Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, Naples 80131, Italy; Department of Pharmaceutical, Chemical and Environmental Sciences, Faculty of Engineering and Science, University of Greenwich, Medway, Central Avenue, Chatham Maritime, Kent ME4 4TB, UK.
Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini 5, Naples 80131, Italy.
J Pharm Sci. 2018 Feb;107(2):654-661. doi: 10.1016/j.xphs.2017.09.026. Epub 2017 Oct 5.
The management of wounds in patients on anticoagulant therapy who require oral surgical procedures is problematic and often results in a nonsatisfactory healing process. Here, we report a method to prepare an advanced dressing able to avoid uncontrolled bleeding by occluding the postextractive alveolar wounds, and simultaneously, capable of a fast release of tranexamic acid (TA). Composite alginate/hyaluronan (ALG/HA) sponge dressings loaded with TA were prepared by a straightforward internal gelation method followed by a freeze-drying step. Both blank and drug-loaded sponges were soft, flexible, and elegant in appearance and nonbrittle in nature. Scanning electron microscopy analysis confirmed the porous nature of these dressings. The integration of HA influenced the microstructure, reducing the porosity, modifying the water uptake kinetic, and increasing the resistance to compression. TA release from ALG/HA sponges showed a controlled release up to 3 h, and it was faster in the presence of HA. Finally, an in vitro clotting test performed on human whole blood confirmed that the TA-loaded sponges significantly reduce the blood clotting index by 30% compared with ALG/HA sponges. These results suggest that, if placed in a socket cavity, these dressings could give a relevant help to the blood hemostasis after dental extractions, especially in patients with coagulation disorders.
接受抗凝治疗的口腔手术患者的伤口管理是一个棘手的问题，往往会导致愈合过程不理想。在这里，我们报告了一种方法，制备一种先进的敷料，能够通过闭塞拔牙后牙槽窝来避免无法控制的出血，同时能够快速释放氨甲环酸（TA）。通过简单的内凝胶化方法和随后的冻干步骤制备了载有 TA 的藻酸盐/透明质酸（ALG/HA）复合海绵敷料。空白和载药海绵均柔软、有弹性、外观美观、性质坚韧。扫描电子显微镜分析证实了这些敷料的多孔性质。HA 的加入影响了微观结构，降低了孔隙率，改变了水吸收动力学，并增加了抗压强度。ALG/HA 海绵中 TA 的释放显示出长达 3 小时的控制释放，并且在存在 HA 的情况下更快。最后，在人全血上进行的体外凝血试验证实，与 ALG/HA 海绵相比，载有 TA 的海绵可使血液凝血指数降低 30%。这些结果表明，如果将这些敷料放置在牙槽窝中，它们可以在拔牙后为血液止血提供重要帮助，特别是在凝血障碍的患者中。
