Search Results (3,038)

Dynamic interactions among cells, including immune cells, stromal cells, endothelial cells, epithelial cells, and extracellular matrix (ECM) components, are involved in the wound healing process. In chronic wounds, particularly diabetic wounds, these interactions are hampered by prolonged inflammation and excessive reactive oxygen species generation by dysregulated immune cells, bacterial infection, and impaired angiogenesis. These pathological features have shifted the therapeutic strategies from wound coverage and antimicrobial protection toward regulation of the immune microenvironment. Polymeric and hybrid materials have emerged as promising platforms for this purpose because their versatile composition, structure, degradation behavior, mechanical properties, and drug loading capacities can be widely engineered to match the dynamic requirements of wound healing, particularly in immunomodulation strategies. In this review, we focus on the major immunological barriers and potential targets in the wound healing process using polymer-based materials. Overall, this review covers recent advances, design strategies, and challenges in immunomodulatory materials including polymer-based nanoparticles, nanofibers, hydrogels, and hybrid materials for wound repair. Full article

Background: Primary malignant bone tumors of the pelvis account for 10–15% of all primary bone sarcomas, most commonly chondrosarcoma, osteosarcoma, and Ewing’s sarcoma. Although advances have shifted treatment toward internal hemipelvectomy, pelvic resections remain challenging due to the complex anatomy. The need for pelvic reconstruction is controversial, balancing potential stability against higher complication rates. This review evaluates the role of pelvic ring reconstruction, focusing on techniques, outcomes, and complications. Methods: A systematic literature review was performed in June 2025 using PubMed, MEDLINE and Cochrane Library as the primary databases, with the following search string: (hemipelvectomy) AND (orthopedic), acknowledging that this search strategy may be limited in scope. Studies published within the last five years were considered. After performing a full-text assessment of 80 studies, 14 studies were included in this review. Data regarding patients, methods, and outcomes were extracted and summarized. Results: Among the 14 included studies, seven investigated patient-specific three-dimensional (3D) printed pelvic reconstructions, four reported biological reconstruction techniques, two studies focused on non-reconstructive management and one study evaluated alternative stabilization using segmental spinal instrumentation. 3D printed and other reconstructive techniques were associated with improvements in the Musculoskeletal Tumor Society score, reduced pain, and demonstrated osseointegration with few mechanical failures. Although individual case series demonstrated good ambulation and stable fixation, complication rates, particularly wound and infection-related events, remained frequent. Type III reconstructions and personalized implants showed the highest functional gains but occasionally revealed asymptomatic fretting wear. In contrast, the only Level I evidence indicated significantly higher complication and infection rates in reconstructed patients and better functional outcomes in those managed without reconstruction when spinopelvic stability was preserved. Non-reconstructive strategies, including spinal instrumentation, supported early ambulation with low mechanical failure, while pediatric patients treated without reconstruction experienced a high complication rate but acceptable long-term oncologic outcomes. Conclusions: Current evidence suggests that routine pelvic ring reconstruction after internal hemipelvectomy may not be justified based on the currently available evidence. Patient-specific 3D-printed implants appear to provide consistent improvements in function, pain reduction, and mechanical stability, but are associated with a relevant risk of wound-related and infectious complications. In patients with preserved spinopelvic stability, non-reconstructive strategies may achieve comparable functional outcomes with lower morbidity. Therefore, pelvic reconstruction should be performed selectively, and further prospective multicenter studies are needed to better define appropriate patient selection and optimize reconstructive strategies. Full article

Diabetic foot ulceration is a severe and common chronic complication of diabetes, accompanied by excessive reactive oxygen species (ROS) accumulation, persistent bacterial infection, prolonged inflammation, and insufficient angiogenesis. Traditional single-function wound dressings fail to simultaneously resolve these pathological barriers, leading to unsatisfactory healing outcomes. In this study, we developed a multifunctional composite hydrogel (E/MGel) by introducing mussel adhesive protein (MAP) into methacrylated hyaluronic acid (mHA) to construct an antibacterial and antioxidant delivery system, which was further loaded with epidermal growth factor (EGF) to promote angiogenesis. The as-prepared E/MGel exhibited a uniform porous structure, favorable rheology, high swelling ratio, and sustained protein release behavior. In vitro results demonstrated that E/MGel exerted potent antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E.coli), high ROS scavenging efficiency, good cytocompatibility, and remarkable pro-angiogenic effect on endothelial cells. In a mouse model of diabetic MRSA-infected full-thickness skin defect, E/MGel significantly accelerated wound closure, reduced bacterial burden, downregulated pro-inflammatory cytokines, promoted collagen deposition, and enhanced neovascularization. Meanwhile, no obvious systemic toxicity was observed. Taken together, this multifunctional hydrogel integrates antibacterial, antioxidant, and pro-angiogenic capacities to break the pathological vicious cycle of diabetic wounds, providing a promising and safe strategy for the clinical treatment of diabetic infected wounds. Full article

Cancer and multidrug-resistant microbial infections remain major global health challenges, underscoring the need for multifunctional, biocompatible, and environmentally sustainable therapeutic platforms. Herein, selenium–hyaluronic acid nanoconjugates (Se/HA NPs) were synthesized through an eco-friendly ascorbic acid-mediated reduction approach to improve the bio-functional stability and therapeutic performance of selenium-based nanomaterials. The formation of Se/HA NPs was confirmed by transmission electron microscopy (TEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), and Fourier-transform infrared spectroscopy (FTIR). FTIR analysis supported the involvement of ascorbic acid- and hyaluronic acid-associated functional groups in nanoparticle formation and stabilization. TEM revealed well-dispersed, predominantly spherical nanoparticles with diameters ranging from 29.72 to 80.38 nm, while XRD confirmed their crystalline nature with an average crystallite size of 31.2 nm. Biologically, Se/HA NPs exhibited strong antibacterial activity against Enterococcus faecalis (21 mm), Staphylococcus aureus (24 mm), Escherichia coli (25 mm), and Klebsiella pneumoniae (27 mm), outperforming hyaluronic acid alone and showing activity comparable to standard antibiotics, with a minimum inhibitory concentration (MIC) of 15.62 µg/mL. Notably, Se/HA NPs showed pronounced antifungal activity against Candida albicans, with an inhibition zone of 34 mm and an MIC of 7.8 µg/mL. In MG-63 osteosarcoma cells, Se/HA NPs demonstrated potent cytotoxicity, with a half-maximal inhibitory concentration (IC₅₀) of 8.36 µg/mL compared with 746.37 µg/mL for hyaluronic acid. Moreover, Se/HA NPs enhanced wound closure to 73.41% and showed strong anti-inflammatory activity, with an IC₅₀ of 5.37 µg/mL, demonstrating multifunctional bioactivity. Full article

Opportunistic bacterial and fungal infections from surface wounds remain a persistent threat to aquaculture, resulting in significant economic losses and reduced stock welfare. Topical wound sealants are widely employed in recreational aquaculture applications, yet no market regulation or efficacy data exist to support their usage. The broader biological/environmental impacts of these products also remain poorly characterized. This study provides the first quantitative assessment of the antibacterial, antifungal and cellular toxicity of a panel of commercially available topical ‘carp care’ formulations. Our data highlights highly variable to no functional growth inhibition or killing of microbial pathogens, significant inherent cyprinid cellular toxicity, and lack of submerged wet adhesion in all products tested. We show for the first time that commercial propolis solutions are ineffective against the four main pathogenic microorganisms affecting carp. Propolis formulations were also found to induce apoptosis and ROS generation in cyprinid cells in vitro, and permeabilise intact carp skin, questioning the foundation of propolis formulations in topical wound-care treatments for carp rearing/angling. We show improved efficacies can be attained through natural compound implementation, with increased antibacterial and antifungal effects, inherent regenerative benefits to cyprinid fibroblasts, and improved human and environmental safety profiles. This research demonstrates the widespread lack of efficacy in currently commercially available wound sealants for carp; of those tested here, many popular formulations are in fact inherently toxic to carp cells, and also have a permeabilizing effect on intact carp skin due to carrier solvent effects, providing a route for secondary infection; most show no activity against any common carp pathogens; and all uniformly lacked wet adhesion. This work provides a framework standard for the future development of topical wound-care formulations for carp and highlights the need for better dialogue between trade and academia when designing novel wound-care products. Full article

Background: Biofilms consist of complex microbial communities embedded in an extracellular matrix which confer resistance to the most used antimicrobial agents. Chronic wounds are often associated with burns, trauma, surgery, diabetes and peripheral vascular disease. They are characterized by a marked delay in wound healing favoring the development of microbial biofilms, which in turn further delay tissue regeneration. Staphylococcus aureus, Staphylococcus epidermidis, and methicillin-resistant staphylococci biofilms are found in chronic wounds, seriously hindering wound treatment. Vitreoscilla filiformis, a Gram-negative non-pathogenic filamentous bacterium, has been shown to improve atopic dermatitis by reducing S. aureus colonization and inducing antioxidant responses in the skin. Objectives: The aim of the present study was to evaluate the antimicrobial, anti-inflammatory, and regenerative activities of the V. filiformis supernatant (VFS). Methods: The effect of VFS on bacteria growth was assessed by microbial growth kinetics and biofilm formation and dispersal. Antioxidant potential was determined by DPPH-scavenging ability and reduction in intracellular reactive oxygen species (ROS). The regenerative properties were assessed by scratch assay. Results: V. filiformis VFS holds strong anti-biofilm activity against S. aureus, S. epidermidis and methicillin-resistant S. aureus (MRSA), acting during both biofilm formation and dispersion. The decrease in biofilm mass is accompanied by a significant increase in the planktonic form compared to the untreated cells. Moreover, VFS is characterized by an interesting antioxidant activity, as demonstrated by a cell-free DPPH assay and a neutrophil-based in vitro assay. In addition, VFS can stimulate tissue regeneration in human dermal fibroblasts and keratinocytes. Conclusions: The demonstration of anti-biofilm, antioxidant and regenerative properties of V. filiformis supernatant could be exploited for the treatment of biofilm-associated wound infections. Full article

Background: While equine patient-mediated introduction of A. baumannii into hospital settings has been documented, its environmental dissemination and the risk of hospital-acquired surgical site infection remain poorly understood. Objective: Therefore, this descriptive observational study examined (a) the environmental distribution of Acinetobacter spp. in an equine university hospital, (b) the impact of the implementation of new hygiene protocols, (c) the specification of resistance patterns, and (d) the evaluation of the presence of Acinetobacter spp. in hospital-acquired wound infections. Methods: During three sampling periods, environmental samples of the stables, the treatment, and surgery areas were collected before and after cleaning and disinfection. After sampling period 1 (December 2021), the cleaning routines were optimized by reviewing the cleaning and disinfection process, as well as including further surfaces in the cleaning schedule for January 2022). This was followed by a second (February 2022) and a third (June 2022) sampling period. During sampling periods 1 and 2, 76 surfaces were sampled; in sampling period 3, only 21 critical surfaces were examined. Samples were cultured on selective agar plates and incubated at 37 °C, with bacterial growth evaluated after 24–48 h. Wound swabs were enriched in broth before culturing. Bacteria were identified using MALDI-TOF mass spectrometry. During the first sampling period, antibiotic susceptibility testing was performed using broth microdilution according to CLSI-vet standards. Results: During each sampling period, Acinetobacter spp. was detected in at least one sample in each of the different areas; however, there was a reduced detection rate from sampling period 1 throughout sampling period 3. The isolates were highly resistant against beta-lactam and macrolide antibiotics but mostly sensitive to fluroquinolones (enrofloxacin, 2.2% resistance; marbofloxacin, 0.0% resistance), aminoglycosides (gentamicin, 6.5% resistance; kanamycin, 8.7% resistance), and tetracyclines. Acinetobacter spp. was not detected in surgical site infections. Conclusions: Environmental persistence of Acinetobacter spp. in an equine clinical setting does not necessarily translate into surgical site infections. Through prudent antibiotic use, the antibiotic susceptibility of the isolates may be perceived. Full article

Burn injury induces profound immune dysregulation that extends beyond the acute phase of wound healing, contributing to complications such as delayed repair, infection, and long-term immune dysfunction. Importantly, these effects are not restricted to severe trauma, as similar immune alterations occur following small- to moderate-sized burns. Despite increasing recognition of post-burn immune dysregulation, targeted immunomodulatory therapies remain limited. In this review, we synthesize current insights into the mechanisms driving immune dysfunction after burn injury and outline therapeutic strategies aimed at restoring immune homeostasis. We examine approaches targeting inflammatory triggers and mediators, including acute clinical interventions, reduction in microbial burden, and inhibition of immune cell activation through systemic and local delivery. We also explore strategies to modulate dysregulated innate immune responses by targeting cell-specific functions, such as neutrophil activity and monocyte/macrophage polarization. Persistent activation and exhaustion of the adaptive immune system may be alleviated through interventions such as β-adrenergic blockade, while metabolic, endocrine, and oxidative stress pathways represent additional therapeutic targets. Finally, we highlight key challenges, including the need for improved diagnostics, early prognostic stratification, and personalized treatment approaches to improve outcomes following burn injury. Full article

Chronic wounds, particularly those complicated by infection, present significant challenges in clinical management. The microenvironment of these wounds is typically characterized by the accumulation of reactive oxygen species (ROS) and abnormal local pH levels, both of which impede the healing process. Baicalin (BA), a natural flavonoid, exhibits anti-inflammatory activity, ROS-scavenging capability, and pro-healing effects. In this study, hydrogels were synthesized through photoinitiated radical polymerization of methacrylic anhydride (MAA) and dopamine (DA)-modified chondroitin sulfate (ChSMA-DA), grafting degrees of MA and DA were 58%, 23%, MPDA@MnO₂ nanoparticles (NPs), and methacrylated gelatin (GelMA). The gelation time, microtopography, swelling behavior, and water retention of the hydrogels were investigated, along with their degradation, rheological properties, and photothermal effects. The results indicate that swelling ratio (SR) and water retention (WR) of optimal HG-MPDA@MnO₂-M sample were 5.7, 82.42%, exhibited responsive behavior upon weakly acidic environment with pH 6.5 and elevated ROS levels, and exhibited a stable photothermal effect (photothermal conversion efficiency was 22.7%) under 808 nm near-infrared (NIR) light. Following the incorporation of the drug model BA, the cumulative release percentage over 24 h under the combined stimulation of pH 6.5, 1 mmol·L⁻¹ H₂O₂, and 808 nm NIR was 81.1%, significantly higher than either factor alone. These hydrogels show promise as an injectable dressing for chronic wounds, effectively integrating the internal microenvironment of the wound tissue with external NIR to modulate drug release. Full article

Chronic and infected wounds remain difficult to treat due to persistent microbial burden, biofilm formation, and dysregulated inflammation. As a multifunctional polyphenol, curcumin exhibits broad-spectrum antimicrobial, anti-inflammatory, and antioxidant activities. Nevertheless, the clinical application of curcumin is constrained by its limited solubility in water, inherent instability, and insufficient bioavailability. Chitosan, a cationic polysaccharide, provides complementary advantages including intrinsic antimicrobial activity, mucoadhesion, and the capacity to form versatile delivery platforms such as nanoparticles, hydrogels, and films. This review reframes chitosan–curcumin systems as dual-function bioactive platforms in which both the carrier and payload actively contribute to therapeutic outcomes. Mechanistically, chitosan disrupts microbial membranes, enhances bioadhesion, and supports tissue regeneration, while curcumin modulates intracellular targets including reactive oxygen species, quorum sensing, and inflammatory signaling pathways. Their integration enables multimodal antimicrobial activity, improved biofilm disruption, and coordinated regulation of the wound-healing cascade. This review critically examines the structure–function relationships governing release kinetics, stability, and cytocompatibility, with particular emphasis on chitosan molecular weight, degree of deacetylation, crosslinking strategies, and curcumin loading. Solubility-enhancement strategies for curcumin, including surfactants, nanoparticles, solid dispersions, and chemical derivatives, are evaluated in the context of antimicrobial efficacy and cytotoxicity. Finally, the review highlights translational challenges and future directions, such as antibiotic synergy, antifungal applications, formulation complexity, and the emerging role of artificial intelligence in predictive material design. Collectively, these insights establish design principles for next-generation multifunctional biomaterials that integrate antimicrobial activity with immune modulation and tissue repair. Full article

Diabetes is a chronic disease that severely impairs wound healing, slowing wound closure; thus, the risk of infection and increases the occurrence of other complications. The development of a suitable material that can accelerate the process of chronic wound regeneration, particularly in diabetic wounds, remains a significant challenge. In the present study, Sepigel 305^® paraffin-based oil-in-water cream containing spherical gold nanoparticles–bioactive glass was used in rats with induced diabetes mellitus. After wound closure, the stage of regeneration was evaluated histopathologically. It was shown that the wounds treated with the experimental product were closed macroscopically after 14 days, but the histological images still indicated an inflammatory process, suggesting incomplete deep dermal healing. Macroscopic closure of wounds treated with the studied cream after 14 days, which is a normal time for skin healing, represents a successful outcome in diabetic patients because the risk of bacterial infection is reduced, and thus the chance of complete healing increases. Full article

Background/Objectives: Effective wound antisepsis and infection control remain central challenges in both acute and chronic wound management. pH-controlled sodium hypochlorite solution (HACCP’ER^®) is a novel agent that optimizes the proportion of bactericidal hypochlorous acid (HOCl) by maintaining pH at 6.0–7.3. The present preliminary study aimed to evaluate its broad-spectrum antimicrobial activity in vitro and clinical outcomes in a retrospective cohort of patients with diverse acute and chronic wounds. Methods: A retrospective observational study was conducted, involving 193 consecutive patients who received HACCP’ER-based wound care between May 2022 and February 2023. Wound categories included pressure ulcers (n = 61), foot ulcers (n = 44), burns (n = 42), acute traumatic wounds (n = 29), and other chronic wounds (n = 17). HACCP’ER was applied at a free available chlorine (FAC) concentration of 50–200 ppm at pH = 6.0–7.3. In vitro antimicrobial suspension testing against ten microbial species was performed at 57 ppm (pH = 5.2, 23 °C) according to Japanese Industrial Standards. Results: HACCP’ER at 57 ppm eliminated Escherichia coli, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Streptococcus spp., Salmonella spp., and Pseudomonas aeruginosa to below the detection limit (<10 CFU/mL) within 1 min, Candida within 3 min, and black Aspergillus within 5 min. In clinical wound cultures, bacterial burden was reduced in 6 of 10 (60%) patients. The mean patient age was 67.4 years. No adverse events attributable to HACCP’ER were recorded. Progressive wound healing was documented across all wound categories, with representative cases achieving closure at 1–11 months. Conclusions: HACCP’ER demonstrates potent broad-spectrum antimicrobial activity at wound-relevant concentrations and is clinically safe in acute and chronic wound care. Its physiologically aligned mechanism of HOCl generation supports both efficacy and biocompatibility. Prospective randomized controlled trials are warranted to definitively establish clinical efficacy. Full article

Emerging optical technologies may offer new opportunities for the non-invasive assessment of diabetic foot ulcers (DFUs), but the role of artificial intelligence (AI)-assisted autofluorescence-based approaches remains unclear. This scoping review aimed to map and summarise the published evidence on AI-assisted analysis of autofluorescence/fluorescence-based signals for DFU assessment and management. We searched Scopus, Web of Science, Embase, PubMed, CINAHL, Google Scholar, and the SPIE Digital Library, and also considered conference proceedings. We included English-language studies published between 2010 and October 2025. Of 197 records identified through database searching, 22 full-text articles were assessed for eligibility, and 5 studies met the inclusion criteria. Four studies focused on infection-related applications, specifically bacterial burden detection and Gram-type classification, whereas one study investigated tissue oxygenation estimation using a related optical imaging approach. All included studies were published between 2022 and 2025, were conducted in India, and four of the five evaluated the same device family or related variants. Overall, the evidence base was limited, geographically restricted, and technologically narrow. In addition, reporting of participant characteristics and AI methodology was often incomplete, with several studies relying on embedded proprietary or insufficiently described algorithmic components. Taken together, the available literature supports early proof-of-feasibility in restricted and largely device-specific evaluation settings rather than robust evidence of broad clinical validity, implementation readiness, or routine-care utility. Larger, more diverse, and independently validated studies with standardised acquisition procedures and more transparent AI reporting are needed before these approaches can be meaningfully evaluated for routine DFU care. Full article

Background: Body contouring surgery is a critical aspect of reconstructive and esthetic care, addressing both functional and psychosocial needs. As the global prevalence of obesity and related metabolic disorders is constantly on the rise, it is inevitable that patients presenting for body contouring procedures would display comorbid cardiometabolic conditions that can negatively impact surgical outcomes. Clustered cardiometabolic abnormalities have been linked to increased rates of surgical complications, medical adverse events, prolonged hospitalization, and need for revision procedures. However, its impact on body contouring surgery outcomes remains insufficiently characterized. Materials and Methods: TriNetX Global Collaborative Network, comprising deidentified electronic medical records from over 170 healthcare organizations was utilized for this study. Adults undergoing body contouring surgery were stratified by the presence of a composite cardiometabolic burden, defined as the combination of obesity, diabetes mellitus and hypertension, in the year preceding surgery. Cohorts were matched 1:1 using propensity score matching based on baseline demographics, comorbidities, and substance use. Risk ratios with 95% confidence intervals were calculated, with statistical significance set at p < 0.05. Outcomes were assessed at 30, 60, and 90 days postoperatively. Results: Among 188,164 body contouring patients, 6892 with composite cardiometabolic burden were propensity score–matched to controls. The study group was associated with significantly higher wound complications, surgical site infections, antibiotic use, and emergency department visits at 30, 60, and 90 days postoperatively, with no difference in hypertrophic scarring. Conclusions: Composite cardiometabolic burden, as defined in the study, demonstrated a significantly increased risk of adverse events following body contouring surgery, including wound-related morbidity, surgical site infection and increased healthcare utilization. These risks are evident from the early postoperative period and persist through at least the first 90 days after the procedure. Full article

With an increased number of chronic wounds and accidents worldwide, the need for advanced wound care approaches has been urgent. In this regard, sprayable hydrogel dressings have emerged as an innovative biomaterial due to their unique rheological properties, minimally invasive operation capabilities, excellent adaptability to irregular surfaces, and in situ rapid gelation. This review focused on elaborating the main materials used to construct sprayable hydrogels, including natural polymers and synthetic polymers, and discussing their respective molecular structures, physicochemical properties, advantages, and challenges in formulation design. This review also explored the properties of sprayable hydrogels, including sprayability, adhesion performance, mechanical strength, moisture absorption, breathability, biocompatibility, and degradability. The mechanisms of their controllable gelation through chemical crosslinking and physical crosslinking strategies were analyzed. Subsequently, the applications of sprayable hydrogels in wound areas, including diabetic wounds, infected wounds, postoperative adhesions, burn wounds, and joint wounds, were comprehensively reviewed. The challenges and future developments in wound healing were clarified to provide valuable references for promoting interdisciplinary research and the clinical translation of sprayable hydrogels. Full article