Chitosan-Based Hemostatic Agents in Wound Care

I'm Dr. Aliza Lee. I am a staff podiatrist, the director of podiatric medical education, and a clinical investigator at the Salem Veteran Affairs Medical Center in Salem, Virginia. I've been asked today to discuss my use on chitosan-based products.

I use many types of hemostatic agents both in the OR and in the clinical setting. Standard gauze and pressure, silver nitrate, electrocautery, oxidized regenerated cellulose, fiber mixes with thrombin, plant-based powders, cellulose, and chitosan.

What is chitosan? Chitosan is a naturally occurring biocompatible, biodegradable, non-toxic hemostatic agent with antimicrobial, antifungal, and wound healing promoting properties, which stops bleeding and is non-caustic.

Chitosan comes in both gauze and granular forms. It is faster acting compared to just gauze and pressure alone. It is not limited to the OR, where electrocautery is. It requires no pre-mixing, like Surgicel. In this case, it's rip and core or tear and press.

Its indications are for minor, moderate to severe bleeding. Most of the other products are not recommended for anything above severe. It does not cause heat or a chemical reaction that can damage the tissue, and electrocautery and silver nitrate do do this.

It's less expensive than Surgiflo, Surgicel or even Arista. It does cost more than silver nitrate, electrocautery, or standard pressure dressings, but because it's so fast-acting, you're saving money because you're saving time.

I use this product everywhere from the OR, clinic, to the bedside. It is used as a hemostatic agent alone or in conjunction with my advanced wound care products. I use it during my surgical debridements. I use it after my surgical debridements as a reinforcement dressing to make sure there's not a further rebleed after the procedure.

You can easily tuck it into your coat pocket and use it when you're going around in clinic rounds in the hospital.

Getting this product approved for our facility was rather easy, because of its combination of high efficiency and low cost.

My debridement practice has forever been impacted by this great product. The ability to achieve hemostasis in the anticoagulated patient population without causing tissue damage, it's just incredible. It allows me to debride at the bedside or in clinic with confidence and without the need of an operating room.