Development of theranostic wound dressings: harnessing the knowledge of biospecific interactions at the biomaterial interface to promote healing and identify biomarkers.
Development of theranostic wound dressings: harnessing the knowledge of biospecific interactions at the biomaterial interface to promote healing and identify biomarkers.
复制标题
治疗诊断伤口敷料的开发：利用生物材料界面上的生物特异性相互作用的知识来促进愈合并识别生物标志物。
DOI：
10.1080/17434440.2023.2181694
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发表时间：
2023
影响因子：
3.1
通讯作者：
Saberianpour S
中科院分区：
文献类型：
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作者：
Saberianpour S
慢性伤口被广泛认为是一个全球性的健康挑战，但我们对伤口生物学的理解和对其治疗的技术创新的实施在过去几十年中只取得了有限的进展[1]。目前，伤口的临床评估是基于临床医生的经验，临床医生遵循一系列可用指南中的建议，并根据其对伤口状况的适用性选择市售伤口敷料[2]。例如，Wounds UK关于慢性伤口管理的最佳实践声明推荐了几个用于评估病变的标准，这些标准主要基于对整体伤口床和伤口周围区域状态（例如炎症）、渗出液体积和粘度、疼痛和感染产生的恶臭的主观临床检查。伤口尺寸测量的方法提供了定量数据，但它们受到有限的评价者内可靠性的影响。同样，选择最合适的伤口敷料的目的是提供有利于愈合的生物条件。尽管可用范围广泛，但伤口敷料均设计有两个主要特征：（i）由聚合物多孔水凝胶制成的吸收层，能够吸收过量渗出液，同时保持伤口湿润;（ii）保护伤口免受外部污染物和细菌影响的薄膜（例如硅）[3]。更先进的伤口敷料包括抗微生物剂（例如银纳米颗粒）或已知可促进愈合的生长因子[3]。后者的使用受到其成本，冷藏条件的需要以及有争议的愈合特性的限制。在这种情况下，高达42%的伤口在首次出现后6个月内无法愈合，通常会导致严重的并发症[4]。基于这些前提，合理地提倡寻求促进愈合的伤口敷料和伤口评价的客观参数。
Chronic wounds are widely recognized as a global health challenge, but both our understanding of wound biology and the implementation of technological innovations for their treatment have made only limited progress in the last few decades [1]. Currently, the clinical assessment of the wound is based on the experience of the clinicians who follow recommendations taken from a range of available guidelines and choose commercially available wound dressings on the basis of their suitability to the wound conditions [2]. For example, the Wounds UK’s best practice statement on the management of chronic wounds recommends several criteria for the assessment of lesions that are mainly based on a subjective clinical inspection of the overall wound bed and peri-wound area status (eg inflammation), the exudate volume and viscosity, pain, and infectiongenerated malodor. Methods of wound size measurement provide quantitative data, but they suffer from limited intra-rater reliability. Likewise, the choice of the most suitable wound dressing is made with the aim of providing biological conditions favorable to healing. Despite the wide range available, wound dressings are all designed with two main characteristics:(i) an absorbent layer made of a polymeric porous hydrogel capable of absorbing excess exudate while keeping the wound moist and (ii) a film (eg silicon) protecting the wound from external contaminants and bacteria [3]. More advanced wound dressings include anti-microbial agents (eg silver nanoparticles) or growth factors known to promote healing [3]. The use of the latter is limited by their costs, need for refrigerated storage conditions, and debated healing properties. In this context, up to 42% of wounds do not heal within 6 months from the first presentation, often leading to severe complications [4]. Based on these premises, the quest for both healing-promoting wound dressings and objective parameters of wound evaluation is legitimately advocated.