Advances in Hemostatic Wound Dressings: Clinical Implications and Insight.

ABSTRACT: Hemorrhagic shock is one of the leading causes of prehospital death in the armed forces. In this state, the body begins to shut down because of blood volume depletion. In both civilian and military trauma, a significant number of hemorrhage deaths occur in the first several hours after injury. Researchers all over the globe are working to develop relatively inexpensive and easy-to-transport products to prevent soldiers from going into hemorrhagic shock. For example, many advances have been made during the last several years toward the development of ideal hemostatic dressings. No current hemostatic agents meet all of the requirements, but the ideal dressing would fulfill many important measures: minimizes or stops blood flow within minutes, contains hemostatic agents to enhance blood clotting, is easy to apply, does not need preapplication preparation, has a reasonably long shelf life, is safe to use, prevents bacterial or viral transmission, is stable at extreme temperatures, and is inexpensive. For this literature review, the authors conducted an extensive search of academic scientific databases for relevant keywords and assessed and summarized the results. This review aimed to identify recent advances in hemostatic wound dressings; summarize the currently available dressings and their supporting literature; and discuss the compositions, mechanisms of action, and clinical relevance of each category of dressing. In addition, case studies and suggestions for future research into hemorrhage control with new hemostatic agents are provided.

Antimicrobial and release study of drug loaded PVA/PEO/CMC wound dressings.

The aim of the present study was to develop PVA/PEO/CMC/aloe vera (PPCAV) and PVA/PEO/CMC/curcumin (PPCCu) dressings with nonwoven polyester fabric as the support layer via freeze-drying (FD) approach. Tetracycline hydrochloride drug (TC) was loaded along with curcumin and aloe vera on these dressings. The morphology of the dressings was characterized by scanning electron microscopy. The swelling behavior, water vapor transmission rate (WVTR), in vitro drug release and antimicrobial nature were analyzed to assess the applicability of these freeze-dried membranes as wound dressing materials. The results show that these dressings made from PPCAVTC and PPCCuTC were highly porous with three-dimensional interconnected porous morphology. The cumulative release of drug from the dressings increases with increasing immersion time and continued up to 24 h, after that it gets leveled off. These dressings evidenced wonderful antimicrobial nature in vitro. These dressings were found to have more than 900 % PBS uptake, WVTR was found to be in the range 2,000-2,500 gm(-2) day(-1). These dressings possess many characteristics desirable in an ideal wound dressing material.