[Preparation and hemostatic evaluation of chitosan composite hemostatic membrane].
OBJECTIVE
To improve the flexibility and hemostatic properties of chitosan (CS)/carboxymethyl chitosan (CMCS) hemostatic membrane by using glycerol and etamsylate to modify CS/CMCS hemostatic membrane. To investigate the mechanical properties and hemostatic capability of modified CS/CMCS hemostatic membrane.


METHODS
The 2% CS solution, 2% CMCS solution, 10%, 15%, 20%, 25%, 30% glycerol with or without 0.5% etamsylate were used to prepare CS/CMCS hemostatic membrane with or without etamsylate by solution casting according to ratio of 16 : 4 : 5. The tensile properties were evaluated by tensile test according to GB 13022-1991. Twenty venous incisions and five arterial incisions hemorrhage of 1 cm x 1 cm in rabbit ears were treated by CS/CMCS hemostatic membrane modified by 15% (group A) and 25% (group B) of glycerol, and a combination of them and 0.5% etamsylate (groups C and D). The bleeding time and blood loss were recorded.


RESULTS
The pH of yellow CS/ CMCS hemostatic membrane with thickness of 30-50 microm was 3-4. The incorporation glycerol into CS/CMCS hemostatic membrane resulted in decreasing in tensile strength (7.6%-60.2%) and modulus (97%-99%). However, elongation at break and water content increased 5.7-11.6 times and 13%-125% markedly. CS/CMCS hemostatic membrane adhered to wound rapidly, absorbed water from blood and became curly. The bleeding time and blood loss of venous incisions were (70 +/- 3) seconds and (117.2 +/- 10.8) mg, (120 +/- 10) seconds and (121.2 +/- 8.3) mg, (52 +/- 4) seconds and (98.8 +/- 5.5) mg, and (63 +/- 3) seconds and (90.3 +/- 7.1) mg in groups A, B, C, and D, respectively; showing significant differences (P < 0.05) between groups A, B and groups C, D. The bleeding time and blood loss of arterial incision were (123 +/- 10) seconds and (453.3 +/- 30.0) mg in group C.


CONCLUSIONS
CS/CMCS hemostatic membrane modified by glycerol and etamsylate can improve the flexibility, and shorten the bleeding time.
Li
Baoqiang
B
Institute for Advanced Ceramics, Harbin Institute of Technology, Harbin Heilongjiang, 150001, P.R. China. libq@hit.edu.cn
Huang
Yanming
Y
Zhang
Yuxi
Y
Sun
Zhan
Z
D000818:Animals; D048271:Chitosan / Q000031:analogs & derivatives* / Q000737:chemistry; D004979:Ethamsylate / Q000737:chemistry*; D005990:Glycerol / Q000737:chemistry*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006490:Hemostatics / Q000737:chemistry*; D008422:Materials Testing; D011817:Rabbits
D006490:Hemostatics; C514968:carboxymethyl-chitosan; D004979:Ethamsylate; D048271:Chitosan; D005990:Glycerol