Thermoresponsive Hemostatic Hydrogel with a Biomimetic Nanostructure Constructed from Aggregated Collagen Nanofibers

A comprehensive exploration of hydrogel applications in multi-stage skin wound healing

Hydrogels, as an emerging biomaterial, have found extensive use in the healing of wounds due to their distinctive physicochemical structure and functional properties. Moreover, hydrogels can be made to match a range of therapeutic requirements for materials used in wound healing through specific functional modifications. This review provides a step-by-step explanation of the processes involved in cutaneous wound healing, including hemostasis, inflammation, proliferation, and reconstitution, along with an investigation of the factors that impact these processes. Furthermore, a thorough analysis is conducted on the various stages of the wound healing process at which functional hydrogels are implemented, including hemostasis, anti-infection measures, encouraging regeneration, scar reduction, and wound monitoring. Next, the latest progress of multifunctional hydrogels for wound healing and the methods to achieve these functions are discussed in depth and categorized for elucidation. Finally, perspectives and challenges associated with the clinical applications of multifunctional hydrogels are discussed.

Preparation and Application of Hemostatic Hydrogels

Hemorrhage remains a critical challenge in various medical settings, necessitating the development of advanced hemostatic materials. Hemostatic hydrogels have emerged as promising solutions to address uncontrolled bleeding due to their unique properties, including biocompatibility, tunable physical characteristics, and exceptional hemostatic capabilities. In this review, a comprehensive overview of the preparation and biomedical applications of hemostatic hydrogels is provided. Particularly, hemostatic hydrogels with various materials and forms are introduced. Additionally, the applications of hemostatic hydrogels in trauma management, surgical procedures, wound care, etc. are summarized. Finally, the limitations and future prospects of hemostatic hydrogels are discussed and evaluated. This review aims to highlight the biomedical applications of hydrogels in hemorrhage management and offer insights into the development of clinically relevant 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.

Functional hemostatic hydrogels: design based on procoagulant principles

Uncontrolled hemorrhage results in various complications and is currently the leading cause of death in the general population. Traditional hemostatic methods have drawbacks that may lead to ineffective hemostasis and even the risk of secondary injury. Therefore, there is an urgent need for more effective hemostatic techniques. Polymeric hemostatic materials, particularly hydrogels, are ideal due to their biocompatibility, flexibility, absorption, and versatility. Functional hemostatic hydrogels can enhance hemostasis by creating physical circumstances conducive to hemostasis or by directly interfering with the physiological processes of hemostasis. The procoagulant principles include increasing the concentration of localized hemostatic substances or establishing a physical barrier at the physical level and intervention in blood cells or the coagulation cascade at the physiological level. Moreover, synergistic hemostasis can combine these functions. However, some hydrogels are ineffective in promoting hemostasis or have a limited application scope. These defects have impeded the advancement of hemostatic hydrogels. To provide inspiration and resources for new designs, this review provides an overview of the procoagulant principles of hemostatic hydrogels. We also discuss the challenges in developing effective hemostatic hydrogels and provide viewpoints.

In situ generated hemostatic adhesives: From mechanisms of action to recent advances and applications

Conventional surgical closure techniques, such as sutures, clips, or skin closure strips, may not always provide optimal wound closure and may require invasive procedures, which can result in potential post-surgical complications. As result, there is a growing demand for innovative solutions to achieve superior wound closure and improve patient outcomes. To overcome the abovementioned issues, in situ generated hemostatic adhesives/sealants have emerged as a promising alternative, offering a targeted, controllable, and minimally invasive procedure for a wide variety of medical applications. The aim of this review is to provide a comprehensive overview of the mechanisms of action and recent advances of in situ generated hemostatic adhesives, particularly protein-based, thermoresponsive, bioinspired, and photocrosslinkable formulations, as well as the design challenges that must be addressed. Overall, this review aims to enhance a comprehensive understanding of the latest advancements of in situ generated hemostatic adhesives and their mechanisms of action, with the objective of promoting further research in this field.

Metal-Phenolic Networks for Chronic Wounds Therapy

Chronic wounds are recalcitrant complications of a variety of diseases, with pathologic features including bacterial infection, persistent inflammation, and proliferation of reactive oxygen species (ROS) levels in the wound microenvironment. Currently, the use of antimicrobial drugs, debridement, hyperbaric oxygen therapy, and other methods in clinical for chronic wound treatment is prone to problems such as bacterial resistance, wound expansion, and even exacerbation. In recent years, researchers have proposed many novel materials for the treatment of chronic wounds targeting the disease characteristics, among which metal-phenolic networks (MPNs) are supramolecular network structures that utilize multivalent metal ions and natural polyphenols complexed through ligand bonds. They have a flexible and versatile combination of structural forms and a variety of formations (nanoparticles, coatings, hydrogels, etc.) that can be constructed. Functionally, MPNs combine the chemocatalytic and bactericidal properties of metal ions as well as the anti-inflammatory and antioxidant properties of polyphenol compounds. Together with the excellent properties of rapid synthesis and negligible cytotoxicity, MPNs have attracted researchers' great attention in biomedical fields such as anti-tumor, anti-bacterial, and anti-inflammatory. This paper will focus on the composition of MPNs, the mechanisms of MPNs for the treatment of chronic wounds, and the application of MPNs in novel chronic wound therapies.

Injectable Sealants Based on Silk Fibroin for Fast Hemostasis and Wound Repairing

Uncontrollable blood loss poses fatality risks and most recently developed sealants still share common limitations on controversial components, degradability, mechanical strength or gelation time. Herein, series of injectable sealants based on silk fibroin (SF) is developed. Random coil/β-sheet conformation transition in SF is achieved by forming dendritic intermediates under induction of the structurally compatible and chemically complementary assembly peptide (Ac-KAEA-KAEA-KAEA-KAEA-NH2 , KA16 ). A ratio of 1:5 (KA-SF-15) shown an accelerating gelation process (≈12 s) and enhanced mechanical strength at physiological conditions. The interweaved nanofibers effectively impeded the bleeding within 30 s and no obvious adverse effects are observed. The supramolecular interactions and in vivo degradation benefit the inflammatory host cells infiltration and cytokines diffusion. Without any exogenous factors, the increased expression of VEGF and PDGF led to a positive feedback regulation on fibroblasts and vascular endothelial cell growth/proliferation and promoted the wound healing. These findings indicated the few assembly-peptide can accelerate fibroin gelation transition at a limited physiological condition, and the injectable amino acid-based sealants show obvious advantages on biocompatibility, degradability, rapid gelation and matched strength, with strong potential to act as next generation of biomedical materials.

Photocuring and Gelatin-Based Antibacterial Hydrogel for Skin Care

The development of moisturizing, antibacterial, and biocompatible multifunctional hydrogels is essential to protect skin and promote skin defects recovery. Gelatin has admired potential to be applied for skin care as a hydrogel in virtue of its hydrophilic biocompatible and biodegradable properties. In this study, triclosan-grafted gelatin and photo-cross-linkable methacrylated gelatin were synthesized and then combined to construct the semi-interpenetrating network and antibacterial hydrogels with the aid of a visible blue light. The antimicrobial test demonstrated that the resulting hydrogel obtained excellent inactivation capacity against E. coli, S. aureus, T. rubrum, and C. albicans with sterilizing rates of 99.998%, 99.998%, 99.19%, and 99.64%, respectively. In addition, the cytotoxicity, hemolysis, skin irritation, and rat skin wound healing experiments proved the good biocompatibility of the hydrogel. Therefore, this investigation sheds light on the development of multifunctional hydrogels in skin care.

Advances in Functional Hydrogel Wound Dressings: A Review

One of the most advanced, promising, and commercially viable research issues in the world of hydrogel dressing is gaining functionality to achieve improved therapeutic impact or even intelligent wound repair. In addition to the merits of ordinary hydrogel dressings, functional hydrogel dressings can adjust their chemical/physical properties to satisfy different wound types, carry out the corresponding reactions to actively create a healing environment conducive to wound repair, and can also control drug release to provide a long-lasting benefit. Although a lot of in-depth research has been conducted over the last few decades, very few studies have been properly summarized. In order to give researchers a basic blueprint for designing functional hydrogel dressings and to motivate them to develop ever-more intelligent wound dressings, we summarized the development of functional hydrogel dressings in recent years, as well as the current situation and future trends, in light of their preparation mechanisms and functional effects.

Collagen processing with mesoscale aggregates as templates and building blocks

Collagen presents a well-organized hierarchical multilevel structure. Microfibers, fibers, and fiber bundles are the aggregates of natural collagen; which achieve an ideal balance of mechanical strength and toughness at the mesoscopic scale for biological tissue. These mesostructured aggregates of collagen isolated from biological tissues retain these inherent organizational features to enable their use as building blocks for constructing new collagen materials with ideal mechanical performance, thermal and dimensional stability. This strategy is distinct from the more common bottom-up or molecular-level design and assembly approach to generating collagen materials. The present review introduces the hierarchical structure of biological collagen with a focus on mesostructural features. Isolation strategies for these collagen aggregates (CAs) are summarized. Recent progress in the use of these mesostructural components for the construction of new collagen materials with emerging applications is reviewed, including in catalysis, environmental applications, biomedicine, food packaging, electrical energy storage, and flexible sensors. Finally, challenges and prospects are assessed for controllable production of CAs as well as material designs.

Polysaccharide-Based Adhesive Antibacterial and Self-Healing Hydrogel for Sealing Hemostasis

Adhesive hydrogels have been considered as one of the most ideal materials for wound dressing. However, most existing adhesive hydrogels still have disadvantages such as low mechanical properties, poor biological activity (antibacterial and hemostatic ability), and low biocompatibility, which largely limit their application. Thus, it is highly desired to prepare a hydrogel-based wound dressing with good self-healing, ideal adhesive properties, rapid hemostasis, and excellent wound infection prevention activity. In this study, a simple method was presented to prepare a PAM-Lignin-CS-Laponite-SA hydrogel for wound dressing. The obtained hydrogel displayed excellent self-healing ability and repeatable adhesive performance, benefiting from the introduction of hydrogen bonding and electrostatic interactions inside the hydrogel network. In addition, the PAM-Lignin-CS-Laponite-SA hydrogel also exhibited low cell cytotoxicity, good antibacterial activity, and outstanding hemostatic properties. In conclusion, the PAM-Lignin-CS-Laponite-SA hydrogel demonstrated good tissue adhesion, excellent self-healing ability, effective bleeding control, and good antibacterial activity to prevent wound infection, which provides a new idea for developing a multifunctional hydrogel-based tissue adhesive hemostatic dressing.

A high-performance wearable pressure sensor based on an MXene/PVP composite nanofiber membrane for health monitoring

Flexible and wearable pressure sensors have attracted extensive attention in domains, such as electronic skin, medical monitoring and human-machine interaction. However, developing a pressure sensor with high sensitivity, mechanical stability and a wide detection range remains a huge challenge. In this work, a flexible capacitive pressure sensor, based on a Ti₃C₂T _x (MXene)/polyvinyl pyrrolidone (PVP) composite nanofiber membrane (CNM), prepared via an efficient electrospinning process, is presented. The experimental results show that even a small mass fraction of MXene can effectively decrease the compression modulus of the PVP nanofiber membrane, thus enhancing the sensing performance. Specifically, the sensor based on (0.1 wt% MXene)/PVP CNM has a high sensitivity (0.5 kPa^-1 at 0-1.5 kPa), a fast response/recovery time (45/45 ms), a wide pressure detection range (0-200 kPa), a low detection limit (∼9 Pa) and an excellent mechanical stability (8000 cycles). Due to its superior performance, the sensor can monitor subtle changes in human physiology and other signals, such as pulse, respiration, human joint motions and airflow. In addition, a 4 × 4 sensor array is fabricated that can accurately map the shape and position of objects with good resolution. The high-performance flexible pressure sensor, as developed in this work, shows good application prospects in advanced human-computer interface systems.

Temperature-triggered fluorocopolymer aggregate coating switching from antibacterial to antifouling and superhydrophobic hemostasis

The multifunction antibacterial hemostatic materials can reduce blood loss, infection and wound complications, which probably decrease morbidity and health care costs. However, the contradictory relationship between antibacterial ability and biocompatibility, and the unnecessary blood loss restricts the practical application of hydrophilic cationic antibacterial hemostatic materials. Herein, a multifunctional temperature-triggered antibacterial hemostatic fluorocopolymer aggregate coating was developed. After self-assembly and quaternization process, the quaternized poly(N,N-dimethylaminoethylmethacrylate)-b-poly(1H,1H,2H,2H-heptadecafluorodecyl acrylate) block copolymers (PDMA-b-PFOEMA) aggregate coating consisting of fluoropolymer and quaternary ammonium salt were built. The synergistic effect on fluorinated block with low surface energy and quaternary ammonium salt block with bactericide activity severs the way of initial bacterial attachment and proliferation, while the migration of fluorinated block greatly promotes the biocompatibility and anti-adhesion performance in response to the switch from room temperature to physiological temperature. Furthermore, the fluorocopolymer aggregate coating with hydrophobic properties possessed the property of rapid coagulation, low blood loss, minor secondary bleeding and least bacteria infiltration. The multifunctional temperature-triggered fluorocopolymer aggregate coating with antifouling, antibacterial and hemostatic properties may have a great potential in the biomedical application.

A Bionic Self-Assembly Hydrogel Constructed by Peptides With Favorable Biosecurity, Rapid Hemostasis and Antibacterial Property for Wound Healing

Bionic self-assembly hydrogel derived by peptide as an effective biomedical hemostatic agent has always gained great attention. However, developing hydrogels with eminent-biosecurity, rapidly hemostatic and bactericidal function remains a critical challenge. Hence, we designed an injectable hydrogel with hemostatic and bactericidal function based on Bionic Self-Assembling Peptide (BSAP) in this study. BSAP was formed with two functionalized peptides containing (RADA)₄ motif and possessed the ability to self-assemble into nanofibers. As expected, BSAP could rapidly co-assemble into hydrogel network structure in situ driven by Ca²⁺. The hydrogel with a concentration of 5% showed a superior microporous structure and excellent shear thinning characteristics, as well as injectability. Moreover, in the foot trauma model and tail amputation model, the fabricated hydrogel exhibited a lower blood clotting index and dramatically reduced blood clotting time and bleeding volume. Remarkably, the hydrogel reduced inflammatory responses by blocking bacterial infection, promoting wound healing. Finally, the hydrogel is highly hemocompatible and has no cytotoxicity. Overall, this work provides a strategy for developing a high-biosecurity hydrogel with hemostatic and antibacterial properties, which will allow for the clinical application of BSAP.

Development of novel hyaluronic acid/human-like collagen bio-composite membranes: A facile "surface modification-assembly" approach

The merits of hyaluronic acid (HA) as a representative biological carbohydrate polymers especially in bioactivity and tailorability makes it ideal building block for the engineering of tissue engineering scaffolds. HA-based bio-composites integrate the characteristics of multi-component materials, possessing versatility and further improving the therapeutic efficacy. Human like collagen (HLC), which is hydrophilic, biomimetic, and bio-safe, with human tissue-derived collagen biofunction, has attracted extensive attention worldwide. Herein, we developed a novel method for HA/HLC bio-composite membranes preparation, comprising one-step surface modification-assembly process by which the HLC self-assembles are simultaneously loaded on the oxidized-modified HA (oxi-HA) from the surface/interface micro-scale. Comprehensive material characterizations and in vitro/in vivo biostudies proved that the HLC/oxi-HA composite membranes exhibited significantly enhanced biological activity, hemostatic performances, and wound healing properties compared to that of the pristine HA. The results of this study highlight the great potential of the prepared biomimetic HLC/oxi-HA bio-composites as a new generation of multifunctional HA-based wound-healing materials.

An injectable anti-microbial and adhesive hydrogel for the effective noncompressible visceral hemostasis and wound repair

An in-situ formed hemostatic hydrogel (GelMA/OD/Borax) was prepared for the emergency wound hemostasis and anti-inflammation applications. Gelatin was chosen as the backbone and modified with methacrylic anhydride (MA) to synthesize GelMA, which showed the admirable UV light activatable polymerizing ability. Aldehyde groups, which cross-linked with the -NH₂ on the tissue surface and afforded the tissue adhesion, were produced by oxidizing the o-hydroxyl groups of dextran. Further, the sodium tetraborate formed dynamic boric acid ester bonds with the oxidized dextran (OD). With this triple-network structure, the as-prepared hydrogel presented excellent hemostatic capacity and surmounted a high blood pressure of 165 mmHg, which is higher than the threshold systolic blood pressure of healthy adults (i.e., 120 mmHg). The mechanical property, morphology, biocompatibility and degradation of the hydrogel were character Borax, the hydrogel successfully blocked the bleeding and accelerated the wound healing. This research provides a new modality for the design of a multifunctional hemostatic hydrogel for effective hemostasis and wound healing.