| خلاصه مقاله | The importance of managing severe bleeding is crucial for patient rescue in both clinical and unexpected
emergency situations. In this context, achieving rapid hemostasis with no stimulation of immune
responses is essential. Although natural clays demonstrate high performance in controlling severe
hemorrhage and have a low stimulatory impact, their large particle size and potential risk of thrombosis
are considered significant drawbacks when compared to synthetic nanoclays. Conversely, the complex
and costly synthesis process of synthetic nanoclays limits their scalability for commercial applications. To
address these limitations, a novel approach using glow discharge plasma irradiation was applied to
convert natural kaolin, sourced from the Marand mine in East Azerbaijan, into pseudohexagonal-shaped
kaolin nanoparticles (30 to 150 nm) following planetary ball milling. This study represents a
comprehensive comparison between hemostatic performance of natural and synthetic nanoclays
embedded in modified cellulose-based sponge for non-compressible massive bleedings. Additionally,
plasma irradiation may directly enhance the specific surface area and pore volume of nano kaolin, thereby
improving the hemostatic performance of the nanocomposite aerogels. The triple-network carboxymethyl
cellulose aerogels, crosslinked with Ca²⁺ , citric acid, and nano kaolin, exhibited a highly porous structure
(~80%) and remarkable absorption of phosphate-buffered saline (PBS) (~3250%), which is effective in
concentrating hemostasis-inducing proteins. Furthermore, these aerogels demonstrated high adhesion
ability to wet tissue surfaces. The aerogels showed excellent performance in forming stable clots (BCI <
14%), with approximately 91% red blood cell attachment and 95% platelet aggregation. The in vivo host
response, assessed through hematological, pathological, and biochemical parameter tests, revealed no
systemic or significant local inflammatory response. The nanocomposite aerogels demonstrated superior
performance, achieving a 2.5-fold and 2-fold reduction in hemostasis time and blood loss, respectively, in
a rat femoral artery bleeding model compared to commercial hemostatic sponges (P-values < 0.01),
respectively. Consequently, this innovative treatment of natural clays offers a viable solution by
producing low-risk materials with reduced synthesis costs compared to synthetic nanoclays. The
engineered nanocomposite aerogels, through the combination of optimized chemical properties and
physical design, exhibited a synergistic effect by simultaneously activating the coagulation cascade and
forming a physical barrier at the bleeding site, thereby minimizing side effects and mitigating the risk of
thrombosis. |