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Edwards JV, Prevost NT, Hinchliffe DJ, Nam S, Chang S, Hron RJ, Madison CA, Smith JN, Poffenberger CN, Taylor MM, Martin EJ, Dixon KJ. Preparation and Activity of Hemostatic and Antibacterial Dressings with Greige Cotton/Zeolite Formularies Having Silver and Ascorbic Acid Finishes. Int J Mol Sci 2023; 24:17115. [PMID: 38069435 PMCID: PMC10706952 DOI: 10.3390/ijms242317115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The need for prehospital hemostatic dressings that exert an antibacterial effect is of interest for prolonged field care. Here, we consider a series of antibacterial and zeolite formulary treatment approaches applied to a cotton-based dressing. The design of the fabric formulations was based on the hemostatic dressing TACGauze with zeolite Y incorporated as a procoagulant with calcium and pectin to facilitate fiber adherence utilizing silver nanoparticles, and cellulose-crosslinked ascorbic acid to confer antibacterial activity. Infra-red spectra were employed to characterize the chemical modifications on the dressings. Contact angle measurements were employed to document the surface hydrophobicity of the cotton fabric which plays a role in the contact activation of the coagulation cascade. Ammonium Y zeolite-treated dressings initiated fibrin equal to the accepted standard hemorrhage control dressing and showed similar improvement with antibacterial finishes. The antibacterial activity of cotton-based technology utilizing both citrate-linked ascorbate-cellulose conjugate analogs and silver nanoparticle-embedded cotton fibers was observed against Staphylococcus aureus and Klebsiella pneumoniae at a level of 99.99 percent in the AATCC 100 assay. The hydrogen peroxide levels of the ascorbic acid-based fabrics, measured over a time period from zero up to forty-eight hours, were in line with the antibacterial activities.
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Affiliation(s)
- J. Vincent Edwards
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Nicolette T. Prevost
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Doug J. Hinchliffe
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Sunghyun Nam
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - SeChin Chang
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Rebecca J. Hron
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Crista A. Madison
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Jade N. Smith
- Southern Regional Research Center, Agricultural Research Service, United States Department of Agriculture, New Orleans, LA 70124, USA; (N.T.P.); (D.J.H.); (S.N.); (S.C.); (R.J.H.); (C.A.M.); (J.N.S.)
| | - Chelsie N. Poffenberger
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
| | - Michelle M. Taylor
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
| | - Erika J. Martin
- Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Kirsty J. Dixon
- Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA; (C.N.P.); (M.M.T.); (K.J.D.)
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Edwards JV, Prevost NT, Cintron MS. A Comparison of Hemostatic Activities of Zeolite-Based Formulary Finishes on Cotton Dressings. J Funct Biomater 2023; 14:jfb14050255. [PMID: 37233365 DOI: 10.3390/jfb14050255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
The need for affordable effective prehospital hemostatic dressings to control hemorrhage has led to an increased interest in new dressing design approaches. Here we consider the separate components of fabric, fiber, and procoagulant nonexothermic zeolite-based formulations on design approaches to accelerated hemostasis. The design of the fabric formulations was based on incorporation of zeolite Y as the principal procoagulant, with calcium and pectin to adhere and enhance the activity. Unbleached nonwoven cotton when combined with bleached cotton displays enhanced properties related to hemostasis. Here, we compare sodium zeolite with ammonium zeolite formulated on fabrics utilizing pectin with pad versus spray-dry-cure and varied fiber compositions. Notably, ammonium as a counterion resulted in shorter times to fibrin and clot formation comparable to the procoagulant standard. The time to fibrin formation as measured by thromboelastography was found to be within a range consistent with modulating severe hemorrhage control. The results indicate a correlation between fabric add-on and accelerated clotting as measured by both time to fibrin and clot formation. A comparison between the time to fibrin formation in calcium/pectin formulations and pectin alone revealed an enhanced clotting effect with calcium decreasing by one minute the time to fibrin formation. Infra-red spectra were employed to characterize and quantify the zeolite formulations on the dressings.
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Affiliation(s)
- J Vincent Edwards
- Southern Regional Research Center, United States Department of Agriculture (USDA), Agricultural Research Service, New Orleans, LA 70124, USA
| | - Nicolette T Prevost
- Southern Regional Research Center, United States Department of Agriculture (USDA), Agricultural Research Service, New Orleans, LA 70124, USA
| | - Michael Santiago Cintron
- Southern Regional Research Center, United States Department of Agriculture (USDA), Agricultural Research Service, New Orleans, LA 70124, USA
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El-Hefnawy ME, Ismail AI, Orif MI, Al-Goul ST, Elmushyakhi A, Abou Taleb M. Preparation of afterglow and photochromic fibrous mats from polypropylene plastics to detect ultraviolet light. LUMINESCENCE 2023. [PMID: 36657955 DOI: 10.1002/bio.4445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
Polypropylene textiles have been used in the development of various industrial products, such as automotives, plastic furniture, and medical tools. However, polypropylene resists dyeing due to a deficiency of active staining spots. Here, we developed a new strategy towards new afterglow and photochromic fibres from recycled polypropylene plastics using plasma-supported coloration with rare-earth activated aluminate nanoparticles (REANPs). Plasma curing was used to generate active dyeing sites on the polypropylene surface. A thin film of REANPs (2-10 nm) was deposited onto the plasma-pretreated polypropylene surface. Various analytical techniques were applied to inspect the morphology of the REANP-finished polypropylene fibres. The polypropylene dyeing activity was much improved after being exposed to plasma. Both photoluminescence analysis and Commission internationale de l'éclairage (CIE) laboratory coordinates proved that the polypropylene fibres exhibited a white colour in daylight and green in ultraviolet light. The thin afterglow layer immobilized onto the polypropylene surface exhibited an emission band of 524 nm upon excitation at 365 nm. The sliding angles dropped from 12° to 9°, but the contacting angles increased from 139.4° to 145.0° when the REANP ratio was raised. These findings show that REANP-finished polypropylene had good colourfastness, antimicrobial activity, and ultraviolet light blocking. Both stiffness and permeability to air of REANP-finished polypropylene were explored to designate excellent comfort characteristics.
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Affiliation(s)
- Mohamed E El-Hefnawy
- Department of Chemistry, Rabigh College of Sciences and Arts, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Chemistry, Faculty of Science, Tanta University, Tanta, Egypt
| | - Ali I Ismail
- Department of Chemistry, Rabigh College of Sciences and Arts, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Chemistry, Faculty of Science, The Hashemite University, P.O. Box 150459, Zarqa, Jordan
| | - Mohammed I Orif
- Marine Chemistry Department, Faculty of Marine Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Soha T Al-Goul
- Department of Chemistry, Rabigh College of Sciences and Arts, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abraham Elmushyakhi
- Department of Mechanical Engineering, College of Engineering, Northern Border University, Arar, Saudi Arabia
| | - Manal Abou Taleb
- Department of Chemistry, College of Science and Humanities, Prince Sattam Bin Abdulaziz University, Al-kharj, Saudi Arabia.,Department of Polymer Chemistry, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority, P.O. Box 7551, Nasr City, Egypt
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Edwards JV, Graves E, Prevost N, Condon B, Yager D, Dacorta J, Bopp A. Development of a Nonwoven Hemostatic Dressing Based on Unbleached Cotton: A De Novo Design Approach. Pharmaceutics 2020; 12:pharmaceutics12070609. [PMID: 32629845 PMCID: PMC7407894 DOI: 10.3390/pharmaceutics12070609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Minimally processed greige (unbleached) cotton fibers demonstrate enhanced clotting relative to highly processed United States Pharmacopeia (USP) type 7 bleached cotton gauze. This effect is thought to be due to the material surface polarity. We hypothesized that a textile could be constructed, conserving the hemostasis-accelerating properties of greige cotton, while maintaining structural integrity and improving absorbance. Spun bond nonwovens of varying surface polarity were designed and prepared based on ratios of greige cotton/bleached cotton/polypropylene fibers. A thromboelastographic analysis was performed on fibrous samples in citrated blood to evaluate the rate of fibrin and clot formation. Lee White clotting times were obtained to assess the material’s clotting activity in platelet fresh blood. An electrokinetic analysis of samples was performed to analyze for material surface polarity. Hemostatic properties varied with composition ratios, fiber density, and fabric fenestration. The determinations of the surface polarity of cotton fabrics with electrokinetic analysis uncovered a range of surface polarities implicated in fabric-initiated clotting; a three-point design approach was employed with the combined use of thromboelastography, thrombin velocity index, Lee White clotting, and absorption capacity determinations applied to fabric structure versus function analysis. The resulting analysis demonstrates that greige cotton may be utilized, along with hydrophilic and hydrophobic fibers, to improve the initiation of fibrin formation and a decrease in clotting time in hemostatic dressings suitable to be commercially developed. Hydroentanglement is an efficient and effective process for imparting structural integrity to cotton-based textiles, while conserving hemostatic function.
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Affiliation(s)
- J. Vincent Edwards
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
- Correspondence: ; Tel.: +1-504-284-4360
| | - Elena Graves
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Nicolette Prevost
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Brian Condon
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Dorne Yager
- Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA 23111, USA;
| | | | - Alvin Bopp
- Department of Natural Sciences, Southern University at New Orleans, New Orleans, LA 70126, USA;
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Chen YW, Lu CH, Shen MH, Lin SY, Chen CH, Chuang CK, Ho CC. In vitro evaluation of the hyaluronic acid/alginate composite powder for topical haemostasis and wound healing. Int Wound J 2019; 17:394-404. [PMID: 31845534 DOI: 10.1111/iwj.13285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 01/14/2023] Open
Abstract
The use of haemostatic agents can provide life-saving treatment for patients who suffer from massive bleeding in both prehospital and intraoperative conditions. However, there are still urgent demands for novel haemostatic materials that exhibit better haemostatic activity, biocompatibility, and biodegradability than existing products. In the present study, we aim to evaluate the feasibility of new wound dressing, RapidClot, for treating uncontrolled haemorrhage through a series of in vitro assessments to determine the swelling ratio, clotting time, enzymatic degradation, haemolytic activity, cytotoxicity, cell proliferation, and migration. The results indicated that the RapidClot revealed better water adsorption capacity and shorter blood clotting time (132.7 seconds) than two commercially available haemostatic agents Celox (378.7 seconds) and WoundSeal (705.3 seconds). Additionally, the RapidClot dressing exhibited a similar level of degradability in the presence of hyaluronidase and lysozyme as that of Celox, whereas negligible degradation of WoundSeal was obtained. Although both Celox and RapidClot revealed a similar level in cell viability (above than 90%) against NIH/3 T3 fibroblasts, improved cell proliferation and migration could be obtained in RapidClot. Taking together, our results demonstrated that RapidClot could possess a great potential for serving as an efficient healing dressing with haemorrhage control ability.
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Affiliation(s)
- Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan.,3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan
| | - Chia-Hsin Lu
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Meng-Han Shen
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Shih-Yeh Lin
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Chia-Hui Chen
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Ching-Kuang Chuang
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Chia-Che Ho
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan
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6
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Recombinant batroxobin-coated nonwoven chitosan as hemostatic dressing for initial hemorrhage control. Int J Biol Macromol 2018. [PMID: 29514041 DOI: 10.1016/j.ijbiomac.2018.03.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The choice of hemostat is determined by the situation and the degree of hemorrhage. One common hemostat, the nonwoven dressing, is easy to handled and controls severe bleeding on wider wounds. In this study, chitosan-based nonwoven dressings with recombinant batroxobin (rBat) were used as efficacious hemostatic dressing agents. Hemostatic agents need to absorb blood quickly in the early stages of blood coagulation cascade to rapidly and effectively control of excessive hemorrhages. To date, most studies of hemostatic agents focused on a single material and hemostats composed of multiple materials have not been studied sufficiently. Thus, we made a chitosan dressing coated with rBat and investigated the microstructure, mechanical properties, hemostatic efficacy, and clotting properties of the coated dressing. Our results showed that the rBat had a synergetic effect on chitosan that improved blood coagulation. Furthermore, the dressing had excellent bleeding control in an Sprague-Dawley (SD) rat femoral artery hemorrhage model. In conclusion, hemostasis can be improved by combining a chitosan-based nonwoven dressing with other agents, and rBat-coated chitosan-based nonwoven dressings have enormous potential to improve blood coagulation.
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Madhavan K, Frid MG, Hunter K, Shandas R, Stenmark KR, Park D. Development of an electrospun biomimetic polyurea scaffold suitable for vascular grafting. J Biomed Mater Res B Appl Biomater 2018; 106:278-290. [PMID: 28130878 PMCID: PMC6080858 DOI: 10.1002/jbm.b.33853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 11/15/2016] [Accepted: 01/01/2017] [Indexed: 12/19/2022]
Abstract
The optimization of biomechanical and biochemical properties of a vascular graft to render properties relevant to physiological environments is a major challenge today. These critical properties of a vascular graft not only regulate its stability and integrity, but also control invasion of cells for scaffold remodeling permitting its integration with native tissue. In this work, we have synthesized a biomimetic scaffold by electrospinning a blend of a polyurea, poly(serinol hexamethylene urea) (PSHU), and, a polyester, poly-ε-caprolactone (PCL). Mechanical properties of the scaffold were varied by varying polymer blending ratio and electrospinning flow rate. Mechanical characterization revealed that scaffolds with lower PSHU content relative to PCL content resulted in elasticity close to native mammalian arteries. We also found that increasing electrospinning flow rates also increased the elasticity of the matrix. Optimization of elasticity generated scaffolds that enabled vascular smooth muscle cells (SMCs) to adhere, grow and maintain a SMC phenotype. The 30/70 scaffold also underwent slower degradation than scaffolds with higher PSHU content, thereby, providing the best option for in vivo remodeling. Further, Gly-Arg-Gly-Asp-Ser (RGD) covalently conjugated to the polyurea backbone in 30/70 scaffold resulted in significantly increased clotting times. Reducing surface thrombogenicity by the conjugation of RGD is critical to avoiding intimal hyperplasia. Hence, biomechanical and biochemical properties of a vascular graft can be balanced by optimizing synthesis parameters and constituent components. For these reasons, the optimized RGD-conjugated 30/70 scaffold electrospun at 2.5 or 5 mL/h has great potential as a suitable material for vascular grafting applications. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 278-290, 2018.
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Affiliation(s)
- Krishna Madhavan
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Maria G. Frid
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kendall Hunter
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Robin Shandas
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Surgery, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kurt R. Stenmark
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Daewon Park
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
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Hickman DA, Pawlowski CL, Sekhon UDS, Marks J, Gupta AS. Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30:10.1002/adma.201700859. [PMID: 29164804 PMCID: PMC5831165 DOI: 10.1002/adma.201700859] [Citation(s) in RCA: 259] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/18/2017] [Indexed: 05/03/2023]
Abstract
Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed.
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Affiliation(s)
- DaShawn A Hickman
- Case Western Reserve University School of Medicine, Department of Pathology, Cleveland, Ohio 44106, USA
| | - Christa L Pawlowski
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Ujjal D S Sekhon
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Joyann Marks
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
| | - Anirban Sen Gupta
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, Ohio 44106, USA
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