Hemorrhage is a detrimental event present in traumatic injury, surgery, and disorders of bleeding that can become life-threatening if not properly managed. Moreover, uncontrolled bleeding can complicate surgical interventions, altering the outcome of surgical procedures. Therefore, to reduce the risk of complications and decrease the risk of morbidity and mortality associated with hemorrhage, it is necessary to use an effective hemostatic agent that ensures the immediate control of bleeding. In recent years, there have been increasingly rapid advances in developing a novel generation of biomaterials with hemostatic properties. Nowadays, a wide array of topical hemostatic agents is available, including chitosan-based biomaterials that have shown outstanding properties such as antibacterial, antifungal, hemostatic, and analgesic activity in addition to their biocompatibility, biodegradability, and wound-healing effects. This review provides an analysis of chitosan-based hemostatic biomaterials and discusses the progress made in their performance, mechanism of action, efficacy, cost, and safety in recent years.

Wound dressings for skin lesions, such as bedsores or pressure ulcers, are widely used for many patients, both during hospitalization and in subsequent treatment at home. To improve the treatment and shorten the healing time and, therefore, the cost, numerous types of wound dressings have been developed by manufacturers. Considering certain inconveniences related to the intolerance of some patients to antibiotics and the antimicrobial, antioxidant, and curative properties of certain essential oils, we conducted research by incorporating these oils, based on polyvinyl alcohol/ polyvinyl pyrrolidone (PVA/PVP) biopolymers, into dressings. The objective of this study was to study the potential of a polymeric matrix for wound healing, with polyvinyl alcohol as the main material and polyvinyl pyrrolidone and hydroxypropyl methylcellulose (HPMC) as secondary materials, together with additives (plasticizers poly(ethylene glycol) (PEG) and glycerol), stabilizers (Zn stearate), antioxidants (vitamin A and vitamin E), and four types of essential oils (fennel, peppermint, pine, and thyme essential oils). For all the studied samples, the combining compatibility, antimicrobial, and cytotoxicity properties were investigated. The obtained results demonstrated a uniform morphology for almost all the samples and adequate barrier properties for contact with suppurating wounds. The results show that the obtained samples containing essential oils have a good inhibitory effect on, or antimicrobial properties against, Staphylococcus aureus ATCC 25923, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, and Candida albicans ATCC 10231. The MTT assay showed that the tested samples were not toxic and did not lead to cell death. The results showed that the essential oils used provide an effective solution as active substances in wound dressings.

This study evaluates the antimicrobial and antioxidant activities of five essential oils (EO): pine oil, thyme oil, sage oil, fennel oil, and eucalyptus essential oils. To identify the chemical composition of the essential oils, we used gas chromatography coupled to a mass spectrometer (GC-MS). EO are predominantly characterized by the presence of monoterpene hydrocarbons and oxygenated monoterpenes, except in the case of fennel essential oil which contains phenylpropanoids as its main components. The antimicrobial activity of the EO was highlighted on four standard microbial strains (two Gram-negative strains-Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853; one Gram-positive strain Staphylococcus aureus ATCC 25923, and one yeast strain-Candida albicans ATCC 10231). Antimicrobial activity was assessed by measuring the diameter of the inhibition zone, and by determining the values of the minimum inhibitory concentration (MIC) and minimum concentration of biofilm eradication (MCBE). Analyzing the diameter values of the inhibition zones we observed increased efficiency of thyme essential oil, which showed the highest values for all tested microbial species. The results of tests performed in a liquid confirm the high sensitivity of the standard strain Escherichia coli ATCC 25922 to the action of all essential oils, the lowest values of MIC being recorded for sage and thyme essential oils. For the most essential oils tested in this study, the MCBE values are close to the MIC values, except for the pine EO which seems to have stimulated the adhesion of the yeast strain at concentrations lower than 5%. The study highlights the antimicrobial activity of the tested essential oils on Gram-positive and Gram-negative strains.

Failure of osteosynthesis implants is an intricate matter with challenging management that calls for efficient investigation and prevention. Using implant retrieval analysis combined with standard radiological examination, we evaluated the main causes for osteosynthesis implant breakdown and the relations among them for a series of cases. Twenty-one patients diagnosed with implant failure were assessed for this work. For metallurgical analysis, microscopy techniques such as scanning electron microscopy (SEM), stereomicroscopy, and optical microscopy were employed. The results showed that material structural deficiencies (nine patients) and faulty surgical techniques (eight patients) were the main causes for failure. An important number of patients presented with material structural deficiencies superimposed on an imperfect osteosynthesis technique (six patients). Consequently, the importance of failure retrieval analysis should not be overlooked, and in combination with other investigational techniques, must provide information for both implant manufacturing and design improvement, as well as osteosynthesis technique optimization.

Intraoperative haemostasis is of paramount importance in the practice of cardiovascular surgery. Over the past 70 years, topical haemostatic methods have advanced significantly and today we deal with various haemostatic agents with different properties and different mechanisms of action. The particularity of coagulation mechanisms after extracorporeal circulation, has encouraged the introduction of new types of topic agents to achieve haemostasis, where conventional methods prove their limits. These products have an important role in cardiac, as well as in vascular, surgery, mainly in major vascular procedures, like aortic dissections and aortic aneurysms. This article presents those agents used for topical application and the mechanism of haemostasis and offers general recommendations for their use in the operating room.

Sarcina ventriculi is an extremely rare pathogen. These gram-positive cocci bacteria are rarely identified in gastric biopsies and usually described in the scientific literature as an incidental finding, particularly in patients with delayed gastric emptying, gastroparesis, emphysematous gastritis or gastric perforation. It occurs most commonly in adult women and can be identified easily by its distinctive morphologic features, such as basophilic staining, cuboidal shape, tetrad arrangement, red blood cell-sized packets, flattened cell walls, and refractile nature in bright field microscopy. Although the pathogenesis of the microorganism is highly debated in humans, this bacterium is a well-known pathogen in livestock. Fewer than 30 cases of human infection have been described in the scientific literature so far, but none mentioned this micro-organism as a potential cause of death. We report the case of a 76-year-old patient with gastric perforation due to massive infection with Sarcina ventriculi. To date, this is the first report of human infection with Sarcina ventriculi in Romania.