Effectiveness of chitosan scaffold in skin, bone and cartilage healing

Chitosan (CS) is a carbohydrate biopolymer, which has been known as a biological material in promoting the healing process of soft and hard connective tissues. It is biocompatible, biodegradable, bioactive, nontoxic, non-expensive and non-immunogenic, with antibacterial capability. Additionally, the capacity of forming complexes with other anionic biomaterials and molecules offers CS the characteristics to be used in biomedical applications. Therefore, this natural polysaccharide has widely been used as a wound dressing and in bone and cartilage regeneration because of these considerable properties. However, some studies have showed limited value in application of CS in tissue regeneration. It has been used alone or in combination with other biopolymers, bioceramics, or promotive growth factors to enhance regeneration of the soft and hard connective tissues. This study has reviewed various forms of CS including hydrogels, sponges, films, and nanofiber membranes. The role of CS alone or in combined form with other materials has also been reviewed in healing and regeneration of the cutaneous, cartilage and bone wounds. In addition, the present study hasattempted to clarify the controversies and conflicts regarding effectiveness of CS in the healing process. (C) 2017 Elsevier B.V. All rights reserved.