Material selection for
wound dressing materials
GROUP: 'G'
Introduction
Wound : disruption in the continuity of the epithelial lining of the skin. resulting from physical
or thermal damage.
Four different phases of wound healing
The coagulation and haemostasis phase (immediately after injury)
The inflammatory phase (shortly after injury to tissue) during which swelling takes place
The proliferation period where new tissues and blood vessels are formed
The maturation phase in which remodeling of new tissues takes place
Transparency: enables visual monitoring of the
ulcer surface area.
Adhesiveness: Adhesives lead to the
attachment of the dressing to the wound
Features of surface, removal of the dressing may then strip
away newly forming epithelium.
dressings
Absorptive Capacity: varies greatly, according
to the type of dressing and manufacturer
Permeability: level of permeability to fluids,
gases, vapor, and bacteria varies according to
the type of dressing. As the level of secretion
increases, more permeable dressings should
be used.
Antimicrobial Effect: Achieved by creating
environment unsuitable for growth of bacteria.
Optimizing the
wound bed
Factors influencing selection of Material
Wound Characteristics
Dry Wound Moist Heavily Exuding
Requires highly h powerful absorptive capacities
Need to keep the area
absorbent dressing that also minimize maceration of
moist and free from bacteria
surrounding healthy skin
Factors influencing selection of Material
Tissue type
Necrotic : This is a fancy term for dead tissue. Necrotic tissue occurs when certain skin cells
in or on one part of the wound die off,
Granulating : At the polar opposite end of necrotic tissue, granulating tissue is the new
connective tissue that is created when the surface area is healing from an injury or wound
Sloughy: As the name suggests, sloughy tissue is separating itself from the body/wound
site, and is often stringy
Epithelizing: Epithelial tissue is a series of tightly-packed cells that provides one or more
layers and often slowly grows over the granulating tissue
Types of wound dressings
Traditional wound dressings: Includes Modern wound dressings: developed
gauze, lint, plasters, bandages (natural or to facilitate the function of the wound
synthetic) and cotton wool. rather than just to cover. It can be
classified as:
Limitations:
Requires frequent changing. Thin films
Becomes adherent to the wound. Hydrocolloid
Indicated for the clean and Hydrogels
dry wounds or used as
secondary dressings Alginates
Fail to provide moist environment to Foam
the wound Activated Charcoal
Modern wound dressings
Thin Films: composed of a thin sheet of Hydrocolloid dressings: contain
polyurethane. hydrocolloidal hydrophilic particles
(mainly sodium carboxy methyl cellulose)
Permeable to moisture vapor and gases
that are gel-forming.
but impermeable to fluid and bacteria.
Provides occlusive moist environment,
maintain a moist wound environment, so
waterproof, can adhere to wet sites
can't be applied on secreting ulcers.
Modern wound dressings
Hydrogels: made up of a 3-D matrix of Alginates: Alginate dressings are made of
hydrophylic polymers, such as carboxy- polysaccharide fiber, containing alginic
methylcellulose or polyethylene oxide. acids, derived from various species of
seaweed.
come in sheets & gel high water content
facilitates debridement by rehydration. Main purpose is haemostasis, and is of
absorbent nature. It forms a gel which
conforms to shape of the wound.
Modern wound dressings
Foams: made up of hydrophobic and Activated Charcoal: activated charcoal is
hydrophilic foam with adhesive borders. bound to a semi-permeable membrane
hydrophobic layer protect from the Semi-permeable dressing encourage the
liquid but allow gaseous exchange. formation of a moist environment, optimal
for enhanced wound healing.
Silicone-based rubber foam (silastic)
molds and contours to wound shape. Silver impregnated activated charcoal dr
essings provides antibacterial effects upto
some extent
Electrospinning, namely the extrusion of polymer fibers
by means of high electric fields, is an interesting
technology for the development of innovative
biomedical devices for wound care.
Because of the ultrafine size of the fiber produced,
Electro spun
following advantages are there:
Complete coverage of the injured tissue and protection
nanofibers
against infections and dehydration, as well as thermal
insulation.
Permeation of gases, transport of nutrients, retention of
for Wound
moisture due to the high porosity of the electro spun
mesh.
Dressing By using this technology, polymers derived from natural
sources, such as alginate, cellulose and chitosan are
used for making nanofiber with controlled size,
morphology and degradation rate. These biopolymers
offer remarkable advantages in terms of
biocompatibility, biodegradability and environmentally
friendliness.
Electrospinning
Schematic
Diagram
Electrospinning apparatus
consisting of a syringe
pump for the delivery of
the polymer solution and a
plate for the collection of
the fibers. The high voltage
is applied between the
metallic needle and the
collector.
Alginate is a polysaccharide derived from brown
algae that exhibits excellent biocompatibility and
relatively low cost. It finds application in tissue
engineering for skin, nerve, bone and cartilage
regeneration, and in the drug delivery systems.
Due to its high water solubility, the corresponding
nanofibers are poorly stable in aqueous
environments.
Alginate How to stabilize alginate nanofibers in aqueous
environments?
Nanofibers Nanofibers of sodium alginate with a diameter of 80
nm are fabricated by the electrospinning technique
and then treated with trifluoroacetic acid (TFA).
The acid soaking induces a chemical modification
of the nanofibers’ structure while maintaining their
shape and network organisation
Sodium alginate nanofibers have been used to treat
skin inflammations and burns.
Cellulose Acetate Nanofibers encapsulating essential
oils with antimicrobial activity
Preventing infections is one of the main focuses of wound care.
The colonisation of wounds by microorganisms can in fact have negative
consequences on the healing process, delaying it.
Essential oils are used as natural antimicrobial agents for cellulose-based fibrous
dressings.
There have been development of the production of composite electrospun fibres
that effectively encapsulate three different types of essential oils (cinnamon,
lemongrass and peppermint).
The fibrous scaffolds are able to inhibit the growth of Escherichia coli, even when
small amounts of essential oils were used.
At the same time, they are not cytotoxic.
Future perspective
Explorations are made with materials that can function more
efficiently as hydrogels, while also delivering anti
microbial agents within the therapeutic range
Biopolymers such as alginates, chitosan, hyaluronates and cellulose derivative
Ability to provide a moist environment for wound healing (
high water imbibing properties)
Function as cellular scaffolds for tissue regeneration
Hydrogel preparation techniques
To increase porosity within the structure, hence increasing the available surface are
a for moisture absorption and retention
Varying porosity and crosslinking density also enables the kinetics of drug release to
be controlled which is beneficial for-
avoiding side effects and toxicity associated with many antimicrobial agent
Incorporating more than one antimicrobial into the hydrogel, possibly in a gradient-
loaded pattern (from high to low concentration at the wound surface) could enhance
infection treatment strategies
Alternative micro-
biocides including metal ions, essential oils and other natural products.
Field of ionic liquids
Potential as novel antimicrobials
Potential to be ‘designer’ antimicrobial agents
Feasibility of altering chemical properties to suit desirable features in efforts to reduced
incidence of resistance development
DEVICES
Topical negative pressure wound therapy (TNPWT)
It is the application of subatmospheric pressure to wounds.
It is used for both infected or contaminated wounds, ischemic tissue, soft tissue defects
and burns) and chronic wound healing
It involves placing a moist foam or porous gauze over the wound, followed by a drain
and occlusive dressing such as polyurethane foam.
The drain is then connected to a vacuum line that can apply pressures
Hyperbaric oxygen therapy (HOT)
Requires the patient to be exposed intermittently to 100% oxygen in a pressurized
chamber (>1 atm)
Pure, super-atmospheric oxygen can be applied directly to the wound site
The positive oxygen pressure can be applied in a cyclical manner, to stimulate
localized circulation and reduce edema
Because the oxygen is applied via a hermetically sealed device, wound healing
progresses in a moist environment.
Facilitates re-epithelialization and angiogenesis within the wound bed
Minimal levels of scarring, wound reopening risks and may also have analgesic effects
Thank you!
