Hemostatic Agents Derived from Chitin and Chitosan

A recent review detailing the role of new hemostatic agents for battlefield hemorrhage control describes the interest in and necessary specifications for such materials. As a consequence, the Defense Department authorized the development and use of three deployable and FDA approved hemostatic agents: Zeolite “Quikclot” and chitosanic “Hemcon” and the American Red Cross Fibrin Dressing. Although chitosan has a number of advantages over the other hemostatic agents, it is the least understood of the three agents noted above. The use of chitosan and chitin in different physical forms as a hemostatic agent is described. The chemical properties of chitosan related to hemostatis possibly include: molecular weight, extent of ionization, counter ion, degree of deacetylation, and degree of crystallinity. Also, its ability to bind with tissues are a function of these parameters. Chitosan can be used in medical and surgical procedures by its direct application to a bleeding surface using the various physical forms such as powder, solution, coating, film, hydrogel, and filament composite.

[1]  B. Derjaguin,et al.  On the relationship between the electrostatic and the molecular component of the adhesion of elastic particles to a solid surface , 1977 .

[2]  E. C. Sung,et al.  The effect of chitosan (poly-N-acetyl glucosamine) on lingual hemostasis in heparinized rabbits. , 1999, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  W. Wake Adhesion and the formulation of adhesives , 1976 .

[4]  S. Hirano,et al.  Wet spun chitosan-collagen fibers, their chemical N-modifications, and blood compatibility. , 2000, Biomaterials.

[5]  E. Fu,et al.  Chitosan enhances platelet adhesion and aggregation. , 2003, Biochemical and biophysical research communications.

[6]  R. Shuman,et al.  Chitosan: a new topical hemostatic agent for diffuse capillary bleeding in brain tissue. , 1984, Neurosurgery.

[7]  Makoto Kikuchi,et al.  Photocrosslinkable chitosan as a dressing for wound occlusion and accelerator in healing process. , 2002, Biomaterials.

[8]  Peter Rhee,et al.  Hemorrhage control in the battlefield: role of new hemostatic agents. , 2005, Military medicine.

[9]  W. Park,et al.  Blood compatibility and biodegradability of partially N-acylated chitosan derivatives. , 1995, Biomaterials.

[10]  D. Mulder,et al.  Evaluation of Chitosan as a New Hemostatic Agent: in Vitro and in Vivo Experiments , 1986 .

[11]  Nikolaos A. Peppas,et al.  Pharmaceutical and Medical Aspects of Bioadhesive Systems for Drug Administration , 1988 .

[12]  E. Helfand,et al.  Theory of the interface between immiscible polymers , 1996 .

[13]  S. Hirano,et al.  The blood compatibility of chitosan and N-acylchitosans. , 1985, Journal of biomedical materials research.

[14]  C. P. Sharma,et al.  Use of chitosan as a biomaterial: studies on its safety and hemostatic potential. , 1997, Journal of biomedical materials research.

[15]  R. Campion The Influence of Structure on Autohesion (Self-Tack) and other forms of Diffusion into Polymers , 1975 .

[16]  M. Akashi,et al.  Alternating bioactivity of polymeric layer-by-layer assemblies: anticoagulation vs procoagulation of human blood. , 2002, Biomacromolecules.

[17]  M. Akashi,et al.  Layer-by-Layer Assembly on Hydrogel Surfaces and Control of Human Whole Blood Coagulation , 2003 .

[18]  P. Tengvall,et al.  Blood protein adsorption onto chitosan. , 2002, Biomaterials.

[19]  D. E. Perkins,et al.  United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield. , 2000, The Journal of trauma.

[20]  N. Peppas,et al.  A theory of molecular diffusion in the intestinal mucus , 1984 .

[21]  S. Hudson,et al.  Review of Chitin and Chitosan as Fiber and Film Formers , 1994 .

[22]  W. Rainer,et al.  Chitosan: a new hemostatic. , 1983, The Annals of thoracic surgery.

[23]  S. Hudson,et al.  Improved mechanical properties of chitosan fibers , 1999 .

[24]  L. Kenar,et al.  Evaluation of protective ointments used against dermal effects of nitrogen mustard, a vesicant warfare agent. , 2005, Military medicine.

[25]  G. Abraham,et al.  Development of new hydroactive dressings based on chitosan membranes: characterization and in vivo behavior. , 2003, Journal of biomedical materials research. Part A.

[26]  E. Helfand,et al.  Theory of the Interface between Immiscible Polymers. II , 1972 .

[27]  Hao Wu,et al.  Preparation and characterization of a novel Si-containing crosslinkable O-butyrylchitosan , 2004 .

[28]  W. J. Wang,et al.  Covalent immobilization of chitosan and heparin on PLGA surface. , 2003, International journal of biological macromolecules.

[29]  Richard A. Harris,et al.  Advanced hemostatic dressing development program: animal model selection criteria and results of a study of nine hemostatic dressings in a model of severe large venous hemorrhage and hepatic injury in Swine. , 2003, The Journal of trauma.

[30]  K. Powers,et al.  Physicochemical properties and blood compatibility of acylated chitosan nanoparticles , 2004 .