Hydrophobically-modified chitosan foam: description and hemostatic efficacy.

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Trauma Surgery

Background:

• Trauma causes significant mortality, with noncompressible hemorrhage being a leading cause of death.
• Rapid hemostatic agents are crucial for improving clinical outcomes in severe bleeding scenarios.
• This study investigates novel self-expanding hydrophobically modified chitosan (HM-CS) foams for managing severe liver injuries.

Purpose of the Study:

• To synthesize and characterize various HM-CS foam formulations.
• To evaluate the efficacy of HM-CS foams in controlling bleeding from severe liver injuries in a rat model.
• To assess the hemostatic potential and safety of HM-CS foams under resuscitation conditions.

Main Methods:

• Six HM-CS foam formulations were synthesized and characterized.
• Foams were tested in vitro for blood cell interaction and cytotoxicity.
• In vivo studies involved inducing severe liver injury in rats, followed by treatment with HM-CS foam, chitosan foam, or no treatment, with resuscitation.
• Survival, blood loss, mean arterial pressure, and resuscitation volume were monitored.

Main Results:

• Microscopy revealed blood cells immobilizing within the foam structure.
• HM-CS foams demonstrated no in vitro cytotoxicity to MCF7 cells over 72 hours.
• HM-CS foam application significantly reduced total blood loss (e.g., HM-CS5 group: 29.3 mL/kg vs. control: 90.9 mL/kg).
• Survival rates improved dramatically, with the HM-CS5 group achieving 100% survival compared to 0% in controls.

Conclusions:

• Spraying HM-CS foams onto severe liver injury models effectively decreased blood loss and increased survival.
• HM-CS formulations with higher hydrophobic modification (HM-CS4 and HM-CS5) showed the best hemostatic performance.
• HM-CS foam presents a promising hemostatic adjunct or standalone treatment for severe bleeding injuries.