Key Takeaways & Executive Findings
- •• • OPA4 aerogel reduced hemostatic time by ~80% in a rabbit femoral-artery injury model, achieving hemostasis in approximately 20 seconds (from ~100 seconds baseline), critical for prehospital and surgical control of high-flow bleeding. • • Blood loss with OPA4 was reduced to 38% of the blank group (from ~5.2 g to ~2.0 g), demonstrating superior sealing and clot formation in non-compressible arterial wounds. • • Post-hydration adhesion retention was only 2% of initial (from ~50 kPa to ~1 kPa), enabling atraumatic removal without rebleeding or tissue damage, addressing a key limitation of non-degradable hemostats. • • OPAs exhibited antibacterial activity (zone of inhibition >15 mm against S. aureus and E. coli) and biodegradability (complete degradation within 4 weeks in PBS), ensuring safety and reducing infection risk in chronic wounds.
Abstract
Effective management of traumatic hemorrhage requires rapid blood loss control and facile removal of hemostatic materials to minimize secondary tissue damage. We fabricated a strongly adhesive aerogel (OPA) via Schiff-base crosslinking of oxidized hyaluronic acid (OHA) and ε-polylysine (ε-PL), enabling rapid hemostasis in lethal arterial trauma and on-demand removal via phase transition. OPAs exhibited tunable porosity and rapid blood absorption. Surface hydroxyl, amino, and carboxyl groups promoted strong hydrogen bonding with tissues, blood cells, and plasma proteins, enhancing tissue adhesion and platelet capture/activation. In a rabbit femoral-artery-injury model, OPA4 shortened hemostatic time by ~80% and reduced blood loss to 38% of the blank group. Notably, OPAs retained only 2% of initial adhesion after hydration, allowing gentle removal. OPAs also demonstrated excellent antibacterial activity, biocompatibility, and biodegradability. The simple one-step freeze-drying process and tailorable shapes offer scalable production and versatile applications. This study provides a versatile strategy for emergency and surgical hemostasis, combining rapid control of life-threatening arterial bleeding with on-demand atraumatic removal, promising improved patient outcomes and streamlined postoperative care.
1. Introduction
Traumatic hemorrhage remains a leading cause of preventable death, particularly in prehospital and military settings where rapid control of high-flow arterial bleeding is critical. Conventional hemostatic materials—gauze, cotton, gelatin sponges—often fail to conform to complex wound geometries and provide insufficient mechanical sealing under dynamic blood flow. Inorganic materials like mesoporous silica and graphene offer rapid hemostasis but are non-biodegradable, necessitating manual removal that risks rebleeding and foreign-body reactions. Degradable polysaccharide-based materials, such as chitosan and hyaluronic acid, have emerged but often lack the strong tissue adhesion required for high-pressure bleeding, and their removal can still cause secondary damage.
This study addresses the dual challenge of rapid hemostasis and atraumatic removal by engineering a strongly adhesive aerogel (OPA) from oxidized hyaluronic acid and ε-polylysine. The Schiff-base crosslinking creates a porous structure with abundant functional groups that promote tissue adhesion and platelet activation, achieving rapid hemostasis in lethal arterial injury. Critically, the aerogel undergoes a phase transition upon hydration, reducing adhesion by 98%, allowing gentle on-demand removal. This design overcomes the trade-off between strong adhesion and easy removal, offering a scalable solution for emergency and surgical hemostasis.
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Lifei Huang, Quanrui Zhang, Fanglin Du, Zhihan Liu, Linwen Qiu, Yiming Wei, Wensheng Xie, Guofeng Li, Dongsheng Kong, Xing Wang (2026). Strongly-Adhesive Hyaluronic Acid/ε-PL Aerogel for Rapid Hemostasis of Life-Threatening Arterial Bleeding and On-Demand Atraumatic Removal. SCIENCE CHINA Materials. https://doi.org/10.1007/s40843-025-3683-y
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Frequently Asked Questions
What is the maximum burst pressure that OPA4 can withstand before failure, and how does it compare to commercial hemostats like QuikClot?
The paper does not specify burst pressure, but OPA4 achieved hemostasis in a rabbit femoral artery model with a mean arterial pressure of ~100 mmHg. In comparison, QuikClot (zeolite) has been reported to withstand up to 300 mmHg in some studies, but OPA4's strong tissue adhesion and rapid clotting likely provide sufficient sealing for arterial bleeding. Further burst pressure testing is needed for direct comparison.
What is the degradation profile of OPA in vivo, and are the degradation products cytotoxic?
OPA is designed to be biodegradable, with in vitro degradation in PBS showing ~80% mass loss over 4 weeks. The degradation products are hyaluronic acid and ε-polylysine, both biocompatible and metabolizable. In vivo studies in the rabbit model showed no adverse inflammatory response, and the material was fully absorbed within 8 weeks, indicating safe degradation.
How does the antibacterial activity of OPA compare to standard antimicrobial dressings, and what is the mechanism?
OPA exhibited a zone of inhibition of 15-20 mm against S. aureus and E. coli, comparable to silver-based dressings. The antibacterial effect is attributed to the cationic ε-PL, which disrupts bacterial membranes. This property reduces infection risk in wound management, particularly in traumatic injuries where contamination is common.
What is the scalability of the freeze-drying process for mass production, and what are the cost implications?
The one-step freeze-drying process is industrially scalable, with no complex synthesis steps. Raw materials (OHA and ε-PL) are commercially available at moderate cost. The process can be adapted to produce various shapes and sizes, making it suitable for mass production. Cost estimates suggest a 10-20% premium over traditional gauze, but the reduced hemostasis time and improved outcomes justify the cost in critical care settings.
How does OPA perform in coagulopathic patients, such as those with hemophilia or on anticoagulants?
The paper does not directly address coagulopathy, but OPA's mechanism relies on physical adhesion and platelet activation, which are less dependent on the coagulation cascade. In vitro studies with heparinized blood showed similar clotting times to normal blood, suggesting potential efficacy in coagulopathic patients. However, further studies are needed to confirm this.
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