Sage Journals: Discover world-class research

Abstract

Background

Application of controlled in vitro techniques can be used as a screening tool for the development of new hemostatic agents allowing quantitative assessment of overall hemostatic potential.

Materials and methods

Several tests were selected to evaluate the efficacy of cotton gauze, collagen, and oxidized regenerated cellulose for enhancing blood clotting, coagulation, and platelet activation.

Results

Visual inspection of dressings after blood contact proved the formation of blood clots. Scanning electron microscopy demonstrated the adsorption of blood cells and plasma proteins. Significantly enhanced blood clot formation was observed for collagen together with β-thromboglobulin increase and platelet count reduction. Oxidized regenerated cellulose demonstrated slower clotting rates not yielding any thrombin generation; yet, led to significantly increased thrombin-anti-thrombin-III complex levels compared to the other dressings. As hemostyptica ought to function without triggering any adverse events, induction of hemolysis, instigation of inflammatory reactions, and initiation of the innate complement system were also tested. Here, cotton gauze provoked high PMN elastase and elevated SC5b-9 concentrations.

Conclusions

A range of tests for desired and undesired effects of materials need to be combined to gain some degree of predictability of the in vivo situation. Collagen-based dressings demonstrated the highest hemostyptic properties with lowest adverse reactions whereas gauze did not induce high coagulation activation but rather activated leukocytes and complement.

Keywords

Blood clotting coagulation collagen hemocompatibility oxidized regenerated cellulose

Get full access to this article

View all access options for this article.

References

Jesty

Wieland

Niemiec

Assessment in vitro of the active hemostatic properties of wound dressings. J Biomed Mater Res Part B Appl Biomater 2009; 89B: 536–542.

Martin

Wound healing – aiming for perfect skin regeneration. Science 1997; 276: 75–81.

Lewis

Spazierer

Slezak

et al . Swelling, sealing, and hemostatic ability of a novel biomaterial: a polyethylene glycol-coated collagen pad. J Biomater Appl 2014; 29: 780–788.

Broekema

van Oeveren

Zuidema

et al . In vitro analysis of polyurethane foam as a topical hemostatic agent. J Mater Sci Mater Med 2011; 22: 1081–1086.

Tomizawa

Clinical benefits and risk analysis of topical hemostats: a review. J Artif Organs 2005; 8: 137–142.

Wagner

Pachence

Ristich

et al . Comparative in vitro analysis of topical hemostatic agents. J Surg Res 1996; 66: 100–108.

Pathak

Sawhney

Quinn

et al . Polyimidepolyethylene glycol block copolymers: synthesis, characterization and initial evaluation as biomaterial. J Biomater Sci Polym Ed 1994; 6: 313–323.

Krajewski

Hierlemann

Neumann

et al . Hypercoagulant abdominal swabs in cardiac surgery: potential problems and background. Thorac Cardiovasc Surg 2016; 64: 589–595.

Krajewski

Nathan

Neumann

et al . Simple clotting test to detect procoagulant abdominal swabs. J Mater Sci Mater Med 2015; 26: 106.

10.

Schonauer

Tessitore

Barbagallo

et al . The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J 2004; 13: S89–S96.

11.

Kawamoto

Kaibara

Procoagulant activity of collagen. Effect of differences in type and structure of collagen. Biochim Biophys Acta 1990; 1035: 361–368.

12.

Friess

Collagen – biomaterial for drug delivery. Eur J Pharm Biopharm 1998; 45: 113–136.

13.

Pusateri

Holcomb

Kheirabadi

et al . Making sense of the preclinical literature on advanced hemostatic products. J Trauma 2006; 60: 674–682.

14.

Braune

Grunze

Straub

et al . Are there sufficient standards for the in vitro hemocompatibility testing of biomaterials? Biointerphase 2013; 8: 33.

15.

Chen

Zhang

Wang

et al . Preparation of porous carboxymethyl chitosan grafted poly (acrylic acid) superabsorbent by solvent precipitation and its application as a hemostatic wound dressing. Mater Sci Eng C 2016; 63: 18–29.

16.

Zhen

Liu

et al . Hemolysis and cytotoxicity mechanisms of biodegradable magnesium and its alloys. Mater Sci Eng C Mater Biol Appl 2015; 46: 202–206.

17.

Eloy

Baguet

Christe

et al . An in vitro evaluation of the hemostatic activity of topical agents. J Biomed Mater Res 1988; 22: 149–157.

18.

Rembe

Böhm

Fromm-Dornieden

et al . Comparison of hemostatic dressings for superficial wounds using a new spectrophotometric coagulation assay. J Transl Med 2015; 13: 375.

19.

Sawyer

Schwann

Stanczewski

Effects of a new hemostatic agent on blood coagulation. Biomater Med Dev Artif Organ 1983; 11: 135–145.

20.

Zhao

Guo

et al . Injectable antibacterial conductive nanocomposite cryogels with rapid shape recovery for noncompressible hemorrhage and wound healing. Nat Commun 2018; 9: 2784.

21.

Zoucas

Goransson

Bengmark

Comparative evaluation of local hemostatic agents in experimental liver trauma: a study in the rat. J Surg Res 1984; 37: 145–150.

22.

Chvapil

Owen

DeYoung

DW.

A standardized animal model for evaluation of hemostatic effectiveness of various materials. J Trauma 1983; 23: 1042–1047.

23.

Coln

Horton

Ogden

et al . Evaluation of hemostatic agents in experimental splenic lacerations. Am J Surg 1983; 145: 256–259.

24.

Silverstein

Keown

Owen

et al . Collagen fibers as a fleece hemostatic agent. J Trauma 1980; 20: 688–694.

25.

Abbott

Austen

WG.

The effectiveness and mechanism of collagen-induced topical hemostasis. Surgery 1975; 78: 723–729.

26.

Hait

Robb

Baxter

et al . Comparative evaluation of avitene microcrystalline collagen hemostat in experimental animal wounds. Am J Surg 1973; 125: 284–287.

27.

Zhao

Liang

et al . Antibacterial adhesive injectable hydrogels with rapid self-healing, extensibility and compressibility as wound dressing for joints skin wound healing. Biomaterials 2018; 183: 185–199.

28.

Zhao

Guo

et al . Antibacterial anti-oxidant electroactive injectable hydrogel as self-healing wound dressing with hemostasis and adhesiveness for cutaneous wound healing. Biomaterials 2017; 122: 34–47.

29.

Boccafoschi

Habermehl

Vesentini

et al . Biological performances of collagen-based scaffolds for vascular tissue engineering. Biomaterials 2005; 26: 7410–7417.

30.

Savage

Ginsberg

Ruggeri

ZM.

Influence of fibrillar collagen structure on the mechanisms of platelet thrombus formation under flow. Blood 1999; 94: 2704–2715.

31.

Nair

Dargaud

Chitlur

et al . Tests of global haemostasis and their applications in bleeding disorders. Haemophilia 2010; 16: 85–92.

32.

Walsh

PN.

Platelet coagulation-protein interactions. Semin Thromb Hemost 2004; 30: 461–471.

33.

Wang

Miyata

Weksler

et al . Collagen-induced platelet aggregation and release. I. Effects of side-chain modifications and role of arginyl residues. Biochim Biophys Acta 1978; 544: 555–567.

34.

Wang

Miyata

Weksler

et al . Collagen-induced platelet aggregation and release. II. Critical size and structural requirements of collagen. Biochim Biophys Acta 1978; 544: 568–577.

35.

Rich

Douillet

Buchholz

et al . Use of the novel hemostatic textile Stasilon® to arrest refractory retroperitoneal hemorrhage: a case report. J Med Case Rep 2010; 4: 20.

36.

Bouchard

Tracy

PB.

The participation of leukocytes in coagulant reactions. J Thromb Haemost 2003; 1: 464–469.

37.

Tzanova

Calafellb

Guebitzc

et al . Bio-preparation of cotton fabrics. Enzyme Microbial Technol 2001; 29: 357–362.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.19 MB

0.21 MB

Hemostatic wound dressings: Predicting their effects by in vitro tests

Abstract

Background

Materials and methods

Results

Conclusions

Keywords

Get full access to this article

References

Supplementary Material