TY - JOUR
T1 - Sprayable Foams Based on an Amphiphilic Biopolymer for Control of Hemorrhage Without Compression
AU - Dowling, Matthew B.
AU - MacIntire, Ian C.
AU - White, Joseph C.
AU - Narayan, Mayur
AU - Duggan, Michael J.
AU - King, David R.
AU - Raghavan, Srinivasa R.
N1 - Publisher Copyright:
© 2015 American Chemical Society.
PY - 2015/12/14
Y1 - 2015/12/14
N2 - Hemorrhage (severe blood loss) from traumatic injury is a leading cause of death for soldiers in combat and for young civilians. In some cases, hemorrhage can be stopped by applying compression of a tourniquet or bandage at the injury site. However, the majority of hemorrhages that prove fatal are "non-compressible", such as those due to an internal injury in the truncal region. Currently, there is no effective way to treat such injuries. In this initial study, we demonstrate that a sprayable polymer-based foam can be effective at treating bleeding from soft tissue without the need for compression. When the foam is sprayed into an open cavity created by injury, it expands and forms a self-supporting barrier that counteracts the expulsion of blood from the cavity. The active material in this foam is the amphiphilic biopolymer, hydrophobically modified chitosan (hmC), which physically connects blood cells into clusters via hydrophobic interactions (the hemostatic mechanism of hmC is thus distinct from the natural clotting cascade, and it works even with heparinized or citrated blood). The amphiphilic nature of hmC also allows it to serve as a stabilizer for the bubbles in the foam. We tested the hmC-based hemostatic foam for its ability to arrest bleeding from an injury to the liver in pigs. Hemostasis was achieved within minutes after application of the hmC foams (without the need for external compression). The total blood loss was 90% lower with the hmC foam relative to controls.
AB - Hemorrhage (severe blood loss) from traumatic injury is a leading cause of death for soldiers in combat and for young civilians. In some cases, hemorrhage can be stopped by applying compression of a tourniquet or bandage at the injury site. However, the majority of hemorrhages that prove fatal are "non-compressible", such as those due to an internal injury in the truncal region. Currently, there is no effective way to treat such injuries. In this initial study, we demonstrate that a sprayable polymer-based foam can be effective at treating bleeding from soft tissue without the need for compression. When the foam is sprayed into an open cavity created by injury, it expands and forms a self-supporting barrier that counteracts the expulsion of blood from the cavity. The active material in this foam is the amphiphilic biopolymer, hydrophobically modified chitosan (hmC), which physically connects blood cells into clusters via hydrophobic interactions (the hemostatic mechanism of hmC is thus distinct from the natural clotting cascade, and it works even with heparinized or citrated blood). The amphiphilic nature of hmC also allows it to serve as a stabilizer for the bubbles in the foam. We tested the hmC-based hemostatic foam for its ability to arrest bleeding from an injury to the liver in pigs. Hemostasis was achieved within minutes after application of the hmC foams (without the need for external compression). The total blood loss was 90% lower with the hmC foam relative to controls.
KW - hydrophobic interactions
KW - hydrophobically modified chitosan
KW - liquid foam
KW - noncompressible hemorrhage
KW - rheology
UR - http://www.scopus.com/inward/record.url?scp=84969248807&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84969248807&partnerID=8YFLogxK
U2 - 10.1021/acsbiomaterials.5b00067
DO - 10.1021/acsbiomaterials.5b00067
M3 - Article
C2 - 33445247
AN - SCOPUS:84969248807
SN - 2373-9878
VL - 1
SP - 440
EP - 447
JO - ACS Biomaterials Science and Engineering
JF - ACS Biomaterials Science and Engineering
IS - 6
ER -