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Zhu YH, Zhou CY, Peng X, Wang W, Liu Z, Xie R, Pan DW, Ju XJ, Chu LY. Dialdehyde starch cross-linked aminated gelatin sponges with excellent hemostatic performance and biocompatibility. Carbohydr Polym 2024; 342:122326. [PMID: 39048186 DOI: 10.1016/j.carbpol.2024.122326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 07/27/2024]
Abstract
Developing a hemostatic material suitable for rapid hemostasis remains a challenge. This study presents a novel aminated gelatin sponge cross-linked with dialdehyde starch, exhibiting excellent biocompatibility and hemostatic ability. This aminated gelatin sponge features hydrophilic surface and rich porous structure with a porosity of up to 80 %. The results show that the aminated gelatin sponges exhibit superior liquid absorption capacity and can absorb up to 30-50 times their own mass of simulated body fluid within 5 min. Compared with the commercial gelatin hemostatic sponge and non-aminated gelatin hemostatic sponge, the aminated gelatin hemostatic sponge can accelerate the hemostatic process through electrostatic interactions, demonstrating superior hemostatic performance in both in vitro and in vivo hemostasis tests. The aminated gelatin sponge can effectively control the hemostatic time within 80 s in the in vivo rat femoral artery injury model, significantly outperforming both commercial and non-aminated gelatin sponges. In addition, the aminated gelatin sponge also exhibits good biocompatibility and certain antibacterial properties. The proposed aminated gelatin sponge has very good application prospects for the management of massive hemorrhage.
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Affiliation(s)
- Yu-He Zhu
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Chen-Yu Zhou
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China
| | - Xu Peng
- Experimental and Research Animal Institute, Sichuan University, Chengdu 610065, China
| | - Wei Wang
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Zhuang Liu
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Rui Xie
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Da-Wei Pan
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Xiao-Jie Ju
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China.
| | - Liang-Yin Chu
- School of Chemical Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
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2
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Sarkar P, Pugazhendhi AS, Coathup M, Mukhopadhyay K. Antibacterial sponge for rapid noncompressible hemostatic treatment: spatiotemporal studies using a noninvasive model. Biomater Sci 2024; 12:4155-4169. [PMID: 38916074 DOI: 10.1039/d4bm00506f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Hemorrhage is one of the leading causes of preventable death. While minor injuries can be treated mainly by conventional methods, deep and irregular wounds with profuse bleeding present significant challenges, some of which can be life-threatening and fatal. This underscores the need to develop easily applicable FDA-approved hemostatic treatments that can effectively stanch blood loss at the point of care before professional medical care. A silicone-based bandage system (SilFoam), a non-compressible, self-expanding, antibacterial hemostatic treatment, is reported here. Its two-component system reacts in situ upon mixing to form a stretchable sponge that acts as a 'tamponade' by expanding within seconds with the evolution of oxygen gas from the interaction of the reactive components present in the formulation. This generates autogenous pressure on the wound that can effectively arrest heavy bleeding within minutes. Possessing optimal adhesive properties, the expanded sponge can be easily removed, rendering it optimal for hemostatic wound dressing. With recent advances in biotechnological research, there is a growing awareness of the potential issues associated with in vivo trials, spanning ethical, psychological, economic, and physiological concerns like burnout and fatigue. Bearing this in mind, a unique manikin system simulating a deep abdominal wound has been employed to investigate SilFoam's hemostatic efficacy with different blood-flow rates using a non-invasive model that aims to provide an easy, fast, and economical route to test hemostatic treatments before in vivo studies. This is the first time an Ag2O-based oxygen-induced foaming system has been reported as a hemostatic agent.
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Affiliation(s)
- Pritha Sarkar
- Department of Materials Science and Engineering, University of Central Florida, Orlando, USA.
| | | | - Melanie Coathup
- Biionix Cluster and College of Medicine, University of Central Florida, Orlando, USA
| | - Kausik Mukhopadhyay
- Department of Materials Science and Engineering, University of Central Florida, Orlando, USA.
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3
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Majidi RF, Mesgar ASM, Milan PB. Surface-modified, zinc-incorporated mesoporous silica nanoparticles with improved antibacterial and rapid hemostatic properties. Colloids Surf B Biointerfaces 2024; 243:114132. [PMID: 39094209 DOI: 10.1016/j.colsurfb.2024.114132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/20/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
Severe bleeding and bacterial infections pose significant challenges to the global public health. Effective hemostatic materials have the potential to be used for rapid control of bleeding at the wound site. In this study, mesoporous silica nanoparticles (MSN) were doped with zinc ions (MSN@Zn) and subsequently functionalized with carboxyl (-COOH) groups through post-grafting, resulting in (MSN@Zn-COOH). The results demonstrated the successful functionalization of carboxyl groups on the surface of MSN@Zn mesoporous materials with minimal impact on the morphology. The released zinc ions showed potent antibacterial activity (above ∼80 %) against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). In vitro and in vivo assessments of MSN@Zn-COOH revealed excellent hemostatic effects and favorable blood compatibility. Hemolysis percentages associated with MSN@Zn-COOH exhibited noteworthy reductions in comparison to MSN. Furthermore, a decrease in APTT (a test evaluating the intrinsic coagulation pathway) of modified MSN@Zn indicated enhanced hemostasis, supported by their negative zeta potential (∼ -14 to -43 mV). Importantly, all samples showed no cytotoxicity. This work underscores the potential of MSN@Zn-COOH, with its combined hemostatic performance and antibacterial activity, for emergency clinical applications.
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Affiliation(s)
- Raheleh Faridi Majidi
- Biomaterials Laboratory, Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Abdorreza Sheikh-Mehdi Mesgar
- Biomaterials Laboratory, Division of Biomedical Engineering, Department of Life Science Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran.
| | - Peiman Brouki Milan
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
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4
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Pu S, Zhang J, Shi C, Hou X, Li K, Feng J, Wu L. A multifunctional chitosan based porous membrane for pH-responsive antibacterial activity and promotion of infected wound healing. J Mater Chem B 2024; 12:7191-7202. [PMID: 38932741 DOI: 10.1039/d3tb03067a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Unsatisfactory mechanical and antibacterial properties restricted the solo use of chitosan (CS) as a wound dressing. In this work, a novel CS/hydroxyapatite/ZIF-8 (CS/HAp/ZIF-8, CHZ-10) porous membrane was facilely constructed by in situ loading of ZIF-8 on CS/HAp. The advantages of the three compositions were rationally integrated, and the multifunctionality and practicality of this CS-based dressing were improved. HAp not only improved the mechanical strength and stability of CS, but also promoted cell proliferation and accelerated hemostasis with its released Ca2+. Meanwhile, ZIF-8 enhanced the antibacterial activity of CS by releasing antibacterial Zn2+ in a pH-responsive and sustainable manner, avoiding the bio-accumulation toxicity of heavy metals. Compared with CS/HAp and conventionally used gauze, CHZ-10 exhibited superior coagulation and hemolytic ability, as well as outstanding antibacterial activity against E. coli and S. aureus. Besides, both in vivo observation and histological evaluation demonstrated that CHZ-10 could not only effectively inhibit bacterial infection and reduce inflammation of the wound, but also promote its re-epithelialization, granulation, tissue formation and collagen fibre growth, leading to effectively enhanced wound-healing. This work provides a new method for the easy construction of multifunctional antibacterial dressings based on CS, showing promise for application in clinical wound care.
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Affiliation(s)
- Shan Pu
- Analytical & Testing Center, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Jiale Zhang
- Analytical & Testing Center, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Chaoting Shi
- Analytical & Testing Center, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Xiandeng Hou
- Analytical & Testing Center, Sichuan University, Chengdu 610064, Sichuan, China.
- Key Laboratory of Green Chemistry & Technology, Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, Sichuan, China
| | - Ka Li
- West China School of Nursing, Sichuan University/Department of Biliary, West China Hospital, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Jinhua Feng
- West China School of Nursing, Sichuan University/Department of Biliary, West China Hospital, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Lan Wu
- Analytical & Testing Center, Sichuan University, Chengdu 610064, Sichuan, China.
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El Halawany M, Khashaba M, AbouGhaly MHH, Latif R. Tranexamic acid loaded in a physically crosslinked trilaminate dressing for local hemorrhage control: Preparation, characterization, and in-vivo assessment using two different animal models. Int J Pharm 2024; 659:124219. [PMID: 38734277 DOI: 10.1016/j.ijpharm.2024.124219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/13/2024]
Abstract
This work aimed at formulating a trilaminate dressing loaded with tranexamic acid. It consisted of a layer of 3 % sodium hyaluronate to initiate hemostasis. It was followed by a mixed porous layer of 5 % polyvinyl alcohol and 2 % kappa-carrageenan. This layer acted as a drug reservoir that controlled its release. The third layer was 5 % ethyl cellulose backing layer for unidirectional release of tranexamic acid towards the wound. The 3 layers were physically crosslinked by hydrogen bonding as confirmed by Infrared spectroscopy. Swelling and release studies were performed, and results proposed that increasing number of layers decreased swelling properties and sustained release of tranexamic acid for 8 h. In vitro blood coagulation study was performed using human blood and showed that the dressing significantly decreased coagulation time by 70.5 % compared to the negative control. In vivo hemostatic activity was evaluated using tail amputation model in Wistar rats. Statistical analysis showed the dressing could stop bleeding in a punctured artery of the rat tail faster than the negative control by 59 %. Cranial bone defect model in New Zealand rabbits was performed to check for bone hemostasis and showed significant decrease in the hemostatic time by 80 % compared to the control.
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Affiliation(s)
- Mai El Halawany
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Ainy Street, Cairo 11562, Egypt.
| | - Mohamed Khashaba
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, 12 Saray El Manial Street, Cairo 11562, Egypt
| | - Mohamed H H AbouGhaly
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Ainy Street, Cairo 11562, Egypt; Department of Pharmaceutics and Industrial Pharmacy, School of Pharmacy, Newgiza University, Km. 22 Cairo-Alex Road, Giza P.O. Box 12577, Egypt
| | - Randa Latif
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Ainy Street, Cairo 11562, Egypt
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Nguyen M, Foreman A, Lockwood C. Effectiveness of fibrin sealants in head and neck surgery: a systematic review protocol. JBI Evid Synth 2024; 22:1151-1160. [PMID: 38015095 DOI: 10.11124/jbies-23-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE This review will investigate the effectiveness of fibrin sealants in adult patients who underwent head and neck surgery. INTRODUCTION Controlling bleeding is important in head and neck surgery. Complications involving nearby vital structures increase the risk of morbidity and mortality. Surgical tissue adhesives are used in addition to other traditional hemostatic methods to reduce surgical site bleeding. Fibrin sealants have shown some success compared with other tissue adhesives, but individual studies have been inconclusive. INCLUSION CRITERIA We will include studies comparing fibrin sealants with placebo or usual care in patients 18 years or older who have undergone soft tissue surgery of the head and neck with drain placement. Primary outcomes include wound complications and time to surgical drain removal. Secondary outcomes include length of hospital stay, drain volume output, surgical management of postoperative hematoma, rate of blood transfusions, and adverse reactions. METHODS We will search electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials CINAHL, Scopus, Web of Science) for studies published from 1975 onwards. Sources to be search for unpublished literature will include ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, MedNar, and ProQuest Dissertations and Theses. Titles, abstracts, and full-text papers will be assessed against the inclusion criteria by 2 independent reviewers. Study screening and selection will be performed, and critical appraisal conducted using the standardized JBI appraisal tools. Data will be extracted by 2 independent reviewers. Meta-analysis will be conducted for all outcomes where appropriate, with weighted mean differences for continuous data. Risk ratios will be used for dichotomous data. Certainty will be reported using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. REVIEW REGISTRATION PROSPERO CRD42023412820.
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Affiliation(s)
- Marie Nguyen
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Andrew Foreman
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Craig Lockwood
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Zhang M, Han F, Duan X, Zheng D, Cui Q, Liao W. Advances of biological macromolecules hemostatic materials: A review. Int J Biol Macromol 2024; 269:131772. [PMID: 38670176 DOI: 10.1016/j.ijbiomac.2024.131772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/02/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024]
Abstract
Achieving hemostasis is a necessary intervention to rapidly and effectively control bleeding. Conventional hemostatic materials currently used in clinical practice may aggravate the damage at the bleeding site due to factors such as poor adhesion and poor adaptation. Compared to most traditional hemostatic materials, polymer-based hemostatic materials have better biocompatibility and offer several advantages. They provide a more effective method of stopping bleeding and avoiding additional damage to the body in case of excessive blood loss. Various hemostatic materials with greater functionality have been developed in recent years for different organs using diverse design strategies. This article reviews the latest advances in the development of polymeric hemostatic materials. We introduce the coagulation cascade reaction after bleeding and then discuss the hemostatic mechanisms and advantages and disadvantages of various polymer materials, including natural, synthetic, and composite polymer hemostatic materials. We further focus on the design strategies, properties, and characterization of hemostatic materials, along with their applications in different organs. Finally, challenges and prospects for the application of hemostatic polymeric materials are summarized and discussed. We believe that this review can provide a reference for related research on hemostatic materials, contributing to the further development of polymer hemostatic materials.
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Affiliation(s)
- Mengyang Zhang
- Clinical Medical College/Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China; Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, China
| | - Feng Han
- Clinical Medical College/Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China; Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, China
| | - Xunxin Duan
- Clinical Medical College/Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China; Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, China
| | - Dongxi Zheng
- School of Mechanical and Intelligent Manufacturing, Jiujiang University, Jiujiang, Jiangxi, China
| | - Qiuyan Cui
- The Second Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
| | - Weifang Liao
- Clinical Medical College/Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China; Jiujiang Clinical Precision Medicine Research Center, Jiujiang, Jiangxi, China.
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8
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Do K, Vachirakorntong B, Kawana E, Do J, Phan TD, Phan TD. The Use of Bone Wax in Hemostatic Control for Total Knee and Hip Arthroplasties: A Systematic Review. J Clin Med 2024; 13:2752. [PMID: 38792294 PMCID: PMC11122341 DOI: 10.3390/jcm13102752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/27/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: Blood loss can be a serious complication in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Various methods are used by surgeons to achieve hemostatic control in these patients. Complications are associated with perioperative blood loss. In this systematic review, we examined the efficacy of using bone wax to control bleeding in patients undergoing THA and TKA. Methods: The PRISMA model was used to systematically identify and aggregate articles for this study. The PubMed and EMBASE databases were used to search individual studies that examined the use of bone wax in THA or TKA. After applying the search term "bone wax", 2478 articles were initially identified. After inclusion and exclusion criteria were applied, three articles were aggregated for this systematic review. Results: The use of bone wax in THA and TKA decreased blood loss in patients undergoing these operations. Postoperative blood loss following surgery was lower in the bone wax groups compared to the control groups as well. Patients in the bone wax groups also required fewer blood transfusions than those who did not receive bone wax. Conclusions: Bone wax appears to be another modality that can be used by physicians to maintain hemostatic control in THA or TKA patients. Reduced blood loss and transfusion rates in surgery can increase patient outcomes. More studies are needed to examine the efficacy of bone wax in comparison with other hemostatic tools.
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Affiliation(s)
- Kenny Do
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89106, USA;
| | | | - Eric Kawana
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89106, USA;
| | - Jenifer Do
- School of Life Sciences, University of Nevada, Las Vegas, NV 89154, USA;
| | - Thinh Dat Phan
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700100, Vietnam; (T.D.P.); (T.D.P.)
- Department of Internal Medicine, 115 People’s Hospital, Ho Chi Minh City Quận 10, Vietnam
| | - Thinh Dai Phan
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700100, Vietnam; (T.D.P.); (T.D.P.)
- Department of Internal Medicine, 115 People’s Hospital, Ho Chi Minh City Quận 10, Vietnam
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Zhou M, Lin X, Wang L, Yang C, Yu Y, Zhang Q. Preparation and Application of Hemostatic Hydrogels. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309485. [PMID: 38102098 DOI: 10.1002/smll.202309485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/28/2023] [Indexed: 12/17/2023]
Abstract
Hemorrhage remains a critical challenge in various medical settings, necessitating the development of advanced hemostatic materials. Hemostatic hydrogels have emerged as promising solutions to address uncontrolled bleeding due to their unique properties, including biocompatibility, tunable physical characteristics, and exceptional hemostatic capabilities. In this review, a comprehensive overview of the preparation and biomedical applications of hemostatic hydrogels is provided. Particularly, hemostatic hydrogels with various materials and forms are introduced. Additionally, the applications of hemostatic hydrogels in trauma management, surgical procedures, wound care, etc. are summarized. Finally, the limitations and future prospects of hemostatic hydrogels are discussed and evaluated. This review aims to highlight the biomedical applications of hydrogels in hemorrhage management and offer insights into the development of clinically relevant hemostatic materials.
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Affiliation(s)
- Minyu Zhou
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xiang Lin
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland
| | - Li Wang
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland
| | - Chaoyu Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
| | - Yunru Yu
- Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland
| | - Qingfei Zhang
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, 325035, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
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10
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Kim YS, Lee JS, Jeong MY, Jang JW, Kim MS. Recombinant human fibroblast growth factor 7 obtained from stable Chinese hamster ovary cells enhances wound healing. Biotechnol J 2024; 19:e2300596. [PMID: 38719591 DOI: 10.1002/biot.202300596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 05/14/2024]
Abstract
Although fibroblast growth factor 7 (FGF7) is known to promote wound healing, its mass production poses several challenges and very few studies have assessed the feasibility of producing FGF7 in cell lines such as Chinese hamster ovary (CHO) cells. Therefore, this study sought to produce recombinant FGF7 in large quantities and evaluate its wound healing effect. To this end, the FGF7 gene was transfected into CHO cells and FGF7 production was optimized. The wound healing efficacy of N-glycosylated FGF7 was evaluated in animals on days 7 and 14 post-treatment using collagen patches (CPs), FGF7-only, and CP with FGF7 (CP+FGF7), whereas an untreated group was used as the control. Wound healing was most effective in the CP+FGF7 group. Particularly, on day 7 post-exposure, the CP+FGF7 and FGF7-only groups exhibited the highest expression of hydroxyproline, fibroblast growth factor, vascular endothelial growth factor, and transforming growth factor. Epidermalization in H&E staining showed the same order of healing as hydroxyproline content. Additionally, the CP+FGF7 and FGF7-only group exhibited more notable blood vessel formation on days 7 and 14. In conclusion, the prepared FGF7 was effective in promoting wound healing and CHO cells can be a reliable platform for the mass production of FGF7.
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Affiliation(s)
- Young Sik Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
- The Institute of Biomaterial and Medical Engineering, Cellumed Co., Ltd., Seoul, Sourh Korea
| | - Jung Soo Lee
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
- The Institute of Biomaterial and Medical Engineering, Cellumed Co., Ltd., Seoul, Sourh Korea
| | - Mi Yeong Jeong
- The Institute of Biomaterial and Medical Engineering, Cellumed Co., Ltd., Seoul, Sourh Korea
| | - Ju Woong Jang
- The Institute of Biomaterial and Medical Engineering, Cellumed Co., Ltd., Seoul, Sourh Korea
| | - Moon Suk Kim
- Department of Molecular Science and Technology, Ajou University, Suwon, South Korea
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11
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Janahmadi Z, Momeni S, Manoochehri H, Talebi S. Development of an efficient hemostatic material based on cuttlefish ink nanoparticles loaded in cuttlebone biocomposite. J Mater Chem B 2024; 12:4172-4183. [PMID: 38591253 DOI: 10.1039/d3tb01966g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Traumatic hemorrhage is one of the main causes of mortality in civilian and military accidents. This study aimed to evaluate the effectiveness of cuttlefish bone (cuttlebone, CB) and CB loaded with cuttlefish ink (CB-CFI) nanoparticles for hemorrhage control. CB and CB-CFI were prepared and characterized using different methods. The hemostasis behavior of constructed biocomposites was investigated in vitro and in vivo using a rat model. Results showed that CFI nanoparticles (NPs) are uniformly dispersed throughout the CB surface. CB-CFI10 (10 mg CFI in 1.0 g of CB) showed the best blood clotting performance in both in vitro and in vivo tests. In vitro findings revealed that the blood clotting time of CB, CFI, and CB-CFI10 was found to be 275.4 ± 12.4 s, 229.9 ± 19.9 s, and 144.0 ± 17.5 s, respectively. The bleeding time in rat liver injury treated with CB, CFI, and CB-CFI10 was 158.1 ± 9.2 s, 114.0 ± 5.7 s, and 46.8 ± 2.7 s, respectively. CB-CFI10 composite resulted in more reduction of aPTT (11.31 ± 1.51 s) in comparison with CB (17.34 ± 2.12 s) and CFI (16.79 ± 1.46 s) (p < 0.05). Furthermore, CB and CB-CFI10 exhibited excellent hemocompatibility. The CB and CB-CFI did not show any cytotoxicity on human foreskin fibroblast (HFF) cells. The CB-CFI has a negative surface charge and may activate coagulation factors through direct contact with their components, including CaCO3, chitin, and CFI-NPs with blood. Thus, the superior hemostatic potential, low cost, abundant, simple, and time-saving preparation process make CB-CFI a very favorable hemostatic material for traumatic bleeding control in clinical applications.
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Affiliation(s)
- Zeinab Janahmadi
- Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr 75147, Iran.
| | - Safieh Momeni
- Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr 75147, Iran.
| | - Hamed Manoochehri
- Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr 75147, Iran.
| | - Shadi Talebi
- Department of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran
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12
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M S M, Samal DB, Amirtraj J V, Subramanian S, Venkatasubbu GD. Enhanced coagulation cascade activation and styptic effects of Zn@SiO 2 nanocomposite. Colloids Surf B Biointerfaces 2024; 239:113927. [PMID: 38714078 DOI: 10.1016/j.colsurfb.2024.113927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/09/2024]
Abstract
Humans often have bleeding, which exerts substantial selective pressure on the coagulation system to optimize hemostasis in a variety of situations. Uncontrolled hemorrhage due to severe trauma leads to morbidity and mortality. Although nonbiological surfaces such as silicates can activate coagulation factor XII (FXII), the presence of Zn (Zinc) in the material stimulates and activates the various steps in the coagulation cascade. This results in blood clotting. The Zn@SiO2 nanocomposite has an excellent hemostatic property that establishes hemostasis by activating the factors responsible for the formation of a stable clot called fibrin mesh. This can be used as a hemostatic agent during surgeries and in any other trauma condition related to bleeding. Zn@SiO2 was synthesized and characterized with XRD, FTIR and HRTEM. It is analyzed for its RBC (Red Blood Corpuscles) aggregation and Platelet adhesion ability, fibrin formation, thrombus formation and prothrombin time (PT), Activated Partial Thromboplastin Time (aPTT), D-dimer for its ability to activate the coagulation cascade to achieve stable clotting.
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Affiliation(s)
- Marvaan M S
- Department of Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India
| | - Debashree Banita Samal
- Department of Biotechnology, School of Bioengineering, College of Engineering and technology, SRM Institute of science and technology, Katankulathur, Chengalpattu, Tamilnadu, India; Apollo Specialty Hospitals, OMR, Chennai, Tamilnadu, India
| | | | | | - G Devanand Venkatasubbu
- Department of Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India.
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13
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Schepers LE, Martindale BL, Berman AG, Cebull HL, Van Alstine W, Hollingshead SE, Novak T, Goergen CJ. Photocurable extracellular matrix sealant for cessation of venous hemorrhage. J Biomed Mater Res B Appl Biomater 2024; 112:e35401. [PMID: 38520703 DOI: 10.1002/jbm.b.35401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/23/2024] [Accepted: 02/18/2024] [Indexed: 03/25/2024]
Abstract
Hemorrhage is the second leading cause of death in patients under 46 years of age in the United States. Cessation of hemorrhage prevents hemorrhagic shock and tissue hypoxia. Controlling the bleed via direct pressure or tourniquet is often the first line of defense, but long-term care requires staples, hemostatic agents, or sealants that seal the vessel and restore blood flow. Here, we compare a new photocurable extracellular matrix sealant (pcECM) with low, medium, and high crosslink density formulations to a commercially available fibrin-based sealant, TISSEEL®. pcECM has potential uses in surgical and remote settings due to room temperature storage conditions and fast preparation time. Here, we determine if pcECM sealant can stop venous hemorrhage in a murine model, adhere to the wound site in vivo throughout the wound-healing process, and has the mechanical properties necessary for stopping hemorrhage. Adjusting pcECM crosslinking density significantly affected viscosity, swelling, burst strength, tensile strength, and elasticity of the sealant. 3-Dimensional ultrasound volume segmentations showed pcECM degrades to 17 ± 8% of its initial implant volume by day 28. Initially, local hemodynamic changes were observed, but returned close to baseline levels by day 28. Acute inflammation was observed near the puncture site in pcECM implanted mice, and we observed inflammatory markers at the 14-day explant for both sealants. pcECM and fibrin sealant successfully sealed the vessel in all cases, and consistently degraded over 14-28 days. pcECM is a durable sealant with tunable mechanical properties and possible uses in hemorrhage control and other surgical procedures.
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Affiliation(s)
- Luke E Schepers
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | | | - Alycia G Berman
- Product Engineering, Cook Biotech Inc., West Lafayette, Indiana, USA
| | - Hannah L Cebull
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | | | | | - Tyler Novak
- Product Engineering, Cook Biotech Inc., West Lafayette, Indiana, USA
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
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14
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Huang Y, Wang X, Luo B, Jin P, Zheng Y, Xu C, Wu Z. MXene-NH 2/chitosan hemostatic sponges for rapid wound healing. Int J Biol Macromol 2024; 260:129489. [PMID: 38242399 DOI: 10.1016/j.ijbiomac.2024.129489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/14/2023] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Abstract
Effective control of wound bleeding and sustained promotion of wound healing remain a major challenge for hemostatic materials. In this study, the hemostatic sponge with controllable antibacterial and adjustable continuous promotion of wound healing (CMNCu) was prepared by chitosan, aminated MXene and copper ion. Interestingly, the internal topological point-line-surface interaction endowed the CMN-Cu sponge longitudinal staggered tubular porous microstructure, combined with the lipophilic properties obtained by modified MXene, which greatly improved its flexibility, wet elasticity and blood enrichment capacity. In addition, the sponge achieved controlled release of active ingredients, which made it present highly effective antibacterial activity and long-lasting ability to promote wound healing. In vitro and in vivo experiments confirmed that CMN-Cu sponge presented high-efficient hemostatic performance. Last but not least, a series of cell experiments showed that the CMN-Cu sponge had excellent safety as a hemostatic material.
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Affiliation(s)
- Yanan Huang
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Xiaotong Wang
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Bodan Luo
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Peng Jin
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Yonghua Zheng
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Changliang Xu
- Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, Jiangsu 210023, China.
| | - Zhengguo Wu
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China.
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15
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Wang X, Liu C, Liu C, Shi Z, Huang F. Development of alginate macroporous hydrogels using sacrificial CaCO 3 particles for enhanced hemostasis. Int J Biol Macromol 2024; 259:129141. [PMID: 38176504 DOI: 10.1016/j.ijbiomac.2023.129141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Polymeric hydrogels have increasingly garnered attention in the field of hemostasis. However, there remains a lack of targeted development and evaluation of non-dense polymeric hydrogels with physically incorporated pores to enhance hemostasis. Here, we present a facile route to macroporous alginate hydrogels using acid-induced CaCO3 dissolution to provide Ca2+ for alginate gelation and CO2 bubbles for subsequent macropore formation. The as-prepared pore structure in the hydrogels and its formation mechanisms were characterized through microscopic imaging and nitrogen adsorption/desorption tests. Functional analyses revealed that the macroporous hydrogels exhibited improved rheology, blood absorption, coagulation factor delivery, and platelet aggregation. Ultimately, the introduction of pores significantly enhanced the hemostatic effectiveness of alginate hydrogels in vivo, as demonstrated in rat tail amputation and liver injury models, leading to a reduction in blood loss of up to 77 % or a decrease in bleeding time of up to 88 %. Notably, hydrogels with higher porosity achieved with a CaCO3 to alginate ratio of 40 % outperformed those with lower porosity in the aforementioned properties. Furthermore, these improvements were found to be biocompatible and elicited minimal inflammation. Our findings underscore the potential of a simple porous hydrogel design to enhance hemostasis efficacy by physically incorporating macropores.
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Affiliation(s)
- Xiaoqiang Wang
- State Key Laboratory of Heavy Oil Processing & College of Chemistry and Chemical Engineering, China University of Petroleum (East China), 66 West Changjiang Road, Qingdao, Shandong 266580, China.
| | - Chang Liu
- State Key Laboratory of Heavy Oil Processing & College of Chemistry and Chemical Engineering, China University of Petroleum (East China), 66 West Changjiang Road, Qingdao, Shandong 266580, China
| | - Chengkun Liu
- State Key Laboratory of Heavy Oil Processing & College of Chemistry and Chemical Engineering, China University of Petroleum (East China), 66 West Changjiang Road, Qingdao, Shandong 266580, China
| | - Zhuang Shi
- State Key Laboratory of Heavy Oil Processing & College of Chemistry and Chemical Engineering, China University of Petroleum (East China), 66 West Changjiang Road, Qingdao, Shandong 266580, China
| | - Fang Huang
- State Key Laboratory of Heavy Oil Processing & College of Chemistry and Chemical Engineering, China University of Petroleum (East China), 66 West Changjiang Road, Qingdao, Shandong 266580, China.
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16
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Feng C, Yang L. State of the art, trends, hotspots, and prospects of injection materials for controlling bleeding. Int Wound J 2024; 21:e14644. [PMID: 38272794 PMCID: PMC10789653 DOI: 10.1111/iwj.14644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Traumatic haemorrhage is a prevalent clinical condition, and effective and timely haemostasis is crucial for the preservation of patients' lives. In recent years, injectable hemostatic materials have gained significant attention due to their excellent hemostatic efficacy, biocompatibility, and biodegradability, making them widely applied in the treatment of incompressible traumatic haemorrhage. Systematic analysis of injectable hemostatic materials is crucial for research in this area. This article provides a comprehensive review of the development and research trends of injectable hemostatic materials over the past 20 years using visualization techniques. Analysis of collaboration and co-citation networks revealed localized research collaboration networks, highlighting the need for enhanced international collaboration in the field of injectable hemostatic materials. Current research focuses primarily on hemostatic materials, hemostatic processes, and hemostatic mechanisms. Injectable hemostatic materials with excellent performance offer promising strategies for wound healing. This review provides a comprehensive and systematic summary of injectable hemostatic materials, offering valuable guidance for the development and clinical application of novel injectable hemostatic materials. Additionally, visualized methodology and mapping analysis are effective data mining methods that provide approaches and strategies for clear knowledge network analysis. These methods facilitate better understanding and interpretation of research dynamics in the field of injectable hemostatic materials, thereby guiding and inspiring future research.
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Affiliation(s)
- Changsheng Feng
- School of Physics and Electronic InformationYan'an UniversityYan'anChina
| | - Liang Yang
- School of Physics and Electronic InformationYan'an UniversityYan'anChina
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17
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Huang X, Zheng Y, Ming J, Ning X, Bai S. Natural polymer-based bioadhesives as hemostatic platforms for wound healing. Int J Biol Macromol 2024; 256:128275. [PMID: 38000608 DOI: 10.1016/j.ijbiomac.2023.128275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
Medical adhesives are advanced but challenging alternatives to wound closure and repair, especially in mitigating uncontrolled hemorrhage. Ideal hemostatic adhesives need to meet good biocompatibility and biodegradability, adequate mechanical strength, and strong tissue adhesion functionality under wet and dynamic conditions. Considering these requirements, natural polymers such as polysaccharide, protein and DNA, attract great attention as candidates for making bioadhesives because of their distinctive physicochemical performances and biological properties. This review systematically summarizes the advances of bioadhesives based on natural polysaccharide, protein and DNA. Various physical and chemical cross-linking strategies have been introduced for adhesive synthesis and their hemostatic applications are introduced from the aspect of versatility. Furthermore, the possible challenges and future opportunities of bioadhesives are discussed, providing insights into the development of high-performance hemostatic materials.
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Affiliation(s)
- Xiaowei Huang
- Industrial Research Institute of Nonwovens and Technical Textiles, College of Textiles and Clothing, Qingdao University, Qingdao 266071, People's Republic of China
| | - Yankun Zheng
- College of Biological Science and Engineering, Fuzhou University, Fuzhou 350108, People's Republic of China
| | - Jinfa Ming
- Industrial Research Institute of Nonwovens and Technical Textiles, College of Textiles and Clothing, Qingdao University, Qingdao 266071, People's Republic of China.
| | - Xin Ning
- Industrial Research Institute of Nonwovens and Technical Textiles, College of Textiles and Clothing, Qingdao University, Qingdao 266071, People's Republic of China
| | - Shumeng Bai
- College of Biological Science and Engineering, Fuzhou University, Fuzhou 350108, People's Republic of China.
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18
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Yin X, Hu Y, Kang M, Hu J, Wu B, Liu Y, Liu X, Bai M, Wei Y, Huang D. Cellulose based composite sponges with oriented porous structure and superabsorptive capacity for quick hemostasis. Int J Biol Macromol 2023; 253:127295. [PMID: 37806413 DOI: 10.1016/j.ijbiomac.2023.127295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/24/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
Excessive bleeding is the leading cause of death in accidents and operations. Ca2+ crosslinked carboxyl nanocellulose (CN)/montmorillonite (MMT) composite (CaCNMMT) sponges were prepared by uniform mixing and directional freeze-drying methods which was inspired by the coordination mechanism of blood clot formation and coagulation cascade activation in natural hemostasis process. Carboxyl nanocellulose (CaCN) sponge has instantaneous water absorption capacity, and CaCNMMT sponges could further activate clotting factors. Therefore, CaCNMMT sponges achieved quick hemostasis by efficient concentrating blood, inducing hemocyte aggregation and stimulating coagulation cascade activation based on the synergistic effects of CN and MMT. Blood clotting index of CaCNMMT (15.90 ± 0.52 %) was significantly lower than CaCN (59.3 ± 1.43 %), and APTT time (22 ± 2 s) was almost equivalent to MMT (20 ± 2 s). CaCNMMT sponge showed good quick hemostatic effect on massive hemorrhage in both tail-breaking and liver injury model which provided a new strategy for the application of MMT in hemostatic and trauma treatment fields.
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Affiliation(s)
- Xiangfei Yin
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Yinchun Hu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China; Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan 030032, PR China.
| | - Min Kang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Junjie Hu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Baogang Wu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Yeying Liu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Xuanyu Liu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Miaomiao Bai
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China
| | - Yan Wei
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China; Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan 030032, PR China
| | - Di Huang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, PR China; Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan 030032, PR China
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19
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Edwards JV, Prevost NT, Hinchliffe DJ, Nam S, Chang S, Hron RJ, Madison CA, Smith JN, Poffenberger CN, Taylor MM, Martin EJ, Dixon KJ. Preparation and Activity of Hemostatic and Antibacterial Dressings with Greige Cotton/Zeolite Formularies Having Silver and Ascorbic Acid Finishes. Int J Mol Sci 2023; 24:17115. [PMID: 38069435 PMCID: PMC10706952 DOI: 10.3390/ijms242317115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The need for prehospital hemostatic dressings that exert an antibacterial effect is of interest for prolonged field care. Here, we consider a series of antibacterial and zeolite formulary treatment approaches applied to a cotton-based dressing. The design of the fabric formulations was based on the hemostatic dressing TACGauze with zeolite Y incorporated as a procoagulant with calcium and pectin to facilitate fiber adherence utilizing silver nanoparticles, and cellulose-crosslinked ascorbic acid to confer antibacterial activity. Infra-red spectra were employed to characterize the chemical modifications on the dressings. Contact angle measurements were employed to document the surface hydrophobicity of the cotton fabric which plays a role in the contact activation of the coagulation cascade. Ammonium Y zeolite-treated dressings initiated fibrin equal to the accepted standard hemorrhage control dressing and showed similar improvement with antibacterial finishes. The antibacterial activity of cotton-based technology utilizing both citrate-linked ascorbate-cellulose conjugate analogs and silver nanoparticle-embedded cotton fibers was observed against Staphylococcus aureus and Klebsiella pneumoniae at a level of 99.99 percent in the AATCC 100 assay. The hydrogen peroxide levels of the ascorbic acid-based fabrics, measured over a time period from zero up to forty-eight hours, were in line with the antibacterial activities.
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Affiliation(s)
- J. Vincent Edwards
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Nicolette T. Prevost
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Doug J. Hinchliffe
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Sunghyun Nam
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - SeChin Chang
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Rebecca J. Hron
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Crista A. Madison
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Jade N. Smith
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Chelsie N. Poffenberger
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
| | - Michelle M. Taylor
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
| | - Erika J. Martin
- Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Kirsty J. Dixon
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
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20
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Monteiro LPG, Rodrigues JMM, Mano JF. In situ generated hemostatic adhesives: From mechanisms of action to recent advances and applications. BIOMATERIALS ADVANCES 2023; 155:213670. [PMID: 37952461 DOI: 10.1016/j.bioadv.2023.213670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
Conventional surgical closure techniques, such as sutures, clips, or skin closure strips, may not always provide optimal wound closure and may require invasive procedures, which can result in potential post-surgical complications. As result, there is a growing demand for innovative solutions to achieve superior wound closure and improve patient outcomes. To overcome the abovementioned issues, in situ generated hemostatic adhesives/sealants have emerged as a promising alternative, offering a targeted, controllable, and minimally invasive procedure for a wide variety of medical applications. The aim of this review is to provide a comprehensive overview of the mechanisms of action and recent advances of in situ generated hemostatic adhesives, particularly protein-based, thermoresponsive, bioinspired, and photocrosslinkable formulations, as well as the design challenges that must be addressed. Overall, this review aims to enhance a comprehensive understanding of the latest advancements of in situ generated hemostatic adhesives and their mechanisms of action, with the objective of promoting further research in this field.
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Affiliation(s)
- Luís P G Monteiro
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
| | - João M M Rodrigues
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - João F Mano
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal.
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21
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Gheorghiță D, Antoniac I, Moldovan H, Antoniac A, Grosu E, Motelica L, Ficai A, Oprea O, Vasile E, Dițu LM, Raiciu AD. Influence of Lavender Essential Oil on the Physical and Antibacterial Properties of Chitosan Sponge for Hemostatic Applications. Int J Mol Sci 2023; 24:16312. [PMID: 38003499 PMCID: PMC10671502 DOI: 10.3390/ijms242216312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Uncontrollable bleeding continues to stand as the primary cause of fatalities globally following surgical procedures, traumatic incidents, disasters, and combat scenarios. The swift and efficient management of bleeding through the application of hemostatic agents has the potential to significantly reduce associated mortality rates. One significant drawback of currently available hemostatic products is their susceptibility to bacterial infections at the bleeding site. As this is a prevalent issue that can potentially delay or compromise the healing process, there is an urgent demand for hemostatic agents with antibacterial properties to enhance survival rates. To mitigate the risk of infection at the site of a lesion, we propose an alternative solution in the form of a chitosan-based sponge and antimicrobial agents such as silver nanoparticles (AgNPs) and lavender essential oil (LEO). The aim of this work is to provide a new type of hemostatic sponge with an antibacterial barrier against a wide range of Gram-positive and Gram-negative microorganisms: Staphylococcus epidermidis 2018 and Enterococcus faecalis VRE 2566 (Gram-positive strains) and Klebsiella pneumoniae ATCC 10031 and Escherichia coli ATCC 35218 (Gram-negative strains).
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Affiliation(s)
- Daniela Gheorghiță
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
| | - Horațiu Moldovan
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Elena Grosu
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Ludmila Motelica
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Anton Ficai
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania
| | - Ovidiu Oprea
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania
| | - Eugeniu Vasile
- Department of Oxide Materials Science and Engineering, National University of Science and Technology Politehnica Bucharest, 1–7 Gh. Polizu, 060042 Bucharest, Romania;
| | - Lia Mara Dițu
- Botanic and Microbiology Department, Faculty of Biology, University of Bucharest, 3, Aleea Portocalelor, 17 District 5, Grădina Botanică, 030018 București, Romania;
| | - Anca Daniela Raiciu
- Faculty of Pharmacy, Titu Maiorescu University, 22 Dambovnicului Street, 040441 Bucharest, Romania;
- S.C. Hofigal Import Export S.A., 2 Intrarea Serelor Street, 042124 Bucharest, Romania
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22
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Du Y, Bai Y, Lang S, Xing D, Ma L, Li K, Peng J, Li X, Liu G. Gelatin Sponges with a Uniform Interoperable Pore Structure and Biodegradability for Liver Injury Hemostasis and Tissue Regeneration. Biomacromolecules 2023; 24:5313-5327. [PMID: 37725632 DOI: 10.1021/acs.biomac.3c00803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Developing a hemostatic sponge that can effectively control bleeding from visceral injuries while guiding in situ tissue regeneration in incompressible wounds remains a challenge. Most of the existing hemostatic sponges degrade slowly, are relatively single-functioning, and cannot cope with complex environments. Herein, a biodegradable rapidly hemostatic sponge (GPZ) was created by dual-dynamic-bond cross-linking among Zn2+, protocatechualdehyde (PA)-containing catechol and aldehyde groups, and gelatin. GPZ had a uniformly distributed interconnected pore structure with excellent fluid absorption. It could effectively absorb the oozing blood and increase the blood concentration while stimulating platelet activation and accelerating blood coagulation. Compared to commercial hemostats, GPZ treatment significantly accelerated hemostasis in the rat liver defect model (∼0.33 min, ≥50% reduction in the hemostatic time) and in the rabbit liver defect model (∼1.02 min, ≥60% reduction in the hemostatic time). Additionally, GPZ had excellent antibacterial and antioxidant properties that effectively protected the wound from infection and excessive inflammation. In the liver regeneration model, GPZ significantly increased the rate of hepatic tissue repair and promoted rapid functional recovery without complications and adverse reactions. Overall, we designed a simple and effective biodegradable rapid hemostatic sponge with good clinical translational potential for treating lethal incompressible bleeding and promoting wound healing.
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Affiliation(s)
- Yangrui Du
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Yangjing Bai
- West China School of Nursing, Sichuan University/Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shiying Lang
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Dandan Xing
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Li Ma
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Kaijun Li
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Jinyu Peng
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Xinyun Li
- Dazhou Hospital of Integrated Traditional Chinese and Western Medicine, Dazhou, Sichuan 635000, China
| | - Gongyan Liu
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
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23
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Deng J, Wang Z, Xing J. Rapid hemostatic antibacterial self-gelling powder based on methacryloylsulfonyl betaine and quaternized carboxymethyl chitosan. J Mech Behav Biomed Mater 2023; 146:106079. [PMID: 37634426 DOI: 10.1016/j.jmbbm.2023.106079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023]
Abstract
Hemostatic powders can be used for deep wounds and wounds with irregular shapes that are frequently inaccessible to traditional hemostatic dressings like hemostatic gauze, sponges, and foams. In this study, sulfobetaine methacrylate (SBMA) and quaternized carboxymethyl chitosan (QCCS) were combined to create an antibacterial hemostatic hydrogel through photopolymerization under green LED irradiation, which was then changed into PSBMA/QCCS powder. PSBMA/QCCS powder could quickly form hydrogel with strong wet adhesion. The internal structure, water absorption capacity, and adhesion properties of the powder were evaluated. The coagulation ability, antimicrobial properties, and biocompatibility of the powder were also characterized. The PSBMA/QCCS powder could aggregate blood cells and platelets to enhance hemostasis. Meanwhile, PSBMA/QCCS powder also showed effective antibacterial ability against both gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). In summary, PSBMA/QCCS powder is a promising hemostatic agent with the characteristics of quick hemostasis, tough wet adhesion, satisfactory biocompatibility, considerable antibacterial effect, and adaptability to any irregularly shaped wounds.
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Affiliation(s)
- Junxia Deng
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China
| | - Zhen Wang
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China
| | - Jinfeng Xing
- School of Chemical Engineering and Technology, Tianjin University, No. 135 Yaguan Road, Haihe Education Park, Jinnan District, Tianjin 300350, China.
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24
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Zheng Y, Shariati K, Ghovvati M, Vo S, Origer N, Imahori T, Kaneko N, Annabi N. Hemostatic patch with ultra-strengthened mechanical properties for efficient adhesion to wet surfaces. Biomaterials 2023; 301:122240. [PMID: 37480758 DOI: 10.1016/j.biomaterials.2023.122240] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 07/24/2023]
Abstract
Controlling traumatic bleeding from damaged internal organs while effectively sealing the wound is critical for saving the lives of patients. Existing bioadhesives suffer from blood incompatibility, insufficient adhesion to wet surfaces, weak mechanical properties, and complex application procedures. Here, we engineered a ready-to-use hemostatic bioadhesive with ultra-strengthened mechanical properties and fatigue resistance, robust adhesion to wet tissues within a few seconds of gentle pressing, deformability to accommodate physiological function and action, and the ability to stop bleeding efficiently. The engineered hydrogel, which demonstrated high elasticity (>900%) and toughness (>4600 kJ/m3), was formed by fine-tuning a series of molecular interactions and crosslinking mechanisms involving N-hydroxysuccinimide (NHS) conjugated alginate (Alg-NHS), poly (ethylene glycol) diacrylate (PEGDA), tannic acid (TA), and Fe3+ ions. Dual adhesive moieties including mussel-inspired pyrogallol/catechol and NHS synergistically enhanced wet tissue adhesion (>400 kPa in a wound closure test). In conjunction with physical sealing, the high affinity of TA/Fe3+ for blood could further augment hemostasis. The engineered bioadhesive demonstrated excellent in vitro and in vivo biocompatibility as well as improved hemostatic efficacy as compared to commercial Surgicel®. Overall, the hydrogel design strategy described herein holds great promise for overcoming existing obstacles impeding clinical translation of engineered hemostatic bioadhesives.
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Affiliation(s)
- Yuting Zheng
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Kaavian Shariati
- David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA 90095, USA
| | - Mahsa Ghovvati
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA; Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA 90095, USA
| | - Steven Vo
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Nolan Origer
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Taichiro Imahori
- Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA 90095, USA
| | - Naoki Kaneko
- Division of Interventional Neuroradiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA 90095, USA
| | - Nasim Annabi
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, United States.
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25
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Yang Z, Chen L, Liu J, Zhuang H, Lin W, Li C, Zhao X. Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2301849. [PMID: 36942893 DOI: 10.1002/adma.202301849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Short designer self-assembling peptide (dSAP) biomaterials are a new addition to the hemostat group. It may provide a diverse and robust toolbox for surgeons to integrate wound microenvironment with much safer and stronger hemostatic capacity than conventional materials and hemostatic agents. Especially in noncompressible torso hemorrhage (NCTH), diffuse mucosal surface bleeding, and internal medical bleeding (IMB), with respect to the optimal hemostatic formulation, dSAP biomaterials are the ingenious nanofiber alternatives to make bioactive neural scaffold, nasal packing, large mucosal surface coverage in gastrointestinal surgery (esophagus, gastric lesion, duodenum, and lower digestive tract), epicardiac cell-delivery carrier, transparent matrix barrier, and so on. Herein, in multiple surgical specialties, dSAP-biomaterial-based nano-hemostats achieve safe, effective, and immediate hemostasis, facile wound healing, and potentially reduce the risks in delayed bleeding, rebleeding, post-operative bleeding, or related complications. The biosafety in vivo, bleeding indications, tissue-sealing quality, surgical feasibility, and local usability are addressed comprehensively and sequentially and pursued to develop useful surgical techniques with better hemostatic performance. Here, the state of the art and all-round advancements of nano-hemostatic approaches in surgery are provided. Relevant critical insights will inspire exciting investigations on peptide nanotechnology, next-generation biomaterials, and better promising prospects in clinics.
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Affiliation(s)
- Zehong Yang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
- Institute for Nanobiomedical Technology and Membrane Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lihong Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Ji Liu
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Hua Zhuang
- Department of Ultrasonography, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, Sichuan, 610041, China
| | - Wei Lin
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Women and Children Diseases of the Ministry of Education, Sichuan University, No. 17 People's South Road, Chengdu, Sichuan, 610041, China
| | - Changlong Li
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaojun Zhao
- Institute for Nanobiomedical Technology and Membrane Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
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26
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Bell KT, Salmon CM, Purdy BA, Canfield SG. EVALUATION OF TRANEXAMIC ACID AND CALCIUM CHLORIDE IN MAJOR TRAUMAS IN A PREHOSPITAL SETTING: A NARRATIVE REVIEW. Shock 2023; 60:325-332. [PMID: 37477447 PMCID: PMC10510828 DOI: 10.1097/shk.0000000000002177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/13/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023]
Abstract
ABSTRACT Excessive blood loss in the prehospital setting poses a significant challenge and is one of the leading causes of death in the United States. In response, emergency medical services (EMS) have increasingly adopted the use of tranexamic acid (TXA) and calcium chloride (CaCl 2 ) as therapeutic interventions for hemorrhagic traumas. Tranexamic acid functions by inhibiting plasmin formation and restoring hemostatic balance, while calcium plays a pivotal role in the coagulation cascade, facilitating the conversion of factor X to factor Xa and prothrombin to thrombin. Despite the growing utilization of TXA and CaCl 2 in both prehospital and hospital environments, a lack of literature exists regarding the comparative effectiveness of these agents in reducing hemorrhage and improving patient outcomes. Notably, Morgan County Indiana EMS recently integrated the administration of TXA with CaCl 2 into their treatment protocols, offering a valuable opportunity to gather insight and formulate updated guidelines based on patient-centered outcomes. This narrative review aims to comprehensively evaluate the existing evidence concerning the administration of TXA and CaCl 2 in the prehospital management of hemorrhages, while also incorporating and analyzing data derived from the co-administration of these medications within the practices of Morgan County EMS. This represents the inaugural description of the concurrent use of both TXA and CaCl 2 to manage hemorrhages in the scientific literature.
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Affiliation(s)
- Kameron T. Bell
- Indiana University School of Medicine–Terre Haute, Terre Haute, Indiana
| | - Chase M. Salmon
- Indiana University School of Medicine–Terre Haute, Terre Haute, Indiana
| | | | - Scott G. Canfield
- Indiana University School of Medicine–Terre Haute, Terre Haute, Indiana
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27
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Liberale C, Segato E, Sacchetto A, Silvestrini M, Saetti R. Oxidized cellulose-based reaction mimicking thyroidal recurrence of disease: a case report and literature review. Indian J Otolaryngol Head Neck Surg 2023; 75:2427-2431. [PMID: 37636794 PMCID: PMC10447742 DOI: 10.1007/s12070-023-03556-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/31/2023] [Indexed: 08/29/2023] Open
Abstract
Oxidized cellulose is a hemostatic agent currently used in surgery. Foreign body reactions have been described after its use. This paper describes a foreign body reaction caused by oxidized cellulose in a young woman who underwent thyroid surgery. A patient underwent two thyroid surgeries for treatment of papillary carcinoma. Five years after the last surgery, an asymptomatic mass was detected with a routine ultrasound in the left thyroid cavity. After surgical removal, the mass turned out to be a foreign body granuloma based on oxidized cellulose sheets used in the previous surgery. The patient was discharged from the hospital without complications. The follow-up period was uneventful. Oxidized cellulose is a useful tool in surgery to control and prevent intra and post-operative bleeding. Even if it is a biodegradable material, sometimes it persists in the human body causing foreign body reactions that can be misdiagnosed. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03556-0.
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Affiliation(s)
- Carlotta Liberale
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro, 10, Verona, VR 37134 Italy
| | - Erika Segato
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro, 10, Verona, VR 37134 Italy
| | - Andrea Sacchetto
- Department of Otorhinolaryngology, San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, Vicenza, VI 36100 Italy
| | - Marina Silvestrini
- Department of Otorhinolaryngology, San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, Vicenza, VI 36100 Italy
| | - Roberto Saetti
- Department of Otorhinolaryngology, San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, Vicenza, VI 36100 Italy
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28
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Wang H, Yang L. Applications of injectable hemostatic materials in wound healing: principles, strategies, performance requirements, and future perspectives. Theranostics 2023; 13:4615-4635. [PMID: 37649606 PMCID: PMC10465227 DOI: 10.7150/thno.86930] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
Uncontrolled traumatic bleeding can lead to death due to excessive blood loss within minutes. Early intervention is crucial to save lives, making timely and effective hemostasis is a major global challenge. Injectable hemostatic materials (IHMs) have been proposed to improve the effectiveness of hemostasis, facilitate wound healing, and enhance survival rates in emergency situations. The superior hemostatic performance of IHMs has garnered significant attention. However, there are relatively few comprehensive reviews on IHMs. This paper aims to provide a comprehensive review of the latest research progress on IHMs in recent years. Firstly, the physiological hemostatic process and the underlying principles of hemostasis are analyzed. Subsequently, the synthesis strategies for different IHMs are discussed. The performance requirements of IHMs are then summarized, including high efficiency, biocompatibility, degradability, manipulability, stability and antibacterial ability. Finally, the development prospects and challenges of IHMs are presented. This review serves as a necessary and systematic summary of IHMs, providing a valuable reference for the development of new high-performance hemostatic materials and their practical clinical applications.
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Affiliation(s)
| | - Liang Yang
- School of Physics and Electronic Information, Yan'an University, Yan'an, 716000, China
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29
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Rho SY, Jin M, Kim HK, Park JI, Park JH, Yun S, Lee M, Choi SB, Hong JY, Kim KS. The novel use and feasibility of hemostatic oxidized regenerated cellulose agent (SurgiGuard ®): multicenter retrospective study. Gland Surg 2023; 12:905-916. [PMID: 37727334 PMCID: PMC10506122 DOI: 10.21037/gs-22-675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/01/2023] [Indexed: 09/21/2023]
Abstract
Background SurgiGuard® is an absorbent hemostatic agent based on oxidized regenerated cellulose. The efficacy, effects and safety of SurgiGuard® are equivalent to existing hemostatic agents in animal experiments. This study was designed to confirm that the use of SurgiGuard® alone is effective, safe and feasible compared to combination with other hemostatic methods. Methods We retrospectively reviewed clinical data from 12 surgery departments in seven tertiary centers in South Korea nationwide. All surgeries were performed between January and December 2018. Results A total of 807 patients were enrolled; 447 patients (55.4%) had comorbidities. The rate of major surgery (operative time ≥4 hours) was 44% (n=355 patients). Regarding the type of SurgiGuard® used in surgery, more than 70% of minor surgeries used non-woven types. In major surgery, more than five SurgiGuards® were used in 7.3% (26 patients), and the proportion of co-usage (with four other hemostatic products) was 19.7% (70 patients). The effectiveness score was higher when SurgiGuard® was used alone in both major (5.3±0.5 vs. 5.1±0.6, P=0.048) and minor surgery (5.4±0.6 vs. 5.2±0.4, P<0.001). Seven patients had immediate re-bleeding, and all of them used SurgiGuard® and other products together. Nine patients reported adverse effects, such as abscess, bleeding, or leg swelling, but we found no direct correlation with SurgiGuard®. Conclusions SurgiGuard® exhibited greater effectiveness when used alone. No direct adverse effects associated with SurgiGuard® use were reported, and SurgiGuard® had stable feasibility. Prospective comparative studies are needed in the future.
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Affiliation(s)
- Seoung Yoon Rho
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Miryung Jin
- Clinical & Regulatory Affairs Team, Samyang Biopharmaceuticals Corp., Gyeonggi, Korea
| | - Hyun Koo Kim
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jeong-Ik Park
- Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jong-Hwa Park
- Department of Neurosurgery, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Sangchul Yun
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Maria Lee
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sae Byeol Choi
- Department of HBP surgery, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jae-Young Hong
- Department of Orthopedic Surgery, Spine Division, Korea University Medical Center, Ansan Hospital, Ansan, Korea
| | - Kyung Sik Kim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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30
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Gheorghiță D, Moldovan H, Robu A, Bița AI, Grosu E, Antoniac A, Corneschi I, Antoniac I, Bodog AD, Băcilă CI. Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances. Int J Mol Sci 2023; 24:10540. [PMID: 37445718 DOI: 10.3390/ijms241310540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Hemorrhage is a detrimental event present in traumatic injury, surgery, and disorders of bleeding that can become life-threatening if not properly managed. Moreover, uncontrolled bleeding can complicate surgical interventions, altering the outcome of surgical procedures. Therefore, to reduce the risk of complications and decrease the risk of morbidity and mortality associated with hemorrhage, it is necessary to use an effective hemostatic agent that ensures the immediate control of bleeding. In recent years, there have been increasingly rapid advances in developing a novel generation of biomaterials with hemostatic properties. Nowadays, a wide array of topical hemostatic agents is available, including chitosan-based biomaterials that have shown outstanding properties such as antibacterial, antifungal, hemostatic, and analgesic activity in addition to their biocompatibility, biodegradability, and wound-healing effects. This review provides an analysis of chitosan-based hemostatic biomaterials and discusses the progress made in their performance, mechanism of action, efficacy, cost, and safety in recent years.
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Affiliation(s)
- Daniela Gheorghiță
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Horațiu Moldovan
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Ana-Iulia Bița
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Elena Grosu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iuliana Corneschi
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alin Dănuț Bodog
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, 410073 Oradea, Romania
| | - Ciprian Ionuț Băcilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 10 Victoriei Boulevard, 550024 Sibiu, Romania
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31
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Zhou F, Xin L, Wang S, Chen K, Li D, Wang S, Huang Y, Xu C, Zhou M, Zhong W, Wang H, Chen T, Song J. Portable Handheld "SkinPen" Loaded with Biomaterial Ink for In Situ Wound Healing. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 37262337 DOI: 10.1021/acsami.3c02825] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In situ bioprinting has emerged as an attractive tool for directly depositing therapy ink at the defective area to adapt to the irregular wound shape. However, traditional bioprinting exhibits an obvious limitation in terms of an unsatisfactory bioadhesive effect. Here, a portable handheld bioprinter loaded with biomaterial ink is designed and named "SkinPen". Gelatin methacrylate (GelMA) and Cu-containing bioactive glass nanoparticles (Cu-BGn) serve as the main components to form the hydrogel ink, which displays excellent biocompatibility and antibacterial and angiogenic properties. More importantly, by introducing ultrasound and ultraviolet in a sequential programmed manner, the SkinPen achieves in situ instant gelation and amplified (more than threefold) bioadhesive shear strength. It is suggested that ultrasound-induced cavitation and the resulting topological entanglement contribute to the enhanced bioadhesive performance together. Combining the ultrasound-enhanced bioadhesion with the curative role of the hydrogel, the SkinPen shows a satisfactory wound-healing effect in diabetic rats. Given the detachable property of the SkinPen, the whole device can be put in a first-aid kit. Therefore, the application scenarios can be expanded to many kinds of accidents. Overall, this work presents a portable handheld SkinPen that might provide a facile but effective approach for clinical wound management.
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Affiliation(s)
- Fuyuan Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Liangjing Xin
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Shuya Wang
- Key State Laboratory of Fine Chemicals, Dalian 116024, P. R. China
- School of Bioengineering, Dalian University of Technology, Dalian 116024, P. R. China
| | - Kaiwen Chen
- Key State Laboratory of Fine Chemicals, Dalian 116024, P. R. China
- School of Bioengineering, Dalian University of Technology, Dalian 116024, P. R. China
| | - Dize Li
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Si Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Yuanding Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Chuanhang Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Mengjiao Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Wenjie Zhong
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Huanan Wang
- Key State Laboratory of Fine Chemicals, Dalian 116024, P. R. China
- School of Bioengineering, Dalian University of Technology, Dalian 116024, P. R. China
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
| | - Jinlin Song
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, P. R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, P. R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, P. R. China
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Selvakumar G, Lonchin S. A bio-polymeric scaffold incorporated with p-Coumaric acid enhances diabetic wound healing by modulating MMP-9 and TGF-β3 expression. Colloids Surf B Biointerfaces 2023; 225:113280. [PMID: 36989817 DOI: 10.1016/j.colsurfb.2023.113280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/22/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023]
Abstract
Diabetic wounds lead to severe health complications as the tissue regeneration process fails predominantly due to prolonged inflammation, reactive oxygen species generation, and imbalance in collagen turnover. Modern wound dressings that can aid in wound management thus improving the public healthcare system, is the present need. This study aims to fabricate an effective wound dressing using plant polyphenol to treat chronic wounds as polyphenols possess excellent wound-healing ability. The collagen scaffold enriched with the polyphenol, p-Coumaric acid, was fabricated by freeze-drying method (Col-OxP3-Ca) and examined for its wound-healing ability by in vitro and in vivo analyses. Col-OxP3-Ca scaffold exhibited 85% antioxidant activity, biocompatibility in fibroblast cells, enhanced cell proliferation and migration rate. The diabetic excision wound treated with Col-OxP3-Ca scaffold healed within 21 days and a well-developed epidermis, blood vessels, hair follicle formation, fewer inflammatory cells and collagen deposition was observed in histological analysis. The immunohistochemical results depicted the enhanced expression of TGF-β3 and lessened expression of the MMP-9 in Col-OxP3-Ca scaffold treatment group. p-Coumaric acid shortened the inflammatory stage, enhanced angiogenesis, tissue regeneration and balanced collagen turnover during healing. From this, we can accomplish that the Col-OxP3-Ca wound dressing could be an outstanding alternative to treat chronic wounds.
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Affiliation(s)
- Gopika Selvakumar
- Biochemistry and Biotechnology Laboratory, CSIR - Central Leather Research Institute, Adyar, Chennai 600 020, India; University of Madras, Chepauk, Chennai 600005, India
| | - Suguna Lonchin
- Biochemistry and Biotechnology Laboratory, CSIR - Central Leather Research Institute, Adyar, Chennai 600 020, India.
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Andrabi SM, Kumar A. A kaolin/calcium incorporated shape memory and antimicrobial chitosan-dextran based cryogel as an efficient haemostatic dressing for uncontrolled hemorrhagic wounds. BIOMATERIALS ADVANCES 2023; 150:213424. [PMID: 37068405 DOI: 10.1016/j.bioadv.2023.213424] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
Increased mortalities associated with uncontrolled and excessive bleeding is still of paramount concern in the clinics, caregivers and military medics. Herein, we designed a shape memory cryogel based on chitosan (C) and functionalized-dextran (D), incorporated with Kaolin (K) and calcium (Ca2+) as haemostatic agents. The developed cryogel (CDKCa) exhibits a uniform interconnected porous architecture with profound fluid absorption ability, rapid blood clotting, stable clot formation and good antibacterial activity. The CDKCa elucidates significantly less clotting time (~30 s; in-vitro) and increased aggregation and activation of platelets/red blood cells in comparison to the control groups and commercial dressings (Axiostat and QuikClot). The developed CDKCa also significantly reduced the aPTT and PT values by ~58 % and 31 % respectively, leading to the activation of intrinsic and extrinsic coagulation cascades. The CDKCa cryogel displays enhanced mechanical stability, flexibility and a good shape memory, a property quintessential to cease uncontrolled bleeding in irregular and non-compressible wounds. Further, the Kaolin and Ca2+ incorporated shape memory CDKCa cryogel demonstrates a rapid blood coagulation and stable clot formation in different compressible and non-compressible rat liver and femur hemorrhagic models. In summary, the endorsed results of CDKCa suggest that the design, fabrication and excellent clotting ability may attribute to high haemostatic efficiency of CDKCa dressing and have a great potential to prevent uncontrollable hemorrhages.
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Affiliation(s)
- Syed Muntazir Andrabi
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India; Centre for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
| | - Ashok Kumar
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India; Centre for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India; Center for Nanosciences, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India; The Mehta Family Centre for Engineering in Medicine, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India; Centre of Excellence, Gangwal School of Medical Sciences and Technology, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India.
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Song Y, Li S, Chen H, Han X, Duns GJ, Dessie W, Tang W, Tan Y, Qin Z, Luo X. Kaolin-loaded carboxymethyl chitosan/sodium alginate composite sponges for rapid hemostasis. Int J Biol Macromol 2023; 233:123532. [PMID: 36740110 DOI: 10.1016/j.ijbiomac.2023.123532] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
There are several factors that contribute to the mortality of people who suffer from unmanageable bleeding. Therefore, the development of rapid hemostatic materials is necessary. Herein, novel rapid hemostatic composite sponges were developed by incorporation of kaolin (K) into carboxymethyl chitosan (CMCS)/sodium alginate (SA) via a combination of methods that includes ionic crosslinking, polyelectrolyte action, and freeze-drying. The CMCS/SA-K composite sponges were cross-linked with calcium ions provided by a sustained-release system consisting of D-gluconolactone (GDL) and Ca-EDTA, and the hemostatic ability of the sponges was enhanced by loading the inorganic hemostatic agent-kaolin (K). It was demonstrated that the CMCS/SA-K composite sponges had a good porous structure and water absorption properties, excellent mechanical properties, outstanding biodegradability, and biocompatibility. Simultaneously, they exhibited rapid hemostatic properties, both in vitro and in vivo. Significantly, the hemostatic time of the CMCS/SA-K60 sponge was improved by 82.76 %, 191.82 %, and 153.05 %, compared with those of commercially available gelatin sponges in the rat tail amputation, femoral vein, and liver injury hemorrhage models respectively, indicating that its hemostatic ability was superior to that of commercially available hemostatic materials. Therefore, CMCS/SA-K composite sponges show great promise for rapid hemostasis.
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Affiliation(s)
- Yannan Song
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Shuo Li
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China
| | - Huifang Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Xinyi Han
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Gregory J Duns
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Wubliker Dessie
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Wufei Tang
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China
| | - Yimin Tan
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China
| | - Zuodong Qin
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China.
| | - Xiaofang Luo
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, Yongzhou 425199, China.
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35
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Cui G, Guo X, Su P, Zhang T, Guan J, Wang C. Mussel-inspired nanoparticle composite hydrogels for hemostasis and wound healing. Front Chem 2023; 11:1154788. [PMID: 37065820 PMCID: PMC10097955 DOI: 10.3389/fchem.2023.1154788] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/14/2023] [Indexed: 04/01/2023] Open
Abstract
Uncontrolled hemorrhage caused by trauma can easily lead to death. Efficient and safe hemostatic materials are an urgent and increasing need for hemostatic research. Following a trauma, wound healing is induced by various cellular mechanisms and proteins. Hemostatic biomaterials that can not only halt bleeding quickly but also provide an environment to promote wound healing have been the focus of research in recent years. Mussel-inspired nanoparticle composite hydrogels have been propelling the development of hemostatic materials owing to their unique advantages in adhesion, hemostasis, and bacteriostasis. This review summarizes the hemostatic and antimicrobial fundamentals of polydopamine (PDA)-based nanomaterials and emphasizes current developments in hemorrhage-related PDA nanomaterials. Moreover, it briefly discusses safety concerns and clinical application problems with PDA hemostatic nanomaterials.
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Affiliation(s)
- Guihua Cui
- College of Chemistry, Northeast Normal University, Changchun, Jilin, China
- Department of Chemistry, Jilin Medical University, Jilin City, Jilin, China
- *Correspondence: Guihua Cui, ; Chungang Wang,
| | - Xiaoyu Guo
- Jilin Vocational College of Industry and Technology, Jilin City, Jilin, China
| | - Ping Su
- Affiliated 465 Hospital, Jilin Medical University, Jilin City, Jilin, China
| | - Tianshuo Zhang
- Department of Chemistry, Jilin Medical University, Jilin City, Jilin, China
| | - Jiao Guan
- Department of Chemistry, Jilin Medical University, Jilin City, Jilin, China
| | - Chungang Wang
- College of Chemistry, Northeast Normal University, Changchun, Jilin, China
- *Correspondence: Guihua Cui, ; Chungang Wang,
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Lang S, Du Y, Ma L, Bai Y, Ji Y, Liu G. Multifunctional and Tunable Coacervate Powders to Enable Rapid Hemostasis and Promote Infected Wound Healing. Biomacromolecules 2023; 24:1839-1854. [PMID: 36924317 DOI: 10.1021/acs.biomac.3c00043] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Hemostatic powders provide an important treatment approach for time-sensitive hemorrhage control. Conventional hemostatic powders are challenged by the lack of tissue adhesiveness, insufficient hemostatic efficacy, limited infection control, and so forth. This study develops a hemostatic powder from tricomponent GTP coacervates consisting of gelatin, tannic acid (TA), and poly(vinyl alcohol) (PVA). The physical cross-linking by TA results in facile preparation, good storage stability, ease of application to wounds, and removal, which provide good potential for clinical translation. When rehydrated, the coacervate powders rapidly form a cohesive layer with interconnected microporous structure, competent flexibility, switchable wet adhesiveness, and antibacterial properties, which facilitate the hemostatic efficacy for treating irregular, noncompressible, or bacteria-infected wounds. Compared to commercial hemostats, GTP treatment results in significantly accelerated hemostasis in a liver puncture model (∼19 s, >30% reduction in the hemostatic time) and in a tail amputation model (∼38 s, >60% reduction in the hemostatic time). In the GTP coacervates, gelatin functioned as the biodegradable scaffold, while PVA introduced the flexible segments to enable shape-adaptability and interfacial interactions. Furthermore, TA contributed to the physical cross-linking, adhesiveness, and antibacterial performance of the coacervates. The study explores the tunability of GTP coacervate powders to enhance their hemostatic and wound healing performances.
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Affiliation(s)
- Shiying Lang
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Yangrui Du
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Li Ma
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Yangjing Bai
- West China School of Nursing, Sichuan University/Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ying Ji
- Institute of Textiles and Clothing, Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR 999077, China
| | - Gongyan Liu
- College of Biomass Science and Engineering, Sichuan University, Chengdu 610065, China
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37
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Yu X, Gao Z, Mu J, Lian H, Meng Z. Gelatin/calcium chloride electrospun nanofibers for rapid hemostasis. Biomater Sci 2023; 11:2158-2166. [PMID: 36734397 DOI: 10.1039/d2bm01767a] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Blood coagulation is the body's main defense to bleeding caused by trauma and is divided into endogenous and exogenous pathways. Calcium ions play a very important role in the process of blood coagulation, as the ions activate the many enzymes that are required for coagulation. In this paper, gelatin hemostatic membranes containing calcium ions were prepared by electrospinning. The fibers were characterized with scanning electron microscopy, Fourier transform infrared spectroscopy, and X-ray diffraction. The biocompatibility and coagulation processes using the calcium ion-containing gelatin fibrous membranes were evaluated in vitro with dynamic whole-blood coagulation tests, hemolysis tests, coagulation time tests, and platelet adhesion tests. It was demonstrated that the calcium ion-containing gelatin membranes had lower hemolysis rates and shorter clotting times than commercially available hemostatic sponges and hemostatic gauzes. In vivo hemostasis experiments were also conducted on the tail vein and liver of mice. Animal experiments demonstrated that the incorporation of calcium ions into the electrospun gelatin membranes promoted platelet aggregation, ensured adhesion of the electrospun membrane to the wound and reduced the bleeding volume and hemostasis time. The composite calcium ion-gelatin electrospun membranes exhibited good in vivo and in vitro hemostatic abilities and accelerated blood clotting by stimulating the coagulation pathway to promote platelet aggregation at the wounds and the formation of mature blood clots for a new approach for acute trauma treatment.
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Affiliation(s)
- Xinrong Yu
- Faculty of Medical Instrument, Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Zichun Gao
- Faculty of Medical Instrument, Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Jiaxiang Mu
- Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - He Lian
- Faculty of Medical Instrument, Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Zhaoxu Meng
- Faculty of Medical Instrument, Shenyang Pharmaceutical University, Shenyang 110016, China.
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38
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Shi Y, Fang Y, Liang X, Huang C, Liang Y, Yang Z, Yu J, Wang J, Zhao G. Yeast cell templated porous hollow silica spheres for rapid hemostasis accompanied by antibacterial action. Biomater Sci 2023; 11:3104-3113. [PMID: 36916604 DOI: 10.1039/d2bm01619b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Uncontrolled haemorrhage is the leading cause in nearly 91% of pre-hospital deaths, which were considered potentially survivable. In particular, severe trauma is susceptible to infection, which further affects the natural healing process and can even lead to life-threatening sepsis. Therefore, we established Ag@HMSN nanocomposites based on a yeast cell template that combines hemostasis with antibiosis and further studied the effects of different calcination temperatures on the hemostatic and antibacterial properties. From the experimental results, Ag@HMSNs/500 shows excellent bactericidal effect on a mouse skin infection model and outstanding hemostatic effect on a mouse liver injury model, which could be used as the next-generation hemostatic and antibacterial material.
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Affiliation(s)
- Yuting Shi
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China. .,State Key Laboratory for Marine Corrosion and Protection, Luoyang Ship Material Research Institute (LSMRI), Xiamen, 361101, P. R. China
| | - Yu Fang
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China.
| | - Xiaoqin Liang
- Department of Pathology, Gansu Provincial Hospital, Lanzhou 730000, P. R. China
| | - Congshu Huang
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China. .,State Key Laboratory for Marine Corrosion and Protection, Luoyang Ship Material Research Institute (LSMRI), Xiamen, 361101, P. R. China
| | - Yu Liang
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China. .,State Key Laboratory for Marine Corrosion and Protection, Luoyang Ship Material Research Institute (LSMRI), Xiamen, 361101, P. R. China
| | - Zheng Yang
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China.
| | - Jianping Yu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, P. R. China.
| | - Jianrong Wang
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, P. R. China.
| | - Guanghui Zhao
- State Key Laboratory of Applied Organic Chemistry, Institute of Biochemical Engineering & Environmental Technology, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China.
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39
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Polysaccharides based rapid self-crosslinking and wet tissue adhesive hemostatic powders for effective hemostasis. Carbohydr Polym 2023; 312:120819. [PMID: 37059547 DOI: 10.1016/j.carbpol.2023.120819] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023]
Abstract
Hemostatic powders with flexible shape are widely used for the noncompressible and inaccessible hemorrhage wounds. However, current hemostatic powders display poor wet tissue adhesion and fragile mechanical strength of the powder-supported blood clots, leading to compromised hemostasis efficacy. Herein, a bi-component of carboxymethyl chitosan (CMCS) and aldehyde-modified hyaluronic acid grafted with catechol groups (COHA) was designed. Upon absorption of blood, the bi-component powders (CMCS-COHA) spontaneously self-crosslinks into an adhesive hydrogel within 10 s, tightly adhering to wound tissue to form a pressure-resistant physical barrier. During gelation, the hydrogel matrix captures and locks the blood cells/platelets to generate a robust thrombus in the bleeding sites. Compared with traditional hemostatic powder Celox™, CMCS-COHA displays superior blood coagulation and hemostatic performance. More importantly, CMCS-COHA has inherent cytocompatibility and hemocompatibility. These prominent advantages in rapid and effective hemostasis, adaptability to fit irregulate defective wound, easy preservation, facile usage, and bio-safety, make CMCS-COHA a promising hemostatic in emergency situations.
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40
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Kushwah H, Sandal N, Chauhan M, Mittal G. Fabrication, characterization and efficacy evaluation of natural gum-based bioactive haemostatic gauzes with antibacterial properties. J Biomater Appl 2023; 37:1409-1422. [PMID: 36045495 DOI: 10.1177/08853282221124366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Management of uncontrolled bleeding due to traumatic injuries occurring in battlefields and road traffic accidents is a major healthcare concern, especially in developing countries like India. Since natural coagulation mechanism alone is insufficient to achieve haemostasis quickly in such cases, application of an external haemostatic product is generally required to accelerate the coagulation process. We had recently reported preliminary comparison of four natural absorbent gums, which indicated towards haemostatic potential of gum tragacanth (GT) and xanthan gum (XG). Present study involves fabrication of haemostatic dressings incorporated with different concentrations of GT or XG, along with ciprofloxacin (a broad-spectrum antibiotic) and other excipients over woven cotton gauze. Prepared gauzes were investigated for physico-chemical characteristics, in-vitro blood interaction studies, antibacterial effect and in-vivo haemostatic efficacy in Sprague Dawley rats using two bleeding models. Acute dermal toxicity studies were also carried out as per OECD guidelines. SEM studies showed that gauzes coated with XG had thin, uniform layer of coating, while in case of GT; coating was comparatively rough with insoluble particles of GT adhering over gauze surface, forming voids on the fibers. Coated gauzes exhibited optimum mechanical properties in terms of tensile strength and percent extension at break. GT coated dressings showed good fluid uptake and retention ability in-vitro. Test gauzes were non-hemolytic in nature, did not elicit any dermal toxicity on animals' skin and had the ability to protect against E. coli infection. In-vivo efficacy studies in rat femoral artery and liver laceration bleeding models indicated that gauzes coated with 4% GT were able to clot blood in least time (36.67 ± 3.33s and 40 ± 2.58s respectively) as compared to other gum combinations and commercially available dressing 'Surgispon® (103.3 ± 4.22s and 85 ± 5.62s respectively). Results of this study validate our initial findings of the potential of gum tragacanth to be developed into a suitable haemostatic product.
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Affiliation(s)
- Himanshu Kushwah
- Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi, India
| | - Nidhi Sandal
- Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi, India
| | - Meenakshi Chauhan
- Delhi Institute of Pharmaceutical Sciences and Research, 633274Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Gaurav Mittal
- Institute of Nuclear Medicine and Allied Sciences, Defence Research & Development Organisation, New Delhi, India
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Jiang Y, Yang Y, Peng Z, Li Y, Peng J, Zhang Y, Jin H, Tan D, Tao L, Ding Y. Sustainable sepiolite-based composites for fast clotting and wound healing. BIOMATERIALS ADVANCES 2023; 149:213402. [PMID: 37058779 DOI: 10.1016/j.bioadv.2023.213402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/12/2023] [Accepted: 02/21/2023] [Indexed: 03/30/2023]
Abstract
Uncontrolled bleeding and bacterial coinfection are the major causes of death after an injury. Fast hemostatic capacity, good biocompatibility, and bacterial coinfection inhibition pose great challenges to hemostatic agent development. A prospective sepiolite/Ag nanoparticles (sepiolite@AgNPs) composite has been prepared by using natural clay sepiolite as template. A tail vein hemorrhage mouse model and a rabbit hemorrhage model were used to evaluate the hemostatic properties of the composite. The sepiolite@AgNPs composite can quickly absorb fluid to subsequently stop bleeding due to the natural fibrous crystal structure of sepiolite, and inhibit bacterial growth with the antibacterial ability of AgNPs. Compared with commercially-available zeolite material, the as-prepared composite exhibits competitive hemostatic properties without exothermic reaction in the rabbit model of femoral and carotid artery injury. The rapid hemostatic effect was due to the efficient absorption of erythrocyte and activation of the coagulation cascade factors and platelets. Besides, after heat-treatment, the composites can be recycled without significant reduction of hemostatic performance. Our results also prove that sepiolite@AgNPs nanocomposites can stimulate wound healing. The sustainability, lower-cost, higher bioavailability, and stronger hemostatic efficacy of sepiolite@AgNPs composite render these nanocomposites as more favorable hemostatic agents for hemostasis and wound healing.
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Vu TT, Gulfam M, Jo SH, Rizwan A, Joo SB, Lee B, Park SH, Lim KT. The effect of molecular weight and chemical structure of cross-linkers on the properties of redox-responsive hyaluronic acid hydrogels. Int J Biol Macromol 2023; 238:124285. [PMID: 37004930 DOI: 10.1016/j.ijbiomac.2023.124285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
In this work, we investigated the effect of the size and the chemical structure of crosslinkers on the properties of hyaluronic acid-based hydrogels prepared via an inverse electron demand Diels-Alder reaction. Hydrogels having loose and dense networks were designed by cross-linkers with and without polyethylene glycol (PEG) spacers of different molecular weights (1000 and 4000 g/mol). The study showed that the properties of hydrogels such as swelling ratios (20-55 times), morphology, stability, mechanical strength (storage modulus in the range 175-858 Pa), and drug loading efficiency (87 % ~ 90 %) were greatly influenced by the addition of PEG and changing its molecular weight in the cross-linker. Particularly, the presence of PEG chains in redox- responsive crosslinkers increased the doxorubicin release (85 %, after 168 h) and the degradation rate (96 %, after 10 d) of hydrogels in the simulated reducing medium (10 mM DTT). The in vitro cytotoxicity experiments conducted for HEK-293 cells revealed that the formulated hydrogels were biocompatible, which could be a promising candidate for drug delivery applications.
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Liu Z, Xu Y, Su H, Jing X, Wang D, Li S, Chen Y, Guan H, Meng L. Chitosan-based hemostatic sponges as new generation hemostatic materials for uncontrolled bleeding emergency: Modification, composition, and applications. Carbohydr Polym 2023; 311:120780. [PMID: 37028883 DOI: 10.1016/j.carbpol.2023.120780] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/12/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
The choice of hemostatic technique is a curial concern for surgery and as first-aid treatment in combat. To treat uncontrolled bleeding in complex wound environments, chitosan-based hemostatic sponges have attracted significant attention in recent years because of the excellent biocompatibility, degradability, hemostasis and antibacterial properties of chitosan and their unique sponge-like morphology for high fluid absorption rate and priority aggregation of blood cells/platelets to achieve rapid hemostasis. In this review, we provide a historical perspective on the use of chitosan hemostatic sponges as the new generation of hemostatic materials for uncontrolled bleeding emergencies in complex wounds. We summarize the modification of chitosan, review the current status of preparation protocols of chitosan sponges based on various composite systems, and highlight the recent achievements on the detailed breakdown of the existing chitosan sponges to present the relationship between their composition, physical properties, and hemostatic capacity. Finally, the future opportunities and challenges of chitosan hemostatic sponges are also proposed.
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A wet-adhesive carboxymethylated yeast β-glucan sponge with radical scavenging, bacteriostasis and anti-inflammatory functions for rapid hemostasis. Int J Biol Macromol 2023; 230:123158. [PMID: 36610582 DOI: 10.1016/j.ijbiomac.2023.123158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
Local hemostats still face obstacles to efficiently achieving hemostasis and promoting wound healing. Herein, a series of multifunctional well-degradable hemostatic sponges based-on carboxymethylated yeast β-glucan (CMYG) were fabricated by lyophilization. The porous CMYG sponge not only could absorb blood quickly (44.12 g/g), but also possessed unexpected tissue adhesion (∼30 kPa), and it represented good biocompatibility in vitro on fibroblasts and red blood cells. Notably, compared with the commercial Celox™, the CMYG sponge achieved more rapid hemostasis and significantly reduced blood loss in liver injury rat models by rapid wound block. Interestingly, the developed sponge showed an outstanding effect on antioxidant, anti-infection, anti-inflammatory, and cell proliferation, which are beneficial for further wound repair. Overall, these results suggest that the CMYG sponge is a promising candidate for the clinical management of uncontrollable hemorrhage and the further development of wound dressing materials throughout skin defect repair.
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Guo Y, Cheng N, Sun H, Hou J, Zhang Y, Wang D, Zhang W, Chen Z. Advances in the development and optimization strategies of the hemostatic biomaterials. Front Bioeng Biotechnol 2023; 10:1062676. [PMID: 36714615 PMCID: PMC9873964 DOI: 10.3389/fbioe.2022.1062676] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/29/2022] [Indexed: 01/12/2023] Open
Abstract
Most injuries are accompanied by acute bleeding. Hemostasis is necessary to relieve pain and reduce mortality in these accidents. In recent years, the traditional hemostatic materials, including inorganic, protein-based, polysaccharide-based and synthetic materials have been widely used in the clinic. The most prominent of these are biodegradable collagen sponges (Helistat®, United States), gelatin sponges (Ethicon®, SURGIFOAM®, United States), chitosan (AllaQuixTM, ChitoSAMTM, United States), cellulose (Tabotamp®, SURGICEL®, United States), and the newly investigated extracellular matrix gels, etc. Although these materials have excellent hemostatic properties, they also have their advantages and disadvantages. In this review, the performance characteristics, hemostatic effects, applications and hemostatic mechanisms of various biomaterials mentioned above are presented, followed by several strategies to improve hemostasis, including modification of single materials, blending of multiple materials, design of self-assembled peptides and their hybrid materials. Finally, the exploration of more novel hemostatic biomaterials and relative coagulation mechanisms will be essential for future research on hemostatic methods.
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Affiliation(s)
- Yayuan Guo
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Nanqiong Cheng
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Hongxiao Sun
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Jianing Hou
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Yuchen Zhang
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Du Wang
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China
| | - Wei Zhang
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China,School of Medicine, Northwest University, Xi’an, Shaanxi Province, China
| | - Zhuoyue Chen
- Faculty of Life Science, Northwest University, Xi’an, Shaanxi Province, China,School of Medicine, Northwest University, Xi’an, Shaanxi Province, China,*Correspondence: Zhuoyue Chen,
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Criollo-Mendoza MS, Contreras-Angulo LA, Leyva-López N, Gutiérrez-Grijalva EP, Jiménez-Ortega LA, Heredia JB. Wound Healing Properties of Natural Products: Mechanisms of Action. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020598. [PMID: 36677659 PMCID: PMC9867334 DOI: 10.3390/molecules28020598] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
A wound is the loss of the normal integrity, structure, and functions of the skin due to a physical, chemical, or mechanical agent. Wound repair consists of an orderly and complex process divided into four phases: coagulation, inflammation, proliferation, and remodeling. The potential of natural products in the treatment of wounds has been reported in numerous studies, emphasizing those with antioxidant, anti-inflammatory, and antimicrobial properties, e.g., alkaloids, saponins, terpenes, essential oils, and polyphenols from different plant sources, since these compounds can interact in the various stages of the wound healing process. This review addresses the most current in vitro and in vivo studies on the wound healing potential of natural products, as well as the main mechanisms involved in this activity. We observed sufficient evidence of the activity of these compounds in the treatment of wounds; however, we also found that there is no consensus on the effective concentrations in which the natural products exert this activity. For this reason, it is important to work on establishing optimal treatment doses, as well as an appropriate route of administration. In addition, more research should be carried out to discover the possible side effects and the behavior of natural products in clinical trials.
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Affiliation(s)
- Marilyn S. Criollo-Mendoza
- Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a Eldorado Km 5.5, Col. Campo el Diez, Culiacán CP 80110, SI, Mexico
| | - Laura A. Contreras-Angulo
- Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a Eldorado Km 5.5, Col. Campo el Diez, Culiacán CP 80110, SI, Mexico
| | - Nayely Leyva-López
- Post-Doc. CONACYT-Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a Eldorado Km 5.5, Col. Campo El Diez, Culiacán CP 80110, SI, Mexico
| | - Erick P. Gutiérrez-Grijalva
- Cátedras CONACYT-Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a Eldorado Km 5.5, Col. Campo El Diez, Culiacán CP 80110, SI, Mexico
| | - Luis Alfonso Jiménez-Ortega
- Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a Eldorado Km 5.5, Col. Campo el Diez, Culiacán CP 80110, SI, Mexico
| | - J. Basilio Heredia
- Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a Eldorado Km 5.5, Col. Campo el Diez, Culiacán CP 80110, SI, Mexico
- Correspondence:
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Multifunctionalized alginate/polydopamine cryogel for hemostasis, antibacteria and promotion of wound healing. Int J Biol Macromol 2023; 224:1373-1381. [PMID: 36550789 DOI: 10.1016/j.ijbiomac.2022.10.223] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/07/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022]
Abstract
Hemostasis and anti-infection are crucial for emergency treatment of severe trauma. Developing functional biomaterial with efficient hemostasis, antibacterial activity and wound healing is of great social significance and clinical value to fast stop bleeding and save lives, but it is still challenged. Here we designed a series of multifunctionalized SA/PDA cryogels by using two-step cross-linking of dopamine and sodium alginate. The resulting interpenetrating network structure had good swelling ratio, excellent mechanical and shape memory properties. Compared with cotton gauze and gelatin sponge, the cryogels exhibited excellent activation of coagulation cascade, more blood cells and platelet adhesion. Due to the action of polydopamine, the cryogel also showed good antioxidant activity and photothermal antibacterial ability assisted by near-infrared radiation, as well as better wound healing performance than gelatin sponge and Tegaderm™ film. Moreover, in the tests of mouse tail docking model, rat femoral artery hemostasis model and non-compressible rabbit liver defect model, the treatment by SA/PDA cryogels presented less blood loss and shorter hemostasis time than cotton gauze and gelatin sponge. Therefore, SA/PDA cryogels with simple preparation process, low cost, and good biocompatibility would be applied in the variety of great clinical applications in bleeding control, anti-infection and wound healing, etc.
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Li XF, Lu P, Jia HR, Li G, Zhu B, Wang X, Wu FG. Emerging materials for hemostasis. Coord Chem Rev 2023. [DOI: 10.1016/j.ccr.2022.214823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Zhang X, Shi L, Xiao W, Wang Z, Wang S. Design of Adhesive Hemostatic Hydrogels Guided by the Interfacial Interactions with Tissue Surface. ADVANCED NANOBIOMED RESEARCH 2022. [DOI: 10.1002/anbr.202200115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Xiaobin Zhang
- Key Laboratory of Bio-inspired Materials and Interface Science Technical Institute of Physics and Chemistry Chinese Academy of Sciences Beijing 100190 P.R. China
- University of Chinese Academy of Sciences Beijing 100049 P.R. China
| | - Lianxin Shi
- Key Laboratory of Bio-inspired Materials and Interface Science Technical Institute of Physics and Chemistry Chinese Academy of Sciences Beijing 100190 P.R. China
- Binzhou Institute of Technology Binzhou 256600 P.R. China
| | - Wuyi Xiao
- Key Laboratory of Bio-inspired Materials and Interface Science Technical Institute of Physics and Chemistry Chinese Academy of Sciences Beijing 100190 P.R. China
- University of Chinese Academy of Sciences Beijing 100049 P.R. China
| | - Zhao Wang
- Key Laboratory of Bio-inspired Materials and Interface Science Technical Institute of Physics and Chemistry Chinese Academy of Sciences Beijing 100190 P.R. China
| | - Shutao Wang
- Key Laboratory of Bio-inspired Materials and Interface Science Technical Institute of Physics and Chemistry Chinese Academy of Sciences Beijing 100190 P.R. China
- University of Chinese Academy of Sciences Beijing 100049 P.R. China
- Qingdao Casfuture Research Institute Co. Ltd Qingdao 266109 P.R. China
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Zheng Y, Wu J, Zhu Y, Wu C. Inorganic-based biomaterials for rapid hemostasis and wound healing. Chem Sci 2022; 14:29-53. [PMID: 36605747 PMCID: PMC9769395 DOI: 10.1039/d2sc04962g] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
The challenge for the treatment of severe traumas poses an urgent clinical need for the development of biomaterials to achieve rapid hemostasis and wound healing. In the past few decades, active inorganic components and their derived composites have become potential clinical products owing to their excellent performances in the process of hemorrhage control and tissue repair. In this review, we provide a current overview of the development of inorganic-based biomaterials used for hemostasis and wound healing. We highlight the methods and strategies for the design of inorganic-based biomaterials, including 3D printing, freeze-drying, electrospinning and vacuum filtration. Importantly, inorganic-based biomaterials for rapid hemostasis and wound healing are presented, and we divide them into several categories according to different chemistry and forms and further discuss their properties, therapeutic mechanisms and applications. Finally, the conclusions and future prospects are suggested for the development of novel inorganic-based biomaterials in the field of rapid hemostasis and wound healing.
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Affiliation(s)
- Yi Zheng
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Jinfu Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Yufang Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
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