Gas-jet propelled hemostats for targeted hemostasis in wounds with irregular shape and incompressibility.

Abstract

Since hemostats are likely to be flushed off a wound by a massive gushing of blood, achieving rapid and effective hemostasis in complex bleeding wounds with powder hemostats continues to be a significant therapeutic challenge. In order to counter the flushing effect of gushing blood, a gas-jet propelled powder hemostat ((COL/PS)4@CaCO3-T-TXA+) has been developed. (COL/PS)4@CaCO3-T-TXA+ dives into the deep bleeding sites of complex wounds for targeted hemostasis. In preparation, protamine sulfate and collagen are first electrostatically deposited on CaCO3, which is then loaded with thrombin, and finally doped with protonated tranexamic acid (TXA-NH3+) to produce the final therapeutic medicine (COL/PS)4@CaCO3-T-TXA+. When applied to bleeding tissues, CaCO3 and TXA-NH3+ from (COL/PS)4@CaCO3-T-TXA+ immediately react with each other in blood to release countless CO2 macro-bubbles, which direct the hemostatic powder, (COL/PS)4@CaCO3-T-TXA+, precisely towards deep bleeding sites from complex wounds. Then the carried thrombin is released to accomplish targeted hemostasis. According to animal studies, (COL/PS)4@CaCO3-T-TXA+ has better effects in rabbit hepatic hemorrhage models; the hemorrhage quickly stops within 30 s, which is roughly 20% less than with the commercial product CeloxTM. The present study provides a new strategy for using powder hemostats to quickly and effectively stop bleeding in complex bleeding wounds.