According to National Institute of Health statistics, more than 6.7 million individuals currently have chronic wounds, and that number is set to increase at a rate of more than 2% over the course of the next ten years. Rising geriatric population, increasing rates of illnesses and ailments including diabetes, obesity, and the long-lasting effects of radiation therapy is expected to contribute towards the increased occurrence of chronic wounds. If untreated, these wounds can lower quality of life and even necessitate amputation of the afflicted limb. Chronic wounds cost the healthcare system more than USD50 billion annually. Hence, there is a growing need to develop wound dressings than can detect and treat pathogenic bacteria accurately and accelerate the healing process. With recent advancement of tissue engineering, molecular biology, nanotechnology, and functional genomics, wound dressings have evolved from the traditional cotton gauze to composite materials.
The creation of a wound dressing that could really turn into an actual "ideal dressing" looks to be within reach, which has given patients hope for better wound care in recent years. Advancements in microfabrication technologies have led to the creation of many cutting-edge wound dressings that not only imitate the native skin tissue environment, but also monitor the healing process. Hence, researchers are discovering many new natural and synthetic polymers as well as bioactive products to develop advanced dressing wounds integrating diagnosis sensors, helping the patients to heal quicker. Here are some of the recent advances in wound dressing materials, revolutionizing the way wounds can be healed.
Alginate wound dressings composed from calcium salts and sodium alginic acid forms a gel when it comes in contact with the fluid of the wound. The main feature of alginate dressings is to absorb the excess wound secretions up to twenty times of their weight due to high porosity. However, these kinds of dressings require a second layer such as foams or hydrocolloids to be nonocclusive. The calcium component acts as a hemostat and helps in blood clothing, thus provides a great wound healing performance. Alginates dressings are antioxidants, anti-microbial, antiviral, anti-anaphylactic, and ant-inflammatory with regenerative properties.
Hydrogel is one of the most promising forms of alginate wound dressing as it promotes wound healing by retaining moisture, absorbing excessive exudate. Besides, hydrogel has a cooling effect on the wound that reduces local pain, does not adhere to the wound bed, and can hold active substances like various drugs, signaling molecules, or stem cells. Hydrogel is used to entrap cells for tissue regeneration and engineering, as a physical support for cells or tissue, or as a barrier between two media because it shields the cells from the host's immune system until it reaches the targeted area.
Alginate is a top choice when selecting the substance that could serve as both a support and as a carrier for the bio-active compounds that must reach a wound due to the versatility of alginate-based wound dressings, the encouraging results after both in vivo and in vitro trials, and the affordability of obtaining them.
Collagen (COL) is biologically active, biocompatible, and biodegradable, which possesses mild antigenicity when used as the main ingredient in wound dressings. The protein stimulates cell development and proliferation, promotes coagulation, prevents the formation of scars, etc. When used as a wound dressing, hydrogels with self-healing properties might prolong the material's shelf life, especially in urgent situations where improved wound protection is needed. As a result, there is significant potential for the creation of high-grade collagen hydrogels with strong self-healing, injectable, antibacterial, and hemostatic capabilities. Additionally, the research's findings revealed that fish scale collagen might be a viable option for biomedical materials that are sustainable, affordable, and environmentally benign.
- Silver Nanoparticle Wound Dressings
The amount of active silver discharged into the wound as well as the silver composition have a significant role in determining how silver wound dressings differ from one another. Many of the reported dressings are made by simply impregnating silver nitrate into a dressing material that is prone to uncontrolled quick release, which causes short-term activity and necessitates frequent dressing changes. Additionally, wound fluid can quickly render conventional silver dressings inactive, forming chemical compounds that can inhibit their antibacterial activity. The amount of silver in the wound dressings is substantially increased to replace silver ions to make up for the probable loss of activity. As a result, developments in nanotechnology have made it possible to create silver nanoparticles (NPs) that carry much lower quantities of the metal into wounds, boosting safety without sacrificing its great antibacterial characteristics.
The rise in the number of patents for silver's medicinal uses over the recent years is a sign of this field's advancement and emphasizes the tremendous potential for industrial and medical applications. In contrast to traditional silver nitrate, the treatment poses a significant danger to bacterial viability because of the continuous activity of silver ions and the ideal physicochemical characteristics of AgNPs. AgNPs' adaptable and dynamic qualities also provide scientists more freedom to manipulate important physicochemical characteristics, including as structure, size, surface functionalization, and biocompatibility, to obtain desired antimicrobial advantages.
According to TechSci Research report on “Silver Based Wound Dressing Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, 2018-2028F Segmented By Product Type (Hydrofiber Silver Dressing, Nanocrystalline Silver Dressing, Silver Plated Nylon Fiber Dressing, Silver Nitrate Dressing, Others), By Dressing Type (Fibrous gauze, Film, Foam, Hydrogel, Others), By Mechanism (Antibacterial Effects, Anti-Inflammatory Effects, Antioxidant Activity, Debridement and Anti-Eschar Action, Others), By Application (Burns, Ulcers, Cuts and Lacerations, Others), By End User (Hospitals, Ambulatory Surgery Centers, Homecare, Others), By Region and Competition”, the global silver based wound dressing market is expected to register growth at a significant rate. The market growth can be attributed to the increase in acute wound surgeries and increase in the number of diabetic foot ulcers.
Polymer based Wound Dressings Loaded with Bioactive Agents
- Nanofiber-based Wound Dressings
The typical diameter of nanofiber-based wound dressings is less than 1 micrometer. After being applied to the wound, they are quickly removed. Small diameter, high porosity, narrow diameter distribution, gas permeation, and a high specific surface to area ratio are just a few of the benefits that nanofibers provide. Drug administration using these wound dressings is being widely employed, particularly for the treatment of chronic wounds.
Films are a type of wound dressing material that are often made of adherent and translucent PU, allowing gases like oxygen, water vapour, and carbon dioxide to pass between the wound and the environment. These dressing materials are also helpful for the autolytic clearance of injured dead tissue. The polymer-based films have exceptional mechanical characteristics, such as high elasticity and flexibility, which enable them to be bent into any desired shape without further tapping. Film dressings are suitable for the care of shallow wounds, epithelizing injuries with low exudates, and superficial wounds due to their transparency, which allows observation of the healing progress of the wound without removing the dressing.
Foams are bio adhesive foams with hydrophobic and hydrophilic foam borders that are solid, porous wound dressings. Water vapour may pass through the exterior hydrophobic layer, which shields the wound from liquid while allowing gaseous exchange. If these wound dressings' parameters—such as their mechanical characteristics, density, and thickness—are properly suited, they can be sterilised and placed to wounds without causing the patient any discomfort. Foam wound dressings are useful for treating burns, diabetic ulcers, traumatic wounds, and other wounds because they improve gaseous exchange, guard against maceration, provide adequate moisture for quick wound healing, and absorb a lot of exudates.
Emergence of Smart Wound Dressings
Chronic wounds are more vulnerable to infection because of the difficult healing process. The treatment of the healing process depends on knowing the condition of the chronic wound. The current chronic dressing, in its ideal state, may serve primarily as a wound covering while also passively delivering the therapeutic ingredients. By providing adequate fundamental conditions for the wound environment, the existing dressings can slow the spread of this silent pandemic, but owing to the dynamic nature of chronic wounds, they are unable to provide all the characteristics necessary to speed up the healing process. Therefore, the existing dressing ineffectiveness in the care of wounds that are difficult to heal has exposed the urgent need for a new type of wound care. In recent years, a new type of wound dressing known as "the smart skin bandages" has emerged in recent years as a result of the integration of microelectronic technology with wound dressing substrates.
This type of wound dressing is capable of real-time monitoring of the markers expressed in the wound site and on-demand release of encapsulated therapeutic molecules to the wound site. The main components of smart bandages include microprocessors, wireless connection, and electronic sensors. The dressing's use of sensor and actuator technology ushers in novel ideas for continuously checking on the condition of the wound without changing the dressing. Numerous wound parameters, including pH, temperature, moisture content, and oxygen concentration, which could not be monitored with the prior dressing, are now detectable thanks to the incorporated flexible microsensors in the dressing. The development of smart bandages that can analyze and distribute therapeutic molecules to the wound site automatically or semi-automatically would dramatically improve wound treatment outcomes. For instance, France-based Medtech startup, Grapheal has launched an electronic wearable patch that enables continuous monitoring of wounds and stores wound patch measures, then communicates them to a medical cloud via a smartphone app. This allows caregivers to monitor remotely the wound healing evolution.
Upcoming Advancements in Wound Dressings
- Bioengineered Skin Substitutes
Bioengineered cellular-based live skin replacements (grafts) have just developed and are still in the early phases of clinical application, however their usage is increasing at a rapid rate. They have had mixed outcomes in various clinical settings when compared to more conventional wound dressings and skin grafting methods, but generally they have shown promising results and provide a chance to further wound care. In many clinical settings, bioengineered skin grafts are now thought to be non-inferior to autologous skin grafting and frequently superior to conventional wound dressing modalities. They are made up of a variety of synthetic, semi-synthetic, and biologically generated polymers and polypeptides, and frequently include an autologous or allogeneic cellular component made up of human keratinocytes and/or fibroblasts. Bioengineered skin grafts can be employed as a more permanent replacement for tissue or temporarily to stimulate tissue development. Currently, bioengineered skin grafts are being utilised for superficial wounds as well as deeper wounds that include more substantial damage to deeper anatomical structures, such as partial or full thickness wounds.
The main benefits of printing technologies include the ability to combine an infinite number of bioactive chemicals and cells with polymers, the creation of complex scaffold patterns, quicker healing periods, and customized wound dressings. The affected skin is surgically removed as part of burn therapy, especially for severe burn wounds, and the burn wound is then rebuilt using skin substitutes. Bioprinting process is used to complete the skin replacement. The latest and most cutting-edge wound care method is skin bioprinting. Layer-by-layer deposition of cells and scaffolding materials is used in bioprinting to rebuild burn wounds. A repeatable production method that permits precise cell type insertion is called bioprinting. Traditional dressings control bleeding and keep external microorganisms out of the wound.
- D Printed Wound Dressing Integrated with Sensors
Non-contact, inexpensive, efficient, and distant monitoring sensors are required for use during the wound's healing phase. Devices called biosensors can transmit analytical and biochemical data to the system. As a result, professionals may not be as frequently required to help with diagnosis and treatment. Hydrogels are intelligent materials that may react to both chemical and physical stimuli, including pH, ions, and certain chemical compositions. Physical stimuli include temperature, electric and magnetic fields, light intensity, and pressure. The capacity of hydrogels to expand back to their original size when triggers are removed is an intriguing characteristic.
According to TechSci Research report on “Wound Treatment Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, 2018-2028F Segmented By Therapy (Instrumental Based Therapy, Platelet Therapy, Cell Therapy, Wound Dressing, Others), By Wound Type (Subcutaneous Abdominal Wound, Traumatic & Infected Wound, Bilateral Reduction Mammaplasty Wound, Others), By Application (Burns, Ulcers, Cuts & Lacerations, Others), By End User (Hospitals & Clinics, Ambulatory Surgery Centers, Homecare, Others), By Region and Competition”, the global wound treatment market is anticipated to grow at a formidable rate. The market growth can be attributed to the rising awareness of the importance of wound care and advances in wound treatment technologies. Besides, rising incidences of chronic wounds and emergence of innovative wound care products are some of the factors expected to fuel the market growth in coming years.