Recent advances in biopolymer-based hemostatic materials (original) (raw)
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Polymeric Materials for Hemostatic Wound Healing
Pharmaceutics
Hemorrhage is one of the greatest threats to life on the battlefield, accounting for 50% of total deaths. Nearly 86% of combat deaths occur within the first 30 min after wounding. While external wound injuries can be treated mostly using visual inspection, abdominal or internal hemorrhages are more challenging to treat with regular hemostatic dressings because of deep wounds and points of injury that cannot be located properly. The need to treat trauma wounds from limbs, abdomen, liver, stomach, colon, spleen, arterial, venous, and/or parenchymal hemorrhage accompanied by severe bleeding requires an immediate solution that the first responders can apply to reduce rapid exsanguinations from external wounds, including in military operations. This necessitates the development of a unique, easy-to-use, FDA-approved hemostatic treatment that can deliver the agent in less than 30 s and stop bleeding within the first 1 to 2 min at the point of injury without application of manual pressure ...
2023
Hemostasis refers to the harmless practice of any surgical procedure or any other chronic ulcer which immediately requires therapy to prevent substantial blood loss and mortality from extreme hemorrhage in surgery/emergency conditions. Various natural, semi-synthetic as well as synthetic biopolymers are available with excellent hemostatic activity and further offer biodegradable and biocompatible nature with the live cells. Now a day's biopolymers have become the most significant hemostatic agents used in emergency operations and surgical procedures. However, to date, there is no comprehensive report evaluating natural hemostatic materials based on biopolymers. Therefore, this current review attempts to combine the most advanced methods and secondly reviews various biopolymers including their preparation, origin, and composition, as well as safety and biodegradability. Insights on the various commercially available products based on biopolymers exhibiting hemostatic activity are well discussed. Thus, the paper summarizes the latest research work on commonly used biopolymers as the most widely used materials and provides an orientation for further research and development in this field.
Next Generation Hemostatic Materials Based on NHS-Ester Functionalized Poly(2-oxazoline)s
Biomacromolecules
In order to prevent hemorrhage during surgical procedures, a wide range of hemostatic agents have been developed. However, their efficacy is variable; hemostatic devices that use bioactive components to accelerate coagulation are dependent on natural sources, which limits reproducibility. Hybrid devices in which chain-end reactive poly(ethylene glycol) is employed as active component sometimes suffer from irregular cross-linking and dissolution of the polar PEG when blood flow is substantial. Herein, we describe a synthetic, nonbioactive hemostatic product by coating Nhydroxysuccinimide ester (NHS)-functional poly(2-oxazoline)s (POx-NHS) onto gelatin patches, which acts by formation of covalent cross-links between polymer, host blood proteins, gelatin and tissue to seal the wound site and prevent hemorrhage during surgery. We studied different process parameters (including polymer, carrier, and coating technique) in direct comparison with clinical products (Hemopatch and Tachosil) to obtain deeper understanding of this class of hemostatic products. In this work, we successfully prove the hemostatic efficacy of POx-NHS as polymer powders and coated patches both in vitro and in vivo against Hemopatch and Tachosil, demonstrating that POx-NHS are excellent candidate polymers for the development of next generation hemostatic patches.
Blood-aggregating hydrogel particles for use as a hemostatic agent
Acta Biomaterialia, 2014
The body is unable to control massive blood loss without treatment. Available hemostatic agents are often expensive, ineffective or raise safety concerns. Synthetic hydrogel particles are an inexpensive and promising alternative. In this study we synthesized and characterized N-(3-aminopropyl)methacrylamide (APM) hydrogel particles and investigated their use as a hemostatic material. The APM hydrogel particles were synthesized via inverse suspension polymerization with a narrow size distribution and rapid swelling behavior. In vitro coagulation studies showed hydrogel particle blood aggregate formation as well as bulk blood coagulation inhibition. In vivo studies using multiple rat injury and ovine liver laceration models demonstrated the particles' ability to aid in rapid hemostasis. Subsequent hematoxylin and eosin and Carstairs' method staining of the ovine liver incision sites showed significant hemostatic plug formation. This study suggests that these cationic hydrogel particles form a physical barrier to blood loss by forming aggregates, while causing a general decrease in coagulation activity in the bulk. The formation of a rapid sealant through aggregation and the promotion of local hemostasis through electrostatic interactions are coupled with a decrease in overall coagulation activity. These interactions require the interplay of a variety of mechanisms stemming from a simple synthetic platform.
Hemostatic biomaterials to halt non-compressible hemorrhage
Journal of Materials Chemistry B
Non-compressible hemorrhage is an unmet clinical challenge, which occurs in inaccessible sites in the body where compression cannot be applied to stop bleeding. Current treatments reliant on blood transfusion are limited in efficacy and complicated by blood supply (short shelf-life and high cost), immunogenicity and contamination risks. Alternative strategies based on hemostatic biomaterials exert biochemical and/or mechanical cues to halt hemorrhage. The biochemical hemostats are built upon native coagulation cascades, while the mechanical hemostats use mechanical efforts to stop bleeding. This review covers the design principles and applications of such hemostatic biomaterials, following an overview of coagulation mechanisms and clot mechanics. We present how biochemical strategies modulate coagulation and fibrinolysis, and also mechanical mechanisms such as absorption, agglutination, and adhesion to achieve hemostasis. We also outline the challenges and immediate opportunities to provide comprehensive guidelines for the rational design of hemostatic biomaterials.
Hemostatic, Resorbable Dressing of Natural Polymers-Hemoguard
Autex Research Journal, 2016
Investigations are presented for the preparation of a model hemostatic dressing that would exhibit an adequate hemostatic capacity in injuries and surgical wounds, an antibacterial activity to prevent primary and secondary infections, and offer safety in use. The Hemoguard dressing has been designed as a powder prepared from the complex chitosan/alginate Na/Ca in the form of micro- and nano-fibrids. Useful antibacterial and hemostatic properties of Hemoguard, which would qualify the material as first aid dressing and a temporary protection of injury wounds in field conditions, were assessed. Biocompatibility of the dressing was confirmed by biological in vitro examinations.
REVIEW ON BLOOD CLOTTING ACTION OF NANOFIBER FROM BIOPOLYMERS
Hemorrhage is the leading cause of death. Potentially preventable death. Improving our ability to control hemorrhage may represent the next major hurdle in reducing trauma mortality. New techniques and fibers for hemorrhage control are being developed and applied across the continuum trauma care such as hospital or other medical facility.
Injectable chitosan-nano bioglass composite hemostatic hydrogel for effective bleeding control
International Journal of Biological Macromolecules, 2019
Effective bleeding control is a major concern in trauma and major surgeries. Chitosan (Ch) as hemostatic agent has been widely used and when applied at the site of injury it acts by aggregating blood cells and forming a plug. Our prime interest is to enhance the blood clotting potential of Ch hydrogel. Incorporation of nano bioglass (nBG) with silica (activate coagulation factor XII), calcium (activate intrinsic pathway) and phosphate (initiates extrinsic pathway) ions into Ch hydrogel (protonated amine group) would act simultaneously on mechanisms involved in hemostasis and bring about effective bleeding control. Sol-gel method was followed to synthesize nBG particles and its particle size was found to be 14 ± 3 nm. 2%Ch-5%nBG composite hydrogel was then prepared and characterized using SEM and FTIR. Rheological studies showed the shear-thinning property of the developed hydrogel. 2%Ch-5%nBG hydrogel was observed to be cytocompatible with HUVEC cells. In the in vitro and in vivo (liver and femoral artery injury in rat model) blood clotting analysis, 2%Ch-5%nBG hydrogel formed rapid blood clot compared to control 2%Ch hydrogel. Therefore, the synthesized 2%Ch-5%nBG hydrogel may have great potential to achieve effective bleeding control during critical situations.
Regenerative Biomaterials
Massive hemorrhage may be detrimental to the patients, which necessitates the advent of new materials with high hemostatic efficiency and good biocompatibility. The objective of this research was to screen for the effect of the different types of bio-elastomers as hemostatic dressings. 3D loose nanofiber sponges were prepared; PU-TA/Gel showed promising potential. Polyurethane (PU) was synthesized and electrospun to afford porous sponges, which were crosslinked with glutaraldehyde (GA). FTIR and 1H-NMR evidenced the successful synthesis of PU. The prepared PU-TA/Gel sponge had the highest porosity and water absorption ratio. Besides, PU-TA/Gel sponges exhibited cytocompatibility, negligible hemolysis and the shortest clotting time. PU-TA/Gel sponge rapidly induced stable blood clots with shorter hemostasis time and less bleeding volume in a liver injury model in rats. Intriguingly, PU-TA/Gel sponges also induced good skin regeneration in a full-thickness excisional defect model as r...
Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances
International Journal of Molecular Sciences
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 bio...