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Dr Rati Parwani
Dr Rati Parwani is a Practising Professional BHMS Doctor having experience of 8 years in the medical field. She is a good homeopathic doctor.Her approach towards each and every patient is the utmost professional with high standards of homoeopathic practice. She has nurtured her writing skills and proves it as an asset to her professionalism. She has experience in content writing and likes her writing ethical and scientific-based Her expertise in curing chronic cases of osteoarthritis,, endocrinological disorders, lifestyle disorders, Female health problems such as acne PCOS, uterine fibroids and endometriosis, skin problems such as psoriasis and eczema, GIT troubles, Respiratory issues and other ailments . Her expertise lies in treating chronic cases. Medical Education Bachelor of homoeopathic medicine, bachelor of surgery - BHMS Medicine A+ Padmashree Dr D. Y. Patil Medical College, Hospital and Research Centre, Pune

Hemostasis is the natural process that stops blood loss when the injury occurs. Hemo meaning blood and stasis meaning stopping. During hemostasis, blood changes from the fluid state to the gelatinous stage.

Steps of hemostasis :

Hemostasis includes three steps that occur in rapid sequence.
1) Vascular spasm or vasoconstriction a brief and intense contraction of blood vessels
2) Formation of the platelet plug
3) Blood clotting or coagulation reinforces the platelet plug with fibrin mesh that acts as a glue to hold the clot together. Once the blood flow has ceased tissue repair can begin.

1.Vasoconstriction: Intact blood vessels are central to moderating blood’s clotting tendency. the endothelial cells of intact vessels prevent clotting by expressing a fibrinolytic heparin molecule and thrombomodulin which prevents platelet aggregation and stops the coagulation cascade with nitrous oxide. When the endothelial injury occurs, the endothelial cells stop the secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand Factor which causes platelet adherence during the initial formation of the clot. the vasoconstriction that occurs during hemostasis is a brief reflexive contraction that causes a decrease in the blood flow to that area.

2. Platelet plug formation: Platelet create the platelet plug that forms almost directly after the blood vessel has been ruptured. Within twenty seconds of injury in which the blood vessel’s epithelium wall is disrupted, coagulation is initiated. It takes approximately 60 seconds until the first fibrin strands begin to intersperse among the wound. After several minutes the platelet plug is completely formed by the fibrin. Contrary to popular belief, clotting of the skin is not caused by exposure to air, but by platelets adhering to and being activated by collagen in blood vessels endothelium. The activated platelets then release the contents of their granules, which contain a variety of substances that stimulate further platelet activation and enhance the hemostatic process.

When the lining of the blood vessel breaks and the endothelial blood cells are damaged, revealing subendothelial collagen proteins from the extracellular matrix, thromboxane causes platelet to swell grow filaments, and start clumping together of aggregating. Von Willebrand’s factor causes them to adhere to each other and the walls of the vessel. this continues as more platelet congregate and undergo these same transformations. This process results in a platelet plug that seals the injured area. If the injury is small the platelet plug can form in several seconds.

3. Coagulation cascade: If the platelet plug is not enough to stop bleeding, the third stage of hemostasis begins, the formation of the blood clot. Platelets contain secretory granules. When they stick to the protein in vessel walls they degranulate thus releasing their products which include ADP adenosine diphosphate, serotonin, and thromboxane 2 which activate other platelets. First blood changes from liquid to gel. At least 12 substances called clotting factors or tissue factors take part in a cascade of chemical reactions that eventually create the meshwork of fibrin within the blood. Each of the clotting factors has a specific function. Prothrombin, thrombin, and fibrinogen are the main factors involved in the outcome of the coagulation cascade.

Prothrombin and fibrinogens are proteins that are produced and deposited in the blood by the liver. When the blood vessels are damaged, vessels and nearby platelets are stimulated to release a substance called prothrombin activator which in turn activates the conversion of prothrombin, a plasma protein into an enzyme called thrombin. This reaction requires calcium ions.

Here is where the calcium metabolism that we spoke about initially comes into play which is present in the vitamin K2 and chitosan as both have the calcium ions present in them. So this is the catch in the entire hemostatic pathway to stop the blood.

Thrombin facilitates the conversion of a soluble plasma called fibrinogen into long insoluble fibers or threads of a protein called fibrin. Fibrin threads wind around the platelet plug at the damaged area of the blood vessel forming an interlocking network of fibers and the framework for the clot. The net of fibers traps and holds the platelets, blood cells, and the other molecules tight to the site of injury, functional as the initial clot.

this temporary fibrin clot can form in less than a minute and slows the blood flow before platelet attach. So there is some connection between calcium ions and calcium metabolism that gets involved in the process and forms the initial clot. So this is how the chitosan and Vitamin K2 works in conjunction with calcium ions. The similarity between chitosan chitin and vitamin K2 Chitin is a polymer of glucosamine that is found in shells or walls of invertebrates fungi and yeast. It is the main component of crustacean exoskeletons and is made up of calcium oxide and protein unit s. Chitin forms 50-80 % of organic compounds in crustacean shells. Chitosan, an amino polysaccharide is prepared from shellfish chitin by treatment with alkali. Both chitin and chitosan are nonstarch polysaccharides and have the potential to be regarded as components of dietary fiber.

On the other hand, if you go with vitamin K3 it has effects on the calcium ions and bone formation as explained above. so there is some affinity between the calcium metabolism of the body and blood clotting which needs extensive research. Research is advanced now. Every new day scientists are coming up with research therapies about the same Coagulation is now being taken a further step by entering the coagulation pathways which will be explained further in connection with the calcium metabolism. Hemostatic arrest bleeding and the main function of chitosan and vitamin K2 is an application that is widely extensively used for blood clotting.

A functional chitosan-based hydrogel with vitamin K2 as a wound dressing and drug delivery system in the treatment of wound healing. Function active wound dressings are expected to provide a moist wound environment offer protection from secondary infections, remove wound exudate, and accelerate tissue regeneration as well as to improve the efficiency of wound healing. Chitosan-based hydrogels are considered ideal materials for enhancing wound healing owing to biodegradable, biocompatible, non-toxic, antimicrobial, biologically adhesive, biological activity, and hemostatic effects.

Chitosan-based hydrogels with vitamin K2 have been demonstrated to promote wound healing at different wound healing stages and also can alleviate the factors against wound healing such as excessive inflammatory and chronic wound infection. The unique biological properties of chitosan-based hydrogel with vitamin k2 enable it to serve both as a wound dressing and a drug delivery system (DDS) to deliver antibacterial agents and growth factors stem cells and so on which could further accelerate wound healing. For various kinds of wounds, chitosan-based hydrogels can promote the effectiveness of wound healing by modifying or combining with other polymers and carrying different types of active substances. Let us take a closer look at the applications of chitosan-based hydrogels with vitamin K2 in wound healing and drug delivery system to enhance wound healing.

Useful resources

  • /patients/haemostasis-management/haemostasis-what-is-haemostasis.html



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