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      Superhydrophobic hemostatic nanofiber composites for fast clotting and minimal adhesion

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          Abstract

          Hemostatic materials are of great importance in medicine. However, their successful implementation is still challenging as it depends on two, often counteracting, attributes; achieving blood coagulation rapidly, before significant blood loss, and enabling subsequent facile wound-dressing removal, without clot tears and secondary bleeding. Here we illustrate an approach for achieving hemostasis, rationally targeting both attributes, via a superhydrophobic surface with immobilized carbon nanofibers (CNFs). We find that CNFs promote quick fibrin growth and cause rapid clotting, and due to their superhydrophobic nature they severely limit blood wetting to prevent blood loss and drastically reduce bacteria attachment. Furthermore, minimal contact between the clot and the superhydrophobic CNF surface yields an unforced clot detachment after clot shrinkage. All these important attributes are verified in vitro and in vivo with rat experiments. Our work thereby demonstrates that this strategy for designing hemostatic patch materials has great potential.

          Abstract

          Nanotechnology can bring significant advancements to hemostatic patches. Here, the authors design a superhydrophobic hemostatic surface with immobilized carbon nanofibers that can stop bleeding instantaneously upon application, seal the wound subsequently by promoting quick fibrin formation, and facilitate unforced and facile patch removal without tearing the wound.

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          Most cited references51

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          Development of a chitosan-based wound dressing with improved hemostatic and antimicrobial properties.

          Hemorrhage remains a leading cause of early death after trauma, and infectious complications in combat wounds continue to challenge caregivers. Although chitosan dressings have been developed to address these problems, they are not always effective in controlling bleeding or killing bacteria. We aimed to refine the chitosan dressing by incorporating a procoagulant (polyphosphate) and an antimicrobial (silver). Chitosan containing different amounts and types of polyphosphate polymers was fabricated, and their hemostatic efficacies evaluated in vitro. The optimal chitosan-polyphosphate formulation (ChiPP) accelerated blood clotting (p = 0.011), increased platelet adhesion (p=0.002), generated thrombin faster (p = 0.002), and absorbed more blood than chitosan (p 99.99% kill of Staphylococcus aureus consistently. The silver dressing also significantly reduced mortality from 90% to 14.3% in a P. aeruginosa wound infection model in mice. Although the dressing exerted severe cytotoxicity against cultured fibroblasts, wound healing was not inhibited. This study demonstrated for the first time, the application of polyphosphate as a hemostatic adjuvant, and developed a new chitosan-based composite with potent hemostatic and antimicrobial properties.
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            Flexible and microporous chitosan hydrogel/nano ZnO composite bandages for wound dressing: in vitro and in vivo evaluation.

            Current wound dressings have disadvantages such as less flexibility, poor mechanical strength, lack of porosity, and a tendency for dressings to adhere onto the wound surface; in addition, a majority of the dressings did not possess antibacterial activity. Hydrogel-based wound dressings would be helpful to provide a cooling sensation and a moisture environment, as well as act as a barrier to microbes. To overcome these hassles, we have developed flexible and microporous chitosan hydrogel/nano zinc oxide composite bandages (CZBs) via the incorporation of zinc oxide nanoparticles (nZnO) into chitosan hydrogel. The prepared nanocomposite bandages were characterized using Fourier transform infrared spectroscopy (FT-IR), X-ray diffractometry (XRD), and scanning electron microscopy (SEM). In addition, swelling, degradation, blood clotting, antibacterial, cytocompatibility, cell attachment on the material, and cell infiltration into the composite bandages were evaluated. The nanocomposite bandage showed enhanced swelling, blood clotting, and antibacterial activity. Cytocompatibility of the composite bandage has been analyzed in normal human dermal fibroblast cells. Cell attachment and infiltration studies showed that the cells were found attached to the nanocomposite bandages and penetrated into the interior. Furthermore, the in vivo evaluations in Sprague-Dawley rats revealed that these nanocomposite bandages enhanced the wound healing and helped for faster re-epithelialization and collagen deposition. The obtained data strongly encourage the use of these composite bandages for burn wounds, chronic wounds, and diabetic foot ulcers.
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              The biocompatibility of carbon nanotubes

                Author and article information

                Contributors
                dpoulikakos@ethz.ch
                bieyapc@nus.edu.sg
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                5 December 2019
                5 December 2019
                2019
                : 10
                : 5562
                Affiliations
                [1 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering, , Sun Yat-Sen University, ; Guangzhou, 510006 China
                [2 ]ISNI 0000 0001 2180 6431, GRID grid.4280.e, Department of Biomedical Engineering, , National University of Singapore, ; Singapore, 117583 Singapore
                [3 ]ISNI 0000 0001 2156 2780, GRID grid.5801.c, Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, , ETH Zurich, ; 8092 Zurich, Switzerland
                [4 ]ISNI 0000 0001 2180 6431, GRID grid.4280.e, Department of Chemical and Biomolecular Engineering, , National University of Singapore, ; Singapore, 117585 Singapore
                Author information
                http://orcid.org/0000-0002-1991-7930
                http://orcid.org/0000-0002-0049-1255
                http://orcid.org/0000-0003-3734-8839
                http://orcid.org/0000-0002-8403-8385
                http://orcid.org/0000-0001-5733-6478
                http://orcid.org/0000-0003-2918-3077
                Article
                13512
                10.1038/s41467-019-13512-8
                6895059
                31804481
                b4bcdc68-bc71-4492-9495-05b670eac45a
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 October 2018
                : 11 November 2019
                Funding
                Funded by: European Union's Horizon 2020 research and innovation programme (grant number No 801229)
                Funded by: European Union's Horizon 2020 research and innovation programme (grant number No 801229)
                Funded by: FundRef https://doi.org/10.13039/501100001350, Ministry of Health -Singapore (MOH);
                Award ID: NMRC/OFIRG/0060/2017
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/501100001381, National Research Foundation Singapore (National Research Foundation-Prime Minister's office, Republic of Singapore);
                Award ID: NRF2017-ITS002-012
                Award Recipient :
                Categories
                Article
                Custom metadata
                © The Author(s) 2019

                Uncategorized
                biomedical engineering,biomedical materials,carbon nanotubes and fullerenes,nanowires

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