Southern Regional Research Center - ARS, USDA, New Orleans, LA 70124, USA.
Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA.
Mil Med. 2021 Jan 25;186(Suppl 1):116-121. doi: 10.1093/milmed/usaa271.
Developing affordable and effective hemostatic and antimicrobial wound dressings for prolonged field care (PFC) of open wounds is of interest to prevent infection, to prevent sepsis, and to conserve tissue viability. The need for an effective hemostatic dressing that is also antimicrobial is required of a hemostatic dressing that can be left in place for extended periods (days). This is particularly important in light of the existence of pathogens that have coagulopathy properties. Thus, dressings that provide effective hemostasis and reduction in the frequency of dressing changes, whereas exerting robust antimicrobial activity are of interest for PFC. Highly cleaned and sterile unbleached cotton has constituents not found in bleached cotton that are beneficial to the hemostatic and inflammatory stages of wound healing. Here, we demonstrate two approaches to cotton-based antimicrobial dressings that utilize the unique components of the cotton fiber with simple modification to confer a high degree of hemostatic and antimicrobial efficacy.
Spun bond nonwoven unbleached cotton was treated using traditional pad dry cure methods to add ascorbic acid, zeolite (NaY) with pectin, calcium chloride, and sodium carbonate/calcium chloride. Similarly, nanosilver-embedded cotton fiber was blended with pristine cotton fibers at various weight ratios to produce hydroentangled nonwoven fabrics. The resulting treated fabrics were assessed for hemostasis using thromboelastographic clotting assays and antimicrobial activity utilizing American Association of Textile Chemists and Colorists 100.
Zeolite-containing dressings possessed significant hemostatic activity, whereas ascorbic acid- and silver-containing dressings reduced Gram-positive and Gram-negative organism numbers by several logs.
Based on this study, a multilayered hemostatic dressing with antimicrobial properties is envisioned. This dressing would be safe, would be economical, and have a stable shelf-life that would be conducive for using PFC.
为了预防感染、败血症和保持组织活力，开发可负担得起且有效的止血和抗菌伤口敷料以用于野外长时间（PFC）处理开放性伤口具有重要意义。对于可以长时间（数天）留在原处的止血敷料，需要一种有效的止血敷料，同时还具有抗菌作用。鉴于存在具有凝血功能障碍特性的病原体，这一点尤其重要。因此，对于 PFC，能够提供有效止血和减少更换敷料频率、同时发挥强大抗菌活性的敷料是非常有意义的。高度清洁和无菌的未漂白棉花具有未漂白棉花中没有的、有益于止血和炎症阶段伤口愈合的成分。在这里，我们展示了两种基于棉花的抗菌敷料方法，它们利用棉花纤维的独特成分，通过简单的改性赋予高度的止血和抗菌功效。
采用传统的垫干法对纺粘非织造未漂白棉进行处理，添加抗坏血酸、载有果胶的沸石（NaY）、氯化钙和碳酸钠/氯化钙。同样，将纳米银嵌入棉纤维与原棉纤维以各种重量比混合，以生产水力缠结非织造织物。使用血栓弹性图凝血测定法评估处理后的织物的止血效果，并使用美国纺织化学家和染色家协会 100 法评估抗菌活性。
含沸石的敷料具有显著的止血活性，而含抗坏血酸和银的敷料可使革兰氏阳性和革兰氏阴性菌的数量减少几个对数级。
基于这项研究，我们设想了一种具有抗菌特性的多层止血敷料。这种敷料将是安全的、经济的，并且具有稳定的保质期，非常适合用于 PFC。
