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The skin is the largest organ in the human body, covering an area of about 2 square meters in an adult, and performs a variety of critical functions. It protects the body from external threats and acts as the first line of immune defense against invading pathogens. The skin also prevents excessive loss of water and nutrients, senses changes in the environment, and regulates body temperature, underscoring the importance of maintaining skin integrity. Skin wounds caused by physical injury, surgery, or exposure to extreme temperatures and chemicals can significantly affect human health. Skin wounds cause about 5.8 million deaths each year, accounting for one-tenth of global mortality. In conditions such as diabetes or infection, wounds can become chronic. Chronic wounds affect 1-2% of the population in developed countries and worldwide. In the UK, their point prevalence is 1.47/1000. By 2022, approximately 30 million people in China alone will suffer from chronic wounds. Chronic wounds are divided into pressure ulcers, vascular ulcers, and diabetic ulcers. According to a 2019 cross-sectional study, the global prevalence of pressure ulcers (chronic ulcers caused by sustained pressure) ranges from 3.4% to 32.4%. The prevalence of venous leg ulcers is thought to be between 1.5‰ and 3‰. In addition, 20-25% of diabetic patients will develop foot ulcers. Given this prevalence, promoting regenerative healing of skin wounds is essential. Although debridement and skin grafting are the gold standard for managing severe wounds, the scarcity of available skin sources and potential donor site damage limit their widespread use.
The main point of this paper
Wound care goals:
Protect the wound from mechanical forces and microorganisms.
Promote cell proliferation and migration to achieve scar-free healing.
Limitations of traditional dressings:
Traditional dressings such as gauze are non-occlusive and inert, making it difficult to control drug release and short-term antibacterial.
Advantages of nanofiber membranes:
The structure is similar to the extracellular matrix (ECM), suitable for wound dressings.
Manufactured by stretching, template-assisted synthesis, self-assembly and electrospinning.
Electrospinning technology:
Low cost, high efficiency and high yield.
The phenomenon of electrostatic attraction was first observed by William Gilbert in the 17th century.
John Francis Cooley applied for the first electrospinning patent in the early 20th century.
Geoffrey Ingram Taylor proposed the mathematical formula for electrospinning in 1969.
The technology was further developed in the 1980s.
In 1977, electrospun nanofibers were successfully used in wound dressings.
Limitations of uniaxial electrospinning:
It is difficult to control the sustained release of drugs.
Challenges in manufacturing complex structures.
Advantages of coaxial electrospinning (CES):
Overcome the limitations of uniaxial electrospinning.
Simple production process and strong drug loading capacity.
Effectively promote wound healing.
Overview of CEF dressings:
Morphology, unique role in wound healing.
Physiological stages and factors affecting wound healing.
Basic principles of CE and advantages as wound dressings.
Special structure of CEF dressings and drug delivery system for sustained drug release.
Skin function:
The skin acts as the main immune barrier, protecting the body from pathogens.
Importance of wound management:
Effective wound management is essential to reduce the physiological burden on patients.
Dressing type:
Electrospinning nanofiber dressings have become a research hotspot due to their ease of preparation, high cost-effectiveness, and structure similar to the extracellular matrix.
Advantages of coaxial electrospinning:
It has significant advantages in drug delivery, fiber structure transformation, and enhanced host interaction.
Application prospects:
Coaxial electrospinning materials are expected to become candidates for precision and personalized wound dressings in medical treatment
Wound healing is a multifaceted process of great global significance, and the utilization of wound dressings plays a key role. Wound healing is affected by high inflammation levels and microbial infection, which guides the design of dressings. Notably, CEF dressings stand out for their ability to mimic the ECM structure of healthy skin tissue and facilitate drug delivery. Different polymers and structural forms of CEFs are designed to adapt to different wound microenvironments.
Although various forms of CEF dressings show great application potential, they also have some shortcomings. For example, hollow fibers provide a large surface area but cannot sustain effective drug release. Multilayered coaxial fibers have properties that are conducive to multi-stage drug release. However, they require more stringent solvent conditions, which limits the choice of CEF polymers. In addition, electrospinning solvents are usually toxic and environmentally unfriendly. The development of more environmentally friendly solvents (green electrospinning solvents) may drive CEF production towards environmental sustainability.
