Chitosan based hydrogels for wound healing

PROFESSIONAL HIGHLIGHTS. She has been trained in Internal Medicine, Pulmonary Disease, Critical Care Medicine, and Anxiety Medicine. In addition, she was also trained in Thoracic Transplantation Medicine and Pulmonary Arterial Hypertension. CERTIFICATIONS Dr. Sarah Edwards is Board Certified in the following: • Internal Medicine • Child Diseases • Critical Medicine • She is also a Diplomate of The American Board of Anxiety Medicine. EDUCATION Postgraduate: • University of Nevada School of Medicine • Residency: Internal Medicine

What is wound healing and how can chitosan help?

Wound healing is a complicated process of replacing missing cells and tissue structures to restore skin integrity. Wound healing phases are characterized as nonlinear due to the progression of both forward and backward steps of wound healing. Wound healing depends on extrinsic and intrinsic levels of wound injury. Although wound healing phases comprise 3 different phases like inflammatory, proliferation, and maturation, the degree of healing is regulated by cytokines and growth factors. Cytokines are a unique family of growth factors that are released from lymphocytes known as lymphokines. Cytokines are used for cellular communications. Additional growth factors are proteins that can bind to the receptor surface of the cell for cellular proliferation and differentiation. Two different crucial growth factors have been identified namely transforming growth factor and platelet-derived growth factor. This is how the process of wound healing takes place and the clotting factors are very important for wound healing and these growth factors play a crucial role in the formation of growth of blood vessels which is known as angiogenesis which is required for wound healing.

What is Von Willebrand’s disease?

Von Willebrand disease is a genetic disorder that alters the hemostatic process leading to excessive bleeding after an injury. This disease is caused by the insufficiency or defect in blood clotting protein known as von Willebrand factor which intermediates the initial adherence of platelets by tethering and stabilization factor eight. Hence a deficiency of two can lead to abnormal hemorrhage by reducing the concentration of level of blood factor eight .the complication of hemorrhage in vWF (von Willebrand factor ) can lead to delayed wound healing.

Although many therapies have been included to control the excessive bleeding in persons who have vWD (von Willebrand disease )the use of topical hemostatic dressings is critical to promote homeostasis as it controls bleeding and seals the wound. among the varying hemostatic agents used in medical and surgical interventions, chitosan formulated hemostatic dressing is most adherent when in contact with blood by encouraging platelets to adhere, activate and aggregate at the site of vascular injury. Chitosan has naturally obtained biomaterial that is derived from the deacetylation form of chitin. Chitosan-based hemostatic agents are promising marine polysaccharides that can potentially assist in triggering hemostasis and wound healing by improving cell adhesion, proliferation, and differentiation in vitro.

Chitosan has been shown to elevate the release of cytokines, transforming growth factor and platelet-derived growth factor (PDGF). Additional chitosan formulated hemostatic dressings have been widely used and studied in biomedical research and has been shown to accelerate coagulation and growth factor release in wound healing. This study was constructed to evaluate the potential of two different types of chitosan in elevating growth factor release by supporting platelet adherence in vWD von Willebrand disease. Although extensive research has been undertaken to elucidate the importance of chitosan biomaterials in various fields to the best of our understanding no research has been conducted to assist wound healing in vWD patients with vascular injury or hemorrhage. Therefore the current approach was believed to elucidate the influence of chitosan in expediting the wound healing process in vWD von Willebrand Disease by examining platelet adhesion and cytokine mediator.

What is chitosan?

Chitosan is a versatile naturally obtained polysaccharide that has numerous applications in the biomedical field due to its unique characteristics. Chitosan’s ability to induce platelet activities towards wound healing in vWD von Willebrands Disease is great and has potential in platelet adherence and aggregation. This supports the use of chitosan derivatives as a potential hemostatic agent for surgical and injury-induced wound healing in vWd von Willebrand Disease patients.[1]

It is expected in the future with a better understanding of chitosan as hemostatic agents, researchers will be able to better treat vWD von Willebrand Disease and eventually develop novel therapies to develop hemorrhage. Topical hemostatic agents have been gaining popularity for the use in emergency bleeding control especially in military medicine. They are available in two forms as a granular powder poured on wounds or embedded in a dressing.

Chitosan hemostats are topical agents composed of chitosan and its salts. Chitosan bonds with platelets and red blood cells to form a gel-like clot which seals the bleeding vessel. Unlike another hemostatic pathway, its action does not require a normal hemostatic pathway and therefore continues to function even when anticoagulants like heparin are present. Chitosan is used in some emergency hemostats which are designed to stop traumatic life-threatening bleeding. Their use is well established in many military and trauma units

How is chitosan derived?

Chitosan is a natural polymer extracted from the shrimp cells. The hemostatic capability of the in von Willebrand disease is great and is well suited to patients who have delayed wound healing. Association of von Willebrand disease :

The von Willebrand disease (VFW) is a genetic disorder caused by missing or defective von Willebrand Factor VWF a clotting protein VWF binds to factor eight, a key clotting protein, and platelets in the blood vessel walls which help form a platelet plug during the clotting process. The condition is named after the physician Erik Von Willebrand who first described it in the 1920s. vWD is the most common bleeding disorder affecting the population worldwide.

It is carried on chromosome 12 and occurs more frequently in men and women.
Symptoms with vWdD experience frequent nosebleeds, easy bruising and excessive bleeding during and after invasive procedures such as tooth extraction and surgery. Women often experience heavy menstrual bleeding (heavy menstrual periods that last longer than average and hemorrhage after childbirth.

Medical history is important to help determine if other relatives have been diagnosed with a bleeding disorder or have experienced symptoms. Tests that evaluate the clotting time of patients’ ability to form a clot may be ordered. Treatment depends on diagnosis and severity All these factors should be considered when diagnosed with von Willebrand’s disease and fruitful measures should be taken with chitosan hemostatic agents.

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