Du Changling, Liu Jingyi, Fikhman David Anthony, Dong Katheryn Shi, Monroe Mary Beth Browning
Department of Biomedical and Chemical Engineering and Syracuse BioInspired Institute, Syracuse University, Syracuse, NY, United States.
Front Bioeng Biotechnol. 2022 Feb 17;10:809361. doi: 10.3389/fbioe.2022.809361. eCollection 2022.
The leading cause of trauma-related death before arrival at a hospital is uncontrolled blood loss. Upon arrival at the hospital, microbial infections in traumatic wounds become an additional factor that increases mortality. The development of hemostatic materials with antimicrobial and antioxidant properties could improve morbidity and mortality in these wounds. To that end, phenolic acids (PAs) were successfully incorporated into the network of shape memory polymer (SMP) polyurethane foams by reacting them with isocyanates. Resulting PA-containing SMP foam shape memory properties, antimicrobial and antioxidant activity, and blood and cell interactions were characterized. Results showed that p-coumaric, vanillic, and ferulic acids were successfully incorporated into the SMP foams. The PA-containing SMP foams retained the antimicrobial and antioxidant properties of the incorporated PAs, with ∼20% HO scavenging and excellent antimicrobial properties again (∼5X reduction in CFUs vs. control foams), (∼4.5X reduction in CFUs vs. control foams, with comparable CFU counts to clinical control), and (∼25-120X reduction in CFUs vs. control foams, with comparable CFU counts to clinical control). Additionally, appropriate thermal and shape memory properties of PA foams could enable stable storage in low-profile secondary geometries at temperatures up to ∼55°C and rapid expand within ∼2 min after exposure to water in body temperature blood. PA foams had high cytocompatibility (>80%), non-hemolytic properties, and platelet attachment and activation, with improved cytocompatibility and hemocompatibility in comparison with clinical, silver-based controls. The incorporation of PAs provides a natural non-antibiotic approach to antimicrobial SMP foams with antioxidant properties. This system could improve outcomes in traumatic wounds to potentially reduce bleeding-related deaths and subsequent infections.
在抵达医院之前，创伤相关死亡的主要原因是无法控制的失血。抵达医院后，创伤伤口中的微生物感染成为增加死亡率的另一个因素。开发具有抗菌和抗氧化特性的止血材料可以改善这些伤口的发病率和死亡率。为此，通过使酚酸（PAs）与异氰酸酯反应，成功地将其掺入形状记忆聚合物（SMP）聚氨酯泡沫网络中。对所得含PA的SMP泡沫的形状记忆性能、抗菌和抗氧化活性以及血液与细胞相互作用进行了表征。结果表明，对香豆酸、香草酸和阿魏酸成功地掺入了SMP泡沫中。含PA的SMP泡沫保留了掺入的PA的抗菌和抗氧化特性，具有约20%的羟基清除能力和优异的抗菌性能（与对照泡沫相比，菌落形成单位减少约5倍），（与对照泡沫相比，菌落形成单位减少约4.5倍，与临床对照的菌落形成单位数量相当），以及（与对照泡沫相比，菌落形成单位减少约25 - 120倍，与临床对照的菌落形成单位数量相当）。此外，PA泡沫适当的热性能和形状记忆性能能够在高达约55°C的温度下以低轮廓二级几何形状稳定储存，并在暴露于体温血液中的水后约2分钟内快速膨胀。PA泡沫具有高细胞相容性（>80%）、非溶血特性以及血小板附着和活化能力，与临床银基对照相比，细胞相容性和血液相容性得到改善。PA的掺入为具有抗氧化特性的抗菌SMP泡沫提供了一种天然的非抗生素方法。该系统可以改善创伤伤口的治疗效果，有可能减少出血相关死亡和随后的感染。
