Application of biodegradable polymer materials in the treatment of wound

doi:10.3877/cma.j.issn.1673-9450.2017.05.013

Abstract

Abstract:

The process of wound healing is consists of three phases: inflammation, proliferation and tissue remodeling. As wounds have faild to pcroceed through the normal healing process, chronic wounds will be characterized. As the population ages, chronic wounds are becoming more prevalent, the treatment of chronic wound has become a heavy burden of the medical system, In developed countries, the care for chronic wounds has been reported to cost 2% to 3% of the healthcare budgets. Traditional debridement treatment and textile dressing treatment has not been able to meet the needs of complex and varied wounds, the emergence of biodegradable polymer materials provides a new treatment program for the wound repair and regeneration. They′re biocompatible, biodegradable and can provide topographical guidance for tissue regeneration. They can also promote the healing process through the load of bioactive agents, antibacterial agents and stem cells. In this paper, the characteristics of commonly used biodegradable polymer materials and its latest applications in chronic wound repair are introduced, the future direction of development is briefly discussed.

Key words: Wound healing, Therapeutic uses, Biodegradable material, Polymer material, Wound healing, Wound dressing

Dan Yao, Daifeng Hao, Fan Zhao. Application of biodegradable polymer materials in the treatment of wound[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2017, 12(05): 382-388.

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URL: https://zhssyxfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9450.2017.05.013

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References 81

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负载物		优缺点
SC		可自我更新和特异性分化，持续释放GF^[14]，激活免疫细胞，促进再上皮化、新血管生成和细胞外基质沉积^[15]。但技术难度高、造价昂贵、储存时间短^[16]
生物活性剂		?
?	GF	促进血管生成、再上皮化和肉芽组织形成，增加胶原蛋白合成和成纤维细胞、上皮细胞的迁移活性。但半衰期短、组织渗透性较弱^[17]
?	肽序列	能为细胞粘附提供位点，能设计成仿GF功能序列，能作为新的运载系统^[12]
?	QHREDGS	促进角质形成细胞粘附和集体迁移，保护该细胞免受H₂O₂应激，诱导Akt和MAPK p42/44磷酸化上调。但活性受体内蛋白水解酶等影响^[18]
?	IL-4	能抑制人单核细胞中的肿瘤坏死因子，刺激成纤维细胞的增殖和胶原合成^[19]。但半衰期短，生物利用度低
?	NO	(1)早期能聚集巨噬细胞，去除损伤组织，激活、调解炎症。促进角质细胞增殖和再上皮化。(2)促进新生血管形成^[20]。(3)调节成纤维细胞表型，增强创面胶原合成和沉积。(4)使细菌蛋白功能障碍，氧化杀死细菌^[21]。(5)上调TGF-β1，加速肉芽组织形成和伤口愈合^[22]。但费用高、处理时间长、潜在宿主细胞毒性、使用设备不便^[22]
?	核酸	相对GF稳定，可通过调控GF表达促进角化细胞和肉芽组织增殖。但怎样有效转染和靶向释放是需研究的主要问题^[16]
抗菌剂		?
?	抗生素	能抑制创面病原体增生，促进创面正常愈合。但易产生耐药性，不同抗生素有不同的微生物作用范围^[23,24]。不推荐预防性局部外用^[25]
?	Ag	对革兰阳性/阴性菌、真菌有抗菌作用，不易产生耐药性^[26]。但易起皱，导致过敏反应、伤口干燥、愈合延迟，新形成皮肤与自然皮肤不同、不易清洗^[26]；大面积长时间使用会产生皮肤毒性^[27]
?	Cu	上调VEGF、FGF、PDGF，促进血管生成。上调整联蛋白的表达，稳定纤维蛋白原，上调铜依赖性酶。但对3T3成纤维细胞具有剂量依赖性细胞毒性^[28]
?	HY	有效抑制MRSA，照射时能产生活性氧物质^[29]。亲脂性强，亲水性欠佳^[29]

负载物		优缺点
SC		可自我更新和特异性分化，持续释放GF^[14]，激活免疫细胞，促进再上皮化、新血管生成和细胞外基质沉积^[15]。但技术难度高、造价昂贵、储存时间短^[16]
生物活性剂		?
?	GF	促进血管生成、再上皮化和肉芽组织形成，增加胶原蛋白合成和成纤维细胞、上皮细胞的迁移活性。但半衰期短、组织渗透性较弱^[17]
?	肽序列	能为细胞粘附提供位点，能设计成仿GF功能序列，能作为新的运载系统^[12]
?	QHREDGS	促进角质形成细胞粘附和集体迁移，保护该细胞免受H₂O₂应激，诱导Akt和MAPK p42/44磷酸化上调。但活性受体内蛋白水解酶等影响^[18]
?	IL-4	能抑制人单核细胞中的肿瘤坏死因子，刺激成纤维细胞的增殖和胶原合成^[19]。但半衰期短，生物利用度低
?	NO	(1)早期能聚集巨噬细胞，去除损伤组织，激活、调解炎症。促进角质细胞增殖和再上皮化。(2)促进新生血管形成^[20]。(3)调节成纤维细胞表型，增强创面胶原合成和沉积。(4)使细菌蛋白功能障碍，氧化杀死细菌^[21]。(5)上调TGF-β1，加速肉芽组织形成和伤口愈合^[22]。但费用高、处理时间长、潜在宿主细胞毒性、使用设备不便^[22]
?	核酸	相对GF稳定，可通过调控GF表达促进角化细胞和肉芽组织增殖。但怎样有效转染和靶向释放是需研究的主要问题^[16]
抗菌剂		?
?	抗生素	能抑制创面病原体增生，促进创面正常愈合。但易产生耐药性，不同抗生素有不同的微生物作用范围^[23,24]。不推荐预防性局部外用^[25]
?	Ag	对革兰阳性/阴性菌、真菌有抗菌作用，不易产生耐药性^[26]。但易起皱，导致过敏反应、伤口干燥、愈合延迟，新形成皮肤与自然皮肤不同、不易清洗^[26]；大面积长时间使用会产生皮肤毒性^[27]
?	Cu	上调VEGF、FGF、PDGF，促进血管生成。上调整联蛋白的表达，稳定纤维蛋白原，上调铜依赖性酶。但对3T3成纤维细胞具有剂量依赖性细胞毒性^[28]
?	HY	有效抑制MRSA，照射时能产生活性氧物质^[29]。亲脂性强，亲水性欠佳^[29]

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