Современные гемостатические губки для паренхиматозного кровотечения: Состав, механизмы действия и клиническая эффективность. Обзор литературы

Авторы

DOI:

https://doi.org/10.52889/1684-9280-2025-76-6-jto033

Ключевые слова:

гемостатические губки, местный гемостаз, паренхиматозное кровотечение, коллаген, желатин, хитозан

Аннотация

 Паренхиматозное кровотечение, возникающее при повреждениях печени, селезенки и почек, является одним из наиболее сложных типов кровотечений для контроля из-за его диффузного характера, отсутствия четкой точки кровотечения и высокой вероятности коагулопатии. Несмотря на широкое применение механического гемостаза, электрокоагуляции и тампонады, их эффективность остается ограниченной при глубоких или мультифокальных повреждениях паренхимы. В связи с этим использование различных видов местных гемостатических губок приобретает все большую значимость как в экстренной, так и в плановой хирургии. Цель исследования ‒ оценить эффективность гемостатических губок в лечении паренхиматозного кровотечения посредством анализа доклинических и клинических работ, посвященных различным категориям местных гемостатических материалов. Был проведен комплексный обзор доклинических и клинических исследований, систематических обзоров и метаанализов, оценивающих гемостатические губки животного, растительного и синтетического происхождения при паренхиматозных кровотечениях. Поиск выполнялся в базах PubMed, MedLine и Scopus за период 2019-2025 гг. Всего было выявлено 213 публикаций; 119 были исключены по заранее определенным критериям (дублирование, недостаточный уровень доказательности, отсутствие данных о паренхиматозных органах). В окончательный анализ включены 94 исследования, соответствующие критериям отбора. Большинство работ демонстрируют, что использование местных гемостатических губок значительно сокращает время достижения гемостаза, уменьшает интраоперационную кровопотерю и снижает риск повторного кровотечения по сравнению со стандартными методами. Наиболее изученными материалами являются губки на основе коллагена, желатина, окисленной целлюлозы, фибрина и хитозана, каждая из которых обладает собственным механизмом действия. Сравнительные исследования показывают, что, несмотря на сопоставимую клиническую эффективность многих типов губок, оптимальный выбор зависит от особенностей раны и интраоперационных условий. В настоящее время доступен широкий ассортимент гемостатических губок для лечения паренхиматозного кровотечения, однако универсального идеального материала не существует. Представленный обзор подтверждает, что местные гемостатические губки являются оправданным и клинически эффективным дополнением к стандартным методам гемостаза.

Биографии авторов

  • Алжанов Е., Карагандинский медицинский университет

    PhD-студент

  • Криворучко Т., Национальный центр биотехнологии

    Старший научный сотрудник

  • Унышева Г., Национальный центр биотехнологии

    Ведущий научный сотрудник

  • Sari Al Hajaj, Trauma and Orthopaedics Trust Grade SHO Kettering General Hospital NHS Trust

    Врач-резидент

  • Атепилева А., Национальный научный центр травматологии и ортопедии имени академика Н.Д. Батпенова

    Травматолог-ортопед

  • Римашеский Д., Российский университет дружбы народов

    Кафедра травматологии и ортопедии

  • Балгазаров С., Национальный научный центр травматологии и ортопедии имени академика Н.Д. Батпенова

    Заместитель директора по клиническим вопросам

  • Ахметкаримова Ж., Национальный центр биотехнологии

    Заведующая лабораторией токсикологии и фармакологии

  • Рамазанов Ж., Национальный научный центр травматологии и ортопедии имени академика Н.Д. Батпенова

    Травматолог-ортопед

  • Жуликеева А., Национальный центр биотехнологии

    Научный сотрудник

Библиографические ссылки

1. Boonstra, E. A., Molenaar, I. Q., Porte, R. J., & de Boer, M. T. (2009). Topical haemostatic agents in liver surgery: do we need them?. HPB : the official journal of the International Hepato Pancreato Biliary Association, 11(4), 306–310. https://doi.org/10.1111/j.1477-2574.2009.00065.x

2. Brustia, R., Granger, B., & Scatton, O. (2016). An update on topical haemostatic agents in liver surgery: systematic review and meta-analysis. Journal of hepato-biliary-pancreatic sciences, 23(10), 609–621. https://doi.org/10.1002/jhbp.389

3. Robledo, A. B., Seller, A. N., & Tamarit, M. N. (2021). Is the Use of Sealing and Hemostatic Agents Justified in Hepatic Resections. Review and Meta-analysis. J Healthcare, 4(1), 39-45. https://doi.org/10.36959/879/380

4. Fischer, L., Seiler, C. M., Broelsch, C. E., de Hemptinne, B., Klempnauer, J., Mischinger, H. J., Gassel, H. J., Rokkjaer, M., Schauer, R., Larsen, P. N., Tetens, V., & Büchler, M. W. (2011). Hemostatic efficacy of TachoSil in liver resection compared with argon beam coagulator treatment: an open, randomized, prospective, multicenter, parallel-group trial. Surgery, 149(1), 48–55. https://doi.org/10.1016/j.surg.2010.02.008

5. Kakaei, F., Seyyed Sadeghi, M. S., Sanei, B., Hashemzadeh, S., & Habibzadeh, A. (2013). A randomized clinical trial comparing the effect of different haemostatic agents for haemostasis of the liver after hepatic resection. HPB surgery: a world journal of hepatic, pancreatic and biliary surgery, 2013, 587608. https://doi.org/10.1155/2013/587608

6. Huang, L., Liu, G. L., Kaye, A. D., & Liu, H. (2020). Advances in Topical Hemostatic Agent Therapies: A Comprehensive Update. Advances in therapy, 37(10), 4132–4148. https://doi.org/10.1007/s12325-020-01467-y

7. Deineka, V., Sulaieva, O., Pernakov, N., Radwan-Pragłowska, J., Janus, L., Korniienko, V., Husak, Y., Yanovska, A., Liubchak, I., Yusupova, A., Piątkowski, M., Zlatska, A., & Pogorielov, M. (2021). Hemostatic performance and biocompatibility of chitosan-based agents in experimental parenchymal bleeding. Materials science & engineering. C, Materials for biological applications, 120, 111740. https://doi.org/10.1016/j.msec.2020.111740

8. Du, X., Wu, L., Yan, H., Jiang, Z., Li, S., Li, W., Bai, Y., Wang, H., Cheng, Z., Kong, D., Wang, L., & Zhu, M. (2021). Microchannelled alkylated chitosan sponge to treat noncompressible hemorrhages and facilitate wound healing. Nature communications, 12(1), 4733. https://doi.org/10.1038/s41467-021-24972-2

9. Yudin, A. B., Nosov, A. M., Volkova, M. V., Demchenko, K. N., Zhabin, A. V., Zaychikov, D. A., ... & Kovalevsky, Y. B. (2025). Evaluation of the Safety and Efficacy of Chitosan-Based Hemostatic Sponges in a Chronic Large-Animal Model. Russian Military Medical Academy Reports, 44(1), 19-26. https://doi.org/10.17816/rmmar641798

10. Fu, H., Amantay, M., Kim, J., Jiang, T., Pan, H., & Wang, Y. (2025). Constructing a hemostatic sponge loaded with copper nanoparticles and carboxymethyl chitosan for wound hemostasis and infection prevention. Biomaterials science, 13(15), 4245–4263. https://doi.org/10.1039/d5bm00556f

11. Sánchez-Del-Valle, F. J., Sánchez-Seco, M. I., Jiménez, A. G., Acosta, F., Fernández-Domínguez, P., & Pérez-Alegre, J. J. (2024). Effectiveness of a thrombin-gelatin flowable for treating severe liver bleeding: an experimental study. BMC gastroenterology, 24(1), 71. https://doi.org/10.1186/s12876-023-03114-6

12. Sánchez Del Valle, F. J., De Nicolás, L., Fernández, G., Fernández, P., Gómez, E., & Aranaz Corral, I. (2023). Comparison of a gelatin thrombin versus a modified absorbable polymer as a unique treatment for severe hepatic hemorrhage in swine. Scientific reports, 13(1), 20854. https://doi.org/10.1038/s41598-023-41983-9

13. Lim, S. Y., Choi, G. H., Lim, J. H., Han, H. S., Yoon, Y. S., Lee, H. W., Lee, B., Park, Y., Kang, M., Kim, J., Joo, H., & Cho, J. Y. (2025). A Prospective, Multicenter, Randomized, Noninferiority Trial of Stopad® Versus Tachosil® for Hemostasis After Liver Resection. Cancers, 17(5), 757. https://doi.org/10.3390/cancers17050757

14. de Wilt, J. H. W., Verhoef, C., de Boer, M. T., Stommel, M. W. J., van der Plas-Kemper, L., Garms, L. M., van der Zijden, C. J., Head, S. J., Bender, J. C. M. E., van Goor, H., & Porte, R. J. (2024). Clinical Safety and Performance of GATT-Patch for Hemostasis in Minimal to Moderate Bleeding During Open Liver Surgery. The Journal of surgical research, 298, 316–324. https://doi.org/10.1016/j.jss.2024.03.033

15. Jamali, B., Nouri, S., & Amidi, S. (2024). Local and Systemic Hemostatic Agents: A Comprehensive Review. Cureus, 16(10), e72312. https://doi.org/10.7759/cureus.72312

16. López-Guerra, D., Santos-Naharro, J., Rojas-Holguín, A., Jaen-Torrejimeno, I., Prada-Villaverde, A., & Blanco-Fernández, G. (2019). Postoperative bleeding and biliary leak after liver resection: A cohort study between two different fibrin sealant patches. Scientific reports, 9(1), 12001. https://doi.org/10.1038/s41598-019-48529-y

17. Rostami, F., Tamjid, E., & Behmanesh, M. (2020). Drug-eluting PCL/graphene oxide nanocomposite scaffolds for enhanced osteogenic differentiation of mesenchymal stem cells. Materials science & engineering. C, Materials for biological applications, 115, 111102. https://doi.org/10.1016/j.msec.2020.111102

18. Zou, C. Y., Han, C., Xing, F., Jiang, Y. L., Xiong, M., Li-Ling, J., & Xie, H. Q. (2024). Smart design in biopolymer-based hemostatic sponges: From hemostasis to multiple functions. Bioactive materials, 45, 459–478. https://doi.org/10.1016/j.bioactmat.2024.11.034

19. Yu, P., & Zhong, W. (2021). Hemostatic materials in wound care. Burns & trauma, 9, tkab019. https://doi.org/10.1093/burnst/tkab019

20. Behrens, A. M., Sikorski, M. J., & Kofinas, P. (2014). Hemostatic strategies for traumatic and surgical bleeding. Journal of biomedical materials research. Part A, 102(11), 4182–4194. https://doi.org/10.1002/jbm.a.35052

21. Malik, A., Rehman, F. U., Shah, K. U., Naz, S. S., & Qaisar, S. (2021). Hemostatic strategies for uncontrolled bleeding: A comprehensive update. Journal of biomedical materials research. Part B, Applied biomaterials, 109(10), 1465–1477. https://doi.org/10.1002/jbm.b.34806

22. Zhou, W., Yang, T., Xu, W., Huang, Y., Ran, L., Yan, Y., ... & Cao, Y. (2022). The polysaccharides from the fruits of Lycium barbarum L. confer anti-diabetic effect by regulating gut microbiota and intestinal barrier. Carbohydrate Polymers, 291, 119626. https://doi.org/10.1016/j.carbpol.2022.119626

23. Du, J., Wang, J., Xu, T., Yao, H., Yu, L., & Huang, D. (2023). Hemostasis Strategies and Recent Advances in Nanomaterials for Hemostasis. Molecules (Basel, Switzerland), 28(13), 5264. https://doi.org/10.3390/molecules28135264

24. Xu, H., Liu, Y., Qiu, L., Mangue, A. L. M. M., Zhang, J., Wei, B., ... & Wang, H. (2025). Preparation and application of collagen-based hemostatic materials: a review. Collagen and Leather, 7(1), 11. https://doi.org/10.1186/s42825-025-00193-x

25. Manon-Jensen, T., Kjeld, N. G., & Karsdal, M. A. (2016). Collagen-mediated hemostasis. Journal of thrombosis and haemostasis: JTH, 14(3), 438–448. https://doi.org/10.1111/jth.13249

26. He, Y., Wang, J., Si, Y., Wang, X., Deng, H., Sheng, Z., Li, Y., Liu, J., & Zhao, J. (2021). A novel gene recombinant collagen hemostatic sponge with excellent biocompatibility and hemostatic effect. International journal of biological macromolecules, 178, 296–305. https://doi.org/10.1016/j.ijbiomac.2021.02.162

27. Wang, L., Li, W., Qu, Y., Wang, K., Lv, K., He, X., & Qin, S. (2022). Preparation of Super Absorbent and Highly Active Fish Collagen Sponge and its Hemostatic Effect in vivo and in vitro. Frontiers in bioengineering and biotechnology, 10, 862532. https://doi.org/10.3389/fbioe.2022.862532

28. Chang C. T. (2023). The hemostatic effect and wound healing of novel collagen-containing polyester dressing. Journal of biomaterials science. Polymer edition, 34(15), 2124–2143. https://doi.org/10.1080/09205063.2023.2230842

29. Yang, Y., Zhang, Y., Min, Y., & Chen, J. (2022). Preparation of methacrylated hyaluronate/methacrylated collagen sponges with rapid shape recovery and orderly channel for fast blood absorption as hemostatic dressing. International journal of biological macromolecules, 222(Pt A), 30-40. https://doi.org/10.1016/j.ijbiomac.2022.09.054

30. D'Amico, E., Pierfelice, T. V., Lepore, S., Iezzi, G., D'Arcangelo, C., Piattelli, A., Covani, U., & Petrini, M. (2023). Hemostatic Collagen Sponge with High Porosity Promotes the Proliferation and Adhesion of Fibroblasts and Osteoblasts. International journal of molecular sciences, 24(9), 7749. https://doi.org/10.3390/ijms24097749

31. Weber, L. M., Lopez, C. G., & Anseth, K. S. (2009). Effects of PEG hydrogel crosslinking density on protein diffusion and encapsulated islet survival and function. Journal of Biomedical Materials Research Part A: An Official Journal of The Society for Biomaterials, The Japanese Society for Biomaterials, and The Australian Society for Biomaterials and the Korean Society for Biomaterials, 90(3), 720-729. https://doi.org/10.1002/jbm.a.32134

32. Anderson, T. S., Hattersley, R. D., & Demetriou, J. L. (2025). A randomized comparison of an adhesive gelatin sponge and a plain collagen sponge for hemostatic control during canine liver surgery. Veterinary surgery: VS, 54(2), 345–353. https://doi.org/10.1111/vsu.14160

33. Albala D. M. (2003). Fibrin sealants in clinical practice. Cardiovascular surgery (London, England), 11 Suppl 1, 5–11. https://doi.org/10.1016/S0967-2109(03)00065-6

34. Washio, A., Kérourédan, O., Kitamura, C., & Tabata, Y. (2025). Biocompatibility and bioactivity of gelatin hydrogel sponges incorporating bioactive glasses capable of controlled release of basic fibroblast growth factor. Journal of biomaterials science. Polymer edition, 1–22. Advance online publication. https://doi.org/10.1080/09205063.2025.2544947

35. Lan, G., Lu, B., Wang, T., Wang, L., Chen, J., Yu, K., Liu, J., Dai, F., & Wu, D. (2015). Chitosan/gelatin composite sponge is an absorbable surgical hemostatic agent. Colloids and surfaces. B, Biointerfaces, 136, 1026–1034. https://doi.org/10.1016/j.colsurfb.2015.10.039

36. Bhattacharjee, B., Mukherjee, R., & Haldar, J. (2022). Biocompatible Hemostatic Sponge Exhibiting Broad-Spectrum Antibacterial Activity. ACS biomaterials science & engineering, 8(8), 3596–3607. https://doi.org/10.1021/acsbiomaterials.2c00410

37. Han, Q., Zhao, F., Wu, T., Zhao, C., Li, J., Huang, S., Zhang, T., & Xing, J. (2025). Gelatin/quaternized chitosan-based macroporous sponge inspired by food foaming for rapid hemostasis and wound healing. International journal of biological macromolecules, 320(Pt 4), 146117. https://doi.org/10.1016/j.ijbiomac.2025.146117

38. Chu, T. L., Tripathi, G., Bae, S. H., & Lee, B. T. (2021). In-vitro and in-vivo hemostat evaluation of decellularized liver extra cellular matrix loaded chitosan/gelatin spongy scaffolds for liver injury. International journal of biological macromolecules, 193(Pt A), 638-646. https://doi.org/10.1016/j.ijbiomac.2021.10.128

39. Zhang, Y., Li, M., Chang, J., Li, C., Hui, Y., Wang, Y., & Xu, W. (2024). Silk fibroin-gelatine haemostatic sponge loaded with thrombin for wound haemostasis and tissue regeneration. Burns & trauma, 12, tkae026. https://doi.org/10.1093/burnst/tkae026

40. Xie, X., Li, D., Chen, Y., Shen, Y., Yu, F., Wang, W., Yuan, Z., Morsi, Y., Wu, J., & Mo, X. (2021). Conjugate Electrospun 3D Gelatin Nanofiber Sponge for Rapid Hemostasis. Advanced healthcare materials, 10(20), e2100918. https://doi.org/10.1002/adhm.202100918

41. Zhu, Y., Zhang, L., Duan, W., Martin-Saldaña, S., Li, C., Yu, H., Feng, L., Zhang, X., Du, B., Li, G., Zheng, X., & Bu, Y. (2023). Succinic Ester-Based Shape Memory Gelatin Sponge for Noncompressible Hemorrhage without Hindering Tissue Regeneration. Advanced healthcare materials, 12(5), e2202122. https://doi.org/10.1002/adhm.202202122

42. Tomizawa, Y. (2005). Clinical benefits and risk analysis of topical hemostats: a review. Journal of artificial organs: the official journal of the Japanese Society for Artificial Organs, 8(3), 137–142. https://doi.org/10.1007/s10047-005-0296-x

43. Yang, Y., Lu, Y. T., Zeng, K., Heinze, T., Groth, T., & Zhang, K. (2021). Recent Progress on Cellulose-Based Ionic Compounds for Biomaterials. Advanced materials (Deerfield Beach, Fla.), 33(28), e2000717. https://doi.org/10.1002/adma.202000717

44. Spotnitz, W. D., & Burks, S. (2010). State-of-the-art review: Hemostats, sealants, and adhesives II: Update as well as how and when to use the components of the surgical toolbox. Clinical and applied thrombosis/hemostasis: official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 16(5), 497–514. https://doi.org/10.1177/1076029610363589

45. Ye, L., Xiao, X., & Zhu, L. (2017). The Comparison of Etomidate and Propofol Anesthesia in Patients Undergoing Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis. Surgical laparoscopy, endoscopy & percutaneous techniques, 27(1), 1–7. https://doi.org/10.1097/SLE.0000000000000373

46. Chang, Y. F., Chao, A., Shih, P. Y., Hsu, Y. C., Lee, C. T., Tien, Y. W., Yeh, Y. C., Chen, L. W., & NTUH Center of Microcirculation Medical Research (NCMMR) (2018). Comparison of dexmedetomidine versus propofol on hemodynamics in surgical critically ill patients. The Journal of surgical research, 228, 194–200. https://doi.org/10.1016/j.jss.2018.03.040

47. Cheng, W., He, J., Wu, Y., Song, C., Xie, S., Huang, Y., & Fu, B. (2013). Preparation and characterization of oxidized regenerated cellulose film for hemostasis and the effect of blood on its surface. Cellulose, 20(5), 2547-2558. https://doi.org/10.1007/s10570-013-0005-5

48. Kleine, J., Leisz, S., Ghadban, C., Hohmann, T., Prell, J., Scheller, C., Strauss, C., Simmermacher, S., & Dehghani, F. (2021). Variants of Oxidized Regenerated Cellulose and Their Distinct Effects on Neuronal Tissue. International journal of molecular sciences, 22(21), 11467. https://doi.org/10.3390/ijms222111467

49. Firmino, F., Villela-Castro, D., & Santos, V. L. C. G. (2024). Oxidized Regenerated Cellulose Versus Calcium Alginate in Controlling Bleeding From Malignant Wounds: A Randomized Controlled Trial. Cancer nursing, 47(5), 377-387. https://doi.org/10.1097/NCC.0000000000001235

50. Rho, S. Y., Jin, M., Kim, H. K., Park, J. I., Park, J. H., Yun, S., Lee, M., Choi, S. B., Hong, J. Y., & Kim, K. S. (2023). The novel use and feasibility of hemostatic oxidized regenerated cellulose agent (SurgiGuard®): multicenter retrospective study. Gland surgery, 12(7), 905-916. https://doi.org/10.21037/gs-22-675

51. Kaneko T., Hayakawa K., Miyazaki T. Clinical efficacy of oxidized regenerated cellulose powder in perioperative blood management in direct anterior total hip arthroplasty. SICOT J. 2025;11:36. PMCID: PMC12266662. PMID: 40668976. https://doi.org/10.1051/sicotj/2025036

52. Kanagal, D., Rao, K., Gathoga, P., Moharana, K., Patil, R., Jaiswal, P., Ap, V., & Ts, D. (2025). Biomaterial-Based Hemostasis: A Review of the Clinical and Functional Versatility of Oxidized Regenerated Cellulose. Cureus, 17(10), e94602. https://doi.org/10.7759/cureus.94602

53. Malik, A. K., Amer, A. O., Tingle, S. J., Thompson, E. R., White, S. A., Manas, D. M., & Wilson, C. (2023). Fibrin-based haemostatic agents for reducing blood loss in adult liver resection. The Cochrane database of systematic reviews, 8(8), CD010872. https://doi.org/10.1002/14651858.CD010872.pub2

54. Genyk, Y., Kato, T., Pomposelli, J. J., Wright, J. K., Jr, Sher, L. S., Tetens, V., & Chapman, W. C. (2016). Fibrin Sealant Patch (TachoSil) vs Oxidized Regenerated Cellulose Patch (Surgicel Original) for the Secondary Treatment of Local Bleeding in Patients Undergoing Hepatic Resection: A Randomized Controlled Trial. Journal of the American College of Surgeons, 222(3), 261–268. https://doi.org/10.1016/j.jamcollsurg.2015.12.007

55. Lavigne, J. P., Postal, A., Kolh, P., & Limet, R. (2003). Prosthetic vascular infection complicated or not by aortoenteric fistula: comparison of treatment with and without cryopreserved allograft (homograft). European journal of vascular and endovascular surgery, 25(5), 416-423. https://doi.org/10.1053/ejvs.2002.1865

56. Chetter, I., Stansby, G., Sarralde, J. A., Riambau, V., Giménez-Gaibar, A., MacKenzie, K., Acín, F., Navarro-Puerto, J., & Investigators of the Fibrin Sealant Grifols Study Group (2017). A Prospective, Randomized, Multicenter Clinical Trial on the Safety and Efficacy of a Ready-to-Use Fibrin Sealant as an Adjunct to Hemostasis during Vascular Surgery. Annals of vascular surgery, 45, 127–137. https://doi.org/10.1016/j.avsg.2017.06.043

57. Karna, R., Deliwala, S., Ramgopal, B., Mohan, B. P., Kassab, L., Becq, A., Dhawan, M., & Adler, D. G. (2023). Efficacy of topical hemostatic agents in malignancy-related GI bleeding: a systematic review and meta-analysis. Gastrointestinal endoscopy, 97(2), 202–208.e8. https://doi.org/10.1016/j.gie.2022.07.033

58. Spotnitz W. D. (2014). Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive-a Laboratory and Clinical Perspective. ISRN surgery, 2014, 203943. https://doi.org/10.1155/2014/203943

59. Jackson M. R. (2001). Fibrin sealants in surgical practice: An overview. American journal of surgery, 182(2 Suppl), 1S–7S. https://doi.org/10.1016/s0002-9610(01)00770-x

60. Sierra D. H. (1993). Fibrin sealant adhesive systems: a review of their chemistry, material properties and clinical applications. Journal of biomaterials applications, 7(4), 309–352. https://doi.org/10.1177/088532829300700402

61. Klokkevold, P. R., Fukayama, H., Sung, E. C., & Bertolami, C. N. (1999). The effect of chitosan (poly-N-acetyl glucosamine) on lingual hemostasis in heparinized rabbits. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 57(1), 49–52. https://doi.org/10.1016/s0278-2391(99)90632-8

62. Zhang, J., Xia, W., Liu, P., Cheng, Q., Tahirou, T., Gu, W., & Li, B. (2010). Chitosan modification and pharmaceutical/biomedical applications. Marine drugs, 8(7), 1962–1987. https://doi.org/10.3390/md8071962

63. Kheirabadi, B. S., Mace, J. E., Terrazas, I. B., Fedyk, C. G., Estep, J. S., Dubick, M. A., & Blackbourne, L. H. (2010). Safety evaluation of new hemostatic agents, smectite granules, and kaolin-coated gauze in a vascular injury wound model in swine. The Journal of trauma, 68(2), 269–278. https://doi.org/10.1097/TA.0b013e3181c97ef1

64. Gheorghiță, D., Moldovan, H., Robu, A., Bița, A. I., Grosu, E., Antoniac, A., Corneschi, I., Antoniac, I., Bodog, A. D., & Băcilă, C. I. (2023). Chitosan-Based Biomaterials for Hemostatic Applications: A Review of Recent Advances. International journal of molecular sciences, 24(13), 10540. https://doi.org/10.3390/ijms241310540

65. Fan, P., Zeng, Y., Zaldivar-Silva, D., Agüero, L., & Wang, S. (2023). Chitosan-Based Hemostatic Hydrogels: The Concept, Mechanism, Application, and Prospects. Molecules (Basel, Switzerland), 28(3), 1473. https://doi.org/10.3390/molecules28031473

66. Lunkov, A. P., Zubareva, A. A., Varlamov, V. P., Nechaeva, A. M., & Drozd, N. N. (2023). Chemical modification of chitosan for developing of new hemostatic materials: A review. International journal of biological macromolecules, 253(Pt 8), 127608. https://doi.org/10.1016/j.ijbiomac.2023.127608

67. Liu, Z., Xu, Y., Su, H., Jing, X., Wang, D., Li, S., Chen, Y., Guan, H., & Meng, L. (2023). Chitosan-based hemostatic sponges as new generation hemostatic materials for uncontrolled bleeding emergency: Modification, composition, and applications. Carbohydrate polymers, 311, 120780. https://doi.org/10.1016/j.carbpol.2023.120780

68. Cheng, F., Xu, L., Dai, J., Yi, X., He, J., & Li, H. (2022). N, O-carboxymethyl chitosan/oxidized cellulose composite sponge containing ε-poly-l-lysine as a potential wound dressing for the prevention and treatment of postoperative adhesion. International journal of biological macromolecules, 209(Pt B), 2151–2164. https://doi.org/10.1016/j.ijbiomac.2022.04.195

69. Asadzadeh, F., Ghorbanzadeh, S., Poursattar Marjani, A., Gholami, R., Asadzadeh, F., & Lotfollahi, L. (2024). Assessing polylactic acid nanofibers with cellulose and chitosan nanocapsules loaded with chamomile extract for treating gram-negative infections. Scientific reports, 14(1), 22336. https://doi.org/10.1038/s41598-024-72398-9

70. Du, F., A, W., Liu, F., Wu, B., Liu, Y., Zheng, W., Feng, W., Li, G., & Wang, X. (2023). Hydrophilic chitosan/graphene oxide composite sponge for rapid hemostasis and non-rebleeding removal. Carbohydrate polymers, 316, 121058. https://doi.org/10.1016/j.carbpol.2023.121058

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Опубликован

2025-12-30

Выпуск

Volume 76, Number 6 (2025)

Раздел

Статьи

Лицензия

Лицензия Creative Commons

Это произведение доступно по лицензии Creative Commons «Attribution» («Атрибуция») 4.0 Всемирная.