Chitosan-Based Haemostatic Systems (Axiostat): An Integrated Approach to Post-operative Wound Management in Vascular Surgery

Abstract The effective management of perioperative and post-traumatic bleeding is critical to preventing severe complications, shock, and fatal outcomes. In this context, chitosan emerges as a premier polymeric biomaterial due to its exceptional biochemical properties and inherent hemostatic nature. Among commercially available solutions, the Axiostat sponge stands out as a promising device for promoting hemostasis at surgical and endovascular access sites. This study aimed to conduct a comprehensive chemical-physical characterization of the Axiostat device. The investigation sought to quantify its antioxidant capacity, antibacterial activity, and swelling ratio upon contact with biological fluids—all critical parameters for clot stability and infection prevention. The evaluation was conducted through a multi-scale approach: in vitro Cytotoxicity tests on human adult epidermal keratinocytes (HaCaT) cell lines confirmed the material's biocompatibility. Results demonstrated significant antibacterial activity, with particularly marked efficacy against the pathogen Klebsiella pneumoniae. In vivo application on patients undergoing endovascular procedures validated the device’s effectiveness in the secure closure of arterial access sites. The analysis demonstrates that the Axiostat sponge does not merely act as a mechanical barrier but as a multifunctional medical device. The combination of excellent hemostatic properties, biocompatibility, and antibacterial capacity renders it a high-value clinical tool for optimizing post-operative recovery and reducing infectious complications.