Denver — Nanotechnology shows promise for delivering many advanced wound-healing agents, says an expert. However, he adds, dermatologists may need to step up their wound-healing game to master these technologies.
“My belief is, go small or go home,” says Adam Friedman, M.D., assistant professor of medicine/physiology and biophysics, and director of dermatologic research, Montefiore-Einstein College of Medicine, New York. “Nanomaterials represent an innovative direction. It’s not the future — it’s already present in dermatology, and it will continue to grow with time.”
However, he adds that as dermatologists, “We should be at the crux of wound healing, developing new therapies. But we’re often not.”
Wound healing represents a major gap in dermatology training, Dr. Friedman says, but understanding which nanomaterials can accelerate wound healing — and how and when to use them — requires knowledge of the wound-healing process.
Moist wound healing
In this regard, he says, the current concept of moist wound healing suits nanotechnology well. Dry wound exudate and eschar impede the entry of new cells to the wound area, Dr. Friedman says.
“Many patients believe they should let the wound dry out. That’s actually the worst thing to do. Simple occlusion with petroleum jelly and a Band-Aid will start wound healing probably as well as any prescription vehicle,” he says.
At the nanoscale, Dr. Friedman adds, wound-healing materials are more occlusive than their bulk counterparts.
“They’ll sit more evenly on the wound bed or the skin itself. That will decrease transepidermal water loss,” he says. Maintaining moisture in the wound bed facilitates advanced cell migration and, perhaps more importantly, electrochemical communication between cells.
Different materials pertain to different wound-healing stages, Dr. Friedman says.
“In the inflammatory stage, you want antimicrobial agents,” he says, noting that immunomodulatory agents not only stimulate the immune response, but also must taper off when the proliferative stage begins. At this stage, wounds benefit from interventions such as growth factors and scaffolding.
“Where the wound is in terms of healing determines what product you’re going to use,” he says. “With nanotechnology, you can have multiple agents in one platform. And dermatologists are kings of synergy, combining different ingredients in the same platform.”
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