Liquid-infused microstructured bioadhesives halt non-compressible hemorrhage

Abstract

Non-compressible hemorrhage is an unmet clinical challenge that accounts for high mortality in trauma. Rapid pressurized blood flows under hemorrhage impair the function and integrity of hemostatic agents and the adhesion of bioadhesive sealants. Here, we report the design and performance of bioinspired microstructured bioadhesives, formed with a macroporous tough xerogel infused with functional liquids. The xerogel can rapidly absorb interfacial fluids such as whole blood and promote blood clotting, while the infused liquids facilitate interfacial bonding, sealing, and antibacterial function. Their synergy enables the bioadhesives to form tough adhesion on ex vivo human and porcine tissues and diverse engineered surfaces without the need for compression, as well as on-demand instant removal and storage stability. We demonstrate a significantly improved hemostatic efficacy and biocompatibility in rats and pigs compared to non-structured counterparts and commercial products. This work opens new avenues for the development of bioadhesives and hemostatic sealants.

Chitosan-Based Hemostatic Hydrogels: The Concept, Mechanism, Application, and Prospects

“…Therefore, CS bioadhesives can be widely used in biomedical fields such as drug delivery, wound dressing, hemostasis and sutureless surgery [ 131 ]. For instance, Bao et al [ 132 ] designed a liquid-infused microstructured bioadhesive (LIMBs) formed from a macroporous, tough CS dry gel infused with a functional fluid. The CS dry gel rapidly absorbed interfacial fluids and can promote blood clotting.…”

“… ( a ) Structure of LIMB, diagram of adherent blood and absorption of interfacial fluid. ( b ) Diagram of repair of mouse skin after burns, 0, 7, 14, and 21 days [ 132 ]. Copyright 2022.…”

Morphological, cytotoxicity, and coagulation assessments of perlite as a new hemostatic biomaterial

“…These materials are classied according to their forms and types such as hemostatic dressings, 7-10 solid particles or powders, [11][12][13][14][15] bers, 16 hydrogels, [17][18][19] liquid tissue sealants, [20][21][22] and dispersions, 23 made from natural or synthetic polymers, ceramics and their combinations, and bioadhesives. [23][24][25] One of the ceramics proposed as a hemostatic agent is aluminosilicate combination. Aluminosilicates absorb water from wounds and their surrounding due to their chemical and structural properties, and thus, increase the concentration of coagulation factors and accelerate this procedure.…”

A Choline Phosphoryl-Conjugated Chitosan/Oxidized Dextran Injectable Self-Healing Hydrogel for Improved Hemostatic Efficacy

“…1 Timely and effective hemostatic intervention after trauma has been approved to be the most critical for improving survival and reducing bleeding-related complications. 2−5 To date, multiple sutureless hemostats composed of inorganic and polymeric materials with different forms and functions have been extensively explored for bleeding control, including powders, 6−8 sponges, 9−11 cryogels, 12,13 aerogel, 14 bioadhesive patches, 15,16 paste, 17 and hydrogels. 18−21 However, most existing hemostatic materials, such as protein-based agents and cyanoacrylate, usually suffer from limitations in terms of potential toxicity, immunogenic components, and unsatisfied hemostatic capability.…”

“…Massive bleeding caused by severe injuries in emergencies (e.g., battlefield, traffic accidents, hospital settings, and natural disasters) is an increasing global health issue that is responsible for approximately 40% of traumatic deaths . Timely and effective hemostatic intervention after trauma has been approved to be the most critical for improving survival and reducing bleeding-related complications. − To date, multiple sutureless hemostats composed of inorganic and polymeric materials with different forms and functions have been extensively explored for bleeding control, including powders, − sponges, − cryogels, , aerogel, bioadhesive patches, , paste, and hydrogels. − However, most existing hemostatic materials, such as protein-based agents and cyanoacrylate, usually suffer from limitations in terms of potential toxicity, immunogenic components, and unsatisfied hemostatic capability. , Therefore, the development of new hemostatic agents with high biocompatibility and improved hemostatic performance is highly desirable.…”