Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
  • A61L27/56—Porous materials, e.g. foams or sponges
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/506—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
  • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
  • A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
  • A61L15/225—Mixtures of macromolecular compounds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
  • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
  • A61L15/42—Use of materials characterised by their function or physical properties
  • A61L15/425—Porous materials, e.g. foams or sponges
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
  • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
  • A61L15/42—Use of materials characterised by their function or physical properties
  • A61L15/44—Medicaments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
  • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
  • A61L15/42—Use of materials characterised by their function or physical properties
  • A61L15/60—Liquid-swellable gel-forming materials, e.g. super-absorbents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/14—Macromolecular materials
  • A61L27/22—Polypeptides or derivatives thereof, e.g. degradation products
  • A61L27/24—Collagen
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
  • A61L27/52—Hydrogels or hydrocolloids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
  • A61L27/54—Biologically active materials, e.g. therapeutic substances
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
  • A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
  • A61L2300/204—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials with nitrogen-containing functional groups, e.g. aminoxides, nitriles, guanidines
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
  • A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
  • A61L2300/416—Anti-neoplastic or anti-proliferative or anti-restenosis or anti-angiogenic agents, e.g. paclitaxel, sirolimus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
  • A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
  • A61L2300/602—Type of release, e.g. controlled, sustained, slow
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2430/00—Materials or treatment for tissue regeneration
  • A61L2430/18—Materials or treatment for tissue regeneration for hair reconstruction
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2430/00—Materials or treatment for tissue regeneration
  • A61L2430/34—Materials or treatment for tissue regeneration for soft tissue reconstruction

Definitions

• compositions including a porous scaffold and a focal adhesion kinase (FAK) inhibitor, and methods of making and using such compositions.
• FAK focal adhesion kinase
• a key modulator of this process is focal adhesion kinase (FAK), a cytoplasmic tyrosine kinase, which plays a central role in transducing mechanical signals to elicit fibrotic responses.
• FAK focal adhesion kinase
• the Integrin-FAK pathway also mediates tumor progression and metastasis in various malignancies.
• Pharmacological inhibitors of FAK have been emerging as anti-cancer chemotherapeutic s in preclinical and clinical studies. Cancer and hypertrophic scars share similarities in that exuberant fibroproliferative and extracellular matrix -remodeling events underlie their pathogenesis.
• the present invention relates to treating wounds and promoting tissue healing of wounds.
• compositions including a porous scaffold and a focal adhesion kinase (FAK) inhibitor, and methods of making and using such compositions.
• FAK focal adhesion kinase
• compositions for promoting tissue healing may include a porous scaffold.
• the composition may include focal adhesion kinase (FAK) inhibitor disposed in pores of the scaffold.
• FAK focal adhesion kinase
• the composition is configured to deliver a dose of FAK inhibitor effective to promote tissue healing at a controlled rate during a treatment time.
• the porous scaffold includes a hydrogel film. In some embodiments, the porous scaffold includes a pullulan-collagen hydrogel.
• the FAK inhibitor includes VS-6062 (PF-562271) or a benzenesulfonate salt of PF-562271. In some embodiments, the composition includes from about 1 pg/cm 2 to about 500 pg/cm 2 of the FAK inhibitor. In some embodiments, the composition includes from about 40 pg/cm 2 to about 200 pg/cm 2 of the FAK inhibitor.
• the composition is configured for sustained release of the FAK inhibitor disposed in pores of the scaffold. In some embodiments, the composition is configured for sustained release of the FAK inhibitor disposed in pores of the scaffold over a period of up to about 96 hours.
• the composition is fabricated by molecular imprinting of the FAK inhibitor during formation of the porous scaffold. In some embodiments, the composition is fabricated for rapid release of FAK inhibitor. In some embodiments, the composition includes FAK inhibitor on a delivery surface of the composition. In some embodiments, the composition is further configured for rapid release of FAK inhibitor from the delivery surface of the composition. In some embodiments, the composition is configured for rapid release of FAK inhibitor from a delivery surface of the composition within about 24 hours.
• the composition is tailored to release substantially all of the FAK inhibitor during the treatment time. In some embodiments, the composition is tailored to release from about 30% of the FAKI inhibitor to about 75% of the FAK inhibitor during the treatment time.
• the composition includes a plurality of layers wherein one or more layers is fabricated for sustained release of the FAK inhibitor and one or more layers is fabricated for rapid release of the FAK inhibitor. In some embodiments, the composition includes a layer configured for both sustained release of the FAK inhibitor and rapid release of the FAK inhibitor.
• the composition is configured to deliver during the treatment time a dose of the FAK inhibitor effective to reduce scarring of the tissue.
• both variables vary with the concentration of collagen that is present in the hydrogel.
• the average pore size will usually range from about 25 mih to about 50 mih, from about 30 mih to about 40 mih, and may be about 35 mih.
• the average pore size will usually range from about 10 mih to about 25 mih, from about 12 mih to about 18 mih, and may be about 15 mih.
• the scaffold porosity will usually range from about 50% to about 85%, and may range from about 70% to about 75%, and will decrease with increasing concentrations of collagen.
• Pullulan A polysaccharide polymer originally from the fungus Aureobasidium pullulans. It is a linear homopolysaccharide having alpha-(l-6) linked maltotriose units and exhibits water retention capabilities in a hydrogel state which makes it an ideal therapeutic vehicle for both cells and biomolecules. Additionally, pullulan contains multiple functional groups that permit crosslinking and delivery of genetic material and therapeutic cytokines.
• Collagens are widely found in vertebrate species, and have been sequenced for many different species. Due to the high degree of sequence similarity between species, collagen from different species can be used for biomedical purposes, e.g., between mammalian species. Typical commercial animal sources include the bovine Achilles tendon, calfskin and the bones of cattle. In some embodiments the collagen used in the preparation of the oriented thin film is Type I, Type II or Type III collagen, and is derived from any convenient source, e.g., bovine, porcine, etc., usually a mammalian source. [0063] Collagen has a triple- stranded ropelike coiled structure.
• the major collagen of skin, tendon, and bone is collagen I, containing 2 alpha- 1 polypeptide chains and 1 alpha-2 chain.
• the collagen of cartilage contains only 1 type of polypeptide chain, alpha- 1.
• the fetus also contains collagen of distinctive structure.
• the genes for types I, II, and III collagens, the interstitial collagens, exhibit an unusual and characteristic structure of a large number of relatively small exons (54 and 108 bp) at evolutionarily conserved positions along the length of the triple helical gly-X-Y portion.
• wound generally refers to both open and closed wounds, as described below.
• a wound can be further classified as an acute or chronic wound.
• An acute wound is one that does not have an underlying healing defect, and usually occurs secondarily to surgery or trauma in a healthy individual, healing quickly and completely.
• a chronic wound is one that has a loss in tissue integrity, produced by insult or injury that is of extended duration or frequent recurrence.
• skin wound' refers to a break in the skin.
• Lacerations may show bridging, as connective tissue or blood vessels are flattened against the underlying hard surface.
• Abrasions grazes
• Puncture wounds may be caused by an object puncturing the skin, such as a nail or needle.
• Penetration wounds may be caused by an object such as a knife entering the body.
• Gunshot wounds are caused by a bullet or similar projectile driving into or through the body. As such, there may be two wounds, one at the site of entry and one at the site of exit, which is generally known as a through-and-through.
• closed wound refers to contusions, more commonly known as bruises, caused by blunt force trauma that damages tissue under the skin; hematomas, also called blood tumors, caused by damage to a blood vessel that in turn causes blood to collect under the skin; and crushing injuries, which may be caused by a great or extreme amount of force applied over a long period of time.
• scar refers to an abnormal morphological structure resulting from a previous injury or wound (e.g., an incision, excision or trauma).
• Scars are composed of a connective tissue which is predominately a matrix of collagen types 1 and 3 and fibronectin.
• a scar may consist of collagen fibers in an abnormal organization (as seen in normal scars of the skin) or may be an abnormal accumulation of connective tissue (as seen in scars of the central nervous system or pathological scarring of the skin).
• the types of scars include, but are not limited to, atrophic, hypertrophic and keloidal scars, as well as scar contractures. Atrophic scars are flat and depressed below the surrounding skin as a valley or hole.
• Hypertrophic scars are elevated scars that remain within the boundaries of the original lesion, and often contain excessive collagen arranged in an abnormal pattern.
• Keloidal scars are elevated scars that spread beyond the margins of the original wound and invade the surrounding normal skin in a way that is site specific, and often contain whorls of collagen arranged in an abnormal fashion.
• Scar contractures are scars that cross joints or skin creases at right angles, and are prone to developing shortening or contracture. Scar contractures occur when the scar is not fully matured, often tend to be hypertrophic, and are typically disabling and dysfunctional.
• a variety of conditions may cause scarring, including surgical wounds, burns, cuts, gunshot, etc.
• Scars commonly form as a result of facial plastic surgery, which includes, but is not limited to, rhytidectomy, blepharoplasty, rhinoplasty, otoplasty, mentoplasty, face lift, fore head lift, brow lift, facial scar revision, facial scar removal, laser surgery, skin resurfacing, wrinkle treatment, plasma skin regeneration, facial fat grafting, skin tightening, tattoo removal and hair replacement.
• this disclosure is advantageous to patients who undergo facial plastic surgery, particularly to aid with scarring and bruising, by speeding up wound healing and reducing scar formation.
• kits for promoting healing comprising the step of contacting a wound with an effective dose of an FAK inhibitor hydrogel as disclosed herein for a period of time sufficient to reduce scarring, form hair or form dermal appendages.
• methods for promoting tissue healing including placing a composition comprising a porous scaffold and a focal adhesion kinase (FAK) inhibitor fabricated for controlled drug release disposed in pores of the scaffold; applying the composition to a tissue surface; and delivering from a delivery surface of the composition to the tissue a dose of the FAK inhibitor effective to promote tissue healing at a controlled rate during a treatment time.
• FAK focal adhesion kinase
• the composition includes a hydrogel, such as a pullulan-collagen hydrogel.
• the dose of the FAK inhibitor is effective to reduce scarring of the tissue during the treatment time.
• the FAK inhibitor is effective to reduce scarring of the tissue after the treatment time, e.g., through activation of healing pathways in the body.
• the dose of the FAK inhibitor is effective to promote hair growth in the tissue during (or after) the treatment time. For example, hair may continue to grow even after a porous scaffold is removed.
• the composition is configured as a wound dressing.
• FAK inhibitor is disposed on a delivery surface.
• the controlled rate comprises a rapid release rate (for release to a tissue surface) and a sustained release rate (for release to a tissue surface).
• FAKI for rapid release is released to the tissue surface within about 12 hours, about 24 hours or in between these times.
• the FAKI for sustained release is released to the delivery surface over a period of up to about 24 hours, 48 hours, 72 hours or 96 hours or any length of time in between.
• the FAKI for sustained release is released to the tissue surface over a period of up to about 24 hours, 48 hours, 72 hours or 96 hours or any length of time in between.
• Some methods include removing the composition from the tissue surface such as by lifting or pulling it from the surface.
• Some methods include biodegrading the composition.
• swelling and wound exudates may indicate that the hydrogel be applied later than three days following injury.
• a first hydrogel can be applied within an initial period following injury, e.g., within the first three days, and then removed, and a second hydrogel can be applied thereafter.
• the second hydrogel can be adapted to changes in the skin and tissue surrounding the wound that can occur after the initial period, e.g., decreased swelling and exudates.
• Wounds may be confined to the epidermis such that they do not penetrate into the dermal layer, may be as deep as the dermis or deeper, e.g., may penetrate to or through the dermis and even to or through the subcutaneous tissue layer or deeper, e.g., may penetrate through or to the muscle layer or further.
• the subject methods may be used to debride wounds that having a depth that ranges from about 0.005 mm to about 2.35 mm, e.g., from about 0.007 mm to about 2.3 mm, e.g., from about 0.01 mm to about 2 mm.
• a wound dressing may comprise an effective dose of an FAK inhibitor imprinted or surface-applied to a pullulan/collagen hydrogel, which hydrogel may be attached or adhered to a substrate, e.g. a breathable protective layer, or other protective film.
• the dressing may be separately configured from a protective dressing.
• the support is generally made of a flexible material which is capable of fitting in the movement of the human body and includes, for example, various non-woven fabrics, woven fabrics, spandex, flannel, or a laminate of these materials with polyethylene film, polyethylene glycol terephthalate film, polyvinyl chloride film, ethylene-vinyl acetate copolymer film, polyurethane film, and the like.
• the support may be substantially bent or folded without breaking, tearing, ripping, etc.
• the support may be porous or non-porous, but is typically non-porous or impermeable to the hydrogel composition, active agent if employed and fluids, e.g., any fluids exuded from the wound site.
• the length and width dimensions of the support are typically substantially
• the support layer typically may have a thickness that ranges from about 10 mih to about 1000 mih, but may be less than about 10 mih and/or greater than 1000 mih in certain embodiments.
• the dressing may also include a release film on the surface of the hydrogel composition layer opposite a backing that provides for protection of the patch layer from the environment.
• the release film may be any convenient material, where representative release films include polyesters, such as PET or PP, and the like.
• the shape of the dressing may vary, where representative shapes include square, rectangle, oval, circle, triangular, etc.
• the size of the dressing may also vary, where in many embodiments the size of the hydrogel ranges from about 1 cm2 or less to about 1000 cm2 or more, e.g., in certain embodiments ranges from about 10 to about 300 cm 2 , e.g., from about 20 to about 200 cm 2 , e.g., about 130 cm 2 to about 150 cm 2 .
• the surface area is sufficient to cover a substantial portion or even the entire truck or even a substantial portion of the entire body or even the entire body of a subject. Accordingly, the surface area may range from about 1000 cm 2 to about 5000 cm 2 or more. It should be noted that the above
• manufacturing protocol is merely representative. Any convenient protocol that is capable of producing the subject hydrogel patch compositions, as described above, may be employed.
• the devices and bandages described herein may have any suitable shape.
• the devices or bandages may be rectangular, square, circular, oval, toroidal, or segments or combinations thereof.
• the devices will be flexible and planar to allow conformal placement against skin.
• the devices and bandages may also be of any suitable size, to deal with a variety of wounds.
• the devices and bandages may be cut immediately prior to use from a roll or sheet of bandage to ensure appropriate coverage of the wound site.
• Devices and bandages can extend out to about 20 cm (about 8 inches) from the wound in some instances, and in other instances the devices or bandages can extend about 2, 4, 6, 8, 10, 12, 14, 16, or 18 cm from the wound, where“about” qualifies each of the distances.
• the bandages can extend about 22 cm, about 24 cm, about 26 cm, or even more, from the wound.
• the devices are made from a polymer, for example, a shape memory polymer. Any suitable shape memory polymer may be used, e.g., styrene-based, epoxy-based, or acrylate-based shape memory polymers.
• kits for ameliorating the formation of scars and/or keloids and/or developing hair and skin appendages are also described here.
• the kits comprise in packaged combination a unit dosage of an effective amount of an FAKI containing hydrogel as described herein.
• biomaterial-based anti-scar drug delivery approach for wound and scar management is a biomaterial-based anti-scar drug delivery approach for wound and scar management.
• FAKI delivered via hydrogel suppresses scar-forming pro-fibrotic activity in excisional wounds. Without scar-promoting stimuli (e.g., mechanical strain), murine skin typically does not develop elevated HTS; however, pro-fibrotic events following injury can be measured by the amount of collagen deposition and the presence of myofibroblasts after the wounds are healed. On Day 17 post-injury, histological analyses of collagen staining
• FIG. 7A-FIG. 7D shows the setup for analyzing the effects of topical treatment of FAKI applied in a hydrogel device to deep cutaneous wounds in a red Duroc pig model.
• FIG. 8A shows photographs of the wounds taken from postoperative day (POD) 2 to POD 30 as described above and in FIGS. 7A-7E. Wounds treated with FAKI hydrogel are visibly more healed at POD 11, POD 21, and POD 30, compared with untreated wounds or wounds treated with hydrogel alone. In addition to visibly improved appearance, wounds treated with FAKI hydrogel were significantly smaller.
• FIG. 8C shows that untreated wounds or wounds treated with hydrogel alone take 25 days to fully close, while wounds treated with FAKI in a hydrogel device are closed by POD 14, a statistically significant result (D).
• FIG. 9A - FIG. 9B and FIG. 10A - FIG. 10B show that topically treating deep cutaneous wounds with FAKI delivered via hydrogel significantly improves scar appearance at POD 45, POD 60, POD 90 (3 months), and POD 180 (6 months).
• FIG. 9B shows results from Visual Analog Scale (VAS) analysis of scars. Visual Analog Scale scores were assessed by four blinded scar experts for untreated control, hydrogel treated and FAKI via hydrogel treatment. The scarring in the control was arbitrarily set at 100 and results were scaled relative to the control.
• VAS Visual Analog Scale
• FIG. 11A - FIG. 11C show results from POD 90. Images in FIG. 11A show Trichrome staining at POD 90. Arrow 1 points to a hair follicle. Arrow 3 points to a hair follicle with surrounding glandular structures. Arrow 2 and Arrows 4-6 point to cutaneous glands (sweat and sebaceous glands).
• FIG. 12A shows that FAKI delivered via hydrogel significantly decreases a-smooth muscle action (a-SMA) expression in wounds treated with FAKI delivered via hydrogel vs untreated controls at POD 60 and POD 90.
• FIG. 12B shows that level of a-SMA expression is significantly lower in treated wounds (about 2% of the areas is stained green (indicative of a-SMA) in the treated sample vs. about 28% in the untreated control; *p, 0.001) and this trend persists at POD 90 (FIG. 12C).
• a-smooth muscle action (a-SMA) was quantified by blinded observers for randomly selected regions within scar lesions.
• FIG. 13 A - FIG. 13C show that wounds treated with FAKI delivered via hydrogel results in dermal collagen structure that resembles unwounded skin.
• FIG. 13A shows that tissue from pigs treated topically with FAKI delivered via hydrogel has shorter fibrils compared with either untreated control wounds or hydrogel treated wounds (compare the third row panel with the top and second row panels in FIG. 13A). Rather, the collagen fibrils from the tissue from pigs treated topically with FAKI far more closely resembles tissue from an unwounded animal (bottom panel).
• FIG. 13B shows results from quantitating collagen fibril length from samples stained such as those shown in FIG. 13 A.
• FIG. 15A - FIG. 15B shows safety of FAKI delivered locally via hydrogel.
• FIG. 15A shows FIG. 15A - FIG. 15B shows toxicology and pharmacokinetic studies of FAKI delivered locally via hydrogel.
• FAKI hydrogel samples were applied daily at high concentrations of FAKI (150 um FAKI, 1.5 mM FAKI) to unwounded skin and the results are shown in FIG. 15B. Daily application of FAKI, even at high concentrations, did not result in irritation or sensitization of skin.
• biodegradable pullulan-collagen dermal hydrogel alone can augment early wound healing in murine wounds.
• Pullulan hydrogels are non-toxic and modifiable and exhibit ideal water retention capabilities.
• the porous matrix also has multiple functional groups allowing crosslinking and the potential to serve as a structured template for cell-based and/or biomolecule delivery for various cutaneous healing disorders. Using this bioengineered matrix, we delivered mesenchymal stem cells to high oxidative-stress wounds for restoration of skin cell populations.
• the present findings are the first to deliver an anti- scarring agent in a pullulan- collagen hydrogel for open wounds.
• Molecular imprinting techniques to encapsulate FAKI combined with unique hydrogel fabrication methods allowed precisely controlled sustained release of FAKI from the hydrogel scaffold for sustained release, rapid release, or a combination of the two.
• FAKI therapy significantly accelerated the healing of full-thickness excisional and burn wounds and reduced scar formation. Acceleration of wound healing is likely due to the inhibitory effects of FAKI on early immune cell responses (e.g., proliferation and migration) and inflammation.
• mice All animal procedures were approved by the Administrative Panel on Laboratory Animal Care at Stanford University and the US Army Medical Research and Material Command Animal Care and Use Review Office. Wild type female C57BL/6J mice 8- 10 weeks old (The Jackson Laboratory, Bar Harbor, ME) were used to create either splinted full- thickness excisional or third degree bum wounds according to published methods (Wang et ah, 2013; Wong et ah, 201 lb; Sultan et ah, 2012).
• Excisional wounding For surgically-created excisional wounds, two full-thickness wounds (one wound on each side of the dorsal midline) were made with a 6-mm punch biopsy tool. Silicone rings that circumscribe the wound were sutured to the skin to prevent wound contracture (primary means of rodent wound healing) but to allow the wound to close by re- epithelialization (similar to human wound healing).
• Burn wounding Contact burn wounds were created only on one side in the dorsum with an aluminum rod heated to 100° C in a hot water bath for 20 sec. Wounds were
• Hypertrophic scar model and local subcutaneous injection of FAKI Incisional wounding and development of hypertrophic scars on the dorsum of mice were performed by previously described methods (Aarabi et ah, 2007; Wong et ah, 201 la). Animals were randomly assigned to receive 15, 75, or 150 mM concentrations of FAKI dissolved in 10% DMSO via daily local subcutaneous injection adjacent to the wound site. Animals that received 150 mM FAKI did not survive more than 2 days due to undetermined systemic complications. Specimens were harvested at Day 14 post-injury for histology and scar areas were quantified (Figure 6).
• Wounds were near full-thickness in the center and deep partial-thickness towards the periphery. Wounds were randomly assigned to control (no treatment), hydrogel only (placebo), or hydrogel with FAKI treatment.
• Immunofluorescent staining was performed using a primary antibody against mouse alpha- smooth muscle actin (a-SMA). Secondary antibodies conjugated to FITC were used and images were observed under a fluorescent microscope. The percentage of green area was quantified using ImageJ.
• a-SMA mouse alpha- smooth muscle actin
• CT-FIRE Sections were stained for collagen and analyzed using CT-FIRE software.
• CT-FIRE software allows users to automatically extract collagen fibers from an image and quantify fibers with descriptive statistics including: fiber angle, length, straightness, and width.
• the program reads image files supported by MATLAB and extracts the individual collagen fibers via a combined method called CT-FIRE (named ctFIRE in the software implementation).
• CT-FIRE named ctFIRE in the software implementation.
• the approach of CT-FIRE is described in Bredfeldt JS, Liu Y, Pehlke CA, et al (2014)

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