A comparison of hemostatic activities of zeolite-based formulary finishes on cotton dressings

Authors: Edwards, Judson - Vince; Prevost, Nicolette; Santiago Cintron, Michael

Submitted to: Journal of Functional Biomaterials
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/26/2023
Publication Date: 5/4/2023
Citation: Edwards, J.V., Prevost, N.T., Santiago Cintron, M. 2023. A comparison of hemostatic activities of zeolite-based formulary finishes on cotton dressings. Journal of Functional Biomaterials. 14(5):255. https://doi.org/10.3390/jfb14050255.
DOI: https://doi.org/10.3390/jfb14050255

Interpretive Summary: Uncontrolled hemorrhage is the leading cause of death on the battlefield and second leading cause of death in civilian trauma. Thus there is a need for improved hemorrhage control dressings. Moreover, in recent years the use of domestic cotton in hemorrhage control dressings has become a priority due to potential near peer conflict causing supply chain issues. The work reported in the paper focuses on the design of cotton-based dressings that control hemorrhage. Thus, cotton-based dressings were combined with procoagulant formularies. To this end we have prepared a series of different wound dressing types based on different application approaches similar to those used in the manufacturing process. We then characterized the dressing properties with their procoagulant formularies using spectroscopic methods and examined the performance of the modified cotton fabrics prepared with different finishing approaches. Techniques utilizing viscoelastic measurements of blood clotting were used to determine their ability to rapidly initiate blood clotting. The results suggest that several types of cotton dressing modifications employed can promote blood clotting at a level that is consistent with controlling hemorrhage.

Technical Abstract: The need for affordable effective prehospital hemostatic dressings to control hemorrhage has led to an increased interest in new dressing design approaches. Here we consider the separate components of fabric, fiber, and procoagulant non-exothermic zeolite-based formulations on design approaches to accelerated hemostasis. The design of the fabric formulations was based on incorporation of zeolite Y as the principal procoagulant, with calcium and pectin to adhere and enhance the activity. Unbleached nonwoven cotton when combined with bleached cotton dis-plays enhanced properties related to hemostasis. Here we compare sodium zeolite with am-monium zeolite formulated on fabrics utilizing pectin with pad versus spray-dry-cure and varied fiber compositions. Notably ammonium as a counterion resulted in shorter times to fibrin and clot formation comparable to the procoagulant standard. The time to fibrin formation was found to be within a range that is indicative of modulating severe hemorrhage control. The results indicate a correlation between fabric add-on and accelerated clotting as measured by both time to fibrin and clot formation. A comparison between the time to fibrin formation in calcium/pectin formula-tions and pectin alone revealed an enhanced clotting effect with calcium decreasing by one minute the time to fibrin formation. Infra-red spectra were employed to characterize and quantify the zeolite formulations on the dressings.