Stricker-Krongrad Anne-Heloise, Alikhassy Zahra, Matsangos Nicolette, Sebastian Raul, Marti Guy, Lay Frank, Harmon John W
Section of Surgical Sciences, Department of Surgery, John Hopkins Bayview Medical Center, John Hopkins University School of Medicine, Baltimore, Md.
Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md.
Eplasty. 2018 Mar 10;18:e14. eCollection 2018.
Excessive bleeding is a complication of wound debridement in patients receiving anticoagulation treatment. Chitosan is a linear, positively charged polysaccharide that has potential as a hemostatic topical dressing. This study examined the hemostatic efficacy of the chitosan based Opticell dressing (Medline Industries, Chicago, Ill) in heparinized rats with excisional wounds mimicking debridement. Three paired 12-mm excisional wounds were created on the dorsum of 600-g Sprague-Dawley rats 2 hours after intraperitoneal injection of heparin 800 IU/kg. Opticell or gauze dressings were applied with 3 seconds of gentle pressure. : The dressings were left in place until cessation of bleeding. Ten minutes was enough time for complete bleeding cessation in both groups. Gauze and Opticell were weighed before and after bleeding cessation, with the difference representing blood loss. Total blood loss was 627 ± 47 mg/10 min with the standard gauze, but 247 ± 47 mg/10 min with Opticell ( = .002 Mann-Whitney). N = 6 wounds per group. Gauze and Opticell dressings were removed and instantly replaced with 3 seconds of gentle pressure every minute until bleeding cessation. The removed dressings were weighed before and after application. There was less bleeding in the Opticell group at minutes 1, 2, and 3. Gauze: 183 ± 40, 140 ± 30, and 109 ± 15 mg/min vs Opticell: 91 ± 17, 54 ± 8, and 57 ± 11 mg/min). Analysis of variance, Tukey's test, < .05. N = 12 wounds per group. Topical application of Opticell dressing with chitosan has hemostatic effects that could be a useful tool to control bleeding associated with wound debridement.
出血过多是接受抗凝治疗患者伤口清创的一种并发症。壳聚糖是一种线性带正电荷的多糖，有潜力作为一种止血局部敷料。本研究在模拟清创的切除伤口的肝素化大鼠中检验了基于壳聚糖的Opticell敷料（Medline Industries，芝加哥，伊利诺伊州）的止血效果。在600克的Sprague-Dawley大鼠腹腔注射800 IU/kg肝素2小时后，在其背部制造三个成对的12毫米切除伤口。Opticell或纱布敷料在轻柔按压3秒后应用。敷料保留在位直至出血停止。两组中10分钟的时间足以使出血完全停止。出血停止前后对纱布和Opticell进行称重，差值代表失血量。使用标准纱布时总失血量为627±47毫克/1十分钟，但使用Opticell时为247±47毫克/1十分钟（曼-惠特尼检验，P = 0.002）。每组n = 6个伤口。去除纱布和Opticell敷料，每分钟轻柔按压3秒立即更换，直至出血停止。对去除的敷料应用前后进行称重。Opticell组在第1、2和3分钟时出血较少。纱布：183±40、140±30和109±15毫克/分钟，而Opticell为：91±17、54±8和57±克/分钟）。方差分析，Tukey检验，P < 0.05。每组n = 12个伤口。局部应用含壳聚糖的Opticell敷料具有止血作用，可能是控制与伤口清创相关出血的有用工具。
