Study On The Hemostatic Effect Of Chitosan-based Fibre In Liver Wound

Objective: Liver is one of the most important organs,which undertakes more than 5000 physiological functions.Because of vascularity,liver trauma is often accompanied by massive hemorrhage.The classical methods of hemostasis include direct compression, ligation, electric cauterization and so on ,but these methods are ineffective.The mortality rate is still as high as 2%-8%.Bleeding is the most common cause. Presently, hemostatic material including absorbable gelatin sponge, oxidized cellulose, collagen sponge and fibrin glue are used limited in clinical hepatic operation, not only because it consumes time, but also it's easily washed away by active bleeding.Chitosan is the product of chitin after deacetylation, which is natural non-toxic, non-antigetic, biocompatible and has unique biological activities. Chitosan derivatives also have good water-solude, film-forming , anti-inflammatory,so they have a wide application prospect in the field of medical materials.This experiment aims at discussing the hemostatic and healing effects of chitosan-based fibre, including acting mechanism, providing the theoretical basis as hemostasia repair material.Methods: 1.Evalute the physicochemical properties of chitosan-based fibre by using methods such as potentiometric titration and infrared spectrum. Examine the biocompatibility by hemolysis test, acute toxicity test, intradermal irritation and cytotoxicity test. 2. Establish the model of hepatic hemorrhage of New Zealand White rabbits with part of liver left lobe resection and an open-type wound.All rabbits are randomly divided into three groups: experimental group, control group and blank group. Hemostasis is performed with chitosan-based fibre in experimental group, Surgicel in control group and common gauze in blank group. The hemostatic effects and mechanism are evaluated by hemostatic rate, blood loss, prothrombin time, partial thromboplastin time, thrombin time, fibrinogen, hemorheology, erythrocyte aggregation and platelet adhesion tests. 3.Two types(chitosan-based fibre and Surgicel )are used in a model of hepatic trauma of rats. Regular macroscopic and histological observation are carried out to examine operative incision adhesion, inflammatory infiltration and tissue proliferation.The effect of the chitosan-based fibre on BRL is evaluated by using MTT.Results: 1.Chitosan-based fibre is aseptic and consistent with the standard of medical use. Experiment results show that the fibre has no hemolytic reaction, acute toxicity, intradermal irritation or cytotoxicity.The Chitosan-based fibre solutions with different densities can promote L929 proliferation,significantly for 100ug/mL. 2. Animal experiment shows that the effects of Chitosan-based fibre are better than Surgicel in hemostatic rate and blood loss(P<0.05).The hemostatic rate of Chitosan-based fibre is 100% and the blood loss is only 0.443±0.030g.Different densities of Chitosan-based fibre have no significant effect on APTT and PT,but can increase the FIB and decrease the TT. The density is directly proportional to FIB and inversely proportional to TT. The Hemorrheology test shows that Chitosan-based fibre can increase the whole blood viscosity in low stree, middle stree and high stree. The promotions of erythrocyte sedimentation and platelet aggregation are remarkable. 3. By comparing materials degradation time, inflammatory cell infiltration and wound healing through histological examination, the experimental group is much better than the control group. Chitosan-based fibre can promote BRL proliferation. The optimal concentration is 100ug/mL.Conclusions:Chitosan-based fibre is proved in those experiments to have met the biomedical materials requirements .It has outstanding biocompatibility and biodegradability. Animal experiment shows that chitosan-based fibre has effective hemostatic effect and stimulating cell proliferation. Chitosan-based fibre is a biosafetive and bioactive material with effective hemostatic and healing functions.