An anti-infective and pro-coagulant chitosan-based composite sponge with shape memory for effective hemostasis in multi-tissue defects

The development of an anti-infective and pro-coagulant sponge with shape memory for hemostasis in multi-tissue defects remains a challenge. Herein, a novel composite sponge was developed using quaternized and phosphated chitosan, disuccinimide carbonate modified polyethylene glycol, and attapulgite. The sponge featured a macroporous structure, sufficient mechanical strength, high affinity for water and blood, and shape recovery when exposed to water and blood. The sponge promoted blood cell adhesion, aggregation, and activation, as well as the activation of intrinsic and extrinsic coagulation pathways. The sponge exhibited potent antibacterial efficacy against Staphylococcus aureus and Escherichia coli in a bacteria-infected rat skin defect model. More importantly, the biocompatible sponge demonstrated superior hemostatic capacity than commercial hemostats in rat femoral artery injury, rat liver and rabbit femora defect models. The developed sponge shows great potential for hemostasis and anti-infection in multi-tissue defects. This study provides a new strategy for designing and preparing novel chitosan-based hemostatic sponges.