Hemostatic wound dressings: Predicting their effects by in vitro tests

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.

Cuttlebone Fillers for Topical Hemorrhage and Wound Healing: In Vitro Insights and a Suppository Model

“…"Test-tube" experiments prior to cell-culture and in vivo tests are important when new prototypes are rst introduced. As was stressed by Wiegand et al 40 , "the application of controlled in vitro techniques might serve as a screening tool in the development of new hemostatic agents." Nowadays, worldwide research is concentrated on comparability between results of in vitro and in vivo tests 41,42 .…”

In vivo Hemostatic Activity of Jatropha mollissima: A Triple-Blinded, Randomized, Controlled Trial in an Animal Model

“…1 The basic treatment for bleeding wounds consists the application of pressure using gauze, in an effort to stop the blood flow, which may also need the use of suture materials. 2 As a result, hemostasis will occur in minutes, with the exception of cases involving serious wounds or bleeding disorders, in which hemostatic materials can be used to induce or accelerate coagulation. 1 The hemostatic materials should be able to curb the bleeding rapidly, be biocompatible and if possible biodegradable.…”

“…1 The hemostatic materials should be able to curb the bleeding rapidly, be biocompatible and if possible biodegradable. 2 Biomaterials have contributed to the health research field, especially in association with phytotherapy, 3 employing different medicinal plants with known or unknown biological activities. 4,5 As a result, quality control to ascertain the safety of these phytotherapy is necessary to guarantee safety against toxicity.…”

“… 1 The hemostatic materials should be able to curb the bleeding rapidly, be biocompatible and if possible biodegradable. 2 …”

A novel hemostat and antibacterial nanofibrous scaffold based on poly(vinyl alcohol)/poly(lactic acid)

“…ability to form a blood clot) would result in an effective hemostatic wound dressing. [20][21][22] Wiegand et al 23 implemented several tests to evaluate the efficacy of cotton gauze (Gazin ® , Lohmann & Rauscher, Germany), collagen The Suprasorb C Collagen Wound Dressing (SC) (Suprasorb ® C, Lohmann & Rauscher) and collagen The Puracol™ (collagen PC) Collagen Wound Dressing (PC) (Puracol™, Medline Industries, Inc., USA), and oxidized regenerated cellulose (Tabotamp ® , Johnson & Johnson, USA) for enhancing blood clotting, coagulation, and platelet activation. They used four wound dressing with acknowledged hemostyptic properties.…”