In Vitro Evaluation of the Coagulation Activity of a Chitosan-Based Emergency Hemostatic Sponge: A Domestically Developed Product in Vietnam
DOI:
https://doi.org/10.65795/a5nsce32Keywords:
chitosan, hemostatic sponge, in vitro, clotting kinetics, plasma coagulationAbstract
Rapid control of hemorrhage is essential in emergency and surgical settings. Chitosan-based hemostats act primarily through electrostatic interactions with blood components and can function even when the intrinsic coagulation pathway is impaired. This study aims to evaluate the in vitro coagulation performance of a domestically developed chitosan-based emergency hemostatic sponge (EHS) compared with a commercial chitosan dressing (Axiostat®). Red blood cell (RBC) adhesion was assessed by scanning electron microscopy. Whole-blood interaction and absorption were quantified by gravimetric uptake and by residual free-RBC absorbance at 540 nm. Whole-blood clotting kinetics (5–15 min) and clotting blood time (CBT) were measured using citrated rabbit blood. Plasma coagulation parameters (PT, APTT, fibrinogen) were assessed in rabbit platelet-poor plasma after 10, 20 and 30 min incubation with the test materials. EHS promoted dense RBC adhesion on the sponge surface. Blood uptake was 712.6 ± 58.0 mg for EHS and 704.8 ± 37.2 mg for Axiostat® (p > 0.05). In the clotting-kinetics assay, residual free-RBC absorbance decreased markedly for both materials (e.g., at 10 min: 0.031 ± 0.005 for EHS vs 0.737 ± 0.009 in the control; p < 0.001). CBT was significantly shorter with EHS (213.2 ± 5.4 s) and Axiostat® (214.9 ± 6.0 s) than with no material (535.3 ± 8.1 s; p < 0.001). PT and fibrinogen did not differ significantly among groups, whereas APTT was significantly reduced in both material groups compared with the control (p < 0.01). EHS demonstrates effective in vitro hemostatic activity comparable to a commercial chitosan dressing, mainly through cellular interactions and acceleration of clot formation, supporting further evaluation in clinically relevant bleeding models.
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References
Brown KGM, Solomon MJ. Topical haemostatic agents in surgery. Br J Surg, 111(1), (2024).
Berry C, Gallagher JM, Goodloe JM, Dorlac WC, Dodd J, Fischer PE. Prehospital Hemorrhage Control and Treatment by Clinicians: A Joint Position Statement. Prehosp Emerg Care, 27(5), 544-551, (2023).
Nepal A, Tran HDN, Nguyen NT, Ta HT. Advances in haemostatic sponges: Characteristics and the underlying mechanisms for rapid haemostasis. Bioact Mater, 27, 231-256, (2023).
Guo Y, Wang M, Liu Q, Liu G, Wang S, Li J. Recent advances in the medical applications of hemostatic materials. Theranostics, 13(1), 161-196, (2023).
Cassano R, Perri P, Scarcello E, Piro P, Sole R, Curcio F, et al. Chitosan Hemostatic Dressings: Properties and Surgical Applications. Polymers (Basel), 16(13), (2024).
Hu Z, Lu S, Cheng Y, Kong S, Li S, Li C, et al. Investigation of the Effects of Molecular Parameters on the Hemostatic Properties of Chitosan. Molecules, 23(12), (2018).
Hartmann J, Hermelin D, Levy JH. Viscoelastic testing: an illustrated review of technology and clinical applications. Res Pract Thromb Haemost, 7(1), 100031, (2023).
Cheng Y, Yang Q, Wang J, Hu Z, Li C, Zhong S, et al. Optimization Preparation and Evaluation of Chitosan Grafted Norfloxacin as a Hemostatic Sponge. Polymers (Basel), 15(3), (2023).
Pogorielov M, Kalinkevich O, Deineka V, Garbuzova V, Solodovnik A, Kalinkevich A, et al. Haemostatic chitosan coated gauze: in vitro interaction with human blood and in-vivo effectiveness. Biomater Res, 19, 22, (2015).
Zhang M, Wang D, Ji N, Lee S, Wang G, Zheng Y, et al. Bioinspired Design of Sericin/Chitosan/Ag@MOF/GO Hydrogels for Efficiently Combating Resistant Bacteria, Rapid Hemostasis, and Wound Healing. Polymers (Basel), 13(16), (2021).
Sun L, Li B, Song W, Zhang K, Fan Y, Hou H. Comprehensive assessment of Nile tilapia skin collagen sponges as hemostatic dressings. Mater Sci Eng C Mater Biol Appl, 109, 110532, (2020).
Weisel JW, Litvinov RI. Red blood cells: the forgotten player in hemostasis and thrombosis. J Thromb Haemost, 17(2), 271-282, (2019).
Huang Z, Zhang D, Tong L, Gao F, Zhang S, Wang X, et al. Protonated-chitosan sponge with procoagulation activity for hemostasis in coagulopathy. Bioact Mater, 41, 174-192, (2024).
Chen R, Du F, Yuan Q. Multifunctional Sodium Hyaluronate/Chitosan Foam Used as an Absorbable Hemostatic Material. Bioengineering (Basel), 10(7), (2023).
Li J, Wu X, Wu Y, Tang Z, Sun X, Pan M, et al. Porous chitosan microspheres for application as quick in vitro and in vivo hemostat. Mater Sci Eng C Mater Biol Appl, 77, 411-419, (2017).
Pan M, Tang Z, Tu J, Wang Z, Chen Q, Xiao R, et al. Porous chitosan microspheres containing zinc ion for enhanced thrombosis and hemostasis. Materials Science and Engineering: C, 85, 27-36, (2018).
Zhang J, Chen Z, Zeng D, Xia Y, Fan Y, Zhang X, et al. Antibacterial and rapidly absorbable hemostatic sponge by aldehyde modification of natural polysaccharide. Communications Materials, 5(1), 129, (2024).
Chen Z, Yao X, Liu L, Guan J, Liu M, Li Z, et al. Blood coagulation evaluation of N-alkylated chitosan. Carbohydr Polym, 173, 259-268, (2017).
He W, Huang X, Zhang J, Zhu Y, Liu Y, Liu B, et al. CaCO3–Chitosan Composites Granules for Instant Hemostasis and Wound Healing. 14(12), 3350, (2021).
Wang YW, Liu CC, Cherng JH, Lin CS, Chang SJ, Hong ZJ, et al. Biological Effects of Chitosan-Based Dressing on Hemostasis Mechanism. Polymers (Basel), 11(11), (2019).
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Copyright (c) 2026 Thai Vu Quang, Ngan Hoang Nguyen, Xoan Le Thi (Author)
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How to Cite
Accepted 04-02-2026
Published 24-02-2026
