Hemostatic efficacy of composite polysaccharide powder (starch-chitosan) for emergency bleeding control: An animal model study

• Published in: Surgery 2022-09, Vol.172 (3), p.1007-1014
• Main Authors: Mardani, Mohsen, Eftekharian, Hamid Reza, Naseri, Mahmood, Hosseini, Seyed Mohammad Hashem, Mohammadi, Hamid, Danesteh, Hossein, Ghadimi, Niloofar, Fazel, Saeed
• Format: Article
• Language: English
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2022.04.054

Blood clot formation or hemostasis is vital to minimize blood loss and mitigate the risk of death from severe bleeding. This study investigates the characteristics of a novel hemostatic composite containing chemically modified chitosan and starch for emergency bleeding control. The performance of this novel hemostatic powder was compared with commercially available starch-based (Arista AH) and chitosan-based (Celox) hemostats. Hemostatic composite was prepared according to the patent registered by the authors (Patent No. 100865, Iranian Intellectual Property Organization) in Bani Zist Baspar Healda, Inc. (Shiraz, Iran). The properties of the product were surveyed by Fourier-transform infrared spectroscopy and compared with Arista-AH and Celox as commercial counterparts. The cytocompatibility, hemolysis, platelet and red blood cells (RBCs) adhesion, biocompatibility, and biodegradability attributes were evaluated in in vivo and in vitro studies. Hemostatic efficacy was evaluated in 24 healthy 6-month-old male New Zealand white rabbits in lethal and sublethal injuries of femoral artery and veins, respectively. Modification and composition led to a fundamental development in physicochemical characteristics including swelling properties, water absorption, and platelet and RBC adhesion due to improved electrostatic and hydrophilic attributes. The significant superiority in clotting efficiency was confirmed after the application of the composite in 2 models of venous and arterial injury in comparison with common commercial hemostats. Simultaneous use of water-absorbing compounds and introducing positively charged functional groups to hemostatic material led to a considerable control of femoral bleeding in emergency conditions. The introduced composite was biodegradable and biocompatible and prompts RBC aggregation and platelet adhesion.