Biological Effects of Chitosan-Based Dressing on Hemostasis Mechanism.

Wang Wang,Chang Chang,Hsu Hsu,Cherng Cherng,Hong Hong,Chiu Chiu,Liu Liu,Lin Lin

doi:10.3390/polym11111906

Abstract

There have been numerous recent advances in wound care management. Nevertheless, the assessment of hemostatic dressing is essential to enable surgeons and other physicians and healthcare professionals to make the correct decisions regarding the disposition of severe hemorrhage. Here, we investigated the relative efficacies of chitosan-based and conventional gauze dressings in a rat model of femoral artery hemorrhage and in patients with surgical wounds. Dressing effectiveness was evaluated based on hemostatic profiles, biocompatibility, antimicrobial activity, and blood factor responses in coagulation. Relative to standard gauze dressing, the chitosan fiber (CF) dressing treatment significantly shortened the time to hemostasis in injured rats. Moreover, the CF dressing significantly prolonged partial thromboplastin time, enhanced blood absorption, and reduced antithrombin production without altering the prothrombin ratio. Unlike regular gauze bandages, the CF dressing demonstrated remarkable antibacterial activity. The results of this study indicate the effectiveness of chitosan as a hemostatic dressing and elucidate its underlying mechanism. It is possible that chitosan surgical dressings could serve as first-line intervention in hospital emergency care for uncontrolled hemorrhage.

Highlights

Serious hemorrhage caused by abnormal blood coagulation, injuries, ruptured organs, surgical complications, femoral artery puncture site bleeding, or vascular malformation may induce potentially fatal shock and extreme local suppression [1,2,3]
Evaluation of the efficacy of chitosan dressing at accelerating clotting time and staunching massive bleeding in a rat femoral artery hemorrhage model; (3) in vitro analysis and ex vivo coagulation tests (prothrombin time (PT), activated partial thromboplastin time, and coagulation factors) of the chitosan dressing; and (4) assessment of hemoglobin absorption by chitosan dressing applied to surgical wounds
The present study showed that chitosan fiber (CF) dressing had superior hemostatic properties to regular gauze-type surgical dressing

Summary

Introduction

Serious hemorrhage caused by abnormal blood coagulation, injuries, ruptured organs, surgical complications, femoral artery puncture site bleeding, or vascular malformation may induce potentially fatal shock and extreme local suppression [1,2,3]. To prevent death caused by bleeding, effective hemorrhage control must be provided immediately after the injury and should control active bleeding within minutes. They are easy and simple to use, may be precisely applied to deeply penetrating wounds, and could potentially stimulate regeneration [7]. The underlying mechanism by which chitosan induces rapid clotting is unclear. It merits further investigation as it furnishes effective hemorrhage management strategies that could save lives at the acute emergency level

Objectives

Methods

Results

Conclusion