The use of chitosan-based biomaterials for the treatment of hard-healing wounds

Abstract

Wound healing is a complex process that engages skin cells, the blood, the immune system and a number of circulating substances in the body. Infections, contamination of the wound or a vast area of damage complicate and delay the natural process of skin regeneration. The incidence of hard-to-heal wounds is an increasingly common problem, because they can significantly impair the quality of life of the patient. For this reason, it is extremely important to look for factors (drugs, dressings or other substances) that could accelerate and relieve wound healing. Among many compounds in the area of medical engineering interest, attention should be paid to natural polysaccharides, e.g. chitosan and alginate. This article is devoted to biomaterials that play an important role in the treatment of chronic wounds. These include the following: hydrogels, non-wovens, membranes and chitosan sponges as well as chitosan-alginate composites or chitosan composites combined with zinc oxide and nanosilver. The material, which has chitosan as a base, works on all stages of the healing process. Many in vitro, in vivo and clinical studies that provide the basis for using chitosan materials as a substitute for conventional bandages and dressings have been carried out. At the stage of hemostasis, it accelerates platelet aggregation and the formation of a fibrin clot. In the inflamed stage, they cause the proliferation of neutrophils and macrophages that cleanse the wound, releasing cytokines at the wound site. Studies have shown that chitosan mimics the native extracellular matrix, providing the optimal microenvironment for the wound.