An ultrafast water absorption composite cryogel containing Iron-doped bioactive glass with rapid hemostatic ability for non-compressible and coagulopathic bleeding

Traditional hemostatic materials have limited hemostatic effect on non-compressible wound, that is likely to develop into coagulopathy and leads to high mortality. As a powerful hemostatic material, in addition to having the function of forming solid physical barriers and effectively activating coagulation factors to rapidly control hemostasis, it should also has the ability to bypass the coagulation pathway to handle the bleeding of coagu-lopathic patients. In this work, we designed a QCOC composite cryogel by gelation of quaternized chitosan (QCS) and hydroxyethyl cellulose oxide (OHEC) at low temperature. Meanwhile, iron-doped bioactive glass (FeBG) as an active substance was introduced into the QCOC composite cryogel to promote erythrocyte aggregation by ion dissolution and activate intrinsic and extrinsic pathways. QCOC/FeBG composite cryogel had interconnected macroporous structure, ultrafast water absorption performance (reaching water absorption saturation in 4 s) and good shape memory properties (restoring to its original shape in 1 s). Additionally, the composite cryogel showed excellent antibacterial properties against S. aureus and E. coli as well as good cell biocompatibility. Furthermore, the QCOC/FeBG composite cryogel showed excellent hemostatic performance in the model of liver non -compressible hemorrhage with coagulation disorders, and the hemostasis time and blood loss were 60.87 & PLUSMN; 2.09 s and 366.38 & PLUSMN; 32.69 mg respectively, which were much lower than commercial gelatin sponge (196.62 & PLUSMN; 19.02 s and 1439.37 & PLUSMN; 165.27 mg). These results proved that QCOC/FeBG composite cryogel has excellent hemostatic properties, antibacterial properties, portability and usability, indicating a great potential as a timely hemostatic material in daily civil and military hemostasis.