Current Trends in Advanced Alginate-Based Wound Dressings for Chronic Wounds

Abstract

Chronic wounds represent a major public health issue, with an extremely high cost worldwide. In healthy individuals, the wound healing process takes place in different stages: inflammation, cell proliferation (fibroblasts and keratinocytes of the dermis), and finally remodeling of the extracellular matrix (equilibrium between metalloproteinases and their inhibitors). In chronic wounds, the chronic inflammation favors exudate persistence and bacterial film has a special importance in the dynamics of chronic inflammation in wounds that do not heal. Recent advances in biopolymer-based materials for wound healing highlight the performance of specific alginate forms. An ideal wound dressing should be adherent to the wound surface and not to the wound bed, it should also be non-antigenic, biocompatible, semi-permeable, biodegradable, elastic but resistant, and cost-effective. It has to give protection against bacterial, infectious, mechanical, and thermal agents, to modulate the level of wound moisture, and to entrap and deliver drugs or other molecules This paper explores the roles of alginates in advanced wound-dressing forms with a particular emphasis on hydrogels, nanofibers networks, 3D-scaffolds or sponges entrapping fibroblasts, keratinocytes, or drugs to be released on the wound-bed. The latest research reports are presented and supported with in vitro and in vivo studies from the current literature.

An Up-to-Date Review of Biomaterials Application in Wound Management

“…When applied to a wound, they form a hydrophilic sodium alginate gel as the calcium present in the material’s structure reacts with the sodium salts present in the wounded area. The formed gel further absorbs the fluid at the injury site, providing a moist environment for the wound to heal optimally [ 23 , 32 , 44 , 84 , 85 , 86 ]. Other advantages of alginate dressings include their easy removal, hemostatic properties, flexibility, permeability to water vapor, carbon dioxide, and oxygen, and protection against bacterial infections.…”

Pectin–Zeolite-Based Wound Dressings with Controlled Albumin Release

“…In total, 30 mg of Nazeolite is used in the experiments. BSA is loaded to pectin-zeolite hydrogels at different concentrations (10,25,50,75, or 100 mg BSA/g film) and pH values (4.3, 4.7, or 6.4). Two loading methods, mixing and adsorption, are investigated in this study.…”

“…In acute wounds, exudate production reduces over time; on the other hand, in chronic and burn wounds and wound dehiscence, large amounts of exudate can be produced, which can lead to a significant amount of albumin loss [9]. Bacterial contamination has a special importance to the chronic inflammation of wounds that do not heal [6,10]. Reduction in serum albumin levels can lead to prolonged inflammation, poor and delayed wound healing, tissue oedema, elevated levels of reactive oxygen species, muscle atrophy, and an increase in morbidity and even mortality, especially in major burn patients [11][12][13][14][15].…”

“…Hydrogel systems have been broadly used in the development of delivery systems for drugs [17,18] and protein [19]. Because of their hydrophilic structure [10], natural polysaccharides in hydrogel form such as chitosan [6,20,21], alginate [10,22], starch [23], hyaluronic acid, and pectin [24] have been widely used in the fabrication of dressings for burned, exuding, and bleeding wounds. Pectin, one of the most abundant polysaccharides, is a promising biomaterial for tissue engineering and drug delivery systems due to its good biocompatibility, biodegradability, and antimicrobial activity [25].…”

Personalized Medicine in the Field of Inflammatory Skin Disorders

“…They present the properties and roles of alginates that make them one of the favorite therapies for chronic wounds. They focused mainly on hydrogels, nanofiber networks, 3D scaffolds and sponges able to capture different cells such as fibroblasts or keratinocytes, or drugs to be released on the wound surface [ 20 ]. Georgescu et al conducted a meta-analysis that investigated the effectiveness of platelet-rich plasma therapy in androgenic alopecia.…”