Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis
Abstract
:1. Introduction
2. Physiological Hemostatic Mechanisms
3. Physical Hemostatic Methods
4. Commonly Used Hemostatic Materials
5. Research and Application of Hemostatic Nanomaterials
5.1. Nanoparticles
5.2. Nanosheets
5.3. Liposomes
5.4. Nanofibers
5.5. Self-Assembling Peptides
5.6. Nanocomposite Hydrogel
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Sample Availability
References
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Hemostatic Method | Principle | Advantage | Disadvantage |
---|---|---|---|
Tourniquet hemostasis [12] | Use a hose to deflate blood vessels to stop bleeding. | Firm and reliable. | Wrapping too much will lead to skin damage, and too long will promote tissue ischemia and necrosis. |
Pneumatic hemostasis [13] | Filling the tourniquet with gas through a high-efficiency air pump can compress the limbs and block the blood flow. | The operation field of vision is clear to avoid minor structural damage. | It will cause paralysis, shock, pain, skin injury, tissue ischemia, and other adverse reactions. |
Single ligation hemostasis [14] | Hemostatic forceps were used to stop bleeding. The ligated tissue was completely sheathed by a ligation line and then ligated. | It can accurately stop bleeding by single ligation of blood vessels. | Postoperative bleeding may occur due to inaccurate ligation or falling off, and too tight will cut blood vessels. |
Suture ligation hemostasis [15] | Penetrating ligature hemostasis. | Prevent the ligature wire from falling off. | The suture takes a long time and consumes a lot of sutures, which may lead to uneven tissue alignment. |
Electrocoagulation hemostasis [16] | The coagulation current of the probe generates high heat, which promotes the edema of the tissue around the trauma, and the compressed vascular cavity becomes smaller or blocked, forming thrombosis and hemostasis. | Simple, safe, and economical. | Too long will cause the wound to become larger and deeper, resulting in bleeding again. |
Ultrasonic scalpel hemostasis [17] | Through the ultrasonic system in the handle, the kinetic energy on the cutter rod is amplified to cut the tissue. After the tissue in contact with the cutter head absorbs the ultrasonic energy, the protein hydrogen bond breaks, and then solidifies, denatures, and cuts into one. | The utility model has the advantages of a wide application range, a clear field of vision during operation, fast cutting, and small cutting tissue damage. | Slow operation, high price, and limited cutting range. |
Laser hemostasis [18] | The use of laser coagulation hemostasis, the use of heat energy to evaporate the water in the cells, promotes the degeneration and contraction of vascular wall collagen, and forms small vascular thrombosis. | It has little damage to surrounding tissues, is effective in hemostasis of capillaries and arterioles, and sterilizes at the same time. | It produces toxic smoke and is easy to adhere to after operation. |
Microwave knife Hemostasis [19] | The radiation of the microwave knife head generates heat energy, and the tissue absorbing heat energy will solidify and stop bleeding after resection. | The hemostatic effect is obvious; it is not easy to produce a burning taste, the wound heals quickly, and the postoperative bleeding is less. | Only coagulate the blood vessels within 3 mm and temporarily block the blood vessels. |
Radio frequency knife hemostasis [20] | Through RF energy, a small plasma electric field is formed in the electrolyte. After the acceleration energy is sufficient, the energy is transmitted to the tissue to destroy the protein ion bond and coagulate. | The heat effect is small, the damage is small, and the saline drops out at the same time as hemostasis. | It can only solidify blood vessels less than 2 mm. A large amount of normal saline is required in the liquid environment, which makes the operation inconvenient. |
Argon knife hemostasis [15] | Through the ionized gas conduction of high-frequency current to the tissue, the thermal effect can play a good therapeutic effect. | The gas is stable, the operation does not produce smoke, the fabric damage is small, the continuous solidification is small, and the thermal effect is small. It can form dense eschar, and the hemostatic effect is better. | It can only coagulate blood vessels < 2 mm, which may increase pneumoperitoneum pressure and promote gas embolism and vascular gas embolism. |
Ablation hemostasis [21] | Using the thermal tissue effect to dehydrate the tissue and further lead to protein degeneration, coagulation, and necrosis, electrocoagulation and electro-resection of the tissue are carried out in surgery, so as to stop bleeding and cutting. | Avoid accidental tissue injury, reduce tissue adhesion, reduce tissue injury and scar, and shorten the postoperative healing time. It is not easy to produce harmful smoke and clear vision during the operation. | The higher the tissue temperature, the deeper the damage and the worse the safety. |
Type | Hemostatic Materials | Advantage | Disadvantage |
---|---|---|---|
Polysaccharide-based Hemostatic Hydrogels [30] | Chitosan | Good biocompatibility and degradability, antibacterial and healing-promoting ability, and excellent hemostatic and adhesive properties. | It can be used in patients with coagulopathy. But hemostasis in the wound of extensive bleeding is not very satisfactory. |
Hyaluronic Acid | The ability of rapid hemostasis, accelerating wound healing and preventing infection, is similar to that of fibrin glue. | Poor mechanical properties. | |
Alginate | Can accelerate platelet aggregation to accelerate hemostasis, and has good adhesion. | It is suitable for filling the wound, especially the deep and wide surgical cavity, after endoscopic surgery. | |
Cellulose | Low cost and excellent mechanical properties. | It is suitable for packaging, application, stuffing, and other operations hemostasis for capillary arterioles and venous bleeding, but it is not suitable for the treatment of peripheral nerve-rich wounds and irregular lacerations. | |
Protein-Based Hemostatic Hydrogels [30] | Gelatin | Effective control of small blood vessel bleeding, absorption by the body within 4–6 weeks, neutral, can be used with a physiological hemostatic agent. | Water swelling may compress nerves; Use around the site of arterial bleeding may cause displacement of sponges; Use in vascular lacunae may cause embolism. |
Silk | Has unique physical and chemical properties, good mechanical strength, and certain hemostatic abilities. | SF has drawbacks such as brittleness, easy fragmentation, and difficulty in generating a uniform thickness. Further studies are warranted to create a new array of SF-based hemostatic agents. | |
Elastin | Components of the extracellular matrix in the vasculature, skin, and lung. | It is insoluble and has poor structural stability. | |
Inorganic hemostatic agent [31] | Zeolites | Contains inert mineral particles. When it is spread on a wound, the inert particles in it absorb water and clot blood factors. | It cannot achieve rapid hemostasis, and is less effective in arterial bleeding and coagulopathic patients. |
Kaolin | An aluminosilicate clay that activates hemostasis mechanisms. | It cannot achieve rapid hemostasis, and is less effective in arterial bleeding and coagulopathic patients. | |
Biologically active agents [31] | Fibrin | Fibrin adhesive accelerates the clot tissue in the application area, achieving stable and rapid hemostasis without mixing or other preparation. | The price is high, and there is a risk of disease transmission. |
Thrombin | Local thrombin activates platelets and constrains blood vessels; simple to use and quick to take effect. | The use of animal thrombin may cause an immune response and increase the likelihood of blood clots forming. | |
Tranexamic acid | A synthetic lysine analog that acts by blocking the lysine binding site on plasminogen and preventing its activation. | ||
Recombinant factor VIIa (rFVIIa) | Significantly reduced transfusion volumes. | Resulting in reduced utilization of blood products in patients with coagulation diseases, high cost, potentially harmful effects, and difficult storage. |
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Du, J.; Wang, J.; Xu, T.; Yao, H.; Yu, L.; Huang, D. Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis. Molecules 2023, 28, 5264. https://doi.org/10.3390/molecules28135264
Du J, Wang J, Xu T, Yao H, Yu L, Huang D. Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis. Molecules. 2023; 28(13):5264. https://doi.org/10.3390/molecules28135264
Chicago/Turabian StyleDu, Jian, Jingzhong Wang, Tao Xu, Hai Yao, Lili Yu, and Da Huang. 2023. "Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis" Molecules 28, no. 13: 5264. https://doi.org/10.3390/molecules28135264