1. Introduction
The complex and dynamic process of wound healing can be effectively managed by creating a favorable environment employing suitable wound-dressing products. It is reported that the global annual cost of wound care products including surgical and chronic wound is expected to increase from
$15 billion (2022) to
$22 billion (2024) [
1]. Even though a wide range of wound dressings are already present in the market, there is scope for great improvement and innovation to address some unmet needs viz. incapability to adjust properties in accordance with changing wound condition; pain and secondary injuries (disturbed new epidermis) due to excessive drying; and loss of efficiency on saturation with exudates. Newer interactive dressings like films and foams are associated with the latter issue of excessive exudate accumulation on site, leading to delayed healing [
2].
In contrast to other systems, hydrogels are advanced and interactive and have attracted attention due to (i) their high water content that initiates granulation and epithelialization by promoting fibroblast proliferation and keratinocyte migration; (ii) their soft elastic nature, easy application, and removal; and, (iii) soothing and cooling effect on wounds [
3].
However, hydrogel wound dressings may present incompatibility with high exudate wounds and exhibit limited mechanical property and non-adherent and macroscopic nature [
2].
Statins are reported to elicit wound healing [
4,
5] beyond their much-claimed cholesterol-reducing effects. More than one biological mechanism has been attributed to their role in cutaneous tissue regeneration, including pro-lymphangiogenic, pro-angiogenic, antiinflammatory, antifibrotic, antibacterial, and immunomodulatory effects [
6]. Since, amongst the various available statins, studies on the role of simvastatin (SIM) in wound healing are more frequent [
7], it was selected as a model drug.
Though observed to be an excellent wound-healing agent in vitro [
6], clinical translation to wound healing products of SIM will be limited due to its low solubility (0.03 mg/mL) and variable absorption. Further, its lactone moiety is reported to undergo hydrolysis in the acidic (approx. pH 2) and alkaline media [
8]. In aqueous surfactant solution and in the presence of an initiator, SIM is reported to be susceptible to oxidation at the diene functional group [
9]. To overcome poor solubility, many approaches viz. salt formation, use of surfactant, use of prodrugs, and micronization of SIM have been tried. Solid lipid nanoparticles (SLNs) have gained considerable attention in topical application due to high stability, safety, efficacy, and their occlusive film-forming properties on the skin surface [
10]. In addition, SLNs offers advantages like increased solubility, protection of actives against degradation, high payload, and the possibility of actives targeting and controlled release characteristics.
SLN is also compatible for use on inflamed skin due to the non-skin irritation and non-toxic properties of the lipid matrix, making it a suitable option for wound-healing application.
Following the evaporation of water from the lipid nano dispersion when applied to the wounds, lipid particles form an adhesive layer occluding the surface. The latter maintains a moist environment in and around the wound, promoting fast and efficient wound healing [
11]. However, SLN dispersions are usually aqueous and are free flowing, suggesting the need to incorporate into secondary vehicles like hydrogels for better topical application.
In apropos to overcoming the aforementioned issues with current wound dressing options and harnessing advantages of SLNs and hydrogel, presently we endeavor to develop a self-gelling solid lipid nanoparticle wound dressing. To this end, this system provides a cross-over for combinations of hydrogel and nanomaterials. The proposed system is comprised of solid lipids, surfactants, and water. The novelty/uniqueness of the presently reported dressing lies in the choice of its components and eduction of multifactorial properties and effects. ‘Poloxamer’, one of the key components of presently developed dressing, was employed at a concentration where it imparted a four-in-one effect of an (i) emulsifier for SLN formation, (ii) cosolvent for SIM, (iii) gelling agent, and (iv) precipitation inhibitor (PI).
The latter effect overcomes the issue of SIM precipitation/crystallization, which is often seen in nano systems with a high load of poorly soluble actives [
12]. The suitable viscosity achieved with the presently described system will ensure ease of application, patient compliance, sufficient contact time, and negates the need to add a secondary gelling agent as is proposed for other topical applications employing SLNs.
Further, the SIM-loaded self-gelling SLN hydrogel wound dressing was prepared employing high-pressure homogenization technique, which is a high output method. Also, no organic solvent was deployed, and care was taken to avoid common surfactants like tweens. The latter resulted in SIM degradation in solution forms. The developed SIM-SLN hydrogel wound dressing was characterized extensively and employed topically to establish its effects on wound healing in the excision wound model in rats.
Conclusively, presently we report not only on the lesser explored wound-healing property of SIM but also endeavor to develop a novel self-gelling SLN-hydrogel wound dressing system with significant advantages as discussed above. Reported SIM dressing is a new class of hydrogel dressing where SLNs perse contribute to the gel structure. The system was characterized for physical, chemical, and crystal characteristics and release; and evaluated for safety (biocompatibility) and effectiveness (in terms of hydrophobic active loading and wound healing). Atomic and sub-atomic studies may however be undertaken next to describe, understand, and harness the structural behavior of such systems.
4. Conclusions
Hydrogels, due to high biocompatibility, hydrophilicity, and three-dimensional (3D) porous structure that matches the extracellular matrix, are extensively explored as wound dressings [
28]. However, their popularity is partly marred due to maceration of adjacent skin due to exudate retention, requirement of secondary dressing, poor mechanical properties, and easy dehydration if kept uncovered [
29]. Presently it is proposed to manage these issues and harness all the advantages of hydrogel by development of an amalgam of SLNs and hydrogel. The former is popularly known to provide good elasticity and occlusivity when applied to the skin surface, and hence will manage the drying of hydrogel, undertoning of adjacent skin, and spreadability. In addition to the nature of the dressing, the inclusion of a good healing agent with suitable antibacterial property to manage infected wounds is also important. Although antibiotics are the preferred choice, the issue of bacterial resistance with antibiotic therapy is becoming a challenge. Similarly, biotoxicity and long-term retention of inorganic metals as alternate antimicrobials also points towards exploring other newer options [
28].
Simvastatin, HMG-Co A reductase inhibitor is reported to exhibit pleiotropic effects such as increased vascular endothelial growth factor (VEGF) production, stimulation of angiogenesis, reduced oxidative stress, and improved endothelial function effects, all of which can positively influence wound healing. Furthermore, it also exhibits antibiofilm activities [
30].
However, to elicit physiological effects, there is a need to enhance the bioprofile of SIM because it shows low aqueous solubility and is susceptible to hydrolytic degradation. In this study, we described a novel SLN system where the external aqueous phase of the dispersion per se formed a gel structure comparable to liquid crystals upon cooling. SIM-SLN hydrogel exhibited a high drug loading of 10 mg/g of formulation (1%
w/
w), which was challenging in light of the fact that it is poorly soluble and the choice of surfactants for developing SIM-SLN was limited due to its proneness to degrade in aqueous surfactant solutions viz. tweens. SIM-SLN hydrogel was prepared using hot high-pressure homogenization method. The achieved loading was 5–10 times more than those reported [
16,
17] previously. An entrapment efficiency of 60% was achieved, which, though less than that reported by others, is more in terms of the total amount encapsulated per unit weight or volume. Further achieving this encapsulation without employing any organic solvent is a significant achievement. Encapsulating SIM within the lipid core of SLNs in an aqueous media without crystallization involved a tremendous effort and optimization. XRD, DSC, and FTIR spectra confirm the absence of precipitation of the drug and amorphousness of the lipid phase, indicating effective encapsulation of SIM and formation of lipidic nanoparticles. The morphological change in developed SLNs upon cooling from liquid to semi-solid state after 24 h was investigated in terms of particle size. An increase in particle size from 294 nm to 2 µm and broadening of the peak can be attributed to the formation of poloxamer assemblies [
31].
The developed wound dressing was established to be safe in vivo. The ease of application, extrusion from container, and esthetics were confirmed to be satisfactory as indicated by texture analysis and rheological studies. The prepared formulations were evaluated for their wound-healing efficacy using an excision-wound model in rats. It is reported that the low doses of topically applied statins exhibit better effects, while these effects may be reversed at higher doses [
21]. Similar was observed presently as the effects produced at 1 mg dose showed faster and better healing than the 3 mg dose. Free SIM dispersed in CMC gel also showed effects, though significantly less than SIM-SLN hydrogel, on wound healing. Since the presently used excision model involves whole skin removal, the advantages obtained with improved penetration due to SLN nature are not so evident; however, the occlusion for maintaining moist conditions in the wound and porosity are a definite advantage. Though histology and rate of wound healing was monitored along with the oxidative stress markers i.e., MDA and catalase, it will be appropriate to conduct more elaborate studies like monitoring various molecular markers of inflammation, healing, angiogenesis, and various genetic markers to more elaborately establish the mechanism of action. Apart from appropriate safety, efficacy, and patient compliance, it will also be worthwhile and of scientific interest to study the structural aspects of present formulation in depth and develop a clearer insight and understanding of its mechanical properties and sub-atomic structure.