Abstract
Rapid and effective hemostasis is of great importance to improve the quality of treatment and save lives in emergency, surgical practice, civilian, and military settings. Traditional hemostatic materials such as tourniquets, gauze, bandages, and sponges have shown limited efficacy in the management of uncontrollable bleeding, resulting in widespread interest in the development of novel hemostatic materials and techniques. Benefiting from biocompatibility, degradability, injectability, tunable mechanical properties, and potential abilities to promote coagulation, wound healing, and anti-infection, hydrogel-based biomaterials, especially those on the basis of natural polysaccharides and proteins, have been increasingly explored in preclinical studies over the past few years. Despite the exciting research progress and initial commercial development of several hemostatic hydrogels, there is still a significant distance from the desired hemostatic effect applicable to clinical treatment. In this review, after elucidating the process of biological hemostasis, the latest progress of hydrogel biomaterials engineered from natural polysaccharides and proteins for hemostasis is discussed on the basis of comprehensive literature review. We have focused on the preparation strategies, physicochemical properties, hemostatic and wound-healing abilities of these novel biomaterials, and highlighted the challenges that needed to be addressed to achieve the transformation of laboratory research into clinical practice, and finally presented future research directions in this area.
Highlights
Traumatic, surgical, disease-related, or drug-induced bleeding can lead to serious clinical outcomes or even death (Wang et al, 2019a)
This review demonstrates a brief introduction of the physiological mechanisms of hemostasis, and focuses on the natural-derived polysaccharide- and protein-based hemostatic hydrogels in terms of preparation strategies, physicochemical properties, hemostatic and wound-healing abilities, as well as recent advances for clinical applications
In response to the weak adhesion of existing hemostatic agents to moist and mobile tissues, an impressive study on hydrogel adhesives was conducted by Hong et al (2019) The design of this hydrogel system with gelatin and hyaluronic acid (HA) as the main components was inspired by the extracellular matrix
Summary
Surgical, disease-related, or drug-induced bleeding can lead to serious clinical outcomes or even death (Wang et al, 2019a). Hydrogel-based biomaterials have shown many advantages compared with traditional hemostatic methods Based on their injectability and flowability, hydrogels can be applied to a variety of irregular wounds and intracavity injuries, which is meaningful for rapid and effective hemostasis. The excellent biocompatibility and biodegradability ensure the safety of hydrogel-based biomaterials for in vivo applications and enhance their ability to promote wound healing Other properties such as drug delivery, self-healing, self-growth, and stimulation response can be tailored as needed, endowing the materials with additional therapeutic functions (Khunmanee et al, 2017; Vakalopoulos et al, 2017; Wang et al, 2019b; Hashemnejad and Kundu, 2019; Matsuda et al, 2019; Xue et al, 2019). This review demonstrates a brief introduction of the physiological mechanisms of hemostasis, and focuses on the natural-derived polysaccharide- and protein-based hemostatic hydrogels in terms of preparation strategies, physicochemical properties, hemostatic and wound-healing abilities, as well as recent advances for clinical applications
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