Poly(aspartic acid) based self-healing hydrogel with blood coagulation characteristic for rapid hemostasis and wound healing applications

Injectable Ca/ε-aminocaproic acid/dextran phosphate hydrogel for effective acute bleeding control

The development of new hemostatic agents is crucial for advancing medical treatments and improving outcomes in surgical and trauma settings, where controlling bleeding is often a critical challenge. Herein, we developed and characterized the physicochemical properties and hemostatic potential of Ca/ε-aminocaproic acid/dextran phosphate composite hydrogels. The phosphorylation of dextran in the system tributyl phosphate - orthophosphoric acid - phosphorus (V) oxide - chloroform at 30 °C with the formation of hydrogels was studied in detail. We explored physical and chemical properties of the hydrogels, including rheology, swelling, and morphology. Additionally, the sorption kinetics and isotherms of ε-aminocaproic acid by the hydrogels were studied, revealing a maximum sorption capacity of 80 %. The hydrogels rapidly released ε-aminocaproic acid in vitro at 37 °C in PBS. Significantly, they demonstrated in vitro effectiveness by reducing blood clotting time, enhancing the clotting index, and showing minimal hemolysis. In vivo tests further indicated that these hydrogels markedly decreased bleeding time and average blood loss in a rat liver hemorrhage model, surpassing control experiments. These results suggest that Ca/ε-aminocaproic acid/dextran phosphate hydrogels are effective in controlling bleeding and show promise as a future hemostatic agent.

Synthesis and characterization of gelatin/chondroitin sulfate microgels with NaCl: Preliminary research toward wound healing applications

Gelatin and chondroitin sulfate are natural polymers with significant potential in the biomedical field, particularly for wound healing applications. They can form hydrogels that absorb exudates and exhibit anti-inflammatory and antioxidant properties. Silver nanoparticles (AgNPs) can be used as antibacterial agents in wound management. Moreover, the addition of NaCl may enhance the efficacy and mechanical properties of the microgels. This study focuses on the synthesis and characterization of gelatin/chondroitin sulfate powder hydrogels, both with and without AgNPs, obtained through fungal digestion and NaCl for potential acute wound healing application. As a result, AgNPs were successfully synthesized, they are spherical with an average size of 19 ± 6 nm. Microgels were obtained via electrostatic interactions and processed using spray drying equipment, the highest yield was 50.2 ± 7.1 %. Characterization results indicated that the composition significantly influenced the yield percentage, which was greater in samples containing NaCl. Moreover, particle areas varied significantly from 6.0 ± 1.3 μm2 to 85.6 ± 35.9 μm2 with the incorporation of salt. Swelling capacities were similar over time, with highest values at 15 min exceeding 500 % under physiological conditions. Notably, microgels exhibited enhanced disintegration resistance compared to gelatin alone, making them suitable for sustained wound coverage. The incorporation of AgNPs conferred notable antimicrobial activity; however, it adversely affected erythrocyte viability. Therefore, microgels without AgNPs, particularly those containing NaCl, may be suitable for acute wounds management, while alternative methods or lower concentrations of AgNPs may be required to retain antibacterial properties.

A facile way to fabricate a thrombin immobilized composite sponge with dual hemostatic effects for acute hemorrhage control

Uncontrolled bleeding and excessive blood loss stand as the leading causes of death in complex surgeries, civilian traumas, and military operations. Sponges have been used for developing efficiency hemostats, but most commonly used hemostatic sponges possess only one single coagulation mechanism or lack inherent blood clotting ability. Herein, we proposed simple yet innovative approaches for creating novel hemostatic composite sponges with dual hemostatic effects. Bacterial cellulose (BC) was first introduced into polyvinyl alcohol (PVA) matrix to develop a BC/PVA (CP) sponge featuring a unique cellulose-embedded porous network structure and desirable properties. Subsequently, thrombin was immobilized on CP through an easy method that combines physical adsorption and covalent binding to fabricate thrombin-carrying CP (TCP) composite sponges. The resulting composites boasted a highly porous structure, outstanding liquid-absorption capacity, low hemolysis rate, and superior biocompatibility. In vitro clotting tests revealed that TCP displayed potent coagulation capabilities, a rapid blood absorption rate, and the ability to stimulate and activate blood components along with the coagulation cascade. In vivo hemostatic assessments further confirmed that TCP offered high hemostatic efficiency and multifaceted hemostatic effects, making it suitable for the management of acute and severe bleeding.

Self-assembled ROS-triggered Bletilla striata polysaccharide-releasing hydrogel dressing for inflammation-regulation and enhanced tissue-healing

The antimicrobial and pro-healing properties remain critical clinical objectives for skin wound management. However, the escalating problem of antibiotic overuse and the corresponding rise in bacterial resistance necessitates an urgent shift towards an antibiotic-free approach to antibacterial treatment. The quest for antimicrobial efficacy while accelerating wound healing without antibiotic treatment have emerged as innovative strategies in skin wound treatment. Here, a dual-function hydrogel with antimicrobial and enhanced tissue-healing properties was developed by utilizing cyclodextrin, ferrocene, polyethyleneimine (PEI), and Bletilla striata polysaccharide (BSP), through multiple non-covalent interactions, which can intelligently release BSP by recognizing the wound inflammatory microenvironment through the cyclodextrin-ferrocene unit. Moreover, the porosity (65 % - 85 %), Young's modulus (400 KPa - 140 KPa), and DPPH scavenge rate (18 % - 40 %) of the hydrogel are modulated by varying the BSP content. The hydrogel exhibits outstanding antibacterial properties (98.3 % reduction of Escherichia coli observed after exposure to HTFC@BSP-20 for 24 h) and favorable biocompatibility. Furthermore, in a rat full-thickness skin wound model, the dual-function hydrogel significantly accelerates wound healing, increased CD31 expression promotes vascular regeneration, reduced TNF-α express and inhibited the inflammation. This multifunctional ROS responsive hydrogel provides a new perspective for antibiotics-free treatment of skin injuries.

Laponite/lactoferrin hydrogel loaded with eugenol for methicillin-resistant Staphylococcus aureus-infected chronic skin wound healing

Severe bacterial infections can give rise to protracted wound healing processes, thereby posing a significant risk to a patient's well-being. Consequently, the development of a versatile hydrogel dressing possessing robust bioactivity becomes imperative, as it holds the potential to expedite wound healing and yield enhanced clinical therapeutic outcomes. In this context, the present study involves the formulation of an injectable multifunctional hydrogel utilizing laponite (LAP) and lactoferrin (LF) as foundational components and loaded with eugenol (EG). This hydrogel is fabricated employing a straightforward one-pot mixing approach that leverages the principle of electrostatic interaction. The resulting LAP/LF/EG2% composite hydrogel can be conveniently injected to address irregular wound geometries effectively. Once administered, the hydrogel continually releases lactoferrin and eugenol, mitigating unwarranted oxidative stress and eradicating bacterial infections. This orchestrated action culminates in the acceleration of wound healing specifically in the context of MRSA-infected wounds. Importantly, the LAP/LF/EG2% hydrogel exhibits commendable qualities including exceptional injectability, potent antioxidant attributes, and proficient hemostatic functionality. Furthermore, the hydrogel composition notably encourages cellular migration while maintaining favorable cytocompatibility. Additionally, the hydrogel manifests noteworthy bactericidal efficacy against the formidable multidrug-resistant MRSA bacterium. Most significantly, this hydrogel formulation distinctly expedites the healing of MRSA-infected wounds by promptly inducing hemostasis, curbing bacterial proliferation, and fostering angiogenesis, collagen deposition, and re-epithelialization processes. As such, the innovative hydrogel material introduced in this investigation emerges as a promising dressing for the facilitation of bacterial-infected wound healing and consequent tissue regeneration.

Natural blackcurrant extract contained gelatin hydrogel with photothermal and antioxidant properties for infected burn wound healing

Burns represent a prevalent global health concern and are particularly susceptible to bacterial infections. Severe infections may lead to serious complications, posing a life-threatening risk. Near-infrared (NIR)-assisted photothermal antibacterial combined with antioxidant hydrogel has shown significant potential in the healing of infected wounds. However, existing photothermal agents are typically metal-based, complicated to synthesize, or pose biosafety hazards. In this study, we utilized plant-derived blackcurrant extract (B) as a natural source for both photothermal and antioxidant properties. By incorporating B into a G-O hydrogel crosslinked through Schiff base reaction between gelatin (G) and oxidized pullulan (O), the resulting G-O-B hydrogel exhibited good injectability and biocompatibility along with robust photothermal and antioxidant activities. Upon NIR irradiation, the controlled temperature (around 45-50 °C) generated by the G-O-B hydrogel resulted in rapid (10 min) and efficient killing of Staphylococcus aureus (99 %), Escherichia coli (98 %), and Pseudomonas aeruginosa (82 %). Furthermore, the G-O-B0.5 hydrogel containing 0.5 % blackcurrant extract promoted collagen deposition, angiogenesis, and accelerated burn wound closure conclusively, demonstrating that this well-designed and extract-contained hydrogel dressing holds immense potential for enhancing the healing process of bacterial-infected burn wounds.

Advancements and Challenges in Self-Healing Hydrogels for Wound Care

This manuscript explores self-healing hydrogels as innovative solutions for diverse wound management challenges. Addressing antibiotic resistance and tailored wound care, these hydrogels exhibit promising outcomes, including accelerated wound closure and tissue regeneration. Advancements in multifunctional hydrogels with controlled drug release, antimicrobial properties, and real-time wound assessment capabilities signal a significant leap toward patient-centered treatments. However, challenges such as scalability, long-term safety evaluation, and variability in clinical outcomes persist. Future directions emphasize personalized medicine, manufacturing innovation, rigorous evaluation through clinical trials, and interdisciplinary collaboration. This manuscript features the ongoing pursuit of effective, adaptable, and comprehensive wound care solutions to transform medical treatments and improve patient outcomes.

Functional hemostatic hydrogels: design based on procoagulant principles

Uncontrolled hemorrhage results in various complications and is currently the leading cause of death in the general population. Traditional hemostatic methods have drawbacks that may lead to ineffective hemostasis and even the risk of secondary injury. Therefore, there is an urgent need for more effective hemostatic techniques. Polymeric hemostatic materials, particularly hydrogels, are ideal due to their biocompatibility, flexibility, absorption, and versatility. Functional hemostatic hydrogels can enhance hemostasis by creating physical circumstances conducive to hemostasis or by directly interfering with the physiological processes of hemostasis. The procoagulant principles include increasing the concentration of localized hemostatic substances or establishing a physical barrier at the physical level and intervention in blood cells or the coagulation cascade at the physiological level. Moreover, synergistic hemostasis can combine these functions. However, some hydrogels are ineffective in promoting hemostasis or have a limited application scope. These defects have impeded the advancement of hemostatic hydrogels. To provide inspiration and resources for new designs, this review provides an overview of the procoagulant principles of hemostatic hydrogels. We also discuss the challenges in developing effective hemostatic hydrogels and provide viewpoints.

Pectin based hydrogel with covalent coupled doxorubicin and limonin loading for lung tumor therapy

Self-healing hydrogels have shown great application potential in drug delivery for anti-tumor therapy and tissue engineering. In this research, Doxorubicin (DOX) was coupled onto the oxidized pectin (pec-Ald) to prepare DOX grafted pec-AD and used to fabricate self-healing hydrogel for lung cancer therapy combined with novel herbal medicine extract limonin targeting lung cancer cells. The hydrogel was prepared with P(NIPAM195-co-AH54) cross-linking and the hydrazone bond cross-linked hydrogel showed good mechanical property and self-healing behavior. With pectin composition, the hydrogel was still biodegradable catalyzed by enzyme and in vivo. The hydrogel formed fast fit for injectable application and the hydrogel itself showed moderate lung cancer inhibition activity. With limonin loading, the hydrogel showed synergistic lung cancer therapy with the tumor growth greatly inhibited. The covalent coupling of DOX and loaded limonin in the hydrogel decreased in vivo toxicity and the hydrogel degraded on time. With biodegradability and improved lung cancer therapy efficiency, this DOX grafted self-healing hydrogel could find great potential application in cancer therapy in near future.

Bioinspired poly(aspartic acid) based hydrogel with ROS scavenging ability as mEGF carrier for wound repairing applications

Poly(amino acid) based self-healing hydrogels have important application in biomedications. In this research, the catechol pendant groups were imported to poly(aspartic acid) based self-healing hydrogel to improved skin adhesion and ROS scavenging performance. The poly(succinimide) (PSI) was reacted with 3,4-dihydroxyphenylalanine (DA) and then hydraziolyzed to import catechol group and hydrazide group respectively, which are responsible for mussel inspired tissue adhesion and dynamic coupling reactivity. The dopamine modified poly(aspartic hydrazide) (PDAH) was reacted with PEO90 dialdehyde (PEO90 DA) to prepare hydrogels, and the resultant hydrogel showed good biocompatibility both in vitro and in vivo. The skin adhesion strength of the mussel inspired hydrogel increased notably with enhanced radical scavenging efficiency fit for in vivo wound repairing applications. The PDAH/PEO90 DA hydrogel also showed sustained albumin release profile and the in vivo wound repairing experiment proved the mouse Epidermal Growth Factor (mEGF) loaded hydrogel as wound dressing material accelerated the wound repairing rate.

Polyphosphate as an antithrombotic target and hemostatic agent

Polyphosphate (PolyP) is a polymer comprised of linear phosphate units connected by phosphate anhydride bonds. PolyP exists in a diverse range of eukaryotes and prokaryotes with varied chain lengths ranging from six to thousands of phosphate units. Upon activation, human platelets and neutrophils release short-chain PolyP, along with other components, to initiate the coagulation pathway. Long-chain PolyP derived from cellular or bacterial organelles exhibits higher proinflammatory and procoagulant effects compared to short-chain PolyP. Notably, PolyP has been identified as a low-hemorrhagic antithrombotic target since neutralizing plasma PolyP suppresses the thrombotic process without impairing the hemostatic functions. As an inorganic polymer without uniform steric configuration, PolyP is typically targeted by cationic polymers or recombinant polyphosphatases rather than conventional antibodies, small-molecule compounds, or peptides. Additionally, because of its procoagulant property, PolyP has been incorporated in wound-dressing materials to facilitate blood hemostasis. This review summarizes current studies on PolyP as a low-hemorrhagic antithrombotic target and the development of hemostatic materials based on PolyP.

Mussel-inspired self-healing hydrogel form pectin and cellulose for hemostasis and diabetic wound repairing

Diabetic wound is considered as a kind of chronic wound prone to infection and difficult to repair due to high glucose level in the blood of patients. In this research, a biodegradable self-healing hydrogel with mussel inspired bioadhesion and anti-oxidation properties is fabricated based on Schiff-base cross-linking. The hydrogel was designed from dopamine coupled pectin hydrazide (Pec-DH) and oxidized carboxymethyl cellulose (DCMC) for mEGF loading as a diabetic wound repair dressing. The Pectin and CMC as natural feedstock endowed the hydrogel with biodegradability to avoid possible side effects, while the coupled catechol structure could enhance the tissue adhesion of the hydrogel for hemostasis. The results showed the Pec-DH/DCMC hydrogel formed fast and can cover irregular wounds with good sealing effect. The catechol structure also improved the reactive oxygen species (ROS) scavenging ability of the hydrogel, which can eliminate the negative effect of ROS during wound healing. The in vivo diabetic wound healing experiment revealed the hydrogel as mEGF loading vehicle greatly enhanced the diabetic wound repairing rate in mice model. As a result, the Pec-DH/DCMC hydrogel could show advantages as EGF carrier in wound healing applications.

A photoactive self-healing carboxymethyl chitosan-based hydrogel for accelerated infected wound healing through simultaneously modulating multiple critical tissue repair factors

Infected wounds cause severe medical complications and even chronic mortality, leading to persistent health burdens. Therefore, the enhancement of wound healing has been a major goal of medical researchers. Herein, a photoactive self-healing hydrogel (termed as Macropatch), composed of carboxymethyl chitosan (CMCS), tannic acid (TA) and graphitic carbon nitride g-C₃N₄ (GCN), was developed to promote wound healing through simultaneously modulating pathological related factors. We identified that dynamic hydrogen bond, hydrophobic interaction and crosslinking between hydrogel backbones endowed Macropatch with good self-healing capability and mechanical property, allowing for protecting the wound from further injury. In addition, Macropatch exhibited superior tissue adhesiveness and cell affinity due to numerous catechol groups of TA chains, and enabled tight wound adhesion to seal organ bleeding. Specifically, GCN endowed Macropatch with improving mechanical strength, self-healing ability and especially visible light-induced antibacterial activity, leading to a fast recovery of bacteria-infected wounds. More remarkably, benefiting from inherent and photodynamic antibacterial properties, Macropatch could prevent bacterial infections under visible light irradiation, and consequently increase the collagen synthesis and re-epithelization, accelerating bacteria-infected wound healing process. Overall, photoactive Macropatch is a safe wound dressing with the potential of overcoming challenges in infectious wound healing, and might be applied in clinical condition.

Dual drug-loaded hydrogels with pH-responsive and antibacterial activity for skin wound dressing

Antibacterial and hemostatic properties are essential for wound healing dressing. In this study, a new type of hydrogel composed of gelatin methacryloyl (GelMA) and hyaluronic acid-aldehyde (HA-CHO) is fabricated by photo-crosslinking and respectively loaded with a single drug gentamicin sulfate (GS), and two drugs of GS and lysozyme (LZM). The composite hydrogel of GelMA and HA-CHO is successfully synthesized by the aldehyde and Schiff base reactions. The structures and compositions of the hydrogels with and without drug loaded are characterized by FT-IR, ¹H NMR, and XPS. Furthermore, the microstructure and swelling behaviour of hydrogels prove that the content of HA-CHO has a significant role in the formation of hydrogels with dense porous structures and super absorbent. pH 7.4 and pH 5.0 conditions are used to evaluate the drug release behaviour of the obtained hydrogels. The released amount of GS of the drug-loaded hydrogels in the acidic buffer is more than that of the physiological environment because of the cleaved Schiff base bonds and the electrostatic interaction. Especially for the dual drug-loaded hydrogel GelMA/HA-CHO/GS/LZM, the released ratio of GS is elevated from 59 % in pH 7.4 buffer to about 78 % in pH 5.0 buffer within the first 6 h, which verifies the excellent pH-stimulus responsiveness. These endow the GS-LZM dual drug-loaded hydrogels with superior antibacterial efficiencies to that of the single GS drug-loaded hydrogels, no drug-loaded hydrogels, and SEBS control, especially in inhibiting S. aureus in a lower concentration of 10⁶ CFU mL^-1, which can be attributed to the synergistic effect of LZM and GS. For S. aureus at 10⁶ CFU mL^-1, the bacterial survival of GelMA/HA-CHO/GS/LZM is 1.1 %, which shows outstanding antibacterial effect. Hence, the drug-loaded hydrogels, especially the dual drug-loaded hydrogels with pH-responsive, antibacterial, and hemostatic properties have great potential as wound healing materials.

Optimization Preparation and Evaluation of Chitosan Grafted Norfloxacin as a Hemostatic Sponge

Considering the great harm to the human body caused by severe and massive bleeding, in this study, chitosan-grafted norfloxacin (CTS-NF) composites were prepared with chitosan (CTS) and norfloxacin (NF) as raw materials by a 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide-mediated coupling method to solve the limitations of slow hemostatic and poor anti-infective effects of current dressings on the market. The effects of the mass ratio of CTS to NF (M_CTS/M_NF), reaction temperature T and reaction time t on the grafting rate (η%) of the products were investigated through single factor tests. The preparation process was optimized with the η% as an evaluation index by means of the Box-Behnken test design and response surface analysis. The antimicrobial activity was evaluated by inhibition zone assay, and the hemostatic activity of the prepared composites was evaluated in vitro and in vivo. The results suggested that the optimum preparation conditions were the mass ratio of CTS to NF (M_CTS/M_NF) 5:3, reaction temperature 65 °C, and reaction time 4 h. Under this condition, the η% of CTS-NF was 45.5%. The CTS-NF composites displayed significant antimicrobial activities. Moreover, in vitro hemostasis results revealed that the CTS-NF composite had a lower blood clotting index and absorbed red blood cells to promote aggregation. In vivo ear and live hemostasis, the CTS-NF groups showed short hemostatic time (49.75 ± 3.32 s and 50.00 ± 7.21 s) and more blood loss (0.07 ± 0.010 g and 0.075 ± 0.013 g). The results showed that CTS-NF reduced the bleeding time and volume, exhibiting a significant coagulation effect. Therefore, the CTS-NF sponge is expected to be a new, effective hemostatic and antibacterial material in the future.

Advances in Hemostatic Hydrogels That Can Adhere to Wet Surfaces

Currently, uncontrolled bleeding remains a serious problem in emergency, surgical and battlefield environments. Despite the specific properties of available hemostatic agents, sealants, and adhesives, effective hemostasis under wet and dynamic conditions remains a challenge. In recent years, polymeric hydrogels with excellent hemostatic properties have received much attention because of their adjustable mechanical properties, high porosity, and biocompatibility. In this review, to investigate the role of hydrogels in hemostasis, the mechanisms of hydrogel hemostasis and adhesion are firstly elucidated, the adhesion design strategies of hemostatic hydrogels in wet environments are briefly introduced, and then, based on a comprehensive literature review, the studies and in vivo applications of wet-adhesive hemostatic hydrogels in different environments are summarized, and the improvement directions of such hydrogels in future studies are proposed.

A Review on Electrospun Poly(amino acid) Nanofibers and Their Applications of Hemostasis and Wound Healing

The timely and effective control and repair of wound bleeding is a key research issue all over the world. From traditional compression hemostasis to a variety of new hemostatic methods, people have a more comprehensive understanding of the hemostatic mechanism and the structure and function of different types of wound dressings. Electrospun nanofibers stand out with nano size, high specific surface area, higher porosity, and a variety of complex structures. They are high-quality materials that can effectively promote wound hemostasis and wound healing because they can imitate the structural characteristics of the skin extracellular matrix (ECM) and support cell adhesion and angiogenesis. At the same time, combined with amino acid polymers with good biocompatibility not only has high compatibility with the human body but can also be combined with a variety of drugs to further improve the effect of wound hemostatic dressing. This paper summarizes the application of different amino acid electrospun wound dressings, analyzes the characteristics of different materials in preparation and application, and looks forward to the development of directions of poly(amino acid) electrospun dressings in hemostasis.