by traditional wound dressing materials. Hence, to improve and accelerate the process of wound healing, an antibacterial wound dressing is to be designed. Electrospun nanofibers offer a promising solution to the management of wound healing, and numerous options are available to load antibacterial compounds onto the nanofiber webs. This review gives us an overview of some recent advances of electrospun antibacterial nanomaterials used in wound dressings. First, we provide a brief overview of the electrospinning process of nanofibers in wound healing and later discuss electrospun fibers that have incorporated various antimicrobial agents to be used in wound dressings. In addition, we highlight the latest research and patents related to electrospun nanofibers in wound dressing. This review also aims to concentrate on the importance of nanofibers for wound dressing applications and discuss functionalized antibacterial nanofibers in wound dressing.

scholarly journals Functional Mining of the Crotalus Spp. Venom Protease Repertoire Reveals Potential for Chronic Wound Therapeutics

Molecules ◽  
2020 ◽  
Vol 25 (15) ◽  
pp. 3401
Author(s):  
David Meléndez-Martínez ◽  
Luis Fernando Plenge-Tellechea ◽  
Ana Gatica-Colima ◽  
Martha Sandra Cruz-Pérez ◽  
José Manuel Aguilar-Yáñez ◽  
...  
Keyword(s):  
Wound Healing ◽  
Serine Proteases ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Wound Healing Process ◽  
Major Health Problem ◽  
Normal Wound Healing ◽  
Alternative Sources ◽  
Fibrin Clots

Chronic wounds are a major health problem that cause millions of dollars in expenses every year. Among all the treatments used, active wound treatments such as enzymatic treatments represent a cheaper and specific option with a fast growth category in the market. In particular, bacterial and plant proteases have been employed due to their homology to human proteases, which drive the normal wound healing process. However, the use of these proteases has demonstrated results with low reproducibility. Therefore, alternative sources of proteases such as snake venom have been proposed. Here, we performed a functional mining of proteases from rattlesnakes (Crotalus ornatus, C. molossus nigrescens, C. scutulatus, and C. atrox) due to their high protease predominance and similarity to native proteases. To characterize Crotalus spp. Proteases, we performed different protease assays to measure and confirm the presence of metalloproteases and serine proteases, such as the universal protease assay and zymography, using several substrates such as gelatin, casein, hemoglobin, L-TAME, fibrinogen, and fibrin. We found that all our venom extracts degraded casein, gelatin, L-TAME, fibrinogen, and fibrin, but not hemoglobin. Crotalus ornatus and C. m. nigrescens extracts were the most proteolytic venoms among the samples. Particularly, C. ornatus predominantly possessed low molecular weight proteases (P-I metalloproteases). Our results demonstrated the presence of metalloproteases capable of degrading gelatin (a collagen derivative) and fibrin clots, whereas serine proteases were capable of degrading fibrinogen-generating fibrin clots, mimicking thrombin activity. Moreover, we demonstrated that Crotalus spp. are a valuable source of proteases that can aid chronic wound-healing treatments.

scholarly journals Chitosan & Conductive PANI/Chitosan Composite Nanofibers - Evaluation of Antibacterial Properties

2019 ◽  
Vol 4 (1) ◽  
pp. 6-20 ◽  
Author(s):  
Panagiota Moutsatsou ◽  
Karen Coopman ◽  
Stella Georgiadou
Keyword(s):  
Chronic Wounds ◽  
Antibacterial Properties ◽  
Wound Dressings ◽  
Bacterial Strains ◽  
Healthcare Applications ◽  
E Coli ◽  
Jet Stability ◽  
Electrospun Membranes ◽  
New Treatments ◽  
Chitosan Composite

Background: Within the healthcare industry, including the care of chronic wounds, the challenge of antimicrobial resistance continues to grow. As such, there is a need to develop new treatments that can reduce the bioburden in wounds. Objective: The present study is focused on the development of polyaniline (PANI) / chitosan (CH) nanofibrous electrospun membranes and evaluates their antibacterial properties. Methods: To this end, experimental design was used to determine the electrospinning windows of both pure chitosan and PANI/CH blends of different ratios (1:3, 3:5, 1:1). The effect of key environmental and process parameters (relative humidity and applied voltage) was determined, as well as the effect of the PANI/CH ratio in the blend and the molecular interactions between PANI and chitosan that led to jet stability. Results: The nanofibrous mats were evaluated regarding their morphology and antibacterial effect against model gram positive and gram negative bacterial strains, namely B. subtilis and E. coli. High PANI content mats show increased bactericidal activity against both bacterial strains. Conclusion: The blend fibre membranes combine the materials’ respective properties, namely electrical conductivity, biocompatibility and antibacterial activity. This study suggests that electrospun PANI/CH membranes are promising candidates for healthcare applications, such as wound dressings.

Chronic wounds: the challenges of appropriate management

2019 ◽  
Vol 24 (Sup9) ◽  
pp. S26-S32 ◽  
Author(s):  
Leanne Atkin
Keyword(s):  
Wound Healing ◽  
Health Services ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Management ◽  
Product Selection ◽  
Wound Assessment ◽  
Moisture Balance ◽  
Selection For ◽  
Chronic Wound Management

The immense burden imposed by chronic wounds—those persisting over 6 weeks despite active intervention—on patients and health services is well recognised. There are various reasons for why a wound fails to progress towards closure, and clinicians must investigate the underlying cause of wound chronicity, as this information guides the management of such wounds. The TIME framework (T=tissue; I=infection/inflammation; M=moisture balance; E=wound edges) is a useful tool for practitioners to systematically undertake wound assessment and product selection. This article discusses chronic wound management based on the TIME framework, examining the aspects to be considered when managing chronic wounds. It also describes the process of dressing selection for overcoming the various barriers to wound healing, specifically discussing the AQUACEL family of dressings.

scholarly journals Antibacterial-Integrated Collagen Wound Dressing for Diabetes-Related Foot Ulcers: An Evidence-Based Review of Clinical Studies

Polymers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2168
Author(s):  
Ibrahim N. Amirrah ◽  
Mohd Farhanulhakim Mohd Razip Wee ◽  
Yasuhiko Tabata ◽  
Ruszymah Bt Hj Idrus ◽  
Abid Nordin ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Trials ◽  
Clinical Studies ◽  
Wound Dressing ◽  
Chronic Wounds ◽  
Gentian Violet ◽  
Antibacterial Properties ◽  
Small Sample ◽  
Wound Dressings ◽  
Sample Sizes

Diabetic foot ulcer (DFU) is a chronic wound frequently delayed from severe infection. Wound dressing provides an essential barrier between the ulcer and the external environment. This review aimed to analyse the effectiveness of antibacterial collagen-based dressing for DFU treatment in a clinical setting. An electronic search in four databases, namely, Scopus, PubMed, Ovid MEDLINE(R), and ISI Web of Science, was performed to obtain relevant articles published within the last ten years. The published studies were included if they reported evidence of (1) collagen-based antibacterial dressing or (2) wound healing for diabetic ulcers, and (3) were written in English. Both randomised and non-randomised clinical trials were included. The search for relevant clinical studies (n) identified eight related references discussing the effectiveness of collagen-based antibacterial wound dressings for DFU comprising collagen impregnated with polyhexamethylene biguanide (n = 2), gentamicin (n = 3), combined-cellulose and silver (n = 1), gentian violet/methylene blue mixed (n = 1), and silver (n = 1). The clinical data were limited by small sample sizes and multiple aetiologies of chronic wounds. The evidence was not robust enough for a conclusive statement, although most of the studies reported positive outcomes for the use of collagen dressings loaded with antibacterial properties for DFU wound healing. This study emphasises the importance of having standardised clinical trials, larger sample sizes, and accurate reporting for reliable statistical evidence confirming DFU treatment efficiency.

Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

2020 ◽  
Vol 29 (Sup9b) ◽  
pp. S1-S22 ◽  
Author(s):  
Georgina Gethin ◽  
Sebastian Probst ◽  
Jan Stryja ◽  
Natalia Christiansen ◽  
Patricia Price
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Patient Knowledge ◽  
Person Centered Care ◽  
Centered Care ◽  
Recommendations For Practice ◽  
The Impact

Background Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided. Aim We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research. Method Using a systematic review methodology, we searched six databases for full-text papers from 2009–2019 published in peer-reviewed journals with no limits on language. Results Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care. Conclusions The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

scholarly journals Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

2018 ◽  
Vol 19 (4) ◽  
pp. 373-382 ◽  
Author(s):  
Victor Alexandrovich Stupin ◽  
Ruslan Borisovich Gabitov ◽  
Tatiana Georgievna Sinelnikova ◽  
Ekaterina Vladimirovna Silina
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
World Literature ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Treatment Algorithm ◽  
Diabetic Foot Syndrome ◽  
Results Of Treatment ◽  
Native Collagen ◽  
Chronic Ulcers

Abstract The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

scholarly journals Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis

10.2196/15574 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15574
Author(s):  
Lihong Chen ◽  
Lihui Cheng ◽  
Wei Gao ◽  
Dawei Chen ◽  
Chun Wang ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Studies ◽  
Mobile Phones ◽  
Standard Care ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Meta Analysis ◽  
Wound Management ◽  
Efficacy And Safety ◽  
Chronic Wound Management

Background Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management. Objective The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management. Methods We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints. Results A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P<.001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies. Conclusions Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.

scholarly journals Bioactive Antimicrobial Peptides as Therapeutic Agents for Infected Diabetic Foot Ulcers

Biomolecules ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1894
Author(s):  
Jessica Da Silva ◽  
Ermelindo C. Leal ◽  
Eugénia Carvalho
Keyword(s):  
Wound Healing ◽  
Antimicrobial Peptides ◽  
Broad Spectrum ◽  
Diabetic Foot ◽  
Molecular Mechanisms ◽  
Antimicrobial Agents ◽  
Chronic Wounds ◽  
Foot Ulcer ◽  
Wound Management ◽  
Diabetic Patients

Diabetic foot ulcer (DFU) is a devastating complication, affecting around 15% of diabetic patients and representing a leading cause of non-traumatic amputations. Notably, the risk of mixed bacterial–fungal infection is elevated and highly associated with wound necrosis and poor clinical outcomes. However, it is often underestimated in the literature. Therefore, polymicrobial infection control must be considered for effective management of DFU. It is noteworthy that antimicrobial resistance is constantly rising overtime, therefore increasing the need for new alternatives to antibiotics and antifungals. Antimicrobial peptides (AMPs) are endogenous peptides that are naturally abundant in several organisms, such as bacteria, amphibians and mammals, particularly in the skin. These molecules have shown broad-spectrum antimicrobial activity and some of them even have wound-healing activity, establishing themselves as ideal candidates for treating multi-kingdom infected wounds. Furthermore, the role of AMPs with antifungal activity in wound management is poorly described and deserves further investigation in association with antibacterial agents, such as antibiotics and AMPs with antibacterial activity, or alternatively the application of broad-spectrum antimicrobial agents that target both aerobic and anaerobic bacteria, as well as fungi. Accordingly, the aim of this review is to unravel the molecular mechanisms by which AMPs achieve their dual antimicrobial and wound-healing properties, and to discuss how these are currently being applied as promising therapies against polymicrobial-infected chronic wounds such as DFUs.

Recent Advances in the Development of Nitric Oxide-Releasing Biomaterials and Their Application Potentials in Chronic Wound Healing

2021 ◽  
Author(s):  
Min Wu ◽  
Zhihui Lu ◽  
Keke Wu ◽  
Changwoo Nam ◽  
Lin Zhang ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Wound Healing ◽  
Persistent Infection ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Pressure Ulcers ◽  
Chronic Wound ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Nitric Oxide Releasing

Chronic wounds, such as pressure ulcers, vascular ulcers and diabetic foot ulcers (DFUs), often stays in a state of pathological inflammation and suffers from persistent infection, excess inflammation, and hypoxia,...

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