State Key Laboratory of Fine Chemicals, School of Chemical Engineering, Dalian University of Technology, Dalian, 116024, PR China.
The First Affiliated Hospital of Dalian Medical University, Dalian Medical University, Dalian, 116000, PR China.
Biomaterials. 2019 Jun;205:23-37. doi: 10.1016/j.biomaterials.2019.03.016. Epub 2019 Mar 16.
Uncontrolled hemorrhage is closely related to the high risk of death. However, local hemostats still have various defects and side effects. Herein, an aldehyde dextran (PDA) sponge with proper absorption and adhesion properties is developed for hemorrhage control. PDA sponge with pore size of ∼30-50 μm fabricated by lyophilization not only absorbs blood quickly (47.7 g/g), but also possesses strong tissue adhesion (∼100 kPa). PDA sponge with low cytotoxicity and hemolysis achieves effective hemostasis and remarkable blood loss reduction in the ear vein, femoral artery and liver injuries of rabbit models. Furthermore, the exploration of hemostatic mechanisms related to tissue, blood, plasma, cells and coagulation system indicates that PDA sponge can significantly accelerate coagulation by rapid wound block, fast cells aggregation and initiation, and high coagulation factors concentration, instead of by the coagulation cascade activation. Importantly, this hemostat exhibits excellent biodegradability and nearly no skin irritation. Overall, the biodegradable and tissue adhesive PDA sponge will be a promising quick-hemostatic dressing for uncontrollable hemorrhage.
失控性出血与高死亡率密切相关。然而,局部止血剂仍存在各种缺陷和副作用。在此,我们开发了一种具有适当吸收和黏附性能的醛化葡聚糖(PDA)海绵,用于控制出血。通过冷冻干燥制备的具有约 30-50μm 孔径的 PDA 海绵不仅能快速吸收血液(47.7g/g),而且具有很强的组织黏附性(约 100kPa)。PDA 海绵具有低细胞毒性和低溶血率,在兔耳静脉、股动脉和肝脏损伤模型中实现了有效的止血和显著减少失血量。此外,与组织、血液、血浆、细胞和凝血系统相关的止血机制的探索表明,PDA 海绵可以通过快速堵塞伤口、快速细胞聚集和启动以及高凝血因子浓度来显著加速凝血,而不是通过凝血级联反应的激活。重要的是,这种止血剂具有良好的生物降解性,几乎没有皮肤刺激性。总的来说,这种可生物降解和组织黏附的 PDA 海绵将是一种有前途的用于控制失控性出血的快速止血敷料。