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Contraction occurs in the context of open wounds to assist the healing process, as it results in a smaller deficit to be filled with connective tissue. The underlying process of contraction is still poorly understood, but it likely involves c ontractile forces generated by fibroblasts within the wound. Wound contraction Slower degradation of the dextran hydrogel with the high content of nondegradable PEGDA and higher cross-linking density Aids in chronic wounds, exudate absorbing capacity, optimizes moist microenvironment, and aids cell growth.
Aloe vera contains glucomannan, a substance that helps cellular regeneration and causes the body to produce collagen. This substance is a protein that promotes wound healing. The specially designed wound-healing gel is loaded with two types of FDA-approved skin cells – keratinocytes (essential for skin repair) and fibroblast (for formation of connective tissue) – and tiny magnetic particles. When combined with a dynamic magnetic field generated by an external device, the mechanical stimulation of the gel encourages dermal fibroblasts to become more active.If the wound becomes swollen, reddened or painful, or doesn’t start to heal within a few days seek medical advice. Wound healing is a natural physiological reaction to tissue injury. However, wound healing is not a simple phenomenon but involves a complex interplay between numerous cell types, cytokines, mediators, and the vascular system. The cascade of initial vasoconstriction of blood vessels and platelet aggregation is designed to stop bleeding. This is followed by an influx of a variety of inflammatory cells, starting with the neutrophil. These inflammatory cells, in turn, release a variety of mediators and cytokines to promote angiogenesis, thrombosis, and reepithelialization. The fibroblasts, in turn, lay down extracellular components which will serve as scaffolding. [1] The H&E stained skin section of day 24 showed an increase in epithelialization level (Fig. (Fig.6a13-a16). 6a13-a16). Epithelialization score was found to be significantly increased in each treatment group compared to the control group. Among treated groups, AM+AV had a higher epithelialization ( P<0.05) rate than AV (Fig. (Fig.6b). 6b). However, at this stage inflammation in AM+AV treated group increased again, while other treatment groups showed reduced inflammation (Fig. (Fig.6c). 6c). At day 24, angiogenesis in the AV group ( P<0.05), was higher than in the AM and the AM+AV group (Fig. (Fig.6d) 6d) but all groups showed elevated levels than the control. The inflammatory phase begins with hemostasis and chemotaxis. Both the white cells and thrombocytes speed up the inflammatory process by releasing more mediators and cytokines. Besides the platelet-derived growth factor, other factors promote collagen degradation, the transformation of fibroblasts, the growth of new vessels, and re-epithelialization. All of the processes occur at the same time but in a synchronized fashion. Mediators like serotonin and histamine are released from platelets and increase cellular permeability. The platelet-derived growth factor attracts fibroblasts and, along with transforming growth factor, enhances the division and multiplication of fibroblasts. The fibroblasts, in turn, synthesize collagen. In total 40 healthy female Wistar rats of 180–200g body weight were used in this study and randomly assigned into four experimental groups (control/no gel, treated with AV, treated with AM and treated with AM+AV). All animals received human care according to the guideline for the care and use of laboratory animals published by NIH. Rats were fed a standard rat chow and tap water ad libitum. The rats were kept in the animal quarter at a temperature of 25±2°C, humidity 50–55% and with 14h light/10h dark cycles. Each rat was anesthetized with Ketamine HCl solution (Gonoshasthaya Pharmaceuticals Ltd., Bangladesh) of 100mg/Kg body weight by intra peritoneal injection. Subsequently, the hair at dorsal region was trimmed using electric hair clipper and then shaved with sharp blade. The shaved areas were cleansed with alcohol swab.
One time application, prevents dehydration, ease of usage, provide moist microenvironment, non-cytotoxic nonirritating, exudates break down the Col powder. Bioadhesive hydrogels facilitate the adhesion of a hydrogel dressing to a wet wound bed and can provide long-term stability. Due to their flexibility and stretchability, the presence of a hydrogel on the wound provides comfort to the patient. Compared to conventional wound dressings, such as gauze and films, bioadhesive hydrogels are biologically more compatible and can be removed more easily from the wound. The bioadhesive property can be provided to the hydrogel dressings by modification with polyphenol derived moieties, such as catechol, dopamine, gallic acid, or tannic acid [ 51, 52, 58, 79, 80]. Metal oxides also showed antibacterial properties when they are incorporated into hydrogels for chronic wound healing. For example, zinc oxide (ZnO), titanium dioxide (TiO 2), and copper oxide (CuO 2) have been reported to have antibacterial activities [ 90, 91]. Some metal nanoparticles display antibacterial activity against only certain types of bacteria [ 82]. However, some of the inorganic materials might not have good cytocompatibility with mammalian cells. A moist healing environment has been clinically proven to aid and speed up the natural wound healing process. Elastoplast Wound Healing Ointment creates a breathable film that protects the wound from external influences while preventing the wound from drying out. This is clinically proven to promote faster wound healing and reduce the risk of scarring.This is major step forward in active wound care,” explained Professor Tay. “Our goal is to provide an effective and convenient wound-healing solution that improves outcomes for millions around the world.” Nevin, K. G., et al. (2010). Effect of topical application of virgin coconut oil on skin components and antioxidant status during dermal wound healing in young rats. In vitro biocompatibility and cytotoxicity test were done as described by Khan et al., (2012) [ 39]. To do the heparinized human blood biocompatibility assay, AM, AV and AM+AV gels were diluted with different ratios of blood. A blood sample of the same donor diluted with DW and saline water (SW) at the same ratios as done for the gels was used as a control. After an incubation time of 2h at room temperature, the blood/gel mixtures were spread on glass slides, and observed under a light microscope for possible morphological changes in the blood cells. The proliferative phase is characterized by the formation of granulation tissue, reepithelialization, and neovascularization. This phase can last several weeks.
Over half a billion people across the world are currently living with diabetes, and this number continues to increase. Therefore, chronic diabetic wounds are becoming a “global healthcare challenge”. A 2016 review states that laboratory research suggests honey significantly improves the healing rate of wounds in animals. It also says that it reduced scar formation and inhibited bacterial growth in acute wounds and burns. matrix that enhances skin regeneration, decreases enzymatic degradation, provides structural support, and enhances cell proliferation by creating ECM like structure.Beside active ingredients, the applicability of burn wound healing gel is dependent on the properties such as pH, appearance, homogeneity, and viscosity. Carbopol is a widely used gelling agent for producing burn-healing gels for skin application. CMC-Na salt is another agent used alongside with carbopol [ 46]. However, in this study the gel was prepared from human amniotic membrane extract (AM), Aloe vera extracts (AV), and a combination of both AM+AV using 6% CMC-Na salt as a gelling agent. Extensive studies confirm the effectiveness and safety of lyophilized amnion as a wound dressing and grafting materials for promoting the healing process and preventing infections [ 47]. Khorasani et al. , (2009) reported that AV cream or gel could be more effective than silver sulfadiazine cream in treating burn wound healing [ 30]. The end products (gels) in all three conditions evaluated in this study were homogenous, granule less and of a whitish creamy color (Fig. (Fig.1a10, 1a10, 1b3, 1c). In addition, pH of all formulations ranged between 6.5–6.9, and this pH does not interfere with skin physiology [ 48]. Erythema and edema are the common symptoms of skin irritation which lasts for three to 7 days [ 49]. Our formulated gels did not induce any irritation including no erythema or edema on rat skin upon topical application for a period of 7days (Fig. (Fig.4c). 4c). Thus, CMC-Na salt, AM and AV extract formulated gel could be useful as wound healing gel as the gels have good spreadability and consistency. In vitro and in vivo studies clearly and collectively demonstrated the potentials of the formulated gels from amnion when combined with Aloe vera. In this preliminary research, we found that the formulated gels can induce and accelerate the proliferation and attachment of HaCaT and HFF1 cells (Fig. (Fig.3), 3), and promote wound healing in vitro (Fig. (Fig.4a, 4a, b) [ 50]. Amnion has been reported to facilitate the migration of epithelial cells, reinforces attachment, and promotes proliferation [ 51]. According to researchers from the National University of Singapore (NUS), “chronic diabetic wounds are a significant global healthcare challenge”.
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