dressings are non-adhesive against the wound and are effective in healing partial-thickness wounds. Amorphous hydrogels are more effective in treatment of full-thickness wounds than sheet-form dressings because they can conform to the shape of the wound bed and they facilitate autolytic debridement. Impregnated hydrogel dressings are dry dressings (e.g. gauzes) saturated with an amorphous hydrogel. Sprayable hydrogel dressings are composed of amorphous hydrogels which rapidly increase in viscosity after application. Sprayable hydrogels have also been shown to increase the penetration and efficacy of therapeutic agents. "Smart" hydrogel dressings "Smart" hydrogels which are stimuli-responsive (i.e. thermoresponsive, bioresponsive, pH-responsive, photoresponsive, and redox-responsive) are also being produced. pH-responsive hydrogel dressings which release growth factors and antibiotic agents as the pH of the wound increases from normal skin levels (pH 4–6) to internal levels (pH ~7.4). Redox-responsive hydrogel dressings can be disintegrated on-demand by addition of a reducing agent. Assembly of the 3D network of photoresponsive hydrogel dressings is initiated by UV radiation. Thermoresponsive hydrogel dressings which exhibit temperature-dependent sol-gel transition and/or temperature-dependent drug release. Applications The efficacy of hydrogel dressings has been assessed on various wound types. There is some evidence to suggest that hydrogels are effective dressings for chronic wounds including pressure ulcers, diabetic ulcers, and venous ulcers although the results are uncertain. Hydrogels have been shown to accelerate healing in partial and full thickness burn wounds of varying size. Other studies have shown that hydrogel dressings accelerate healing in radioactive skin injuries and dog bite wounds. Hydrogel dressings decrease the healing time of traumatic skin injuries by an average 5.28 days and reduce the pain reported by patients. Types Naturally-derived hydrogel dressings Polysaccharide-based hydrogel dressings have been synthesized from polymers such as hyaluronic acid, chitin, chitosan, alginate, and agarose. Naturally-derived protein/proteoglycan hydrogel dressings have been synthesized from polymers such as collagen, gelatin, kappa-carrageenan, and fibrin. Synthetic hydrogel dressings Synthetic hydrogel dressings may be derived from synthetic polymers such as polyvinyl alcohol (PVA), poly(ethylene glycol) (PEG), polyurethane (PU), and poly(lactide-co-glycolide) (PLGA). Synthetic hydrogel dressings may also be formed from designer peptides. Researchers are applying 3D printing to the synthesis of hydrogel dressings. Biohybrid hydrogel dressings Hydrogels may be modified to incorporate metal cations (e.g. copper (II)), degradable linkers (e.g. dextran), and adhesive functional groups (e.g. RGD). Integrating biological derivatives into synthetic hydrogels allows producers to tailor binding affinities and specificity, mechanical properties, and stimuli-responsive properties. References Medical treatments