Abstract：
Wound infection and excessive blood loss are the two major challenges associated with trauma injuries that account for 10% of annual deaths in the United States. Nitric oxide (NO) is a gasotransmitter cell signaling molecule that plays a crucial role in the natural wound healing process due to its antibacterial, anti-inflammatory, cell proliferation, and tissue remodeling abilities. Tranexamic acid (TXA), a prothrombotic agent, has been used topically and systemically to control blood loss in reported cases of epistaxis and combat-related trauma injuries. Its properties could be incorporated in wound dressings to induce immediate clot formation, which is a key factor in controlling excessive blood loss. This study introduces a novel, instant clot-forming NO-releasing dressing, and fabricated using a strategic bi-layer configuration. The layer adjacent to the wound was designed with TXA suspended on a resinous bed of propolis, which is a natural bioadhesive possessing antibacterial and anti-inflammatory properties. The base layer, located furthest away from the wound, has an NO donor, S-nitroso-N-acetylpenicillamine (SNAP), embedded in a polymeric bed of Carbosil®, a copolymer of polycarbonate urethane and silicone. Propolis was integrated with a uniform layer of TXA in variable concentrations: 2.5, 5.0, and 7.5 vol % of propolis. This design of the TXA-SNAP-propolis (T-SP) wound dressing allows TXA to form a more stable clot by preventing the lysis of fibrin. The lactate dehydrogenase-based platelet adhesion assay showed an increase in fibrin activation with 7.5% T-SP as compared with control within the first 15 min of its application. A scanning electron microscope (SEM) confirmed the presence of a dense fibrin network stabilizing the clot for fabricated dressing. The antibacterial activity of NO and propolis resulted in a 98.9 ± 1% and 99.4 ± 1% reduction in the colony-forming unit of Staphylococcus aureus and multidrug-resistant Acinetobacter baumannii, respectively, which puts forward the fabricated dressing as an emergency first aid for traumatic injuries, preventing excessive blood loss and soil-borne infections.
摘要：
伤口感染和过度失血是与外伤相关的两个主要挑战，在美国，外伤占每年死亡人数的10％。一氧化氮（NO）是一种气体转运细胞信号分子，由于其抗菌作用，在自然伤口愈合过程中起着至关重要的作用，抗炎,细胞增殖，和组织重塑能力。氨甲环酸(TXA),一种促血栓形成的药物,已局部和全身用于控制所报告的鼻出血和与战斗有关的外伤病例的失血。它的特性可以结合在伤口敷料中，以诱导立即形成凝块，这是控制过度失血的关键因素。这项研究介绍了一部小说，即时凝块形成NO释放敷料，并使用战略双层配置制造。伤口附近的层设计有TXA悬浮在蜂胶树脂床上，这是一种具有抗菌和抗炎特性的天然生物粘合剂。基层,离伤口最远，没有捐赠者，S-亚硝基-N-乙酰青霉胺（SNAP），嵌入Carbosil®聚合物床中，聚碳酸酯聚氨酯和硅酮的共聚物。蜂胶与TXA的均匀层整合在一起，浓度可变：2.5、5.0和7.5vol％的蜂胶。TXA-SNAP-蜂胶(T-SP)伤口敷料的这种设计允许TXA通过防止纤维蛋白溶解而形成更稳定的凝块。基于乳酸脱氢酶的血小板粘附测定法显示，在其应用的前15分钟内，与对照组相比，使用7.5％T-SP的纤维蛋白活化增加。扫描电子显微镜(SEM)证实了用于制造敷料的稳定凝块的致密纤维蛋白网络的存在。NO和蜂胶的抗菌活性导致金黄色葡萄球菌和多重耐药鲍曼不动杆菌的菌落形成单位减少98.9±1％和99.4±1％，分别,提出了制作的敷料作为创伤的紧急急救，防止过度失血和土传感染。
