Graphene materials in antimicrobial nanomedicine : current status and future perspectives

Graphene materials (GMs), such as graphene, graphene oxide (GO), reduced GO (rGO), and graphene quantum dots (GQDs), are rapidly emerging as a new class of broad‐spectrum antimicrobial agents. This report describes their state‐of‐the‐art and potential future covering both fundamental aspects and biomedical applications. First, the current understanding of the antimicrobial mechanisms of GMs is illustrated, and the complex picture of underlying structure–property–activity relationships is sketched. Next, the different modes of utilization of antimicrobial GMs are explained, which include their use as colloidal dispersions, surface coatings, and photothermal/photodynamic therapy agents. Due to their practical relevance, the examples where GMs function as synergistic agents or release platforms for metal ions and/or antibiotic drugs are also discussed. Later, the applicability of GMs in the design of wound dressings, infection‐protective coatings, and antibiotic‐like formulations (“nanoantibiotics”) is assessed. Notably, to support our assessments, the existing clinical applications of conventional carbon materials are also evaluated. Finally, the key hurdles of the field are highlighted, and several possible directions for future investigations are proposed. We hope that the roadmap provided here will encourage researchers to tackle remaining challenges toward clinical translation of promising research findings and help realize the potential of GMs in antimicrobial nanomedicine.ASTAR (Agency for Sci., Tech. and Research, S’pore

Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial

Diabetic foot ulcers are serious and challenging wounds associated with high risk of infection and lower-limb amputation. Ulcers are deemed neuroischaemic if peripheral neuropathy and peripheral artery disease are both present. No satisfactory treatment for neuroischaemic ulcers currently exists, and no evidence supports one particular dressing. We aimed to assess the effect of a sucrose octasulfate dressing versus a control dressing on wound closure in patients with neuroischaemic diabetic foot ulcers

Protease-modulating polyacrylate-based hydrogel stimulates wound bed preparation in venous leg ulcers - a randomized controlled trial

BackgroundStringent control of proteolytic activity represents a major therapeutic approach for wound-bed preparation. ObjectivesWe tested whether a protease-modulating polyacrylate- (PA-) containing hydrogel resulted in a more efficient wound-bed preparation of venous leg ulcers when compared to an amorphous hydrogel without known protease-modulating properties. MethodsPatients were randomized to the polyacrylate-based hydrogel (n=34) or to an amorphous hydrogel (n=41). Wound beds were evaluated by three blinded experts using photographs taken on days 0, 7 and 14. ResultsAfter 14 days of treatment there was an absolute decrease in fibrin and necrotic tissue of 37.629.9 percentage points in the PA-based hydrogel group and by 16.8 +/- 23.0 percentage points in the amorphous hydrogel group. The absolute increase in the proportion of ulcer area covered by granulation tissue was 36.0 +/- 27.4 percentage points in the PA-based hydrogel group and 14.5 +/- 22.0 percentage points in the control group. The differences between the groups were significant (decrease in fibrin and necrotic tissue P=0.004 and increase in granulation tissue P=0.0005, respectively). ConclusionIn particular, long-standing wounds profited from the treatment with the PA-based hydrogel. These data suggest that PA-based hydrogel dressings can stimulate normalization of the wound environment, particularly in hard-to-heal ulcers