TABLE 1.
The different types of biomaterials for hemostasis.
| Types | Materials | Brand names | Characteristics | Application |
|---|---|---|---|---|
| Protein-based | Collagen | Avitene® Helitene® | Biodegradability, biocompatibility, cell adhesion, non-toxicity, and low antigenicity | It has a hemostasis in almost all operations, but cannot be applied to patients with thrombocytopenia |
| Gelatin | Gelfoam® Surgifoam® Gelfilm® Gelita-spon® | Has no toxicity or antigenicity, has soft fiber, strong adsorption, and can adhere to the wound surface | It could be used in the treatment of various wounds and traumas, in particular, transfixed wounds from solid organs. But it cannot be used in confined spaces or near nerve structures owing to easily causing complications of compressive origin | |
| Fibrin glue | Tisseel TachoSil® Evicel® Crosseal® | Good hemostatic properties, adhesive properties and histocompatibility | It can be applied to extensive bleeding after clinical tumor removal, bleeding in parenchymal organs, and patients with abnormal blood coagulation. But not allowed to be applied to blood vessels bleeding | |
| Polysaccharide | Cellulose | Surgicel® Original® NuKnit Fibrillar SNoW® | Soft and thin, good histocompatibility, antibacterial effect | It is suitable for packaging, application, stuffing and other operations, hemostasis for capillary, arterioles and venous bleeding, bone bleeding. But it is not suitable for the treatment of peripheral nerve-rich wounds and irregular lacerations |
| Chitosan | HemCon Celox Rapid gauze | Good affinity with human cells, no rejection, good biocompatibility, biodegradation, and hemostatic effect | It can be used in patients with coagulopathy. But hemostasis in the wound of extensive bleeding is not very satisfactory | |
| Starch | MPH, Per Clot | Reduce bleeding and transfusion, minimize blood infection, reduce seroma formation, has no immune, allergic reactions, and toxic side effects | It has effective hemostasis, but cannot enter into the blood vessel, lest form an embolism | |
| Alginate | Algosteril | Hygroscopicity, gelation, good biocompatibility, and the ability to ignite and shield electromagnetics | It is suitable for filling the wound, especially the deep and wide surgical cavity after endoscopic surgery | |
| Inorganic | Zeolite, kaolin, montmorillonite | Quikclot, Woundstat Combat Gauze | Stability, ease of use, no biological toxicity, and no disease transmission | They cannot achieve rapid hemostasis, and are less effective in arterial bleeding and coagulopathic patients |
| Synthetic polymer-based | Poly(ethyelene oxide) | CoSeal® | Has good biocompatibility, histocompatibility, low cytotoxicity, and great hemostasis | It has been widely used in surgical bleeding |
| Poly(cyanoacrylates) | Dermabond® Omnex® Glubran®and Glubran2® | Non-toxic, non-carcinogenic, and has good histocompatibility and significant hemostasis | It can be widely used in anastomosis, wound hemostasis, wound adhesion, and tendon. But may lead to vascular embolization and release toxic substances | |
| Self-assembling peptide | RADA-16 | SAPB-T45K, Pura Stat, Pura Matrix | Programmable, good viscoelasticity and biocompatibility, low antigenicity, and low cost | It can achieve complete and rapid hemostasis in the fields of the brain, spinal cord, liver, femoral artery and skin wounds |
| SPG-178 PSFCFKFGP KOD | It overcame the disadvantage of RADA, whose low pH is easy to cause tissue damage. And it could coagulate whole blood, minimize bleeding |