Preparation and evaluation of chitosan-polyvinyl alcohol/polyhexamethylene guanidine hydrochloride antibacterial dressing to accelerate wound healing for infectious skin repair

Xiaotong Yue; Lingying Liu; Yushou Wu; Xiangyu Liu; Shaozeng Li; Zihao Zhang; Shaofang Han; Xiaoteng Wang; Yang Chang; Hailiang Bai; Jiake Chai; Sen Hu; Hongyu Wang

doi:10.21037/atm-21-509

Preparation and evaluation of chitosan-polyvinyl alcohol/polyhexamethylene guanidine hydrochloride antibacterial dressing to accelerate wound healing for infectious skin repair

Ann Transl Med. 2021 Mar;9(6):482. doi: 10.21037/atm-21-509.

Authors

Affiliations

¹ Burns Institute of PLA, Department of Burns and Plastic Surgery, the Fourth Medical Center Affiliated to PLA General Hospital, Beijing, China.
² Department of Clinical Laboratory, the Fourth Medical Center Affiliated to PLA General Hospital; Beijing, China.
³ Research Laboratory of Trauma Surgery, the Fourth Medical Center Affiliated to PLA General Hospital, Beijing, China.
⁴ Department of Burn Surgery, the Third Affiliated Hospital of Inner Mongolia Medical University (Inner Mongolia Baogang Hospital), Baotou, China.

Abstract

Background: Wound infections, especially multidrug-resistant (MDR) bacterial infections, are a major challenge in clinical medicine.

Methods: In this study, a new type of antibacterial sponge was prepared from a solution containing a chitosan-polyvinyl alcohol (CTS-PVA) emulsion with added polyhexamethylene guanidine hydrochloride (PHMG) in a homogeneous medium using lyophilization technology. The antibacterial ability of and CTS-PVA/PHMG sponge against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, Methicillin-resistant Staphylococcus aureus, multidrug-resistant Pseudomonas aeruginosa, and multidrug-resistant Acinetobacter baumannii in vitro. The structure and physical properties were characterized. The sponge dressing was tested in a Pseudomonas aeruginosa-infected full-thickness mouse skin wound defect model. The effects were evaluated by wound area measurement and histological analysis.

Results: The CTS-PVA/PHMG sponge showed broad-spectrum antibacterial ability, including for MDR bacterial stains from clinical sources, while maintaining excellent physicochemical properties, including a high swelling degree and good moisture retention capability. Scanning electron microscopy images displayed the surface morphology of the CTS-PVA/PHMG sponge dressing. The detection of the wound healing rate and histological analysis supported that the new dressing can alleviate the inflammation and accelerate the healing speed of infected wounds and in vivo.

Conclusions: CTS-PVA/PHMG sponge shows broad-spectrum antibacterial activity, which can provide a new pathway for clinical prevention and treatment of superbug-infected wounds.

Keywords: Antibacterial; dressing; infectious wound; polymer.