A hydrogel sealant for the treatment of severe hepatic and aortic trauma with a dissolution feature for post-emergent care.
A hydrogel sealant for the treatment of severe hepatic and aortic trauma with a dissolution feature for post-emergent care.
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DOI：
10.1039/c6mh00378h
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发表时间：
2017-03-01
影响因子：
13.3
通讯作者：
Grinstaff MW
中科院分区：
文献类型：
--
作者：
Konieczynska MD;Villa-Camacho JC;Ghobril C;Perez-Viloria M;Blessing WA;Nazarian A;Rodriguez EK;Grinstaff MW
不可压缩性出血是创伤后院前死亡的重要原因，立即控制失血至关重要。出血管理的理想材料不需要手动压力来控制出血，不依赖于自然凝血级联，适用于腔内出血，并且无需清创即可取出。描述了一种用于腔内伤口的可溶性树枝状硫酯水凝胶密封剂。该水凝胶由赖氨酸基树枝化基元和PEG基交联剂组成，其以高产率合成，随后通过1H，13 C NMR光谱和MALDI进行表征。水凝胶溶解依赖于硫醇-硫酯交换机制。与未处理的对照组相比，水凝胶密封剂的应用使严重肝出血大鼠模型的失血量减少了33%（23.57 ± 8.27 mL kg− 1 vs. 35.21 ± 7.47 mL kg−1; p = 0.02）和22%的大鼠主动脉损伤模型（17.95 ± 3.84 mL kg− 1 vs. 23.09 ± 3.80 mL kg−1; p = 0.03）。水凝胶的一个独特特征是其在初始应用后与生物相容性溶液溶解-因此，治疗的伤口区域可以在手术环境中重新暴露以进行最终的手术护理。
Non-compressible hemorrhage is an important cause of pre-hospital death following trauma, and immediate control of blood loss is critical. An ideal material for hemorrhage management does not require manual pressure to control bleeding, does not rely on the natural clotting cascade, is suitable for intracavitary hemorrhage, and is removed without debridement. A dissolvable dendritic thioester hydrogel sealant is described for intracavitary wounds. The hydrogel is composed of a lysine-based dendron and a PEG-based crosslinker, which are synthesized in high yields and subsequently characterized by 1H, 13C NMR spectroscopy, and MALDI. The hydrogel dissolution relies on a thiol–thioester exchange mechanism. When compared to untreated controls, the application of the hydrogel sealant reduces blood loss by 33% in a rat model of severe hepatic hemorrhage (23.57 ± 8.27 mL kg−1vs. 35.21 ± 7.47 mL kg−1; p = 0.02) and by 22% in a rat model of aortic injury (17.95 ± 3.84 mL kg−1vs. 23.09 ± 3.80 mL kg−1; p = 0.03). A unique feature of the hydrogel is its dissolution with a biocompatible solution following initial application – thus the treated wound area can be re-exposed for definitive surgical care in an operative setting.