Study of double-bonded carboxymethyl chitosan/cysteamine-modified chondroitin sulfate composite dressing for hemostatic application

Stanching severe traumatic bleeding requires hemostatic materials that can provide rapid and efficient hemostasis. However, most currently available hemostatic agents exhibit low efficiency and poor biocompatibility. In this study, a novel carboxymethyl chitosan modified with methacrylic anhydride (double-bonded carboxymethyl chitosan)/cysteamine-modified chondroitin sulfate (Me-CMC/CSS) rapid hemostatic dressing was developed using thiol-ene click chemistry. The freeze-dried Me-CMC/CSS dressings absorbed water rapidly and transformed into soft hydrogels that could seal wounds, achieving good hemostasis. The relative blood clotting index of the optimal Me-CMC/CSS dressing was decreased by 53% (p < 0.001) and 29% compared with a pure Me-CMC dressing and a commercial hemostatic gelatin sponge, respectively. In a rat liver hemorrhage model, the Me-CMC/CSS dressing stopped bleeding rapidly, and the total blood loss was significantly decreased by 92% (p < 0.0001) compared with the untreated group and was lower than that with gelatin sponge treatment. The Me-CMC/CSS dressing also exhibited a higher ability to adhere to platelets than the gelatin sponge. Furthermore, the Me-CMC/CSS dressing exhibited good hemocompatibility and cytocompatibility. The results indicate that the composite dressings can be potentially applied as rapid hemostatic materials.