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.

Magnesium alloys as bioresorbable materials with good biocompatibility have raised a growing interest in the past years in temporary implant manufacturing, as they offer a steady resorption rate and optimal healing in the body. Magnesium exhibits tensile strength properties similar to those of natural bone, which determines its application in load-bearing mechanical medical devices. In this paper, we investigated the biodegradation rate of Mg-Zn-Mn biodegradable alloys (ZMX410 and ZM21) before and after coating them with hydroxyapatite (HAP) via the electrophoretic deposition method. The experimental samples were subjected to corrosion tests to observe the effect of HAP deposition on corrosion resistance and, implicitly, the rate of biodegradation of these in simulated environments. X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) provided detailed information on the quality, structure, and morphology of the HAP coating. The obtained results demonstrate that coating of Mg-Zn-Mn alloys by HAP led to the improvement of corrosion resistance in simulated environments, and that the HAP coating could be used in order to control the biodegradation rate.

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.

PMMA bone cements are mainly used to fix implanted prostheses and are introduced as a fluid mixture, which hardens over time. The problem of infected prosthesis could be solved due to the development of some new antibacterial bone cements. In this paper, we show the results obtained to develop four different modified PMMA bone cements by using antimicrobial additives, such as gentamicin, peppermint oil incorporated in hydroxyapatite, and silver nanoparticles incorporated in a ceramic glass matrix (2 and 4%). The structure and morphology of the modified bone cements were investigated by SEM and EDS. We perform experimental measurements on wettability, hydration degree, and degradation degree after immersion in simulated body fluid. The cytotoxicity was evaluated by MTT assay using the human MG-63 cell line. Antimicrobial properties were checked against standard strains Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The addition of antimicrobial agents did not significantly affect the hydration and degradation degree. In terms of biocompatibility assessed by the MTT test, all experimental PMMA bone cements are biocompatible. The performance of bone cements with peppermint essential oil and silver nanoparticles against these two pathogens suggests that these antibacterial additives look promising to be used in clinical practice against bacterial infection.

The main problems directly linked with the use of PMMA bone cements in orthopedic surgery are the improper mechanical bond between cement and bone and the absence of antimicrobial properties. Recently, more research has been devoted to new bone cement with antimicrobial properties using mainly antibiotics or other innovative materials with antimicrobial properties. In this paper, we developed modified PMMA bone cement with antimicrobial properties proposing some experimental antimicrobial agents consisting of silver nanoparticles incorporated in ceramic glass and hydroxyapatite impregnated with peppermint oil. The impact of the addition of antimicrobial agents on the structure, mechanical properties, and biocompatibility of new PMMA bone cements was quantified. It has been shown that the addition of antimicrobial agents improves the flexural strength of the traditional PMMA bone cement, while the yield strength values show a decrease, most likely because this agent acts as a discontinuity inside the material rather than as a reinforcing agent. In the case of all samples, the addition of antimicrobial agents had no significant influence on the thermal stability. The new PMMA bone cement showed good biocompatibility and the possibility of osteoblast proliferation (MTT test) along with a low level of cytotoxicity (LDH test).