Abstract
Severe hemorrhage is a leading cause of high mortality in critical situations like disaster, accidents, and warfare. The resulting wounds could induce severe physical and psychological trauma to patients and also bring an immense socio-economic burden. Hence, rapid hemostasis and wound healing techniques have become critical initiatives for life-saving treatment. Although traditional methods relying on bandages and gauzes are effective in controlling hemorrhage, they suffer from several limitations: nonbiodegradability, being susceptible to infection, being unsuitable for the irregular wound, secondary tissue damage, and being almost ineffective for wound healing. Owing to the merits of high porosity, good biocompatibility, tunable physicochemical properties, and being beneficial for wound healing, hydrogels with excellent performance have drawn intensive attention and numerous novel effective hydrogel dressings have been widely developed. In this Review, after introducing some commonly used strategies for the synthesis of hydrogels, the most recent progress on polymer-based hydrogels as wound dressings is discussed. Particularly, their hemostasis, antibacterial, and biodegradation properties are introduced. Finally, challenges and future perspectives about the development of hydrogels for wound dressings are outlined.
Highlights
The widespread use of high-speed and high-energy weapons in modern warfare has led to an increasing incidence of explosive injuries
Traditional methods relying on bandages and gauzes are effective in controlling hemorrhage, they suffer from several limitations: nonbiodegradability, being susceptible to infection, being unsuitable for the irregular wound, secondary tissue damage, and being almost ineffective for wound healing
The results of rheology showed a shear-thinning behavior of the chitosan-6PG–Naþ hydrogel based on chitosan cross-linked with 6phosphogluconic trisodium salt (6-PG–Naþ) when increasing the shear rate,[58] indicating that the hydrogel would be a candidate for injectable hydrogels
Summary
The widespread use of high-speed and high-energy weapons in modern warfare has led to an increasing incidence of explosive injuries. Conventional dressings like gauzes and bandages are still widely used in the clinic They have an unsatisfactory hemostatic performance for arterial ruptures and wounds with irregular, deep, narrow shapes. They need long-term treatment, are unsuitable for inherently complicated procedures, adhere to desiccated wound surfaces, and are required to be surgically and mechanically removed from the damaged area, which inflict serious secondary damage on patients.[13,14,15,16] A favorable dressing should fulfill the following characteristics: it should (1) accommodate. Despite their good wound healing performance, there exist some deficiencies, including high cost, harsh storage conditions, inability to provide adequate mechanical protection, and poor permeability of gases. The Review aims to provide a stateof-art overview about the development of hydrogel for wound dressings, including the general synthetic strategies and its raw materials (shown in Fig. 1), and their advantages and disadvantages are shown in Tables II and III, respectively
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