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Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model

Zita Jessop Orcid Logo, Elena García-Gareta Orcid Logo, YADAN ZHANG, Thomas Jovic, Nafiseh Badiei, Vaibhav Sharma, Iain Whitaker, Norbert Kang Orcid Logo

JPRAS Open, Volume: 29, Pages: 113 - 122

Swansea University Authors: Zita Jessop Orcid Logo, YADAN ZHANG, Thomas Jovic, Nafiseh Badiei, Iain Whitaker

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DOI (Published version): 10.1016/j.jpra.2021.04.008

Abstract

Three per cent hydrogen peroxide (H2O2) is widely used to irrigate acute and chronic wounds in the surgical setting and clinical experience tells us that it is more effective at removing dried-on blood than normal saline alone. We hypothesise that this is due to the effect of H2O2 on fibrin clot arc...

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Published in: JPRAS Open
ISSN: 2352-5878
Published: Elsevier BV 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa60415
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We hypothesise that this is due to the effect of H2O2 on fibrin clot architecture via fibrinolysis. We investigate the mechanisms and discuss the clinical implications using an in vitro model. Coagulation assays with normal saline (NaCl), 1% and 3% concentrations of H2O2 were performed to determine the effect on fibrin clot formation. These effects were confirmed by spectrophotometry. The effects of 1%, 3% and 10% H2O2 on the macroscopic and microscopic features of fibrin clots were assessed at set time intervals and compared to a NaCl control. Quantitative analysis of fibrin networks was undertaken to determine the fibre length, diameter, branch point density and pore size. Fibrin clots immersed in 1%, 3% and 10% H2O2 demonstrated volume losses of 0.09-0.25mm3/min, whereas those immersed in the normal saline gained in volume by 0.02&#xB1;0.13 mm3/min. Quantitative analysis showed that H2O2 affects the structure of the fibrin clot in a concentration-dependent manner, with the increase in fibre length, diameter and consequently pore sizes. Our results support our hypothesis that the efficacy of H2O2 in cleaning blood from wounds is enhanced by its effects on fibrin clot architecture in a concentration- and time-dependent manner. The observed changes in fibre size and branch point density suggest that H2O2 is acting on the quaternary structure of the fibrin clot, most likely via its effect on cross-linking of the fibrin monomers and may therefore be of benefit for the removal of other fibrin-dependent structures such as wound slough.</abstract><type>Journal Article</type><journal>JPRAS Open</journal><volume>29</volume><journalNumber/><paginationStart>113</paginationStart><paginationEnd>122</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2352-5878</issnPrint><issnElectronic/><keywords>Wound irrigation, hydrogen peroxide, fibrinolysis, fibrin clot, coagulation assay</keywords><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-09-01</publishedDate><doi>10.1016/j.jpra.2021.04.008</doi><url/><notes/><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was supported by the Restoration of Appearance and Function Trust (Registered Charity No 299811, United Kingdom), the Medical Research Council (MR/N002431/1), the Welsh Clinical Academic Training Pathway, ABM University Health Board / Health Research Wales, the Oakgrove Foundation (Registered charity No 1164926, United Kingdom), Royal College of Surgeons of England, British Association of Plastic and Reconstructive Surgeons, and the Fulbright Commission. 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spelling 2022-08-03T14:59:22.1732081 v2 60415 2022-07-08 Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model 0184f610b62d649a59dad304e48ea03b 0000-0003-2886-9165 Zita Jessop Zita Jessop true false 0b87eada14b5f81ff93ab9f6b30f6294 YADAN ZHANG YADAN ZHANG true false 7d95ed2bceb18fc0fdfd4048277c6eed Thomas Jovic Thomas Jovic true false c82cd1b82759801ab0045cb9f0047b06 Nafiseh Badiei Nafiseh Badiei true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2022-07-08 BMS Three per cent hydrogen peroxide (H2O2) is widely used to irrigate acute and chronic wounds in the surgical setting and clinical experience tells us that it is more effective at removing dried-on blood than normal saline alone. We hypothesise that this is due to the effect of H2O2 on fibrin clot architecture via fibrinolysis. We investigate the mechanisms and discuss the clinical implications using an in vitro model. Coagulation assays with normal saline (NaCl), 1% and 3% concentrations of H2O2 were performed to determine the effect on fibrin clot formation. These effects were confirmed by spectrophotometry. The effects of 1%, 3% and 10% H2O2 on the macroscopic and microscopic features of fibrin clots were assessed at set time intervals and compared to a NaCl control. Quantitative analysis of fibrin networks was undertaken to determine the fibre length, diameter, branch point density and pore size. Fibrin clots immersed in 1%, 3% and 10% H2O2 demonstrated volume losses of 0.09-0.25mm3/min, whereas those immersed in the normal saline gained in volume by 0.02±0.13 mm3/min. Quantitative analysis showed that H2O2 affects the structure of the fibrin clot in a concentration-dependent manner, with the increase in fibre length, diameter and consequently pore sizes. Our results support our hypothesis that the efficacy of H2O2 in cleaning blood from wounds is enhanced by its effects on fibrin clot architecture in a concentration- and time-dependent manner. The observed changes in fibre size and branch point density suggest that H2O2 is acting on the quaternary structure of the fibrin clot, most likely via its effect on cross-linking of the fibrin monomers and may therefore be of benefit for the removal of other fibrin-dependent structures such as wound slough. Journal Article JPRAS Open 29 113 122 Elsevier BV 2352-5878 Wound irrigation, hydrogen peroxide, fibrinolysis, fibrin clot, coagulation assay 1 9 2021 2021-09-01 10.1016/j.jpra.2021.04.008 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University Another institution paid the OA fee This work was supported by the Restoration of Appearance and Function Trust (Registered Charity No 299811, United Kingdom), the Medical Research Council (MR/N002431/1), the Welsh Clinical Academic Training Pathway, ABM University Health Board / Health Research Wales, the Oakgrove Foundation (Registered charity No 1164926, United Kingdom), Royal College of Surgeons of England, British Association of Plastic and Reconstructive Surgeons, and the Fulbright Commission. We thank Dr A. Al-Sabah for the statistical analysis advice. 2022-08-03T14:59:22.1732081 2022-07-08T11:54:26.3822846 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Zita Jessop 0000-0003-2886-9165 1 Elena García-Gareta 0000-0001-7062-9099 2 YADAN ZHANG 3 Thomas Jovic 4 Nafiseh Badiei 5 Vaibhav Sharma 6 Iain Whitaker 7 Norbert Kang 0000-0002-9343-8487 8 60415__24502__65a8acc2daac40bb8d008f7c1fc84819.pdf 60415.VOR.pdf 2022-07-08T11:57:58.9889266 Output 1959699 application/pdf Version of Record true Distributed under the terms of a Creative Commons CC-BY Attribution 4.0 Licence. true eng http://creativecommons.org/licenses/by/4.0/
title Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
spellingShingle Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
Zita Jessop
YADAN ZHANG
Thomas Jovic
Nafiseh Badiei
Iain Whitaker
title_short Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
title_full Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
title_fullStr Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
title_full_unstemmed Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
title_sort Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model
author_id_str_mv 0184f610b62d649a59dad304e48ea03b
0b87eada14b5f81ff93ab9f6b30f6294
7d95ed2bceb18fc0fdfd4048277c6eed
c82cd1b82759801ab0045cb9f0047b06
830074c59291938a55b480dcbee4697e
author_id_fullname_str_mv 0184f610b62d649a59dad304e48ea03b_***_Zita Jessop
0b87eada14b5f81ff93ab9f6b30f6294_***_YADAN ZHANG
7d95ed2bceb18fc0fdfd4048277c6eed_***_Thomas Jovic
c82cd1b82759801ab0045cb9f0047b06_***_Nafiseh Badiei
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Zita Jessop
YADAN ZHANG
Thomas Jovic
Nafiseh Badiei
Iain Whitaker
author2 Zita Jessop
Elena García-Gareta
YADAN ZHANG
Thomas Jovic
Nafiseh Badiei
Vaibhav Sharma
Iain Whitaker
Norbert Kang
format Journal article
container_title JPRAS Open
container_volume 29
container_start_page 113
publishDate 2021
institution Swansea University
issn 2352-5878
doi_str_mv 10.1016/j.jpra.2021.04.008
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description Three per cent hydrogen peroxide (H2O2) is widely used to irrigate acute and chronic wounds in the surgical setting and clinical experience tells us that it is more effective at removing dried-on blood than normal saline alone. We hypothesise that this is due to the effect of H2O2 on fibrin clot architecture via fibrinolysis. We investigate the mechanisms and discuss the clinical implications using an in vitro model. Coagulation assays with normal saline (NaCl), 1% and 3% concentrations of H2O2 were performed to determine the effect on fibrin clot formation. These effects were confirmed by spectrophotometry. The effects of 1%, 3% and 10% H2O2 on the macroscopic and microscopic features of fibrin clots were assessed at set time intervals and compared to a NaCl control. Quantitative analysis of fibrin networks was undertaken to determine the fibre length, diameter, branch point density and pore size. Fibrin clots immersed in 1%, 3% and 10% H2O2 demonstrated volume losses of 0.09-0.25mm3/min, whereas those immersed in the normal saline gained in volume by 0.02±0.13 mm3/min. Quantitative analysis showed that H2O2 affects the structure of the fibrin clot in a concentration-dependent manner, with the increase in fibre length, diameter and consequently pore sizes. Our results support our hypothesis that the efficacy of H2O2 in cleaning blood from wounds is enhanced by its effects on fibrin clot architecture in a concentration- and time-dependent manner. The observed changes in fibre size and branch point density suggest that H2O2 is acting on the quaternary structure of the fibrin clot, most likely via its effect on cross-linking of the fibrin monomers and may therefore be of benefit for the removal of other fibrin-dependent structures such as wound slough.
published_date 2021-09-01T04:18:30Z
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score 11.03559

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