A local hemostatic agent in the form of a chitosan-based gel is a promising technique for stopping ongoing intra-abdominal bleeding: an experimental study

Abstract

Bleeding is one of the most common causes of death in armed conflicts. Moreover, many medical devices have been developed to stop ongoing external bleeding, including local hemostatic agents, turnstiles, and compressors. Stopping ongoing internal bleeding remains an urgent problem in military medicine. Before the current era wherein qualified medical care is provided, internal bleeding is impossible to stop. Thus, new methods and techniques are being developed to stop (control) intracavitary bleeding at the prehospital stage. In this study, a chitosan-based agent was developed in the form of a gel to stop internal bleeding. In an experiment of large laboratory animals as models of ongoing intra-abdominal bleeding, the effectiveness of the developed drug was evaluated, and it demonstrated high hemostatic efficiency. The developed local hemostatic agent, administered by laparocentesis, could stop grade 3 bleeding according to the validated intraoperative bleeding scale from the liver wound without causing inflammatory changes in the surrounding organs and tissues. The local hemostatic agent helped avoid fatal outcomes in the experimental group compared with the control group (one fatal outcome in three animals). Changes in the hemoglobin level and erythrocyte count indicated that hemostasis occurred almost immediately after the administration of the local hemostatic agent in the experimental group, whereas in the control group, hemostasis remained unstable throughout the observation period. The histological examination of liver preparations confirmed stable hemostasis without the development of a local inflammatory reaction or necrosis when a local biocompatible hemostatic agent was used. The developed technology can be used starting from the stage of first aid, helping stop intracavitary bleeding at the prehospital stage and improving the treatment outcomes of wounded individuals and those with abdominal injuries.