1. Introduction
Plant-based biomaterials have several benefits over synthetic materials, such as cost-effectiveness, safety for humans, and environmentally friendly [
1]. In addition, developing novel wound dressings containing medicinal plant extracts can improve clinical outcomes and plant value [
2,
3]. In this study, we are interested in
Eclipta prostrata L. (
E. prostrata L.) due to their pharmacological properties.
E. prostrata L., commonly known as False daisy, Ink plant, Bhringraj, Bhumiraj, Aali jhar, or Nash jhar, is a herbaceous plant that belongs to the family Asteraceae [
4]. It is a weed that grows in moist places such as rivers, marshes or the edge of rice fields [
4,
5]. It is found in many parts of the world, including Thailand, China, India, Nepal, and Brazil [
4]. It has been long used in several diseases such as coronary heart disease, diabetes, gastrointestinal diseases, respiratory diseases, skin diseases, and wounds [
5]. The leaves have various biological activities, including antibacterial, antifungal, and anti-inflammatory activities, which improve wound healing [
6,
7,
8,
9]. Therefore, wound dressing containing
E. prostrata L. extract will be used for treating infection and inflammation in wound healing. Kang et al. [
10] suggest that
E. prostrata L. extract is a potential treatment for inflammatory skin conditions such as atopic dermatitis. The
E. prostrata L. extract improved the allergic inflammation of the skin by restoring the skin barrier dysfunction, decreasing epidermis/dermis thickness, and regulating the immune balance [
10]. Raoul et al. evaluated wound healing in rats after applying the ointment containing
E. prostrata leaf extract [
11]. The results showed that the wounds treated with medicinal ointment completely healed faster than vaseline
® and cicatryl
® [
11]. Babu et al. [
12] developed the hydrogel containing
E. prostrata leaf extract and evaluated its physical properties such as pH, viscosity, and spreadability. However, no studies have developed wound dressing containing
E. prostrata leaf extract in sheet form or foam dressings. Wound dressing selection is based on the wound's cause, location, healing phase, exudate level, pain, odor, infection, size, and depth [
13]. For deep or tunneling wounds, packing wounds with dressing in the form of rope is essential for promoting wound healing from the inside out [
14]. On the other hand, superficial or partial-thickness wounds require dressing in the form of a sheet to cover the wound and facilitate wound function [
15]. In addition, choosing the physical characteristics of wound dressings according to the exudate level will provide the optimum environment for facilitating wound healing.
Referring to our previous point, the development of foam dressing for wound healing applications should focus on physical properties. According to ideal wound dressing properties, the wound dressings should be able to absorb wound exudate to prevent maceration (softening and breaking down of the surrounding skin because of prolonged exposure to moisture), malodor, local wound infection, and delayed wound healing [
15,
16,
17,
18,
19]. However, different absorption properties of wound dressings are appropriate for different types of wounds [
16,
20,
21]. For example, a wound dressing with a high absorption capacity should be selected for wounds with a high level of exudate. Additionally, the dehydration rate of wound dressing is also an important property that maintains a moist wound-healing environment [
22]. A moist wound environment has several benefits, including increased keratinocyte migration and re-epithelialization, increased collagen synthesis, increased autolytic debridement, reduced pain, and decreased inflammation [
23,
24].
Moreover, elevated exudate pH correlates with an increased risk of infection and delayed wound healing [
25,
26]. Therefore, the ideal wound dressing should not provide an alkaline wound environment. Foam dressing's porous structure is also an essential factor in the wound-healing process [
27,
28]. The wound-healing process is a complex biological process to recover damaged tissues and restore the skin’s normal function. The wound-healing process consists of four continuous and overlapping phases, including hemostasis, inflammation, proliferation, and remodeling [
29]. The appropriate pore size of the porous structure is essential for the proliferative phase. Natural and synthetic polymers are both used in wound dressings, and each type of polymer can help to produce a porous structure. Natural polymers are commonly chosen for wound dressing development, such as chitosan, cellulose, hyaluronic acid, collagen, alginate, and gelatin [
30]. Gelatin could be used to produce porous structures with the freeze-drying technique [
31,
32]. The porous gelatin materials support cell migration and the development of new tissue [
33]. Interestingly, gelatin could also provide biodegradable and biocompatible material [
31,
34]. Thus, the present study aimed to develop a foam dressing containing
E. prostrata leaf extract and gelatin, and their physical properties and pH wound environment were subsequently evaluated
. The results from this study could deliver the profile of physical characteristics and pseudo-wound environment after being treated with foam dressing containing
E. prostrata leaf extract and gelatin.
3. Discussion
E. prostrata leaf extract has been studied for its potential wound-healing benefits, including antimicrobial, and anti-inflammatory properties [
6,
7,
8,
9]. Prior studies in developing wound healing products containing E. prostrata focus only on ointment and hydrogel formulation [
11,
12]. Nowadays, no studies have developed wound dressing containing E. prostrata leaf extract in sheet form or foam dressings. Developing wound dressing in sheet form has several advantages, such as preventing trauma, minimizing external contamination, absorbing exudate, and keeping a wound in an optimally moist environment [
16].
In this study, the foam dressing containing E. prostrata extract and gelatin was developed to evaluate the physical properties and pH wound environment. Result of the general appearance, the E. prostrata dressings were soft and flexible. These properties help to maintain a moist wound environment, reduce the risk of maceration, and allow use in the movement areas such as the knee or elbow [
37]. In addition, the E. prostrata A dressing was thicker than the E. prostrata B dressing. It would be explained by the high protein content in bovine gelatin increased the polymer matrix's solids content. Hence, the increase in gelatin or protein concentration has induced an increase in the thickness of the foam dressing [
38]. However, the thickness was unrelated to the absorption and dehydration properties, as shown in
Figure 4 and
Figure 5.
The FTIR spectra are used to identify the functional groups present in the E. prostrata dressing, as compared to the E. prostrata leaf extract. It was found that the FTIR spectra of E. prostrata dressing had an increased intensity in the functional groups, including amide I and II (
Figure 2). The amide I and II bands in the FTIR spectrum are commonly used to identify the presence of gelatin [
35,
36]. The amide I band in FTIR spectra is a strong absorption peak corresponding to the stretching vibration of the C=O bond in the peptide backbone[
39]. This band of gelatin appears in the region of 1600-1700 cm
-1 [
35]. As shown in
Figure 2, the amide I band was around 1646-1648 cm
-1, indicating the presence of a predominantly random coil structure [
39]. The amide II band in the FTIR spectra I also provide information on the vibrational bands of the protein backbone [
39] This band corresponds to the bending vibration of the N-H bond (40–60 % of the potential energy) and the stretching vibration of the C-N bond (18–40 %) in the protein backbone [
39]. In the case of gelatin, the amide II band appears in the region of 1565–1520 cm
-1 [
35]. As shown in
Figure 2, the amide II band was around 1553-1555 cm
-1. The amide II is often used in combination with the amide I band to confirm the presence of gelatin. Therefore, it indicates that our process to develop E. prostrata dressing did not affect the structural property of gelatin. Gelatin could provide a porous structure and produce biodegradable and biocompatible material [
31,
34].
The resulting SEM image provides information about the morphology or porous structure of the E. prostrata dressing (
Figure 3). The porous structure is crucial in wound healing because it allows cell migration and proliferation [
28,
40]. When a wound occurs, the first phase of wound healing is hemostasis, with vascular constriction, platelet aggregation, degranulation, and fibrin clot formation [
29]. Hemostasis helps to stop bleeding, and inflammatory cells, namely neutrophils, monocytes, macrophages, and lymphocytes, migrate into the wound, which triggers the inflammatory response (also known as the “inflammatory phase”) [
29]. The next phase is proliferation, with re-epithelialization, angiogenesis, collagen synthesis, and extracellular matrix (ECM) formation, which generally overlaps with the inflammatory phase [
29]. The porous structure supports this phase. Fibroblasts and endothelial cells need to migrate into the wound bed in order to proliferate and form granulation tissue at the site of injury [
29]. A porous structure advantage allows for these cells to migrate into the wound bed, promoting efficient wound healing. Following cell proliferation, the final phase is remodeling, with collagen remodeling and vascular maturation, and regression [
29]. A previous study by Murphy et al. [
41] showed that a mean pore size of 325 µm facilitated the highest cell attachment and proliferation compared with pores in the 85-190 µm. As seen in
Figure 3b, our SEM images of the cross-section show the average pore sizes of around 300 µm. This was supposed that the E. prostrata A and B dressings had an appropriate pore size for efficient wound healing. Nevertheless, the E. prostrata B dressing was more consistent porosity than E. prostrata A dressing. The effect of this difference in porosity between the E. prostrata A and B dressings could exhibit differences in absorption ability.
We developed the E. prostrata dressing that was designed with a porous structure in order to increase the absorption ability. In this study, the absorption ability was obtained by using pseudo-wound exudate. The E. prostrata B dressing exhibited a stronger absorption ability than the E. prostrata A dressing (
Figure 4). The absorption ability of the E. prostrata B dressing was derived from a higher-density porous structure (
Figure 3b). The ideal wound dressing properties must absorb excess wound exudate and provide a moist environment [
18,
21,
22,
42]. Wound exudate or wound drainage is the fluid that discharges from a wound during the healing process [
43]. The mechanism of exudate formation is usually due to inflammation or infection [
43]. The amount of exudate produced can vary depending on the type and severity of the wound. A moist wound environment is necessary for the wound-healing process to occur effectively. An optimal moisture level enhances cell migration and proliferation, reduces pain and discomfort, and reduces infection rates [
22,
23]. Macerated peri-wound skin can lead to an increased risk of infection, whereas desiccated peri-wound skin can lead to decreased epithelial migration and cell death [
22,
44]. Therefore, the selection of absorbent wound dressing depends on the amount of exudate to prevent maceration and desiccation. Moreover, a moist environment promotes autolysis or breakdown of necrotic tissue, called autolytic debridement [
23,
45]. In our previous work [
20], the commercial hydrocolloid dressing and hydrocolloid with foam layer dressing had the lowest absorption capacity. Therefore it is an appropriate dressing for wounds with a low amount of exudate. In this study, both the E. prostrata A and B dressings had absorption characteristics similar to commercial hydrocolloid dressing and hydrocolloid with foam layer dressing [
20]. These absorption characteristics meant that both the E. prostrata A and B dressings would be chosen for wounds with low exudate.
Apart from absorption properties, the dehydration rate is also essential to control the moisture balance of the wound and enhance wound healing due to water-retaining properties [
22,
46]. This can be achieved through the use of appropriate wound dressings that are designed to manage moisture levels and prevent dehydration. In addition, the selection of wound dressing also depends on the amount of exudate produced by the wound. The E. prostrata B dressing showed a higher dehydration rate than the E. prostrata A dressing. It can be explained by the higher-density porous structure of the E. prostrata B dressing (
Figure 3b). Therefore, the E. prostrata B dressing would have the ability to dehydrate exudate to create a moist wound-healing environment rapidly.
Furthermore, the pH wound environment would be an essential factor for wound healing. The pH of healthy human skin is in the range of 5.4-5.9, which is slightly acidic. [
47]. Propionibacterium is commonly found on human skin. Propionibacterium grows well at pH 6.00-6.50 [
48]. Staphylococcus aureus is a pyogenic bacteria [
49]. S. aureus prefers a neutral pH environment for optimal growth and survival [
50]. Thus, an acidic environment is not favorable for harmful bacterial growth. In addition, the pH environment of chronic wounds exists at a range of 7.15-8.90, which is alkaline and chronic wounds are characterized by excessive protease activity [
51,
52,
53,
54,
55]. Sim et al. found that faster recovery of wounded tissues was observed in wounds treated by pH 4 buffers compared to pH 6 buffers [
25]. A previous study by Leveen et al. showed that a slightly acidic environment significantly inhibits protease activity and may potentially enhance the healing of cutaneous wounds [
56]. Previous studies reported fibroblast proliferation and migration behaviors associated with the acidic environment [
57,
58]. It means rapid wound healing occurs in an acidic environment [
25,
54]. We found that the E. prostrata A and B dressings showed similar pH decreases continuously over the period. Our E. prostrata dressings tend to create a slightly acidic environment. Hence, this was supposed that the E. prostrata A and B dressings would not interfere wound healing process.
The dispersion of the wound dressing refers to how well the dressing covers the wound surface. In this study, the spectra of the pseudo-wound exudate after being submerged with the E. prostrata A and B dressings were not similar to those of the pseudo-wound exudate (
Figure 8). In our previous study, commercial alginate dressings also had the spectra of the pseudo-wound exudate after being submerged with the dressings not quite similar to those of the pseudo-wound exudate [
20]. Nevertheless, after interacting with the pseudo-wound exudate, the Eclipta prostrata A and B dressings did not change much from their original structure (
Figure 7). It means that the E. prostrata dressing will not be difficult to remove. According to the spectra of the pseudo-wound exudate after being submerged with the dressings, our E. prostrata dressings are an immediate-release formulation. The E. prostrata dressing should be further modified for controlled release applications by crosslinking techniques with a crosslinker, such as glutaraldehyde [
59,
60].