Hemostatic efficacy of composite polysaccharide powder (starch-chitosan) for emergency bleeding control: An animal model study

Mardani, Mohsen; Eftekharıan, Hamıd Reza; Naseri, Mahmood; Hosseini, Seyed Mohammad Hashem; Mohammadi, Hamid; Danesteh, Hossein; Ghadimi, Niloofar; Fazel, Saeed

doi:10.1016/j.surg.2022.04.054

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…This phenomenon is closely related to the composite structure of the SQG sponge. 32 With the binding of QSt and gelatin onto the SP sponge surface, the exposure of the α-amylase action site on the starch molecular chain was reduced, resulting in the slow degradation of SQG.…”

Section: Resultsmentioning

confidence: 99%

“…The concentration of a-amylase in the human body is about 40 U-220 U L À1 , so 100 U L À1 a-amylase SBF solution was configured as the simulating solution. 32 The sponge was added to the centrifuge tube at a ratio of 5 mg mL À1 simulating solution, and in vitro degradation experiments were conducted at 37 1C and 100 rpm. The samples were removed at 3, 6, 12, 24, 36, 48, and 72 h, centrifuged at 1 Â 10 4 rpm, the supernatant was removed and washed three times with ultrapure water, and the samples were dried under vacuum and weighed.…”

Section: Degradation Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Starch-based shape memory sponge for rapid hemostasis in penetrating wounds

Huang

Zhao

et al. 2023

J. Mater. Chem. B

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Section: Resultsmentioning

confidence: 99%

Section: Degradation Evaluationmentioning

confidence: 99%

Starch-based shape memory sponge for rapid hemostasis in penetrating wounds

Huang

Zhao

et al. 2023

J. Mater. Chem. B

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“…18 Naar and colleagues demonstrated increased survival in swine with noncompressible abdominal hemorrhage in swine treated with an injectable hydrophobically modified chitosan foam. 19 Mardani and colleagues 20 studied a chitosan-starch composite in powder form, comparing it to its components starch (Arista) and chitosan (Celox) granules in rabbit femoral artery and vein injuries. The chitosan-starch composite controlled bleeding better than starch or chitosan alone.…”

Section: Discussionmentioning

confidence: 99%

Novel cross-linked polysaccharide-polyelectrolyte hemostatic foam improves survival compared to CombatGauze in swine femoral artery hemorrhage model

Dougherty

Izer

Kunselman

et al. 2023

J Trauma Acute Care Surg

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Background Uncontrolled hemorrhage is the leading cause of preventable death in combat and civilian trauma. Efficacious hemostatic agents in junctional hemorrhage can quell blood loss and improve survival. We hypothesized that a novel hemostatic foam of starch and chitosan would improve hemostasis, and thereby increase survival in a swine femoral artery hemorrhage model when compared to CombatGauze. Methods A novel hemostatic foam of starch and chitosan was created and modified over the study period. 30 pigs (4 excluded) were assigned to treatment using either foam version 1 (FV1, n = 9) or 2 (FV2, n = 8), or CombatGauze (CG, n = 9) in a standard swine femoral artery hemorrhage model. Animals were observed for 150 minutes. Outcomes assessed included hemostasis, survival, post-treatment blood loss, IV fluid volume, and hemodynamic and laboratory trends. Results Hemostasis prior to 150 minutes was similar with 44.4%, 77.8%, and 50% of swine treated with CG, FV1 and FV2, respectively (Kaplan-Meyer and log-rank test [KM-LR] p > 0.05). Survival to 150 minutes was improved in swine treated with FV1 (100%) compared to CG (55.6%) (KM-LR p = 0.02). Survival was similar between FV1 and FV2 (75%) (KM-LR p > 0.05), and between CG and FV2 (KM-LR p > 0.05). Using mixed model for longitudinal data, MAP decreased significantly in CG- and FV2-treated swine, while there was no significant change in MAP in FV1-treated swine. Trends in lactic acid, hematocrit, platelets, INR, and TEG were more favorable for FV1 compared to CG. Conclusions In this preclinical study of junctional hemorrhage, survival was improved in swine treated with version 1 of a novel chitosan/starch foam compared to CombatGauze. Trends in hemodynamics and laboratory data were also more favorable in the FV1-treated swine. This novel hemostatic foam may be an effective alternative to current hemostatic agents. Level of evidence not applicable Study type: Original research: animal research

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“…However, the preventive use of IV TXA regarding thromboembolic events in high-risk patients remains limited because of a lack of supporting evidence 9 , while the general interest is directed towards topical hemostatic agents 10 , 11 . Arista ® AH Absorbable Hemostatic Particles (Davol Inc., Warwick, RI, USA) is such a topical agent which harnesses the physical and chemical properties of hydrophilic microporous polysaccharide hemospheres (MPH) to assist in the control of blood loss 12 . In the field of TKA, there were two studies to evaluate MPH effectiveness for reduction of blood loss.…”

Section: Introductionmentioning

confidence: 99%

Comparison of blood loss between intra-articular microporous polysaccharide hemospheres powder and tranexamic acid following primary total knee arthroplasty

Jeon,

Cha,

et al. 2024

Sci Rep

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Total knee arthroplasty (TKA) is associated with substantial blood loss and tranexamic acid (TXA) effectively reduces postoperative bleeding. Although it is known that there is no difference between intravenous or intra-articular (IA) injection, the general interest is directed towards topical hemostatic agents regarding thromboembolic events in high-risk patients. This study aimed to compare the blood conservation effects of IA MPH powder and TXA in patients undergoing primary TKA. We retrospectively analyzed 103 patients who underwent primary TKA between June 2020 and December 2021. MPH powder was applied to the IA space before capsule closure (MPH group, n = 51). TXA (3 g) was injected via the drain after wound closure (TXA group, n = 52). All patients underwent drain clamping for three postoperative hours. The primary outcome was the drain output, and the secondary outcomes were the postoperative hemoglobin (Hb) levels during the hospitalization period and the perioperative blood transfusion rates. An independent Student’s t-test was used to determine differences between the two groups. The drain output in the first 24 h after surgery was significantly higher in the MPH group than in the TXA group. The postoperative Hb levels were significantly lower in the MPH group than in the TXA group. In patients with simultaneous bilateral TKA, there was a significant difference in the blood transfusion volumes and the rates between groups. It is considered that IA MPH powder cannot replace IA TXA because of an inferior efficacy in reducing blood loss and maintaining postoperative Hb levels in the early postoperative period after primary TKA. Moreover, in the case of simultaneous bilateral TKA, we do not recommend the use of IA MPH powder because it was notably less effective in the field of transfusion volume and rate.

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Hemostatic efficacy of composite polysaccharide powder (starch-chitosan) for emergency bleeding control: An animal model study

Cited by 5 publications

References 21 publications

Starch-based shape memory sponge for rapid hemostasis in penetrating wounds

Starch-based shape memory sponge for rapid hemostasis in penetrating wounds

Novel cross-linked polysaccharide-polyelectrolyte hemostatic foam improves survival compared to CombatGauze in swine femoral artery hemorrhage model

Comparison of blood loss between intra-articular microporous polysaccharide hemospheres powder and tranexamic acid following primary total knee arthroplasty

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