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Siegel R, Budri D, Morrison J. Uncontrolled Bleeding After Tongue Laceration Leading to a Difficult Airway in the Setting of Hemophilia A: A Case Report. Cureus 2022; 14:e31455. [DOI: 10.7759/cureus.31455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
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Notario-Pérez F, Martín-Illana A, Cazorla-Luna R, Ruiz-Caro R, Veiga MD. Applications of Chitosan in Surgical and Post-Surgical Materials. Mar Drugs 2022; 20:md20060396. [PMID: 35736199 PMCID: PMC9228111 DOI: 10.3390/md20060396] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/06/2023] Open
Abstract
The continuous advances in surgical procedures require continuous research regarding materials with surgical applications. Biopolymers are widely studied since they usually provide a biocompatible, biodegradable, and non-toxic material. Among them, chitosan is a promising material for the development of formulations and devices with surgical applications due to its intrinsic bacteriostatic, fungistatic, hemostatic, and analgesic properties. A wide range of products has been manufactured with this polymer, including scaffolds, sponges, hydrogels, meshes, membranes, sutures, fibers, and nanoparticles. The growing interest of researchers in the use of chitosan-based materials for tissue regeneration is obvious due to extensive research in the application of chitosan for the regeneration of bone, nervous tissue, cartilage, and soft tissues. Chitosan can serve as a substance for the administration of cell-growth promoters, as well as a support for cellular growth. Another interesting application of chitosan is hemostasis control, with remarkable results in studies comparing the use of chitosan-based dressings with traditional cotton gauzes. In addition, chitosan-based or chitosan-coated surgical materials provide the formulation with antimicrobial activity that has been highly appreciated not only in dressings but also for surgical sutures or meshes.
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Kou SG, Peters L, Mucalo M. Chitosan: A review of molecular structure, bioactivities and interactions with the human body and micro-organisms. Carbohydr Polym 2022; 282:119132. [PMID: 35123764 DOI: 10.1016/j.carbpol.2022.119132] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 12/14/2022]
Abstract
Chitosan has many desirable attributes e.g. antimicrobial properties and promoting wound healing, and is used in various applications. This article first discusses how degree of deacetylation (DD) and molecular weight (MW) impacts on what level of bioactivities chitosan manifests, then introduces the "molecular chain configuration" model to explain various possible mechanisms of antimicrobial interactions between chitosan with different MW and different types of bacteria. Similarly, the possible pathways of how chitosan reacts with cancer and the body's immune system to demonstrate immune and antitumor effects are also discussed by using this model. Moreover, the possible mechanisms of how chitosan enhances coagulation and wound healing are also discussed. With these beneficial bioactivities in mind, the application of chitosan in surgery, tissue engineering and oncology is outlined. This review concludes that as chitosan demonstrates many beneficial bioactivities via multiple mechanisms, it is an important polymer with a promising future in medicine.
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Affiliation(s)
| | - Linda Peters
- School of Science, University of Waikato, New Zealand
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Mu Y, Fu Y, Li J, Shao K, Pang J, Su C, Cai Y, Sun X, Cong X, Chen X, Feng C. Thrombin immobilized polydopamine-diatom biosilica for effective hemorrhage control. Biomater Sci 2021; 9:4952-4967. [PMID: 34075916 DOI: 10.1039/d0bm02116d] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In this study, an efficient composite hemostatic material (DA-diatom-T) was prepared, using a polydopamine layer as a linker to immobilize thrombin on the surface of diatom biosilica. DA-diatom-T retained the porous structure of the diatom with high water absorption capacity, which can absorb 31 times its own weight of water. The thrombin activity of DA-diatom-T was as high as 5.81 U mg-1 that could be maintained at 67% after 30 days at room temperature. DA-diatom-T exhibited non-toxicity to mouse fibroblast cell lines, favorable hemocompatibility and fast procoagulant ability. DA-diatom-T could promote the initiation of the coagulation process and increase platelet activity and blood clot strength to form a physical barrier at the wound. In an in vivo study, DA-diatom-T could significantly reduce the clotting time and reduce the bleeding volume. The above results showed that DA-diatom-T had potential as a new hemostatic material.
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Affiliation(s)
- Yuzhi Mu
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Yangmu Fu
- Department of Orthopaedics, Hainan Hospital of Chinese PLA General Hospital, Jianglin Road, Sanya 572013, P. R. China
| | - Jing Li
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Kai Shao
- Department of Central Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758# Hefei Road, Qingdao 266035, Shandong Province, China
| | - Jianhui Pang
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Chang Su
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Yibo Cai
- Department of Orthopaedics, Hainan Hospital of Chinese PLA General Hospital, Jianglin Road, Sanya 572013, P. R. China
| | - Xiaojie Sun
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Xin Cong
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
| | - Xiguang Chen
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China. and Qingdao National Laboratory for Marine Science and Technology, 1# Wenhai Road, Qingdao 266000, Shandong Province, China
| | - Chao Feng
- College of Marine Life Science, Ocean University of China, 5# Yushan Road, Qingdao 266003, Shandong Province, China.
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Cao J, Xiao L, Shi X. Injectable drug-loaded polysaccharide hybrid hydrogels for hemostasis. RSC Adv 2019; 9:36858-36866. [PMID: 35539059 PMCID: PMC9075136 DOI: 10.1039/c9ra07116d] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/02/2019] [Indexed: 12/25/2022] Open
Abstract
An injectable hydrogel with high adhesion strength, non-toxicity and low cost is highly desired for developing highly efficient hemostasis. In this study, we developed a new type of injectable adhesive drug loaded hydrogel utilizing the formation of Schiff-base linkages based on carboxymethyl chitosan (CMC), gelatin (GEL) and oxidized alginate (OSA). By optimizing the concentration of the biopolymers, the hybrid hydrogel (CMC-GEL/OSA) demonstrated an extremely fast gelation rate (30 s) and adhesive strength of 11 kPa. The freeze-dried hydrogel showed a three-dimensional porous structure. The hydrogel loaded with levofloxacin exhibited good antibacterial properties. Hemostatic performance of the hydrogel was demonstrated in a rat liver injury model. Compared with the untreated wound, the hemostasis time of the hydrogel treated wound was shortened by 84.2% and the blood loss was reduced by 82.2%. Thus, the proposed injectable hydrogel holds great potential applications for hemostasis, drug delivery and in other biomedical fields. A levofloxacin loaded CMC-GEL/OSA hydrogel was synthesized that exhibited good antibacterial properties, 84.2% shortened hemostatic time and 82.2% reduced blood loss.![]()
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Affiliation(s)
- Jinying Cao
- School of Resource and Environmental Science
- Key Laboratory for Biomass Resource Chemistry and Environmental Biotechnology of Hubei Province
- Wuhan University
- Wuhan
- China
| | - Ling Xiao
- School of Resource and Environmental Science
- Key Laboratory for Biomass Resource Chemistry and Environmental Biotechnology of Hubei Province
- Wuhan University
- Wuhan
- China
| | - Xiaowen Shi
- School of Resource and Environmental Science
- Key Laboratory for Biomass Resource Chemistry and Environmental Biotechnology of Hubei Province
- Wuhan University
- Wuhan
- China
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Fibrin-Modified Cellulose as a Promising Dressing for Accelerated Wound Healing. MATERIALS 2018; 11:ma11112314. [PMID: 30453657 PMCID: PMC6266344 DOI: 10.3390/ma11112314] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 02/07/2023]
Abstract
Dermal injuries and chronic wounds usually regenerate with scar formation. Successful treatment without scarring might be achieved by pre-seeding a wound dressing with cells. We aimed to prepare a wound dressing fabricated from sodium carboxymethylcellulose (Hcel® NaT), combined with fibrin and seeded with dermal fibroblasts in vitro. We fabricated the Hcel® NaT in a porous and homogeneous form (P form and H form, respectively) differing in structural morphology and in the degree of substitution of hydroxyl groups. Each form of Hcel® NaT was functionalized with two morphologically different fibrin structures to improve cell adhesion and proliferation, estimated by an MTS assay. Fibrin functionalization of the Hcel® NaT strongly enhanced colonization of the material with human dermal fibroblasts. Moreover, the type of fibrin structures influenced the ability of the cells to adhere to the material and proliferate on it. The fibrin mesh filling the void spaces between cellulose fibers better supported cell attachment and subsequent proliferation than the fibrin coating, which only enwrapped individual cellulose fibers. On the fibrin mesh, the cell proliferation activity on day 3 was higher on the H form than on the P form of Hcel® NaT, while on the fibrin coating, the cell proliferation on day 7 was higher on the P form. The Hcel® NaT wound dressing functionalized with fibrin, especially when in the form of a mesh, can accelerate wound healing by supporting fibroblast adhesion and proliferation.
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Rodriguez-Merchan EC. Fibrin glue for local haemostasis in haemophilia surgery. Hosp Pract (1995) 2017; 45:187-191. [PMID: 28942686 DOI: 10.1080/21548331.2017.1384689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/22/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Local fibrin glue (FG) appears to be a useful local haemostatic agent for severe haemorrhage in people with haemophilia (PWH) undergoing surgical procedures. AIM To evaluate the role of local FG in PWH. METHODS A review of the literature on the topic has been performed. RESULTS Local FG is not always necessary to achieve haemostasis in all surgical procedures performed in PWH. However, it could be a good adjunct therapy, primarily when a surgical field will bleed more than expected (e.g. patients with inhibitors), and also for circumcisions, dental extractions, and surgical treatment of pseudotumours. CONCLUSIONS Although correct surgical haemostasis can typically be achieved by the infusion of factor concentrate at the adequate dose, my recommendation for surgeons is always to have local FG by their side. Local FG appears to be an effective adjunctive therapy for cases in which bleeding is likely (e.g. patients with inhibitors), and for circumcisions, oral surgery, and treatment of pseudotumours. Through the use of local FG, the doses of factor concentrate necessary to prevent bleeding could be reduced, providing considerable cost savings.
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Panovski MJ, Fildishevski IV, Ognjenovic LL, Dejanova-Ilijevska VI. New Surgical Technologies Could Facilitate Surgical Hemostasis in Hemophilic Patients. Open Access Maced J Med Sci 2017; 5:295-298. [PMID: 28698745 PMCID: PMC5503725 DOI: 10.3889/oamjms.2017.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/02/2017] [Accepted: 04/05/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND It's assumed that surgery in haemophilia can be accomplished these days safely. AIM The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs. METHODS Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery. We used the available surgical technologies and techniques with a proven value in the best clinical practice, to achieve proper and permanent hemostasis. Postoperatively, the replacement therapy and thromboembolic prophylaxis was continued according to the international guidelines for the management of haemophilia. RESULTS The operative and post-operative periods were uneventful. No significant differences were found in the operation time in our hemophilic patients versus non-hemophilic patients. Significant differences related to the hospital stay duration were found in both patients compared with controls, due to the necessary replacement therapy. CONCLUSION With new surgical technologies, proper and permanent hemostasis can be achieved, without prolonging the operation time.
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Affiliation(s)
- Milcho J. Panovski
- University Clinic for Digestive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Igor V. Fildishevski
- University Clinic for Digestive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Ljubomir Lj. Ognjenovic
- University Clinic for Digestive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Violeta I. Dejanova-Ilijevska
- National Center for Hemophilia, Republic Institute for Transfusiology, Vodnjanska 17, Skopje 1109, Republic of Macedonia
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Givol N, Hirschhorn A, Lubetsky A, Bashari D, Kenet G. Oral surgery‐associated postoperative bleeding in haemophilia patients – a tertiary centre's two decade experience. Haemophilia 2014; 21:234-240. [DOI: 10.1111/hae.12573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- N. Givol
- Unit of Oral and Maxillofacial Surgery Soroka University Medical Center Beer ShevaIsrael
| | - A. Hirschhorn
- Department of Oral and Maxillofacial SurgerySheba Medical Center Ramat Gan Israel
- Sackler Medical School Tel Aviv UniversityRamat GanIsrael
| | - A. Lubetsky
- Sackler Medical School Tel Aviv UniversityRamat GanIsrael
- National Hemophilia Center Sheba Medical Center Ramat Gan Israel
| | - D. Bashari
- Sackler Medical School Tel Aviv UniversityRamat GanIsrael
- National Hemophilia Center Sheba Medical Center Ramat Gan Israel
| | - G. Kenet
- Sackler Medical School Tel Aviv UniversityRamat GanIsrael
- National Hemophilia Center Sheba Medical Center Ramat Gan Israel
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Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive-a Laboratory and Clinical Perspective. ISRN SURGERY 2014; 2014:203943. [PMID: 24729902 PMCID: PMC3960746 DOI: 10.1155/2014/203943] [Citation(s) in RCA: 200] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 11/18/2013] [Indexed: 02/07/2023]
Abstract
Background. Fibrin sealant became the first modern era material approved as a hemostat in the United States in 1998. It is the only agent presently approved as a hemostat, sealant, and adhesive by the Food and Drug Administration (FDA). The product is now supplied as patches in addition to the original liquid formulations. Both laboratory and clinical uses of fibrin sealant continue to grow. The new literature on this material also continues to proliferate rapidly (approximately 200 papers/year). Methods. An overview of current fibrin sealant products and their approved uses and a comprehensive PubMed based review of the recent literature (February 2012, through March 2013) on the laboratory and clinical use of fibrin sealant are provided. Product information is organized into sections based on a classification system for commercially available materials. Publications are presented in sections based on both laboratory research and clinical topics are listed in order of decreasing frequency. Results. Fibrin sealant remains useful hemostat, sealant, and adhesive. New formulations and applications continue to be developed. Conclusions. This agent remains clinically important with the recent introduction of new commercially available products. Fibrin sealant has multiple new uses that should result in further improvements in patient care.
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Emir S, Bali İ, Sözen S, Yazar FM, Kanat BH, Gürdal SÖ, Özkan Z. The efficacy of fibrin glue to control hemorrhage from the gallbladder bed during laparoscopic cholecystectomy. ULUSAL CERRAHI DERGISI 2013; 29:158-61. [PMID: 25931869 DOI: 10.5152/ucd.2013.2319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/24/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of the study is to report our experience with fibrin glue application in the management of bleeding from the gallbladder bed during laparoscopic cholecystectomy, which could not be controlled by conventional methods. MATERIAL AND METHODS Three hundred eighty-two patients underwent laparoscopic cholecystectomy. Fourteen patients with bleeding from the gallbladder bed, which could not be controlled by conventional methods, were analyzed retrospectively. RESULTS Fibrin glue was used in 10 patients. Six (71%) were female and 4 were (29%) male. The mean age was 55.7 years. Fourteen patients were operated for the presence of symptomatic gallstones. Thirteen patients (92%) had a concomitant pathology. The mean time spent to maintain hemostasis was 23.9 minutes (15-35). Blood products were used in two patients with hemoglobin values under 8 mg/dL. Hemostasis could not be achieved in a patient despite fibrin glue application, and the operation was converted to open surgery. CONCLUSION The application of fibrin glue for bleeding from the gallbladder bed during laparoscopic cholecystectomy can reduce conversion rates, further studies including more patients are required.
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Affiliation(s)
- Seyfi Emir
- Department of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - İlhan Bali
- Department of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Selim Sözen
- Department of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Fatih Mehmet Yazar
- Department of General Surgery, Elazığ Teaching and Training Hospital, Elazığ, Turkey
| | - Burhan Hakan Kanat
- Department of General Surgery, Elazığ Teaching and Training Hospital, Elazığ, Turkey
| | - Sibel Özkan Gürdal
- Department of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Zeynep Özkan
- Department of General Surgery, Elazığ Teaching and Training Hospital, Elazığ, Turkey
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Bernasek T, Mangar D, Omar HR, Lyons S, Karlnoski RA, Chen R, Baumgarten A, Sprenker CJ, Camporesi EM. Bloodless surgery by a regional intraarterial tourniquet during primary and revision THA. Orthopedics 2013; 36:e1527-33. [PMID: 24579225 DOI: 10.3928/01477447-20131120-17] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Primary total hip arthroplasty (THA) and revision THA are associated with blood loss that can be significant. The purpose of this retrospective study was to compare the efficacy of intra-arterial occlusive balloons in reducing blood loss during primary and revision THA. Twelve patients (Jehovah’s Witnesses) scheduled for a primary (n=6) or revision (n=6) THA who refused blood transfusions were compared with 48 control-matched patients (primary THA, n=24; revision THA, n=24). All Jehovah’s Witnesses received an intra-arterial balloon preoperatively, and all control patients underwent conventional surgery. Intraoperatively, balloons were periodically inflated to reduce blood loss and deflated to prevent limb ischemia. Endpoints for the study were estimated blood loss, perioperative hemoglobin, mean hospital stay, mean operative time, amount of intraoperative fluid or blood administered, and complications. None of the patients with an occlusive balloon received blood, whereas the primary THA group received an average of 0.6 units (P=.08) and the revision THA group received an average of 1.9 units (P=.02). Estimated blood loss was significantly decreased in the balloon group compared with the primary THA group (145 vs 402 mL, respectively; P<.01) and the revision THA group (333 vs 767 mL, respectively; P<.01). No complications were associated with the intra-arterial balloons. All patients showed a significant reduction in hemoglobin immediately postoperatively compared with preoperative values. No statistically significant differences existed in the amount of fluids given intraoperatively or the mean hospital stay among all groups. Temporary internal tourniquets used as an adjuvant to surgery significantly reduce intraoperative blood loss during primary and revision THA.
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Eshghi P, Jenabzade A, Habibpanah B. A self-controlled comparative clinical trial to explore the effectiveness of three topical hemostatic agents for stopping severe epistaxis in pediatrics with inherited coagulopathies. ACTA ACUST UNITED AC 2013; 19:361-4. [PMID: 24164872 DOI: 10.1179/1607845413y.0000000135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to assess the effectiveness of localized treatments to persistently stop epistaxis in patients with inherited bleeding disorders. METHODS In a self-controlled comparative clinical trial, to offer the best solution to stop epistaxis at home (within 10 minutes), patients with inherited bleeding disorders were treated using three different topical hemostatic agents, including Tranexamic acid impregnated tampon, EpiCell tampon prepared from oxidized regenerated cellulose pad, and ChitoHem tampon (reinforced with chitosan). The results of using these different products on three groups of randomly selected patients were ultimately compared using the χ(2) and Fisher's exact test statistics. RESULTS A total of 31 patients, 5 females and 26 males with a mean age of 5.6 years, were included in the study. Twenty-three patients had Glanzmann disease, four had von-Willebrand disease, two had Bernard soulier syndrome, two had activated factor VII deficiency, and one patient had impaired secretion of adenosine deaminase. The study exhibited that statistically there was no significant difference between EpiCell tampon and Tranexamic acid impregnated tampon treatments with respect to the hemostasis duration. However, ChitoHem tampon was more efficient than Tranexamic acid impregnated tampon (P value <0.001) and EpiCell tampon (P value < 0.05). CONCLUSION ChitoHem tampon, the chitosan-reinforced product, was the best therapy solution to stop epistaxis. We recommend further research on the use of other hemostatic agents for localized bleeding in patients with inherited bleeding disorders.
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Busilacchi A, Gigante A, Mattioli-Belmonte M, Manzotti S, Muzzarelli RAA. Chitosan stabilizes platelet growth factors and modulates stem cell differentiation toward tissue regeneration. Carbohydr Polym 2013; 98:665-76. [PMID: 23987397 DOI: 10.1016/j.carbpol.2013.06.044] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 06/17/2013] [Accepted: 06/19/2013] [Indexed: 12/31/2022]
Abstract
The idea of using chitosan as a functional delivery aid to support simultaneously PRP, stem cells and growth factors (GF) is associated with the intention to use morphogenic biomaterials to modulate the natural healing sequence in bone and other tissues. For example, chitosan-chondroitin sulfate loaded with platelet lysate was included in a poly(D,L-lactate) foam that was then seeded with human adipose-derived stem cells and cultured in vitro under osteogenic stimulus: the platelet lysate provided to the bone tissue the most suitable assortment of GF which induces the osteogenic differentiation of the mesenchymal stem cells. PDGF, FGF, IGF and TGF-β were protagonists in the repair of callus fractures. The release of GF from the composites of chitosan-PRP and either nano-hydroxyapatite or tricalcium phosphate was highly beneficial for enhancing MSC proliferation and differentiation, thus qualifying chitosan as an excellent vehicle. A number of biochemical characteristics of chitosan exert synergism with stem cells in the regeneration of soft tissues.
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Affiliation(s)
- Alberto Busilacchi
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto 10-A, IT-60126 Ancona, Italy
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