Morphological, cytotoxicity, and coagulation assessments of perlite as a new hemostatic biomaterial
Esmaeil BiazarSaeed Heidari KeshelVahid NiaziNader Vazifeh ShiranRoxana SaljooghiM. JarrahiAhmad Mehdipour Arbastan
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Hemorrhage control is vital for clinical outcomes after surgical treatment and pre-hospital trauma injuries. Numerous biomaterials have been investigated to control surgical and traumatic bleeding. In this study, for the first time, perlite was introduced as an aluminosilicate biomaterial and compared with other ceramics such as kaolin and bentonite in terms of morphology, cytotoxicity, mutagenicity, and hemostatic evaluations. Cellular studies showed that perlite has excellent viability, good cell adhesion, and high anti-mutagenicity. Coagulation results demonstrated that the shortest clotting time (140 seconds with a concentration of 50 mg mL-1) was obtained for perlite samples compared to other samples. Therefore, perlite seems most efficient as a biocompatible ceramic for hemorrhage control and other biomaterial designs.Keywords:
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Hemostatic Agent
Collagen is a biomaterial with good and unique properties such as high tensile strength, biocompatibility and low cytotoxicity as well as capacity for promoting cell proliferation, and so on. As a hemostasis biomaterial, collagen is a hot research spot at home and abroad all the time. In this review collagen hemostasis materials were classified according to their physical shapes, and then the preparation technologies of several kinds of common collagen hemostatic materials and their evaluation for application in animal test and clinical test were analyzed. Finally, the future development trend of collagen hemostatic materials was prospected.
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Hemorrhage control is vital for clinical outcomes after surgical treatment and pre-hospital trauma injuries. Numerous biomaterials have been investigated to control surgical and traumatic bleeding. In this study, for the first time, perlite was introduced as an aluminosilicate biomaterial and compared with other ceramics such as kaolin and bentonite in terms of morphology, cytotoxicity, mutagenicity, and hemostatic evaluations. Cellular studies showed that perlite has excellent viability, good cell adhesion, and high anti-mutagenicity. Coagulation results demonstrated that the shortest clotting time (140 seconds with a concentration of 50 mg mL-1) was obtained for perlite samples compared to other samples. Therefore, perlite seems most efficient as a biocompatible ceramic for hemorrhage control and other biomaterial designs.
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Abstract A quantitative analysis of cell adhesion is essential in understanding physiological phenomena and designing biomaterials, implant surfaces, and tissue‐engineering scaffolds. The most common cell adhesion assays used to evaluate biomaterial surfaces lack sensitivity and reproducibility and/or require specialized equipment and skill‐intensive operation. We describe a modified centrifugation cell adhesion assay that uses simple and convenient techniques with standard laboratory equipment and provides reliable, quantitative measurements of cell adhesion. This centrifugation assay applies controlled and uniform detachment forces to a large population of adherent cells, providing robust statistics for quantifying cell adhesion. The applicability of this system to the design and characterization of biomaterial surfaces is shown by evaluating cell adhesion on substrates using different coating proteins, cell types, seeding times, and relative centrifugal forces (RCF). Results verify that this centrifugation cell adhesion assay represents a simple, convenient, and standard method for high‐throughput characterization of a variety of biomaterial surfaces and conditions. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res 67A: 328–333, 2003
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BACKGROUND: In this study, for the first time, an experimental evaluation of the effectiveness of samples of a new local biocompatible hemostatic agent in the form of a gel based on chitosan was carried out with ongoing intra-abdominal bleeding.
AIM: to evaluate the effectiveness of promising local biocompatible hemostatic agents for ongoing intra-abdominal bleeding in an experiment using biological objects.
MATERIALS AND METHODS: When performing this work, an experimental model was developed on biological objects (rabbits) to evaluate the effectiveness of hemostatic agents in the form of a gel with continued bleeding from a liver wound.
RESULTS: During the experiment, the high efficiency of new LBHA samples was established, which allowed to avoid mortality in comparison with the control group, where the mortality rate was 100%.
CONCLUSION: The developed experimental model, which includes injury to the liver with the subsequent development of intense intra-abdominal bleeding, has fully justified itself. The use of local biocompatible hemostatic agents in the form of a gel is a promising way to achieve hemostasis in the early stages of medical evacuation for abdominal injuries, which in turn has the potential to significantly reduce the number of deaths caused by ongoing intra-abdominal bleeding. The data obtained, indicating the high efficiency of individual samples, make it possible to consider the continuation of research in this direction appropriate. Further evaluation of the efficacy and safety of local biocompatible hemostatic agents requires additional studies on medium and large biological objects with all the samples presented to determine their effect on the body, biocompatibility, as well as local irritant action.
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Hemostasis is a process causing bleeding to stop, and it is known from the literature that hemostasis can be enhanced using chitosan on wound gauzes. We proposed here a continuous flow-through device, with the test blood flowing through the gauze sample at a constant flow rate and the pressure drop across the gauze measured, for assessing the hemostatic performance of the gauze. Experiments were performed using the device with both whole blood and washed blood (with clotting factors and platelets removed from the whole blood), and their results agree with each other within 10% discrepancy, indicating quantitatively that hemostatic enhancement via chitosan is essentially independent of classical clotting pathways, which was demonstrated qualitatively through animal tests in the literature. The proposed device and method can be applied for evaluating quantitatively the hemostatic performance of various gauzes in a flowing blood environment (in comparison with static tests) with less test blood (20-60% less, in comparison with that of a flow-through device driven by a constant pressure gradient), and are thus, helpful for designing better wound gauzes. In particular, it is effective to enhance the hemostatic performance further (additional 30%) through acidification (changing the amino group to the ammonium group) of the gauze for chitosan-based wound gauzes.
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Hemostatic biomaterials show great promise in wound control for the treatment of uncontrolled bleeding associated with damaged tissues, traumatic wounds, and surgical incisions. A surge of interest has been directed at boosting hemostatic properties of bioactive materials via mechanisms triggering the coagulation cascade. A wide variety of biocompatible and biodegradable materials has been applied to the design of hemostatic platforms for rapid blood coagulation. Recent trends in the design of hemostatic agents emphasize chemical conjugation of charged moieties to biomacromolecules, physical incorporation of blood-coagulating agents in biomaterials systems, and superabsorbing materials in either dry (foams) or wet (hydrogel) states. In addition, tough bioadhesives are emerging for efficient and physical sealing of incisions. In this Review, we highlight the biomacromolecular design approaches adopted to develop hemostatic bioactive materials. We discuss the mechanistic pathways of hemostasis along with the current standard experimental procedures for characterization of the hemostasis efficacy. Finally, we discuss the potential for clinical translation of hemostatic technologies, future trends, and research opportunities for the development of next-generation surgical materials with hemostatic properties for wound management.
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