Strongly-adhesive hyaluronic acid/ε-PL aerogel for rapid hemostasis of life-threatening arterial bleeding and on-demand atraumatic removal

Effective management of traumatic hemorrhage requires not only rapid blood loss control but also facile removal of hemostatic materials after hemostasis to minimize secondary tissue damage. Herein, we fabricated a strongly adhesive aerogel OPA based on Schiff-base crosslinking of oxidized hyaluronic acid (OHA) and ε-polylysine (ε-PL), enabling rapid hemostasis in lethal arterial trauma and facile on-demand removal via phase transition to minimize secondary tissue damage. OPAs featured tunable porosity and rapid blood absorption. Moreover, the surface abundant hydroxyl, amino and carboxyl groups promoted strong hydrogen bonding interactions with tissues, blood cells and plasma proteins, enhancing tissue adhesion as well as platelet capture and activation. In the rabbit femoral-artery-injury model, OPA4 significantly shortened hemostatic time by ~80% and reduced blood loss to 38% of that in the blank group. Notably, OPAs retained only 2% of initial adhesion after hydration, allowing for gentle removal. OPAs also demonstrated excellent antibacterial activity, biocompatibility and biodegradability. Their simple one-step freeze-drying process and tailorable material shapes offered great promise for scalable production and versatile applications. Therefore, this study provides a versatile strategy for emergency and surgical hemostasis by combining rapid control of life-threatening arterial bleeding with on-demand atraumatic removal, promising to improve patient outcomes and streamline postoperative care.