A hydrogel-based first-aid tissue adhesive with effective hemostasis and anti-bacteria for trauma emergency management

Abstract

Background Clinical tissue adhesives remain some critical drawbacks for managing emergency injuries, such as inadequate adhesive strength and insufficient anti-infection ability. Herein, a novel, self-healing, and antibacterial carboxymethyl chitosan/polyaldehyde dextran (CMCS/PD) hydrogel is designed as the first-aid tissue adhesive for effective trauma emergency management. Methods We examined the gel-forming time, porosity, self-healing, antibacterial properties, cytotoxicity, adhesive strength, and hemocompatibility. Liver hemorrhage, tail severance, and skin wound infection models of rats are constructed in vivo, respectively. Results Results demonstrate that the CMCS/PD hydrogel has the rapid gel-forming (~ 5 s), good self-healing, and effective antibacterial abilities, and could adhere to tissue firmly (adhesive strength of ~ 10 kPa and burst pressure of 327.5 mmHg) with excellent hemocompatibility and cytocompatibility. This suggests the great prospect of CMCS/PD hydrogel in acting as a first-aid tissue adhesive for trauma emergency management. The CMCS/PD hydrogel is observed to not only achieve rapid hemostasis for curing liver hemorrhage and tail severance in comparison to commercial hemostatic gel (Surgiflo ®) but also exhibit superior anti-infection for treating acute skin trauma compared with clinical disinfectant gel (Prontosan ®). Conclusions Overall, the CMCS/PD hydrogel offers a promising candidate for first-aid tissue adhesives to manage the trauma emergency. Because of the rapid gel-forming time, it could also be applied as a liquid first-aid bandage for mini-invasive surgical treatment. Graphical Abstract

Recent Progress in antibacterial hydrogel coatings for targeting biofilm to prevent orthopedic implant-associated infections

“…However, systemic antibiotics often require high doses that can lead to side effects (e.g., cytotoxicity) and bacterial drug resistance (Uddin et al, 2021). To address infections caused by drug-resistant bacteria, various antimicrobial materials [such as hydrogels (Dou et al, 2023;Zhang D. et al, 2023), and surface coatings (Wei et al, 2022)], and antimicrobial molecules [such as antibacterial peptides (Costa et al, 2021) and amphiphiles (Ye et al, 2022)] have been developed. While progress has been made in post-infection treatment, interventions for biofilm prevention have been increasing dramatically (Connaughton et al, 2014).…”

Editorial: Adhesive hydrogels: design, fabrication, and bio-applications

“…Based on their unique (bio) physicochemical features above, adhesive hydrogels have been applied in numerous indications, including implant scaffolds in tissue engineering, hemostasis, mucosal adhesives to extend the administration site time, and bio-adhesives in place of wounds to reduce infection ( Hao et al, 2022 ; Ko and Liao, 2023 ; Zhao et al, 2023 ). In addition, therapeutic cells and drug molecules can be transported by adhesive hydrogels and released at the injury site to enhance efficacy ( Duan et al, 2023a ; Zhang et al, 2023 ). Adhesive hydrogels perform suitably in clinical investigations for soft tissue regeneration, anti-exudation, medicine distribution, and other applications.…”