Topical biomaterials to prevent post-tonsillectomy hemorrhage

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Abstract

Despite advances in surgical technique, postoperative hemorrhage remains a common cause of mortality and morbidity for patients following tonsillectomy. Application of biomaterials at the time of tonsillectomy can potentially accelerate mucosal wound healing and eliminate the risk of post-tonsillectomy hemorrhage (PTH). To understand the current state and identify possible routes for the development of the ideal biomaterials to prevent PTH, topical biomaterials for eliminating the risk of PTH were reviewed. Alternative topical biomaterials that hold the potential to reduce the risk of PTH were also summarized.

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Most cited references 152

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Chitosan is a natural polysaccharide that has attracted significant scientific interest during the last two decades. It is a potentially biologically compatible material that is chemically versatile (-NH2 groups and various M(w)). These two basic properties have been used by drug delivery and tissue engineering scientists to create a plethora of formulations and scaffolds that show promise in healthcare. Despite the high number of published studies, chitosan is not approved by the FDA for any product in drug delivery, and as a consequence very few biotech companies are using this material. This review will aim to provide information on these biological properties that affect chitosan's safe use in drug delivery. The term "Chitosan" represents a large group of structurally different chemical entities that may show different biodistribution, biodegradation and toxicological profiles. Here we aim to review research in this area and critically discuss chitosan's potential to be used as a generally regarded as safe (GRAS) material. 2009 Elsevier B.V. All rights reserved.

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Chitosan derivatives with quaternary ammonium salt, such as N,N,N-trimethyl chitosan, N-N-propyl-N,N-dimethyl chitosan and N-furfuryl-N,N-dimethyl chitosan were prepared using different 96% deacetylated chitosan of M(v) 2.14x10(5), 1.9x10(4), 7.8x10(3). Amino groups on chitosan react with aldehydes to from a Schiff base intermediate. Quaternized chitosan were obtained by reaction of a Schiff base with methyl iodide. The yields, degree of quaternization and water-solubility of quaternized chitosan were influenced by the molecular weight of the chitosan sample. The antibacterial activities of quaternized chitosan against Escherichia coli were explored by calculation of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in water, 0.25 and 0.50% acetic acid medium. Results show the antibacterial activities of quaternized chitosan against E. coli is related to its molecular weight. Antibacterial activities of quaternized chitosan in acetic acid medium is stronger than that in water. Their antibacterial activities is increased as the concentration of acetic acid is increased. It was also found that the antibacterial activity of quaternized chitosan against E. coli is stronger than that of chitosan.

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Author and article information

Contributors

Tendy Chiang: Tendy.Chiang@NationwideChildrens.org

Journal

Journal ID (nlm-ta): J Otolaryngol Head Neck Surg

Journal ID (iso-abbrev): J Otolaryngol Head Neck Surg

Title: Journal of Otolaryngology - Head & Neck Surgery

Publisher: BioMed Central (London )

ISSN (Print): 1916-0208

ISSN (Electronic): 1916-0216

Publication date (Electronic): 6 September 2019

Publication date PMC-release: 6 September 2019

Publication date Collection: 2019

Volume: 48

Electronic Location Identifier: 45

Affiliations

[1 ]ISNI 0000 0004 0392 3476, GRID grid.240344.5, Center of Regenerative Medicine, , Research Institute at Nationwide Children’s Hospital, ; Columbus, OH USA

[2 ]ISNI 0000 0001 2285 7943, GRID grid.261331.4, College of Medicine, , The Ohio State University, ; Columbus, OH USA

[3 ]ISNI 0000 0004 0392 3476, GRID grid.240344.5, Department of Pediatric Otorhinolaryngology, , Nationwide Children’s Hospital, ; Columbus, OH USA

[4 ]GRID grid.436793.c, Nanofiber Solutions, ; Hilliard, OH USA

Article

Publisher ID: 368

DOI: 10.1186/s40463-019-0368-1

PMC ID: 6731608

PubMed ID: 31492172

SO-VID: f6e9a940-d683-438b-adaa-350f949171d9

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 20 May 2019

Date accepted : 27 August 2019

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Keywords: post-tonsillectomy hemorrhage,biomaterial,topical,surgical hemostasis,tonsillectomy

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Keywords: post-tonsillectomy hemorrhage, biomaterial, topical, surgical hemostasis, tonsillectomy

Topical biomaterials to prevent post-tonsillectomy hemorrhage

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Abstract

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Applied use of fungi

Most cited references 152

Biodegradation, biodistribution and toxicity of chitosan.

Fibrin gels and their clinical and bioengineering applications.

Synthesis and antibacterial activities of quaternary ammonium salt of chitosan.

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