What Makes the Optimal Wound Healing Material? A Review of Current Science and Introduction of a Synthetic Nanofabricated Wound Care Scaffold

Abstract

Wound matrix materials are used to improve the regeneration of dermal and epidermal layers in both acute and chronic wounds. Contemporary wound matrices are primarily composed of biologic materials such as processed xenogeneic and allogeneic tissues. Unfortunately, existing biologic wound matrices possess multiple limitations including poor longevity, durability, strength, and enzymatic resistance required for persistent support for new tissue formation. A fully-synthetic, resorbable electrospun material (Restrata Wound Matrix, Acera, St.Louis, Missouri ) that exhibits structural similarities to the native extracellular matrix offers a new approach to the treatment of acute and chronic wounds. This novel matrix is the first product to combine the advantages of synthetic construction (e.g. resistance to enzymatic degradation, excellent biocompatibility, strength/durability and controlled degradation) with the positive attributes of biologic materials (e.g. biomimetic architecture similar to human extracellular matrix (ECM), fibrous architecture optimized to support cellular migration and proliferation, engineered porosity to encourage tissue ingrowth and vascularization). These features allow RWM to achieve rapid and complete healing of full-thickness wounds that, in preclinical studies, is comparable to Integra Bilayer Wound Matrix (Integra LifeSciences, Plainsboro, New Jersey), a gold standard biologic material with diverse clinical indications in the wound care. Together, this review suggests that the RWM offers a unique fully-synthetic alternative to existing biologic matrices that is effective, widely available, easy to store, simple to apply and low cost.

Keywords: chronic wound; dressing; nanofiber; skin; synthetic; wound; wound care; wound healing; wound material.

Figure 1. The diagram of processes governing normal (acute) wound healing and failed (chronic) wound healing.

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Figure 2. The Restrata Wound Matrix, a non-woven fully-resorbable material optimized for the wound care applications.

Figure 3. The Restrata Wound Matrix is a fully synthetic nanofabricated material consisting of a non-woven “fleece” composed of nanoscale polymer fibers.

Figure 4. Full-thickness cutaneous wounds immediately after the application at day 15 and day 30 for Integra® Bilayer Wound Matrix (control-A, B, C) or Restrata Wound Matrix (treatment-D, E, F).

Figure 5. Gross evaluation of the inflammation and wound healing. A) Wound area (average ± standard deviation (SD) as determined by planimetric analysis of the wound photographs, where *p

Figure 6. Hematoxylin and eosin stained sections from wounds treated with (A) Integra® Bilayer Wound Matrix or (B) Restrata Wound Matrix at Day 15. The G represents the granulation tissue, N: neutrophils, S: seroma, arrowheads showing the wound matrix material, arrows showing the multinucleated giant cells surrounding wound matrix material. Hematoxylin and eosin stained sections from wounds treated with (C) Integra® Bilayer Wound Matrix or (D) Restrata Wound Matrix at Day 30. The G represents the granulation tissue, I: inflammation (infiltrating neutrophils and macrophages), S: serocellular debris. Arrows showing the blood vessels.