Abstract
Effective hemostasis is vital to reduce the pain and mortality of patients, and the research and development of hemostatic materials are prerequisite for effective hemostasis. Chitosan (CS), with good biodegradability, biocompatibility and non-toxicity, has been widely applied in bio-medicine, the chemical industry, the food industry and cosmetics. The excellent hemostatic properties of CS have been extensively studied. As a result, chitosan-based composite hemostatic materials have been emerging. In this review, the hemostatic mechanism of chitosan is briefly discussed, and then the progress of research on chitosan-based composite hemostatic materials with multiple forms such as films, sponges, hydrogels, particles and fibers are introduced. Finally, future perspectives of chitosan-based composite hemostatic materials are given. The objective of this review is to provide a reference for further research and development of effective hemostatic materials.
Highlights
Hemostasis is a vital step in emergency medical care
The interaction of chitosan with red blood cells increased with the increase of its molecular weight, which might be explained by the increase of entanglement degree due to the special intermolecular hydrogen bonding force or electrostatic repulsion between polyelectrolyte molecules [14,15]
The results showed that CTSH sponge had no significant effects on the blood parameters of mice including coagulation, anticoagulation, fibrinolytic and hemorheology, suggesting that CTSH sponge had potential possibility to be developed into clinical hemostatic agents
Summary
Hemostasis is a vital step in emergency medical care. Effective and quick hemostasis is critically important for surgical operation and emergent trauma, for trauma caused in battlefields and other complicated situations [1,2]. Hemostatic materials currently available from the market mainly include collagen (Col), gelatin (GE), alginate (AG), chitosan (CS), oxidized cellulose, cyanoacrylic acid tissue adhesive and porous zeolite. All of these have effective hemostasis functions, but there are some disadvantages as well. Many studies showed that chitosan triggered coagulation without the activation of the intrinsic pathway, indicating that the hemostatic mechanism of CS was independent of the classical coagulation cascade [7,8,9] It was not quite clearly understood yet, the hemostatic mechanism of CS involved the following aspects
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