Atomic layer deposition of titanium dioxide on cellulose acetate for enhanced hemostasis

A variety of biologically-derived hemostatic agents,including cellulose, bone wax, chitosan, collagen,and gelatin, have been utilized over the years forreducing blood loss associated with trauma [1,2].Ahemostatic agent should exhibit several properties,including (a) the ability to stop hemorrhage fromarterial and/or venous sources in a short time peri-od, (b) usability with minimal training, (b) lowweight, (c) high stability, (d) low cost, (e) and bio-compatibility (e.g., absence of cytotoxicity) [1–7].There are several benefits to the use of plant-derived materials such as cellulose in hemostasisapplications,including an absence of disease trans-mission from donor to recipient and an absence ofantibody formation to coagulation factors [8]. Cel-lulose is a wood pulp-derived material that hasbeen utilized in hemostasis for over 60 years;use ofoxidized cellulose, oxidized regenerated cellulose,carboxymethylcellulose, and cellulose acetate hasbeen described [1, 9–12]. In addition, these porous,water-absorbable materials do not need to be re-moved after use because they are degraded withinthe body over several weeks,increasing patient sat