Haemorrhage or severe blood loss can soon turn into a life-threatening situation. In a recent study, a team of Indian scientists led by Deepa Ghosh from the Institute of Nano Science and Technology (INST), Mohali, fabricated a biodegradable powder which can prevent haemorrhaging. When sprinkled over an injury, the powder rapidly arrests bleeding and quickens healing.

The study was performed in collaboration with the National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad.

Special materials which can soak up excess fluid and aid in stopping local bleeding are known as topical haemostats. Topical Haemostats are much in demand during emergencies as they can arrest profuse bleeding from injuries. However, currently, they are usually made up of expensive, nondegradable materials.

Despite advancements in science, no single material can prevent all types of bleeding. Some currently available options in the west such as Chitosan sponge and Kaolin are either not flexible enough to properly cover the contours of the wound area or are non-biodegradable. They have to be removed immediately after absorbing the blood, leading to the risk of disrupting the just-formed clot and causing further bleeding. 

Moreover, these materials are expensive and therefore may not be affordable for many in developing nations like India. A few upcoming starch-based haemostats are biodegradable, but are slow in absorbing blood and poor in adhering to the injured site, thereby limiting their clinical application.

To overcome these limitations, Ghosh’s team modified a natural starch compound to convert it into a better performing haemostat. They started with a biodegradable pharmaceutical excipient — a type of starch used as the base material in medicines — and tweaked the hydroxyl groups in the compounds to carboxymethyl (CM) groups. They then converted this into a powder form consisting of CM-starch microparticles.

The team observed that when these free-flowing microparticles came in contact with blood, they absorbed the excess fluid within 30 seconds and formed a sticky gel-like network. The gel served as a barrier to prevent blood flow, thereby abating the bleeding. As the gel was biodegradable, it could be left at the wound site without causing toxicity or disrupting clot formation.

Ghosh says, ​“We wanted the microparticles to facilitate the clotting mechanism as well. So in a bid to quicken clot formation, we fortified the powder with Calcium ions.” Calcium (Ca) plays a crucial role in clot formation. During this process, activated platelets release protein factors that combine with calcium ions to create a mesh-like substance, which then forms the clot that plugs the injury site.

When the researchers sprinkled the Calcium-fortified powder (Ca-CM Starch) on injuries in animal models, it could stop the bleeding in less than one minute. This was due to the combined action of the gel creating a barrier to blood flow, and the Calcium providing a pathway for the natural clotting mechanism to take over.

“The Ca-CM Starch appears to be a promising haemostat, ready for the next phase of testing in clinical trials,” says Santhosh Satheesh, Professor of Cardiology at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, who was not associated with the study. He adds, ​“Another potential use could be as a replacement for PVC microparticles used in surgical procedures (such as arterial embolization) where the flow to a blood vessel is stopped.”

“Our new material has demonstrated its efficacy in meeting the pressing demand for a better and cost-effective haemostat, that could prevent the complications associated with heavy bleeding,” says Ghosh. The researchers look forward to patenting the product for use as single-use sachets.

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