Abstract
Blood plays an essential role in the human body. Hemorrhage is a critical cause of both military and civilian casualties. The human body has its own hemostatic mechanism that involves complex processes and has limited capacity. However, in emergency situations such as battlefields and hospitals, when the hemostatic mechanism of the human body itself cannot stop bleeding effectively, hemostatic materials are needed for saving lives. In this review, the hemostatic mechanisms and performance of the most commonly used hemostatic materials, (including fibrin, collagen, zeolite, gelatin, alginate, chitosan, cellulose and cyanoacrylate) and the commercial wound dressings based on these materials, will be discussed. These materials may have limitations, such as poor tissue adhesion, risk of infection and exothermic reactions, that may lessen their hemostatic efficacy and cause secondary injuries. High-performance hemostatic materials, therefore, have been designed and developed to improve hemostatic efficiency in clinical use. In this review, hemostatic materials with advanced performances, such as antibacterial capacity, superhydrophobicity/superhydrophilicity, superelasticity, high porosity and/or biomimicry, will be introduced. Future prospects of hemostatic materials will also be discussed in this review.
Highlights
Blood is composed of erythrocytes, leukocytes, platelets and plasma, making up about 7–8% of total body weight
In a rat femoral artery model, the material can reduce the hemostasis time by 90% compared with the control group
Highly effective hemostats play an essential role in controlling hemorrhage and reducing the death rate in prehospital treatment
Summary
Blood is composed of erythrocytes, leukocytes, platelets and plasma, making up about 7–8% of total body weight. In vivo hemostatic experiments in the mouse liver and tail amputation models and the rabbit liver volume injury model indicated that QCSG/CNT4 (cryogels with 4 mg/ml CNT) has a better hemostatic ability compared with TegadermTM film, such as quick hemostasis, lower blood loss and smaller wound surface. Aerogels have been broadly used in varied fields, such as energy applications [134], drug delivery systems [135], skeletal muscle regeneration [136] and 3D printing [137] Due to their high porosity and broad surface area, aerogels can be used in the hemostatic process and may have a similar hemostatic mechanism to ORC, that is, absorbing water when in contact with blood, forming a barrier at the bleeding site and serving as a matrix for clot formation [138]. The self-assembled KOD have the potential to serve as wound dressings
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