Development of an Injectable Polyelectrolyte Complex and Bacterial Cellulose Hemostatic Sponge for Non-Compressible Wounds

Abstract

Severe blood loss during emergencies causes trauma, a decrease in oxygen level, dysfunctional organs, and can even lead to unexpected death. Therefore, among combatants and civilians, hemorrhage is a major concern. In case of irregularly shaped deep wounds, external pressure cannot be applied with pre-developed hemostatic agents (for example, tourniquets or cotton gauze). In this study, a hemostatic sponge developed from a polyelectrolyte complex and bacterial cellulose (PEC-C) with shape-recovery property has been developed through a lyophilization process. The PEC-C sponge exhibits excellent fluid absorption due to its nanofibrous structure. The porous structure of the sponges facilitates rapid blood absorption and maintains a moist surrounding environment, thereby enhancing the wound healing process. The ionic bond between the positively charged amino group and the negatively charged carboxyl group leads to the formation of nanofibers, resulting lowest blood clotting index within 10 seconds. The sponge has exhibited an improved mechanical property of 0.48±0.25 MPa, attributed to the hydrogen bonding between PEC and cellulose. These sponges can recover to their original shape by coming in contact with fluid in less than 5 seconds. The quick shape recovery will help create extra force by expanding to prevent excessive blood loss in case of severe bleeding. The PEC-C sponges can be injected into irregularly shaped deep wounds that occur in cases of arterial bleeding. The excellent hemostatic property is attributed to the numerous blood cells and platelets that adhere to the surface of the developed hemostatic biomaterial. Also, the sponges are highly hemocompatible (<5%) and cytocompatible (>80%), therefore, show excellent potential in clinical translational as a hemostatic device. An in vitro cell migration assay has also been performed to evaluate the wound healing capability of the developed sponges. The sponges resulted in the migration of L929 fibroblasts within 48 hours of cell seeding. The fabricated PEC-C sponges exhibit potential as a rapidly clotting hemostatic device for hemorrhage with wound healing properties.