ReviewsWound Healing Dressings and Drug Delivery Systems: A Review
Section snippets
INTRODUCTION
Wound dressings and devices form an important segment of the medical and pharmaceutical wound care market worldwide. In the past, traditional dressings such as natural or synthetic bandages, cotton wool, lint and gauzes all with varying degrees of absorbency were used for the management of wounds. Their primary function was to keep the wound dry by allowing evaporation of wound exudates and preventing entry of harmful bacteria into the wound. It has now been shown however, that having a warm
WOUNDS
A wound can be described as a defect or a break in the skin, resulting from physical or thermal damage or as a result of the presence of an underlying medical or physiological condition. According to the Wound Healing Society, a wound is the result of ‘disruption of normal anatomic structure and function’.3 Based on the nature of the repair process, wounds can be classified as acute or chronic wounds. Acute wounds are usually tissue injuries that heal completely, with minimal scarring, within
WOUND DRESSINGS
Wound dressings have developed over the years from the crude applications of plant herbs, animal fat and honey to tissue engineered scaffolds. Many traditional medicinal plants used in Africa to treat wounds exhibit antibacterial activity.57 The leaves of Guiera senegalensis used in Senegal and Nigeria for treating wounds and inflammatory swelling, show antibacterial and anti radical effects.58 Ghanaian researchers have reported that extracts of Commelina diffusa herb and Spathodea campanulata
MEDICATED DRESSINGS FOR DRUG DELIVERY
The active ingredients used in wound management have evolved alongside the pharmaceutical agents and dressings used to deliver them. The use of topical pharmaceutical agents in the form of solutions, creams and ointments to wound sites have already been described. For example solutions such as thymol and hydrogen peroxide106 used commonly for cleansing and debridement, also possess antiseptic and antibacterial actions.
A new generation of medicated dressings incorporate new chemicals which have
CONTROLLED DRUG DELIVERY TO THE WOUND
Controlled release of drugs to a given target generally involves prolonging the action of the active drug over time by allowing continual release from a polymeric dosage form.193 There is however, little literature on the controlled delivery of drugs from polymeric wound dressings. The use of hydrophilic polymers as controlled release dressings has great promise because of the potential advantages they offer.
PHYSICAL CHARACTERISATION OF WOUND DRESSINGS
The physical properties of all pharmaceutical formulations including wound dressings influence their ultimate performance and contribute to satisfying the desirable properties of dressings (see Tab. 2). The specific property to be characterised will depend on both the type of wound dressing, the nature of the surface to which the dressing will be applied and any secondary dressings that may be involved.56 As for controlled drug delivery from polymeric dressings, there is very little literature
CONCLUDING REMARKS
This review has considered many classes of wound dressings including topical pharmaceutical agents, traditional wound dressings and modern dressings such as hydrocolloids, alginates, hydrogels, polyurethane film and foam and novel biomaterials such as collagen, chitosan and hyaluronic acid used directly or as tissue engineered matrices for skin replacement.
Polymeric dressings designed as vehicles to deliver therapeutic agents directly to the surface of wounds have also been discussed. These
REFERENCES (299)
- et al.
Complex wounds
Clinics
(2006) Physiology of wound healing
New Inf Nurs Rev
(2001)Burn wound healing and skin substitutes
Burns
(2001)- et al.
Characterization of biological properties of wound fluid collected during early stages of wound healing
J Invest Dermatol
(1992) Wound healing and its impairment in the diabetic foot
Lancet
(2005)Growth effects of Phaenicia sericata larval extracts on fibroblasts: Mechanism for wound healing by maggot therapy
Life Sci
(1997)- et al.
Screening of some Nigerian medicinal plants for antibacterial activity
J Ethnopharmacol
(1999) - et al.
An ethnopharmacological survey of plants used for wound healing in Dogonland, Mali, West Africa
J Ethnopharmacol
(2004) - et al.
Update on topical wound medications
Clin Tech Equine Pract
(2004) - et al.
Scanning electron microscopic examination of bacterial immobilisation in a carboxymethylcellulose (AquacelR) and alginate dressings
Biomaterials
(2003)
Ionically crosslinked alginate hydrogels as scaffolds for tissue engineering: Part 1. Structure, gelation rate and mechanical properties
Biomaterials
Evaluation of sodium alginate for bone marrow cell tissue engineering
Biomaterials
Alginates from wound dressings activate human macrophages to secrete tumour necrosis factor-α
Biomaterials
Wounds—What should a dressing formulary include?
Hosp Pharmacist
Definitions and guidelines for assessment of wounds and evaluation of healing
Arch Dermatol
Classification of wounds and their management
Surgery
Science, medicine and the future: Healing chronic wounds
Br Med J
Prediction and monitoring the therapeutic response of chronic dermal wounds
Int Wound J
Wound dressings: Meeting clinical and biological needs
Dermatol Nurs
The ABCs of wound care dressings
Wound Manag
Understanding physiology of wound healing and how dressings help
Br J Nurs
The skin
Molecular regulation of wound healing
Growth factors, their biology and promise in dermatologic disease and tissue repair
Arch Dermatol
Wound healing: New understandings
Nurs Pract Forum
Wound healing—Aiming for perfect skin regeneration
Science
Wound management, stoma and incontinence products
Wound dressings
Assessment and management of wound exudates
J Wound Care
The wound exudate continuum: An aid to wound assessment
Optimal use of an occlusive dressing to enhance healing: Effect of delayed application and early removal on wound healing
Arch Dermatol
Dressing choices
Nurs Times
Use of a fibrous dressing in exuding leg ulcers
J Wound Care
Preparing the wound bed: Focus on infection and inflammation
Ostomy Wound Manag
Maceration of the skin and wound bed 1: Its nature and causes
J Wound Care
Measuring the impact of venous leg ulcers on quality of life
J Wound Care
Bacterial colonisation of leg ulcers and its effect on success rate of skin grafting
Ann R Coll Surg
Minimizing factors that impair wound healing: A nursing approach
Ostomy Wound Manag
Surgical site infection in the elderly following orthopaedic surgery. Risk factors and outcomes
J Bone Joint Surg Am
Vitamin C and acute respiratory infections
Int J Tuberc Lung Dis
Patients with chronic leg ulcers show diminished levels of vitamins A and E, carotenes and zinc
Dermatol Surg
The role of nutrition in the management of lower extremity wounds
Int J Low Extrem Wounds
Transforming growth factor β reverses the glucocorticoid-induced wound healing deficit in rats: Possible regulation in macrophages by platelet-derived growth factor
Proc Nat1 Acad Sci USA
One systemic administration of transforming growth factor β1 reverses age- or glucocorticoid-impaired wound healing
J Clin Invest
Glucocorticoids inhibit keratinocyte growth factor production in primary dermal fibroblasts
Endocrinol
Debridement and wound bed preparation
Dermatol Ther
Sharp technique for wound debridement
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