Hemostatic and Tissue Regeneration Performance of Novel Electrospun Chitosan-Based Materials

Recent advances of chitosan as a hemostatic material: Hemostatic mechanism, material design and prospective application

Uncontrolled hemorrhage arising from surgery or trauma may cause morbidity and even mortality. Therefore, facilitating control of severe bleeding is imperative for health care worldwide. Among diverse hemostatic materials, chitosan (CS) is becoming the most promising material owing to its non-toxic feature, as well as inherently hemostatic performance. However, further enhancing hemostatic property of CS-based materials without compromising more beneficial functions remains a challenge. In this review, representative hemostatic mechanisms of CS-based materials are firstly discussed in detail, mostly including red blood cells (RBCs) aggregation, platelet adherence and aggregation, as well as interaction with plasma proteins. Also, various forms (involving powder/particle, sponge, hydrogel, nanofiber, and other forms) of CS-based hemostatic materials are systematically summarized, mainly focusing on their design and preparation, characteristics, and comparative analysis of various forms. In addition, varied hemostatic applications are described in detail, such as skin wound hemostasis, liver hemostasis, artery hemostasis, and heart hemostasis. Finally, current challenges and future directions of functional design of CS-based hemostatic materials in diverse hemostatic applications are proposed to inspire more intensive researches.

Electrospun nanofiber membranes for rapid liver hemostasis via N-alkylated chitosan doped chitosan/PEO

The ideal hemostatic agents should be able to stop bleeding quickly and avoid secondary bleeding caused by adhesion with blood clots during dressing change. Herein, a hydrophobic electrospun nanofiber membrane was prepared for achieving hemostasis, rationally targeting both attributes, via doping N-alkylated chitosan (N-CS) grafted with octadecyl into chitosan/polyethylene oxide (PEO). In vitro and in vivo coagulation tests showed that CPNs doped with small amounts of N-CS (CPN31) could significantly shorten hemostasis time and promote the formation of more stable and stronger blood clots. In particular, the whole blood clotting time of CPN31 (58.8 ± 2.2 s) was significantly lower than that of chitosan/PEO (CPN0) nanofiber membrane (67 ± 3.5 s) and the medical sterile gauze (86.7 ± 0.6 s). Furthermore, due to the hemophobic nature of CPNs, blood wetting of the dressing was severely limited and blood can coagulated at the site of liver injury in rats, thus reducing blood loss and allowing rapid removal of the dressing without triggering secondary hemorrhage. The CPN31 exhibited excellent hemostasis properties, easy to remove, blood compatibility, biocompatibility and promoting fibroblast proliferation properties. This hydrophobic CPNs is a promising biological adhesive for hemorrhage control.

Exploring the potential of polysaccharide-based hybrid hydrogel systems for their biomedical and therapeutic applications: A review

Hydrogels are a versatile category of biomaterials that have been widely applied in the fields of biomedicine for the last several decades. The three-dimensional polymeric crosslinked hydrophilic structures of the hydrogel can proficiently hold drugs, nanoparticles, and cells, making them a potential delivery system. However, disadvantages like low mechanical strength, poor biocompatibility, and unusual in-vivo biodegradation are associated with conventional hydrogels. To overcome these hurdles, hybrid hydrogels are designed using two or more structurally different polymeric units. Polysaccharides, characterized by their innate biocompatibility, biodegradability, and abundance, establish an ideal foundation for the development of these hybrid hydrogels. This review aims to discuss the studies that have utilized naturally occurring polysaccharides to prepare hybrid systems, which were aimed for various biomedical applications such as tissue engineering, bone and cartilage regeneration, wound healing, skin cancer treatment, antimicrobial therapy, osteoarthritis treatment, and drug delivery. Furthermore, this review extensively examines the properties of the employed polysaccharides within hydrogel matrices, emphasizing the advantageous characteristics that make them a preferred choice. Furthermore, the challenges associated with the commercial implementation of these systems are explored alongside an assessment of the current patent landscape.

Integrating Chinese Herbs and Western Medicine for New Wound Dressings through Handheld Electrospinning

In this nanotechnology era, nanostructures play a crucial role in the investigation of novel functional nanomaterials. Complex nanostructures and their corresponding fabrication techniques provide powerful tools for the development of high-performance functional materials. In this study, advanced micro-nanomanufacturing technologies and composite micro-nanostructures were applied to the development of a new type of pharmaceutical formulation, aiming to achieve rapid hemostasis, pain relief, and antimicrobial properties. Briefly, an approach combining a electrohydrodynamic atomization (EHDA) technique and reversed-phase solvent was employed to fabricate a novel beaded nanofiber structure (BNS), consisting of micrometer-sized particles distributed on a nanoscale fiber matrix. Firstly, Zein-loaded Yunnan Baiyao (YB) particles were prepared using the solution electrospraying process. Subsequently, these particles were suspended in a co-solvent solution containing ciprofloxacin (CIP) and hydrophilic polymer polyvinylpyrrolidone (PVP) and electrospun into hybrid structural microfibers using a handheld electrospinning device, forming the EHDA product E3. The fiber-beaded composite morphology of E3 was confirmed through scanning electron microscopy (SEM) images. Fourier-transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD) analysis revealed the amorphous state of CIP in the BNS membrane due to the good compatibility between CIP and PVP. The rapid dissolution experiment revealed that E3 exhibits fast disintegration properties and promotes the dissolution of CIP. Moreover, in vitro drug release study demonstrated the complete release of CIP within 1 min. Antibacterial assays showed a significant reduction in the number of adhered bacteria on the BNS, indicating excellent antibacterial performance. Compared with the traditional YB powders consisting of Chinese herbs, the BNS showed a series of advantages for potential wound dressing. These advantages include an improved antibacterial effect, a sustained release of active ingredients from YB, and a convenient wound covering application, which were resulted from the integration of Chinese herbs and Western medicine. This study provides valuable insights for the development of novel multiscale functional micro-/nano-composite materials and pioneers the developments of new types of medicines from the combination of herbal medicines and Western medicines.

Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances

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.

Turning gray selenium and sublimed sulfur into a nanocomposite to accelerate tissue regeneration by isothermal recrystallization

BACKGROUND

Globally, millions of patients suffer from regenerative deficiencies, such as refractory wound healing, which is characterized by excessive inflammation and abnormal angiogenesis. Growth factors and stem cells are currently employed to accelerate tissue repair and regeneration; however, they are complex and costly. Thus, the exploration of new regeneration accelerators is of considerable medical interest. This study developed a plain nanoparticle that accelerates tissue regeneration with the involvement of angiogenesis and inflammatory regulation.

METHODS

Grey selenium and sublimed sulphur were thermalized in PEG-200 and isothermally recrystallised to composite nanoparticles (Nano-Se@S). The tissue regeneration accelerating activities of Nano-Se@S were evaluated in mice, zebrafish, chick embryos, and human cells. Transcriptomic analysis was performed to investigate the potential mechanisms involved during tissue regeneration.

RESULTS

Through the cooperation of sulphur, which is inert to tissue regeneration, Nano-Se@S demonstrated improved tissue regeneration acceleration activity compared to Nano-Se. Transcriptome analysis revealed that Nano-Se@S improved biosynthesis and ROS scavenging but suppressed inflammation. The ROS scavenging and angiogenesis-promoting activities of Nano-Se@S were further confirmed in transgenic zebrafish and chick embryos. Interestingly, we found that Nano-Se@S recruits leukocytes to the wound surface at the early stage of regeneration, which contributes to sterilization during regeneration.

CONCLUSION

Our study highlights Nano-Se@S as a tissue regeneration accelerator, and Nano-Se@S may provide new inspiration for therapeutics for regenerative-deficient diseases.

Recent advances in the medical applications of hemostatic materials

Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials. Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials.

Nanofibrous hemostatic materials: Structural design, fabrication methods, and hemostatic mechanisms

Development of rapid and effective hemostatic materials has always been the focus of research in the healthcare field. Nanofibrous materials which recapitulate the delicate nano-topography feature of fibrin fibers produced during natural hemostatic process, offer large length-to-diameter ratio and surface area, tunable porous structure, and precise control in architecture, showing great potential for staunching bleeding. Here we present a comprehensive review of advances in nanofibrous hemostatic materials, focusing on the following three important parts: structural design, fabrication methods, and hemostatic mechanisms. This review begins with an introduction to the physiological hemostatic mechanism and current commercial hemostatic agents. Then, it focuses on recent progress in electrospun nanofibrous hemostatic materials in terms of composition and structure control, surface modification, and in-situ deposition. The article emphasizes the development of three-dimensional (3D) electrospun nanofibrous materials and their emerging evolution for improving hemostatic function. Next, it discusses the fabrication of self-assembling peptide or protein-mimetic peptide nanofibers, co-assembling supramolecular nanofibers, as well as other nanofibrous hemostatic agents. Further, the article highlights the external and intracavitary hemostatic management based on various nanofiber aggregates. In the end, this review concludes with the current challenges and future perspectives of nanofibrous hemostatic materials. STATEMENT OF SIGNIFICANCE: This article reviews recent advances in nanofibrous hemostatic materials including fabrication methods, composition and structural control, performance improvement, and hemostatic mechanisms. A variety of methods including electrospinning, self-assembly, grinding and refining, template synthesis, and chemical vapor deposition, have been developed to prepare nanofibrous materials. These methods provide robustness in control of the nanofiber architecture in the forms of hydrogels, two-dimensional (2D) membranes, 3D sponges, or composites, showing promising potential in the external and intracavitary hemostasis and wound healing applications. This review will be of great interest to the broad readers in the field of hemostatic materials and multifunctional biomaterials.

Polysaccharide Electrospun Nanofibers for Wound Healing Applications

As a type of biological macromolecule, natural polysaccharides have been widely used in wound healing due to their low toxicity, good biocompatibility, degradability and reproducibility. Electrospinning is a versatile and simple technique for producing continuous nanoscale fibers from a variety of natural and synthetic polymers. The application of electrospun nanofibers as wound dressings has made great progress and they are considered one of the most effective wound dressings. This paper reviews the preparation of polysaccharide nanofibers by electrospinning and their application prospects in the field of wound healing. A variety of polysaccharide nanofibers, including chitosan, starch, alginate, and hyaluronic acid are introduced. The preparation strategy of polysaccharide electrospun nanofibers and their functions in promoting wound healing are summarized. In addition, the future prospects and challenges for the preparation of polysaccharide nanofibers by electrospinning are also discussed.

A keratin/chitosan sponge with excellent hemostatic performance for uncontrolled bleeding

Uncontrolled bleeding leads to a higher fatality rate in the situation of surgery, traffic accidents and warfare. Traditional hemostatic materials such as bandages are not ideal for uncontrolled or incompressible bleeding. Therefore, it is of great significance to develop a new medical biomaterial with excellent rapid hemostatic effect. Keratin is a natural, biocompatible and biodegradable protein which contains amino acid sequences that induce cell adhesion. As a potential biomedical material, keratin has been developed and paid attention in tissue engineering fields such as promoting wound healing and nerve repair. Herein, a keratin/chitosan (K/C) sponge was prepared to achieve rapid hemostasis. The characterizations of K/C sponge were investigated, including SEM, TGA, liquid absorption and porosity, showing that the high porosity up to 90.12 ± 2.17 % resulted in an excellent blood absorption. The cytotoxicity test and implantation experiment proved that the K/C sponge was biocompatible and biodegradable. Moreover, the prepared K/C sponge showed better hemostatic performance than chitosan sponge (CS) and the commercially available gelatin sponge in both rat tail amputation and liver trauma bleeding models. Further experiments showed that K/C sponge plays a hemostatic role through the endogenous coagulation pathway, thus shortening the activated partial thromboplastin time (APTT) effectively. Therefore, this study provided a K/C sponge which can be served as a promising biomedical hemostatic material.

Polysaccharide-based nanofibers for pharmaceutical and biomedical applications: A review

Nanofibers are fibrous nanocarriers that can be synthesized from natural polymers, synthetic polymers, semiconducting materials, composite materials, and carbon-based materials. Recently, natural polysaccharides-based nanofibers are gaining attention in the field of pharmaceuticals and biomedical as these are biocompatible, biodegradable, non-toxic, and economic. Nanofibers can deliver a significant amount of drug to the targeted site and provide effective interaction of therapeutic agent at the site of action due to a larger surface area. Other important advantages of nanofibers are low density, high porosity, small pore size, high mechanical strength, and low cost. In this review, natural polysaccharides such as alginate, pullulan, hyaluronic acid, dextran, cellulose, chondroitin sulfate, chitosan, xanthan gum, and gellan gum are discussed for their characteristics, pharmaceutical utility, and biomedical applications. The authors have given particular emphasis to the several fabrication processes that utilize these polysaccharides to form nanofibers, and their recent updates in pharmaceutical applications such as drug delivery, tissue engineering, skin disorders, wound-healing dressings, cancer therapy, bioactive molecules delivery, anti-infectives, and solubility enhancement. Despite these many advantages, nanofibers have been explored less for their scale-up and applications in advanced therapeutic delivery.

Iota-carrageenan/xyloglucan/serine powders loaded with tranexamic acid for simultaneously hemostatic, antibacterial, and antioxidant performance

This study sought to prepare powder hemostats based on iota-carrageenan (ιC), xyloglucan (XYL), l-serine (SER), and tranexamic acid (TA). The powder form was chosen because it enables the hemostat to be used in wounds of any shape and depth. The powder hemostats showed irregular shapes and specific surface areas ranging from 34 to 46 m²/g. Increasing TA amount decreases the specific surface area, bulk density, water and blood absorption, and the antibacterial activities of the powder hemostats, but not the water retention ability. Conversely, in vitro biodegradation was positively impacted by increasing the TA content in the powder hemostats. In both the in vitro and in vivo tests, powder hemostats showed reduced bleeding time, significant adhesion of red blood cells, great hemocompatibility, moderate antioxidant activity, and high biocompatibility. These findings shed new light on designing powder hemostats with intrinsic antibacterial and antioxidant activity and excellent hemostatic performance.

Chitosan and polyhexamethylene guanidine dual-functionalized cotton gauze as a versatile bandage for the management of chronic wounds

Development of versatile medical dressing with good immediate and long-lasting antibacterial, hygroscopic and moisturizing abilities is of great significance for management of chronic wounds. Cotton gauze (CG) can protect wounds and promote scabbing, but can cause wound dehydration and loss of biologically active substances, thereby greatly delays wound healing. Herein, a bi-functional CG dressing (CPCG) was developed by chemically grafting polyhexamethylene guanidine (PHMG) and physically adsorbing chitosan (CS) onto the CG surface. Due to the powerful microbicidal activity of PHMG, CPCG exhibited excellent immediate and long-lasting antibacterial activity against gram-positive and gram-negative bacteria. Moreover, the abundant hydroxyl and amino groups in CS endowed CPCG with good biocompatibility, moisture absorption, moisturizing and cell scratch healing performances. Importantly, CPCG can be easily fabricated into a bandage to conveniently manage infected full-skin wounds. Together, this study suggests that CPCG is a versatile wound dressing, having enormous application potential for management chronic wounds.

Natural Scaffolds Used for Liver Regeneration: A Narrative Update

Annually chronic liver diseases cause two million death worldwide. Although liver transplantation (LT) is still considered the best therapeutic option, the limited number of donated livers and lifelong side effects of LT has led researchers to seek alternative therapies. Tissue engineering (TE) as a promising method is considered for liver repair and regeneration. TE uses natural or synthetic scaffolds, functional somatic cells, multipotent stem cells, and growth factors to develop new organs. Biological scaffolds are notable in TE because of their capacity to mimic extracellular matrices, biodegradability, and biocompatibility. Moreover, natural scaffolds are classified based on their source and function in three separate groups. Hemostat-based scaffolds as the first group were reviewed for their application in coagulation in liver injury or surgery. Furthermore, recent studies showed improvement in the function of biological hydrogels in liver regeneration and vascularity. In addition, different applications of natural scaffolds were discussed and compared with synthetic scaffolds. Finally, we focused on the efforts to improve the performance of decellularized extracellular matrixes for liver implantation.

A Study of Compressibility, Compactability and Mucoadhesivity of Tableting Materials for Matrix Systems Based on Chitosan

The objective of the present research is to evaluate directly compressible chitosan-based tableting materials for the formulation of mucoadhesive matrix tablets intended for targeted drug release to distal segments of the GIT. The influence of sodium alginate, hypromellose, and silicified microcrystalline cellulose (P90) on compressibility, compactability and lubricant sensitivity ratio was tested. Furthermore, the rheological properties of the hydrated surface layer of the matrix tablets and the mucoadhesion to a mucin substrate were analysed. Compressibility was evaluated using the energy profile of the compression process, compactability by means of the tensile strength of tablets, and lubricant sensitivity ratio was calculated to assess the sensitivity to lubricant. Addition of P90 to chitosan improved compressibility, which is demonstrated by the increase in the energy of plastic deformation and the higher tensile strength of tablets. P90 also significantly reduced the high lubricant sensitivity of chitosan. Presence of retarding components led to a decrease in Emax. All tested matrix tablets revealed a good mucoadhesion without a negative effect of P90 content. The viscosity of a gel layer on the surface of matrix tablets containing hypromellose was higher compared to those with sodium alginate. This was not reflected in the adhesive strength of the tablets. The formulated tableting materials combining chitosan and P90 are a suitable matrix for incorporation of an active ingredient, whose delayed release in the intestine can be achieved by the functionality of the chitosan-sodium alginate complex.