Type I collagen matrix plus polyhexamethylene biguanide antimicrobial for the treatment of cutaneous wounds

Bain, Michael; Koullias, George J.; Morse, Keith; Wendling, Santina; Sabolinski, Michael L.

doi:10.2217/cer-2020-0058

Cited by 11 publications

(9 citation statements)

References 44 publications

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“…Other studies in porcine models and in humans have demonstrated that another form of debridement, enzymatic debridement, may decrease wound size, reduce inflammation, and increase granulation tissue, with the caveat that they may require a secondary dressing to penetrate the rooted layers of the wound in order to control the biofilms present [ 139 , 140 , 141 ]. Likewise, it has been shown that hydro-active dressing soaked with polyhexamethylene biguanide (in humans) can promote macrophage activation in the wound, inhibiting bacterial proliferation and dampening inflammation [ 138 , 142 , 143 ].…”

Section: Treatment Strategiesmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

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Section: Treatment Strategiesmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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“…To build on the current evidence base and further elucidate how processing methodologies (e.g., layering and crosslinking) impact key properties, we utilized commercially available products constructed of SIS and OFM and evaluated matrix structure and protease attenuation; this analysis was complimented by the development and application of an in vitro degradation chronic wound model to study scafold degradation dynamics and functionality [4,[29][30][31]. Here, both SIS and OFM were able to attenuate MMPs; however, structural and functional properties determined the magnitude of MMP reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Te products in this study are both native collagen ECMs, with SIS undergoing layering and an additional chemical crosslinking process. Both tissue sources have been shown clinically to support progression through the wound healing phases [29,30].…”

Section: Discussionmentioning

confidence: 99%

Varying Properties of Extracellular Matrix Grafts Impact Their Durability and Cell Attachment and Proliferation in an In Vitro Chronic Wound Model

Harmon,

Burnette,

Avery

et al. 2024

Journal of Tissue Engineering and Regenerative Medicine

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While acute wounds typically progress through the phases of wound healing, chronic wounds often stall in the inflammatory phase due to elevated levels of matrix metalloproteinases (MMPs) and proinflammatory cytokines. Dysregulated expression of MMPs can result in the breakdown of extracellular matrix (ECM) formed during the wound healing process, resulting in stalled wounds. Native collagen-based wound dressings offer a potential wound management option to sequester excess MMPs and support cellular interactions that allow wound progression through the natural healing process. Herein, we utilized commercially available ECM matrices, two derived from porcine small intestinal submucosa (PCMP, 2 layers; PCMP-XT, 5 layers) and one derived from propria submucosa (ovine forestomach matrix, OFM, 1 layer), to demonstrate the impact of processing methodologies (e.g., layering and crosslinking) on functional characteristics needed for the management of chronic wounds. Grafts were evaluated for structural composition using scanning electron microscopy and histology, ability to reduce MMPs using fluorometric assays, and durability in an in vitro degradation chronic wound model. Both intact (nondegraded) and partially degraded grafts were assessed for their ability to serve as a functional cell scaffold using primary human fibroblasts. Grafts differed in matrix substructure and composition. While all grafts demonstrated attenuation of MMP activity, PCMP and PCMP-XT showed larger reductions of MMP levels. OFM rapidly degraded in the in vitro degradation model (<3 hours), while PCMP and PCMP-XT were significantly more durable (>7 days). The ability of PCMP and PCMP-XT to serve as scaffolds for cellular attachment was not impacted by degradation in vitro. Three ECM grafts with varying structural and functional characteristics exhibited differential durability when degraded in a simulated chronic wound model. Those that withstood rapid degradation maintained their ability to function as a scaffold to support attachment and proliferation of fibroblasts, a cell type important for wound healing.

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“…It is a novel product enabling a proactive BBWM approach that constitutes 2 crucial elements: i) physical removal of the biofilm via debridement and ii) restricting the biofilm reformation via a broad spectrum, nontoxic, and positively charged antimicrobial agent polyhexamethylene biguanide. [ 167,168 ] The EDC (1‐ethyl‐3‐(3‐dimethylamino propyl) carbodiimide) chemically cross‐linked native ECM strengthens the matrix bonds to enhance resistance against MMPs. The combination of both native crosslinked ECM and broad‐spectrum polyhexamethylene biguanide prevents a proinflammatory hyper proteolytic environment that stalls the healing of wounds.…”

Section: Commercial Products For Chronic Wounds Treatmentmentioning

confidence: 99%

Updates on Recent Clinical Assessment of Commercial Chronic Wound Care Products

Sharma

Zhao

2023

Adv Healthcare Materials

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Impaired wound healing after trauma, disorders, and surgeries impact millions of people globally every year. Dysregulation in orchestrated healing mechanisms and underlying medical complications make chronic wound management extremely challenging. Besides standard‐of‐care treatments including broad spectrum antibiotics and wound‐debridement, novel adjuvant therapies are clinically tested and commercialized. These include topical agents, skin substitutes, growth factor delivery, and stem cell therapies. With a goal to overcome factors playing pivotal role in delayed wound healing, researchers are exploring novel approaches to elicit desirable healing outcomes in chronic wounds. Although recent innovations in wound care products, therapies, and devices are extensively reviewed in past, a comprehensive review summarizing their clinical outcomes is surprisingly lacking. Herein, this work reviews the commercially available wound care products and their performance in clinical trials to provide a statistically comprehensive understanding of their safety and efficacy. The performance and suitability of various commercial wound care platforms, including xenogeneic and allogenic products, wound care devices, and novel biomaterials, are discussed for chronic wounds. The current clinical evaluation will provide a comprehensive understanding of the benefits and drawbacks of the most‐recent approaches and will enable researchers and healthcare providers to develop next‐generation technologies for chronic wound management.

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Type I collagen matrix plus polyhexamethylene biguanide antimicrobial for the treatment of cutaneous wounds

Cited by 11 publications

References 44 publications

Diabetic Wound-Healing Science

Diabetic Wound-Healing Science

Varying Properties of Extracellular Matrix Grafts Impact Their Durability and Cell Attachment and Proliferation in an In Vitro Chronic Wound Model

Updates on Recent Clinical Assessment of Commercial Chronic Wound Care Products

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