orabase and Hemorrhage

Hemostats that can strongly adhere to wound tissue and are easy to remove when stopping bleeding are favored for the control of noncompressible hemorrhage. Here, we prepared a citric acid (CA)-crosslinked and N-hydroxysuccinimide (NHS) ester-activated carboxymethyl cellulose (CMC-NHS) aerogel for noncompressible hemostasis. CA was used to crosslink CMC to form a strengthened structure. NHS ester was introduced to activate the adhesion of CMC-NHS aerogel to wound tissue and promoted blood coagulation through the formation of amide crosslinks between CMC and erythrocytes and free blood proteins. The plentiful carboxyl groups could also trigger the intrinsic coagulation pathway. Thus, the aerogel could quickly adhere to wound tissue to stop bleeding, and then could be easily removed when fully hydrated as CMC was dissolved at the adhesion interface. The aerogel also had good biocompatibility and antibacterial capability. Overall, CMC-NHS aerogel is a competitive hemostat for the control of noncompressible hemorrhage.

Topics: Adhesives; Blood Coagulation; Carboxymethylcellulose Sodium; Esters; Hemorrhage; Humans

Uncontrolled hemorrhage poses a severe life-threatening situation. However, traditional hemostats still have various limitations. It is urgent to develop a material with excellent biocompatibility and hemostatic ability. Evidence has shown that carboxymethyl chitosan (CMCS) has hemostatic properties and good compatibility. Herein, we develop an expandable hemostatic sponge by modifying CMCS with cellulose nanofibrils (CNFs) through the CO-NH cross-linking method. We verified its potential as a hemostatic agent both in vivo and in vitro. The results demonstrated that the prepared carboxymethyl chitosan/cellulose nanofiber composite (CNF-CMCS) sponges could absorb blood, quickly expand to exert pressure in the wound, and exhibit an excellent coagulation ability. The CNF-CMCS sponges significantly decreased the bleeding time and blood loss in several hemorrhage models and possessed a significant advantage in treating the deep penetrating injury hemorrhage. Therefore, the sponges provide a unique application prospect and potential as a penetrating trauma hemostatic agent.

Topics: Carboxymethylcellulose Sodium; Cellulose; Chitosan; Hemorrhage; Hemostasis; Hemostatics; Humans; Nanofibers

Carboxymethyl cellulose granules (CMC-G) and kappa-carrageenan/polyethylene oxide/polyethylene glycol dressing (KPP-D) hemostatic agents, developed through radiation-induced crosslinking and sterilization, were tested in Sprague-Dawley rats using three bleeding models: (a) deep wound with the puncture of femoral artery; (b) aortic puncture; and (c) partial nephrectomy. Dressing and granules were applied in the animals without sustained compression and monitored for a period of 7 or 14 days. Comparisons were made against the commercial chitosan-based agent, Celox (CLX). Primary outcomes observed were bleeding time, the incidence of re-bleeding, animal survival, as well as gross and microscopic changes. The KPP-D group showed the shortest bleeding time for all bleeding models (a. 2.75 ± 0.64, b. 1.63 ± 0.54, c. 2.05 ± 0.62), significantly faster than all the other treatment groups. KPP-D also registered the highest survival rate of 100% with no display of gross abnormalities. CMC-G showed comparable bleeding time with CLX products but had a better survival rate at 98% compared to 96%. The incidence of re-bleeding was greater in CLX treated groups as well as more occurrence of granular adhesions that impacted mortality outcomes. Findings indicate the efficacy of KPP-D in the treatment of severe hemorrhage due to traumatic injury and intraoperative cases, while CMC-G was more suited for external trauma. Complications arising from inflammation, granules deposition, and adhesions emphasize stringent handling and removal of granular hemostat as a critical consideration in hemostat development and testing.

Topics: Animals; Aorta; Bandages; Bleeding Time; Carboxymethylcellulose Sodium; Carrageenan; Disease Models, Animal; Femoral Artery; Gamma Rays; Hemorrhage; Hemostatics; Male; Polyethylene Glycols; Rats, Sprague-Dawley

Fully soluble hemostatic fiber (FHF) is made from cotton yarn through a series of chemical reactions with NaOH and chloroacetic acid. The major component of FHF is carboxymethylcellulose. FHF is a kind of biodegradation macromolecule material that can disassociate into a low-molecular-weight compound or a simple substance by hydrolytic and enzymatic courses. The purpose of the present study is to investigate the hemostatic mechanism of FHF. The study indicated that FHF can stop bleeding by physical, chemical and physiological routes. In the physical route, expansion of carboxymethylcellulose in FHF stops bleeding by forming a mechanical clog after contacting with the blood. In the chemical route, the platelets can quickly aggregate around FHF and stimulate releasing and disaggregating reactions, after contacting with the rough surface of FHF, producing thrombus and hemostasis. In the physiological route, gluey particles with negative charges can activate intrinsic coagulation systems by activating the blood coagulation factor XII after FHF dissolution.

Topics: Animals; Carboxymethylcellulose Sodium; Cotton Fiber; Hemorrhage; Hemostasis; Hemostatics; Rabbits