Zhao Tiange, Ren Ruyi, Qiao Shiyue, Tang Xinyi, Chi Zhe, Jiang Fei, Liu Chenguang
College of Marine Life Sciences, Ocean University of China, No. 5 Yushan Road, Qingdao 266003, China.
Medical College, Linyi University, Shuangling Road, Linyi 276005, China.
J Colloid Interface Sci. 2025 Apr;683(Pt 2):828-844. doi: 10.1016/j.jcis.2024.12.202. Epub 2024 Dec 26.
Emergency bleeding presents significant challenges such as high blood flow and rapid hemorrhaging. However, many existing hemostatic bandages face limitations, including the uncontrolled release of hemostatic agents, insufficient mechanical strength, poor adhesion, and complex manufacturing processes. To address these limitations, we developed a multifunctional hydrogel bandage for emergency hemostasis using a one-pot synthesis method. The hydrogel was composed of kaolin, N-hydroxysuccinimide-grafted oxidized microcrystalline cellulose (OMCC-NHS), and polyacrylic acid (PAA). Featuring a multi-crosslinked network, it exhibited favorable elasticity (∼942 %), tensile strength (∼220 kPa), fatigue resistance, and robust tissue adhesion (∼55 kPa)-3.9 times stronger than commercial wound-closure strips, and it maintained adhesion even underwater. In addition to its mechanical properties, the hydrogel also exhibited satisfactory antibacterial activity, cytocompatibility, and histocompatibility. In vivo evaluations revealed an impressive hemostatic performance in rat models of liver bleeding, femoral artery bleeding, and tail amputation. Specifically, in the liver bleeding model, the hydrogel reduced blood loss to only 0.1 g, which is just 32 % of the blood loss seen with medical gauze. Notably, in New Zealand rabbit models with cardiac punctures and liver injuries, the hydrogel achieved rapid hemostasis and stopped the bleeding within seconds. The effective hemostatic ability of this hydrogel is primarily due to its ability to facilitate multistep hemostasis, which includes sealing the wound, rapidly absorbing blood, promoting RBC and platelets adhesion, and activating the intrinsic coagulation cascade. Therefore, this study provides a promising approach for developing gel-based hemostatic bandages, specifically tailored for emergency compressible bleeding scenarios.
紧急出血带来了重大挑战，如高血流量和快速出血。然而，许多现有的止血绷带存在局限性，包括止血剂的无控制释放、机械强度不足、粘附性差以及制造工艺复杂。为了解决这些局限性，我们采用一锅合成法开发了一种用于紧急止血的多功能水凝胶绷带。该水凝胶由高岭土、N-羟基琥珀酰亚胺接枝的氧化微晶纤维素（OMCC-NHS）和聚丙烯酸（PAA）组成。它具有多交联网络，表现出良好的弹性（约942%）、拉伸强度（约220 kPa）、抗疲劳性和强大的组织粘附力（约55 kPa）——比商业伤口闭合条强3.9倍，并且即使在水下也能保持粘附力。除了机械性能外，该水凝胶还表现出令人满意的抗菌活性、细胞相容性和组织相容性。体内评估显示，在肝出血、股动脉出血和断尾大鼠模型中，其止血性能令人印象深刻。具体而言，在肝出血模型中，水凝胶将失血量减少至仅0.1 g，仅为医用纱布失血量的32%。值得注意的是，在新西兰兔心脏穿刺和肝损伤模型中，水凝胶实现了快速止血，在几秒钟内就止住了出血。这种水凝胶的有效止血能力主要归因于其促进多步骤止血的能力，包括封闭伤口、快速吸收血液、促进红细胞和血小板粘附以及激活内源性凝血级联反应。因此，本研究为开发基于凝胶的止血绷带提供了一种有前景的方法，特别适用于紧急可压缩出血情况。
