Department of Orthopaedic Surgery, Second Affiliated Hospital and Zhejiang University-University of Edinburgh Institute and School of Basic Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Dr. Li Dak Sum and Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Nat Commun. 2019 May 14;10(1):2060. doi: 10.1038/s41467-019-10004-7.
Uncontrollable bleeding is a major problem in surgical procedures and after major trauma. Existing hemostatic agents poorly control hemorrhaging from traumatic arterial and cardiac wounds because of their weak adhesion to wet and mobile tissues. Here we design a photo-reactive adhesive that mimics the extracellular matrix (ECM) composition. This biomacromolecule-based matrix hydrogel can undergo rapid gelling and fixation to adhere and seal bleeding arteries and cardiac walls after UV light irradiation. These repairs can withstand up to 290 mm Hg blood pressure, significantly higher than blood pressures in most clinical settings (systolic BP 60-160 mm Hg). Most importantly, the hydrogel can stop high-pressure bleeding from pig carotid arteries with 4~ 5 mm-long incision wounds and from pig hearts with 6 mm diameter cardiac penetration holes. Treated pigs survived after hemostatic treatments with this hydrogel, which is well-tolerated and appears to offer significant clinical advantage as a traumatic wound sealant.
无法控制的出血是手术和重大创伤后的一个主要问题。现有的止血剂由于与湿动产组织的粘附力较弱，难以控制创伤性动脉和心脏伤口的出血。在这里，我们设计了一种光反应性粘合剂，模仿细胞外基质（ECM）的组成。这种基于生物大分子的基质水凝胶可以在紫外线照射下快速胶凝和固定，以粘附和密封出血的动脉和心脏壁。这些修复可以承受高达 290 毫米汞柱的血压，明显高于大多数临床环境中的血压（收缩压 60-160 毫米汞柱）。最重要的是，该水凝胶可以阻止猪颈动脉有 4~5 毫米长的切口伤口和猪心有 6 毫米直径的心脏穿孔的高压出血。用这种水凝胶进行止血治疗后，处理过的猪存活下来，该水凝胶耐受性良好，似乎作为一种创伤性伤口密封剂具有显著的临床优势。
