LAUSR

Abstract Excessive blood loss is one of the leading causes of death in trauma, and developing injectable and antibacterial shape-memory hemostatic materials with high blood absorption ratio and fast shape recovery for noncompressible torso hemorrhage (NCTH) remains challenging. Herein, we prepared an injectable hemostatic sponge with shape memory property, high elasticity, high blood absorption ratio, and antibacterial activity engineered from the skin secretion of Andrias davidianus (SSAD), cellulose nanocrystals (CNCs), and cellulose nanofibers (CNFs). The good biocompatibility of the obtained SSAD@CNC/CNF sponges (SSAD-CSs) was confirmed via cytotoxicity and hemocompatibility tests. Their excellent hemostasis ability was demonstrated in vitro via a blood-clotting assay, and their antibacterial effect was demonstrated via a bacterial contact-killing assay. Furthermore, the composition of the SSAD-CSs to achieve the best performance was determined by in vivo and in vitro experiments. SSAD-CS with CNF:SSAD@CNC = 4:1 wt% (SSAD-CS3), which showed sufficient mechanical strength and high resilience after absorbing liquid, and when applied onto the wound, it rapidly absorbed blood and reverted to its original shape within 3 s. In addition, SSAD-CS3 showed excellent hemostatic properties in an incompressible animal bleeding model compared with a pure cellulose sponge (CS) and a gelatin sponge. This study revealed the great potential of the novel SSAD-CSs formulation for the treatment of NCTH.