Antibacterial quaternary ammonium chitosan/carboxymethyl starch/alginate sponges with enhanced hemostatic property for the prevention of dry socket
Xuyang DengDanyang WangDongjie ZhangMing SunLiying ZhouYuxi WangXiaowen KongChangqing YuanQihui Zhou
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Abstract:
Tooth extraction commonly leads to postoperative wound bleeding, bacterial infection, and even the occurrence of dry socket. Therefore, developing a biomedical material with favorable antibacterial and excellent hemostatic properties to prevent the post-extraction dry socket is necessary. Herein, quaternary ammonium chitosan/ carboxymethyl starch/alginate (ACQ) sponges are developedKeywords:
Hemostatic Agent
Biocompatibility
Sponge
With the help of tests on 10 big biological objects (sheep) was studied a modern model of severe lateral damage (6 mm diameter) of femoral artery. Within 45 seconds blood loss was 432.5 +/- 258.2 ml. The usage of domestic local hemostatic agent--"Gemostop" based on zeolite and "Gemofleks" based on chitosan. The total three-hour mortality was 50%. Primary hemostasis was recorded only in 20% of biological objects, the final hemostasis in 60%. Thus, the model of standard 6-mm lateral damage of femoral artery with a free primary hemmorage during 45 seconds should be considered as. optimal for evaluating the effectiveness of modern hemostatic agents.
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To investigate the hemostasis of thermosensitive chitosan hemostatic film.Fifty adult Sprague Dawley rats, male or female and weighing 190-210 g, were made the models of liver injury. The models were randomly divided into 5 groups (n=10) depending on different hemostatic materials. The incision of the liver was covered with the hemostatic materials of 2.0 cm x 1.0 cm x 0.5 cm in size: thermosensitive chitosan hemostatic film (group A), chitosan hemostatic film (group B), cellulose hemostatic cotton (group C), gelatin sponge (group D), and no treatment (group E), respectively. The bleeding time and bleeding amount were recorded. After 4 weeks, the incisions of the liver were observed with HE staining.Gross observation showed better hemostatic effect and faster hemostatic time in groups A, B, and C; group D had weaker hemostatic effect and slower hemostatic time; group E had no hemostatic effect. The bleeding time and bleeding amount of groups A, B, C, and D were significantly lower than those of group E (P < 0.05). The bleeding time and bleeding amount of groups A, B, and C were significantly lower than those of group D (P < 0.05), but no significant difference was found among groups A, B, and C (P > 0.05). The liver cells of group A had milder edema and ballooning degeneration than other 4 groups through histological observation.The thermosensitive chitosan hemostatic film has good hemostasis effect on the liver incision of rats.
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Objective To evaluate the efficacy of a novel hemostatic material AristaTM in the management of active and local bleeding in neurosurgery, and discuss the indications for its application. Methods Forty-eight patients undergoing elective craniotomy in our department between April, 2008 and May, 2009 were randomized into the test group (n=24) and control group (n=24) with intraoperative hemostatic management using AristaTM and gelatin sponge, respectively. The hemostasis time and efficacy of the two materials were compared. Results Hemostasis was effective in all the 48 patients. The mean hemostasis time in the test group and control group was 1.88±0.74 min and 3.38±0.92 min, respectively, showing a significant difference between them (Z=4.711, P=0.001). Conclusion AristaTM allows more efficient management of active and local bleeding than gelatin sponge during neurosurgeries and has great potential for clinical application.
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AristaTM, Neurosurgery
Gelatin sponge
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We sought to test whether Celox topical hemostatic dressing (Medtrade Products) would maintain hemostasis in extended use.An anesthetized swine underwent bilateral arteriotomies and treatment with topical hemostatic dressings in line with the Kheirabadi method. The dressings were covered with standard field dressings, and these were visually inspected for bleeding every 2 hours until 8 hours, when the swine was euthanized.There was no evidence of rebleeding at any point up to and including 8 hours. The Celox dressings maintained hemostasis in extended use.Celox topical hemostatic dressing is effective for extended use and maintains hemostasis. It should be considered for use in situations in which evacuation and definitive care may be delayed.
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Uncontrolled bleeding from trauma or surgery remains an important factor affecting the survival and prognosis of surgical patients. Failure to timeously stop bleeding will not only prolong the operative time but also threaten the patient’s life. Timely hemostasis after bleeding has become the most concerned event for surgeons. At present, the most commonly used hemostasis methods in the operating room include ligation of blood vessels, electrocautery, and gauze compression to stop bleeding. However, These hemostatic methods do great harm to surrounding tissues while achieving hemostasis. Based on tissue engineering repair strategies, the use of natural polymer materials as hemostatic agents has achieved clinical success. Gelatin sponge and cellulose gauze have been used clinically with good results. However, gelatin sponges are very expensive and place enormous financial pressure on patients. Therefore, there is an urgent need for new hemostatic materials for surgical hemostasis. Chitosan is a natural polysaccharide with biocompatibility and biodegradability, which plays an important role in tissue engineering and regenerative medicine. Chitosan gauze has been proven to have good hemostatic effects. The positive charge on the surface of chitosan can adsorb red blood cells and platelets at the bleeding site to form platelet thrombosis. However, chitosan is not easily soluble in water and has poor adsorption, which makes it a weak local hemostatic agent. Therefore, it is important to improve chitosan-based hemostatic material such that it l has an excellent hemostatic effect. In this review, we introduce the physiological coagulation process and discuss the physicochemical properties of chitosan and its role in hemostasis. Furthermore, we discuss the advantages and disadvantages of chitosan-based hemostatic materials. Finally, we summarize and discuss chitosan-based hemostatic materials.
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The treatment of bleeding wound of solid visceral and the rescue of uncontrollable bleeding are still confronted with difficulties in surgery and first-aid field. Many researchers devote to study in the field of hemostasis, and the novel porous hemostatic agent is one of the hot spot of research about hemostasis. The review focuses on the hemostatic effect, properties, hemostatic mechanism, shortcoming and future trends of three novel porous hemostatic agents such as polysaccharides, zeolite and wollastonite.
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Traumatic hemorrhage can be a fatal event, particularly when large quantities of blood are lost in a short period of time. Therefore, hemostasis has become a crucial part of emergency treatment. For small wounds, hemostasis can be achieved intrinsically depending on the body's own blood coagulation mechanism; however, for large-area wounds, particularly battlefield and complex wounds, materials delivering rapid and effective hemostasis are required. In parallel with the constant progress in science, technology, and society, advances in hemostatic materials have also undergone various iterations by integrating new ideas with old concepts. There are various natural and synthetic hemostatic materials, including hemostatic powders, adhesives, hydrogels, and tourniquets, for the treatment of severe external trauma. This review covers the differences among the currently available hemostatic materials and comprehensively describes the hemostatic effects of different materials based on the underlying mechanisms. Finally, solutions for current issues related to trauma bleeding are discussed, and the prospects of hemostatic materials are proposed.
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