Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical wast...Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.展开更多
Delays in infected wound healing are usually a result of bacterial infection and local inflammation,which imposes a significant and often underappreciated burden on patients and society.Current therapies for chronic w...Delays in infected wound healing are usually a result of bacterial infection and local inflammation,which imposes a significant and often underappreciated burden on patients and society.Current therapies for chronic wound infection generally suffer from limited drug permeability and frequent drug administration,owing to the existence of a wound biofilm that acts as a barrier restricting the entry of various antibacterial drugs.Here,we report the design of a biocompatible probiotic-based microneedle(MN)patch that can rapidly deliver beneficial bacteria to wound tissues with improved delivery efficiency.The probiotic is capable of continuously producing antimicrobial substances by metabolizing introduced glycerol,thereby facilitating infected wound healing through long-acting antibacterial and anti-inflammatory effects.Additionally,the beneficial bacteria can remain highly viable(>80%)inside MNs for as long as 60 days at 4℃.In a mouse model of Staphylococcus aureus-infected wounds,a single administration of the MN patch exhibited superior antimicrobial efficiency and wound healing performance in comparison with the control groups,indicating great potential for accelerating infected wound closure.Further development of live probiotic-based MN patches may enable patients to better manage chronically infected wounds.展开更多
Regulating macrophage phenotypes to reconcile the conflict between bacterial suppression and tissue regeneration is ideal for treating infectious skin wounds. Here, an injectable immunoregulatory hydrogel (SrmE20) tha...Regulating macrophage phenotypes to reconcile the conflict between bacterial suppression and tissue regeneration is ideal for treating infectious skin wounds. Here, an injectable immunoregulatory hydrogel (SrmE20) that sequentially drives macrophage phenotypic polarization (M0 to M1, then to M2) was constructed by integrating anti-inflammatory components and proinflammatory solvents. In vitro experiments demonstrated that the proinflammatory solvent ethanol stabilized the hydrogel structure, maintained the phenolic hydroxyl group activity, and achieved macrophages' proinflammatory transition (M0 to M1) to enhance antibacterial effects. With ethanol depletion, the hydrogel's cations and phenolic hydroxyl groups synergistically regulated macrophages' anti-inflammatory transition (M1 to M2) to initiate regeneration. In the anti-contraction full-thickness wound model with infection, this hydrogel effectively eliminated bacteria and even achieved anti-inflammatory M2 macrophage accumulation at three days post-surgery, accelerated angiogenesis and collagen deposition. By sequentially driving macrophage phenotypic polarization, this injectable immunoregulatory hydrogel will bring new guidance for the care and treatment of infected wounds.展开更多
In clinical applications,there is a lack of wound dressings that combine efficient resistance to drug-resistant bacteria with good self-healing properties.In this study,a series of adhesive self-healing conductive ant...In clinical applications,there is a lack of wound dressings that combine efficient resistance to drug-resistant bacteria with good self-healing properties.In this study,a series of adhesive self-healing conductive antibacterial hydrogel dressings based on oxidized sodium alginate-grafted dopamine/carboxymethyl chitosan/Fe3+(OSD/CMC/Fe hydrogel)/polydopamine-encapsulated poly(thiophene-3-acetic acid)(OSD/CMC/Fe/PA hydrogel)were prepared for the repair of infected wound.The Schiff base and Fe3+coordination bonds of the hydrogel structure are dynamic bonds that can be repaired automatically after the hydrogel network is disrupted.Macroscopically,the hydrogel exhibits self-healing properties,allowing the hydrogel dressing to adapt to complex wound surfaces.The OSD/CMC/Fe/PA hydrogel showed good conductivity and photothermal antibacterial properties under near-infrared(NIR)light irradiation.In addition,the hydrogels exhibit tunable rheological properties,suitable mechanical properties,antioxidant properties,tissue adhesion properties and hemostatic properties.Furthermore,all hydrogel dressings improved wound healing in the infected full-thickness defect skin wound repair test in mice.The wound size repaired by OSD/CMC/Fe/PA3 hydrogel+NIR was much smaller(12%)than the control group treated with Tegaderm™film after 14 days.In conclusion,the hydrogels have high antibacterial efficiency,suitable conductivity,great self-healing properties,good biocompatibility,hemostasis and antioxidant properties,making them promising candidates for wound healing dressings for the treatment of infected skin wounds.展开更多
Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble bec...Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble because of the infection of Vibrio vulnificus.Bdellovibrio bacteriovorus,one kind of natural predatory bacteria,is recognized as a promising biological therapy against intractable bacteria.Here,we prepared a B.bacteriovorus-loaded polyvinyl alcohol/alginate hydrogel for the topical treatment of the seawater immersion wounds infected by V.vulnificus.The B.bacteriovorus-loaded hydrogel(BG)owned highly microporous structures with the mean pore size of 90μm,improving the rapid release of B.bacteriovorus from BG when contacting the aqueous surroundings.BG showed high biosafety with no L929 cell toxicity or hemolysis.More importantly,BG exhibited excellent in vitro anti-V.vulnificus effect.The highly effective infected wound treatment effect of BG was evaluated on mouse models,revealing significant reduction of local V.vulnificus,accelerated wound contraction,and alleviated inflammation.Besides the high bacterial inhibition of BG,BG remarkably reduced inflammatory response,promoted collagen deposition,neovascularization and re-epithelization,contributing to wound healing.BG is a promising topical biological formulation against infected wounds.展开更多
Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-resp...Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-responsive drug-releasing microcarriers which were loaded with vascular endothelial growth factor(VEGF)that promotes angiogenesis and actively respond to wound pH for control and prolong VEGF release.The surfaces of the microcarriers were coated with polydopamine which can reduce the silver nanoparticles(AgNPs)in situ,and dynamically crosslink with the polyacrylamide,which forms a stable slow-release system with different release behavior for the VEGF and AgNPs.The hydrogel inhib-ited bacterial formation and accelerated wound healing.With the hydrogel dressing,83.3%±4.29%of the wound heals at day 7,which is 40.9%±8.5%higher than the non-treatment group in defect infected model.The antibacterial properties of hydrogel down-regulate early inflammation-related cytokines,and the release of VEGF in the middle and late phases of wound healing in response to pH changes pro-motes angiogenesis and up-regulate the expression of angiogenesis-associated cytokine.The sequential release of antibacterial agents and pro-vascularizing agents in response to the change in wound microen-vironmental cues facilitate temporally controlled therapy that suites the need of different wound healing phases.Collectively,the hydrogel loaded with multifunctional microcarriers that enable controlled release of AgNPs and VEGF is an effective system for treating infected wounds.展开更多
BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting th...BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting the clinical use of autologous platelet-rich plasma(PRP)in treatment of such wounds is becoming increasingly compelling.Mechanisms involved include complex interactions between the patient’s thrombocytes,cytokines,and growth factors.CASE SUMMARY We present a case of a 72-year-old male patient with a long-standing chronic wound and multiple comorbidities.Over the course of more than 7 months,the patient was unsuccessfully treated with all routinely used measures,including different dressing approaches.Multiple antibiotic regimens were administered for wound infection,with repeated evaluation of microbiological swab results.Finally,after three PRP applications,the wound showed clinical improvement with complete restitution of the epithelial layer of the skin.CONCLUSION PRP treatment may be beneficial to reduce healing time in chronic wounds.展开更多
Bio-adhesive polysaccharide-based hydrogels have attracted much attention in first-aid hemostasis and wound healing for excellent biocompatibility,antibacterial property and pro-healing bioactivity.Yet,the inadequate ...Bio-adhesive polysaccharide-based hydrogels have attracted much attention in first-aid hemostasis and wound healing for excellent biocompatibility,antibacterial property and pro-healing bioactivity.Yet,the inadequate mechanical properties and bio-adhesion limit their applications.Herein,based on dynamic covalent bonds,photo-triggered covalent bonds and hydrogen bonds,multifunctional bio-adhesive hydrogels comprising modified carboxymethyl chitosan,modified sodium alginate and tannic acid are developed.Multi-crosslinking strategy endows hydrogels with improved strength and flexibility simultaneously.Owing to cohesion enhancement strategy and self-healing ability,considerable bio-adhesion is presented by the hydrogel with a maximal adhesion strength of 162.6 kPa,12.3-fold that of commercial fibrin glue.Based on bio-adhesion and pro-coagulant activity(e.g.,the stimulative aggregation and adhesion of erythrocytes and platelets),the hydrogel reveals superior hemostatic performance in rabbit liver injury model with blood loss of 0.32 g,only 54.2%of that in fibrin glue.The healing efficiency of hydrogel for infected wounds is markedly better than commercial EGF Gel and Ag+Gel due to the enhanced antibacterial and antioxidant properties.Through the multi-crosslinking strategy,the hydrogels show enhanced mechanical properties,fabulous bio-adhesion,superior hemostatic performance and promoting healing ability,thereby have an appealing application value for the first-aid hemostasis and infected wound healing.展开更多
Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significanc...Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significance.Here,we developed a fresh type of antibacterial cotton dressing through a succinct strategy based on chemically anchoring polyhexamethylene biguanide(PHMB).Intriguingly,after PHMB modification,the cotton dressing exhibited outstanding antibacterial performance which could maintain>99.99%antibacterial rate after several treatments,including washing 50 times,repeated use 10 times,UV irradiation for 7 days,cationic dyes dying,and conditioned under 90℃water bath for 2 h.In addition,the water contact angle of cotton dressing increased dramatically from 0°to 111°,which could facilitate bacterial adhesion,thus further enhance the antibacterial efficiency,and easily remove the bacterial debris.Apart from that,the developed cotton dressing showed good cytocompatibility,promoted blood clotting and expression of platelets,and promoted the wound healing process in the infection intervened skin wound model.Taken together,this antibacterial cotton dressing with desirable blood clotting,sustained protection against bacterial infection and bacterial removal features shows the potential to be a candidate for infected skin wound healing.展开更多
BACKGROUND Orthopedic surgeries after device implantation are susceptible to infections and may require device removal in the worst cases.For this reason,many efforts are being made to control infections after spinal ...BACKGROUND Orthopedic surgeries after device implantation are susceptible to infections and may require device removal in the worst cases.For this reason,many efforts are being made to control infections after spinal surgery;however,the number of infec-tion cases is increasing owing to the increasing number of elderly citizens.CASE SUMMARY A 75-year-old male with a chronic spinal defect due to previous spine surgery underwent reconstruction using a perforator-based island flap.After bursectomy and confirmation that there was no connection with the deep tissue,reconstruction was performed.However,wound disruption occurred with abscess formation on postoperative day 29,which led to an imaging workup revealing delayed deep tissue infection.CONCLUSION Infection is one of the most common causes of surgical wound dehiscence and is associated with devastating results if not controlled promptly and definitively.Surgeons should always suspect delayed infections when reconstructing chronic soft tissue defects.展开更多
BACKGROUND Surgical resection is the cornerstone treatment for colorectal cancer.Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care,subsequently reducing t...BACKGROUND Surgical resection is the cornerstone treatment for colorectal cancer.Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care,subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly.AIM To assess the effect of rapid rehabilitation care on clinical outcomes,including overall postoperative complications,anastomotic leaks,wound infections,and intestinal obstruction in patients with colorectal cancer.METHODS We searched the PubMed,Web of Science,Embase,Elsevier Science Direct,and Springer Link databases from January 1,2010,to January 1,2024,to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery.Patients were screened based on the inclusion and exclusion criteria.RevMan 5.4 software was used for statistical analysis of the data.RESULTS Twelve studies were enrolled,which included 2420 patients.The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications(OR:0.44,95%CI:0.26–0.74,P=0.002),anastomotic leaks(OR:0.68,95%CI:0.41–1.12,P=0.13),wound infections(OR:0.45,95%CI:0.29–0.72,P=0.0007),and intestinal obstruction(OR:0.54,95%CI:0.34–0.86,P=0.01)compared to conventional care.Further trials and studies are needed to confirm these results.CONCLUSION Rapid rehabilitation care decreased the occurrence of postoperative complications,anastomotic leaks,wound infections,and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery.Therefore,promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.展开更多
BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were...BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.展开更多
Chromobacterium violaceum is a Gram negative, facultative anaerobe, generally present in water, soil in tropical and subtropical regions. This bacterium is an emerging environmental pathogen that causes life threateni...Chromobacterium violaceum is a Gram negative, facultative anaerobe, generally present in water, soil in tropical and subtropical regions. This bacterium is an emerging environmental pathogen that causes life threatening infection in humans and animals. It can cause wound infection, visceral abscess, septicaemia, meningitis, diarrhoea, UTI. It is associated with significant mortality due to severe systemic infection. As the bacteria have high spreading tendency leading to sepsis, early identification and prompt treatment is necessary. Here we report a case of Chromobacterium violaceum wound infection in a 9 years old male from Dhaka, who was successfully treated with combination of cefixime and flucloxacillin antibiotics as per culture sensitivity report.展开更多
Background: Deep sternal wound infection (DSWI), or mediastinitis, is a devastating complication of coronary artery bypass grafting (CABG). This prospective study aimed to assess our management of DSWI in view of the ...Background: Deep sternal wound infection (DSWI), or mediastinitis, is a devastating complication of coronary artery bypass grafting (CABG). This prospective study aimed to assess our management of DSWI in view of the published literature. Methods: Over 2-years (ending in January 2016), 29 patients (20 males) developed DSWI amongst 520 patients who underwent standard CABG surgeries (5.6%). Pre-, intra- and postoperative variables were documented. Whenever possible, the infections were culture-verified. Besides antibiotics, patients received one or more of the following therapies: drainage, debridement, closed irrigation, sternal re-wiring, vacuum-assisted closure (VAC), and bone resection. Results: the male to female ratio was 2.2:1. Mean age was 58.1 ± 7.3 years. The mean body mass index (BMI) was 27.9 ± 3.4 kg/m<sup>2</sup>. There were 18, 16 and 11 patients with diabetes mellitus (DM), hypertension and chronic obstructive pulmonary disease (COPD) respectively. Cardiopulmonary bypass (CPB) was utilized in 26 (89.7%) patients with a mean time of 117.5 ± 23.3 minutes. Most surgeries (n = 21, 72.4%) lasted 5 - 6 hrs. According to Pairolero classification, there were 3 (10.3%) Type I, 22 (75.9%) Type II and 4 (13.8%) Type III infections. Four (13.8%) cases were culture-verified. Twenty-three (79.3%) DSWIs were surgically managed. Sternal re-wiring was performed in 14 (48.3%) cases while VAC was added to other therapies in 2 (6.9%) patients. DSWIs completely resolved in 18 (62.0%) patients within 3 - 24 weeks while two (6.9%) patients died within 30 days. Conclusion: We have identified six independent risk factors for DSWI (male gender, obesity, DM, hypertension, COPD and CPB), five of them are modifiable.展开更多
Damaged skin cannot prevent harmful bacteria from invading tissues,causing infected wounds or even severe tissue damage.In this study,we developed a controlled-release antibacterial composite hydrogel system that can ...Damaged skin cannot prevent harmful bacteria from invading tissues,causing infected wounds or even severe tissue damage.In this study,we developed a controlled-release antibacterial composite hydrogel system that can promote wound angiogenesis and inhibit inflammation by sustained releasing Cu-Epigallocatechin-3-gallate(Cu-EGCG)nano-capsules.The prepared SilMA/HAMA/Cu-EGCG hydrogel showed an obvious inhibitory effect on Escherichia coli(E.coli)and Staphylococcus aureus(S.aureus).It could also promote the proliferation and migration of L929 fibroblasts.In vivo full-thickness infected wound healing experiments confirmed the angiogenesis and inflammation regulating effect.Accelerate collagen deposition and wound healing speed were also observed in the SilMA/HAMA/Cu-EGCG hydrogel treated group.The findings of this study show the great potential of this controlled-release antibacterial composite hydrogel in the application of chronic wound healing.展开更多
OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative in...OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively. RESULTS: All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence. CONCLUSION: Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.展开更多
Background and Objectives: Duration of antibiotic prophylaxis for cardiac surgery is still debated and controversial. International guidelines are vague: French guidelines recommend an intraoperative administration, w...Background and Objectives: Duration of antibiotic prophylaxis for cardiac surgery is still debated and controversial. International guidelines are vague: French guidelines recommend an intraoperative administration, while the Society of Thoracic Surgeons’ guidelines suggest that optimal postoperative prophylactic antibiotics be given for 48 hours or less. Very few studies have compared the same antibiotic with 2 different administration durations. The study was designed to compare the efficacy of 24-hour administration of cefamandole vs intraoperative cefamandole to prevent deep sternal wound infection and endocarditis after cardiac surgery. Methods: This retrospective and observational study compared the rates of severe surgical site infections (deep sternal wound infection, endocarditis) after cardiac surgery between period 1, 01/01/2008-31/08/2008, with 24-hour administration of cefamandole, and period 2, 01/09/2008-30/04/2009 with intraoperative cefamandole. Results: Among 933 patients, 14 patients (1.5%) developed surgical site infection during the 16-month study: 1.3% during the first period and 1.7% during the second (ns). The populations (470 patients in period 1 and 463 in period 2) were homogeneous and comparable for pre-, intra- and postoperative characteristics. Surgical site infection characteristics (pathogens involved, time to diagnosis) and consequences (longer hospital stay, outcomes) were comparable in the 2 groups. Conclusions: Intraoperative cefamandole was as safe as its 24-hour administration to prevent deep sternal wound infection and endocarditis after adult cardiac surgery.展开更多
To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infect...To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before an...展开更多
Infected wounds pose a significant clinical challenge due to bacterial resistance, recurrent infections, and impaired healing. Reactive oxygen species (ROS)-based strategies have shown promise in eradicating bacterial...Infected wounds pose a significant clinical challenge due to bacterial resistance, recurrent infections, and impaired healing. Reactive oxygen species (ROS)-based strategies have shown promise in eradicating bacterial infections. However, the excess ROS in the infection site after treatments may cause irreversible damage to healthy tissues. To address this issue, we developed bovine serum albumin-iridium oxide nanoclusters (BSA-IrOx NCs) which enable photo-regulated ROS generation and scavenging using near infrared (NIR) laser. Upon NIR laser irradiation, BSA-IrOx NCs exhibit enhanced photodynamic therapy, destroying biofilms and killing bacteria. When the NIR laser is off, the nanoclusters' antioxidant enzyme-like activities prevent inflammation and repair damaged tissue through ROS clearance. Transcriptomic and metabolomic analyses revealed that BSA-IrOx NCs inhibit bacterial nitric oxide synthase, blocking bacterial growth and biofilm formation. Furthermore, the nanoclusters repair impaired skin by strengthening cell junctions and reducing mitochondrial damage in a fibroblast model. In vivo studies using rat infected wound models confirmed the efficacy of BSA-IrOx NCs. This study presents a promising strategy for treating biofilm-induced infected wounds by regulating the ROS microenvironment, addressing the challenges associated with current ROS-based antibacterial approaches.展开更多
Chronic diabetic wound healing remains a formidable challenge due to susceptibility to bacterial infection,excessive oxidative stress,and poor angiogenesis.To address these issues,a sodium alginate(SA)based phototherm...Chronic diabetic wound healing remains a formidable challenge due to susceptibility to bacterial infection,excessive oxidative stress,and poor angiogenesis.To address these issues,a sodium alginate(SA)based photothermal hydrogel dressing with multifunction was fabricated to facilitate wound treatment.Ceria nanoparticles(CeO_(2)NPs)was synthesized,and their antibacterial performance by near-infrared light triggered photothermal effects was first studied and verified in this work.In addition,to release CeO_(2)NPs to achieve antioxidation and pro-vascularization,thermosensitive gelatin(Gel)was utilized to embed the nanoparticles in advance and then composited in SA hydrogel networks.SA network was finally strengthened by acid soaking to form partially crystalline regions to act as natural crosslinkers.Results showed that the Gel/SA/CeO_(2)hydrogel displayed temperature-responsive release of CeO_(2)NPs,significant antibacterial and antioxidative activity,as well as the ability to remove without injury and promote infected diabetic wound healing with low cytotoxicity,according to antibacterial investigations,cell studies,and in vivo animal studies.This research offers not only a successful method for quickening the healing of diabetic wounds but also a fresh approach to the general use of CeO_(2)NPs.展开更多
基金supported by the National Natural Science Foundation of China(Nos.82370977,52073186)Medical Science and Technology Project of Sichuan Provincial Health Commission(No.21PJ059)+2 种基金Science and Technology Application Fundamental Project of Sichuan Province(No.2022YFS0124)Funding for Distinguished Young Scholars of Sichuan Province(No.23NSFJQ0001)Strategic Cooperation Projects of Yi Bin City and Sichuan University(No.2020CDYB-6)。
文摘Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.
基金support from the National Natural Science Foundation of China(NSFC,No.82373798,No.52103182)Youth Interdisciplinary Special Fund of Zhongnan Hospital of Wuhan University(Grant No.ZNQNJC2023002)Young Talents Project of Hubei Province Administration of Traditional Chinese Medicine(No.ZY2023Q014).
文摘Delays in infected wound healing are usually a result of bacterial infection and local inflammation,which imposes a significant and often underappreciated burden on patients and society.Current therapies for chronic wound infection generally suffer from limited drug permeability and frequent drug administration,owing to the existence of a wound biofilm that acts as a barrier restricting the entry of various antibacterial drugs.Here,we report the design of a biocompatible probiotic-based microneedle(MN)patch that can rapidly deliver beneficial bacteria to wound tissues with improved delivery efficiency.The probiotic is capable of continuously producing antimicrobial substances by metabolizing introduced glycerol,thereby facilitating infected wound healing through long-acting antibacterial and anti-inflammatory effects.Additionally,the beneficial bacteria can remain highly viable(>80%)inside MNs for as long as 60 days at 4℃.In a mouse model of Staphylococcus aureus-infected wounds,a single administration of the MN patch exhibited superior antimicrobial efficiency and wound healing performance in comparison with the control groups,indicating great potential for accelerating infected wound closure.Further development of live probiotic-based MN patches may enable patients to better manage chronically infected wounds.
基金National Key R&D Project of China(No.2022YFC2401800)National Natural Science Foundation of China(32071352 and 32271419).
文摘Regulating macrophage phenotypes to reconcile the conflict between bacterial suppression and tissue regeneration is ideal for treating infectious skin wounds. Here, an injectable immunoregulatory hydrogel (SrmE20) that sequentially drives macrophage phenotypic polarization (M0 to M1, then to M2) was constructed by integrating anti-inflammatory components and proinflammatory solvents. In vitro experiments demonstrated that the proinflammatory solvent ethanol stabilized the hydrogel structure, maintained the phenolic hydroxyl group activity, and achieved macrophages' proinflammatory transition (M0 to M1) to enhance antibacterial effects. With ethanol depletion, the hydrogel's cations and phenolic hydroxyl groups synergistically regulated macrophages' anti-inflammatory transition (M1 to M2) to initiate regeneration. In the anti-contraction full-thickness wound model with infection, this hydrogel effectively eliminated bacteria and even achieved anti-inflammatory M2 macrophage accumulation at three days post-surgery, accelerated angiogenesis and collagen deposition. By sequentially driving macrophage phenotypic polarization, this injectable immunoregulatory hydrogel will bring new guidance for the care and treatment of infected wounds.
基金Deanship of Scientific Research at Najran University for funding this work,under the Research Groups Funding Program grant code(NU/RG/MRC/12/5)the National Natural Science Foundation of China(grant numbers:51973172,52273149)+2 种基金Supported by 111 Project 2.0(BPO618008)the Natural Science Foundation of Shaanxi Province(No.2020JC-03)State Key Laboratory for Mechanical Behavior of Materials,and the World-Class Universities(Disciplines)and the Characteristic Development Guidance Funds for the Central Universities.
文摘In clinical applications,there is a lack of wound dressings that combine efficient resistance to drug-resistant bacteria with good self-healing properties.In this study,a series of adhesive self-healing conductive antibacterial hydrogel dressings based on oxidized sodium alginate-grafted dopamine/carboxymethyl chitosan/Fe3+(OSD/CMC/Fe hydrogel)/polydopamine-encapsulated poly(thiophene-3-acetic acid)(OSD/CMC/Fe/PA hydrogel)were prepared for the repair of infected wound.The Schiff base and Fe3+coordination bonds of the hydrogel structure are dynamic bonds that can be repaired automatically after the hydrogel network is disrupted.Macroscopically,the hydrogel exhibits self-healing properties,allowing the hydrogel dressing to adapt to complex wound surfaces.The OSD/CMC/Fe/PA hydrogel showed good conductivity and photothermal antibacterial properties under near-infrared(NIR)light irradiation.In addition,the hydrogels exhibit tunable rheological properties,suitable mechanical properties,antioxidant properties,tissue adhesion properties and hemostatic properties.Furthermore,all hydrogel dressings improved wound healing in the infected full-thickness defect skin wound repair test in mice.The wound size repaired by OSD/CMC/Fe/PA3 hydrogel+NIR was much smaller(12%)than the control group treated with Tegaderm™film after 14 days.In conclusion,the hydrogels have high antibacterial efficiency,suitable conductivity,great self-healing properties,good biocompatibility,hemostasis and antioxidant properties,making them promising candidates for wound healing dressings for the treatment of infected skin wounds.
基金supported by the National Natural Science Foundation of China(82073791)。
文摘Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble because of the infection of Vibrio vulnificus.Bdellovibrio bacteriovorus,one kind of natural predatory bacteria,is recognized as a promising biological therapy against intractable bacteria.Here,we prepared a B.bacteriovorus-loaded polyvinyl alcohol/alginate hydrogel for the topical treatment of the seawater immersion wounds infected by V.vulnificus.The B.bacteriovorus-loaded hydrogel(BG)owned highly microporous structures with the mean pore size of 90μm,improving the rapid release of B.bacteriovorus from BG when contacting the aqueous surroundings.BG showed high biosafety with no L929 cell toxicity or hemolysis.More importantly,BG exhibited excellent in vitro anti-V.vulnificus effect.The highly effective infected wound treatment effect of BG was evaluated on mouse models,revealing significant reduction of local V.vulnificus,accelerated wound contraction,and alleviated inflammation.Besides the high bacterial inhibition of BG,BG remarkably reduced inflammatory response,promoted collagen deposition,neovascularization and re-epithelization,contributing to wound healing.BG is a promising topical biological formulation against infected wounds.
文摘Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-responsive drug-releasing microcarriers which were loaded with vascular endothelial growth factor(VEGF)that promotes angiogenesis and actively respond to wound pH for control and prolong VEGF release.The surfaces of the microcarriers were coated with polydopamine which can reduce the silver nanoparticles(AgNPs)in situ,and dynamically crosslink with the polyacrylamide,which forms a stable slow-release system with different release behavior for the VEGF and AgNPs.The hydrogel inhib-ited bacterial formation and accelerated wound healing.With the hydrogel dressing,83.3%±4.29%of the wound heals at day 7,which is 40.9%±8.5%higher than the non-treatment group in defect infected model.The antibacterial properties of hydrogel down-regulate early inflammation-related cytokines,and the release of VEGF in the middle and late phases of wound healing in response to pH changes pro-motes angiogenesis and up-regulate the expression of angiogenesis-associated cytokine.The sequential release of antibacterial agents and pro-vascularizing agents in response to the change in wound microen-vironmental cues facilitate temporally controlled therapy that suites the need of different wound healing phases.Collectively,the hydrogel loaded with multifunctional microcarriers that enable controlled release of AgNPs and VEGF is an effective system for treating infected wounds.
文摘BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting the clinical use of autologous platelet-rich plasma(PRP)in treatment of such wounds is becoming increasingly compelling.Mechanisms involved include complex interactions between the patient’s thrombocytes,cytokines,and growth factors.CASE SUMMARY We present a case of a 72-year-old male patient with a long-standing chronic wound and multiple comorbidities.Over the course of more than 7 months,the patient was unsuccessfully treated with all routinely used measures,including different dressing approaches.Multiple antibiotic regimens were administered for wound infection,with repeated evaluation of microbiological swab results.Finally,after three PRP applications,the wound showed clinical improvement with complete restitution of the epithelial layer of the skin.CONCLUSION PRP treatment may be beneficial to reduce healing time in chronic wounds.
基金sponsored by the National Natural Science Foundation of China(Grant No.32171351)the“1.3.5”Project for Disciplines of Excellence,West China Hospital,Sichuan University(Grant No.ZYJC18002)Med-X Innovation Programme of Med-X Center for Materials,Sichuan University(Grant No.MCM202104).
文摘Bio-adhesive polysaccharide-based hydrogels have attracted much attention in first-aid hemostasis and wound healing for excellent biocompatibility,antibacterial property and pro-healing bioactivity.Yet,the inadequate mechanical properties and bio-adhesion limit their applications.Herein,based on dynamic covalent bonds,photo-triggered covalent bonds and hydrogen bonds,multifunctional bio-adhesive hydrogels comprising modified carboxymethyl chitosan,modified sodium alginate and tannic acid are developed.Multi-crosslinking strategy endows hydrogels with improved strength and flexibility simultaneously.Owing to cohesion enhancement strategy and self-healing ability,considerable bio-adhesion is presented by the hydrogel with a maximal adhesion strength of 162.6 kPa,12.3-fold that of commercial fibrin glue.Based on bio-adhesion and pro-coagulant activity(e.g.,the stimulative aggregation and adhesion of erythrocytes and platelets),the hydrogel reveals superior hemostatic performance in rabbit liver injury model with blood loss of 0.32 g,only 54.2%of that in fibrin glue.The healing efficiency of hydrogel for infected wounds is markedly better than commercial EGF Gel and Ag+Gel due to the enhanced antibacterial and antioxidant properties.Through the multi-crosslinking strategy,the hydrogels show enhanced mechanical properties,fabulous bio-adhesion,superior hemostatic performance and promoting healing ability,thereby have an appealing application value for the first-aid hemostasis and infected wound healing.
基金the National Natural Science Foundation of China(Nos.51803128,52073186,21802097)Fundamental Research Funds for the Central Universities(No.20826041D4160)+2 种基金Sichuan Science and Technology Programs(Nos.2020KJT0031-2020ZHCG0051,2020KJT0061-2020ZHFP0148)State Key Laboratory of Polymer Materials Engineering(No.sklpme20213–01)Funding of Engineering Characteristic Team,Sichuan University(No.2020SCUNG122)。
文摘Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significance.Here,we developed a fresh type of antibacterial cotton dressing through a succinct strategy based on chemically anchoring polyhexamethylene biguanide(PHMB).Intriguingly,after PHMB modification,the cotton dressing exhibited outstanding antibacterial performance which could maintain>99.99%antibacterial rate after several treatments,including washing 50 times,repeated use 10 times,UV irradiation for 7 days,cationic dyes dying,and conditioned under 90℃water bath for 2 h.In addition,the water contact angle of cotton dressing increased dramatically from 0°to 111°,which could facilitate bacterial adhesion,thus further enhance the antibacterial efficiency,and easily remove the bacterial debris.Apart from that,the developed cotton dressing showed good cytocompatibility,promoted blood clotting and expression of platelets,and promoted the wound healing process in the infection intervened skin wound model.Taken together,this antibacterial cotton dressing with desirable blood clotting,sustained protection against bacterial infection and bacterial removal features shows the potential to be a candidate for infected skin wound healing.
文摘BACKGROUND Orthopedic surgeries after device implantation are susceptible to infections and may require device removal in the worst cases.For this reason,many efforts are being made to control infections after spinal surgery;however,the number of infec-tion cases is increasing owing to the increasing number of elderly citizens.CASE SUMMARY A 75-year-old male with a chronic spinal defect due to previous spine surgery underwent reconstruction using a perforator-based island flap.After bursectomy and confirmation that there was no connection with the deep tissue,reconstruction was performed.However,wound disruption occurred with abscess formation on postoperative day 29,which led to an imaging workup revealing delayed deep tissue infection.CONCLUSION Infection is one of the most common causes of surgical wound dehiscence and is associated with devastating results if not controlled promptly and definitively.Surgeons should always suspect delayed infections when reconstructing chronic soft tissue defects.
基金Supported by the Fourth Batch of Self-funded Projects of the Baise Scientific Research and Technology Development Plan in 2022,No.20223734the 2023 National Key Research and Development Program:Research on Susceptibility Mechanisms and Screening Key Technologies for Major Viral Diseases,No.2023YFC2605400.
文摘BACKGROUND Surgical resection is the cornerstone treatment for colorectal cancer.Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care,subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly.AIM To assess the effect of rapid rehabilitation care on clinical outcomes,including overall postoperative complications,anastomotic leaks,wound infections,and intestinal obstruction in patients with colorectal cancer.METHODS We searched the PubMed,Web of Science,Embase,Elsevier Science Direct,and Springer Link databases from January 1,2010,to January 1,2024,to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery.Patients were screened based on the inclusion and exclusion criteria.RevMan 5.4 software was used for statistical analysis of the data.RESULTS Twelve studies were enrolled,which included 2420 patients.The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications(OR:0.44,95%CI:0.26–0.74,P=0.002),anastomotic leaks(OR:0.68,95%CI:0.41–1.12,P=0.13),wound infections(OR:0.45,95%CI:0.29–0.72,P=0.0007),and intestinal obstruction(OR:0.54,95%CI:0.34–0.86,P=0.01)compared to conventional care.Further trials and studies are needed to confirm these results.CONCLUSION Rapid rehabilitation care decreased the occurrence of postoperative complications,anastomotic leaks,wound infections,and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery.Therefore,promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.
基金in part was funded by a medical student grant($2500)by the Emergency Medicine Foundation
文摘BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.
文摘Chromobacterium violaceum is a Gram negative, facultative anaerobe, generally present in water, soil in tropical and subtropical regions. This bacterium is an emerging environmental pathogen that causes life threatening infection in humans and animals. It can cause wound infection, visceral abscess, septicaemia, meningitis, diarrhoea, UTI. It is associated with significant mortality due to severe systemic infection. As the bacteria have high spreading tendency leading to sepsis, early identification and prompt treatment is necessary. Here we report a case of Chromobacterium violaceum wound infection in a 9 years old male from Dhaka, who was successfully treated with combination of cefixime and flucloxacillin antibiotics as per culture sensitivity report.
文摘Background: Deep sternal wound infection (DSWI), or mediastinitis, is a devastating complication of coronary artery bypass grafting (CABG). This prospective study aimed to assess our management of DSWI in view of the published literature. Methods: Over 2-years (ending in January 2016), 29 patients (20 males) developed DSWI amongst 520 patients who underwent standard CABG surgeries (5.6%). Pre-, intra- and postoperative variables were documented. Whenever possible, the infections were culture-verified. Besides antibiotics, patients received one or more of the following therapies: drainage, debridement, closed irrigation, sternal re-wiring, vacuum-assisted closure (VAC), and bone resection. Results: the male to female ratio was 2.2:1. Mean age was 58.1 ± 7.3 years. The mean body mass index (BMI) was 27.9 ± 3.4 kg/m<sup>2</sup>. There were 18, 16 and 11 patients with diabetes mellitus (DM), hypertension and chronic obstructive pulmonary disease (COPD) respectively. Cardiopulmonary bypass (CPB) was utilized in 26 (89.7%) patients with a mean time of 117.5 ± 23.3 minutes. Most surgeries (n = 21, 72.4%) lasted 5 - 6 hrs. According to Pairolero classification, there were 3 (10.3%) Type I, 22 (75.9%) Type II and 4 (13.8%) Type III infections. Four (13.8%) cases were culture-verified. Twenty-three (79.3%) DSWIs were surgically managed. Sternal re-wiring was performed in 14 (48.3%) cases while VAC was added to other therapies in 2 (6.9%) patients. DSWIs completely resolved in 18 (62.0%) patients within 3 - 24 weeks while two (6.9%) patients died within 30 days. Conclusion: We have identified six independent risk factors for DSWI (male gender, obesity, DM, hypertension, COPD and CPB), five of them are modifiable.
基金funded by National Key Research and Development Program of China(2017YFA0105602,2018YFA0108700)NSFC Projects of INTERNATIONAL COOPERATION and Exchanges(81720108004)+6 种基金National Natural Science Foundation of China(81974019,82100275)Guangdong Provincial Special Support Program for Prominent Talents(2021JC06Y656)Science and Technology Planning Project of Guangdong Province(2020B1111170011,2022B1212010010)Guangdong special funds for science and technology innovation strategy,China(Stability support for scientific research institutions affiliated to Guangdong Province-GDCI 2021)Guangzhou Science and Technology Plan Project(202201000006)The Special Project of Dengfeng Program of Guangdong Provincial People’s Hospital(DFJH201812,KJ012019119,KJ012019423)The Marine Economy Development Project of Department of Natural Resources of Guangdong Province(No.GDNRC[2022]039).
文摘Damaged skin cannot prevent harmful bacteria from invading tissues,causing infected wounds or even severe tissue damage.In this study,we developed a controlled-release antibacterial composite hydrogel system that can promote wound angiogenesis and inhibit inflammation by sustained releasing Cu-Epigallocatechin-3-gallate(Cu-EGCG)nano-capsules.The prepared SilMA/HAMA/Cu-EGCG hydrogel showed an obvious inhibitory effect on Escherichia coli(E.coli)and Staphylococcus aureus(S.aureus).It could also promote the proliferation and migration of L929 fibroblasts.In vivo full-thickness infected wound healing experiments confirmed the angiogenesis and inflammation regulating effect.Accelerate collagen deposition and wound healing speed were also observed in the SilMA/HAMA/Cu-EGCG hydrogel treated group.The findings of this study show the great potential of this controlled-release antibacterial composite hydrogel in the application of chronic wound healing.
文摘OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively. RESULTS: All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence. CONCLUSION: Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.
文摘Background and Objectives: Duration of antibiotic prophylaxis for cardiac surgery is still debated and controversial. International guidelines are vague: French guidelines recommend an intraoperative administration, while the Society of Thoracic Surgeons’ guidelines suggest that optimal postoperative prophylactic antibiotics be given for 48 hours or less. Very few studies have compared the same antibiotic with 2 different administration durations. The study was designed to compare the efficacy of 24-hour administration of cefamandole vs intraoperative cefamandole to prevent deep sternal wound infection and endocarditis after cardiac surgery. Methods: This retrospective and observational study compared the rates of severe surgical site infections (deep sternal wound infection, endocarditis) after cardiac surgery between period 1, 01/01/2008-31/08/2008, with 24-hour administration of cefamandole, and period 2, 01/09/2008-30/04/2009 with intraoperative cefamandole. Results: Among 933 patients, 14 patients (1.5%) developed surgical site infection during the 16-month study: 1.3% during the first period and 1.7% during the second (ns). The populations (470 patients in period 1 and 463 in period 2) were homogeneous and comparable for pre-, intra- and postoperative characteristics. Surgical site infection characteristics (pathogens involved, time to diagnosis) and consequences (longer hospital stay, outcomes) were comparable in the 2 groups. Conclusions: Intraoperative cefamandole was as safe as its 24-hour administration to prevent deep sternal wound infection and endocarditis after adult cardiac surgery.
文摘To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before an...
基金Institutional Research Project of Shanghai Sixth People's Hospital(LY33.X-4020).
文摘Infected wounds pose a significant clinical challenge due to bacterial resistance, recurrent infections, and impaired healing. Reactive oxygen species (ROS)-based strategies have shown promise in eradicating bacterial infections. However, the excess ROS in the infection site after treatments may cause irreversible damage to healthy tissues. To address this issue, we developed bovine serum albumin-iridium oxide nanoclusters (BSA-IrOx NCs) which enable photo-regulated ROS generation and scavenging using near infrared (NIR) laser. Upon NIR laser irradiation, BSA-IrOx NCs exhibit enhanced photodynamic therapy, destroying biofilms and killing bacteria. When the NIR laser is off, the nanoclusters' antioxidant enzyme-like activities prevent inflammation and repair damaged tissue through ROS clearance. Transcriptomic and metabolomic analyses revealed that BSA-IrOx NCs inhibit bacterial nitric oxide synthase, blocking bacterial growth and biofilm formation. Furthermore, the nanoclusters repair impaired skin by strengthening cell junctions and reducing mitochondrial damage in a fibroblast model. In vivo studies using rat infected wound models confirmed the efficacy of BSA-IrOx NCs. This study presents a promising strategy for treating biofilm-induced infected wounds by regulating the ROS microenvironment, addressing the challenges associated with current ROS-based antibacterial approaches.
基金supported by the National Key Research and Development Project(grant no.2019YFD0901905).
文摘Chronic diabetic wound healing remains a formidable challenge due to susceptibility to bacterial infection,excessive oxidative stress,and poor angiogenesis.To address these issues,a sodium alginate(SA)based photothermal hydrogel dressing with multifunction was fabricated to facilitate wound treatment.Ceria nanoparticles(CeO_(2)NPs)was synthesized,and their antibacterial performance by near-infrared light triggered photothermal effects was first studied and verified in this work.In addition,to release CeO_(2)NPs to achieve antioxidation and pro-vascularization,thermosensitive gelatin(Gel)was utilized to embed the nanoparticles in advance and then composited in SA hydrogel networks.SA network was finally strengthened by acid soaking to form partially crystalline regions to act as natural crosslinkers.Results showed that the Gel/SA/CeO_(2)hydrogel displayed temperature-responsive release of CeO_(2)NPs,significant antibacterial and antioxidative activity,as well as the ability to remove without injury and promote infected diabetic wound healing with low cytotoxicity,according to antibacterial investigations,cell studies,and in vivo animal studies.This research offers not only a successful method for quickening the healing of diabetic wounds but also a fresh approach to the general use of CeO_(2)NPs.