Wound healing is a complex, highly regulated process that is critical in maintaining the barrier function of skin. With numerous disease processes, the cascade of events involved in wound healing can be affected, resulting in chronic, non-healing wounds that subject the patient to significant discomfort and distress while draining the medical system of an enormous amount of resources. The healing of a superficial wound requires many factors to work in concert, and wound dressings and treatments have evolved considerably to address possible barriers to wound healing, ranging from infection to hypoxia. Even optimally, wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. This article will review wound healing physiology and discuss current approaches for treating a wound.

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Staphylococcus aureus (SA) is a leading cause of both superficial and invasive infections in community and hospital settings, frequently resulting in chronic refractory disease. It is imperative that innovative therapeutics to which the bacteria are unlikely to evolve resistance be developed to curtail associated morbidity and mortality and ultimately improve our capacity to treat these infections. In this study, a previously unreported nitric oxide (NO)-releasing nanoparticle technology is applied to the treatment of methicillin-resistant SA (MRSA) wound infections. The results show that the nanoparticles exert antimicrobial activity against MRSA in a murine wound model. Acceleration of infected wound closure in NO-treated groups was clinically shown compared with controls. The histology of wounds revealed that NO nanoparticle treatment decreased suppurative inflammation, minimal bacterial burden, and less collagen degradation, providing potential mechanisms for biological activity. Together, these data suggest that these NO-releasing nanoparticles have the potential to serve as a novel class of topically applied antimicrobials for the treatment of cutaneous infections and wounds.

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