Hemostatic action of polyurethane foam with 55% polyethylene glycol compared to collagen and gelatin

BACKGROUND: For most topical hemostatic agents the mechanism of hemostatic action is not fully understood. OBJECTIVE: This work aimed to investigate the hemostatic mechanism of action and viscoelastic properties of polyurethane foam (PU) in comparison to the widely used collagen and gelatin. METHODS: The hemostatic mechanism of action of the materials was tested using human whole blood and platelet-poor plasma (PPP). The ability of the hemostatic agent to exert pressure on the wound was quantified in terms of its viscoelastic properties both under dry and wet conditions using a low load compression tester (LLCT). RESULTS: It has been shown that collagen and PU initiate hemostasis through both thrombocyte aggregation and contact activation of the coagulation cascade. Gelatin did not show improved thrombocyte aggregation or initiation of the coagulation cascade compared to the negative control group. PU is more firm under wet conditions and shows more springback than collagen and gelatin. CONCLUSIONS: We conclude that PU is promising as a topical hemostatic agent because it initiates both the coagulation cascade and thrombocyte aggregation. Furthermore, it has favorable viscoelastic properties compared to collagen and gelatin which leads to increased pressure on a wound.