慢性难愈创面微环境响应型水凝胶材料的研究进展

Research progress in microenvironmentally responsive hydrogel materials for chronic refractory wounds

慢性难愈创面的致病因素多样且病理进程复杂,愈合时间长且治疗成本高,一直是临床治疗的难题。创面微环境包括围创口表面的外部微环境和创面与创面下生理结构的内部微环境,基于慢性难愈创面微环境的临床治疗策略不断创新并取得进展。水凝胶具有高含水量、性能可调节和良好的生物相容性以及与细胞外基质相似等优点,特别是负载药物能力和经过修饰赋予优异的组织黏附、抗菌、抗氧化以及调控炎症因子表达等功能,实现了创面微环境中物理、化学和生物学等多因素的响应和调控,因此在慢性难愈创面修复方面具有突出优势和临床应用前景。主要介绍慢性难愈创面的特点及病因,并对慢性难愈创面微环境响应型水凝胶的分类及其在难愈创面修复中的应用进行综述,同时探讨了当前水凝胶的不足并提出展望。

Chronic refractory wounds have been a challenge for clinical treatment because of their diverse causative factors and complex pathological processes,long healing times,and high treatment costs.The microenvironment of the wound surface includes the external microenvironment of the periwound surface,the internal microenvironment of the wound surface,and subsurface physiological structures.Research on clinical treatment strategies based on the microenvironment of chronic refractory wounds continues to innovate and make progress.Hydrogels have the advantages of high-water content,adjustable performance,good biocompatibility,and similarity to extracellular matrix.The ability of hydrogels to load drugs and their modification to confer excellent tissue adhesion,antibacterial,antioxidant,and modulation of inflammatory factor expression can be used to achieve a multi-factor response and modulation of the physical,chemical,and biological aspects of the trauma microenvironment.Therefore,hydrogels have outstanding advantages and clinical application prospects in the repair of chronic,difficult-to-heal wounds.In this review paper,the characteristics and etiology of chronic refractory wounds were introduced,and the classification of microenvironment-responsive hydrogels for chronic refractory wounds and their application in the repair of refractory wounds were reviewed.Besides,the shortcomings of current hydrogels were discussed,and an outlook was proposed.