RESUMO
Uncontrollable bleeding is a major problem in surgical procedures and after major trauma. Existing hemostatic agents poorly control hemorrhaging from traumatic arterial and cardiac wounds because of their weak adhesion to wet and mobile tissues. Here we design a photo-reactive adhesive that mimics the extracellular matrix (ECM) composition. This biomacromolecule-based matrix hydrogel can undergo rapid gelling and fixation to adhere and seal bleeding arteries and cardiac walls after UV light irradiation. These repairs can withstand up to 290 mm Hg blood pressure, significantly higher than blood pressures in most clinical settings (systolic BP 60-160 mm Hg). Most importantly, the hydrogel can stop high-pressure bleeding from pig carotid arteries with 4~ 5 mm-long incision wounds and from pig hearts with 6 mm diameter cardiac penetration holes. Treated pigs survived after hemostatic treatments with this hydrogel, which is well-tolerated and appears to offer significant clinical advantage as a traumatic wound sealant.
Assuntos
Adesivos/uso terapêutico , Biopolímeros/uso terapêutico , Hemorragia/terapia , Hemostáticos/uso terapêutico , Hidrogéis/uso terapêutico , Adesivos/química , Adesivos/efeitos da radiação , Animais , Artérias/lesões , Artérias/cirurgia , Biopolímeros/química , Biopolímeros/efeitos da radiação , Linhagem Celular , Vasos Coronários/lesões , Vasos Coronários/cirurgia , Modelos Animais de Doenças , Matriz Extracelular/química , Hemorragia/etiologia , Hemostáticos/química , Hemostáticos/efeitos da radiação , Humanos , Hidrogéis/química , Hidrogéis/efeitos da radiação , Masculino , Polimerização/efeitos da radiação , Ferida Cirúrgica/complicações , Resultado do Tratamento , Raios UltravioletaRESUMO
Photodecomposition of solutions of menadione sodium bisulfite (MSB) in the presence and absence of glutathione (GSH) under artificial sunlight was investigated. In presence of 0.02% (GSH), an appreciable increase in photostability was observed when clear glass vials were used. The pH and the temperature of the solution significantly influenced the stability of MSB. Photodegradation of MSB appeared to follow first-order kinetics. Photostabilization of MSB was attributed in part to complex formation between MSB and GSH and the antioxidant property of the latter. Stability constants for the various solutions were determined at several temperatures. Thermodynamic parameters were calculated and were found to support complex formation.