Nanofibrous Electrospun Patches Fabricated from Biodegradable Polyesters Provide Effective Hemorrhage Control.

Abstract

Uncontrolled hemorrhage is the leading cause of preventable death in both civilian and military populations. Current topical hemostats rely on packing the wound cavity, and/or applying external pressure with pelvic binders. These methods have complications, need extensive training, necessitate surgical removal of hemostats, and lack an understanding of the chemical structure-hemostatic property relationships. This work describes the design and testing of hemostatic electrospun patches (EPs) with carboxylic acid (-COOH) and primary amine (-NH₂) as procoagulant functional groups. EPs accelerate whole blood clotting in vitro, with -COOH EPs performing almost twice as better compared to -NH₂ EPs. In a mouse liver hemorrhage model, the EPs lower bleeding times by about 3 times compared to cotton gauze as control. The EPs restrict blood component flow and form a contracted, tissue-adhesive clot at the EP-wound interface due to its nanofibrous nature, thus mediating wound closure. On the other hand, cotton gauze fails to form a contracted clot at the gauze-wound interface leading to open rebleeding wounds upon material removal. Among the EPs, wound closure and clot-mediated tissue adhesion are influenced by the chemical functionality of polyesters with -COOH EPs performing better than -NH₂ EPs.