Marine collagen peptide grafted carboxymethyl chitosan: Optimization preparation and coagulation evaluation

Fabrication and hemostasis evaluation of a carboxymethyl chitosan/sodium alginate/Resina Draconis composite sponge

Hemostasis is the first step of emergency medical treatment. It is particularly important to develop rapid-acting and efficacious hemostatic materials. Carboxymethyl chitosan (CMCS), sodium alginate (SA) and Resina Draconis (RD) were composited uniformly by polyelectrolyte blending. Their composite sponges (CMCS/SA/RD) were prepared by freeze-induced phase separation. CMCS/SA/RD sponges were characterized by Fourier transform infrared spectroscopy and scanning electron microscopy, and their blood absorption and hemolysis ratio were analyzed. The hemostatic effect of the composite sponges was evaluated by coagulation in vitro and in vivo. The composite sponges had a porous network structure. The water absorption ratio was >8000 %, and hemolysis ratio was <5 %. CMCS/SA/RD-II and CMCS/SA/RD-III composite sponges shortened the coagulation time in vitro by 11.33 s and 9.66 s, the hepatic hemostasis time by 13.8 % and 23.3 %, and the hemostasis time after mouse-tail amputation by 28.9 % and 23.9 %, respectively. A preliminary study on its coagulation mechanism showed that CMCS/SA/RD had significant effects on erythrocyte adsorption, platelet adhesion, and shortening of the activated partial thromboplastin time.

Advances of biological macromolecules hemostatic materials: A review

Achieving hemostasis is a necessary intervention to rapidly and effectively control bleeding. Conventional hemostatic materials currently used in clinical practice may aggravate the damage at the bleeding site due to factors such as poor adhesion and poor adaptation. Compared to most traditional hemostatic materials, polymer-based hemostatic materials have better biocompatibility and offer several advantages. They provide a more effective method of stopping bleeding and avoiding additional damage to the body in case of excessive blood loss. Various hemostatic materials with greater functionality have been developed in recent years for different organs using diverse design strategies. This article reviews the latest advances in the development of polymeric hemostatic materials. We introduce the coagulation cascade reaction after bleeding and then discuss the hemostatic mechanisms and advantages and disadvantages of various polymer materials, including natural, synthetic, and composite polymer hemostatic materials. We further focus on the design strategies, properties, and characterization of hemostatic materials, along with their applications in different organs. Finally, challenges and prospects for the application of hemostatic polymeric materials are summarized and discussed. We believe that this review can provide a reference for related research on hemostatic materials, contributing to the further development of polymer hemostatic materials.

Recent research advances on polysaccharide-, peptide-, and protein-based hemostatic materials: A review

Hemorrhage is a potentially life-threatening emergency that can occur at any time or place. Whether traumatic, congenital, surgical, disease-related, or drug-induced, bleeding can lead to severe complications or death. Therefore, the development of efficient hemostatic materials is critical. However, the results and prognosis demonstrated by clinical means of hemostasis do not reach expectations. With the development of technology, novel hemostatic materials have been developed from polysaccharides (chitosan, hyaluronic acid, alginate, cellulose, cyclodextrins, starch, dextran, and carrageenan), peptides (self-assembling peptides), and proteins (silk fibroin, collagen, gelatin, keratin, and thrombin). These new materials exhibit high hemostatic efficacy due to the enhancement or interaction of various hemostatic mechanisms. The main forms include adhesives, sealants, bandages, hemostatic powders, and hemostatic sponges. This article introduces the clotting process and principles of hemostatic methods and reviews the research on polysaccharide-, peptide-, and protein-based hemostatic materials in the last five years. The design ideas and hemostatic principles of polysaccharide-, peptide-, and protein-based hemostatic materials are mainly introduced. Finally, we summarize material designs, advantages, disadvantages, and challenges regarding hemostatic materials.

Dual green hemostatic sponges constructed by collagen fibers disintegrated from Halocynthia roretzi by a shortcut method

Recently, biomacromolecules have received considerable attention in hemostatic materials. Collagen, an ideal candidate for hemostatic sponges due to its involvement in the clotting process, has been facing challenges in extraction from raw materials, which is time-consuming, expensive, and limited by cultural and religious restrictions associated with traditional livestock and poultry sources. To address these issues, this study explored a new shortcut method that using wild Halocynthia roretzi (HR), a marine fouling organism, as a raw material for developing HR collagen fiber sponge (HRCFs), which employed urea to disrupt hydrogen bonds between collagen fiber aggregates. This method simplifies traditional complex manufacturing processes while utilized marine waste, thus achieving dual green in terms of raw materials and manufacturing processes. FTIR results confirmed that the natural triple-helical structure of collagen was preserved. HRCFs exhibit a blood absorption ratio of 2000-3500 %, attributed to their microporous structure, as demonstrated by kinetic studies following a capillary model. Remarkably, the cytotoxicity and hemolysis ratio of HRCFs are negligible. Furthermore, during in vivo hemostasis tests using rabbit ear and kidney models, HRCFs significantly reduce blood loss and shorten hemostasis time compared to commercial gelatin sponge and gauze, benefiting from the capillary effect and collagen's coagulation activity. This study provides new insights into the design of collagen-based hemostatic biomaterials, especially in terms of both raw material and green manufacturing processes.

Synthesis of multicolor luminescent carbon dots based on carboxymethyl chitosan for cell imaging and wound healing application: In vitro and in vivo studies

The construction of biomaterials that can facilitate wound healing is significantly challenging in the medical field, and bacterial infections increase this complexity. In this study, we selected the biomacromolecule carboxymethyl chitosan as a carbon source and citric acid as an auxiliary carbon source. We prepared carbon quantum dots with multicolor luminescence properties and higher quantum yields (QYs) using a facile one-pot hydrothermal method. We characterized them to select carbon dots (CDs) suitable for cell growth. Subsequently, their biocompatibility with L929 cells, antibacterial properties against Staphylococcus aureus, and efficiency in promoting wound healing in vivo were investigated. Our experimental results showed that CDs at an appropriate concentration had excellent bioimaging ability, were suitable for cell growth, and accelerated the healing of infected wounds. We believe these bioactive CDs have great potential in promoting wound healing.

Chemical modification of chitosan for developing of new hemostatic materials: A review

Uncontrolled bleeding that occurs during surgery, trauma, and in combat conditions is critical and require immediate action. Chitosan is a polysaccharide, obtained from natural sources with unique biological properties. It is often used as basis for local hemostatic agents (LHA). We summarized the data on hemostatic properties of chitosan, commercially available chitosan-based products with focus in the field of chemical modification of chitosan. Various approaches are used to enhance hemostatic activity of chitosan-based materials. The approach with chemical modification of chitosan allows changing the properties of the polymer in order to obtain an active macromolecule that contributes to hemostasis. Ongoing research on the mechanism of interaction with blood components in the case of different chitosan derivatives will make it possible to identify promising directions for chemical modification to obtain an effective LHA.

Preparation, Characterization, and Antioxidant Properties of Selenium-Enriched Tea Peptides

The research on the activity of selenium (Se)-enriched agricultural products is receiving increasing attention since Se was recognized for its antioxidant activities and for its enhancement of immunity in trace elements. In this study, antioxidant Se-containing peptides, namely, Se-TAPepI-1 and Se-TAPepI-2, were optimally separated and prepared from Se-enriched tea protein hydrolysates by ultrafiltration and Sephadex G-25 purification, and subsequently, their physicochemical properties, oligopeptide sequence, and potential antioxidant mechanism were analyzed. Through the optimization of enzymatic hydrolysis conditions, the Se-enriched tea protein hydrolyzed by papain exhibited a better free radical scavenging activity. After separation and purification of hydrolysates, the two peptide fractions obtained showed significant differences in selenium content, amino acid composition, apparent morphology, peptide sequence, and free radical scavenging activity. Therein, two peptides from Se-TAPepI-1 included LPMFG (563.27 Da) and YPQSFIR (909.47 Da), and three peptides from Se-TAPepI-2 included GVNVPYK (775.42 Da), KGGPGG (552.24 Da), and GDEPPIVK (853.45 Da). Se-TAPepI-1 and Se-TAPepI-2 could ameliorate the cell peroxidation damage and inflammation by regulating NRF2/ARE pathway expression. Comparably, Se-TAPepI-1 showed a better regulatory effect than Se-TAPepI-2 due to their higher Se content, typical amino acid composition and sequence, higher surface roughness, and a looser arrangement in their apparent morphology. These results expanded the functional activities of tea peptide and provided the theoretical basis for the development of Se-containing peptides from Se-enriched tea as a potential natural source of antioxidant dietary supplements.

Alkylated chitosan-attapulgite composite sponge for rapid hemostasis

This study reported the development of a composite sponge (ACATS) based on alkylated chitosan (AC) and attapulgite (AT) for rapid hemostasis. The well-designed ACATS, with an optimal AC N-alkylation of 5.9 % and an optimal AC/AT mass ratio of 3:1, exhibited a hierarchical porous structure with a favorable biocompatibility. The ACATS can effectively and rapidly stop the uncontrolled bleeding in 235 ± 64 s with a total blood loss of 8.4 ± 4.0 g in comparison with those of Celox as a positive control (602 ± 101 s and 22.3 ± 2.4 g, respectively) using rabbit carotid artery injury model in vivo. ACATS could rapidly interact with blood and its components, including platelets (PLs), red blood cells (RBCs), and coagulation factors, resulting in these blood components rapidly accumulation and the following thrombus formation and coagulation factors activation.

Green Chemistry Principles for Nano- and Micro-Sized Hydrogel Synthesis

The growing demand for drug carriers and green-technology-based tissue engineering materials has enabled the fabrication of different types of micro- and nano-assemblies. Hydrogels are a type of material that have been extensively investigated in recent decades. Their physical and chemical properties, such as hydrophilicity, resemblance to living systems, swelling ability and modifiability, make them suitable to be exploited for many pharmaceutical and bioengineering applications. This review deals with a brief account of green-manufactured hydrogels, their characteristics, preparations, importance in the field of green biomedical technology and their future perspectives. Only hydrogels based on biopolymers, and primarily on polysaccharides, are considered. Particular attention is given to the processes of extracting such biopolymers from natural sources and the various emerging problems for their processing, such as solubility. Hydrogels are catalogued according to the main biopolymer on which they are based and, for each type, the chemical reactions and the processes that enable their assembly are identified. The economic and environmental sustainability of these processes are commented on. The possibility of large-scale processing in the production of the investigated hydrogels are framed in the context of an economy aimed at waste reduction and resource recycling.

pH-responsive release and washout resistance of chitosan-based nano-pesticides for sustainable control of plumeria rust

Controlled pesticide release in response to environmental stimuli by encapsulating pesticides in a carrier is a feasible approach to improve the effective utilization rate. In this study, pH-responsive release nanoparticles loaded with penconazole (PE) were prepared by ionic cross-linking of chitosan and carboxymethyl chitosan (PE@CS/CMCS-NPs). PE@CS/CMCS-NPs exhibited good washout resistance and wettability properties, increasing the washing resistance of the pesticide by approximately 20 times under continuous washing. The results of the release experiments showed that nanoparticles had adjustable controlled-release characteristics with the change in pH based on the swelling of nanoparticles. The results of spore germination experiments showed that PE@CS/CMCS-NPs enhanced the inhibitory effect under acidic conditions. The field experiment results showed that PE@CS/CMCS-NPs had a better control effect than PE-aqueous solution, extended the duration and slowed down the dissipation of PE. These results indicated that the CS/CMCS-NPs pH-responsive release system has great potential in the development of an effective pesticide formulation.

Frozen bean curd-inspired Xenogeneic acellular dermal matrix with triple pretreatment approach of freeze-thaw, laser drilling and ADSCs pre-culture for promoting early vascularization and integration

Xenogeneic acellular dermal matrix (ADM) is widely used in clinical practice given its good biocompatibility and biomechanical properties. Yet, its dense structure remains a hindrance. Incorporation of laser drilling and pre-culture with Adipose-derived stem cells (ADSCs) have been attempted to promote early vascularization and integration, but the results were not ideal. Inspired by the manufacturing procedure of frozen bean curd, we proposed a freeze-thaw treatment to enhance the porosity of ADM. We found that the ADM treated with -80°C3R+-30°C3R had the largest disorder of stratified plane arrangement (deviation angle 28.6%) and the largest porosity (96%), making it an optimal approach. Human umbilical vein endothelial cells on freeze-thaw treated ADM demonstrated increased expression in Tie-2 and CD105 genes, proliferation, and tube formation in vitro compared with those on ADM. Combining freeze-thaw with laser drilling and pre-culture with ADSCs, such tri-treatment improved the gene expression of pro-angiogenic factors including IGF-1, EGF, and VEGF, promoted tube formation, increased cell infiltration, and accelerated vascularization soon after implantation. Overall, freeze-thaw is an effective method for optimizing the internal structure of ADM, and tri-treatments may yield clinical significance by promoting early cell infiltration, vascularization, and integration with surrounding tissues.

Origin of critical nature and stability enhancement in collagen matrix based biomaterials: Comprehensive modification technologies

Collagen is the most abundant protein in animals and one of the most important extracellular matrices that chronically plays an important role in biomaterials. However, the major concern about native collagen is the lack of its thermal stability and weak resistance to proteolytic degradation. Currently, a series of modification technologies have been explored for critical nature and stability enhancement in collagen matrix-based biomaterials, and prosperously large-scale progress has been achieved. The establishment of covalent bonds among collagen noumenon has been verified assuringly to have pregnant influences on its physicochemical properties and biological properties, enlightening to discuss the disparate modification technologies on specific effects on the multihierarchical structures and pivotal performances of collagen. In this review, various existing modification methods were classified from a new perspective, scilicet whether to introduce exogenous substances, to reveal the basic scientific theories of collagen modification. Understanding the role of modification technologies in the enhancement of collagen performance is crucial for developing novel collagen-based biomaterials. Moreover, the different modification effects caused by the interaction sites between the modifier and collagen, and the structure-activity relationship between the structure of the modifier and the properties of collagen were reviewed.

Oxidized dextran crosslinked polysaccharide/protein/polydopamine composite cryogels with multiple hemostatic efficacies for noncompressible hemorrhage and wound healing

Noncompressible hemorrhage caused by gunshots and sharp objects leads to higher trauma mortality, and cryogels have great potential in controlling noncompressible hemorrhage applications owing to their shape-memory properties. However, the use of non-toxic crosslinkers to prepare cryogels for noncompressible hemorrhage remains a challenge. In this study, a series of cryogels were prepared using oxidized dextran (ODex) as a biocompatible crosslinker, combined with the good hemostatic properties of chitosan (CS) and human-like collagen (HLC), and polydopamine nanoparticles (PDA-NPs) were also introduced to strengthen the shape recovery speed of the cryogels and further enhance their hemostatic performance. The CS/HLC/ODex/PDA-NPs (CHOP) cryogels presented a highly interconnected macroporous structure, powerful water/blood absorption capacity, robust mechanical performance, and rapid water/blood-triggered shape recovery. In vitro coagulation and coagulation mechanism tests showed that CHOP exhibited strong procoagulant ability, high adhesion to blood cells and fibrinogen, and the capacity to activate platelets and intrinsic pathways. In vivo hemostatic tests indicated that CHOP could effectively shorten the bleeding time and reduce the bleeding volume of liver incision bleeding and liver noncompressible hemorrhage. Meanwhile, CHOP exhibited good biocompatibility and biodegradability, and could promote wound healing. These results suggest that CHOP cryogels will be a promising hemostatic dressing.

Applications of Chitosan in Surgical and Post-Surgical Materials

The continuous advances in surgical procedures require continuous research regarding materials with surgical applications. Biopolymers are widely studied since they usually provide a biocompatible, biodegradable, and non-toxic material. Among them, chitosan is a promising material for the development of formulations and devices with surgical applications due to its intrinsic bacteriostatic, fungistatic, hemostatic, and analgesic properties. A wide range of products has been manufactured with this polymer, including scaffolds, sponges, hydrogels, meshes, membranes, sutures, fibers, and nanoparticles. The growing interest of researchers in the use of chitosan-based materials for tissue regeneration is obvious due to extensive research in the application of chitosan for the regeneration of bone, nervous tissue, cartilage, and soft tissues. Chitosan can serve as a substance for the administration of cell-growth promoters, as well as a support for cellular growth. Another interesting application of chitosan is hemostasis control, with remarkable results in studies comparing the use of chitosan-based dressings with traditional cotton gauzes. In addition, chitosan-based or chitosan-coated surgical materials provide the formulation with antimicrobial activity that has been highly appreciated not only in dressings but also for surgical sutures or meshes.

Preparation of norfloxacin-grafted chitosan antimicrobial sponge and its application in wound repair

Trauma is one of the most common health issues in humans, and bacterial infection of the wound may result in many complications. In this paper, using 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) as a coupling agent, chitosan (CS) was grafted with norfloxacin (NF), an antibacterial agent, to prepare a CS-NF sponge by freezing-induced phase separation. The CS-NF sponge was characterized by ultra violet-visible spectroscopy, Fourier transform infrared spectroscopy, and scanning electron microscopy. Its porosity and water absorption ratio were determined, the antimicrobial activity was evaluated by inhibition zone assay, and its wound repair effect was investigated in a full-thickness cutaneous excisional wound animal model. The results showed that NF was successfully grafted onto CS, and the obtained CS-NF sponge had both a high porosity and water absorption ratio. The CS-NF sponge displayed significant antimicrobial activities in the inhibition zone assay. In vivo the CS-NF sponge exhibited a strong wound healing effect, with a wound healing rate close to 100% by day 15. Therefore, the CS-NF sponge is a novel promising wound-healing dressing for clinical practice.

Applications of Chitosan and its Derivatives in Skin and Soft Tissue Diseases

Chitosan and its derivatives are bioactive molecules that have recently been used in various fields, especially in the medical field. The antibacterial, antitumor, and immunomodulatory properties of chitosan have been extensively studied. Chitosan can be used as a drug-delivery carrier in the form of hydrogels, sponges, microspheres, nanoparticles, and thin films to treat diseases, especially those of the skin and soft tissue such as injuries and lesions of the skin, muscles, blood vessels, and nerves. Chitosan can prevent and also treat soft tissue diseases by exerting diverse biological effects such as antibacterial, antitumor, antioxidant, and tissue regeneration effects. Owing to its antitumor properties, chitosan can be used as a targeted therapy to treat soft tissue tumors. Moreover, owing to its antibacterial and antioxidant properties, chitosan can be used in the prevention and treatment of soft tissue infections. Chitosan can stop the bleeding of open wounds by promoting platelet agglutination. It can also promote the regeneration of soft tissues such as the skin, muscles, and nerves. Drug-delivery carriers containing chitosan can be used as wound dressings to promote wound healing. This review summarizes the structure and biological characteristics of chitosan and its derivatives. The recent breakthroughs and future trends of chitosan and its derivatives in therapeutic effects and drug delivery functions including anti-infection, promotion of wound healing, tissue regeneration and anticancer on soft tissue diseases are elaborated.

Antimicrobial peptides/ciprofloxacin-loaded O-carboxymethyl chitosan/self-assembling peptides hydrogel dressing with sustained-release effect for enhanced anti-bacterial infection and wound healing

Bacteria-induced wound infections and multifunctional hydrogels have received widespread attention in wound repair. In this study, self-assembling peptides (SAPs) were grafted on O-carboxymethyl chitosan (O-CMCS), and compact spatial structure and good drug sustained-release effect on mel-d1, a new AMP designed based on melittin with the same antimicrobial activity but lower cytotoxicity and ciprofloxacin (CIP) were obtained. In vivo test showed that the O-CMCS/SAP hydrogel loaded with CIP and mel-d1 accelerated the wound closure speed caused by infection of Escherichia coli and skin tissue regeneration. Both of the enhanced interaction between O-CMCS/SAP and CIP/Mel-d1 because of the hydrophobic interaction and π-π stacking, and the potential tissue healing ability of SAP played important roles. This study provided a rational design method of O-CMCS by grafting SAPs to give a wider range of biological functions.

The ion-imprinted oyster shell material for targeted removal of Cd(II) from aqueous solution

In order to realize the sustainable utilization of waste oyster shell and develop a targeted removal technology for cadmium. A novel ion-imprinted oyster shell material (IIOS) was prepared by surface imprinting technique. The prepared samples were characterized by scanning electron microscope, Fourier infrared spectrometer, X-ray diffractometer, thermogravimetric analysis and N₂ adsorption-desorption. The adsorption performances of IIOS for Cd(II) from aqueous solution were studied by the single factor sequential batch, kinetics, isotherms, selectivity and recycling experiments. The characterization researches showed that IIOS was successfully prepared. The adsorption experiments indicated that the adsorption process reached equilibrium within 240 min; the maximum adsorption capacity was up to 69.1 mg g^-1 with the initial Cd(II) concentration of 75 mg L^-1 at pH 5; the adsorption process fitted well to the pseudo-second-order model and the Langmuir isotherm model, which revealed the chemisorption characteristic of Cd(II). Moreover, IIOS exhibited a good targeted adsorption of Cd(II) in several binary competition systems owing to the present of these imprinted cavities. The recycling experiment showed that the targeted removal ratio of IIOS for Cd(II) remained above 80% after used six times. The results of this study indicated that it is a promising prospect for waste oyster shell used as IIOS to dispose heavy metals in wastewater.

What affects the biocompatibility of polymers?

In recent decades synthetic polymers have gained increasing popularity, and nowadays they are an integral part of people's daily lives. In addition, owing to their competitive advantage and being susceptible to modification, polymers have stimulated the fast development of innovative technologies in many areas of science. Biopolymers are of particular interest in various branches of medicine, such as implantology of bones, cartilage and skin tissues as well as blood vessels. Biomaterials with such specific applications must have appropriate mechanical and strength characteristics and above all they must be compatible with the surrounding tissues, human blood and its components, i.e. exhibit high hemo- and biocompatibility, low or no thrombo- and carcinogenicity, foreign body response (host response), appropriate osteoconduction, osteoinduction and mineralization. For biocompatibility improvement many surface treatment techniques have been utilized leading to fabricate the polymer biomaterials of required properties, also at nanoscale. This review paper discusses the most important physicochemical and biological factors that affect the biocompatibility, thus the reaction of the living organism after insertion of the polymer-based biomaterials, i.e. surface modification and/or degradation, surface composition (functional groups and charge), size and shapes, hydrophilic-hydrophobic character, wettability and surface free energy, topography (roughness, stiffness), crystalline and amorphous structure, nanostructure, cell adhesion and proliferation, cellular uptake. Particularly, the application of polysaccharides (chitosan, cellulose, starch) in the tissue engineering is emphasized.

Rapid Hemostatic Biomaterial from a Natural Bath Sponge Skeleton

Uncontrolled bleeding is the main cause of mortality from trauma. Collagen has been developed as an important hemostatic material due to its platelet affinity function. A bath sponge skeleton is rich in collagen, also known as spongin. To understand the hemostatic effect of spongin, spongin materials, SX, SFM and SR were prepared from the bath sponge Spongia officinalis, and hemostatic experiments were performed. The SX, SFM and SR were significantly better than the positive control, type I collagen, in shortening the whole blood clotting time in vitro and hemostasis upon rat tail amputation. In a hemostatic experiment of rabbit common carotid artery injury, the hemostatic time and 3 h survival rate of the SFM group were 3.00 ± 1.53 min and 100%, respectively, which are significantly better than those of the commercial hemostat CELOX-A (10.33 ± 1.37 min and 67%, respectively). Additionally, the SFM showed good coagulation effects in platelet-deficient blood and defibrinated blood, while also showing good biocompatibility. Through a variety of tests, we speculated that the hemostatic activity of the SFM is mainly caused by its hyperabsorbency, high affinity to platelets and high effective concentration. Overall, the SFM and spongin derivates could be potential hemostatic agents for uncontrolled bleeding and hemorrhagic diseases caused by deficiency or dysfunction of coagulation factors.

A biodegradable antibacterial alginate/carboxymethyl chitosan/Kangfuxin sponges for promoting blood coagulation and full-thickness wound healing

Conventional wound-dressing materials with structural and functional deficiencies are not effective in promoting wound healing. The development of multifunctional wound dressings is emerging as a promising strategy to accelerate blood coagulation, inhibit bacterial infection, and trigger full-thickness wound into a regenerative process. Herein, multifunctional composite sponges were developed by incorporation of traditional Chinese medicine Kangfuxin (KFX) into alginate (AG)/carboxymethyl chitosan (CMC) via green crosslinking, electrostatic interaction, and freeze-drying methods. It is demonstrated that the AG/CMC/KFX (ACK) sponges exhibit a highly interconnected and porous structure, suitable water vapor transmittance, excellent elastic properties, antibacterial behavior, cytocompatibility, and rapid hemostasis. Further, in a rat full-thickness wounds model, the ACK sponge containing 10% KFX (ACK-10) significantly facilitates wound closure compared to the AC group and ACK sponge containing 5% and 15% KFX. Thus, the multifunctional ACK-10 composite sponge has great promise for the application of full-thickness wound healing.