A self-hygroscopic, rapidly self-gelling polysaccharide-based sponge with robust wet adhesion for non-compressible hemorrhage control and infected wounds healing

Uncontrollable non-compressible hemorrhage and traumatic infection have been major causes of mortality and disability in both civilian and military populations. A dressing designed for point-of-care control of non-compressible hemorrhage and prevention of traumatic infections represents an urgent medical need. Here, a novel self-gelling sponge OHN@ε-pL is developed, integrating N-succinimidyl ester oxidized hyaluronic acid (OHN) and ε-poly-L-lysine (ε-pL). Upon application to the wound site, the sponge can rapidly absorb interfacial fluids and undergo a phase transition from sponge to gel. The transformed gel facilitates robust tissue adhesion and achieves synergistic hemostasis by enriching coagulation factors within the sponge phase and providing a barrier effect in the gel phase. The in vitro and in vivo studies revealed that the optimized OHN@ε-pL₃ sponge possesses self-gelling capability, tissue adhesion, enhanced coagulation ability, and exhibits excellent biocompatibility and antibacterial efficacy. In hemostasis, OHN@ε-pL₃ sponges exhibited reduced blood loss and decreased hemostatic time compared to commercial hemostatic agents, as demonstrated in rat liver, femoral vein, and tail truncation bleeding models. Furthermore, the OHN@ε-pL₃ sponge exhibited superior performance in accelerating wound closure and healing of <i>S. aureus</i>-infected wounds. Collectively, OHN@ε-pL sponges represent a promising candidate for medical dressings, specifically for managing uncontrollable non-compressible hemorrhage and traumatic infections.