Dual-Oxidation Bacterial Cellulose Sponges with Rapid Shape Recovery for Crosslinker-Free Noncompressible Hemostasis and Tissue Regeneration.

Abstract

Non-compressible hemorrhage (NCH) caused by deep tissue injury remains a major cause of trauma-related death. Developing hemostatic materials with rapid expansion, effective coagulation promotion, good biocompatibility, and tissue regeneration is still urgently needed. This study reports a simple regioselective dual-oxidation (RDO) strategy for fabricating crosslinker-free hemostatic sponges from bacterial cellulose (BC) with high porosity. Carboxyl and aldehyde groups were both introduced into the BC scaffold after TEMPO-mediated oxidation and sodium periodate oxidation. The dual-oxidation BC (DOBC) sponges retained the 3D nanofibrous architecture and rapid shape recovery, associated with aldehyde-driven hemiacetal network formation and enhanced blood interactions. Meanwhile, the sponges exhibited favorable mechanical properties, excellent biocompatibility, high liquid absorption capacity, antibacterial activity, and rapid whole-blood coagulation. Notably, DOBC sponges effectively enrich red blood cells and platelets, further promoting rapid hemostasis. In vivo studies demonstrate that DOBC sponges effectively control bleeding in rat models of NCH and outperform gauze and commercial gelatin sponges. Moreover, they promoted cell infiltration, angiogenesis, and liver tissue regeneration. This study proposes a simple dual-oxidation, crosslinker-free strategy for preparing hemostatic sponges, thereby offering a promising solution for rapid hemostasis and subsequent tissue repair in non-compressible wounds.