Ana M.A. Dias

Recent advances on the development of wound dressings for diabetic foot ulcer treatment—A review

Diabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches.

Chitosan-based dressings loaded with neurotensin—an efficient strategy to improve early diabetic wound healing

One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our results show that MPC has the best fluid handling capacity and delivery profile, also being non-toxic to Raw 264.7 and HaCaT cells. NT-loaded and non-loaded MPC dressings were applied to control/diabetic wounds to evaluate their in vitro/in vivo performance. The results show that the former induced more rapid healing (50% wound area reduction) in the early phases of wound healing in diabetic mice. A NT-loaded MPC foam also reduced expression of the inflammatory cytokine TNF-α (P<0.001) and decreased the amount of inflammatory infiltrate on day 3. On day 10 MMP-9 was reduced in diabetic skin (P<0.001), significantly increasing fibroblast migration and collagen (COL1A1, COL1A2 and COL3A1) expression and deposition. These results suggest that MPC-based dressings may work as an effective support for sustained NT release to reduce DFUs.

Solubility of oxygen in n-hexane and in n-perfluorohexane. Experimental determination and prediction by molecular simulation

The solubility of oxygen in n-hexane and in n-perfluorohexane was determined experimentally and calculated by computer simulation. A precision apparatus based on a saturation method at constant pressure was used to measure the solubility at temperatures from 288 to 313 K and close to atmospheric pressure. Henrys law coefficients, H2,1(T,psat1), were obtained from the experimental data and their temperature dependence was represented by appropriate correlations. The precision of the results was characterised by average deviations of H2,1 from these smoothing equations and is of ±0.5% and ±0.8% for oxygen in n-hexane and in n-perfluorohexane, respectively. From the temperature variation of the Henrys law coefficients, partial molar solvation quantities such as the variation of the Gibbs energy, enthalpy and entropy were derived. Molecular dynamics simulations with all-atom force fields, associated with Widoms test particle insertion method, were used to calculate the residual chemical potential of oxygen in the two solvents studied leading to Henrys law coefficients which were then compared to the experimental values. The difference between oxygen solubility in the two solvents was interpreted on the basis of solute–solvent interactions and structural properties such as solute–solvent radial distribution functions.

Neurotensin-loaded collagen dressings reduce inflammation and improve wound healing in diabetic mice.

Impaired wound healing is an important clinical problem in diabetes mellitus and results in failure to completely heal diabetic foot ulcers (DFUs), which may lead to lower extremity amputations. In the present study, collagen based dressings were prepared to be applied as support for the delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. The performance of NT alone and NT-loaded collagen matrices to treat wounds in streptozotocin (STZ) diabetic induced mice was evaluated. Results showed that the prepared dressings were not-cytotoxic up to 72h after contact with macrophages (Raw 264.7) and human keratinocyte (HaCaT) cell lines. Moreover, those cells were shown to adhere to the collagen matrices without noticeable change in their morphology. NT-loaded collagen dressings induced faster healing (17% wound area reduction) in the early phases of wound healing in diabetic wounded mice. In addition, they also significantly reduced inflammatory cytokine expression namely, TNF-α (p<0.01) and IL-1β (p<0.01) and decreased the inflammatory infiltrate at day 3 post-wounding (inflammatory phase). After complete healing, metalloproteinase 9 (MMP-9) is reduced in diabetic skin (p<0.05) which significantly increased fibroblast migration and collagen (collagen type I, alpha 2 (COL1A2) and collagen type III, alpha 1 (COL3A1)) expression and deposition. These results suggest that collagen-based dressings can be an effective support for NT release into diabetic wound enhancing the healing process. Nevertheless, a more prominent scar is observed in diabetic wounds treated with collagen when compared to the treatment with NT alone.

Correlation between sludge settling ability and image analysis information using partial least squares

In the last years there has been an increase on the research of the activated sludge processes, and mainly on the solid-liquid separation stage, considered of critical importance, due to the different problems that may arise affecting the compaction and the settling of the sludge. Furthermore, image analysis procedures are, nowadays considered to be an adequate method to characterize both aggregated and filamentous bacteria, and increasingly used to monitor bulking events in pilot plants. As a result of that, in this work, image analysis routines were developed in Matlab environment, allowing the identification and characterization of microbial aggregates and protruding filaments. Moreover, the large amount of activated sludge data collected with the image analysis implementation can be subsequently treated by multivariate statistical procedures such as PLS. In the current work the implementation of image analysis and PLS techniques has shown to provide important information for better understanding the behavior of activated sludge processes, and to predict, at some extent, the sludge volume index. As a matter of fact, the obtained results allowed explaining the strong relationships between the sludge settling properties and the free filamentous bacteria contents, aggregates size and aggregates morphology, establishing relevant relationships between macroscopic and microscopic properties of the biological system.

Phosphonium-based ionic liquids as modifiers for biomedical grade poly(vinyl chloride).

This work reports and discusses the influence of four phosphonium-based ionic liquids (PhILs), namely trihexyl(tetradecyl) phosphonium dicyanamide, [P(6,6,6,14)][dca]; trihexyl(tetradecyl) phosphonium bis(trifluoromethylsulfonyl)imide, [P(6,6,6,14)][Tf(2)N]; tetrabutyl phosphonium bromide, [P(4,4,4,4)][Br]; and tetrabutyl phosphonium chloride, [P(4,4,4,4)][Cl], on some of the chemical, physical and biological properties of a biomedical-grade suspension of poly(vinyl chloride) (PVC). The main goal of this work was to evaluate the capacity of these PhILs to modify some of the properties of neat PVC, in particular those that may allow their use as potential alternatives to traditional phthalate-based plasticizers in PVC biomedical applications. PVC films having different PhIL compositions (0, 5, 10 and 20 wt.%) were prepared (by solvent film casting) and characterised by Fourier transform infrared, thermogravimetric analysis, differential scanning calorimetry, dynamical mechanical thermal analysis, scanning electron microscopy/energy-dispersive X-ray/electron probe microanalysis, X-ray diffraction, transmittance, permeability towards oxygen and carbon dioxide, thermal degradation, contact angle measurement, water and vapour uptake, leachability and biocompatibility (haemolytic potential, thrombogenicity and cytotoxicity). A conventional organic plasticizer (di-isononyl phthalate) was used for comparison purposes. The results obtained showed that it was possible to change the neat PVC hydrophobicity, and consequently its water uptake capacity and plasticizer leachability, just by changing the PhIL employed and its composition. It was also possible to significantly change the thermal and mechanical properties of PVC films by choosing appropriate PhIL cation/anion combinations. However, a specific PhIL may not always be capable of simultaneously keeping and/or improving both physical properties. In addition, ionic halide salts were found to promote PVC dehydrochlorination. Finally, none of the prepared materials presented toxicity against Caco-2 cells, though pure [P(6,6,6,14)][dca] decreased HepG2 cells viability. Moreover, PVC films with [P(6,6,6,14)][dca] and [P(4,4,4,4)][Cl] were found to be haemolytic and thus these PhILs must be avoided as PVC modifiers if biomedical applications are envisaged. In conclusion, from all the PhILs tested, [P(6,6,6,14)][Tf(2)N] showed the most promising results regarding blood compatibility, leaching and permeability to gases of PVC films. The results presented are a strong indicator that adequate PhILs may be successfully employed as PVC multi-functional plasticizers for a wide range of potential applications, including those in the biomedical field.

Impregnation of cinnamaldehyde into cassava starch biocomposite films using supercritical fluid technology for the development of food active packaging.

In this work, supercritical solvent impregnation (SSI) has been tested for the incorporation of natural compounds into biocomposite materials for food packaging. Cinnamaldehyde, with proved antimicrobial activity against fungi commonly found in bread products, was successfully impregnated on biocomposite cassava starch based materials using supercritical carbon dioxide as solvent. Different process experimental conditions were tested (pressure, impregnation time and depressurization rate) at a fixed temperature (35 °C) in order to study their influence on the amount of impregnated cinnamaldehyde as well as on the morphology of the films. Results showed that all conditions permitted to impregnate antimicrobial active amounts superior to those previously obtained using conventional incorporation methods. Moreover, a significant decrease of the equilibrium water vapor sorption capacity and water vapor permeability of the films was observed after SSI processing which is a clear advantage of the process, considering the envisaged applications.

Control of the properties of porous chitosan–alginate membranes through the addition of different proportions of Pluronic F68

This work addresses the development and characterization of porous chitosan-alginate based polyelectrolyte complexes, obtained by using two different proportions of the biocompatible surfactant Pluronic F68. These biomaterials are proposed for applications as biodegradable and biocompatible wound dressing and/or scaffolds. The results indicate that thickness, roughness, porosity and liquid uptake of the membranes increase with the amount of surfactant used, while their mechanical properties and stability in aqueous media decrease. Other important properties such as color and surface hydrophilicity (water contact angle) are not significantly altered or did not present a clear tendency of variation with the increase of the amount of surfactant added to the polyelectrolyte complexes, such as real density, average pore diameter, total pore volume and surface area. The prepared biomaterials were not cytotoxic to L929 cells. In conclusion, it is possible to tune the physicochemical properties of chitosan-alginate polyelectrolyte complexes, through the variation of the proportion of surfactant (Pluronic F68) added to the mixture, so as to enable the desired application of these biomaterials.

Activated sludge process monitoring through in situ near-infrared spectral analysis.

The application of near infrared (NIR) spectroscopy for industrial process monitoring is achieving increasing importance over the last twenty years. In fact, the real time monitoring capacity of NIR spectroscopy is a very important feature for process monitoring, prediction and control as it allows a fast evaluation of the state of the process. However, the application of NIR spectroscopy in wastewater treatment processes is still to be explored. Although some applications of the technique for wastewater monitoring have been reported in the literature, there is still a need for more investigation related with applications, limitations and advantages of the technique when compared with other methods. An activated sludge reactor for aerobic treatment of a complex medium was monitored in situ with a NIR transflectance probe and traditional chemical parameters analysed off-line. NIR spectrophotometric data measured at the feed, reactor and settler were coupled to principal component analysis (PCA) to infer about the ability of this monitoring system to detect changes in the feed influent. The analysis of the score plots resulting from PCA permitted to identify the moments at which the perturbations occurred and to follow the consequent instability induced in the reactor till the day where the system is recuperated. The promising results obtained, suggest the interest in more detailed studies on the feasibility of NIR spectroscopy as an alternative method for monitoring and control of wastewater treatment processes.

Supercritical solvent impregnation of natural bioactive compounds in N-carboxybutyl chitosan membranes for the development of topical wound healing applications

Supercritical Solvent Impregnation (SSI) was used to load topical membrane-type wound dressing biomaterials with natural based bioactive compounds namelly quercetin as an antiinflammatory and thymol as anaesthetic and skin permeation enhancer. The biodegradable and biocompatible membranes where prepared as film- and foam-like structures of N-carboxybutylchitosan and agarose to study the influence of morphological structure on the fluid handling capacities of the materials. Results show that SSI is a feasible and advantageous process that permits to ‘tune’ the relative loaded amounts of the bioactive substances by changing the operational conditions. The process also promotes the size reduction of quercetin particles with a significant improvement in its solubility in aqueous solutions and consequently in its bioavailability. The prepared materials present a sustained delivery for quercetin and adequate fluid handling capacities that are in the typical and desired ranges for commercial wound dressings.