The Efficacy of Chitosan Hemostatic Pad on Hemostatic Function in Patients Undergoing Cardiac Catheterization: A Systematic Review and Meta-Analysis

Abstract

Background: Chitin is a nitrogen-containing polysaccharide that can promote wound healing and stop bleeding. This paper investigates the effects of the addition of a chitin hemostatic patch on the time to arterial hemostasis, bleeding time, and reduction of the risk of bleeding and hematoma in patients undergoing cardiac catheterization. Methods: Databases were searched for published clinical studies. The subjects were patients who received cardiac catheterization and had a chitin hemostatic patch added at the site of arterial puncture, while the control group received routine hemostatic treatment. The research quality was evaluated using the Cochrane risk-of-bias tool, version 2.0, and the meta-analysis was carried out using RevMan software. Results: After searching literature databases, five randomized controlled trials were retrieved and included in the meta-analysis. The results showed that adding a chitin hemostatic patch could shorten the time to arterial hemostasis in patients, who received cardiac catheterization (Std. Mean Difference, -0.58; P < .001). In the subgroup analysis, the grouped effect of the chitin hemostatic patch on the bleeding time showed that the bleeding time was not significantly shortened after adding a chitin hemostatic patch in patients in the experimental group (RR, 0.78). At the same time, this measure did not significantly reduce the risk of arterial bleeding (RR, 0.49) or hematoma (RR, 0.73). Conclusions: The results of the meta-analysis showed that adding a chitin hemostatic patch at the site of arterial puncture in patients undergoing cardiac catheterization significantly reduced the time to hemostasis, but did not significantly reduce the incidence of bleeding and hematoma.

Application of chitosan-based materials in surgical or postoperative hemostasis

“…Chitosan (CS) is a natural polysaccharide. CS is biocompatible and biodegradable and plays an important role in tissue engineering and regenerative medicine, including anti-tumor, bracket, hemostasis, antibacterial, antiinflammatory, vaccine and preservatives (Hafsa et al, 2021;Huerta-Madroñal et al, 2021;Li et al, 2021;Lin et al, 2021;Yadav et al, 2021;Yan et al, 2021;Yang et al, 2021). The positively charged groups of CS can attract to negative charges on red blood cells (RBC) and platelets at the wound site, thereby achieving hemostasis (Khan and Mujahid, 2019).…”