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      Potential of nanoemulsions for accelerated wound healing: innovative strategies

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          Abstract

          Wounds represent various significant health concerns for patients and also contribute major costs to healthcare systems. Wound healing comprises of overlapped and various coordinated steps such as homeostasis, inflammation, proliferation, and remodeling. In response to the failure of many strategies in delivering intended results including wound closure, fluid loss control, and exhibiting properties such as durability, targeted delivery, accelerated action, along with histocompatibility, numerous nanotechnological advances have been introduced. To understand the magnitude of wound therapy, this systematic and updated review discussing the effectiveness of nanoemulsions has been undertaken. This review portrays mechanisms associated with wound healing, factors for delayed wound healing, and various technologies utilized to treat wounds effectively. While many strategies are available, nanoemulsions have attracted the tremendous attention of scientists globally for the research in wound therapy due to their long-term thermodynamic stability and bioavailability. Nanoemulsions not only aid in tissue repair, but are also considered as an excellent delivery system for various synthetic and natural actives. Nanotechnology provides several pivotal benefits in wound healing, including improved skin permeation, controlled release, and stimulation of fibroblast cell proliferation. The significant role of nanoemulsions in improved wound healing along with their preparation techniques has also been highlighted with special emphasis on mechanistic insights. This article illustrates recent research advancements for the utilization of nanoemulsions in wound treatment. An adequate literature search has been conducted using the keywords ‘Nanoemulsions in wound healing’, ‘Wound therapy and nanoemulsions’, ‘Herbal actives in wound therapy’, ‘Natural oils and wounds treatment’ etc., from PubMed, Science Direct, and Google Scholar databases. Referred and original publications in the English language accessed till April 2022 has been included, whereas nonEnglish language papers, unpublished data, and nonoriginal papers were excluded from the study.

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          Most cited references106

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          Epithelialization in Wound Healing: A Comprehensive Review.

          Significance: Keratinocytes, a major cellular component of the epidermis, are responsible for restoring the epidermis after injury through a process termed epithelialization. This review will focus on the pivotal role of keratinocytes in epithelialization, including cellular processes and mechanisms of their regulation during re-epithelialization, and their cross talk with other cell types participating in wound healing. Recent Advances: Discoveries in epidermal stem cells, keratinocyte immune function, and the role of the epidermis as an independent neuroendocrine organ will be reviewed. Novel mechanisms of gene expression regulation important for re-epithelialization, including microRNAs and histone modifications, will also be discussed. Critical Issues: Epithelialization is an essential component of wound healing used as a defining parameter of a successful wound closure. A wound cannot be considered healed in the absence of re-epithelialization. The epithelialization process is impaired in all types of chronic wounds. Future Directions: A comprehensive understanding of the epithelialization process will ultimately lead to the development of novel therapeutic approaches to promote wound closure.
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            Aging and wound healing.

            Impaired wound healing in the elderly presents a major clinical and economic problem. With the aging population growing in both number and percentage, the importance of understanding the mechanisms underlying age-related impairments in healing is increased. Normal skin exhibits characteristic changes with age that have implications for wound healing. Additionally, the process of wound healing is altered in aged individuals. Although historically healing in the aged was considered defective, there is now consensus that healing in the elderly is delayed but the final result is qualitatively similar to that in young subjects.
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              Advanced Therapeutic Dressings for Effective Wound Healing--A Review.

              Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care.
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                Author and article information

                Contributors
                Journal
                Int J Surg
                Int J Surg
                JS9
                International Journal of Surgery (London, England)
                Lippincott Williams & Wilkins (Hagerstown, MD )
                1743-9191
                1743-9159
                August 2023
                09 May 2023
                : 109
                : 8
                : 2365-2377
                Affiliations
                [a ]Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra
                [b ]Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, Haryana
                [c ]Department of Pharmaceutics, Delhi Pharmaceutical Sciences & Research University, New Delhi
                [d ]Chitkara College of Pharmacy, Chitkara University, Punjab, India
                [e ]School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
                [f ]Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
                [g ]Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
                Author notes
                [* ]Corresponding author. Address: Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh. Tel.: +880 303 356 193, fax: +880 312 550 224. E-mail: talhabmb@ 123456bgctub.ac.bd (T.B. Emran); Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra, Haryana 136119, India. E-mail: rakesh_pahwa2407@ 123456yahoo.co.in (R. Pahwa).
                Author information
                http://orcid.org/0000-0001-8867-7603
                http://orcid.org/0000-0002-0524-1714
                http://orcid.org/0000-0003-3722-991X
                http://orcid.org/0000-0002-8503-0609
                http://orcid.org/0000-0001-8336-1984
                http://orcid.org/0000-0003-3188-2272
                Article
                IJS-D-22-01399 00023
                10.1097/JS9.0000000000000460
                10442146
                37158143
                944ec1ed-04da-4f7d-89bc-ac53f753206d
                Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/

                History
                : 3 October 2022
                : 1 May 2023
                Categories
                Reviews
                Custom metadata
                TRUE

                Surgery
                futuristic developments,mechanistic insights,nanoemulsions,nanoemulsions based hydrogels,natural oils,wound healing

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