Evaluation Of Hemostatic Performance Of Cellulose Absorbable Hemostatic Materials With Different Materials And Shapes

Objective:To study the difference in hemostatic performance of cellulose absorbable hemostatic materials with different materials and shapes through coagulation test in vitro and hemostatic test of brain injury in rats,so as to provide reference for clinical use.Methods:1.In vitro coagulation testCellulose absorbable hemostatic materials in the form of gauze were selected and divided into:（1）carboxymethyl oxidized regenerated cellulose、（2）hydroxyethyl cellulose、（3）carboxyl oxidized regenerated cellulose,Rats were anesthetized intraperitoneally with 10%chloral hydrate（0.4ml/100g）.Whole blood was taken from external jugular vein.The hemostatic material was cut into 1cm×1cm square and placed into 50ml test tube.200ul blood sample was slowly dropped on each sample in the test tube.Then 20ul0.2mmol/l Ca Cl2 solution was added,and the test tube was placed in 37℃incubator for 3min.Then,25 ml of deionized water was added to each tube without damaging the blood clot.Subsequently,7.5 ml of the solution was removed from the test tube and placed in a 15 ml centrifuge tube.The 15 ml test tube was centrifuged at 3600 R/min for 5 min,then 1 ml supernatant was put into 1.5 ml EP tube,centrifuged again at 3600 R/min for 5 min,and then incubated at 37℃for 1 h.The solution in EP tube was divided into 200ul and added to 96 well plate.The hemoglobin level in each solution was compared by measuring the OD value at 540 nm.On this basis,different forms of carboxyl oxidation regenerated cellulose hemostatic materials were divided into:（1）gauze group、（2）fiber group、（3）non-woven group,and（4）control group.The experiment was repeated with ordinary gauze.OD values were measured at 540 nm for each group to compare their hemoglobin levels.2.Hemostatic test of brain injury in ratsAccording to the results of in vitro coagulation experiment and combined with the actual clinical use,the hemostatic materials can be divided into:（1）hydroxyethyl cellulose、（2）carboxyl oxidized regenerated cellulose、（3）Control group:No hemostatic materials were used,with 5 SD rats in each group.After intraperitoneal anesthesia with 10%chloral hydrate（0.4 ml/100g）,the cranial parietal skin was cut longitudinally,and a bone window with a length of 8mm and a width of 5mm was carefully polished at the right parietal bone 5mm from the sagittal suture and coronal suture.Keep the dura mater intact and the sagittal sinus intact.Cotton balls were used to treat the bleeding of bone window and surrounding soft tissues,and dry clean cotton balls were used to protect the periphery of bone window.Surgical scalpel was used in the center of bone window,parallel to sagittal suture,and a wound with a length of 5mm and a depth of 3mm was drawn longitudinally.In the experimental group,The 5 mm×5 mm hemostatic material was quickly placed on the wound,and then the cotton piece was applied.The cotton piece was gently pressed with 5 g weight for 1 s and then removed.The blood absorption of the cotton piece was observed.The cotton piece was removed every 10 s for observation.If the bleeding did not stop,the dry clean cotton piece was replaced and the above operation was repeated.After the cotton piece did not absorb blood again and there was no fresh bleeding in the wound,it was regarded as hemostasis if there was no new bleeding after 1 minute of observation After the hemostatic material was removed from the wound surface,the hemostatic material and the cotton piece were collected.The collected hemostatic materials and cotton pieces were dried at 37℃for 1 h,and then weighed as W₁,W（weight difference）=W₁-W₀.W can represent the amount of bleeding in rats.Compare W and T in each group to evaluate the hemostatic effect of hemostatic materials.On this basis,different forms of carboxyl oxidized cellulose hemostatic materials were selected to repeat the above experiment,and the groups were divided into:（1）gauze group、（2）fiber group,and（3）control group:no hemostatic materials were used,with 5SD rats in each group.The hemostasis time T and the weight difference W before and after the experiment were compared between each group.3.StatisticsSPSS23.0 statistical software was used for data processing.The data were expressed by mean±standard deviation and compared by F test.P value<0.05 was statistically significant.Results:1.In vitro coagulation testOD value of gauze hemostatic materials of different materials:Experimental groups:carboxymethyl oxidation regenerated cellulose group（0.1926±0.0745）,hydroxyethyl cellulose group（0.2424±0.0955）,carboxyl oxidation regenerated cellulose group（0.1756±0.0491）.Control group（0.4275±0.0292）.The OD values of the control group were all higher than that of the experimental groups,with statistical significance（P<0.05）.The pairwise comparison of the experimental groups showed no statistical significance（P>0.05）.OD value of different forms of carboxylic group oxidized to regenerate cellulose hemostatic materialsExperimental groups:gauze group（0.1756±0.0491）,fiber group（0.0019±0.0009）,non-woven group（0.0235±0.0234）.Control group（0.4275±0.0292）.Each group OD values are not all the same,OD value of the control group were higher than the experimental group,with statistical significance（P<0.05）,and the experimental group are pairwise comparison,the gauze and fibril group,the differences between the gauze with the weaving group have statistical significance（P<0.05）,while difference between fibril and weaving group has no statistical significance（P>0.05）.2.Hemostatic test of brain injury in ratsHemostatic time T（s）of gauze hemostatic materials of different materials:The experimental groups were hydroxyethyl cellulose group（134.00±27.02）and carboxyl oxidation regenerated cellulose group（114.00±11.40）.The control group（182.00±20.49）.Weight difference W（g）between gauze hemostatic materials of different materials and cotton sheets before and after the experiment:The experimental groups were hydroxyethyl cellulose group（0.0049±0.0016）and carboxyl oxidation regenerated cellulose group（0.0074±0.0013）.Control group（0.0101±0.0014）.T and W of each group were not all the same,and the difference between T and W of the control group was statistically significant（P<0.05）,while there was no statistically significant difference between T and W of each group in the experimental group（P>0.05）.Hemostasis time T（s）of regenerated cellulose by oxidation of different carboxyl groups:Experimental group:gauze group（114.00±11.40）,fiber group（74.00±11.40）Control group（182.00±20.49）Weight difference W（g）between different forms of carboxyl group and cotton sheetExperimental groups:gauze group（0.0074±0.0013）and fiber group（0.0041±0.0005）.Control group（0.0101±0.0014）.T and W of each group were different,and T and W of the control group were greater than those of the experimental groups,with statistical significance（P<0.05）.In the experimental group,T and W of the gauze group were greater than those of the fiber group,with statistical significance（P<0.05）.Conclusion:1.Cellulose absorbable hemostatic materials have a positive effect on promoting blood coagulation and treating active bleeding.2.There is no significant difference between gauze-like cellulose hemostatic materials of different materials in promoting blood coagulation and treating active bleeding.3.The performance of carboxyl oxidized regenerated cellulose hemostatic materials in the form of fibrils was better than that of gauze under different conditions.