Nanoskin®-The impact of Natural Membrane on COVID-19 and chronic wound

Bacterial cellulose (BC) is a natural polymer synthesized by some bacteria. As a species of natural biopolymer, BC shows good biological activity, biodegradability and biological adaptability. It has many unique physical, chemical and biological properties, such as ultrafine nanofiber network, high crystallinity, high water absorption and water holding capacity


Introduction
Bacterial cellulose (BC) is a natural polymer synthesized by some bacteria.As a kind of natural biopolymer, BC shows good biological activity, biodegradability, and biological adaptability.It has many unique physical, chemical, and biological properties, such as ultrafine nanofiber network, high crystallinity, high absorption and water holding capacity, and high tensile strength and elastic modulus.These excellent properties of BC laid the foundations for its application as a wound healing dressing.[

1,2]
To optimize the biocompatibility and antimicrobial activity of BC, different methods including microbial fermentation, physical modification, chemical modification, and compound modification were adopted to modify BC to ensure better application in wound healing.BC-based dressings have been applied to infected wounds, acute traumatic injuries, burns, and diabetic wounds, showing remarkable therapeutic effects in promoting wound healing.In addition, there have been some commercial BC-based dressings and they have been used in clinical practice.[3,4] Due to its excellent physicochemical characteristics and biological properties, BC shows high clinical value to be used as a wound dressing for skin tissue regeneration.[3,4] Bacterial cellulose (BC) produced by aerobic bacteria has the advantages of high purity, high porosity, strong water absorption, high water holding capacity, high mechanical strength, and good biocompatibility.
Advanced wound healing approaches have attracted a lot of attention in recent decades due to the use of new types of dressings that provide a moist environment and take an active part in tissue protection and regeneration processes.Materials for new wound dressings must have a set of characteristics that will contribute to efficient skin recovery.
The use of bacterial cellulose (BC) is attractive for advanced wound management due to the favorable characteristics of BC, such as its biocompatibility, non-toxicity, mechanical stability, and high moisture content.A number of approaches can be taken to modify BC to address the deficiencies of the native material and to optimize its biocompatibility, water absorption and release, and antimicrobial activity.[5,6] Recent studies showed that the COVID-19 pandemic caused collateral damage in health care in terms of reduced hospital submissions or postponed treatment of other acute or chronic patients.

[7,8]
Chronic wounds are commonly related to the same comorbidities that increase the risk for death from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).However, risk factors for impaired wound healing and wound complications due to SARS-CoV-2 which is associated with physiologic changes that may affect healing.Whether these changes promote de novo wound development or further impair the healing of chronic wounds in patients infected with COVID-19 is unknown.However, these changes may contribute to the already increased risk for pressure-induced skin and soft tissue injury in patients with COVID-19 who require prolonged hospitalization.[9,10]  This article highlights possible paths for the functionalization of BC, affecting all levels of its structural organization.The focus is on the post-production treatment of BC, although selected studies referring to in situ modifications during the biosynthesis process are also emphasized.Besides, this article describes a behavior investigation of this biomaterial in human medicine with bacterial cellulose in covid-19 and chronic wounds.

Materials
The bacterial cellulose raw material was provided from Innovatec´s (São Carlos SP, Brazil).Brassica Nigra extract was purchased from Amazon.

Synthesis of Bacterial Cellulose and Brassica Nigra extract
Bacterial cellulose (BC) was produced by fermentation change of Gram-negative bacteria Gluconacetobacter xylinus, which will obtain from a culture medium in the pure 3-D structure, consisting of an ultra-fine network of cellulose nanofibers.The acetic fermentation process was achieved by using glucose as a carbohydrate source and green tea as a nitrogen source.Results of this process were acetic acid and a nanobiocellulose biomass.The modifying process was based on the addition of Brassica Nigra extract(1 % w/w) to the culture medium before bacteria inoculation and after bacterial cellulose hydrogel is dried in an oven to produce bacterial cellulose mats.[9-13]

2.3) Characterization
In vivo analysis-In vivo wound healing analysis of covid-19 and several chronic wounds.

Results and Discussion
In

Pilonidal Sinus Case
• Under Supervision of Dr. Bassam Noah -NeurospinalHospital   In conclusion, Nanoskin®(Bacterial cellulose membranes) applies for different wound healing treatment, since skin cancer, covid-19 and several chronic and rare wounds.
https://doi.org/10.38207/JCMPHR/2022/MAR03030130Nanoskin® ACT natural extracellular matrix bacterial cellulose (ECM-BC) releases nutrients from bacterial cellulose fermentation to the skin tissue.Produced nanofibers of fermentation have a high concentration of secondary metabolic such as diterpene and alkaloids', that improve skin nutrients and improve the immune system too.[9,10] Besides, Nanoskin® ACT natural membranes have β-glucan polysaccharide and usnic acid which is an effective antibacterial agent and immunogenic substance.When it is linked to cellular receptors, it increases immune body response.Such natural membranes change ECM synthesis of new vessels, granulation tissue, and epithelialization that are produced in patient skin.[9,10]

Figure 5 :
Figure 5: Complete wound healing in Abdominoplasty site infection with Nanoskin-ACT