Towards advanced wound regeneration

Abstract

Wound management is a major contributor towards the economic burden placed upon the national health service (NHS), serving as an important target for the development of advanced therapeutic interventions. The economic expenditure of wound care for the NHS exceeds £5 billion per annum, thus presenting a significant opportunity for the introduction of alternative treatments in regards to their approach in tackling the ever increasing prevalence of wound management associated problems. As most wounds typically fall under the acute or chronic category, it is therefore necessary to design a therapeutic intervention capable of effectively resolving the pathologies associated with each problem. Such an intervention should be of increased economic viability and therapeutic effectiveness when compared to standardized treatments, thus helping to alleviate the financial burden imposed upon the NHS. The purpose of this review is to critically analyse the various aspects associated with wound management, detailing the fundamental concepts of dermal regeneration, whilst also providing an evaluation of the different materials and methods that can be utilised to achieve maximal wound regeneration. The primary aspects of this review revolve around the three concepts of antibacterial methodology, enhancement of dermal regeneration and the utilisation of a carrier medium to facilitate the regenerative process. Each aspect is explored, conveying its justifications as a target for dermal regeneration, whilst offering various solutions towards the fulfilment of a therapeutic design that is both effective and financially feasible.

Cutaneous Wound Healing: An Update from Physiopathology to Current Therapies

“…Topical antibiotics have been widely used in skin wounds. Creams and ointments containing neomycin, bacitracin zinc, polymyxin B sulfate, povidone-iodine, metronidazole, or silver sufadiazine act in the prevention and treatment of infections in wounds, with effectiveness against several bacteria such as Staphylococcus aureus , Streptococcus pyogenes , Pseudomonas aeruginosa , Escherichia coli , and Klebsiella pneumoniae [ 2 , 65 , 66 ]. The topical antimicrobials were developed to prevent wound infection and its complications by stopping the functions of or destroying the microorganisms [ 10 ].…”

“…The skin is the largest organ of humans that acts as the first mechanical barrier between the organism and the external environmental, to protect organism against deleterious agents, control thermal regulation, and regulate water and electrolytes homeostasis [ 1 ]. The morphologic structure of skin comprises two layers, the epidermis and dermis [ 2 ]. The epidermis is the most external layer of the skin and is divided into four or five sub-layers, depending on the region of the body [ 2 ].…”

“…The morphologic structure of skin comprises two layers, the epidermis and dermis [ 2 ]. The epidermis is the most external layer of the skin and is divided into four or five sub-layers, depending on the region of the body [ 2 ]. Among the cells that constitute the epidermis are by far the major cell type, the keratinocytes, as well as melanocytes, Langerhans cells, and Merkel cells.…”

Construction of tissue-customized hydrogels from cross-linkable materials for effective tissue regeneration

“…As with heart regeneration mentioned above, the complexity of skin tissue also makes skin regeneration difficult, necessitating the use of multiple cross-linking strategies for fabricating hydrogels for skin regeneration. 288 Different chemical and enzymatic cross-linking strategies can be applied to provide different mechanical stresses and biomolecule delivery. 40,289 HRP can enzymatically cross-link chitosan and PEG-tyramine into hydrogels, reaching compressive strengths as high as 4.9 Mpa, and with fast gelation at 8 s by modulating the ratio of the components.…”

<p>Honey Combination Therapies for Skin and Wound Infections: A Systematic Review of the Literature</p>

“…Globally, incalcitrant wounds, caused by antibiotic-resistant microbial infections, are a significant burden on health-care systems. 1,2 An increasing global prevalence of diabetes and obesity and an aging population has contributed to the current burden of chronic wounds. 3,4 Non-healing-infected wounds can cause sepsis and inflammation in organs, eg, endocarditis leading to increased morbidity and mortality.…”