Use of a Chitosan-Based Hemostatic Dressing in Dacryocystorhinostomy

Dailey, Roger A.; Chavez, Mauricio R.; Choi, Dongseok

doi:10.1097/iop.0b013e3181b30108

Cited by 21 publications

(7 citation statements)

References 11 publications

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“…Chitosan is also known to have, per se, several biological activities [5][6][7][8][9][10]. Due to its properties described above, chitosan has been widely studied and developed for a variety of biomedical applications including wound dressings [11][12], hemostatic dressings [13][14] and antitumor drug delivery systems [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Anticancer properties of chitosan on human melanoma are cell line dependent

Gibot

Chabaud

Bouhout

et al. 2015

International Journal of Biological Macromolecules

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Purpose: Chitosan, a natural macromolecule, is widely used in medical and pharmaceutical fields because of its distinctive properties such as bactericide, fungicide and above all its antitumor effects. Although its antitumor activity against different types of cancer had been previously described, its mechanism of action was not fully understood. Materials and Methods: Coating of chitosan has been used in cell cultures with A375, SKMEL28 and RPMI7951 cell lines. Adherence, proliferation and apoptosis were investigated. Results: Our results revealed that whereas chitosan decreased adhesion of primary melanoma A375 cell line and decreased proliferation of primary melanoma SKMEL28 cell line, it had potent pro-apoptotic effects against RPMI7951, a metastatic melanoma cell line. In these latter cells, inhibition of specific caspases confirmed that apoptosis was effected through the mitochondrial pathway and Western blot analyses showed that chitosan induced an up regulation of pro-apoptotic molecules such as Bax and a down regulation of anti-apoptotic proteins like Bcl-2 and Bcl-XL. More interestingly, chitosan exposure induced an exposition of a greater number of CD95 receptor at RPMI7951 surface, making them more susceptible to FasL-induced apoptosis. Conclusion: Our results indicate that chitosan could be a promising agent for further evaluations in antitumor treatments targeting melanoma. Point 1: This point is very interesting, notably to verify if lower doses could also affect melanoma cells and especially the RPMI7951 metastatic cancer cells. It could also be pertinent to minimize adverse effect on healthy cells. We have evaluated the effect of chitosan concentration on RPMI7951 cell line and normal primary human dermal fibroblasts and it is reported on Fig.5C (for caspase-3 activity) and D (for cell count using WST-1 test).Point 2: Previous the first submission, we had done tests to verify whether apoptosis induction was detectable on fibroblasts but not extensively. Thus, the remark of the reviewer was a chance to improve this paper. Chitosan effect was assessed on adhesion, proliferation and apoptosis of normal primary human dermal fibroblasts. As depicted in fig.5A, apoptotic morphology was not seen when fibroblasts were cultured on chitosan coating as well as no/low caspase activation (Fig.5C, even at high doses of Chitosan, and Fig.5F, even when cultures were continued for 6 days). However, it could be noted that the cell number was reduced ( Fig.5D and E), probably as a result of a reduced proliferation. In vivo, because fibroblasts, unlike cancer cells, have a very slow proliferation rate, chitosan should have a low action on these cells. Cell attachment was tested (Fig.5B) and, even if a delay could be observed in the presence of chitosan after 6 hours, virtually all fibroblasts had adhered on the plate. Point 3: Long term cultures (here 6 days) have been tested. Caspase activation increased substantially when RPMI7951 were seeded onto chitosan coated plates but such a phenomenon could not b...

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Section: Introductionmentioning

confidence: 99%

Anticancer properties of chitosan on human melanoma are cell line dependent

Gibot

Chabaud

Bouhout

et al. 2015

International Journal of Biological Macromolecules

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“…9 This special characteristic is an important advantage in case of patients with bleeding disorders. 11,12 The US army has published their successful preliminary experience with the use the chitosan dressing by military medical personal. Experiments in animal models of lingual bleeding in thrombocytopathic or heparinized rabbits demonstrated that chitosan significantly reduces the time to hemostasis when compared with pad gauze.…”

Section: Discussionmentioning

confidence: 99%

Chitosan-based Dressing for the Treatment of External/Accessible Bleedings in Children With Bleeding Tendency

Misgav

Kenet

Martinowitz

2014

Journal of Pediatric Hematology/Oncology

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“…11,14 More specifically, another study found that one type of chitosan-based hemostatic dressing was effective as a hemostatic agent across multiple DCR modalities. 15 A more recent addition to our practice, XeroGel (Entellus Medical Inc, Plymouth, Minnesota) is a biocompatible, dissolvable chitosan-based sponge that expands when hydrated to tamponade local intranasal structures, thereby minimizing postoperative bleeding and edema. 16 In the context of minimal consensus on preferred postoperative hemostatic management based on longer term clinical outcomes, the aim of this study was to evaluate improvement in epiphora and need for surgical revision in patients with acquired nasolacrimal duct obstruction (NLDO) following balloon-assisted, middle meatal eDCR with chitosan-based dressing versus other bioresorbable packing versus no dressing.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Bioresorbable Chitosan-Based Dressing for Endoscopic Middle Meatal Dacryocystorhinostomy With Balloon Dilation

et al. 2019

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Purpose: To evaluate the improvement in epiphora and need for surgical revision in patients with acquired nasolacrimal duct obstruction following balloon-assisted, middle meatal endoscopic dacryocystorhinostomy with chitosan-based dressing versus bioresorbable polyurethane packing versus no packing. Patients and Methods: This was a retrospective study of consecutive adult patients seen from 2015 to 2018 with follow-up evaluation of epiphora at least 3 months after balloon-assisted, middle meatal endoscopic dacryocystorhinostomy. Patients with a history of prior punctoplasty, septoplasty, sinus surgery, or dacryocystorhinostomy of any kind were excluded. Those meeting criteria were stratified by postoperative hemostatic intervention: no packing, bioresorbable packing, and chitosan-based dressing (groups 1, 2, and 3, respectively). Procedural outcomes were graded as successes or failures based on subjective report and anatomical findings at most recent visit within an 18-month postoperative window. Instances of recommendation for revision surgery were also recorded. Results: Forty-three cases (36 patients) met the abovementioned criteria. Groups 1, 2, and 3 comprised 12, 17, and 14 cases each, respectively. Average patient age was 55.3 years old, and average duration of follow-up was 6.7 months. Significant variation in outcomes was detected across the 3 groups ( P = .0495), particularly between groups 1 and 3 ( P = .033). Use of chitosan-based dressing trended toward reduced rates of recommendation for surgical revision ( P = .203, P = .113). Conclusions: Use of chitosan-based dressing after endoscopic dacryocystorhinostomy was associated with improved subjective and anatomical outcomes. It may also contribute to less frequent need for revision surgery. Further study in a larger prospective trial is recommended.

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Use of a Chitosan-Based Hemostatic Dressing in Dacryocystorhinostomy

Abstract: The study demonstrates the effectiveness and safety of CBHD as a hemostatic agent in DCR and CDCR and as a promising alternative to CAH.

Cited by 21 publications

References 11 publications

Anticancer properties of chitosan on human melanoma are cell line dependent

Anticancer properties of chitosan on human melanoma are cell line dependent

Chitosan-based Dressing for the Treatment of External/Accessible Bleedings in Children With Bleeding Tendency

Postoperative Bioresorbable Chitosan-Based Dressing for Endoscopic Middle Meatal Dacryocystorhinostomy With Balloon Dilation

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