Dai Niann-Tzyy, Fu Keng-Yen, Hsieh Pai-Shan, Hung Yu-Min, Fang Yun-Lung, Huang Nien-Chi, Lu Tzu-Wei, Dai Lien-Guo, Chen Shyi-Gen, Chen Tim-Mo
From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center; †Institute of Polymer Science and Engineering, National Taiwan University; and ‡Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.
Ann Plast Surg. 2017 Mar;78(3 Suppl 2):S124-S128. doi: 10.1097/SAP.0000000000001017.
Massive bleeding is the leading cause of battlefield-related deaths and the second leading cause of deaths in civilian trauma centers. One of the challenges of managing severe wounds is the need to promote hemostasis as quickly as possible, which can be achieved by using hemostatic dressings. In this study, we fabricated 2 kinds of gelatin/polycaprolactone composites with 2 ratios of gelatin/polycaprolactone, 1:1 and 2:1 (GP11 and GP21, respectively). Scanning electron microscopy revealed that the GP11 composite exhibited rougher and more porous structure than the GP21 composite did. Furthermore, both composites showed similar biocompatibility as that of tissue culture polystyrene. Moreover, both GP composites tended to show a gradual decrease in contact angle to zero within 40 minutes. The in vitro blood plasma coagulation assay revealed that the prothrombin time was significantly longer for the GP composites than it was for the Quikclot composite, whereas the activated partial thromboplastin time of the GP11 composite was significantly shorter than that of the gauze. Furthermore, the GP11 had the largest platelet adsorption of all the composites. The in vivo coagulation test showed an obvious shortening of the bleeding time with the Quikclot and GP21 compared with gauze sample. In conclusion, the GP composites showed superior biocompatibility and hemostasis to the gauze and comparable effects with the Qickclot composite. Therefore, the GP composites have the potential for development as biodegradable surgical hemostatic agents.
大出血是战场相关死亡的首要原因，也是 civilian trauma centers 中死亡的第二大原因。处理严重伤口的挑战之一是需要尽快促进止血，这可以通过使用止血敷料来实现。在本研究中，我们制备了两种明胶/聚己内酯复合材料，明胶与聚己内酯的比例分别为 1:1 和 2:1（分别为 GP11 和 GP21）。扫描电子显微镜显示，GP11 复合材料比 GP21 复合材料表现出更粗糙和多孔的结构。此外，两种复合材料都显示出与组织培养聚苯乙烯相似的生物相容性。而且，两种 GP 复合材料在 40 分钟内接触角都倾向于逐渐减小到零。体外血浆凝血试验表明，GP 复合材料的凝血酶原时间比 Quikclot 复合材料显著更长，而 GP11 复合材料的活化部分凝血活酶时间比纱布显著更短。此外，GP11 在所有复合材料中血小板吸附量最大。体内凝血试验表明，与纱布样本相比，使用 Quikclot 和 GP21 时出血时间明显缩短。总之，GP 复合材料显示出比纱布更好的生物相容性和止血性能，与 Quikclot 复合材料效果相当。因此，GP 复合材料有作为可生物降解手术止血剂开发的潜力。 （注：“civilian trauma centers”直译为“民用创伤中心”，结合语境可能不太准确，但按要求未做修改）
