Search

Introduction: Diabetic foot ulcers may lead to nontraumatic amputations of the foot, leading to a decrease in patient quality of life. Transmetatarsal amputations (TMAs) represent an effective surgical procedure in cases of severe foot infection, but the tissue reconstruction is complicated and additional procedures should be considered. The present case report evaluates the wound closure of an open TMA in a patient with diabetes treated with a new aerogel composed of chitosan (ChS) and chondroitin sulphate (CS), without needing a skin graft., Case Report: A 72-year-old man with diabetes and a history of successive amputations was admitted to a hospital in Valdivia, Chile, due to a severe infection of toes 2 and 4 of the right foot. After the diagnosis of gangrene and osteomyelitis, the patient underwent a TMA of his right forefoot. The surgeon proposed the incorporation of ChS and CS aerogels to accelerate wound healing to avoid another surgical procedure. The TMA surgical wound area closed 50% after day 28 from starting treatment with aerogels. Complete closure was achieved at day 94 of treatment with aerogels, with good epithelial tissue and favorable cosmetic results and without residual limb deformities. The patient experienced minimal physical and psychological impairment from the procedure. Other surgical procedures were not necessary., Conclusions: Due to the results of this patient, use of ChS and CS aerogels could represent an alternative treatment for forefoot TMA wound closure and prevent further surgical procedures, such as skin grafting. Future works should consider a larger number of cases.

In this study, highly neutralized, highly porous, and ultralight polymeric aerogels prepared from aqueous colloidal suspensions of chitosan (CS) and chondroitin sulfate (ChS) nanocomplexes, formulated as quasi-equimolar amounts of both, are described. These aerogels were designed as healing agents under the inspiration of minimizing the amount of matter applied to wounds, reducing the electrostatic potential of the material and avoiding covalent cross-linkers in order to decrease metabolic stress over wounds. Aerogels synthesized under these criteria are biocompatible and provide specific properties for the induction of wound healing. They do not affect neither the metabolic activity of cultured 3T3 fibroblasts nor the biochemical parameters of experimental animals, open wounds close significantly faster and, unlike control wounds, complete reepithelialization and scarring can be attained 14 days after surgery. Because of its hydration abilities, rapid adaptation to the wound bed and the early accelerator effect of wound closure, the CS/ChS aerogels appear to be functional inducers of the healing. Previous information show that CS/ChS aerogels improve wound bed quality, increase granulation tissue and have pain suppressive effect. CS/ChS aerogels are useful as safe, inexpensive and easy to handle materials for topical applications, such as skin chronic wounds. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2464-2471, 2018., (© 2018 Wiley Periodicals, Inc.)

The formation of ultralight, highly porous solid materials (porosity higher than 99%) containing equivalent molar amounts of chitosan (CS) and chondroitin sulfate (ChS) is presented. First, we show protocols to produce colloidal suspensions of assembled polymer nanocomplexes by simultaneously mixing equimolar amounts of the oppositely charged polysaccharides, preventing macroprecipitation. The colloidal suspensions were then freeze-dried to form the active aerogels. Apparent density in the order of 100–101 mg/cm3 was achieved. The materials show low stiffness (Young's modulus of about 2 kPa), which make them easy to handle for clinical applications, and easy to compress, pack, store and transport. These characteristics promote them as cheap, safe and biodegradable materials able to be used for several therapeutic purposes, such as wound healing. [ABSTRACT FROM AUTHOR]

The antibacterial activity against Staphylococcus aureus of aerogels fabricated from colloidal suspensions of chitosan/chondroitin sulfate nanocomplexes is analyzed. Upon freeze-drying the colloidal suspensions, the aerogels presented a porous structure made of microsheets and microfibers. The aerogels could, in addition, be loaded with antimicrobial agents. Loaded with the antibiotic erythromycin, the aerogels showed crystalline deposits, affecting the topography of the samples as well as their mechanical properties, showing a decrease on the apparent Young's modulus and hardness at 40% deformation. Loaded with elephant garlic (Allium ampeloprasum L. var. ampeloprasum) extract, the aerogels showed texturization of the microsheets and microfibers, and the higher relative mass allowed an increase on the apparent Young's modulus and hardness at 40% deformation with respect to pristine aerogels. Unloaded aerogels showed activity against Staphylococcus aureus, including a methicillin-resistant strain. The release of erythromycin from the aerogels to an agar environment is governed by equilibrium forces with the polysaccharides, which allow modulating the load of antibiotic and its concomitant diffusion from the material. The diffusion of the active components of the elephant garlic extract did not show a dependence on the polysaccharide content, revealing a week interaction. The elephant garlic extract resulted active against the methicillin-resistant Staphylococcus aureus strain, while resistance was found for the antibiotic, revealing the therapeutic potential of the natural extract. The antimicrobial aerogels may be used for several therapeutic purposes, such as healing of infected chronic wounds. [ABSTRACT FROM AUTHOR]