Rational design of porous starch/hyaluronic acid composites for hemostasis

Effective hemorrhage control is pivotal for decreasing the trauma death both in civilian and military but has proven to be dauntingly challenging, especially for solid viscera and artery trauma. Here we report the fabrication of a novel starch-based hemostat, sodium trimethaphosphate (STMP)-crosslinked starch/hyaluronic acid (HA) (ScSH) porous composites. Aiming at hemostatic potential, physicochemical properties, cytocompatibility, hemocompatibility, histocompatibility and hemostatic performance of ScSH composites have been studied. As it turned out, the incorporation of HA greatly improved the water absorption capacity and hemostatic performance of ScSH composites. In addition, the composites with a non-toxic crosslinker exhibited non-cytotoxicity, low hemolysis ratio (0.97%) and favorable histocompatibility. Meanwhile, the composites performed exceptionally well in blood clotting of superficial injury, solid viscera and artery trauma and displayed similar hemostatic efficacy to commercialized hemostat (Quickclean® particles). Unambiguously, these encouraging results highlighted potential of our materials to be used as hemostats and made the approach, constructing porous starch/HA composites, a promising strategy to accelerate further development of hemostatic agents applied both in vivo and in vitro.