The effect of chemical and structural modifiers on the haemostatic process and cytotoxicity of the beta-chitin patch

Ahad Sabab,C. John McAdam,Alistair Jukes,Sarah Vreugde,Sha Liu,Shari Javadiyan,Lyall R. Hanton,Peter-John Wormald

doi:10.1038/s41598-021-97781-8

Ahad Sabab, C. John McAdam + Show 6 more

Open Access

https://doi.org/10.1038/s41598-021-97781-8

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Journal: Scientific Reports	Publication Date: Sep 17, 2021
Citations: 2	License type: open-access

Affiliation: University of Adelaide, University of Otago

Abstract

Beta-chitin patch has previously been proven to be an effective haemostat, but whether modifying the patch affects its efficacy and safety, remains unanswered. In this study, the patch was modified using polyethylene oxide, Pluronic-F127, calcium, increased thickness or polyphosphate, and their effect on the process of haemostasis and cytotoxicity was tested and compared with standard-of-care, Surgicel and FloSeal. Whole blood collected from volunteers was applied to the patches to test their whole blood clotting and thrombin generation capacities, whilst platelet isolates were used to test their platelet aggregation ability. The fluid absorption capacity of the patches was tested using simulated body fluid. Cytotoxicity of the patches was tested using AlamarBlue assays and PC12 cells and the results were compared with the standard-of-care. In this study, beta-chitin patch modifications failed to improve its whole blood clotting, platelet aggregation and thrombin generation capacity. Compared to non-modified patch, modifications with polyethylene oxide or calcium reduced platelet aggregation and thrombin generation capacity, while increasing the thickness or adding polyphosphate decreased platelet aggregation capacity. The cytotoxicity assays demonstrated that the beta-chitin patches were non-toxic to cells. In vivo research is required to evaluate the safety and efficacy of the beta-chitin patches in a clinical setting.

Highlights

Beta-chitin patch has previously been proven to be an effective haemostat, but whether modifying the patch affects its efficacy and safety, remains unanswered
The degree of acetylation (DA) was calculated using the equation proposed by Xu et al.25: = [(C/N − 5.14)/1.72] × 100
The patches were prepared from beta-chitin from the New Zealand Arrow squid (Notodarus sloanii)

Summary

Introduction

Beta-chitin patch has previously been proven to be an effective haemostat, but whether modifying the patch affects its efficacy and safety, remains unanswered. The patch was modified using polyethylene oxide, Pluronic-F127, calcium, increased thickness or polyphosphate, and their effect on the process of haemostasis and cytotoxicity was tested and compared with standard-of-care, Surgicel and FloSeal. It is concerning in the endoscopic and neurosurgical setting where intraoperative bleeds can distort the surgeon’s visual field[1] and increase the risk of post-operative h aematoma[2] This can affect the outcome of the patient following surgery[2]. There currently exist a variety of haemostatic techniques and agents that can be utilised to manage bleeds during surgery[3, 4] Haemostatic modalities such as mechanical compression or electro-cautery are two of the oldest techniques used to manage h aemorrhage[4]. The forms commonly encountered are alpha-chitin with anti-parallel chain arrangement, beta-chitin with parallel alignment and gamma-chitin with a combination of parallel and Scientific Reports | (2021) 11:18577

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