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Conception et évaluation d'un pansement à libération de deux principes actifs pour le traitement des plaies chroniques

Abstract : Chronic wounds present a risk of infection, delaying the healing process and leading to severe pain. Chronic wounds represent a public health problem that generates high costs. Silver dressings are widely used to treat wounds already infected or with a risk of infection. Nevertheless, the toxic effect of silver toward fibroblasts and keratinocytes generates a perception lack of efficacy and cost effectiveness, and question their effectiveness as well as its safety. The goal of this work was to design a wound dressing releasing two active ingredients: a silver salt to treat the infection and ibuprofen to relieve the pain. The dressing was coated by a layer-by-layer (L-b-L) system to slow down silver diffusion into the wound and at the same time provide a moist environment to the wound. First, a nonwoven polyester textile was functionalized by chitosan or by β-cyclodextrin polymer, both crosslinked with citric acid under curing conditions to form a thermofixed negatively charged layer at the surface textile to then loaded silver onto the textile. Next, a L-b-L system was built on the support by alternating self-deposition of CHT as cationic polyelectrolyte and cyclodextrin polymer as anionic polyelectrolyte. A curing process was applied to stabilize the L-b-L system. L-b-L system showed a linear evolution of the weight gain in relation to number of layers formed. Loaded silver and ibuprofen reached up to 240 μg/cm2 and 200 μg/cm2 respectively. Silver was released up to 3 μg/cm2 after 3 days in PBS under static conditions, and ibuprofen was released up to 6 hours under the same parameters. Biological studies proved the dressing cytocompatibility using human lung normal cell lines (L132). In vitro microbiological evaluation showed greater antibacterial activity of the dressing against S. aureus and E. coli. Finally, a preliminary in vivo study was performed in C3H/HE mice with a wound infected by E. coli. The dressings tested were applied to the wounds and were maintained for 3 days. Only the free silver-dressing (negative control) showed a colonization by E. coli.
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Alejandra Mogrovejo Valdivia. Conception et évaluation d'un pansement à libération de deux principes actifs pour le traitement des plaies chroniques. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2018. Français. ⟨NNT : 2018LIL2S046⟩. ⟨tel-02880443⟩

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