Future structure and properties of mechanism-based wound dressings

Abstract

The research and development of chronic wound dressings, which possess a mechanism-based mode of action, has entered a new level of understanding in recent years based on improved definition of the biochemical events associated with pathogenesis of the chronic wound. Recently, the molecular modes of action have been investigated for skin substitutes, interactive biomaterials, and some traditional material designs as balancing the biochemical events of inflammation in the chronic wound to improve healing. The interactive wound dressings have activities including up-regulation of growth factors and cytokines and down-regulation of destructive proteolysis. Carbohydrate-based wound dressings have received increased attention for their molecular interactive properties with chronic and burn wounds. Traditionally, the use of carbohydrate-based wound dressings including cotton, xerogels, charcoal cloth, alginates, chitosan, and hydrogels have afforded properties such as absorbency, ease of application and removal, bacterial protection, fluid balance, occlusion, and elasticity. Recent efforts in our lab have been underway to design carbohydrate dressings that are interactive cotton dressings as an approach to regulating destructive proteolysis in the non-healing wound. Elastase is a serine protease that has been associated with a variety of inflammatory diseases and has been implicated as a destructive protease that impedes wound healing. The presence of elevated levels of elastase in non-healing wounds has been associated with the degradation of important growth factors and fibronectin necessary for wound healing. Focus will be given to the design, preparation, and assessment of a type of cotton-based interactive wound dressing designed to intervene in the pathophysiology of the chronic wound through protease sequestration. © 2006 Springer.