Collagen/Chitosan Gels Cross-Linked with Genipin for Wound Healing in Mice with Induced Diabetes

Diabetes mellitus continues to be one of the most common diseases often associated with diabetic ulcers. Chitosan is an attractive biopolymer for wound healing due to its biodegradability, biocompatibility, mucoadhesiveness, low toxicity, and hemostatic effect. A panel of hydrogels based on chitosan, collagen, and silver nanoparticels were produced to treat diabetic wounds. The antibacterial activity, cytotoxicity, swelling, rheological properties, and longitudinal sections of hydrogels were studied. The ability of the gels for wound healing was studied in CD1 mice with alloxan-induced diabetes. Application of the gels resulted in an increase in VEGF, TGF-b1, IL-1b, and TIMP1 gene expression and earlier wound closure in a comparison with control untreated wounds. All gels increased collagen deposition, hair follicle repair, and sebaceous glands formation. The results of these tests show that the obtained hydrogels have good mechanical properties and biological activity and have potential applications in the field of wound healing. However, clinical studies are required to compare the efficacy of the gels as animal models do not reproduce full diabetes pathology.

The Effect of Tranexamic Acid and Epsilon-Aminocaproic Acid on Bleeding During Hip and Knee Arthroplasty：A Retrospective Study

PurposeTo compare the hemostatic effect and risk of thrombosis between tranexamic acid and epsilon-aminocaproic acid.MethodsA retrospective study of 140 cases of joint replacement, including 93 cases in the tranexamic acid (TXA) group and 47 cases in the epsilon-aminocaproic acid (EACA) group. TXA or EACA was injected intravenously 30 minutes before surgery, and TXA or EACA was infused into the joint cavity after the wound was closed. The drainage, blood loss and plasma albumin loss were observed after operation.ResultsThe postoperative hemoglobin loss in the two groups was 19.1±11.4g/L, 20.3±13.6g/L, P>0.05. However, the drainage volume of the TXA group was less than that of the EACA group, which were 103.3±92.1ml and 117.4±120.9ml, respectively, P<0.05. The blood transfusion rate in the TXA group was higher than that in the EACA group, 14% and 34%, respectively, P<0.05. The postoperative plasma albumin loss of the two groups of patients was 7.4±8.0g/L and 7.3±5.5g/L respectively, P=0.05.ConclusionsThe hemostatic effect of TXA was slightly better than that of EACA, and the proportion of transfusion of TXA was lower.Level of Evidence: Level III

The marketing study of the pharmaceutical market of Ukraine in the segment of antihemorrhagic agents to stop dental bleeding

Aim. To conduct the marketing research of the Ukrainian market in the segment of antihemorrhagic agents used in dentistry.Materials and methods. The study was performed using the structural analysis, logical and graphical methods, marketing analysis methods.Results. The state of the Ukrainian market of drugs of this group has been determined. The market structure has been revealed in the number of names, brands, in forms of production, manufacturers, composition. Despite the sufficient number of registered drugs at the market (26 positions), a rather small arsenal of active substances (4) and dosage forms (3) can be observed. The market is characterized by a limited amount of drugs with a certain pharmacodynamics combining a rapid hemostatic effect, safety in use, the ability to suppress bacterial flora, and without the effect on healthy tissues. However, a positive moment should be noted: by the structure of manufacturer countries the market remains domestic (60 : 40).Conclusions. The Ukrainian pharmaceutical market is characterized by a sufficient assortment of hemostatic agents, but the use of these drugs in dentistry has its limitations. Dental doctors have certain problems with the occurrence of capillary bleeding and require a sufficient amount of effective and fastacting drugs for local application. Therefore, the search and creation of new drugs with a similar action at this stage remains a relevant scientific issue.

Uterus-Preserving Treatment for Placenta Percreta by Reconstruction of the Lower Uterine Segment Using Wave Compression Suture: A Retrospective Cohort Study

Purpose To observe the hemostatic efficacy of reconstructing the lower uterine segment by wave compression sutures (WCSs) in patients with placenta previa who underwent cesarean section (CS). Methods Retrospective analysis the medical records with placenta previa underwent WCS at the West China Second University Hospital of Sichuan University.One-hundred-and-twenty-three women who received WCSs as the first uterine suture technique from January 1, 2016, to December 31, 2020, were included in this study. The hemostatic effect of WCS was compared according to the type of placenta previa and the intraoperative situation. All patients were followed up after CS. Results The hemostatic effect during CS and postpartum hemorrhage were observed. Seventy-two (58.5%) patients successfully achieved hemostasis without further intervention. Fifty-one (41.5%) cases required additional uterine artery ligation (UAL), cervical hanging maneuver (CHM), and Bakri tamponade. Seventy-nine cases exhibited thin anterior walls and lower uterine atony after placental dissection; of these, 72 (91.1%) obtained hemostasis by WCS. No patient required repeat laparotomy or hysterectomy. There were no complications attributable to the WCS following surgery. Among the five patients who had a second pregnancy, no intrauterine adhesions or abnormal uterine morphologies were caused by WCS. No ectopic or incision pregnancies occurred. Conclusions Reconstruction of the lower uterine segment by WCS is a suitable technique for patients with thin anterior walls and uterine atony of the lower uterine segment along with placenta previa. WCS is easy to perform, effective, and safe.

Evaluation of the hemostatic effect of a combination of hemostatic agents and fibrin glue in a rabbit venous hemorrhage model

Background In neurosurgery, it is important to use local hemostatic agents. We have explored a more powerful method of hemostasis by the combination of commercially available hemostatic agents with fibrin glue in the hopes of synergistic effects. Method A bleeding model was constructed by puncturing the rabbit posterior vena cava with a needle. After applying the sample to the bleeding point, compression was performed for 10 s. If temporary hemostasis was achieved after pressure release, a 30 s wash was performed to confirm that ultimate hemostasis was achieved. Up to three hemostasis attempts were performed on the same bleeding point until hemostasis was achieved, and the number of attempts required for hemostasis was counted. If hemostasis was not achieved after three attempts, it was counted as four times. Four groups were evaluated: (1) gelatin sponge alone, (2) gelatin sponge + fibrin glue, (3) oxidized cellulose alone, and (4) oxidized cellulose + fibrin glue; each group was tested 16 times. Results The median value (range minimum value–maximum value) of the number of hemostatic attempts in Group 1 to Group 4 was 3 (1–4), 1 (1–1), 4 (4–4), and 4 (2–4). In Group 2, there were two test exclusions owing to deviations of the test procedure. Conclusions The compatibility of gelatin sponge and fibrin glue was very good, with a very strong and rapid hemostatic effect compared to other methods, showed its usefulness. This combination method may be effective for a variety of venous hemorrhages in neurosurgery.

Hemostasis Effect of Absorbable Regenerative Oxidized Cellulose Materials in Colorectal Cancer Surgery

Absorbable oxidized cellulose hemostatic materials are widely used in hemostasis of veins, capillaries or smaller arteries because of their wide sources, low cost, and high biocompatibility. However, in view of the different application sites, the hemostatic effect of absorbable oxidized cellulose in different surgeries may be different, and its hemostatic effect in patients with colorectal cancer still needs more research to confirm. Therefore, this article explores the in vitro degradation of the absorbable regenerated oxidized cellulose material and its hemostatic effect in colorectal cancer surgery. Explore the in vitro degradation products that can absorb oxidized cellulose. The 44 patients undergoing colon cancer surgery were selected and randomly divided into control group (22 cases, absorbable oxidized cellulose material to stop bleeding) and observation group (22 cases, ordinary Sterile gauze to stop bleeding). The intraoperative blood loss, 3 days postoperative drainage volume, total drainage volume, and operation time of the two groups were recorded. The recovery of intestinal function after operation in the two groups was observed. The in vitro complete degradation time of the absorbable oxidized cellulose material is about 12 days. The degradation products are glucose and cellobiose, which are safe and harmless to the human body. The intraoperative blood loss, drainage volume, total drainage volume, and operation time of the observation group were significantly lower than those of the control group (P <0.05), and the postoperative intestinal function recovery of the observation group was better than that of the control group (P <0.05). In addition, there was no significant difference in the incidence of adverse reactions between the observation group and the control group (P > 0.05). Absorbable oxidized cellulose material has a good hemostatic effect in colorectal cancer surgery, and does not increase the risk of adverse reactions in patients after surgery. It is worthy of popularization and application.

Biocompatible and antibacterial soy protein isolate/quaternized chitosan composite sponges for acute upper gastrointestinal hemostasis

Innovative biomedical applications have high requirements for biomedical materials. Herein, a series of biocompatible, antibacterial and hemostatic sponges were successfully fabricated for the treatment of acute upper gastrointestinal bleeding (AUGB). Quaternized chitosan (QC) and soy protein isolate (SPI) were chemically cross-linked to obtain porous SPI/QC sponges (named SQS-n, with n = 30, 40, 50 or 60 corresponding to the weight percentage of the QC content). The chemical composition, physical properties and biological activity of SQS-n were investigated. SQS-n could support the adhesion and proliferation of L929 cells while triggering no obvious blood toxicity. Meanwhile, SQS-n exhibited good broad-spectrum antibacterial activity against both gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). The in vivo hemostatic effect of SQS-n was evaluated using three different bleeding models. The results revealed that SQS-50 performed best in reducing blood loss and hemostatic time. The overall hemostatic effect of SQS-50 was comparable to that of a commercial gelatin sponge. The enhanced antibacterial and hemostatic activities of SQS-n were mainly attributed to the QC component. In conclusion, this work developed a QC-functionalized hemostatic sponge that is highly desirable for innovative biomedical applications, such as AUGB.