Noncritical point dried air-dried samples did not show nanofibrous structure of underlying matrix. Soluble P-selectin from platelet interaction with KOD. With respect to platelet-collagen interaction, the formation of the thrombus proceeds in two key steps; adhesion of the platelets to the collagen followed by collagen-mediated platelet activation.
Initial adhesion of the platelets to collagen is mediated by the platelet receptor GPIb that binds to the A3 domain of the plasma glycoprotein vWF that in turn binds to collagen 51 and activating integrin-based receptors. Overall, the fibrillar morphology of the KOD and the putative triple helical arrangement within fiber place multiple POG tandem repeats on the fiber surface that are conducive to GPVI binding.
We quantified plasma clotting potential by incubating scaffolds with platelet poor plasma, PPP. Plasma recalcification profile on surfaces. Data was normalized to respective sample absorbance at 50 min.
Negative control absorbance was normalized to TCP 50 min absorbance. B PPP clotting rate as measured by the slope of linear region of the curves showed no significant difference for the surfaces.
C Clotting time as determined by half-max time showed that hydrogel surfaces clotted more quickly than TCP. We quantified whole blood clotting potential by incubating scaffolds with recalcified whole blood. Clots that formed on material surfaces trapped RBC within fibrin matrices. As such, absorbance values early in the assay indicate more hemoglobin presence and decrease with larger clot formation. Incubation of blood with materials allowed for quantification of potential hemolysis.
Both KOD Whole blood clotting on material surfaces. A Rate of whole blood clotting was inversely related to absorbance. Whole blood clotting times were quantified on materials surfaces. The distinct nanofibrillar morphology of KOD is similar to native nanostructured collagen and fibrin that are pivotal in abrogating physiologic bleeding and mediating wound healing.
With respect to hemostasis, fibrin clots generate a meshwork that entrap red blood cells RBC , provide a hemostatic plug, and act as the scaffold for tissue regeneration. Similarly, exposed tissue collagen acts in a manner to activate formation of platelet clots and as a barrier hemostat, to prevent hemorrhaging. As such, we sought to analyze specific interactions of blood components responsible for hemostasis with KOD. Similarly, synthetic collagen mimics such as KOD may provide an opportunity to augment wound healing.
Clinical trials have demonstrated the use of Vitagel as a hemostat that allows for improved tissue regeneration. Repeatable and reliable solid phase peptide synthesis, quality control with mass spectroscopy, HPLC, and other analytical methods ensures purity and homogeneity. While this study investigated the use of KOD without mixtures of thrombin or PRP, future studies could involve additional factors to aid in clotting or wound regeneration.
We have demonstrated the use of important chemistries that have aided in the engineering of triple helices that form stable 3D nanofibrous hydrogels in a novel collagen mimetic peptide. Second, the engineered synthetic collagen forms long-range nanofibers that may promote adhesion and activation of platelets and clotting plasma.
Third, KOD matrices have specific moieties that may interact with platelets activating them. The aforementioned factors suggest a possible mechanism for hemostasis on KOD surfaces. As a next step, we envision expanding the repertoire of the nanostructured KOD synthetic collagen family to include moieties that may promote wound healing and other key aspects of native tissue.
Additionally, we plan to study KOD in surgical bleeding in higher animal models. In addition to extravascular hemostasis, use of KOD can be extended to a variety of intravascular pathologies such as filling of graft-vessel wall space, saccular aneurysms, and therapeutic chemoembolization. The authors would like to thank Angie B. Woodley for her assistance in blood draws and Professor Miguel A. Cruz for his useful insight. Welch Foundation Grant C The manuscript was written through contributions of all authors.
All authors have given approval to the final version of the manuscript. National Center for Biotechnology Information , U. Published online Apr 2. Vivek A. Kumar , Nichole L. Taylor , Abhishek A. Jalan , Lyahn K. Hwang , Benjamin K. Wang , and Jeffery D.
Author information Article notes Copyright and License information Disclaimer. Tel: Received Jan 20; Revised Mar This article has been cited by other articles in PMC. Open in a separate window.
Figure 1. Around and within the matrix hyaluronic acid increased during the first 8 to 10 days. Initially stromal cells stained with CD34 and reticulum fibers were present at 8 to 10 days. Biopsy specimens allowed to heal without the matrix showed a delayed and an uneven increase in hyaluronic acid. Furthermore, the granulation tissue within the dermis showed no organization with a persistent acute inflammatory infiltrate and increased muscle actin-positive stromal cells as scar formation proceeded.
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Case reports and a review of the literature. Minim Invasive Neurosurg. Download references. The Authors would like to thank Dr. Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. You can also search for this author in PubMed Google Scholar. OC and SC conceived the study, assembled the various parts and wrote the paper.
All the authors participated in the design and categorized the local hemostatic agents during general discussion. Each group defined the statements and scientific foundation for the assigned category of agents, with level of evidence and grade of recommendation.
Four persons analyzed the properties of single agents with discussion with factories S. R and wrote the section of mechanism of action of each group. SS made the final editing for English language appropriateness. All the authors suggested corrections in the text, figures and tables and all approved the final text. Correspondence to Osvaldo Chiara. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Reprints and Permissions. Chiara, O. A systematic review on the use of topical hemostats in trauma and emergency surgery. BMC Surg 18, 68 Download citation. Received : 13 March Accepted : 20 August Published : 29 August Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.
Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control.
Results Fibrin adhesives, in liquid form fibrin glues or with stiff collagen fleece fibrin patch are effective in the presence of spontaneous or drug-induced coagulation disorders. Conclusions Local hemostatic agents are dissimilar products with different indications. Background A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control.
Methods The Organizing Committee O. The organizing committee and SB selected the following main topics: 1. Adhesives Liquid fibrin adhesives Fibrin patch 2. Mechanical Hemostats 3. Sealants 4. Hemostatic Dressings mineral and polysaccharides Each panelist was asked to answer the following key questions and specific sub-questions pertaining to the assigned topic: 1.
Is the hemostat effective in the presence of coagulation disorders? Which type of hemorrhage i. Is the agent effective to control fluid leakages biliary, pancreatic, urinary?
Is the agent effective to control air leak? Is the agent effective to protect vascular anastomosis? Is the agent effective to protect intestinal anastomosis? Which are the possible cautions against use of the single agent? Table 1 Grading of Recommendation from Guyatt et al. Results The database searches identified citations Fig.
Full size image. Table 3 Reviewed papers for adhesives Full size table. Table 4 Reviewed papers for mechanical hemostats Full size table. Table 5 Reviewed papers for Sealants Full size table.
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