Polyelectrolyte Multilayer Films Modification with Ag and rGO Influences Platelets Activation and Aggregate Formation under In Vitro Blood Flow

Surface functionalization of materials to improve their hemocompatibility is a challenging problem in the field of blood-contacting devices and implants. Polyelectrolyte multilayer films (PEMs), which can mimic functions and structure of an extracellular matrix (ECM), are a promising solution to the urgent need for functional blood-contacting coatings. The properties of PEMs can be easily tuned in order to provide a scaffold with desired physico-chemical parameters. In this study chitosan/chondroitin sulfate (Chi/CS) polyelectrolyte multilayers were deposited on medical polyurethane. Afterwards PEMs were modified by chemical cross-linking and nanoparticles introduction. Coatings with variable properties were tested for their hemocompatibility in the cone-plate tester under dynamic conditions. The obtained results enable the understanding of how substrate properties modulate PEMs interaction with blood plasma proteins and the morphotic elements.

Electrospinning synthesis and assessment of physicochemical properties and biocompatibility of cobalt nitrate fibers for wound healing applications

The aim of this study was to develop polyurethane (PU) wound dressing incorporated with cobalt nitrate using electrospinning technique. The morphology analysis revealed that the developed composites exhibited reduced fiber and pore diameter than the pristine PU. The electrospun membranes exhibited average porosity in the range of 67% - 71%. Energy-dispersive X-ray spectra (EDS) showed the presence of cobalt in the PU matrix. The interaction of cobalt nitrate with PU matrix was evident in Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA). The contact angle results indicated the improved wettability of the prepared PU/cobalt nitrate composites (82° ± 2) than the pure PU (100° ± 1). The incorporation of cobalt nitrate into the PU matrix enhanced the surface roughness and mechanical strength as evident in the atomic force microscopy (AFM) and tensile test analysis. The blood compatibility assays revealed the anticoagulant nature of the prepared composites by displaying prolonged blood clotting time than the PU control. Further, the developed composite exhibited less toxicity nature as revealed in the hemolysis and cytotoxicity studies. It was observed that the PU wound dressing added with cobalt nitrate fibers exhibited enhanced physicochemical, better blood compatibility parameters and enhanced fibroblast proliferation rates which may serve as a potential candidate for wound dressings.

Electrospun polyurethane nanofibrous composite impregnated with metallic copper for wound-healing application

In this study, a wound dressing based on polyurethane (PU) blended with copper sulphate nanofibers was developed using an electrospinning technique. The prepared PU and PU nanocomposites showed smooth fibers without any bead defects. The prepared nanocomposites showed smaller fiber (663 ± 156.30 nm) and pore (888 ± 70.93 nm) diameter compared to the pristine PU (fiber diameter 1159 ± 147.48 nm and pore diameter 1087 ± 62.51 nm). The interaction of PU with copper sulphate was evident in the infrared spectrum through hydrogen-bond formation. Thermal analysis displayed enhanced weight residue at higher temperature suggesting interaction of PU with copper sulphate. The contact angle measurements revealed the hydrophilic nature of the prepared nanocomposites (71° ± 2.309°) compared with pure PU (100° ± 0.5774°). The addition of copper sulphate into the PU matrix increased the surface roughness, as revealed in the atomic force microscopy (AFM) analysis. Mechanical testing demonstrated the enhanced tensile strength behavior of the fabricated nanocomposites (18.58 MPa) compared with the pristine PU (7.12 MPa). The coagulation assays indicated the enhanced blood compatibility of the developed nanocomposites [activated partial thromboplastin time (APTT)-179 ± 3.606 s and partial thromboplastin time (PT)-105 ± 2.646 s] by showing a prolonged blood clotting time compared with the pristine PU (APTT-147.7 ± 3.512 s and PT-84.67 ± 2.517 s). Furthermore, the hemolysis and cytotoxicity studies suggested a less toxicity nature of prepared nanocomposites by displaying low hemolytic index and enhanced cell viability rates compared with the PU membrane. It was observed that the fabricated novel wound dressing possesses better physicochemical and enhanced blood compatibility properties, and may be utilized for wound-healing applications.

Proposal for a Quantitative Description of Blood Spiral Flow in Medical Devices

The association between specific blood flow patterns and blood behaviour through medical devices suggests that a Lagrangian study may be a useful instrument for the evaluation of the thrombogenic and/or hemolytic potential of certain devices' geometries and biomaterials. In this study a description of blood particle trajectories in terms of their spiral contents is proposed; such a mathematical description for blood spiral flow, computed along several pathlines, is tested for a quantitative determination of the spiralled motion of blood flow into two three-dimensional numerical models, having different design characteristics, of venous cannula inserted in a vessel. As the influence of vortical flow conditions have been observed to have both beneficial and detrimental influence on blood behaviour in terms of blood-device interaction, of the degradation of its components, and of the efficiency of mass-exchange (in red cells oxygenation and plasma filtration, for example), the herein proposed method for the description of spiral laminar motion may be a helpful instrument to build up a tool to investigate, for example, the existence of correlations between level of spiral flow and geometry (as in the present investigated test case), rather than the effects of blood-surface contact. The results obtained in this test case investigation, confirm the effectiveness of the proposed function for a quantitative analysis of spiral flow in medical devices.

Unravelling the potential of nitric acid as a surface modifier for improving the hemocompatibility of metallocene polyethylene for blood contacting devices

Design of blood compatible surfaces is obligatory to minimize platelet surface interactions and improve the thromboresistance of foreign surfaces when they are utilized as biomaterials particularly for blood contacting devices. Pure metallocene polyethylene (mPE) and nitric acid (HNO3) treated mPE antithrombogenicity and hydrophilicity were investigated. The contact angle of the mPE treated with HNO3 decreased. Surface of mPE and HNO3 treated mPE investigated with FTIR revealed no major changes in its functional groups. 3D Hirox digital microscopy, SEM and AFM images show increased porosity and surface roughness. Blood coagulation assays prothrombin time (PT) and activated partial thromboplastin time (APTT) were delayed significantly (P < 0.05) for HNO3 treated mPE. Hemolysis assay and platelet adhesion of the treated surface resulted in the lysis of red blood cells and platelet adherence, respectively indicating improved hemocompatibility of HNO3 treated mPE. To determine that HNO3 does not deteriorate elastic modulus of mPE, the elastic modulus of mPE and HNO3 treated mPE was compared and the result shows no significant difference. Hence, the overall observation suggests that the novel HNO3 treated mPE may hold great promises to be exploited for blood contacting devices like grafts, catheters, and etc.

Enhanced blood compatibility of metallocene polyethylene subjected to hydrochloric acid treatment for cardiovascular implants

Blood compatibility of metallocene polyethylene (mPE) was investigated after modifying the surface using hydrochloric acid. Contact angle of the mPE exposed to HCl poses a decrease in its value which indicates increasing wettability and better blood compatibility. Surface of mPE analyzed by using FTIR revealed no significant changes in its functional groups after treatment. Furthermore, scanning electron microscope images supported the increasing wettability through the modifications like pit formations and etching on the acid rendered surface. To evaluate the effect of acid treatment on the coagulation cascade, prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured. Both PT and APTT were delayed significantly (P < 0.05) after 60 min exposure implying improved blood compatibility of the surfaces. Hemolysis assay of the treated surface showed a remarkable decrease in the percentage of lysis of red blood cells when compared with untreated surface. Moreover, platelet adhesion assay demonstrated that HCl exposed surfaces deter the attachment of platelets and thereby reduce the chances of activation of blood coagulation cascade. These results confirmed the enhanced blood compatibility of mPE after HCl exposure which can be utilized for cardiovascular implants like artificial vascular prostheses, implants, and various blood contacting devices.

Obstacles in haemocompatibility testing

ISO 10993-4 is an international standard describing the methods of testing of medical devices for interactions with blood for regulatory purpose. The complexity of blood responses to biomaterial surfaces and the variability of blood functions in different individuals and species pose difficulties in standardisation. Moreover, in vivo or in vitro testing, as well as the clinical relevance of certain findings, is still matter of debate. This review deals with the major remaining problems, including a brief explanation of surface interactions with blood, the current ISO 10993 requirements for testing, and the role of in vitro test models. The literature is reviewed on anticoagulation, shear rate, blood-air interfaces, incubation time, and the importance of evaluation of the surface area after blood contact. Two test categories deserve further attention: complement and platelet function, including the effects on platelets from adhesion proteins, venipuncture, and animal derived- blood. The material properties, hydrophilicity, and roughness, as well as reference materials, are discussed. Finally this review calls for completing the acceptance criteria in the ISO standard based on a panel of test results.

Generic nitric oxide (NO) generating surface by immobilizing organoselenium species via layer-by-layer assembly

A universal nitric oxide (NO) generating surface is assembled via Layer-by-Layer (LbL) deposition of sodium alginate (Alg) and organoselenium modified polyethyleneimine (SePEI) on quartz and polymeric substrates. The immobilized SePEI species is capable of catalytically decomposing S-nitrosothiol species (RSNO) to NO in the presence of thiol reducing agents (e.g., glutathione, cysteine, etc.). The stepwise buildup of the multilayer films is monitored by UV-vis spectroscopy, SEM and surface contact angle measurements. X-ray photoelectron spectroscopy is used to study the stoichiometry between the polyanion and polycation, and also the presence of Se in the catalytic LbL film. A reductive annealing process is necessary to improve the stability of freshly coated multilayer films via chain rearrangement. Chemiluminescence measurements illustrate the ability of the LbL films to generate NO from S-nitrosoglutathione (GSNO) in the presence of glutathione (GSH). Enhanced NO fluxes can be achieved by increasing the number of catalytic (SePEI/Alg) bilayers coated on the substrates. Nitric oxide generation is observed even after prolonged contact with sheep whole blood. Preliminary applications of this LbL on silicone rubber tubings and polyurethane catheters reveal similar NO generation behavior from these biomedical grade polymeric substrates.