Preparation and characterization of PEG–PPG–PEG copolymer/pregelatinized starch blends for use as resorbable bone hemostatic wax

For the past century, various biomaterials have been used in the treatment of bone defects and fractures. Their role as potential substitutes for human bone grafts increases as donors become scarce. Metals, ceramics and polymers are all materials that confer different advantages to bone scaffold development. For instance, biocompatibility is a highly desirable property for which naturally-derived polymers are renowned. While generally applied separately, the use of biomaterials, in particular natural polymers, is likely to change, as biomaterial research moves towards mixing different types of materials in order to maximize their individual strengths. This review focuses on osteoconductive biocomposite scaffolds which are constructed around natural polymers and their performance at the in vitro/in vivo stages and in clinical trials.

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“…• Porous HA 75 • Human osteoblasts 77 • β-TCP 80 • Human osteoblasts (CRL-11372) 80 • ICR mice (calvaria) 81 • Extracted from brown seaweed…”

Section: • Thermoreversible Gelationmentioning

confidence: 99%

Composite biopolymers for bone regeneration enhancement in bony defects

Jahan

Tabrizian

2016

Biomater. Sci.

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“…The incorporation of pregelatinized starch provided better handling properties by increasing the stiffness, smoothness to the material and similar to bone wax it also prevents bleeding by acting as physical barrier. The in vivo analysis of the material in rabbit tibia defect models shows that it does not inhibit bone healing process and was resorbed from the sites within 2 days 72,73 . Another alternative to bone wax was PEG‐Calcium phosphate cement with pregelatinized starch which has the properties of hydrophilicity, malleability, and cohesiveness.…”

Section: Progress In Enhancing Sternal Healing Controlling Bleedingmentioning

confidence: 99%

Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing

Pradeep

Rangasamy

Varma

2020

Medicinal Research Reviews

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One of the major risks of cardiac surgery is the occurrence of infection at the sternal wound site. Sternal wound infections are primarily classified into superficial infection and deep sternal wound infection or mediastinitis. A patient is diagnosed with mediastinitis if microorganisms are present in their mediastinal tissue/fluid or with the observation of sternal wound infection during operation and with characteristic symptoms including chest pain, fever, and purulent drainage from the mediastinum. It is usually caused by Staphylococcal organisms in 75.8% of cases and the rest is caused by gram‐negative bacteria. Currently, in cardiac surgery, hemostasis is achieved using electrocautery and bone wax, and the sternum is closed using wire cerclage. Several studies show that bone wax can act as a nidus for initiation of infection and the oozing blood and hematoma at the site can promote the growth of infectious organisms. Many research groups have developed different types of biomaterials and reported on the prevention of infection and healing of the sternum. These materials are reported to have both positive and negative effects. In this review, we highlight the current clinical practices undertaken to prevent infection and bleeding as well as research progress in this field and their outcomes in controlling bleeding, infection, and enhancing sternal healing.

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“…So far, the haemostatic performance has been generally studied through in vivo animal experiments by drilling holes in the bone and plugging with bone wax. Instead of complicated animal testing, an in vitro model has been proposed by Suwanprateeb et al [94] for sealing capability testing. In brief, acrylic glass tubes with a length of 2.00 m and an inner diameter of 3.00 mm were filled with water up to a height of 1.91 m, which corresponds to systolic blood pressure (18.68 kPa, 140 mmHg), and sealed with cone-shaped samples; the constructs were stored at room temperature and monitored until their failure.…”

Section: Outlook and Summarymentioning

confidence: 99%

Translation of bone wax and its substitutes: History, clinical status and future directions

Zhou

Bai

et al. 2019

Journal of Orthopaedic Translation

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Bone wax, primarily composed of beeswax and softening agent, is a century-old material used to control bleeding of disrupted bone surfaces by acting as a mechanical barrier to seal the wound. The current bone wax products are commonly packed in easy-to-open foil in the form of sterile sticks or plates, with excellent malleability and smooth consistency, enabling cost-effective and easy handling approach for bleeding control. It has also been reported that the inert nature of bone wax causes complications including foreign body reaction, infection promotion and bone healing inhibition. With the advances in biomaterials and the market boost of bone haemostatic materials, the arena of bone wax substitute research has expanded to a wide spectrum of material formulations and forms. However, the development of substitutes of bone wax for translation is a pivotal yet challenging topic because currently a potential candidate is recommended to be just as simple to use, effective and inexpensive to produce as traditional bone wax but also be absorbable and osteogenic. This review provides an overview of bone wax including its history, clinical applications and associated complication. In addition, emerging substitutes of bone wax and outlooks of future directions including the standardised evaluation methods are also discussed as an effort to catalyse the innovation and translation of bone haemostatic agents in the near future. The translational potential of this article: Occurrence of osseous haemorrhage is common in surgically incised or traumatically fractured bone. It is essential to stop bone bleeding to avoid further pathologic consequences such as tissue necrosis and eventually mortalities due to blood loss. Medical sterile bone wax is a classical material for haemostasis of bone during orthopaedic surgeries, thoracic surgeries, neurological surgeries and so on. Along with its widespread use, complications such as foreign body reaction, bone healing inhibition and infection promotion associated with bone wax are observed. With the growing knowledge in biomaterials and the boost of market of bone haemostatic materials, bone wax substitute research is thriving. An overview of bone and its substitutes together with evolution of their design criteria is carried out in this work, providing information for the innovation and translation of bone haemostatic agents in the near future.

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Preparation and characterization of PEG–PPG–PEG copolymer/pregelatinized starch blends for use as resorbable bone hemostatic wax

Cited by 22 publications

References 38 publications

Composite biopolymers for bone regeneration enhancement in bony defects

Composite biopolymers for bone regeneration enhancement in bony defects

Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing

Translation of bone wax and its substitutes: History, clinical status and future directions

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