Shape Memory Polymer Foams for Hemorrhage Control in Traumatic Wounds

项目摘要/摘要 失控出血是创伤相关死亡的主要原因，大约 一半的出血死亡发生在患者到达医院之前。当前的技术用于 对大量伤口的出血控制不足，没有充分处理 不可压缩的出血。因此，迫切需要改进止血敷料。 物美价廉、使用方便、有效、长期使用安全的材料 画框。在没有这种治疗选择的情况下，失控出血造成的悲惨死亡将 继续。 拟议工作的长期目标是为出血提供一种可接受的选择 只需最少的培训即可在远程情况下使用的控制。这个项目的总体目标是 应用于表征一种很有前途的生物材料平台-形状记忆的有效性 聚合物(SMP)泡沫，用于临床相关出血模型并开发易于使用的 存储和交付设备。在猪V级肝损伤的初步工作中，SMP泡沫 治疗提供了更快的止血，减少了总失血量，并提高了存活率 临床对照治疗。拟议工作的基本原理是，未来的临床 通过更好地了解泡沫塑料特性如何影响翻译工作将成为可能 这一前景看好的平台的出血控制和扩大的临床前特征。 为实现这些目标，将实现以下具体目标： 具体目标1：评价SMP泡沫结构在体外控制出血的效果 伤口模型，并为不可压缩的躯干伤口和 四肢可压伤。 特定目标2：在不可压缩的V级肝脏中表征SMP泡沫的体内有效性 受伤。 具体目标3：表征SMP泡沫在体内的应用、疗效、清除和安全性 可压缩股动脉损伤。 在这些研究完成后，预期将有临床相关的SMP泡沫- 用于可压缩和不可压缩创伤的止血装置设计 伤口。这些研究的主要积极影响将是一种简单的止血敷料- 适用于一系列出血性伤口类型且有效。

PROJECT SUMMARY/ABSTRACT Uncontrolled hemorrhage is the primary cause of trauma-related death, and approximately half of hemorrhage deaths occur before the patient reaches the hospital. Current techniques for hemorrhage control are insufficient for a large number of wounds and do not adequately address non-compressible hemorrhages. Thus, there is a critical need for improved hemostatic dressing materials that are inexpensive, easy to apply, effective, and safe to use over prolonged time frames. In the absence of such treatment options, tragic deaths from uncontrolled bleeding will continue. The long-term goal of the proposed work is to provide an accessible option for hemorrhage control that can be used with minimal training in remote situations. The overall objectives in this application are to characterize efficacy of a promising biomaterial platform, shape memory polymer (SMP) foams, in clinically-relevant hemorrhage models and to develop easy-to-use storage and delivery devices. In preliminary work in a porcine grade V liver injury, SMP foam treatment provided faster hemostasis, reduced total blood loss, and improved survival relative to treatment with clinical controls. The rationale for the proposed work is that future clinical translation efforts will be enabled by an improved understanding of how foam properties affect hemorrhage control and expanded pre-clinical characterization of this promising platform. To achieve these objectives, the following specific aims will be pursued: Specific Aim 1: Evaluate effects of SMP foam architectures on hemorrhage control in in vitro wound models, and design storage and delivery devices for non-compressible torso wounds and compressible extremity wounds. Specific Aim 2: Characterize SMP foam efficacy in vivo in a non-compressible grade V liver injury. Specific Aim 3: Characterize SMP foam application, efficacy, removal, and safety in vivo in a compressible femoral artery injury. At the completion of these studies, the expectation is to have clinically-relevant SMP foam- based hemostatic device designs for use in compressible and non-compressible traumatic wounds. The primary positive impact of these studies will be a hemostatic dressing that is easy- to-use and effective in a range of hemorrhagic wound types.