Antibacterial polyurethane foams with quaternized-chitosan as a chain extender for nasal packing and hemostasis

Kaidi Ding; Wenlong Cong; Ying Liu; Changtong Song; Haoyang Mi; Chuntai Liu; Yuhong Ma; Changyu Shen

doi:10.1016/j.actbio.2024.04.041

Antibacterial polyurethane foams with quaternized-chitosan as a chain extender for nasal packing and hemostasis

Acta Biomater. 2024 May 3:S1742-7061(24)00225-3. doi: 10.1016/j.actbio.2024.04.041. Online ahead of print.

Authors

Kaidi Ding¹, Wenlong Cong², Ying Liu², Changtong Song², Haoyang Mi¹, Chuntai Liu¹, Yuhong Ma³, Changyu Shen⁴

Affiliations

¹ Key Laboratory of Materials Processing and Mold (Zhengzhou University), Ministry of Education, National Engineering Research Center for Advanced Polymer Processing Technology, Zhengzhou University, Zhengzhou 450002, China.
² College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China.
³ College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, China. Electronic address: mayh@mail.buct.edu.cn.
⁴ Key Laboratory of Materials Processing and Mold (Zhengzhou University), Ministry of Education, National Engineering Research Center for Advanced Polymer Processing Technology, Zhengzhou University, Zhengzhou 450002, China. Electronic address: shency@zzu.edu.cn.

PMID: 38704113
DOI: 10.1016/j.actbio.2024.04.041

Abstract

Endoscopic surgery is an effective and common clinical practice for chronic sinusitis. Nasal packing materials are applied in nasal surgery to prevent hemorrhage and promote wound healing. In this study, a degradable polyurethane foam dressing is successfully developed as a promising nasal packing material with good biocompatibility and antibacterial capability. Specifically, quaternized chitosan (QCS) serves as the crosslinker instead of polyols to offer polyurethane foam (PUF-QCS) antibacterial capability. The PUF-QCS2.0 % (with 2.0 wt% QCS) exhibits satisfactory liquid absorption capacity (19.4 g/g), high compressive strengths at both wet (14.5 kPa) and dry states (7.7 kPa), and a good degradation rate (8.3 %) within 7 days. Meanwhile, PUF-QCS2.0 % retains long-term antibacterial activity for 7 days and kills 97.3 % of S. aureus and 91.8 % of E. coli within 6 hours in antibacterial testing. Furthermore, PUF-QCS2.0 % demonstrates a positive hemostatic response in the rabbit nasal septum mucosa trauma model by reducing hemostatic time over 50.0 % and decreasing blood loss up to 76.1 % compared to the commercial PVA nasal packing sponge. Importantly, PUF-QCS also exhibits a significant antibacterial activity in nasal cavity. This nasal packing material has advantages in post-surgery bleeding control and infection prevention. STATEMENT OF SIGNIFICANCE: The performance of a nasal packing sponge requires good mechanical properties, fast and high liquid absorption rate, effective degradability and strong antibacterial activity. These features are helpful for improving the postoperative recovery and patient healing. However, integrating these into a single polyurethane foam is a challenge. In this study, quaternized chitosan (QCS) is synthesized and used as a chain extender and antibacterial agent in preparing a degradable polyurethane foam (PUF-QCS) dressing. PUF-QCS undergoes partial degradation and exhibits effective broad-spectrum antibacterial activity in 7 days. The reduction of postoperative bleeding and infection observed in the animal experiment further demonstrates that the PUF-QCS developed here outperforms the existing commercial nasal packing materials.

Keywords: Antibacterial; Hemostasis; Nasal packing; Polyurethane foam; Quaternized chitosan.