Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

Abstract

Pressure injuries/pressure ulcers (PIs/PUs) are a critical global healthcare issue and represent a considerable burden on healthcare resources. Prevention of PIs/PUs is the least costly approach and minimizes the patient suffering compared with treatment. Besides, sustained tissue load alleviation and microenvironment management are the most crucial properties for dressings in PI/PU prevention. Hydrogel dressings have attracted a lot of attention to prevent PIs/PUs because of their unique mechanical properties and ability to manage the microenvironment of skin. However, auxiliary prophylaxis and early treatment of PIs/PUs remain a challenge and an acute clinical demand. Here, we report on an electroactive hydrogel with large stretchability (∼380%) and skinlike ductility, and Young's modulus (0.48 ± 0.03 MPa) matches that of human skin (0.5−1.95 MPa). The hydrogel displayed piezoelectric properties and mechanical−electric response stability and sensitivity. Our results indicated that the hydrogel was able to promote in vitro angiogenesis under piezoelectric stimulation and exhibited biocompatibility, which has the potential for forming fine vessels at the damaged sites of PIs/PUs. Furthermore, finite element analysis and pressure dispersion experiments demonstrated that the hydrogel was suitable for preventing PIs/PUs by redistributing force, reducing tissue distortion, and maintaining the microenvironment for skin. This work offers a new strategy for designing and evaluating the dressing for prophylaxis and the early treatment of PIs/PUs.

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

“…8a-h). 301 The piezoelectric gels demonstrated outstanding stretchability, skin-like ductility, and significant mechanical properties with Young's modulus values (0.48 AE 0.03 MPa) that match those of human skin (0.5-1.95 MPa). Moreover, the mechanical-electrical properties analysis revealed that the alignment of dipole moment under a certain applied pressure between acrylonitrile and PVDF resulted in the piezoelectric output characteristics.…”

Engineering Dental Tissues Using Biomaterials with Piezoelectric Effect: Current Progress and Future Perspectives

“…A hydrogel is a three-dimensional network of a hydrophilic polymer system with more than a 10% water content in its structure, which in turn shows good biocompatibility due to the high moisture content [ 122 ] ( Figure 8 ). Owing to its 3D matrix configuration, it not only mimics the natural ECM microenvironment but also supports cell attachment, proliferation, differentiation, regulating cell behavior, and intracellular signaling, simulating the recovery of the microenvironment of cell life properties [ 123 , 124 ]. A recent review by Ye et al [ 124 ] reported the versatility of hydrogel scaffolds for several dental purposes such as dental pulp regeneration, periodontal tissue regeneration, and drug delivery.…”

“…Li et al [ 123 ] fabricated a piezoelectric hydrogel of polyacrylonitrile-acrylamide-styrene sulfate-poly (vinylidene fluoride) (PAAN-PVDF) and reported that the fabricated PAAN-PVDF (15%) hydrogel was able to produce an output voltage close to 50 mV when the force was greater than 35 N [ 123 ]. However, it is important to note that in the case of the hydrogel matrix system, the output electrical signal resulted from two different aspects: one is the dipole moment of the piezo-material and the shape variable generated from the deformed hydrogel under certain forces.…”

“…However, it is important to note that in the case of the hydrogel matrix system, the output electrical signal resulted from two different aspects: one is the dipole moment of the piezo-material and the shape variable generated from the deformed hydrogel under certain forces. PAAN-PVDF also exhibits large stretchability (∼380%) and skin-like ductility and promotes angiogenesis in HUVEC cells under piezoelectric stimulation [ 123 ]. Another piezoelectric hydrogel was created by Zhou et al [ 123 ] by combining poly (2-hydroxyethyl methacrylate) (PHEMA) doped with conductive nanoparticles, i.e., graphene oxide (GO) and single-walled carbon nanotubes (SWCNTs).…”

“…PAAN-PVDF also exhibits large stretchability (∼380%) and skin-like ductility and promotes angiogenesis in HUVEC cells under piezoelectric stimulation [ 123 ]. Another piezoelectric hydrogel was created by Zhou et al [ 123 ] by combining poly (2-hydroxyethyl methacrylate) (PHEMA) doped with conductive nanoparticles, i.e., graphene oxide (GO) and single-walled carbon nanotubes (SWCNTs). They reported that the piezoelectricity of the resulting hydrogel is directly proportional to the amount of GO reinforcement but has a negative impact in the case of SWCNTs due to the internal slipping within a bunch of the nanotubes [ 123 ].…”