PuraStat®is a novel self-assembling peptide(SAP)used as a haemostatic agent in endoscopy,with widespread application in surgical settings.While the current evidence,though deserving further expansion,demonstrates...PuraStat®is a novel self-assembling peptide(SAP)used as a haemostatic agent in endoscopy,with widespread application in surgical settings.While the current evidence,though deserving further expansion,demonstrates a good haemostatic performance profile for this substance,there remains significant heterogeneity among studies,and an analysis of this SAP as monotherapy is not always available.The recent study by Bellester et al in the World Journal of Gastrointestinal Endoscopy provided an optimal effectiveness profile of this SAP in 45 patients treated for gastrointestinal(GI)bleeding,particularly highlighting data on its use as monotherapy in upper GI bleeding.This invited article outlines the current evidence on PuraStat®and offers a commentary on the recently published study.展开更多
Purpose: Haemocoagulase is a topical haemostatic agent which provides the adequate haemostasis after minor oral surgical procedures and it has also been proved to be beneficial in promoting wound healing. The aim of t...Purpose: Haemocoagulase is a topical haemostatic agent which provides the adequate haemostasis after minor oral surgical procedures and it has also been proved to be beneficial in promoting wound healing. The aim of this study was to check the efficacy of haemocoagulase in stopping the bleeding and its effect over wound healing after the minor oral surgical procedure. Material & Method: This study is comprised of 150 surgical sites in 75 patients. The subjects were divided into 2 groups in which Group 1 consists of 50 surgical sites in 25 patients and Group II consists of 100 surgical sites in 50 patients. Group I comprised of the group of simple extraction. In these patients one tooth socket was selected as haemocoagulase site and the other socket was the control group in which no drug was used to control haemorrhage. Group II comprised of the group of patients with bilateral impactions. 50 sockets and surgical sites were sprinkled with Haemocoagulase, and 50 sockets and surgical sites were used as control side in which no drug was used to control haemorrhage. Results: In Group I bleeding was stopped with the average time of 1.35 minutes, while at control side bleeding was stopped with the average time of 2.25 minutes. In Group II bleeding was stopped with average time for haemostasis being 1.46 minutes, while at control side the bleeding was stopped in an average time of 2.43 minutes. Conclusion: Haemocoagulase after minor oral surgery not only provides faster haemostasis but also enhances healing.展开更多
In traumatized patients, the primary cause of mortality is uncontrollable continuous bleeding and unexpected intraoperative bleeding which is likely to increase the risk of complications and surgical failure. High exp...In traumatized patients, the primary cause of mortality is uncontrollable continuous bleeding and unexpected intraoperative bleeding which is likely to increase the risk of complications and surgical failure. High expansion sponges are effective clinical practice for the treatment of wound bleeding (irregular/deep/narrow) that are caused by capillaries, veins and even arterioles as they possess a high liquid absorption ratio so can absorb blood platelets easily in comparison with traditional haemostasis treatments, which involve compression, ligation, or electrical coagulation etc. When in contact with blood, haemostatic sponges can cause platelet adhesion, aggregation, and thrombosis, preventing blood from flowing out from wounds, triggering the release of coagulation factors, causing the blood to form a stable polymerized fibre protein, forming blood clots, and achieving the goal of wound bleeding control. Haemostatic sponges are found in a variety of shapes and sizes. The aim of this review is to facilitate an overview of recent research around haemostatic sponge materials, products, and technology. This paper reviews the synthesis, properties, and characteristics of haemostatic sponges, together with the haemostasis mechanisms of haemostatic sponges (composite materials), such as chitosan, cellulose, gelatin, starch, graphene oxide, hyaluronic acid, alginate, polyethylene glycol, silk fibroin, synthetic polymers silver nanoparticles, zinc oxide nanoparticles, mesoporous silica nanoparticles, and silica nanoparticles. Also, this paper reviews commercial sponges and their properties. In addition to this, we discuss various in-vitro/in-vivo approaches for the evaluation of the effect of sponges on haemostasis .展开更多
Although common in clinical practice,bleeding after tissue puncture may cause serious outcomes,especially in arterial puncture.Herein,gelatin-tannic acid composite hydrogels with varying compositions are prepared,and ...Although common in clinical practice,bleeding after tissue puncture may cause serious outcomes,especially in arterial puncture.Herein,gelatin-tannic acid composite hydrogels with varying compositions are prepared,and their adhesive properties are further optimized in microfluidic channel-based simulated vessels for haemostasis in arterial puncture.It is revealed that the composite hydrogels on the syringe needles used for arterial puncture should possess underwater adhesion higher than 4.9 kPa and mechanical strength higher than 86.0 kPa.The needles coated with the gelatin-tannic acid composite hydrogel completely prevent blood loss after both vein and arterial puncture in different animal models.This study holds great significance for the preparation of haemostatic needles for vessel puncture,and gelatin-tannic acid hydrogel coated needles may help to prevent complications associated with arterial puncture.展开更多
Background:Wound haemostasis is an important part of clinical treatments,especially treatments for patients with avulsion injury,destructive injury and large-scale soft tissue injury.Therefore,developing fast and effe...Background:Wound haemostasis is an important part of clinical treatments,especially treatments for patients with avulsion injury,destructive injury and large-scale soft tissue injury.Therefore,developing fast and effective haemostatic materials is critical.This study aimed to design a novel and efficient silk fibroin-gelatine composite haemostatic sponge loaded with thrombin(SFG@TB)to assist in wound haemostasis.Methods:The SFG@TB composite haemostatic sponge was formed with gelatine,silk fibroin and thrombin through a freeze-drying technique.First,the material characteristics of SFG@TB were measured,including the elastic modulus,swelling rate and porosity.Second,in vitro cell coculture experiments,in vivo embedding experiments and haemolytic analyses were performed to evaluate the biocompatibility of SFG@TB.Then,coagulation experiments and femoral artery and liver bleeding models were used to evaluate the haemostatic performance of SFG@TB.Finally,the ability of SFG@TB to promote tissue healing was evaluated through experiments with Sprague-Dawley rat models of injury.Results:Compared with gelatine sponges,SFG@TB exhibited outstanding mechanical properties and water absorption properties.In addition,the excellent biosafety of the composite haemostatic sponge was confirmed by cell experiments,subcutaneous embedding experiments and haemolytic analysis.Based on the in vitro coagulation test results,SFG@TB exhibited greater adhesion of red blood cells and platelets and a shorter dynamic coagulation time.Compared to the use of silk fibroin-gelatine composite haemostatic sponges or gelatine sponges,the introduction of thrombin resulted in a shorter haemostasis time and a smaller bleeding volume,as revealed by in vivo coagulation tests.The experiments with Sprague-Dawley rat models of injury indicated that SFG@TB accelerated the wound healing process and reduced scar width,which was accompanied by thicker granulation tissue.Conclusions:Overall,the SFG@TB composite haemostatic sponge,which exhibits outstanding mechanical properties,good haemostatic performance and high biosafety,promoted wound haemostasis and tissue repair.Therefore,the SFG@TB composite haemostatic sponge could be a promising material for wound haemostasis.展开更多
Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may b...Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may be able to cause even dangerous consequences） with a comprehensive and multidisciplinary approach, trying to use all the means is available today. The goal of this paper is to describe, even through a brief review of the literature--the State of Art about the bleeding control in oral surgery, the proper use of surgical devices and the NOACs （new oral anticoagulants） appearance.展开更多
Cell-free wound dressings (WDs) with desirable effectiveness and safety have received much attention in the field of regenerative medicine. However, the weak linkages between bioactive polymers and the spatial structu...Cell-free wound dressings (WDs) with desirable effectiveness and safety have received much attention in the field of regenerative medicine. However, the weak linkages between bioactive polymers and the spatial structure of WDs frequently result in interventional treatment failure. Herein, we create a series of quaternized chitosan (QCS)-incorporated composite hydrogels (referred to as GHCH-n) by UV cross-linking and then convert them into microneedle patches (MNPs). QCS, which is positively charged and amphiphilic, is essential for broad-spectrum antibacterial and haemostatic activities. QCS is proven to be slightly toxic, so it is immobilized into the methacrylate gelatine (GelMA) molecular cage to minimize adverse effects. A polydimethylsiloxane micro-mould is used to shape the MNPs. MNPs can pierce tissue, seal off bleeding sites, and cling to wounds securely. Thus, MNPs can cooperate with GHCH-n hydrogels to halt bleeding and accelerate wound healing. This study recommends GHCH-10 MNPs as an advanced biomaterial. Several preclinical research models have thoroughly validated the application effect of GHCH-10 MNPs. This research also proposes a novel strategy for integrating the nature of bioactive polymers and the structure of composite biomaterials. This strategy is not only applicable to the fabrication of next-generation WDs but also shows great potential in expanding interdisciplinary domains.展开更多
文摘PuraStat®is a novel self-assembling peptide(SAP)used as a haemostatic agent in endoscopy,with widespread application in surgical settings.While the current evidence,though deserving further expansion,demonstrates a good haemostatic performance profile for this substance,there remains significant heterogeneity among studies,and an analysis of this SAP as monotherapy is not always available.The recent study by Bellester et al in the World Journal of Gastrointestinal Endoscopy provided an optimal effectiveness profile of this SAP in 45 patients treated for gastrointestinal(GI)bleeding,particularly highlighting data on its use as monotherapy in upper GI bleeding.This invited article outlines the current evidence on PuraStat®and offers a commentary on the recently published study.
文摘Purpose: Haemocoagulase is a topical haemostatic agent which provides the adequate haemostasis after minor oral surgical procedures and it has also been proved to be beneficial in promoting wound healing. The aim of this study was to check the efficacy of haemocoagulase in stopping the bleeding and its effect over wound healing after the minor oral surgical procedure. Material & Method: This study is comprised of 150 surgical sites in 75 patients. The subjects were divided into 2 groups in which Group 1 consists of 50 surgical sites in 25 patients and Group II consists of 100 surgical sites in 50 patients. Group I comprised of the group of simple extraction. In these patients one tooth socket was selected as haemocoagulase site and the other socket was the control group in which no drug was used to control haemorrhage. Group II comprised of the group of patients with bilateral impactions. 50 sockets and surgical sites were sprinkled with Haemocoagulase, and 50 sockets and surgical sites were used as control side in which no drug was used to control haemorrhage. Results: In Group I bleeding was stopped with the average time of 1.35 minutes, while at control side bleeding was stopped with the average time of 2.25 minutes. In Group II bleeding was stopped with average time for haemostasis being 1.46 minutes, while at control side the bleeding was stopped in an average time of 2.43 minutes. Conclusion: Haemocoagulase after minor oral surgery not only provides faster haemostasis but also enhances healing.
基金supported by Australian National Health and Medical Research Council(HTT:APP1037310,APP1182347,APP2002827).
文摘In traumatized patients, the primary cause of mortality is uncontrollable continuous bleeding and unexpected intraoperative bleeding which is likely to increase the risk of complications and surgical failure. High expansion sponges are effective clinical practice for the treatment of wound bleeding (irregular/deep/narrow) that are caused by capillaries, veins and even arterioles as they possess a high liquid absorption ratio so can absorb blood platelets easily in comparison with traditional haemostasis treatments, which involve compression, ligation, or electrical coagulation etc. When in contact with blood, haemostatic sponges can cause platelet adhesion, aggregation, and thrombosis, preventing blood from flowing out from wounds, triggering the release of coagulation factors, causing the blood to form a stable polymerized fibre protein, forming blood clots, and achieving the goal of wound bleeding control. Haemostatic sponges are found in a variety of shapes and sizes. The aim of this review is to facilitate an overview of recent research around haemostatic sponge materials, products, and technology. This paper reviews the synthesis, properties, and characteristics of haemostatic sponges, together with the haemostasis mechanisms of haemostatic sponges (composite materials), such as chitosan, cellulose, gelatin, starch, graphene oxide, hyaluronic acid, alginate, polyethylene glycol, silk fibroin, synthetic polymers silver nanoparticles, zinc oxide nanoparticles, mesoporous silica nanoparticles, and silica nanoparticles. Also, this paper reviews commercial sponges and their properties. In addition to this, we discuss various in-vitro/in-vivo approaches for the evaluation of the effect of sponges on haemostasis .
基金supported by the National Natural Science Foundation of China(81961138007,81974096,81770711,and 52022032).
文摘Although common in clinical practice,bleeding after tissue puncture may cause serious outcomes,especially in arterial puncture.Herein,gelatin-tannic acid composite hydrogels with varying compositions are prepared,and their adhesive properties are further optimized in microfluidic channel-based simulated vessels for haemostasis in arterial puncture.It is revealed that the composite hydrogels on the syringe needles used for arterial puncture should possess underwater adhesion higher than 4.9 kPa and mechanical strength higher than 86.0 kPa.The needles coated with the gelatin-tannic acid composite hydrogel completely prevent blood loss after both vein and arterial puncture in different animal models.This study holds great significance for the preparation of haemostatic needles for vessel puncture,and gelatin-tannic acid hydrogel coated needles may help to prevent complications associated with arterial puncture.
基金supported by the National Key R&D Program of China[grant number 2022YFC3006200]the Natural Science Foundation Key Project of Tianjin[grant number 20JCZDJC00600]+2 种基金the Natural Science Foundation of China[grant numbers 81901251,82003992,82002471]the Beijing Natural Science Foundation[grant number 7232185]the Peking University People’s Hospital Scientific Research Development Funds[grant number RDG2021-06].
文摘Background:Wound haemostasis is an important part of clinical treatments,especially treatments for patients with avulsion injury,destructive injury and large-scale soft tissue injury.Therefore,developing fast and effective haemostatic materials is critical.This study aimed to design a novel and efficient silk fibroin-gelatine composite haemostatic sponge loaded with thrombin(SFG@TB)to assist in wound haemostasis.Methods:The SFG@TB composite haemostatic sponge was formed with gelatine,silk fibroin and thrombin through a freeze-drying technique.First,the material characteristics of SFG@TB were measured,including the elastic modulus,swelling rate and porosity.Second,in vitro cell coculture experiments,in vivo embedding experiments and haemolytic analyses were performed to evaluate the biocompatibility of SFG@TB.Then,coagulation experiments and femoral artery and liver bleeding models were used to evaluate the haemostatic performance of SFG@TB.Finally,the ability of SFG@TB to promote tissue healing was evaluated through experiments with Sprague-Dawley rat models of injury.Results:Compared with gelatine sponges,SFG@TB exhibited outstanding mechanical properties and water absorption properties.In addition,the excellent biosafety of the composite haemostatic sponge was confirmed by cell experiments,subcutaneous embedding experiments and haemolytic analysis.Based on the in vitro coagulation test results,SFG@TB exhibited greater adhesion of red blood cells and platelets and a shorter dynamic coagulation time.Compared to the use of silk fibroin-gelatine composite haemostatic sponges or gelatine sponges,the introduction of thrombin resulted in a shorter haemostasis time and a smaller bleeding volume,as revealed by in vivo coagulation tests.The experiments with Sprague-Dawley rat models of injury indicated that SFG@TB accelerated the wound healing process and reduced scar width,which was accompanied by thicker granulation tissue.Conclusions:Overall,the SFG@TB composite haemostatic sponge,which exhibits outstanding mechanical properties,good haemostatic performance and high biosafety,promoted wound haemostasis and tissue repair.Therefore,the SFG@TB composite haemostatic sponge could be a promising material for wound haemostasis.
文摘Understanding and managing the bleeding＇s causes is essential for a good surgical practice in general. In fact, it is crucial to know how to manage and control this problem （sometimes simply annoying, but that may be able to cause even dangerous consequences） with a comprehensive and multidisciplinary approach, trying to use all the means is available today. The goal of this paper is to describe, even through a brief review of the literature--the State of Art about the bleeding control in oral surgery, the proper use of surgical devices and the NOACs （new oral anticoagulants） appearance.
基金supported by Fellowship of China National Postdoctoral Program for Innovative Talents(BX20220240)National Natural Science Foundation of China(31800805)+3 种基金Project of Health Commission of Hubei Province(WJ2023M059)Research Program for Advanced Talents of Zhongnan Hospital(ZNYB2022010)Supporting Project of Medical Science and Technology Innovation Platform,Zhongnan Hospital of Wuhan University(CXPT20220222)Fundamental Research Funds for the Central Universities(2042023kf0080).
文摘Cell-free wound dressings (WDs) with desirable effectiveness and safety have received much attention in the field of regenerative medicine. However, the weak linkages between bioactive polymers and the spatial structure of WDs frequently result in interventional treatment failure. Herein, we create a series of quaternized chitosan (QCS)-incorporated composite hydrogels (referred to as GHCH-n) by UV cross-linking and then convert them into microneedle patches (MNPs). QCS, which is positively charged and amphiphilic, is essential for broad-spectrum antibacterial and haemostatic activities. QCS is proven to be slightly toxic, so it is immobilized into the methacrylate gelatine (GelMA) molecular cage to minimize adverse effects. A polydimethylsiloxane micro-mould is used to shape the MNPs. MNPs can pierce tissue, seal off bleeding sites, and cling to wounds securely. Thus, MNPs can cooperate with GHCH-n hydrogels to halt bleeding and accelerate wound healing. This study recommends GHCH-10 MNPs as an advanced biomaterial. Several preclinical research models have thoroughly validated the application effect of GHCH-10 MNPs. This research also proposes a novel strategy for integrating the nature of bioactive polymers and the structure of composite biomaterials. This strategy is not only applicable to the fabrication of next-generation WDs but also shows great potential in expanding interdisciplinary domains.
