Study on the Application Efficacy and Mechanism of Domestically Produced Kaolin and Chitosan-based Hemostatic Dressing in Emergency Hemostasis

WANG Gang; YE Chengchen; HE Anni; DIAO Bo

doi:10.13730/j.issn.2097-2148.2025.04.002

Abstract：Objective To explore the efficacy and hemostatic mechanism of two domestically produced novel hemo-static dressings based on kaolin and chitosan in emergency hemorrhage control.Methods Rabbit femoral artery transec-tion hemorrhage models were constructed,and hemostasis was performed by compression using kaolin-based hemostatic dressing(kaolin group),chitosan-based hemostatic dressing(chitosan group)and medical gauze(gauze group)respec-tively.The hemostatic time and blood loss of rabbits were compared among 3 groups;limb flexion-extension and elevation tests were performed to assess hemostatic stability;the 24 h survival rate of rabbits was observed and recorded among 3 groups.Small samples of the kaolin-based hemostatic dressing,chitosan-based hemostatic dressing and medical gauze were sheared and collected;fresh blood(3 ml and 6 ml)was collected from the auricular veins of rabbits,and the in vitro coagulation times induced by different dressings were recorded;heparinized blood was also prepared to test whether the different dressings samples could clot 3 ml and 6 ml of anticoagulated blood,with the coagulation times recorded;samples of the dressings were soaked in phosphate buffer saline(PBS),and the extracts were mixed with freshly collected venous blood at 1∶10 ratio respectively,after which flow cytometry was employed to test platelet activation of hemostatic dressings among 3 groups.Results Rabbits in kaolin and chitosan groups showed signifi-cantly shorter hemostasis times and lower blood loss compared to the gauze group(all P＜0.05),and the kaolin group and chitosan group eath had advantages in bleeding volume and hemostasis time respetively,however,the difference was not statistically significant(P＞0.05).The rebleeding rates of rabbits in kaolin and chitosan groups were 0.00％and 12.50％respectively,both lower than the gauze group(37.50％).After hemostasis and wound suture,the survival rate of rabbits in the 3 groups at 24 h was 100％.In in vitro coagulation tests,chitosan-based hemostatic dressing achieved the fastest clotting time for 3 ml fresh blood,followed by kaolin-based hemostatic dressing and medical gauze,with significant differences among the groups(all P＜0.05);for 6 ml blood,the clotting time from fast to slow was:kaolin-based hemo-static dressing,chitosan-based hemostatic dressing and medical gauze,and there were significant differences among the groups(all P＜0.05).Chitosan-based hemostatic dressing induced coagulation in heparinized blood,while kaolin-based hemostatic dressing and medical gauze failed.Flow cytometry analysis showed that the positive rates of platelet activation biomarkers,activated platelet glycoprotein Ⅱb/Ⅲa complex(PAC1)and CD62p,descended in the order of kaolin group,chitosan group and gauze group;among which,the double-positive rate of PAC1 and CD62p in the kaolin group reached as high as 89.00％.Conclusion Both domestically produced novel hemostatic dressings exhibit excellent hemostatic per-formance and favorable safety in the rabbit femoral artery transection hemorrhage model.Specifically,the kaolin-based hemostatic dressing effectively activates platelets to achieve rapid hemostasis,while the chitosan-based dressing efficiently absorbs fluid to form gel-like blood clots that exerts hemostatic effects through physical occlusion,both dressings exhibit significant potential for clinical application.