The performance of a fly-larva shell-derived chitosan sponge as an absorbable surgical hemostatic agent

Chitosan is a versatile biomaterial lately used as a new generation of local hemostatic agent approved to date for external use only. Here we introduced a fly-larva shell-derived chitosan sponge (CS) and its feasibility for internal use as an absorbable surgical hemostatic agent was evaluated in a rat hepatic hemorrhage model. CS was a better implantable hemostatic material than gelatin sponge (GS) or oxidized cellulose (OC) in both the acute and chronic bleeding models. The better efficacy of CS may be due to its greater ability to enhance platelet activation, erythrocyte aggregation and morphological alteration, and thrombin generation at sites it is applied than GS or OC. Moreover, preliminary safety evaluations have demonstrated excellent blood and cell compatibility in hemorheological measurements, blood coagulation analysis, histological evaluations and hepatocytes culture experiments. None of CS, GS, or OC induced acute inflammation or other adverse effects while normal tissue growth and vascularization were observed in each case 4 weeks after each hemostatic agent had been implanted. Thus, CS has promising properties as an absorbable, implantable agent for promoting perioperative hemostasis and this material warrants further study.