The hemostatic gauze is an important component of hemostasis, and a common practice in surgery. The chitosan-based biopolymer used to make this gauze slows the wicking movement of blood. This hydrophobic effect slows blood movement because long alkyl chains form USO barriers, which form dam-like barriers between the gauze fibers and layers. These barriers significantly delay blood diffusion in horizontal and vertical directions and limit blood movement in the warp and weft yarn pores. Because the barrier is so effective, blood movement is largely restricted to these pores, which results in a large accumulation of erythrocytes.

Efficacy of chitosan-based biopolymer

The proposed chitosan-based biopolyester hemostatic gauze exhibits high porosity and enhanced swelling properties, while exhibiting controlled biodegradation. Because of its large surface area and high porosity, the proposed biomaterials exhibit a higher hemostatic activity than pure chitosan alone. Further, the chitosan-based biopolymer is highly biocompatible and compatible with most tissues.

Hemostatic dressings generally consist of collagen, gelatin, or oxidized regenerated cellulose. The former is bioabsorbable, but the latter is not. The chitosan-loaded hydrogels exhibit good hemostatic efficacy in acute liver punch models in rabbits and rats. These models represent non-lethal liver injury and enable the comparison of the hemostatic efficacy of chitosan-based biopolymers.

Efficacy of chitosans-based biopolymers in hemostatic gauze has not been definitively established yet. However, chitosan-based biopolymers have undergone extensive preclinical and clinical studies. Despite a lack of definitive evidence, these new products appear to be more effective than current hemostatic gauze. Chitosan has been used as an antimicrobial agent for decades and is used in a number of commercial wound dressings. Because of its antimicrobial properties, chitosan-based hemostatic agents improve patient survival rates and promote the clotting of blood.

Clinical application

The clinical application of hemostatic gauze is varied, ranging from prehospital control of bleeding to arterial injuries. A kaolin-impregnated gauze may have a procoagulant effect and initiate the coagulation cascade. These dressings were initially developed for military use. In fact, the Israel Defense Forces Medical Corps utilized these dressings in extremity and junctional hemorrhage control. Clinical data have supported their use, although the studies are limited by bias.

In clinical trials, a polySTAT/chitosan composite gauze decreased blood loss by approximately half in a time period, with a higher survival rate. In other studies, a gel-like hemostatic gauze reduced the risk of infection by as much as 60%. For further studies, a gel-like substance was introduced into the wound, which improved blood flow and increased survival. The gel-like material has anti-coagulant properties.

In the laboratory, a self-assembling peptide has demonstrated unique hemostatic activity, which may be the key to achieving long-term clot formation. The self-assembling peptide nanofibers remain intact during the circulation, but break at the site of vascular injury. The hemostatic agent is able to bind to platelets and exert force to break microcapsules. However visit, further studies are needed to determine if the peptide is effective in the clinical setting.

Re-bleeding after removal of gauze

When it comes to treating uncontrolled hemorrhage, re-bleeding after removal of hemostatic gauge has become an increasing problem. Despite the fact that USO-g-gauze limits blood diffusion in radial and vertical directions, the duration of hemostasis is not accurate. This often leads to re-bleeding after the wound is uncovered. In addition, the time required to clot blood after removal of gauze is not known.

Hemostatic gauze absorbs a significant volume of blood before it stops bleeding. The high hydrophilic nature of cotton, its porous structure, and its capillary action among weaved fibers cause the gauze to absorb a large volume of blood prior to bleeding. This extra blood loss can result in mortality or morbidity. Blood volume is critical in the body’s circulating system. Re-bleeding after removal of hemostatic g-gauze depends on the gauze type. USO-g-gauze absorbs 0.80 g of blood, while QCG, HTMS-g-gauze, and cotton gauze absorb less than half of this amount. This is important because it can be difficult to determine the most suitable hemostatic gauze for a particular wound.