A composite sponge based on alkylated chitosan and diatom-biosilica for rapid hemostasis

Janus structure hydrogels: recent advances in synthetic strategies, biomedical microstructure and (bio)applications

Janus structure hydrogels (JSHs) are novel materials. Their primary fabrication methods and various applications have been widely reported. JSHs are primarily composed of Janus particles (JNPs) and polysaccharide components. They exhibit two distinct physical or chemical properties, generating intriguing characteristics due to their asymmetric structure. Normally, one side (adhesive interface) is predominantly constituted of polysaccharide components, primarily serving excellent adhesion. On the other side (functional surface), they integrate diverse functionalities, concurrently performing a plethora of synergistic functions. In the biomedical field, JSHs are widely applied in anti-adhesion, drug delivery, wound healing, and other areas. It also exhibits functions in seawater desalination and motion sensing. Thus, JSHs hold broad prospects for applications, and they possess significant research value in nanotechnology, environmental science, healthcare, and other fields. Additionally, this article proposes the challenges and future work facing these fields.

One-pot reaction for the preparation of diatom hemostatic particles with effective hemostasis and economic benefits

Effective hemostatic materials have been in demand for rapid pre-hospital hemostasis in emergency situations, which can significantly reduce accidental deaths. The development of emergency hemostatic materials with rapid hemostasis, biosafety, and economical preparation is a great challenge. In this study, Ca(OH)2-complexed diatom powder hemostatic particles (Ca(OH)2-Php) were prepared based on a one-pot reaction by directly mixing various raw materials and by rotary granulation. High-temperature calcination was able to carbonate and consume the organic matter in the hemostatic particles. The crosslinked hydrogen bonds in those particles were converted to silica-oxygen bonds, the particles became more stable, and the porous structure of diatom biosilica (DBs) was exposed. Ca(OH)2-Php has high porosity, can quickly adsorb the water in blood (water absorption: 75.85 ± 6.93%), and exhibits rapid hemostasis capacity (clotting time was shortened by 43% compared with that of the control group), good biocompatibility (hemolysis rate <7%, no cytotoxicity), and simplicity of handling (conveniently debride, no residues, no tissue inflammation). This study provides a new idea for the preparation of emergency hemostatic materials, and Ca(OH)2-Php prepared by one-pot reaction has various high-quality characteristics including rapid hemostasis, wide applicability, economical preparation, and potential for large-scale production.

Self-Oxidated Hydrophilic Chitosan Fibrous Mats for Fatal Hemorrhage Control

Enriching erythrocytes and platelets in seconds and providing a fast seal in bleeding sites is vital to fatal hemorrhage control. Herein, hydrophilic chitosan fibrous mats (CECS-D mats) are fabricated by introducing hydrophilic carboxyethyl groups and subsequent catechol groups onto chitosan fibers. Due to strong hydrophilicity, CECS-D mats exhibit rapid liquid-absorption capacity, especially instantaneous absorptivity to the rabbit blood, which can achieve erythrocyte and platelet aggregations quickly by concentrating blood, thus promoting the formation of blood clots. Furthermore, the mats are self-oxidated to form quinone-amine adducts or quinone multimers by adjusting pH conditions, which not only provides tissue adhesion but also induces erythrocyte aggregation and platelet adhesion, further enhancing the seal and triggering quick closure to achieve fast hemostasis. Therefore, the mats reveal superior hemostatic performance in rabbit liver and spleen models over CECS mats and gauze. Especially in the fatal femoral artery injury model of rabbits, the mats reduce the blood loss by ∼75% and shortened the bleeding time by ∼50% compared with CECS mats, which have been reported to have the same hemostatic effect as commercialized Celox products in a swine femoral artery injury model. Besides, the mats are cytocompatible and degradable as well as antibacterial. This chitosan mat is a promising hemostatic material for fatal hemorrhage control.

Zinc-mineralized diatom biosilica/hydroxybutyl chitosan composite hydrogel for diabetic chronic wound healing

For sustained and stable improvement of the diabetic wound microenvironment, a temperature-sensitive composite hydrogel (ZnDBs/HBC) composed of inorganic zinc mineralized diatom biosilica (ZnDBs) and hydroxybutyl chitosan (HBC) was developed. The interfacial anchoring effect between ZnDBs and HBC enhanced the mechanical strength of the hydrogel. The mechanical strength of the composite hydrogel containing 3 wt% ZnDBs was increased by nearly 2.3times. The hydrogel can be used as a carrier for sustained release of Zn2+ for at least 72 h. In diabetic rats models, ZnDBs/HBC composite hydrogel could accelerate the inflammatory process by regulating the expression of pro-inflammatory factor IL-6 and anti-inflammatory factor IL-10, and also promote tissue cell proliferation and collagen deposition, thereby restoring the normal healing process and accelerating wound healing. The wound contraction rate of the composite hydrogel group was more than 2 times that of the control group. Therefore, ZnDBs/HBC composite hydrogel has the potential to be used as a therapeutic dressing for diabetic chronic wounds.

Biomimetic Diatom Biosilica and Its Potential for Biomedical Applications and Prospects: A Review

Diatom biosilica is an important natural source of porous silica, with three-dimensional ordered and nanopatterned structures referred to as frustules. The unique features of diatom frustules, such as their high specific surface area, thermal stability, biocompatibility, and adaptable surface chemistry, render diatoms valuable materials for high value-added applications. These attributes make diatoms an exceptional cost-effective raw material for industrial use. The functionalization of diatom biosilica surface improves its biophysical properties and increases the potential applications. This review focuses on the potential uses of diatom biosilica including traditional approaches and recent progress in biomedical applications. Not only well-studied drug delivery systems but also promising uses on bone regeneration and wound healing are covered. Furthermore, considerable aspects and possible future directions for the use of diatom biosilica materials are proposed to develop biomedical applications and merit further exploration.

The Art of Exploring Diatom Biosilica Biomaterials: From Biofabrication Perspective

Diatom is a common single-cell microalgae with large species and huge biomass. Diatom biosilica (DB), the shell of diatom, is a natural inorganic material with a micro-nanoporous structure. Its unique hierarchical porous structure gives it great application potential in drug delivery, hemostat materials, and biosensors, etc. However, the structural diversity of DB determines its different biological functions. Screening hundreds of thousands of diatom species for structural features of DB that meet application requirements is like looking for a needle in a seaway. And the chemical modification methods lack effective means to control the micro-nanoporous structure of DB. The formation of DB is a typical biomineralization process, and its structural characteristics are affected by external environmental conditions, genes, and other factors. This allows to manipulate the micro-nanostructure of DB through biological regulation method, thereby transforming the screening mode of the structure function of DB from a needle in a seaway to biofabrication mode. This review focuses on the formation, biological modification, functional activity of DB structure, and its application in biomaterials field, providing regulatory strategies and research idea of DB from the perspective of biofabrication. It will also maximize the possibility of using DB as biological materials.

Harnessing the Potential of Chitosan and Its Derivatives for Enhanced Functionalities in Food Applications

As one of the most abundant natural polysaccharides that possess good biological activity, chitosan is extracted from chitin. Its application in the food field is being increasingly valued. However, chitosan extraction is difficult, and its poor solubility limits its application. At present, the extraction methods include the acid-base method, new chemical methods, and biological methods. The extraction rates of chitin/chitosan are 4-55%, 13-14%, and 15-28%, respectively. Different chemical modifications have different effects on chitosan, making it applicable in different fields. This article reviews and compares the extraction and chemical modification methods of chitosan, emphasizing the importance of green extraction methods. Finally, the application prospects of chitosan in the food industry are discussed. This will promote the understanding of the advantages and disadvantages of different extraction methods for chitosan as well as the relationship between modification and application, providing valuable insights for the future development of chitosan.

Antibacterial chitosan-based composite sponge with synergistic hemostatic effect for massive haemorrhage

Uncontrollable acute bleeding and wound infection pose significant challenges in emergency treatment and surgical operations. Therefore, the research and development of highly efficient antibacterial hemostatic agents are of great importance in reducing the mortality rate among patients with massive hemorrhage. In this study, we utilized hydrophobically modified chitosan (HM-CS) and gallic acid chitosan (GA-CS) to create a composite sponge (HM/GA-CS) that exhibits complementary advantages. The composite sponge combines the alkyl chain and polyphenol structure, allowing it to adsorb blood cells and plasma proteins simultaneously. This synergistic effect was confirmed through various tests, including blood cell adhesion, plasma protein barrier behavior, and in vitro hemostatic testing. Furthermore, experiments conducted on a rat liver injury model demonstrated that the composite sponge achieved rapid coagulation within 52 s, resulting in significantly lower bleeding volume compared with traditional gauze. In addition, the incorporation of GA-CS into HM-CS enhanced the antibacterial properties of the composite sponge. The antibacterial rate of the composite sponge against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) reached 100 % and 98.2 %, respectively. To evaluate its biocompatibility, the composite sponge underwent blood compatibility and cell activity tests, confirming its suitability. The HM/GA-CS sponge holds promising applications in managing cases of massive hemorrhage.

Strategies for the Preparation of Chitosan Derivatives for Antimicrobial, Drug Delivery, and Agricultural Applications: A Review

Chitosan has received much attention for its role in designing and developing novel derivatives as well as its applications across a broad spectrum of biological and physiological activities, owing to its desirable characteristics such as being biodegradable, being a biopolymer, and its overall eco-friendliness. The main objective of this review is to explore the recent chemical modifications of chitosan that have been achieved through various synthetic methods. These chitosan derivatives are categorized based on their synthetic pathways or the presence of common functional groups, which include alkylated, acylated, Schiff base, quaternary ammonia, guanidine, and heterocyclic rings. We have also described the recent applications of chitosan and its derivatives, along with nanomaterials, their mechanisms, and prospective challenges, especially in areas such as antimicrobial activities, targeted drug delivery for various diseases, and plant agricultural domains. The accumulation of these recent findings has the potential to offer insight not only into innovative approaches for the preparation of chitosan derivatives but also into their diverse applications. These insights may spark novel ideas for drug development or drug carriers, particularly in the antimicrobial, medicinal, and plant agricultural fields.

Advances in haemostatic sponges: Characteristics and the underlying mechanisms for rapid haemostasis

In traumatized patients, the primary cause of mortality is uncontrollable continuous bleeding and unexpected intraoperative bleeding which is likely to increase the risk of complications and surgical failure. High expansion sponges are effective clinical practice for the treatment of wound bleeding (irregular/deep/narrow) that are caused by capillaries, veins and even arterioles as they possess a high liquid absorption ratio so can absorb blood platelets easily in comparison with traditional haemostasis treatments, which involve compression, ligation, or electrical coagulation etc. When in contact with blood, haemostatic sponges can cause platelet adhesion, aggregation, and thrombosis, preventing blood from flowing out from wounds, triggering the release of coagulation factors, causing the blood to form a stable polymerized fibre protein, forming blood clots, and achieving the goal of wound bleeding control. Haemostatic sponges are found in a variety of shapes and sizes. The aim of this review is to facilitate an overview of recent research around haemostatic sponge materials, products, and technology. This paper reviews the synthesis, properties, and characteristics of haemostatic sponges, together with the haemostasis mechanisms of haemostatic sponges (composite materials), such as chitosan, cellulose, gelatin, starch, graphene oxide, hyaluronic acid, alginate, polyethylene glycol, silk fibroin, synthetic polymers silver nanoparticles, zinc oxide nanoparticles, mesoporous silica nanoparticles, and silica nanoparticles. Also, this paper reviews commercial sponges and their properties. In addition to this, we discuss various in-vitro/in-vivo approaches for the evaluation of the effect of sponges on haemostasis.

Physico chemical characterisation of pectin incorporated gelatin sponge and its functional evaluation in modulating contact activation haemostasis

Even though it is a common occurrence in practice, maintaining haemostasis can sometimes become a challenging issue in case of trauma, perioperative period, coagulation disorders, cancers, etc. Hemostatic materials are extensively used to assist in the cessation of bleeding. However, the definition of efficiency of haemostasis varies between intended procedures. This paper explores the feasibility of incorporating agents to increase the efficiency of local haemostasis. Pectin or β -D galacto hexopyranuronic acid/β Gal A, a structural polysaccharide widely present in terrestrial plants having an intrinsic hemostatic potential, is blended with gelatin and is explored in modulating passive haemostasis. The sponges are physico chemically characterized, and their hemostatic efficiency is evaluated in vitro using various assays. Biocompatibility evaluation is done by in vitro cytotoxicity assay. The results suggest that this biopolymer combination is a promising candidate for hemostatic control.

Multifunctional Oxidized Dextran Cross-Linked Alkylated Chitosan/Drug-Loaded and Silver-Doped Mesoporous Bioactive Glass Cryogel for Hemostasis of Noncompressible Wounds

Noncompressible wounds resulting from accidents and gunshots are typically associated with excessive bleeding, slow wound healing, and bacterial infection. Shape-memory cryogel presents great potential in controlling the hemorrhaging of noncompressible wounds. In this research, a shape-memory cryogel was prepared using a Schiff base reaction between alkylated chitosan (AC) and oxidized dextran (ODex) and then incorporated with a drug-laden and silver-doped mesoporous bioactive glass (MBG). Hydrophobic alkyl chains enhanced the hemostatic and antimicrobial efficiency of the chitosan, forming blood clots in the anticoagulated condition, and expanding the application scenarios of chitosan-based hemostats. The silver-doped MBG activated the endogenous coagulation pathway by releasing Ca²⁺ and prevented infection through the release of Ag⁺. In addition, the proangiogenic desferrioxamine (DFO) in the mesopores of the MBG was released gradually to promote wound healing. We demonstrated that AC/ODex/Ag-MBG DFO(AOM) cryogels exhibited excellent blood absorption capability, facilitating rapid shape recovery. It provided a higher hemostatic capacity in normal and heparin-treated rat-liver perforation-wound models than gelatin sponges and gauze. The AOM gels simultaneously promoted infiltration, angiogenesis, and tissue integration of liver parenchymal cells. Furthermore, the composite cryogel exhibited antibacterial activity against Staphylococcus aureus and Escherichia coli. Thus, AOM gels show great promise for clinical translation in treating lethal, noncompressible bleeding and the promotion of wound healing.

A bacteriostatic hemostatic dressing prepared from l-glutamine-modified chitosan, tannic acid-modified gelatin and oxidized dextran

In this study, porous hemostatic sponges (CGS1, CGS2 and CGS3) with proper absorption (38-43×) and air permeability (2214 g/m²·day) were prepared from l-glutamine-modified chitosan (CG), tannic acid-modified gelatin (GTA), and oxidized dextran (ODEX) by Schiff base crosslinking reaction. Among them, CGS2 was proved to have high porosity (88.98 %), durable water retention (>6 h), strong antibacterial activity, proper mechanical quality, and suitable tissue adhesion. In addition, CGS2 had good biocompatibility, mainly manifested in low hemolysis rate (<0.4 %), low cytotoxicity (relative cell activity>90 %), and good biodegradability in vitro. The hemostatic time and blood loss in CGS2 group were much lower than those in commercial gelatin sponge group in three animal injury models. Moreover, the activated partial thromboplastin time (APTT) and the prothrombin time (PT) results indicated that CGS2 promoted coagulation by activating the endogenous coagulation pathway. These results suggested that CGS2 had great potential for rapid hemostasis and avoidance of wound infection.

Review: Application of chitosan and its derivatives in medical materials

Chitin is a natural polymeric polysaccharide extracted from marine crustaceans, and chitosan is obtained by removing part of the acetyl group (usually more than 60 %) in chitin's structure. Chitosan has attracted wide attention from researchers worldwide due to its good biodegradability, biocompatibility, hypoallergenic and biological activities (antibacterial, immune and antitumor activities). However, research has shown that chitosan does not melt or dissolve in water, alkaline solutions and general organic solvents, which greatly limits its application range. Therefore, researchers have carried out extensive and in-depth chemical modification of chitosan and prepared a variety of chitosan derivatives, which have expanded the application field of chitosan. Among them, the most extensive research has been conducted in the pharmaceutical field. This paper summarizes the application of chitosan and chitosan derivatives in medical materials over the past five years.

Effect of Matrix Metalloproteinase 23 Accelerating Wound Healing Induced by Hydroxybutyl Chitosan

Skin wounds may cause severe financial and social burden due to the difficulties in wound healing. Original inert dressings cannot meet multiple needs in the process of wound healing. Therefore, the development of materials to accelerate healing progress is essential and urgent. In the previous study, we found that the homogeneously synthesized hydroxybutyl chitosan (HBCS) had an effective performance in promoting wound healing. Proteomic analysis of the same specimen suggested that matrix metalloproteinase 23 (MMP23) may play a key role in HBCS expediting the progress of wound healing. In this work, we aim to reveal the underlying mechanism of MMP23 in the dynamic process of cutaneous proliferation and repair period. In order to regulate the expression level of MMP23 in the local wound area, we leaded in adeno-associated virus (AAV) to specifically decreased expression quantity of MMP23 in rat skin. In contrast to the negative control groups, we found that the wound closed faster and the collagen fibers and neovascularization were significantly increased in AAV groups. These findings highlighted that MMP23 was involved in wound healing after traumatic injury, and managing the expression of MMP23 could be a potential intervention target to accelerate wound healing.

Chitosan-based hemostatic sponges as new generation hemostatic materials for uncontrolled bleeding emergency: Modification, composition, and applications

The choice of hemostatic technique is a curial concern for surgery and as first-aid treatment in combat. To treat uncontrolled bleeding in complex wound environments, chitosan-based hemostatic sponges have attracted significant attention in recent years because of the excellent biocompatibility, degradability, hemostasis and antibacterial properties of chitosan and their unique sponge-like morphology for high fluid absorption rate and priority aggregation of blood cells/platelets to achieve rapid hemostasis. In this review, we provide a historical perspective on the use of chitosan hemostatic sponges as the new generation of hemostatic materials for uncontrolled bleeding emergencies in complex wounds. We summarize the modification of chitosan, review the current status of preparation protocols of chitosan sponges based on various composite systems, and highlight the recent achievements on the detailed breakdown of the existing chitosan sponges to present the relationship between their composition, physical properties, and hemostatic capacity. Finally, the future opportunities and challenges of chitosan hemostatic sponges are also proposed.

Janus Self-Propelled Chitosan-Based Hydrogel Spheres for Rapid Bleeding Control

Uncontrolled hemorrhage is a major cause of potentially preventable death in civilian trauma nowadays. Considerable concern has been given to the development of efficient hemostats with high blood absorption, self-propelled property, and Ca²⁺ release ability, for irregularly shaped and noncompressible hemorrhage. Herein, Janus self-propelled chitosan-based hydrogel with CaCO₃ (J-CMH@CaCO₃ ) is developed by partial ionic crosslinking of carboxylated chitosan (CCS) and Ca²⁺ , gravity settlement, and photopolymerization, followed by removing the shell of CCS. The obtained J-CMH@CaCO₃ is further used as a hemostat powered by the internal CaCO₃ and coordinated protonated tranexamic acid (J-CMH@CaCO₃ /T). Bubbles are generated and detached to provide the driving force, accompanied by the release of Ca²⁺ . The two aspects work in synergy to accelerate clot formation, endowing the J-CMH@CaCO₃ /T with excellent hemostatic efficiency. The J-CMH@CaCO₃ /T presents high blood absorption, favorable blood-clotting ability, desired erythrocyte and platelet aggregation, and acceptable hemocompatibility and cytocompatibility. In rodent and rabbit bleeding models, the J-CMH@CaCO₃ /T exhibits the most effective hemostasis to the best knowledge of the authors, wherein the hemorrhage is rapidly halted within 39 s. It is believed that the J-CMH@CaCO₃ /T with self-propelled property opens up a new avenue to design high-performance hemostats for clinical application.

PEG-mediated hybrid hemostatic gauze with in-situ growth and tightly-bound mesoporous silicon

Pre-hospital control of bleeding is critical to save lives, however the development of hemostatic agents with efficient and safe performance is still a challenge. In this study, a hybrid hemostatic gauze (MG-PEG) with in-situ growth and tightly bound mesoporous silicon (MSN) was prepared by template method for hemorrhage control. This material integrated meso-porosity, blood coagulation and stability into flexible gauze fiber. The PEG in MG-PEG was not only used as template for the in-suit MSN growth, but also acted as joint connection between the gauze fibers and MSN. The MSN particles were firmly bound to the surface of gauze fibers with extremely low leakage after 3 min of sonication and displayed a comparable coagulant activity to untreated sample. The results of animal experiments confirmed that MG-PEG possessed superior hemostatic performance over silicates-based inorganic hemostasis-Combat Gauze, in terms of higher coagulant activity (in vivo clotting time <200 s), minimized loss of active components (liquids OD was only 3 % of CG), well biocompatibility (hemolysis ratio < 5 %, no cytotoxicity) and wider indications range for practical application.

Diatomite hemostatic particles with hierarchical porous structure for rapid and effective hemostasis

The development of fast, safe and effective hemostatic materials is crucial for pre-hospital first aid. In this study, diatomite hemostatic granules (Dhp) were developed by rotating granulation method using silica sol as binder. During rotating granulation process, the Pre-Dhp were prepared by rolling snowball effect, in which nano-silica in silica sol uniformly distributed on the surface of diatomite and polymerized through hydrogen bond to produce strong adhesion. After high-temperature calcination, the hydrogen bond transformed to silica oxygen bond and the three-dimensional gel network formed by silica sol was destroyed to exposed the pores of diatomite. Dhp retained the porous structure of diatomite with hierarchical porous structure (from nano to micro scale). Dhp could quickly adsorb the tangible components in the blood, exhibited rapid hemostatic ability (clotting time was shortened by 43 % than that of control group), and good biocompatibility (hemolysis rate < 7 %, no cytotoxicity). Dhp residue was not found in the wound of rat tail amputation model, indicating that the adhesion of silica sol and high-temperature curing treatment enhanced the stability of Dhp and reduced the hidden danger of micro thrombosis caused by residual substances entering blood vessels. Our study proved that Dhp prepared by silica sol bonding and rotary granulation was excellent hemostatic material with non-toxic side effects and rapid coagulation promotion.

Applications of Chitosan and its Derivatives in Skin and Soft Tissue Diseases

Chitosan and its derivatives are bioactive molecules that have recently been used in various fields, especially in the medical field. The antibacterial, antitumor, and immunomodulatory properties of chitosan have been extensively studied. Chitosan can be used as a drug-delivery carrier in the form of hydrogels, sponges, microspheres, nanoparticles, and thin films to treat diseases, especially those of the skin and soft tissue such as injuries and lesions of the skin, muscles, blood vessels, and nerves. Chitosan can prevent and also treat soft tissue diseases by exerting diverse biological effects such as antibacterial, antitumor, antioxidant, and tissue regeneration effects. Owing to its antitumor properties, chitosan can be used as a targeted therapy to treat soft tissue tumors. Moreover, owing to its antibacterial and antioxidant properties, chitosan can be used in the prevention and treatment of soft tissue infections. Chitosan can stop the bleeding of open wounds by promoting platelet agglutination. It can also promote the regeneration of soft tissues such as the skin, muscles, and nerves. Drug-delivery carriers containing chitosan can be used as wound dressings to promote wound healing. This review summarizes the structure and biological characteristics of chitosan and its derivatives. The recent breakthroughs and future trends of chitosan and its derivatives in therapeutic effects and drug delivery functions including anti-infection, promotion of wound healing, tissue regeneration and anticancer on soft tissue diseases are elaborated.

Copper deposited diatom-biosilica with enhanced photothermal and photodynamic performance for infected wound therapy

Considering the increase in drug resistance due to the abuse of antibiotics, the development of non-conventional antibiotics for the treatment of bacterial infections is necessary and urgent.