1
|
Troisi N, Marconi M, Michelagnoli S, Dalla Caneva P, Frosini P, Di Domenico R, Pratesi C, Berchiolli R. Protein-based tissue adhesive reduces time to haemostasis in peripheral vascular surgery. Vascular 2024:17085381241258556. [PMID: 38817014 DOI: 10.1177/17085381241258556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the effectiveness of protein-based tissue adhesive (Bioglue®) in reducing time to haemostasis in patients undergoing peripheral vascular surgery. METHODS From January to December 2021, 100 consecutive patients from 4 centres have been treated with open peripheral vascular surgery including upper and lower limb interventions. Patients have been allocated in each centre into control with no use of Bioglue® (Group no-Bio, 50 patients) or use of Bioglue® (Group Bio, 50 patients) by a block randomization method 10:10 until the required sample size was reached. Perioperative parameters including time to haemostasis, number of adjunctive stitches, and in-hospital bleeding have been analysed and compared in the two groups by means of mean independent-samples tT -test and Gehan-Breslow-Wilcoxon test. RESULTS Both groups were homogeneous in terms of demographic data, preoperative risk factors, and preoperative medical therapy except for a higher percentage of active smokers in Group Bio (52% vs. 24%, p = 0.004). Femoral endarterectomy was most common in Group Bio (44% vs. 24%, p = 0.03), whilst the percentage of lower limb vein bypasses was higher in Group no-Bio (50% vs. 36%, p = 0.03). Bovine pericardium was the preferred material in Group Bio (20 cases, 40%), whilst autologous vein is mostly used in Group no-Bio (26 cases, 52%) (p = 0.01). Time to haemostasis was faster in Group Bio (4.4 vs. 9.6 minutes, p < 0.001). The need for adjunctive stitches was higher in Group no-Bio (8 cases, 16%, Group Bio vs. 25 cases, 50%, Group no-Bio; p < 0.001). The overall rate of in-hospital bleeding, including those requiring reintervention, was not different between the two groups (9 cases, 18%, Group Bio vs. 7 cases, 14%, Group no-Bio; p = 0.39). CONCLUSIONS The protein-based tissue adhesive Bioglue® reduced time to haemostasis and need for adjunctive stitches in peripheral vascular surgery. However, it did not affect the overall rate of perioperative bleedings. Further studies with larger sample sizes are needed to validate these outcomes.
Collapse
Affiliation(s)
- Nicola Troisi
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Firenze, Italy
| | - Michele Marconi
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Firenze, Italy
| | - Stefano Michelagnoli
- Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy
| | - Patrizia Dalla Caneva
- Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy
| | | | | | - Carlo Pratesi
- Department of Vascular Surgery, University of Florence, Firenze, Italy
| | - Raffaella Berchiolli
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Firenze, Italy
| |
Collapse
|
2
|
Robu M, Radulescu B, Nayyerani R, Enache R, Stiru O, Iosifescu A, Olaru G, Ciomag (Ianula) R, Iliescu VA, Moldovan H. Management of a Rare Case of Multiple Coronary Artery Fistulas Associated with Ascending Aortic and Root Aneurysm: Case Report and Review of Literature. J Clin Med 2024; 13:2297. [PMID: 38673570 PMCID: PMC11050765 DOI: 10.3390/jcm13082297] [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: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Coronary artery fistulas draining into the left ventricle is a rare finding. They can be associated with other congenital cardiac anomalies like ventricular septal defect or tetralogy of Fallot. While most of them are asymptomatic, they can lead to severe cardiac complications like infective endocarditis, heart failure, or myocardial ischemia. Symptomatic coronary artery fistulas can be managed surgically or percutaneously. We present a case of a 61-year-old male patient with both left anterior descending artery and right coronary artery fistulas draining into the left ventricle associated with ascending aorta and root aneurysm. Preoperative assessment for myocardial ischemia and the size and location of the fistulas was performed. The echocardiography stress test was negative. Surgery consisted of replacement of the ascending aorta and reconstruction of the noncoronary sinus with a Dacron patch with aortic valve preservation and no intervention for the coronary artery fistulas. The surgical strategy was adapted for cardioplegia administration to compensate for the volume of coronary blood drained into the left ventricle and for better protection of the distal myocardium.
Collapse
Affiliation(s)
- Mircea Robu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Bogdan Radulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Reza Nayyerani
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Robert Enache
- Radiology Department, Fundeni Clinical Institute, 022322 Bucharest, Romania;
| | - Ovidiu Stiru
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Andrei Iosifescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Georgiana Olaru
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Raluca Ciomag (Ianula)
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Vlad Anton Iliescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania;
| | - Horatiu Moldovan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.R.); (R.N.); (O.S.); (A.I.); (R.C.); (V.A.I.); (H.M.)
- Department of Cardiovascular Surgery, Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania
- Academy of Romanian Scientists, 050711 Bucharest, Romania
| |
Collapse
|
3
|
Liu Y, Zhang Y, Yao W, Chen P, Cao Y, Shan M, Yu S, Zhang L, Bao B, Cheng FF. Recent Advances in Topical Hemostatic Materials. ACS APPLIED BIO MATERIALS 2024; 7:1362-1380. [PMID: 38373393 DOI: 10.1021/acsabm.3c01144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Untimely or improper treatment of traumatic bleeding may cause secondary injuries and even death. The traditional hemostatic modes can no longer meet requirements of coping with complicated bleeding emergencies. With scientific and technological advancements, a variety of topical hemostatic materials have been investigated involving inorganic, biological, polysaccharide, and carbon-based hemostatic materials. These materials have their respective merits and defects. In this work, the application and mechanism of the major hemostatic materials, especially some hemostatic nanomaterials with excellent adhesion, good biocompatibility, low toxicity, and high adsorption capacity, are summarized. In the future, it is the prospect to develop multifunctional hemostatic materials with hemostasis and antibacterial and anti-inflammatory properties for promoting wound healing.
Collapse
Affiliation(s)
- Yang Liu
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Yi Zhang
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Weifeng Yao
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Peidong Chen
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Yudan Cao
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Mingqiu Shan
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Sheng Yu
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Li Zhang
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Beihua Bao
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| | - Fang-Fang Cheng
- Jiangsu Collaborative Innovation Centre of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Centre of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province China
| |
Collapse
|
4
|
Ren Z, Wang Y, Wu H, Cong H, Yu B, Shen Y. Preparation and application of hemostatic microspheres containing biological macromolecules and others. Int J Biol Macromol 2024; 257:128299. [PMID: 38008144 DOI: 10.1016/j.ijbiomac.2023.128299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/18/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023]
Abstract
Bleeding from uncontrollable wounds can be fatal, and the body's clotting mechanisms are unable to control bleeding in a timely and effective manner in emergencies such as battlefields and traffic accidents. For irregular and inaccessible wounds, hemostatic materials are needed to intervene to stop bleeding. Hemostatic microspheres are promising for hemostasis, as their unique structural features can promote coagulation. There is a wide choice of materials for the preparation of microspheres, and the modification of natural macromolecular materials such as chitosan to enhance the hemostatic properties and make up for the deficiencies of synthetic macromolecular materials makes the hemostatic microspheres multifunctional and expands the application fields of hemostatic microspheres. Here, we focus on the hemostatic mechanism of different materials and the preparation methods of microspheres, and introduce the modification methods, related properties and applications (in cancer therapy) for the structural characteristics of hemostatic microspheres. Finally, we discuss the future trends of hemostatic microspheres and research opportunities for developing the next generation of hemostatic microsphere materials.
Collapse
Affiliation(s)
- Zekai Ren
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Yumei Wang
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Han Wu
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Hailin Cong
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China.
| | - Bing Yu
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Youqing Shen
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; Key Laboratory of Biomass Chemical Engineering of Ministry of Education, Center for Bionanoengineering, Department of Chemical and Biological Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| |
Collapse
|
5
|
Gemelli M, Italiano EG, Geatti V, Addonizio M, Cao I, Dimagli A, Dokollari A, Tarzia V, Gallo M, Ferrari E, Slaughter MS, Gerosa G. Optimizing Safety and Success: The Advantages of Bloodless Cardiac Surgery. A Systematic Review and Meta-Analysis of Outcomes in Jehovah's Witnesses. Curr Probl Cardiol 2024; 49:102078. [PMID: 37716536 DOI: 10.1016/j.cpcardiol.2023.102078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
Transfusions are extremely frequent after cardiac surgery, and they have a considerable economic burden and impact on outcomes. Optimal patient blood management could play a fundamental role in reducing the rate of transfusion and Jehovah's Witnesses (JW) represent the ideal surrogate study population. This meta-analysis compares outcomes of JWs and non-JWs' patients undergoing cardiac surgery, assessing the safety of a bloodless cardiac surgery. A scoping review was conducted using a search strategy for studies assessing outcomes of JW undergoing cardiac surgery. The primary outcome was perioperative mortality, and a random-effects meta-analysis was performed. Ten studies were included in our meta-analysis, involving 780 JW patients refusing any type of transfusion ("JW") and 1182 patients accepting transfusion if needed ("non-JW"). 86% of non-JW patients received at least 1 transfusion. There was no significant difference in terms of perioperative mortality (OR 0.91; 95% CI 0.55-1.52; p = 0.72). The volume blood loss was significantly less in the JW (p = 0.001), while the rate of reoperation for bleeding was also lower, but not statistically significative, in the JW (p = 0.16). Both preoperative and postoperative hemoglobin and hematocrit were significantly higher in the JW. Therefore, we concluded that bloodless cardiac surgery is safe and early outcomes are similar between JW and non-JW patients: optimal patient blood management is fundamental in guarantying these results. Further studies are needed to assess if a limitation of transfusion could have a positive long-term impact on outcomes.
Collapse
Affiliation(s)
- Marco Gemelli
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | - Enrico Giuseppe Italiano
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Veronica Geatti
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Mariangela Addonizio
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Irene Cao
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Arnaldo Dimagli
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY
| | - Aleksander Dokollari
- Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA
| | - Vincenzo Tarzia
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Michele Gallo
- Department of Cardiothoracic Surgery, University of Louisville, Louisville, KY
| | - Enrico Ferrari
- Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Mark S Slaughter
- Department of Cardiothoracic Surgery, University of Louisville, Louisville, KY
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| |
Collapse
|
6
|
Gheorghiță D, Antoniac I, Moldovan H, Antoniac A, Grosu E, Motelica L, Ficai A, Oprea O, Vasile E, Dițu LM, Raiciu AD. Influence of Lavender Essential Oil on the Physical and Antibacterial Properties of Chitosan Sponge for Hemostatic Applications. Int J Mol Sci 2023; 24:16312. [PMID: 38003499 PMCID: PMC10671502 DOI: 10.3390/ijms242216312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Uncontrollable bleeding continues to stand as the primary cause of fatalities globally following surgical procedures, traumatic incidents, disasters, and combat scenarios. The swift and efficient management of bleeding through the application of hemostatic agents has the potential to significantly reduce associated mortality rates. One significant drawback of currently available hemostatic products is their susceptibility to bacterial infections at the bleeding site. As this is a prevalent issue that can potentially delay or compromise the healing process, there is an urgent demand for hemostatic agents with antibacterial properties to enhance survival rates. To mitigate the risk of infection at the site of a lesion, we propose an alternative solution in the form of a chitosan-based sponge and antimicrobial agents such as silver nanoparticles (AgNPs) and lavender essential oil (LEO). The aim of this work is to provide a new type of hemostatic sponge with an antibacterial barrier against a wide range of Gram-positive and Gram-negative microorganisms: Staphylococcus epidermidis 2018 and Enterococcus faecalis VRE 2566 (Gram-positive strains) and Klebsiella pneumoniae ATCC 10031 and Escherichia coli ATCC 35218 (Gram-negative strains).
Collapse
Affiliation(s)
- Daniela Gheorghiță
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
| | - Horațiu Moldovan
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Emergency Clinical Hospital Bucharest, 014461 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Elena Grosu
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania; (D.G.); (I.A.); (E.G.)
| | - Ludmila Motelica
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Anton Ficai
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania
| | - Ovidiu Oprea
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania; (A.F.); (O.O.)
- National Research Center for Micro and Nanomaterials, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania;
- National Research Center for Food Safety, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica Bucharest, 1-7 Polizu St., 011061 Bucharest, Romania
| | - Eugeniu Vasile
- Department of Oxide Materials Science and Engineering, National University of Science and Technology Politehnica Bucharest, 1–7 Gh. Polizu, 060042 Bucharest, Romania;
| | - Lia Mara Dițu
- Botanic and Microbiology Department, Faculty of Biology, University of Bucharest, 3, Aleea Portocalelor, 17 District 5, Grădina Botanică, 030018 București, Romania;
| | - Anca Daniela Raiciu
- Faculty of Pharmacy, Titu Maiorescu University, 22 Dambovnicului Street, 040441 Bucharest, Romania;
- S.C. Hofigal Import Export S.A., 2 Intrarea Serelor Street, 042124 Bucharest, Romania
| |
Collapse
|
7
|
Li S, Wu X, Bai N, Ni J, Liu X, Mao W, Jin L, Xiang H, Fu H, Shou Q. Fabricating Oxidized Cellulose Sponge for Hemorrhage Control and Wound Healing. ACS Biomater Sci Eng 2023; 9:6398-6408. [PMID: 37126763 DOI: 10.1021/acsbiomaterials.3c00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Uncontrolled hemorrhage and infection are the main reasons for many trauma-related deaths in both clinic and battlefield. However, most hemostatic materials have various defects and side effects, such as low hemostatic efficiency, poor biocompatibility, weak degradation ability, and lack of antimicrobial properties. Herein, an oxidized cellulose (OC) sponge with antibacterial properties and biosafety was fabricated for hemorrhage control and wound healing. The as-prepared OC sponges were prone to water triggered expansion and superabsorbent capacity, which could facilitate blood component concentration effectively. Importantly, they had significant biodegradability with little irritation to the skin. This hemostat could also reduce the plasma clotting time to 53.54% in vitro and demonstrated less blood loss than commercially available hemostatic agents (GS) in a mouse model of bleeding from liver defects. Furthermore, the biocompatibility antimicrobial properties and possible hemostatic mechanism of the OC sponge were also systematically evaluated. Importantly, the potential wound healing applications have also been demonstrated. Therefore, the materials have broad clinical application prospects.
Collapse
Affiliation(s)
- Shengyu Li
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Jinghua academy of Zhejiang Chinese Medicine University, Jinghua, 321015, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Xijin Wu
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Ningning Bai
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Jianyu Ni
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Xianli Liu
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Weiye Mao
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Lu Jin
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Hai Xiang
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Huiying Fu
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Jinghua academy of Zhejiang Chinese Medicine University, Jinghua, 321015, P. R. China
- Zhejiang Provincial Key Laboratory of Sexual function of Integrated Traditional Chinese and Western Medicine, Hangzhou, 310053, P. R. China
| | - Qiyang Shou
- The Second Affiliated Hospital & Second Clinical Medical School of Zhejiang Chinese Medical University, Hangzhou, 310000, P. R. China
- Basic Medical Sciences of Zhejiang Chinese Medical University, Hangzhou, 310005, P. R. China
- Jinghua academy of Zhejiang Chinese Medicine University, Jinghua, 321015, P. R. China
| |
Collapse
|
8
|
Yang Z, Chen L, Liu J, Zhuang H, Lin W, Li C, Zhao X. Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2301849. [PMID: 36942893 DOI: 10.1002/adma.202301849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Short designer self-assembling peptide (dSAP) biomaterials are a new addition to the hemostat group. It may provide a diverse and robust toolbox for surgeons to integrate wound microenvironment with much safer and stronger hemostatic capacity than conventional materials and hemostatic agents. Especially in noncompressible torso hemorrhage (NCTH), diffuse mucosal surface bleeding, and internal medical bleeding (IMB), with respect to the optimal hemostatic formulation, dSAP biomaterials are the ingenious nanofiber alternatives to make bioactive neural scaffold, nasal packing, large mucosal surface coverage in gastrointestinal surgery (esophagus, gastric lesion, duodenum, and lower digestive tract), epicardiac cell-delivery carrier, transparent matrix barrier, and so on. Herein, in multiple surgical specialties, dSAP-biomaterial-based nano-hemostats achieve safe, effective, and immediate hemostasis, facile wound healing, and potentially reduce the risks in delayed bleeding, rebleeding, post-operative bleeding, or related complications. The biosafety in vivo, bleeding indications, tissue-sealing quality, surgical feasibility, and local usability are addressed comprehensively and sequentially and pursued to develop useful surgical techniques with better hemostatic performance. Here, the state of the art and all-round advancements of nano-hemostatic approaches in surgery are provided. Relevant critical insights will inspire exciting investigations on peptide nanotechnology, next-generation biomaterials, and better promising prospects in clinics.
Collapse
Affiliation(s)
- Zehong Yang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
- Institute for Nanobiomedical Technology and Membrane Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lihong Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Ji Liu
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Hua Zhuang
- Department of Ultrasonography, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, Sichuan, 610041, China
| | - Wei Lin
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Women and Children Diseases of the Ministry of Education, Sichuan University, No. 17 People's South Road, Chengdu, Sichuan, 610041, China
| | - Changlong Li
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaojun Zhao
- Institute for Nanobiomedical Technology and Membrane Biology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| |
Collapse
|
9
|
Gheorghiță D, Moldovan H, Robu A, Bița AI, Grosu E, Antoniac A, Corneschi I, Antoniac I, Bodog AD, Băcilă CI. Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances. Int J Mol Sci 2023; 24:10540. [PMID: 37445718 DOI: 10.3390/ijms241310540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Daniela Gheorghiță
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Horațiu Moldovan
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Cardiovascular Surgery, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Ana-Iulia Bița
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Elena Grosu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iuliana Corneschi
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, District 6, 060042 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei, 050094 Bucharest, Romania
| | - Alin Dănuț Bodog
- Faculty of Medicine and Pharmacy, University of Oradea, 10 P-ta 1 December Street, 410073 Oradea, Romania
| | - Ciprian Ionuț Băcilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 10 Victoriei Boulevard, 550024 Sibiu, Romania
| |
Collapse
|
10
|
Wang H. Biomaterials in Medical Applications. Polymers (Basel) 2023; 15:polym15040847. [PMID: 36850130 PMCID: PMC9960308 DOI: 10.3390/polym15040847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/11/2023] Open
Abstract
Natural biomaterials are materials extracted from living organisms or their by-products [...].
Collapse
Affiliation(s)
- Hsiuying Wang
- Institute of Statistics, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| |
Collapse
|
11
|
Medical Adhesives and Their Role in Laparoscopic Surgery—A Review of Literature. MATERIALS 2022; 15:ma15155215. [PMID: 35955150 PMCID: PMC9369661 DOI: 10.3390/ma15155215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/15/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023]
Abstract
Laparoscopic surgery is undergoing rapid development. Replacing the traditional method of joining cut tissues with sutures or staples could greatly simplify and speed up laparoscopic procedures. This alternative could undoubtedly be adhesives. For decades, scientists have been working on a material to bond tissues together to create the best possible conditions for tissue regeneration. The results of research on tissue adhesives achieved over the past years show comparable treatment effects to traditional methods. Tissue adhesives are a good alternative to surgical sutures in wound closure. This article is a review of the most important groups of tissue adhesives including their properties and possible applications. Recent reports on the development of biological adhesives are also discussed.
Collapse
|