Drug Delivery and Translational Research ( IF 5.7 ) Pub Date : 2021-02-20 , DOI: 10.1007/s13346-021-00932-7 Pia Kaiser 1 , Jana Wächter 1 , Maike Windbergs 1
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In recent years, the incidence of infected wounds is steadily increasing, and so is the clinical as well as economic interest in effective therapies. These combine reduction of pathogen load in the wound with general wound management to facilitate the healing process. The success of current therapies is challenged by harsh conditions in the wound microenvironment, chronicity, and biofilm formation, thus impeding adequate concentrations of active antimicrobials at the site of infection. Inadequate dosing accuracy of systemically and topically applied antibiotics is prone to promote development of antibiotic resistance, while in the case of antiseptics, cytotoxicity is a major problem. Advanced drug delivery systems have the potential to enable the tailor-made application of antimicrobials to the side of action, resulting in an effective treatment with negligible side effects. This review provides a comprehensive overview of the current state of treatment options for the therapy of infected wounds. In this context, a special focus is set on delivery systems for antimicrobials ranging from semi-solid and liquid formulations over wound dressings to more advanced carriers such as nano-sized particulate systems, vesicular systems, electrospun fibers, and microneedles, which are discussed regarding their potential for effective therapy of wound infections. Further, established and novel models and analytical techniques for preclinical testing are introduced and a future perspective is provided.
Graphical abstract
中文翻译：
感染伤口的治疗：通过先进的药物输送系统克服临床挑战
近年来，感染伤口的发生率不断增加，有效治疗的临床和经济利益也在不断增加。这些措施将减少伤口中的病原体负荷与一般伤口管理相结合，以促进愈合过程。当前治疗的成功受到伤口微环境的恶劣条件、慢性性和生物膜形成的挑战，从而阻碍了感染部位活性抗菌药物的足够浓度。全身和局部应用抗生素的剂量准确性不足很容易促进抗生素耐药性的发展，而就防腐剂而言，细胞毒性是一个主要问题。先进的药物输送系统有可能使抗菌药物的定制应用成为可能，从而实现有效治疗且副作用可忽略不计。这篇综述全面概述了感染伤口治疗方案的现状。在这种情况下，特别关注抗菌药物的输送系统，从伤口敷料上的半固体和液体制剂到更先进的载体，如纳米颗粒系统、囊泡系统、电纺纤维和微针，这些系统的讨论涉及它们具有有效治疗伤口感染的潜力。此外，还介绍了用于临床前测试的已建立的新颖模型和分析技术，并提供了未来的前景。
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