Efficacy of 3D-printed chitosan‑cerium oxide dressings coated with vancomycin-loaded alginate for chronic wounds management

Multifunctional wound dressings with antibacterial and antioxidant properties hold significant promise for treating chronic wounds; however, achieving a balance of these characteristics while maintaining biocompatibility is challenging. To enhance this balance, this study focuses on the design and development of 3D-printed chitosan-matrix composite scaffolds, which are incorporated with varying amounts of cerium oxide nanoparticles (0, 1, 3, 5, and 7 wt%) and subsequently coated with a vancomycin-loaded alginate layer. The structure, antibiotic drug delivery kinetics, biodegradation, swelling, biocompatibility, antibacterial, antioxidant, and cell migration behaviors of the fabricated dressings were evaluated in-vitro. The findings reveal that all of the formulations demonstrated a robust antibacterial effect against S. aureus bacterial strains in disk diffusion tests. Furthermore, the dressings containing cerium oxide nanoparticles exhibited proper antioxidant capabilities, with over 78.1 % reactive oxygen species (ROS) scavenging efficiency achieved with 7 % cerium oxide nanoparticles. The sample containing 5 % cerium oxide nanoparticles was identified as the optimal formulation, characterized by the most favorable cell biocompatibility, an ROS scavenging ability of over 73.4 %, and the potential to close the wound bed within 24 h. This study highlights that these dressings are promising for managing chronic wounds by preventing infection and oxidative stress in a correct therapeutic sequence.