Recent advancements in cellulose-based biomaterials for management of infected wounds

ABSTRACT

Introduction

Chronic wounds are a substantial burden on the healthcare system. Their treatment requires advanced dressings, which can provide a moist wound environment, prevent bacterial infiltration, and act as a drug carrier. Cellulose is biocompatible, biodegradable, and can be functionalized according to specific requirements, which makes it a highly versatile biomaterial. Antimicrobial cellulose dressings are proving to be highly effective against infected wounds.

Areas covered

This review briefly addresses the mechanism of wound healing and its pathophysiology. It also discusses wound infections, biofilm formation, and progressive emergence of drug-resistant bacteria in chronic wounds and the treatment strategies for such types of infected wounds. It also summarizes the general properties, method of production, and types of cellulose wound dressings. It explores recent studies and advancements regarding the use of cellulose and its derivatives in wound management.

Expert opinion

Cellulose and its various functionalized derivatives represent a promising choice of wound dressing material. Cellulose-based dressings loaded with antimicrobials are very useful in controlling infection in a chronic wound. Recent studies showing its efficacy against drug-resistant bacteria make it a favorable choice for chronic wound infections. Further research and large-scale clinical trials are required for better clinical evidence of its efficiency.

KEYWORDS:

• Antibiotic-resistance
• bacterial cellulose
• biopolymer
• biofilm
• chronic wound
• oxidized regenerated cellulose
• wound dressing
• wound infection

Article highlights

1. Biopolymers like cellulose are biomimetic and can promote wound healing. Their physical and chemical modifications can confer very important functionality to cellulose, which can make them an excellent choice of biomaterial for wound dressing.

2. Infection is one of the major causes of delayed healing of chronic wounds. Biofilm formation on chronic wounds and drug resistance associated with it makes the wound unmanageable. Antimicrobial loaded cellulose dressings have shown high efficiency in controlling infections associated with this type of wounds.

3. In chronic wounds, cellulose is also used as a healing matrix. It activates the granulation and epithelialization mechanism for partial thickness wounds and full thickness wounds.

4. Nanocellulose are used in bioactive wound dressings by loading antimicrobials, and their sustained release capability is very useful in the treatment of chronic and infected wounds.

5. Bacterial cellulose has a high chemical purity, porosity, and permeability as compared to plant-based cellulose, and they are extensively used in burn wounds due to their exceptional moisture retaining capacity.

6. Oxidized regenerated cellulose and oxidized cellulose have excellent hemostatic and antibacterial properties, and these hemostats are currently being explored as a wound dressing material.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.