Nanodiamond-Reinforced Chitosan Sponge for Rapid and Robust Management of Arterial Hemorrhage in Irregular Wounds

Arterial hemorrhage with high-pressure, spurting blood loss can rapidly cause shock or death. Developing ideal hemostatic materials that combine rapid hemostasis, mechanical stability, antibacterial properties, and biocompatibility remains a challenge. This study reported a nanocomposite hemostatic sponge TCCND/CPL through cross-linking carboxymethyl chitosan (CMCS) and sodium carboxymethyl cellulose (CMC-Na), reinforced with nanodiamonds (NDs), and loaded with chloramphenicol (CPL) and thrombin to improve arterial hemorrhage management in irregular wounds. The incorporation of ND makes TCCND/CPL achieve a wet-state compressive stress of 44.9 kPa, which markedly exceeds typical clinical arterial systolic pressure, while maintaining elasticity, rapid absorption, and retention. Both <i>in vitro</i> and <i>in vivo</i> assessments confirmed TCCND/CPL's exceptional hemostatic capability, demonstrating superior performance to commercial agents in rat tail amputation, rat irregular trauma, femoral artery puncture, and noncompressible rabbit wound models. It achieved rapid hemostasis in just 126 s (22.7% faster than the military-grade ChitoGauze XR PRO), and the hemostatic effect was about 2.5 times that of the conventional gauze and 1.67 times that of ChitoGauze XR PRO in a rabbit femoral artery puncture model. Additionally, TCCND/CPL demonstrated significant antibacterial activity and excellent biocompatibility. The innovative design of TCCND/CPL provides an efficient solution for managing irregular wound hemorrhage in emergency scenarios such as battlefield injuries and traffic accidents.