title: Effective control of massive venous bleeding by "multioverlapping therapy" using polysaccharide nanosheets in a rabbit inferior vena cava injury model.
abstract: OBJECTIVE
  To investigate the efficacy of multioverlapping therapy using a polysaccharide nanosheet having 75-nm thickness for sealing and stopping massive venous hemorrhage.
  
  
  METHODS
  The hydrostatic durability of the polysaccharide nanosheet was evaluated in vitro when secured to an incised silicon tube. For in vivo studies, the inferior vena cava (IVC) of rabbits was cut longitudinally, and multiple polysaccharide nanosheets were overlapped onto the injured IVC.
  
  
  RESULTS
  The mechanical hydrostatic durability of the nanosheets was gradually augmented by an increasing number of multilayered nanosheets in vitro. This durability was saturated at 80 ± 6 mm Hg by four layers of nanosheets, which was robust enough to seal injured vessel walls of the large IVC. Multioverlapping therapy using nanosheets effectively sealed and stopped bleeding from the injured IVC in vivo. One month later, no inflammatory tissue response was observed around the nanosheet attachment sites of the IVC, while conventional suturing repair in control rabbits showed a severe inflammatory response around the sutured area.
  
  
  CONCLUSIONS
  The multioverlapping therapy using the polysaccharide nanosheets will effectively stop massive venous bleeding without adverse effects in the immediate or chronic postoperative setting.
authors.affiliation: Department of Physiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Hagisawa
authors.affiliation: Graduate School of Advanced Science and Engineering, Department of Life Science and Medical Bioscience, Waseda University, Shinjuku, Tokyo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Saito
authors.affiliation: Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Saitama, Japan. Electronic address: manabu@ndmc.ac.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Graduate School of Advanced Science and Engineering, Department of Life Science and Medical Bioscience, Waseda University, Shinjuku, Tokyo, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Fujie
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.affiliation: Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shono
authors.affiliation: Graduate School of Science and Engineering, Department of Bioscience and Bioengineering, Waseda University, Shinjuku, Tokyo, Japan.
authors.forename: Young-Kwang
authors.initials: YK
authors.lastname: Park
authors.affiliation: Graduate School of Advanced Science and Engineering, Department of Life Science and Medical Bioscience, Waseda University, Shinjuku, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Takeoka