Physical, antibacterial, blood coagulation, and healing promotion evaluations of chitosan derivative-based composite films

Chitosan is a potentially suitable material for wound dressing, but is undesirably water-insoluble. Although chitosan can be modified to produce water-soluble derivatives, the best chitosan derivative for wound dressings remains unclear. The present study introduced three water-soluble chitosan derivatives, namely, carboxymethyl chitosan, quaternized chitosan (QCS), and carboxymethyl quaternized chitosan, and explored the physical properties, biochemical properties, and wound care effectiveness of films of these derivatives. The QCS-based film exhibited higher absorption ability, mechanical properties, water-vapor permeability, electroconductivity, and antioxidant capacity than the other films. Most importantly, the cationic quaternary ammonium groups facilitated the antibacterial activity (>95 %) and blood coagulant capacity of the QCS-based film. As this film also promoted wound healing, it presented as an ideal candidate for wound dressings.

Synthesis of hemostatic aerogel of TEMPO-oxidized cellulose nanofibers/collagen/chitosan and in vivo/vitro evaluation

The treatment of internal hemorrhage remains challenging due to the current limited antibacterial capability, hemostatic efficacy, and biocompatibility of hemostatic materials. The TEMPO-oxidized cellulose nanofibers/collagen/chitosan (TCNF/COL/CS) hemostatic aerogel was developed in this work by physically encasing COL in a sandwich structure and electrostatically self-assembling polyanionic TCNF with polycationic CS. In vitro coagulation experiments revealed the favorable procoagulant properties of TCNF/COL/CS along with high adhesion to erythrocytes and platelets. TCNF/COL/CS significantly increased the hemostatic efficacy by 59.8 % and decreased blood loss by 62.2 % in the liver injury model when compared to Surgicel®, the most frequently used hemostatic material. Furthermore, it demonstrated outstanding biodegradability both in vitro and in vivo, and a substantial increase in resistance (96.8 % against E. coli and 95.4 % against S. aureus) compared to TCNF. The significant hemostatic and biodegradable characteristics of TCNF/COL/CS can be ascribed to its interconnected porous structure, increased porosity, and efficient water absorption, along with the synergistic effect of the three constituents. The TCNF/COL/CS aerogel shows significant potential to control internal bleeding. A novel plant-derived nanocellulose composite aerogel has been described here for the first time; it has outstanding antibacterial characteristics, higher biocompatibility, and outstanding hemostatic characteristics in vivo.

Recent advances and biomedical application of 3D printed nanocellulose-based adhesive hydrogels: A review

Nanocellulose-based tissue adhesives show promise for achieving rapid hemostasis and effective wound healing. Conventional methods, such as sutures and staples, have limitations, prompting the exploration of bioadhesives for direct wound adhesion and minimal tissue damage. Nanocellulose, a hydrolysis product of cellulose, exhibits superior biocompatibility and multifunctional properties, gaining interest as a base material for bioadhesive development. This study explores the potential of nanocellulose-based adhesives for hemostasis and wound healing using 3D printing techniques. Nanocellulose enables the creation of biodegradable adhesives with minimal adverse effects and opens avenues for advanced wound healing and complex tissue regeneration, such as skin, blood vessels, lungs, cartilage, and muscle. This study reviews recent trends in various nanocellulose-based 3D printed hydrogel patches for tissue engineering applications. The review also introduces various types of nanocellulose and their synthesis, surface modification, and bioadhesive fabrication techniques via 3D printing for smart wound healing.

Fabricating the multibranch carboxyl-modified cellulose for hemorrhage control

Excessive bleeding is associated with a high mortality risk. In this study, citric acid and ascorbic acid were sequentially modified on the surface of microcrystalline cellulose (MCAA) to increase its carboxyl content, and their potential as hemostatic materials was investigated. The MCAA exhibited a carboxylic group content of 9.52 %, higher than that of citric acid grafted microcrystalline cellulose (MCA) at 4.6 %. Carboxyl functionalization of microcrystalline cellulose surfaces not only plays a fundamental role in the structure of composite materials but also aids in the absorption of plasma and stimulation of platelets. Fourier -transform infrared (FT-IR), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS) spectra confirmed that carboxyl groups were successfully introduced onto the cellulose surface. Physical properties tests indicated that the MCAA possessed higher thermal stability (Tmax = 472.2 °C) compared to microcrystalline cellulose (MCC). Additionally, in vitro hemocompatibility, cytotoxicity and hemostatic property results demonstrated that MCAA displayed good biocompatibility (hemolysis ratio <1 %), optimal cell compatibility (cell viability exceeded 100 % after 72 h incubation), and impressive hemostatic effect (BCIMCAA = 31.3 %). Based on these findings, the hemostatic effect of covering a wound with MCAA was assessed, revealing enhanced hemostatic properties using MCAA in tail-amputation and liver-injury hemorrhage models. Furthermore, exploration into hemostatic mechanisms revealed that MCAA can significantly accelerate coagulation through rapid platelet aggregation and activation of the clotting cascade. Notably, MCAA showed remarkable biocompatibility and induced minimal skin irritation. In conclusion, the results affirmed that MCAA is a safe and potentially effective hemostatic agent for hemorrhage control.

Antibacterial Activity and Mechanism of Oxidized Bacterial Nanocellulose with Different Carboxyl Content

Oxidized bacterial nanocellulose (OBC) is reported to prevent microbial growth, but its antibacterial characteristics and mechanism are still unclear. Here, the antibacterial mechanism of OBC is explored by detecting and assessing the interaction of OBC with different carboxyl content on Staphylococcus aureus and Escherichia coli. The results show that OBC has strong antibacterial activity and antibiofilm activity against S. aureus and E. coli, which is positively correlated with the carboxyl content of OBC. After OBC treatment, the bacteria adhesion is inhibited and the cell membrane is destroyed leading to increased permeability. Further investigation reveals that the concentration of cyclic diguanosine monophosphate (c-di-GMP) that induced biofilm formation is significantly decreased to 1.81 pmol mg^-1 after OBC treatment. In addition, OBC inactivates mature biofilms, with inactivation rates up to 79.3%. This study suggests that OBC has excellent antibacterial and antiadhesion properties, which can increase the cell membrane permeability and inhibit c-di-GMP formation. In addition, OBC also has a strong inactivation effect on mature biofilm, which can be used as an effective antibiofilm agent.

Biocompatible carboxymethyl chitosan-modified glass ionomer cement with enhanced mechanical and anti-bacterial properties

Due to the potential adverse effects of conventional dental cements, the demand for biocompatible cements have grown tremendously in the field of dentistry. In this respect, Glass ionomer cements (GICs) are being developed by different researchers. However, low mechanical strength of GIC make them unsuitable for application in high-stress areas. Thus, numerous initiatives to improve mechanical performance have been attempted till date including incorporation of reinforcing fillers. Novelty of the study lies in using carboxymethyl chitosan (CMC) to develop a biocompatible dental cement (DC/CMC-m-GP), which would have enhanced mechanical strength due to greater interaction of CMC with the particles of GIC and better cyto-compatibility due to its cell-proliferation activity. The mechanical strength, acid erosion and fluoride release of DC/CMC-m-GP were studied and compared with control dental cement (DC/Control). DC/CMC-m-GP shows compressive strength of 157.45 M Pa and flexural strength of 18.76 M Pa which was higher as compared to DC/Control. The morphology of the GICs were studied through FESEM. Anti-microbial activity of DC/CMC-m-GP was studied by Agar disc-diffusion method and biofilm assay against S. mutans, which shows that DC/CMC-m-GP inhibits bacterial adhesion on its surface. MTT assay infers that DC/CMC-m-GP was non-cytotoxic and did not affect the cell viability significantly.

Preparation and shape change of silver nanoparticles (AgNPs) loaded on the dialdehyde cellulose by in-situ synthesis method

With the improvement of medical and health care level in our society, the demand for antibacterial materials is increasing. In this work, we prepared the antibacterial materials by loading silver nanoparticles (AgNPs) on the dialdehyde cellulose (DAC) with in-situ synthesis method. DAC was prepared by pretreating cellulose fiber with sodium metaperiodate (NaIO₄) to convert the hydroxyl group into aldehyde group, and then reacted with silver nitrate (AgNO₃) to obtain AgNPs loaded on DAC. UV-Vis results show that the characteristic absorption peak of AgNPs at 428 nm appeared in the AgNPs-loaded-DAC. It was observed by SEM that the spherical AgNPs were distributed uniformly on the DAC surface without obvious flocculation. The color of DAC was not changed significantly, indicating that a small amount of AgNPs was loaded. In addition, sodium citrate (Na₃C₆H₅O₇) was added in the reaction of DAC and AgNO₃ and its effect on the formation of AgNPs was studied. The results demonstrated that the color of DAC turned deeper and finally dark yellow with reaction time extended. When the reaction time was 60 h, the spherical AgNPs were gradually grown and transformed into triangular prism on the DAC surface. The antibacterial properties of AgNPs showed inhibition zones of 4.90 mm and 7.35 mm (60 h) against Gram-negative (E. coli) and Gram-positive (S. aureus), respectively, which increased by 40.00% and 14.85% compared with spherical AgNPs (2.5 h) obtained without Na₃C₆H₅O₇. The research of AgNPs-loaded cellulose-based materials promotes the development prospect of new nano-antibacterial materials.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10570-022-04692-6.

N, O-carboxymethyl chitosan/oxidized cellulose composite sponge containing ε-poly-l-lysine as a potential wound dressing for the prevention and treatment of postoperative adhesion

Herein, we designed and fabricated a biodegradable composite sponge which main component contained N, O-carboxymethyl chitosan (N,O-CS) and oxidized cellulose nanocrystals (TOCN) as a potential wound dressing for the prevention and treatment of postoperative adhesion. In order to improve antimicrobial properties of N,O-CS/TOCN composite sponges, natural antimicrobial agents (ε-Poly-l-Lysine，EPL) were successfully introduced and the EPL/N,O-CS/TOCN composite sponge exhibited excellent antibacterial properties and biological security. The EPL/N,O-CS/TOCN composite sponge can be degraded in vivo within 3 weeks. Finally, we analyzed the anti-adhesion performance of EPL/N,O-CS/TOCN composite sponge through a rat model of sidewall defect-cecum abrasion. These results demonstrated that EPL/N,O-CS/TOCN-treated group can effectively reduce the peritoneal adhesion formation than the commercial soluble gauze group and normal saline group, which mainly attribute to the excellent hemostatic function and tissue repair function of EPL/N,O-CS/TOCN composite sponge. It is believed that the EPL/N,O-CS/TOCN composite sponge will prove to be as a new medical device treat the internal tissue/organ repair and simultaneous prevention of postoperative adhesion.

Natural-Fiber-Reinforced Chitosan, Chitosan Blends and Their Nanocomposites for Various Advanced Applications

There has been much effort to provide eco-friendly and biodegradable materials for the next generation of composite products owing to global environmental concerns and increased awareness of renewable green resources. This review article uniquely highlights the use of green composites from natural fiber, particularly with regard to the development and characterization of chitosan, natural-fiber-reinforced chitosan biopolymer, chitosan blends, and chitosan nanocomposites. Natural fiber composites have a number of advantages such as durability, low cost, low weight, high specific strength, non-abrasiveness, equitably good mechanical properties, environmental friendliness, and biodegradability. Findings revealed that chitosan is a natural fiber that falls to the animal fiber category. As it has a biomaterial form, chitosan can be presented as hydrogels, sponges, film, and porous membrane. There are different processing methods in the preparation of chitosan composites such as solution and solvent casting, dipping and spray coating, freeze casting and drying, layer-by-layer preparation, and extrusion. It was also reported that the developed chitosan-based composites possess high thermal stability, as well as good chemical and physical properties. In these regards, chitosan-based "green" composites have wide applicability and potential in the industry of biomedicine, cosmetology, papermaking, wastewater treatment, agriculture, and pharmaceuticals.

Development of Cellulose Nanofibril/Casein-Based 3D Composite Hemostasis Scaffold for Potential Wound-Healing Application

Excessive bleeding in traumatic hemorrhage is the primary concern for natural wound healing and the main reason for trauma deaths. The three-dimensional (3D) bioprinting of bioinks offers the desired structural complexity vital for hemostasis activity and targeted cell proliferation in rapid and controlled wound healing. However, it is challenging to develop suitable bioinks to fabricate specific 3D scaffolds desirable in wound healing. In this work, a 3D composite scaffold is designed using bioprinting technology and synergistic hemostasis mechanisms of cellulose nanofibrils (TCNFs), chitosan, and casein to control blood loss in traumatic hemorrhage. Bioinks that consist of casein bioconjugated TCNF (with a casein content of 104.5 ± 34.1 mg/g) using the carbodiimide cross-linker chemistry were subjected to bioprinting for customizable 3D scaffold fabrication. Further, the 3D composite scaffolds were in situ cross-linked using a green ionic complexation approach. The covalent conjugation among TCNF, casein, and chitosan was confirmed by Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR), X-ray photoelectron spectroscopy (XPS), sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and X-ray diffraction (XRD) studies. The in vitro hemostasis activity of the 3D composite scaffold was analyzed by a human thrombin-antithrombin (TAT) assay and adsorption of red blood cells (RBCs) and platelets. The 3D composite scaffold had a better swelling behavior and a faster whole blood clotting rate at each time point than the 3D TCNF scaffold and commercial cellulose-based dressings. The TAT assay demonstrated that the 3D composite scaffold could form a higher content of thrombin (663.29 pg/mL) and stable blood clot compared to a cellulosic pad (580.35 pg/mL), 3D TCNF (457.78 pg/mL), and cellulosic gauze (328.92 pg/mL), which are essential for faster blood coagulation. In addition, the 3D composite scaffold had a lower blood clotting index (23.34%) than the 3D TCNF scaffold (41.93%), suggesting higher efficiencies for RBC entrapping to induce blood clotting. The in vivo cytocompatibility was evaluated by a 3D cell culture study, and results showed that the 3D composite scaffold could promote growth and proliferation of NIH 3T3 fibroblast cells, which is vital for wound healing. Cellulase-based in vitro deconstruction of the 3D composite scaffold showed significant weight loss (80 ± 5%) compared to the lysozyme hydrolysis (22 ± 5%) after 28 days of incubation, suggesting the biodegradation potential of the composite scaffold. In conclusion, this study proposes efficient prospects to develop a 3D composite scaffold from bioprinting of TCNF-based bioinks that can accelerate blood clotting and wound healing, suggesting its potential application in reducing blood loss during traumatic hemorrhage.

Assessment of the Potential of Using Nanofiltration Polymeric and Ceramic Membranes to Treat Refinery Spent Caustic Effluents

Spent caustic effluents are very challenging due to their very hazardous nature in terms of toxicity as well as their extreme pH (approximately 12–14). Spent caustic has presented a challenge for wastewater treatment in refineries, due to its composition rich in mercaptans, sulfides and other aromatic compounds. To address such problems, membrane filtration was studied using real effluents from Sines Refinery, in Portugal. The present study attempts to assess the potential for spent caustic treatment with nanofiltration (NF) polymeric and ceramic membranes, assessing membrane life expectancy. For that, membrane aging studies in static mode were performed with the polymeric membrane before attempting NF treatment (dynamic studies). A ceramic membrane was also tested for the first time with this type of effluents, though only in dynamic mode. Although the polymeric membrane performance was very good and in accordance with previous studies, its lifespan was very reduced after 6 weeks of contact with spent caustic, compromising its use in an industrial unit. Contrarily to expectations, the ceramic membrane tested was not chemically more resistant than the polymeric one upon direct contact with spent caustic (loss of retention capacity in less than 1 h in contact with the spent caustic). The results obtained suggest that a pH of 13.9 is very aggressive, even for ceramic membranes.

Thermal Stability and Dynamic Mechanical Properties of Poly(ε-caprolactone)/Chitosan Composite Membranes

Poly (ε-caprolactone) (PCL) and chitosan (CS) are widely used as biodegradable and biocompatible polymers with desirable properties for tissue engineering applications. Composite membranes (CS-PCL) with various blend ratios (CS:PCL, w/w) of 0:100, 5:95, 10:90, 15:85, 20:80, and 100:0 were successfully prepared by lyophilization. The thermal stabilities of the CS-PCL membranes were systematically characterized by thermogravimetric analysis (TG), dynamic thermogravimetry (DTG), and differential scanning calorimetry (DSC). It was shown that the blend ratio of PCL and CS had a significant effect on the thermal stability, hydrophilicity, and dynamic mechanical viscoelasticity of the CS-PCL membranes. All the samples in the experimental range exhibited high elasticity at low temperature and high viscosity at high temperatures by dynamic mechanical thermal analysis (DMTA). The performances of the CS-PCL membranes were at optimum levels when the blend ratio (w/w) was 10:90. The glass transition temperature of the CS-PCL membranes increased from 64.8 °C to 76.6 °C compared to that of the pure PCL, and the initial thermal decomposition temperature reached 86.7 °C. The crystallinity and porosity went up to 29.97% and 85.61%, respectively, while the tensile strength and elongation at the breakage were 20.036 MPa and 198.72%, respectively. Therefore, the 10:90 (w/w) blend ratio of CS/PCL is recommended to prepare CS-PCL membranes for tissue engineering applications.

Injectable, Self-Healing, and Biocompatible N,O-Carboxymethyl Chitosan/Multialdehyde Guar Gum Hydrogels for Sustained Anticancer Drug Delivery

Local delivery of anticancer agents via injectable hydrogels could be a promising method for achieving spatiotemporal control on drug release as well as minimizing the disadvantages related to the systemic mode of drug delivery. Keeping this in mind, we report the development of N,O-carboxymethyl chitosan (N,O-CMCS)-guar gum-based injectable hydrogels for the sustained delivery of anticancer drugs. The hydrogels were synthesized by chemical crosslinking of multialdehyde guar gum (MAGG) and N,O-CMCS through dynamic Schiff base linkages, without requiring any external crosslinker. Fabrication of injectable hydrogels, involving N,O-CMCS and MAGG via Schiff base crosslinking, is being reported for the first time. The hydrogels exhibited pH-responsive swelling behavior and good mechanical properties with a storage modulus of about 1625 Pa. Due to the reversible nature of Schiff base linkages, hydrogels displayed excellent self-healing and thixotropic properties. Doxorubicin (Dox), an anticancer agent, was loaded onto these hydrogels and its release studies were conducted at pH 7.4 (physiological) and pH 5.5 (tumoral). A sustained release of about 67.06% Dox was observed from the hydrogel after 5 days at pH 5.5 and about 32.13% at pH 7.4. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay on the human embryonic kidney cell line (HEK-293) and the hemolytic assay demonstrated the biocompatible nature of the hydrogels. The Dox-loaded hydrogel exhibited a significant killing effect against breast cancer cells (MCF-7) with a cytotoxicity of about 72.13%. All the data presented support the efficiency of the synthesized N,O-CMCS/MAGG hydrogel as a biomaterial that may find promising applications in anticancer drug delivery.

Antibacterial, hemostasis, adhesive, self-healing polysaccharides-based composite hydrogel wound dressing for the prevention and treatment of postoperative adhesion

Herein, we fabricated novel self-healing, in situ injectable, biodegradable, and non-toxic hydrogels anti-adhesion barrier materials composed of N, O-carboxymethyl chitosan (N,O-CS) and oxidized dextran (ODA) without requiring any chemical cross-linking agent or external stimuli triggers for the prevention and treatment of post-operative peritoneal adhesions. The N,O-CS/ODA hydrogels have a good suitable gelation time, good cytocompatibility and hemocompatibility, good antibacterial activity, excellent biodegradable and biocompatible, and can effectively inhibit the adhesion of fibroblasts to the wound, thereby suggesting that N,O-CS/ODA hydrogels are suitable for preventing post-operative adhesion. Meanwhile, a rat injury sidewall-cecum abrasion model is developed to investigate the efficacy of these hydrogels in achieving post-operative anti-adhesion. A significant reduction of peritoneal adhesions (10% rat with lower score adhesion) is observed in the N,O-CS/ODA-hydrogel-treated group compared with the commercial hydrogel and control groups. These results demonstrated that N,O-CS/ODA hydrogel could effectively prevent post-operative peritoneal adhesion without side effects. Therefore, the N,O-CS/ODA hydrogels with multi-functional properties exhibit great potential for the prevention and treatment of postoperative adhesion.

Multifunctional Hydroxyapatite/Silver Nanoparticles/Cotton Gauze for Antimicrobial and Biomedical Applications

Medical textiles have played an increasingly important protection role in the healthcare industry. This study was aimed at improving the conventional cotton gauze for achieving advanced biomedical specifications (coloration, UV-protection, anti-inflammation, and antimicrobial activities). These features were obtained by modifying the cotton gauze fabrics via in-situ precipitation of hydroxyapatite nanoparticles (HAp NP), followed by in-situ photosynthesis of silver (Ag) NPs with ginger oil as a green reductant with anti-inflammation properties. The HAp-Ag NPs coating provides good UV-protection properties. To further improve the HAp and Ag NPs dispersion and adhesion on the surface, the cotton gauze fabrics were modified by cationization with chitosan, or by partial carboxymethylation (anionic modification). The influence of the cationic and anionic modifications and HAp and Ag NPs deposition on the cotton gauze properties (coloration, UV-protection, antimicrobial activities, and water absorption) was thoroughly assessed. Overall, the results indicate that chemical (anionic and cationic) modification of the cotton gauze enhances HAp and Ag NPs deposition. Chitosan can increase biocompatibility and promotes wound healing properties of cotton gauze. Ag NP deposition onto cotton gauze fabrics brought high antimicrobial activities against Candida albicans, Gram-positive and Gram-negative bacteria, and improved UV protection.

A glimpse on the function of chitosan as a dental hemostatic agent

Managing a bleeding patient can be a challenge during dental surgery. Profuse hemorrhage due to platelet defects, coagulation disorders, vascular anomalies, medication-induced patients, as well as inherited bleeding ailments result in soft tissue hematoma, septic shock, compromised airway, and in some severe cases, death could occur. A vast array of surgical hemostatic agents are available to stop bleeding, including chitosan-based hemostatic agents. Chitosan has an advantage over other topical hemostatic materials for its ability to promote shorter bleeding times and assist in healing. Massive behind-the-scene research and development efforts are ongoing to increase the performance of chitosan as a hemostatic agent. Numerous studies on chitosan use in dental hemostasis have registered it as being safe, biodegradable, biocompatible, promoting healing, antimicrobial and bioactive. This article reviews the application of chitosan in managing hemostasis in dental patients.

Preparation and characterization of carboxymethylated cotton fabrics as hemostatic wound dressing

Uncontrolled hemorrhage is a large cause of death in the global scope, thus leading to an urgent demand to develop efficient hemostatic materials. In this study, a series of modified cotton fabrics (MCFs) with different carboxymethyl group contents were prepared from cotton fabric (CF) by a carboxymethylation process to choose the appropriate one with the best hemostatic performance. The carboxymethyl group contents of MCFs rose up as the dosages of ClCH₂COOH increased. The crystallinity of CF decreased after carboxymethylation, and MCFs can dissolve slightly with the phenomenon that there were vague boundaries between fibers after being treated with water. Furthermore, the MCF with the carboxymethyl group content at 0.77 mmol/g (MCF-0.77) could absorb the blood quickly, achieve dense distribution of blood cells and have high viscosity of leaching liquor. In addition, the MCF-0.77 with good biocompatibility accelerated the hemostasis time to 46.6 ± 8.4 s compared with the CF (88.8 ± 31.5 s) in a rat model of liver injury. In summary, the prepared MCF-0.77 is a potential hemostatic wound dressing for clinical use since every second counts for pre-hospital care.

Injectable, self-healing, antibacterial, and hemostatic N,O-carboxymethyl chitosan/oxidized chondroitin sulfate composite hydrogel for wound dressing

Biodegradable and injectable hydrogels derived from natural polysaccharides have attracted extensive attention in biomedical applications due to their minimal invasiveness and ability to accommodate the irregular wound surfaces. In this work, we report the development of an in-situ-injectable, self-healing, antibacterial, hemostatic, and biocompatible hydrogel derived from the hybrid of N,O-carboxymethyl chitosan (N,O-CMC) and oxidized chondroitin sulfate (OCS), which did not require any chemical crosslinking. The N,O-CMC/OCS hydrogel could be readily produced under physiological conditions by varying the N,O-CMC-to-OCS ratio, relying on the Schiff base reaction between the -NH- functional groups of N,O-CMC and the -CHO functional groups of OCS. The results showed that the N,O-CMC2/OCS1 hydrogel had relatively long gelation time (133 s) and stable performances. The viability of NIH/3T3 cells and endothelial cells cultured with the N,O-CMC2/OCS1 hydrogel extract was roughly 85%, which demonstrated its low cell toxicity. Besides, the N,O-CMC2/OCS1 hydrogel revealed excellent antibacterial properties due to the inherent antibacterial ability of N,O-CMC. Importantly, the hydrogel tightly adhered to the biological tissue and demonstrated excellent in vivo hemostatic performance. Our work describing an injectable, self-healing, antibacterial, and hemostatic hydrogel derived from polysaccharides will likely hold good potential in serving as an enabling wound dressing material.

Fabrication of oxidized bacterial cellulose by nitrogen dioxide in chloroform/cyclohexane as a highly loaded drug carrier for sustained release of cisplatin

Carboxylated bacterial cellulose (OBC) was fabricated by oxidation with nitrogen dioxide in chloroform/cyclohexane and employed as a carrier for sustained release of antitumor substance cisplatin (CDDP). The influence of removing water method, solvent used in the synthesis, concentration of N₂O₄, and duration of the oxidation on content of carboxyl groups in reaction products was established. Due to the possibility of nitrogen dioxide to penetrate into cellulose crystallites, the carboxyl group content of the OBC reaches high values up to 4 mmol/g. In vitro degradation of OBC was determined under simulated physiological conditions. The immobilization of CDDP on OBC was studied in detail. The initial burst release of the drug from the polymer was depressed. The cytotoxicity of CDDP-loaded OBC was evaluated with HeLa cells. The unique structure and properties of OBC make it a great candidate as drug delivery carrier.

Research status and development potential of composite hemostatic materials

Through the discussion of the coagulation mechanism of compositehemostatic materials, the future development potential of hemostatic materials is proposed.

Oxidized cellulose-based hemostatic materials

The application of hemostatic agents is essential to prevent significant blood loss and death from excessive bleeding in surgical or emergency scenarios. Oxidized cellulose is an excellent biodegradable and biocompatible derivate of cellulose, which has become one of the most important hemostatic agents used in surgical procedures. However, to date, there has been no comprehensive report assessing oxidized cellulose-based hemostatic materials. Hence, this paper first reviewed the oxidation preparation, cellulose origin and structure, as well as biodegradability and safety of oxidized cellulose. Then a comprehensive review regarding the hemostatic mechanisms, various forms, modification, and current commercially available products of oxidized cellulose is discussed, which emphatically presents the most significant developments in the recent scientific literature. In conclusion, this paper summarizes the latest developments in oxidized cellulose-based hemostatic materials and provides a reference for further research and development in this field.

Influence of Different Pretreatments on the Antibacterial Properties of Chitosan Functionalized Viscose Fabric: TEMPO Oxidation and Coating with TEMPO Oxidized Cellulose Nanofibrils

The main objective of this study was to obtain chitosan functionalized viscose fabric with improved antibacterial properties and washing durability. In this regard carboxyl and aldehyde groups, as binding points for irreversible chitosan attachment into/onto viscose fabric, were introduced by two different pretreatments: 2,2,6,6-tetramethylpiperidine-1-oxy radical (TEMPO) oxidation and coating with TEMPO oxidized cellulose nanofibrils (TOCN). The Fourier transform infrared spectroscopy, elemental analysis, zeta potential measurements, scanning electron microscopy, breaking strength and antibacterial testing were used to evaluate the influence of these pretreatments on chitosan binding, but also on chemical, electrokinetic, morphological, mechanical and antibacterial properties of pretreated and chitosan functionalized viscose fabrics. Washing durability of chitosan functionalized viscose was monitored through changes in the chitosan content, electrokinetic and antibacterial properties after multiple washing. TOCN coating improves mechanical properties of fabric, while TEMPO oxidation deteriorates them. The results show that both pretreatments improve chitosan adsorption and thus antibacterial properties, which are highly durable to washing. After five washings, the chitosan functionalized pretreated viscose fabrics preserve their antibacterial activity against Staphylococcus aureus, while antibacterial activity against Escherichia coli was lost. TOCN coated and chitosan functionalized viscose fabric is a high value-added product with simultaneously improved antibacterial and mechanical properties, which may find application as medical textiles.

Chitosan-bound carboxymethylated cotton fabric and its application as wound dressing

Cotton fabric (CF) is commonly used in wound treatment, however, its hemostatic efficiency is far from sufficient. In this study, modified cotton fabric (MCF-0.39) was obtained by a carboxymethylation process, which endowed MCF-0.39 with good swelling ability and water absorption capacity. Chitosan (CHI) was bound to MCF-0.39 by the binder sodium carboxymethyl cellulose (NaCMC) via flat-screen printing technique to prepare the hybrid hemostatic material (CHI-MCF-0.39). The blood clotting index (BCI) of CHI-MCF-0.39 was 3.15-fold lower than that of CF, demonstrating the good clotting ability of the material. In rat liver injury and femoral artery animal model, the groups using CHI-MCF-0.39 had less hemostasis time and blood loss compared with those groups using CF. All the above results indicate that the prepared CHI-MCF-0.39 has promising future applications as effective hemostatic material in trauma treatment.

Manufacturing and physical characterization of absorbable oxidized regenerated cellulose braided surgical sutures

Suture is an important part of surgical operation, and closure of the wound associated with this procedure continuous to be a challenge in postoperative care. Currently, oxidized regenerated cellulose (ORC) is widely used in the absorption of hemostatic materials. However, there is no ORC medical suture product in the market. The objective of this article was to prepare novel braided sutures by TEMPO-mediated oxidation regenerated cellulose (TORC) to achieve a suturable material with biodegradability and ideal mechanical properties. Regenerated cellulose (RC) strands were made into sutures on a circular braiding machine, and TEMPO-mediated oxidation treatment was introduced alternatively after braiding. The RC sutures under different oxidation time were characterized by ATR-FTIR, electrical conductivity, XRD analysis, physical properties and in vitro degradation property. We further demonstrate that the RC sutures were oxidized and formed the carboxylic (-COOH) functional group. With the extension of oxidation duration, the carboxyl content in TORC sutures increased gradually from 5.1 to 10.4% and the strength, weight, and diameter of TORC sutures decreased gradually. Moreover, we proved that the knot-pull strength of TORC-45 declined by 77.8% after 28 days, thus this sutures fulfilled U.S. Pharmacopeia requirement of knot-pull strength. We have shown that TEMPO oxidation reaction significantly promoted the degradation of TORC sutures. Overall, TORC sutures were successfully produced with favorable biodegradability, revealing potential prospects of clinical applications.

Cytotoxicity, bactericidal and hemostatic evaluation of oxidized cellulose microparticles: Structure and oxidation degree approach

Oxidized cellulose is the most used hemostatic materials in clinical applications. In addition to its perfect hemostatic efficiency, it is degradable under in vivo conditions and supremely prevents bacterial growth. On the other hand, one of the drawbacks of the oxidized cellulose is cytotoxicity due to the strongly acidic nature during degradation. There is a number of commercially available oxidized cellulose products which are derived from regenerated and non-regenerated cellulose. On the other hand, the effect of oxidation degree and structure (regenerated or non-regenerated) on product efficiency is undetermined. Moreover, oxidation degree which is primary factor for both bactericidal and hemostatic efficiency is also crucial for assessment of the product. In this study, oxidized cellulose versus oxidized regenerated cellulose microparticles with various oxidation degree was produced and characterized. Comparative studies were conducted in terms of bactericidal and hemostatic efficiencies in addition to cytotoxicity. The results could be a reference for the optimized oxidized cellulose product for the hemostatic applications.

Chitosan-Based Composite Materials for Prospective Hemostatic Applications

Effective hemostasis is vital to reduce the pain and mortality of patients, and the research and development of hemostatic materials are prerequisite for effective hemostasis. Chitosan (CS), with good biodegradability, biocompatibility and non-toxicity, has been widely applied in bio-medicine, the chemical industry, the food industry and cosmetics. The excellent hemostatic properties of CS have been extensively studied. As a result, chitosan-based composite hemostatic materials have been emerging. In this review, the hemostatic mechanism of chitosan is briefly discussed, and then the progress of research on chitosan-based composite hemostatic materials with multiple forms such as films, sponges, hydrogels, particles and fibers are introduced. Finally, future perspectives of chitosan-based composite hemostatic materials are given. The objective of this review is to provide a reference for further research and development of effective hemostatic materials.