{{Short description|Medical dressing based on hydrogels}} {{distinguish|Hydrocolloid dressing}} {{Tone|date=October 2024}} '''Hydrogel dressing''' is a medical dressing based on hydrogels – flexible, three-dimensional hydrophilic structures.<ref name=":0">{{Cite journal|last1=Peppas|first1=N. A.|last2=Hilt|first2=J. Z.|last3=Khademhosseini|first3=A.|last4=Langer|first4=R.|date=2006-06-06|title=Hydrogels in Biology and Medicine: From Molecular Principles to Bionanotechnology|url=|journal=Advanced Materials|language=en|volume=18|issue=11|pages=1345–1360|doi=10.1002/adma.200501612|bibcode=2006AdM....18.1345P |s2cid=16865835 |issn=0935-9648}}</ref> The insoluble hydrophilic structures absorb polar wound exudates and allow oxygen diffusion at the wound bed to accelerate healing.<ref name=":1">{{Cite journal|last1=Tavakoli|first1=Shima|last2=Klar|first2=Agnes S.|date=2020-08-11|title=Advanced Hydrogels as Wound Dressings|journal=Biomolecules|language=en|volume=10|issue=8|page=1169|doi=10.3390/biom10081169|pmid=32796593|pmc=7464761|issn=2218-273X|doi-access=free}}</ref> Hydrogel dressings can be designed to prevent bacterial infection, retain moisture, promote optimum adhesion to tissues, and satisfy the basic requirements of biocompatibility.<ref name=":0" /><ref name=":1" /> Hydrogel dressings can also be designed to respond to changes in the microenvironment at the wound bed.<ref name=":2">{{Cite journal|last1=Ulijn|first1=Rein V.|last2=Bibi|first2=Nurguse|last3=Jayawarna|first3=Vineetha|last4=Thornton|first4=Paul D.|last5=Todd|first5=Simon J.|last6=Mart|first6=Robert J.|last7=Smith|first7=Andrew M.|last8=Gough|first8=Julie E.|date=April 2007|title=Bioresponsive hydrogels|journal=Materials Today|language=en|volume=10|issue=4|pages=40–48|doi=10.1016/S1369-7021(07)70049-4|doi-access=free}}</ref> Hydrogel dressings should promote an appropriate microenvironment for angiogenesis, recruitment of fibroblasts, and cellular proliferation.<ref name=":1" /><ref>{{Cite journal|last1=Percival|first1=Steven L.|last2=McCarty|first2=Sara|last3=Hunt|first3=John A.|last4=Woods|first4=Emma J.|date=2014-02-24|title=The effects of pH on wound healing, biofilms, and antimicrobial efficacy|journal=Wound Repair and Regeneration|volume=22|issue=2|pages=174–186|doi=10.1111/wrr.12125|pmid=24611980|s2cid=5393915|issn=1067-1927|doi-access=free}}</ref>

Hydrogels respond elastically to applied stress; gels made from materials like collagen exhibit high toughness and low sliding friction, reducing damage from mechanical stress.<ref name=":0" /><ref>{{Cite journal|last1=Xu|first1=Cancan|last2=Dai|first2=Guohao|last3=Hong|first3=Yi|date=September 2019|title=Recent advances in high-strength and elastic hydrogels for 3D printing in biomedical applications|journal=Acta Biomaterialia|language=en|volume=95|pages=50–59|doi=10.1016/j.actbio.2019.05.032|pmid=31125728|pmc=6710142}}</ref> Hydrogel dressings should possess mechanical and physical properties similar to the 3D microenvironment of the extracellular matrix of human skin.<ref name=":4">{{Cite journal|last1=Jones|first1=Annie|last2=Vaughan|first2=David|date=December 2005|title=Hydrogel dressings in the management of a variety of wound types: A review|url=|journal=Journal of Orthopaedic Nursing|language=en|volume=9|pages=S1–S11|doi=10.1016/S1361-3111(05)80001-9}}</ref> Hydrogel wound dressings are designed to have a mechanism for application and removal which minimizes further trauma to tissues.<ref name=":0" />

Hydrogel dressings can be sorted into three categories: synthetic, natural, and hybrid.<ref name=":0" /> Synthetic hydrogel dressings have been produced using biomimetic extracellular matrix nanofibers such as polyvinyl alcohol (PVA).<ref name=":5">{{Cite journal|last1=Mogoşanu|first1=George Dan|last2=Grumezescu|first2=Alexandru Mihai|date=March 2014|title=Natural and synthetic polymers for wounds and burns dressing|url=|journal=International Journal of Pharmaceutics|language=en|volume=463|issue=2|pages=127–136|doi=10.1016/j.ijpharm.2013.12.015|pmid=24368109}}</ref> Self-assembling designer peptide hydrogels are another type of synthetic hydrogel in development.<ref name=":6">{{Cite journal|last1=Rivas|first1=Manuel|last2=del Valle|first2=Luís|last3=Alemán|first3=Carlos|last4=Puiggalí|first4=Jordi|date=2019-03-06|title=Peptide Self-Assembly into Hydrogels for Biomedical Applications Related to Hydroxyapatite|journal=Gels|language=en|volume=5|issue=1|page=14|doi=10.3390/gels5010014|pmid=30845674|pmc=6473879|issn=2310-2861|doi-access=free}}</ref> Natural hydrogel dressings are further subdivided into either polysaccharide-based (e.g. alginates) or proteoglycan- and/or protein-based (e.g. collagen).<ref name=":5" /> Hybrid hydrogel dressings incorporate synthetic nanoparticles and natural materials.<ref name=":1" />

== Characteristics ==

=== Chemical characteristics === Hydrogel dressings exhibit chemical or physical cross-linking. Chemical cross-linking involves formation of covalent bonds between polymer chains. Chemically cross-linked hydrogel dressings are synthesized by chain-growth polymerization, step-growth polymerization, enzymes, or irradiation polymerization.{{citation needed|date=December 2021}} Synthetic dressings incorporating nanoparticles such as PVA and polyethylene glycol (PEG) are assembled using chemical cross-linking mechanisms.<ref>{{Cite journal|last=Varshney|first=Lalit|date=February 2007|title=Role of natural polysaccharides in radiation formation of PVA–hydrogel wound dressing|url=|journal=Nuclear Instruments and Methods in Physics Research Section B: Beam Interactions with Materials and Atoms|volume=255|issue=2|pages=343–349|doi=10.1016/j.nimb.2006.11.101|bibcode=2007NIMPB.255..343V|issn=0168-583X}}</ref><ref>{{Cite web|last=Kasko|first=Andrea M|title=Degradable Poly(ethylene glycol) Hydrogels for 2D and 3D Cell Culture|url=https://www.sigmaaldrich.com/US/en/technical-documents/technical-article/materials-science-and-engineering/tissue-engineering/degradable-polyethylene-glycol-hydrogels}}</ref> Physically cross-linked hydrogel dressings are assembled via ionic interaction, hydrogen bonding, hydrophobic interactions, or crystallization.{{citation needed|date=December 2021}} Physically cross-linked hydrogels disintegrate due to local changes in pH, ionic strength, and temperature.<ref name=":2" /> Natural dressings incorporating polysaccharides and proteoglycans/proteins form a 3D network using physical cross-linking.<ref>{{Cite journal|last1=Hennink|first1=W.E|last2=van Nostrum|first2=C.F|date=January 2002|title=Novel crosslinking methods to design hydrogels|url=|journal=Advanced Drug Delivery Reviews|volume=54|issue=1|pages=13–36|doi=10.1016/s0169-409x(01)00240-x|pmid=11755704|issn=0169-409X}}</ref> Hydrogel dressings mimic the cross-linked 3D network of extracellular matrix fibers in human skin.<ref name=":0" />

Hydrogels can be formed through a self-assembly process in which monomers diffuse in solution then form noncovalent interactions.{{citation needed|date=December 2021}} Hydrogels used in wound dressings can be self-assembled upon addition of divalent metal cations or electrically charged polysaccharides due to electrostatic interactions.<ref name=":8">{{Cite journal|last1=Gonçalves|first1=Catarina|last2=Pereira|first2=Paula|last3=Gama|first3=Miguel|date=2010-02-24|title=Self-Assembled Hydrogel Nanoparticles for Drug Delivery Applications|journal=Materials|volume=3|issue=2|pages=1420–1460|pmc=5513474| doi=10.3390/ma3021420|bibcode=2010Mate....3.1420G|issn=1996-1944|doi-access=free}}</ref><ref>{{Cite journal|last1=Basak|first1=Shibaji|last2=Nanda|first2=Jayanta|last3=Banerjee|first3=Arindam|date=2014|title=Multi-stimuli responsive self-healing metallo-hydrogels: tuning of the gel recovery property|url=|journal=Chem. Commun.|volume=50|issue=18|pages=2356–2359|doi=10.1039/c3cc48896a|pmid=24448590|issn=1359-7345}}</ref> Self-assembly via hydrophobic interactions can be induced in amphiphilic polysaccharide-based gels by addition of water; it can also be induced in non amphiphilic polysaccharide-based hydrogels by the addition of hydrophobic grafts.<ref name=":6" /><ref name=":8" />

Cross-linking of soluble hydrophilic monomers forms a 3D insoluble netted structure which can incorporate a large amount of water.<ref name=":9">{{Cite journal|last=Wong|first=Vicky|date=2007|title=Hydrogels|url=https://www.stem.org.uk/system/files/elibrary-resources/legacy_files_migrated/8567-catalyst_18_1_335.pdf.|journal=Catalyst|pages=18–21}}</ref> The 3D polymeric network of hydrogels is highly hydrated with 90-99% water w/w; it is capable of binding many times more water molecules when assembled than in the uncross-linked state.<ref name=":1" /><ref name=":2" /> Hydrogel dressings can absorb up to 600 times their initial amount of water, including fluid-based wound exudates.<ref name=":1" /><ref name=":9" /> Hydrogels are effective biomaterials for wound dressings and tissue engineering because they exchange fluid, hydrating necrotic tissues.<ref name=":1" /><ref name=":4" /> The absorption of secretions causes the hydrogel dressing to swell, expanding the cross links in the polymer chains.<ref name=":4" /> The expanded 3D cross-linked network can irreversibly incorporate pathogens and detritus, thereby removing them from the wound.<ref name=":4" />

Some hydrogel dressings have intrinsic antimicrobial properties. Hydrogel dressings formed from antimicrobial peptides (AMPs) and chitosan have inherent antimicrobial activity.<ref name=":10">{{Cite journal|last1=Salomé Veiga|first1=Ana|last2=Schneider|first2=Joel P.|date=November 2013|title=Antimicrobial hydrogels for the treatment of infection|url=|journal=Biopolymers|volume=100|issue=6|pages=637–644|doi=10.1002/bip.22412|pmid=24122459|pmc=3929057|issn=0006-3525}}</ref><ref>{{Cite journal|last1=Chan|first1=David I.|last2=Prenner|first2=Elmar J.|last3=Vogel|first3=Hans J.|date=September 2006|title=Tryptophan- and arginine-rich antimicrobial peptides: Structures and mechanisms of action|journal=Biochimica et Biophysica Acta (BBA) - Biomembranes|volume=1758|issue=9|pages=1184–1202|doi=10.1016/j.bbamem.2006.04.006|pmid=16756942|issn=0005-2736|doi-access=free}}</ref><ref>{{Cite journal|last1=Park|first1=Bae Keun|last2=Kim|first2=Moon-Moo|date=2010-12-15|title=Applications of Chitin and Its Derivatives in Biological Medicine|journal=International Journal of Molecular Sciences|language=en|volume=11|issue=12|pages=5152–5164|doi=10.3390/ijms11125152|pmid=21614199|pmc=3100826|issn=1422-0067|doi-access=free}}</ref> The antimicrobial properties of hydrogel dressings can be enhanced by addition of metal nanoparticles, antibiotics, or other antimicrobial agents.<ref name=":10" /><ref>{{Cite journal|last1=De Giglio|first1=E.|last2=Cometa|first2=S.|last3=Ricci|first3=M.A.|last4=Cafagna|first4=D.|last5=Savino|first5=A.M.|last6=Sabbatini|first6=L.|last7=Orciani|first7=M.|last8=Ceci|first8=E.|last9=Novello|first9=L.|last10=Tantillo|first10=G.M.|last11=Mattioli-Belmonte|first11=M.|date=February 2011|title=Ciprofloxacin-modified electrosynthesized hydrogel coatings to prevent titanium-implant-associated infections|url=|journal=Acta Biomaterialia|volume=7|issue=2|pages=882–891|doi=10.1016/j.actbio.2010.07.030|pmid=20659594|issn=1742-7061}}</ref><ref name=":11">{{Cite journal|last1=Chang|first1=Chiung-Hung|last2=Lin|first2=Yu-Hsin|last3=Yeh|first3=Chia-Lin|last4=Chen|first4=Yi-Chi|last5=Chiou|first5=Shu-Fen|last6=Hsu|first6=Yuan-Man|last7=Chen|first7=Yueh-Sheng|last8=Wang|first8=Chi-Chung|date=2009-11-19|title=Nanoparticles Incorporated in pH-Sensitive Hydrogels as Amoxicillin Delivery for Eradication of Helicobacter pylori|url=|journal=Biomacromolecules|volume=11|issue=1|pages=133–142|doi=10.1021/bm900985h|pmid=19924885|issn=1525-7797}}</ref><ref name=":12">{{Cite journal|last1=Halpenny|first1=Genevieve M.|last2=Steinhardt|first2=Rachel C.|last3=Okialda|first3=Krystle A.|last4=Mascharak|first4=Pradip K.|date=2009-06-24|title=Characterization of pHEMA-based hydrogels that exhibit light-induced bactericidal effect via release of NO|url=|journal=Journal of Materials Science: Materials in Medicine|volume=20|issue=11|pages=2353–2360|doi=10.1007/s10856-009-3795-0|pmid=19554428|pmc=2778696|issn=0957-4530}}</ref> Silver and gold nanoparticles can also be incorporated into hydrogel dressings to enhance antimicrobial activity.<ref name=":10" /> Some hydrogel dressings have antibiotics such as ciprofloxacin and amoxicillin incorporated into their structure which are unloaded into the wound as fluid is exchanged.<ref name=":10" /><ref name=":11" /> Some hydrogel dressings have incorporated stimuli-responsive nitric oxide-releasing agents and other antimicrobial agents.<ref name=":10" /><ref name=":12" />

Hydrogel dressings can adhere directly to the wound bed under normal physiological conditions via oxidation-reduction reactions of quinones.<ref name=":1" /><ref>{{Cite journal|last1=Cencer|first1=Morgan|last2=Liu|first2=Yuan|last3=Winter|first3=Audra|last4=Murley|first4=Meridith|last5=Meng|first5=Hao|last6=Lee|first6=Bruce P.|date=2014-07-17|title=Effect of pH on the Rate of Curing and Bioadhesive Properties of Dopamine Functionalized Poly(ethylene glycol) Hydrogels|url=|journal=Biomacromolecules|volume=15|issue=8|pages=2861–2869|doi=10.1021/bm500701u|pmid=25010812|pmc=4130238|issn=1525-7797}}</ref> The adhesive properties of hydrogels have been shown to be enhanced by addition of positively charged microgels (MR) into the 3D matrix to increase electrostatic and hydrophobic interactions.<ref name=":13">{{Cite journal|last1=He|first1=Xiaoyan|last2=Liu|first2=Liqin|last3=Han|first3=Huimin|last4=Shi|first4=Wenyu|last5=Yang|first5=Wu|last6=Lu|first6=Xiaoquan|date=2018-12-18|title=Bioinspired and Microgel-Tackified Adhesive Hydrogel with Rapid Self-Healing and High Stretchability|url=|journal=Macromolecules|volume=52|issue=1|pages=72–80|doi=10.1021/acs.macromol.8b01678|s2cid=104431319|issn=0024-9297}}</ref>

=== Physical characteristics === Wound dressings should be stretchable to prevent tearing. Hai Lei et al. demonstrated that poor elasticity and hysteresis in naturally-derived protein-based hydrogels can be remedied by the addition of polyprotein cross-linkers.<ref>{{Cite journal|last1=Lei|first1=Hai|last2=Dong|first2=Liang|last3=Li|first3=Ying|last4=Zhang|first4=Junsheng|last5=Chen|first5=Huiyan|last6=Wu|first6=Junhua|last7=Zhang|first7=Yu|last8=Fan|first8=Qiyang|last9=Xue|first9=Bin|last10=Qin|first10=Meng|last11=Chen|first11=Bin|date=2020-08-12|title=Stretchable hydrogels with low hysteresis and anti-fatigue fracture based on polyprotein cross-linkers|url=|journal=Nature Communications|volume=11|issue=1|page=4032|doi=10.1038/s41467-020-17877-z|pmid=32788575|pmc=7423981|bibcode=2020NatCo..11.4032L|issn=2041-1723}}</ref> The flexibility of hydrogels can also be enhanced by incorporating microgels into the matrix.<ref name=":13" /><ref name=":15">{{Cite journal|last1=Huang|first1=Guoyou|last2=Li|first2=Fei|last3=Zhao|first3=Xin|last4=Ma|first4=Yufei|last5=Li|first5=Yuhui|last6=Lin|first6=Min|last7=Jin|first7=Guorui|last8=Lu|first8=Tian Jian|last9=Genin|first9=Guy M.|last10=Xu|first10=Feng|date=2017-10-09|title=Functional and Biomimetic Materials for Engineering of the Three-Dimensional Cell Microenvironment|url=|journal=Chemical Reviews|volume=117|issue=20|pages=12764–12850|doi=10.1021/acs.chemrev.7b00094|pmid=28991456|pmc=6494624|issn=0009-2665}}</ref> Hydrogel dressings mimic the fibrous nature of native ECM to maintain cell-to-cell communication at the wound bed for tissue regeneration.<ref name=":15" />

Self-healing hydrogels automatically and reversibly repair damage done due to mechanical and chemical stress.<ref name=":16">{{Cite journal|last1=Liu|first1=Yi|last2=Hsu|first2=Shan-hui|date=2018-10-02|title=Synthesis and Biomedical Applications of Self-healing Hydrogels|journal=Frontiers in Chemistry|volume=6|page=449|doi=10.3389/fchem.2018.00449|pmid=30333970|pmc=6176467|issn=2296-2646|doi-access=free|bibcode=2018FrCh....6..449L }}</ref> Self-healing mechanisms can involve "dynamic covalent bonding, non-covalent interactions", and mixed interactions.<ref name=":16" /> Covalent interactions involved in self-healing include Schiff base formation and disulfide exchange.<ref name=":16" /> Non-covalent interactions are generally less stable and make the hydrogel more sensitive to microenvironmental changes (e.g. pH, temperature).<ref name=":16" /> Some hydrogel dressings are self-healing due to mixed mechanisms such as host-guest and protein-ligand interactions.<ref name=":16" />

Hydrogel dressings are available in sheet, amorphous, impregnated, or sprayable forms.<ref name=":10" /><ref name=":17">{{Cite web|title=Hydrogels: Sheets|url=https://www.woundsource.com/product-category/dressings/hydrogels-sheets|website=Wound Source}}</ref><ref name=":18">{{Cite web|title=Hydrogels: Amorphous|url=https://www.woundsource.com/product-category/dressings/hydrogels-amorphous.|website=Wound Source}}</ref><ref name=":19">{{Cite web|title=Hydrogels: Impregnated|url=https://www.woundsource.com/product-category/dressings/hydrogels-impregnated|website=Wound Source}}</ref><ref name=":20">{{Cite journal|last1=He|first1=Jacqueline Jialu|last2=McCarthy|first2=Colleen|last3=Camci-Unal|first3=Gulden|date=2021-04-09|title=Development of Hydrogel-Based Sprayable Wound Dressings for Second- and Third-Degree Burns|journal=Advanced NanoBiomed Research|volume=1|issue=6|article-number=2100004|doi=10.1002/anbr.202100004|s2cid=233669658|issn=2699-9307|doi-access=free}}</ref> Sheet-form hydrogel dressings are non-adhesive against the wound and are effective in healing partial-thickness wounds.<ref name=":17" /> Amorphous hydrogels are more effective than sheet-form dressings in treatment of full-thickness wounds because they can conform to the shape of the wound bed and facilitate autolytic debridement.<ref name=":18" /> Impregnated hydrogel dressings are dry dressings (e.g. gauzes) saturated with an amorphous hydrogel.<ref name=":19" /> Sprayable hydrogel dressings are composed of amorphous hydrogels which rapidly increase in viscosity after application.<ref name=":20" /> Sprayable hydrogels have also been shown to increase the penetration and efficacy of therapeutic agents.<ref name=":1" />

==== "Smart" hydrogel dressings ==== "Smart" hydrogels which are stimuli-responsive (i.e. thermoresponsive, bioresponsive, pH-responsive, photoresponsive, and redox-responsive) are also being produced.<ref name=":2" /> * pH-responsive hydrogel dressings release growth factors and antibiotic agents as the pH of the wound increases from normal skin levels (pH 4–6) to internal levels (pH ~7.4).<ref>{{Cite journal|last1=Hendi|first1=Asail|last2=Umair Hassan|first2=Muhammad|last3=Elsherif|first3=Mohamed|last4=Alqattan|first4=Bader|last5=Park|first5=Seongjun|last6=Yetisen|first6=Ali Kemal|last7=Butt|first7=Haider|date=June 2020|title=Healthcare Applications of pH-Sensitive Hydrogel-Based Devices: A Review|journal=International Journal of Nanomedicine|volume= 15|pages=3887–3901|doi=10.2147/ijn.s245743|pmid=32581536|pmc=7276332|issn=1178-2013 |doi-access=free }}</ref> * Redox-responsive hydrogel dressings can be disintegrated on-demand by addition of a reducing agent.<ref>{{Cite journal|last1=Lu|first1=Hao|last2=Yuan|first2=Long|last3=Yu|first3=Xunzhou|last4=Wu|first4=Chengzhou|last5=He|first5=Danfeng|last6=Deng|first6=Jun|date=2018|title=Recent advances of on-demand dissolution of hydrogel dressings|journal=Burns & Trauma|volume=6|page=35|doi=10.1186/s41038-018-0138-8|pmid=30619904|pmc=6310937|issn=2321-3876 |doi-access=free }}</ref> * Assembly of the 3D network of photoresponsive hydrogel dressings is initiated by UV radiation.<ref>{{Cite journal|last1=Witthayaprapakorn|first1=C.|last2=Molloy|first2=Robert|last3=Nalampang|first3=K.|last4=Tighe|first4=B.J.|date=August 2008|title=Design and Preparation of a Bioresponsive Hydrogel for Biomedical Application as a Wound Dressing|url=|journal=Advanced Materials Research|volume=55-57|pages=681–684|doi=10.4028/www.scientific.net/amr.55-57.681|s2cid=136738274|issn=1662-8985}}</ref> * Thermoresponsive hydrogel dressings exhibit temperature-dependent sol-gel transition and/or temperature-dependent drug release.<ref>{{Cite journal|last1=Nizioł|first1=Martyna|last2=Paleczny|first2=Justyna|last3=Junka|first3=Adam|last4=Shavandi|first4=Amin|last5=Dawiec-Liśniewska|first5=Anna|last6=Podstawczyk|first6=Daria|date=2021-06-08|title=3D Printing of Thermoresponsive Hydrogel Laden with an Antimicrobial Agent towards Wound Healing Applications|journal=Bioengineering|language=en|volume=8|issue=6|page=79|doi=10.3390/bioengineering8060079|pmid=34201362|pmc=8227034|issn=2306-5354|doi-access=free}}</ref><ref>{{Cite journal|last1=Mi|first1=Luo|last2=Xue|first2=Hong|last3=Li|first3=Yuting|last4=Jiang|first4=Shaoyi|date=2011-09-07|title=A Thermoresponsive Antimicrobial Wound Dressing Hydrogel Based on a Cationic Betaine Ester|url=|journal=Advanced Functional Materials|volume=21|issue=21|pages=4028–4034|doi=10.1002/adfm.201100871|s2cid=96376955 |issn=1616-301X}}</ref>

== Applications == The efficacy of hydrogel dressings has been assessed on various wound types. There is some evidence to suggest that hydrogels are effective dressings for chronic wounds including pressure ulcers, diabetic ulcers, and venous ulcers although the results are uncertain.<ref>{{Cite journal|last1=Zoellner|first1=P.|last2=Kapp|first2=H.|last3=Smola|first3=H.|date=March 2007|title=Clinical performance of a hydrogel dressing in chronic wounds: a prospective observational study|url=|journal=Journal of Wound Care|volume=16|issue=3|pages=133–136|doi=10.12968/jowc.2007.16.3.27019|pmid=17385591|issn=0969-0700}}</ref><ref>{{Cite journal|last1=Dumville|first1=Jo C|last2=O'Meara|first2=Susan|last3=Deshpande|first3=Sohan|last4=Speak|first4=Katharine|date=2013-07-12|title=Hydrogel dressings for healing diabetic foot ulcers|url=|journal=Cochrane Database of Systematic Reviews|volume=2013 |issue=7|article-number=CD009101|doi=10.1002/14651858.cd009101.pub3|pmid=23846869|pmc=6486218|issn=1465-1858}}</ref><ref>{{Cite journal|last1=Norman|first1=Gill|last2=Westby|first2=Maggie J|last3=Rithalia|first3=Amber D|last4=Stubbs|first4=Nikki|last5=Soares|first5=Marta O|last6=Dumville|first6=Jo C|date=2018-06-15|title=Dressings and topical agents for treating venous leg ulcers|url=|journal=Cochrane Database of Systematic Reviews|volume=2018|issue=6|article-number=CD012583|doi=10.1002/14651858.cd012583.pub2|pmid=29906322|pmc=6513558|issn=1465-1858}}</ref><ref>{{Cite journal|last1=Li|first1=Yuan|last2=Jiang|first2=Shishuang|last3=Song|first3=Liwan|last4=Yao|first4=Zhe|last5=Zhang|first5=Junwen|last6=Wang|first6=Kangning|last7=Jiang|first7=Liping|last8=He|first8=Huacheng|last9=Lin|first9=Cai|last10=Wu|first10=Jiang|date=2021-10-08|title=Zwitterionic Hydrogel Activates Autophagy to Promote Extracellular Matrix Remodeling for Improved Pressure Ulcer Healing|journal=Frontiers in Bioengineering and Biotechnology|volume=9|article-number=740863|doi=10.3389/fbioe.2021.740863|pmid=34692658|pmc=8531594|issn=2296-4185|doi-access=free}}</ref> Hydrogels have been shown to accelerate healing in partial and full thickness burn wounds of varying size.<ref>{{Cite journal|last1=Mohd Zohdi|first1=Rozaini|last2=Abu Bakar Zakaria|first2=Zuki|last3=Yusof|first3=Norimah|last4=Mohamed Mustapha|first4=Noordin|last5=Abdullah|first5=Muhammad Nazrul Hakim|date=2012|title=Gelam ( Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing|journal=Evidence-Based Complementary and Alternative Medicine|language=en|volume=2012|article-number=843025|doi=10.1155/2012/843025|pmid=21941590|pmc=3175734|issn=1741-427X|doi-access=free}}</ref><ref name=":21">{{Cite journal|last1=Nuutila|first1=Kristo|last2=Grolman|first2=Josh|last3=Yang|first3=Lu|last4=Broomhead|first4=Michael|last5=Lipsitz|first5=Stuart|last6=Onderdonk|first6=Andrew|last7=Mooney|first7=David|last8=Eriksson|first8=Elof|date=2020-02-01|title=Immediate Treatment of Burn Wounds with High Concentrations of Topical Antibiotics in an Alginate Hydrogel Using a Platform Wound Device|journal=Advances in Wound Care|language=en|volume=9|issue=2|pages=48–60|doi=10.1089/wound.2019.1018|pmid=31903298|pmc=6940590|issn=2162-1918}}</ref><ref>{{Cite web|date=14 December 2011|title=In third-degree burn treatment, hydrogel helps grow new, scar-free skin|url=http://www.sciencedaily.com/releases/2011/12/111213131956.html|website=Science Daily}}</ref> Other studies have shown that hydrogel dressings accelerate healing in radioactive skin injuries and dog bite wounds.<ref name=":22">{{Cite journal|last1=Zhang|first1=Lijun|last2=Yin|first2=Hanxiao|last3=Lei|first3=Xun|last4=Lau|first4=Johnson N. Y.|last5=Yuan|first5=Mingzhou|last6=Wang|first6=Xiaoyan|last7=Zhang|first7=Fangyingnan|last8=Zhou|first8=Fei|last9=Qi|first9=Shaohai|last10=Shu|first10=Bin|last11=Wu|first11=Jun|date=2019-11-21|title=A Systematic Review and Meta-Analysis of Clinical Effectiveness and Safety of Hydrogel Dressings in the Management of Skin Wounds|journal=Frontiers in Bioengineering and Biotechnology|volume=7|page=342|doi=10.3389/fbioe.2019.00342|pmid=31824935|pmc=6881259|issn=2296-4185|doi-access=free}}</ref><ref>{{Cite journal|last1=Jiang|first1=X|last2=Sun|first2=R|last3=Li|first3=J|date=2018|title=Observation on the effect of hydrogel dressing on radiation-induced skin injury|url=|journal=J. Pract. Clin. Nurs|volume=3|issue=|pages=91–100|doi=|issn=}}</ref><ref>{{Cite journal|last=Wang|first=J|date=2008|title=Local treatment of canine bite wound III with silver ion dressing combined with hydrogel: randomized controlled group|journal=Chin. J. Tissue Eng|volume=12|pages=2659–2662}}</ref> Hydrogel dressings decrease the healing time of traumatic skin injuries by an average 5.28 days and reduce the pain reported by patients.<ref name=":22" /><ref>{{Cite journal|last=Chen|first=L|date=2015|title=Clinical observation of skin wound wet healing treatment.|journal=Huaxi Med|volume=30|pages=1811–1813}}</ref><ref>{{Cite journal|last=Huang|first=G|date=2016|title=Treatment and nursing observation of 42 cases of acute skin abrasion and contusion|journal=J. Yangtze Univ.|volume=13|pages=67–68}}</ref>

== Types ==

=== Naturally-derived hydrogel dressings === Polysaccharide-based hydrogel dressings have been synthesized from polymers such as hyaluronic acid, chitin, chitosan, alginate, and agarose.<ref name=":0" /><ref name=":21" /><ref>{{Cite journal|last1=Ong|first1=Shin-Yeu|last2=Wu|first2=Jian|last3=Moochhala|first3=Shabbir M.|last4=Tan|first4=Mui-Hong|last5=Lu|first5=Jia|date=November 2008|title=Development of a chitosan-based wound dressing with improved hemostatic and antimicrobial properties|url=|journal=Biomaterials|volume=29|issue=32|pages=4323–4332|doi=10.1016/j.biomaterials.2008.07.034|pmid=18708251|issn=0142-9612}}</ref><ref>{{Cite journal|last1=Mattioli-Belmonte|first1=M.|last2=Zizzi|first2=A.|last3=Lucarini|first3=G.|last4=Giantomassi|first4=F.|last5=Biagini|first5=G.|last6=Tucci|first6=G.|last7=Orlando|first7=F.|last8=Provinciali|first8=M.|last9=Carezzi|first9=F.|last10=Morganti|first10=P.|date=September 2007|title=Chitin Nanofibrils Linked to Chitosan Glycolate as Spray, Gel, and Gauze Preparations for Wound Repair|url=|journal=Journal of Bioactive and Compatible Polymers|volume=22|issue=5|pages=525–538|doi=10.1177/0883911507082157|s2cid=56285246|issn=0883-9115}}</ref><ref name=":23">{{Cite journal|last1=Stubbe|first1=Birgit|last2=Mignon|first2=Arn|last3=Declercq|first3=Heidi|last4=Vlierberghe|first4=Sandra|last5=Dubruel|first5=Peter|date=2019-06-25|title=Development of Gelatin-Alginate Hydrogels for Burn Wound Treatment|journal=Macromolecular Bioscience|volume=19|issue=8|article-number=1900123|doi=10.1002/mabi.201900123|pmid=31237746|s2cid=195355185|issn=1616-5187|url=https://lirias.kuleuven.be/bitstream/123456789/663375/3/Development%20of%20Gelatin-Alginate%20Hydrogels%20for%20Burn%20Wound%20Treatment.docx |url-access=subscription}}</ref> Naturally-derived protein/proteoglycan hydrogel dressings have been synthesized from polymers such as collagen, gelatin, kappa-carrageenan, and fibrin.<ref name=":0" /><ref name=":23" /><ref>{{Cite journal|last1=Tavakoli|first1=Shima|last2=Mokhtari|first2=Hamidreza|last3=Kharaziha|first3=Mahshid|last4=Kermanpur|first4=Ahmad|last5=Talebi|first5=Ardeshir|last6=Moshtaghian|first6=Jamal|date=June 2020|title=A multifunctional nanocomposite spray dressing of Kappa-carrageenan-polydopamine modified ZnO/L-glutamic acid for diabetic wounds|url=|journal=Materials Science and Engineering: C|volume=111|article-number=110837|doi=10.1016/j.msec.2020.110837|pmid=32279800|s2cid=215750261|issn=0928-4931}}</ref><ref>{{Cite journal|last1=Ying|first1=Huiyan|last2=Zhou|first2=Juan|last3=Wang|first3=Mingyu|last4=Su|first4=Dandan|last5=Ma|first5=Qiaoqiao|last6=Lv|first6=Guozhong|last7=Chen|first7=Jinghua|date=August 2019|title=In situ formed collagen-hyaluronic acid hydrogel as biomimetic dressing for promoting spontaneous wound healing|journal=Materials Science and Engineering: C|volume=101|pages=487–498|doi=10.1016/j.msec.2019.03.093|pmid=31029343|s2cid=108904004|issn=0928-4931|doi-access=}}</ref>

=== Synthetic hydrogel dressings === Synthetic hydrogel dressings may be derived from synthetic polymers such as polyvinyl alcohol (PVA), poly(ethylene glycol) (PEG), polyurethane (PU), and poly(lactide-co-glycolide) (PLGA).<ref name=":0" /><ref>{{Cite journal|last1=Kamoun|first1=Elbadawy A.|last2=Kenawy|first2=El-Refaie S.|last3=Chen|first3=Xin|date=May 2017|title=A review on polymeric hydrogel membranes for wound dressing applications: PVA-based hydrogel dressings|url=|journal=Journal of Advanced Research|volume=8|issue=3|pages=217–233|doi=10.1016/j.jare.2017.01.005|pmid=28239493|pmc=5315442|issn=2090-1232}}</ref><ref>{{Cite journal|last1=Mir|first1=Mariam|last2=Ali|first2=Murtaza Najabat|last3=Barakullah|first3=Afifa|last4=Gulzar|first4=Ayesha|last5=Arshad|first5=Munam|last6=Fatima|first6=Shizza|last7=Asad|first7=Maliha|date=2018-02-14|title=Synthetic polymeric biomaterials for wound healing: a review|url=|journal=Progress in Biomaterials|volume=7|issue=1|pages=1–21|doi=10.1007/s40204-018-0083-4|pmid=29446015|pmc=5823812|issn=2194-0509}}</ref> Synthetic hydrogel dressings may also be formed from designer peptides.<ref name=":6" /><ref>{{Cite journal|last1=Seow|first1=Wei Yang|last2=Salgado|first2=Giorgiana|last3=Lane|first3=E. Birgitte|last4=Hauser|first4=Charlotte A. E.|date=2016-09-07|title=Transparent crosslinked ultrashort peptide hydrogel dressing with high shape-fidelity accelerates healing of full-thickness excision wounds|url=|journal=Scientific Reports|volume=6|issue=1|article-number=32670|doi=10.1038/srep32670|pmid=27600999|pmc=5013444|bibcode=2016NatSR...632670S|issn=2045-2322}}</ref> Researchers are applying 3D printing to the synthesis of hydrogel dressings.<ref>{{Cite journal|last1=Cereceres|first1=Stacy|last2=Lan|first2=Ziyang|last3=Bryan|first3=Laura|last4=Whitely|first4=Michael|last5=Wilems|first5=Thomas|last6=Greer|first6=Hunter|last7=Alexander|first7=Ellen Ruth|last8=Taylor|first8=Robert J.|last9=Bernstein|first9=Lawrence|last10=Cohen|first10=Noah|last11=Whitfield-Cargile|first11=Canaan|date=June 2019|title=Bactericidal activity of 3D-printed hydrogel dressing loaded with gallium maltolate|journal=APL Bioengineering|language=en|volume=3|issue=2|page=026102|doi=10.1063/1.5088801|pmid=31123722|pmc=6506339|issn=2473-2877}}</ref><ref>{{Cite journal|last1=Jang|first1=M J|last2=Bae|first2=S K|last3=Jung|first3=Y S|last4=Kim|first4=J C|last5=Kim|first5=J S|last6=Park|first6=S K|last7=Suh|first7=J S|last8=Yi|first8=S J|last9=Ahn|first9=S H|last10=Lim|first10=J O|date=2021-04-09|title=Enhanced wound healing using a 3D printed VEGF-mimicking peptide incorporated hydrogel patch in a pig model|journal=Biomedical Materials|volume=16|issue=4|page=045013|doi=10.1088/1748-605x/abf1a8|pmid=33761488|s2cid=232355932|issn=1748-6041|doi-access=free}}</ref>

=== Biohybrid hydrogel dressings === Hydrogels may be modified to incorporate metal cations (e.g. copper (II)), degradable linkers (e.g. dextran), and adhesive functional groups (e.g. RGD).<ref name=":0" /> Integrating biological derivatives into synthetic hydrogels allows producers to tailor binding affinities and specificity, mechanical properties, and stimuli-responsive properties.<ref name=":0" />

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== References == {{Reflist|30em}}

Category:Medical treatments