摘要
针对战时和日常急性创伤引发无法控制的大出血导致高死亡率的问题,首先从纤维素的结构和性能特点入手,剖析了其制品作为高效、安全止血材料的作用机制和应用潜力;然后总结了目前纤维素基止血材料的4类研究热点,包括天然纤维素、改性纤维素、纤维素复合、纳米纤维素止血材料;详细阐述了氧化纤维素、羧甲基纤维素、羟乙基纤维素及其它纤维素基止血材料各自独特的止血机制及其6类常见产品形态(止血纤维及织物、粉末制剂、水凝胶、膜、海绵、气凝胶)、3类功能复合、多种应用场景的设计策略及其局限性和解困之法;最后提出了纤维素基止血材料未来临床应用研究聚焦于止血完成后的修复和促愈、靶向释药、智能治疗、个性化可定制设计的建议和展望。
Significance Uncontrollable massive bleeding can lead to significant blood loss,which can result in shock,organ failure,and even high mortality rates if the issue is not promptly addressed.Effective bleeding control is a fundamental aspect of medical care,and is crucial in both military and civilian trauma fields,for promoting healing,and maintaining overall health.With increasing surgical procedures and trauma cases,there is a significant demand for advanced hemostatic materials that can control bleeding rapidly and safely.Thus,clinical needs highlight the potential of natural materials like cellulose in developing sustainable and biocompatible medical solutions,aligning with the growing interest in green and environmentally friendly technologies in healthcare.Progress Cellulose-based hemostatic materials,with complex functional possibilities conferred by multifunctional groups,have become indispensable in modern trauma treatment and surgical procedures.Advancements in hemostatic materials have been driven by the need for effective,biocompatible,and biodegradable solutions in wound care.Recently,researchers have successfully modified cellulose fibers to enhance their hemostatic properties by incorporating bioactive molecules or nanoparticles.These modifications have led to improved blood absorption and clotting capabilities,as well as enhanced biocompatibility.These materials,derived from cellulose or its derivatives,offer a promising alternative to traditional hemostatic agents.One of the most well-known hemostatic materials is oxidized cellulose,which has been used clinically for decades.It functions by absorbing water from blood,concentrating platelets and clotting factors at the site of injury,and promoting the formation of blood clots.Another area of active research is the use of cellulose-based hydrogels for hemostasis.These hydrogels can be designed to adhere to tissues,providing a physical barrier to bleeding while promoting clot formation.They can also be loaded with hemostatic agents or growth factors to enhance their hemostatic efficacy.Notable achievements include the development of nanocellulose-based aerogels that exhibit rapid swelling and high porosity,facilitating efficient blood absorption.These materials have shown promising results in preclinical studies,demonstrating rapid blood clotting and reduced bleeding times compared to traditional methods.These innovations have been validated through in vitro and in vivo studies,demonstrating their efficacy and safety.These advancements hold great potential for addressing unmet needs in surgical,trauma,and emergency medicine settings.Conclusion and Prospect Cellulose-based hemostatic materials have shown great promise in controlling bleeding in various clinical settings.Especially,they have made significant strides,offering potential solutions for uncontrolled bleeding in various clinical scenarios and have laid a solid foundation for future clinical applications.However,challenges such as inflammatory reactions and foreign body responses,scalability,cost-effectiveness,and long-term biocompatibility remain.Future trends suggest a focus on personalized hemostatic solutions and the integration of advanced technologies such as 3D printing and smart materials and biomaterials science,which are expected to play a significant role in the future development of cellulose-based hemostatic materials.Future research should focus on addressing these issues while also exploring the potential of combining cellulose with other biomaterials to create multifunctional hemostatic dressings.In the future,research into hemostatic materials is moving towards the development of more efficient,versatile,and biocompatible materials to address different types of trauma and provide more optimized treatment options.
作者
符芬
王钰涵
丁凯
赵帆
李超靖
王璐
曾泳春
王富军
FU Fen;WANG Yuhan;DING Kai;ZHAO Fan;LI Chaojing;WANG Lu;ZENG Yongchun;WANG Fujun(College of Textiles,Donghua University,Shanghai 201620,China;Key Laboratory of Textile Science and Technology,Ministry of Education,Donghua University,Shanghai 201620,China;Shanghai Frontiers Science Center of Advanced Textiles,Donghua University,Shanghai 201620,China)
出处
《纺织学报》
北大核心
2025年第4期226-234,共9页
Journal of Textile Research
基金
上海市东方英才计划青年项目(ZX202404290062)
浙江省科技支撑计划项目(ZX202402270018)。
