Determination of efficacy of a novel alginate dressing in a lethal arterial injury model in swine

Matthew B. Dowling, Apurva Chaturvedi, Ian C. MacIntire, Vishal Javvaji, John Gustin, Srinivasa R. Raghavan, Thomas M. Scalea, Mayur Narayan

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Introduction Alginate is a biocompatible polysaccharide that is commonly used in the pharmaceutical, biomedical, cosmetic, and food industries. Though solid dressings composed of alginate can absorb water and promote wound healing, they are not effective hemostatic materials, particularly against massive hemorrhage. The purpose of this study is to attempt to increase the hemostatic capabilities of alginate by means of hydrophobic modification. Previous studies have illustrated that modifying a different polysaccharide, chitosan, in this way enhances its hemostatic efficacy as well as its adhesion to tissue. Here, it was hypothesized that modifying alginate with hydrophobic groups would demonstrate analogous effects. Methods Fifteen Yorkshire swine were randomized to receive hydrophobically-modified (hm) alginate lyophilized sponges (n = 5), unmodified alginate lyophilized sponges (n = 5), or standard Kerlix™ gauze dressing (n = 5) for hemostatic control. Following a splenectomy, arterial puncture (6 mm punch) of the femoral artery was made. Wounds were allowed to freely bleed for 30 s, at which time dressings were applied and compressed for 3 min in a randomized fashion. Fluid resuscitation was given to preserve the baseline mean arterial pressure. Wounds were monitored for 180 min after arterial puncture, and surviving animals were euthanized. Results Blood loss for the hm-alginate group was significantly less than the two control groups of (1) alginate and (2) Kerlix™ gauze (p = < 0.0001). Furthermore, 80% of hm-alginate sponges were able to sustain hemostasis for the full 180 min, whereas 0% of dressings from the control groups were able to achieve initial hemostasis. Conclusions Hm-alginate demonstrates a greatly superior efficacy, relative to unmodified alginate and Kerlix™ gauze dressings, in achieving hemostasis from a lethal femoral artery puncture in swine. This is a similar result as has been previously described when performing hydrophobic modification to chitosan. The current study further suggests that hydrophobic modification of a hydrophilic biopolymer backbone can significantly increase the hemostatic capabilities relative to the native biopolymer.

Original languageEnglish (US)
Pages (from-to)2105-2109
Number of pages5
JournalInjury
Volume47
Issue number10
DOIs
StatePublished - Oct 1 2016

Keywords

  • Hemostasis
  • Hemostatic dressing
  • Hm alginate
  • Modified alginate dressing
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

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    Dowling, M. B., Chaturvedi, A., MacIntire, I. C., Javvaji, V., Gustin, J., Raghavan, S. R., Scalea, T. M., & Narayan, M. (2016). Determination of efficacy of a novel alginate dressing in a lethal arterial injury model in swine. Injury, 47(10), 2105-2109. https://doi.org/10.1016/j.injury.2016.05.003