A contact-polymerizable hemostatic powder for rapid hemostasis

Abstract

The immediate control of a hemorrhage is crucial for reducing fatalities in critical situations such as battlefields, traffic accidents, natural disasters, <i>etc</i>. Most existing commercial hemostatic powders have weak adhesion capability and poor biodegradability, restricting their clinical use. In this paper, a new poly(ethylene glycol)-di(cyanoacrylate) (CA-PEG-CA)-based hemostatic powder with tissue-contact-triggered strong adhesion and controlled fast degradation is proposed. The monomers quickly underwent crosslinking polymerization while in contact with tissue or blood, forming an <i>in situ</i> gel on the wound. The hemostatic mechanism was demonstrated to depend on both adhesive-based sealing and the aggregation of platelets and erythrocytes. The powder showed excellent hemostatic effects both <i>in vitro</i> and <i>in vivo</i>, even in a rat model with a weakened native hemostatic capacity. In addition, the poly-CA-PEG-CA gel could be rapidly biodegraded by ester bond hydrolysis. Notably, a cysteamine (CS)-containing solution could accelerate the degradation rate, endowing the gel with an on-demand removal property. This hemostatic powder not only can be used to efficiently control bleeding in emergency scenarios, but it can also allow nontraumatic re-exposure of wounds during subsequent surgical care. These properties make the CA-PEG-CA powder a promising candidate to act as a multifunctional wound care agent for first aid.