[논문]신개발 키토산 제재의 지혈 효과에 대한 비교

조영규; 이상윤; 김태정; 임현주; 오은정; 이수복; 최강영; 양정덕; 조병채; 정호윤

Abstract ▼ AI-Helper

Purpose: Many hemostatic agents and dressings have been tested with variable degree of success. Chitosan has a positive charge, it attracts red blood cells, which have a negative charge. Our goal is to test the efficacy of new developed chitosan-based hemostatic materials in providing durable hemost...

Purpose: Many hemostatic agents and dressings have been tested with variable degree of success. Chitosan has a positive charge, it attracts red blood cells, which have a negative charge. Our goal is to test the efficacy of new developed chitosan-based hemostatic materials in providing durable hemostasis in a high-flow arterial wound model. Methods: We compared each group with SD rats motality tests and in vitro blood compatibility test by blood clotting index (BCI). We devided the SD rats into 6 groups (N =15) by type of hemostatic agents. A: 100% nonwoven chitosan (degree of the deacetylation: 90%). B: 50% N-acetylation on nonwoven of chitosan gel (degree of the deacetylation: 50%). C: 60% N-acetylation on nonwoven of chitosan ge (degree of the deacetylation: 40%)l. D: Cutanplast$^{(R)}$. E: HemCon$^{(R)}$ F: Gauze. In vivo test, a proximal arterial injury was created in unilateral femoral arteries of 90 anesthetized SD rats. Each materials was made same size and thickness then applied to the injury site for 3 minutes. In vitro test, we compared each group with BCI in human blood. Results: In vivo test, group A showed lower motality rate of 46% than any other groups, Group B and C showed lower motality rate of 60% than group D and E's motality rate of 66%. In vitro test, BCI of group A ($30.6{\pm}1.2$) and B ($29.3{\pm}1.0$) were showed nearly about group D ($29.1{\pm}1.8$) and E ($27.4{\pm}1.6$). Group C ($37.1{\pm}2.0$) showed higher BCI than group A and B, it means group C decreased blood clotting. Conclusion: In conclusion, this study suggests a newly developed chitosan-based hemostatic materials induced durable hemostasis and increased blood clotting, and are considered as effective biologic hemostatic agents.

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제안 방법

A total of 90 white rats were divided into six experimental groups based on seven types of hemostatic agents, for which an experimental assessment was performed. At a 10 minute interval immediately after the surgery, the carotid artery of white rats was palpated and a 2 hr monitoring of the vital signs including the respiratory rate was performed. In the status of acute blood loss, according to the changing trends in the mortality during the observational period in each group, the results were evaluated.
At a 10 minute interval immediately after the surgery, the carotid artery of white rats was palpated and a 2 hr monitoring of the vital signs including the respiratory rate was performed. In the status of acute blood loss, according to the changing trends in the mortality during the observational period in each group, the results were evaluated.
10mL of deionized water were carefully added by dripping water down the inside wall of the bottles without disturbing the clotted blood. The blood clotting test was carried out by spectrophotometric measurement.

대상 데이터

A total of 90 white rats were divided into six experimental groups based on seven types of hemostatic agents, for which an experimental assessment was performed. At a 10 minute interval immediately after the surgery, the carotid artery of white rats was palpated and a 2 hr monitoring of the vital signs including the respiratory rate was performed.
Ninety white rats were assigned to six experimental groups (n = 15 each) according to the constituents of six types of hemostatic agents. Firstly, the hair of white rats was shaved and then disinfected with potadine and alcohol.

데이터처리

Statistical analysis was performed using Chi square test, according to which there was a significant difference between the groups at a value of p= 0.0291. The overall mortality was 46% in the group A and this was significantly lower than other groups (p < 0.

이론/모형

Thus, the chitosan spinning solution was prepared. Through a 24,000 H nozzle, the chitosan fiber with a thickness of 2 denier (a unit thickness of the fiber) was prepared based on the wet spinning method. The prepared chitosan fibers were processed into a 100% chitosan fabric with a density of 90g/m² through the Spunlace method.

성능/효과

In conclusion this study suggest a new developed chitosan-based hemostatic materials induced durable hemostasis and increased blood clotting, and are considered as effective biologic hemostatic agents. It is also presumed that it might be applied to a clinical setting so long as its some demerits are compensated.
So our team set up the upper level of deacetylation rate showing the effectiveness as 90% deacetylation and lower level as 40~50% deacetylation. In results, there was a good profile of bleeding control in the group A, B and C derived from the mortality test of overbleeding and in the group A and B derived from the BCI. According to the final results, we consider the lower level of deacetylation rate showing the effectiveness may be 40~50%, but this presumption should be necessary for the additional studies later.
These results indicate that the BCI was lower than the group A and B. In the group F (BCI = 42.7 ± 3.1), these results indicate that the degree of blood coagulation was relatively lower than all the other groups, which also reached a statistical significance (p < 0.05) (Fig. 6).
To summarize, based on the experimental findings, an animal experimental model of massive bleeding using white rats showed that the overall mortality was 46% in the group A and this was significantly lower than all the other groups (p < 0.05).

후속연구

In results, there was a good profile of bleeding control in the group A, B and C derived from the mortality test of overbleeding and in the group A and B derived from the BCI. According to the final results, we consider the lower level of deacetylation rate showing the effectiveness may be 40~50%, but this presumption should be necessary for the additional studies later. But we consider surely that new developed chitosanbased hemostatic materials are effective in durable hemostasis and increased blood clotting.

참고문헌 (15)

Berger J, Reist M, Mayer JM, Felt O, Gurny R: Structure and interactions in chitosan hydrogels formed by complexation or aggregation for biomedical applications or aggregation for biomedical applications. Eur J Pharm Biopharm 57: 35, 2004

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Klokkevold PR, Fukayama H, Sung EC, Bertolami CN: The effect of chitosan (poly-N-Acetyl Glucosamine) on Lingual Hemostasis in Heparinized Rabbits. J Oral Maxillofac Surg 57: 49, 1999

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Shih MF, Shau MD, Chang MY, Chiou SK, Chang JK, Cherng JY: Platelet absorption and hemolytic properties of liquid crystal/composite polymers. Int J Pharm 327: 117, 2006
Spotnitz WD: Active and mechanical hemostatic agents. Surgery 142: 34, 2007
Fergusson DA, Hebert PC, Mazer CD, Fremes S, MacAdams C, Murkin JM, Teoh K, Duke PC, Arellano R, Blajchman MA, Bussieres JS, Cote D, Karski J, Martineau R, Robblee JA, Rodger M, Wells G, Clinch J, Pretorius R: A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med 358: 2319, 2008

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Seyednejad H, Imani M, Jamieson T, Seifalian AM: Topical haemostatic agent. Br J Surg 95: 1197, 2008

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Hoffmeister FS, Wenner C, Wilkens HJ, Mukhtar F: Effect of N-acetyl-D-Glucosamine on wound healing of surgical wounds and on mitochondrial phosphorylation uncoupled by dinitrophenol. Surgery 56: 1129, 1964

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Prudden JF, Migel P, Hanson P, Friedrich L, Balassa L: The discovery of potent pure chemical wound-healing accelerator. Am J Surg 119: 560, 1970

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Okamoto Y, Shibazaki K, Minami S, Matsuhashi A, Tanioka S, Shigemasa Y: Evaluation of chitin and chitosan an open wound healing in dogs. J Vet Med Sci 57: 851, 1995

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Kheirabadi BS, Acheson EM, Deguzman R, Sondeen JL, Ryan KL, Delgado A, Dick EJ Jr, Holcomb JB: Hemostatic efficacy of two advanced dressings in an aortic hemorrhage model in Swine. J Trauma 59: 25, 2005
Gustafson SB, Fulkerson P, Bildfell R, Aguilera L, Hazzard TM: Chitosan dressing provides hemostasis in swine femoral arterial injury model. Prehosp Emerg Care 11: 172, 2007

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Wedmore I, McManus JG, Pusateri AE, Holcomb JB: A special report on chitosan-based hemostatic dressing: Experience in current combat operations. J Trauma 60: 655, 2006
Yang J, Tian F, Wang Z, Wang Q, Zeng YJ, Chen SQ: Effect of chitosan molecular weight and deacetylation degree on hemostasis. J Biomed Mater Res B Appl Biomater 84: 131, 2008
Sugamori T, Iwase H, Maeda M, Inoue Y, Kurosawa H: Local hemostatic effects of microcrystalline partially deacetylated chitin hydrochloride. J Biomed Mater Res 49: 225, 2000
Brandenberg G, Leibrock LG, Shuman R, Malette WG, Quigley H: Chitosan: A new topical hemostatic agent for diffuse bleeding in brain tissue. Neurosurgery 15: 9, 1984

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연합인증

신개발 키토산 제재의 지혈 효과에 대한 비교
Experimental Assessment of Hemostatic Agents: Comparison with New Developed Chitosan-Based Material 원문보기

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신개발 키토산 제재의 지혈 효과에 대한 비교 Experimental Assessment of Hemostatic Agents: Comparison with New Developed Chitosan-Based Material 원문보기

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조영규 (4) 이상윤 (5) 김태정 (2) 임현주 (4) 오은정 (5) 최강영 (28) 양정덕 (35) 조병채 (42) 정호윤 (48)

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신개발 키토산 제재의 지혈 효과에 대한 비교
Experimental Assessment of Hemostatic Agents: Comparison with New Developed Chitosan-Based Material 원문보기

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