Dual Functionalized Absorbable Hairy Cellulose-Based Fabric for Efficient Hemostasis and Antibacterial Property

Uncontrolled hemorrhage and subsequent infection at the injury sites are major causes of trauma-related mortality. Herein, we present a novel approach to creating a multifunctional biodegradable textile fabric with hemostatic and antibacterial properties, synthesized through chemical modification, including etherification, oxidation (aldehyde), and amination via a Schiff-based reaction between octadecyl ammonium and oxidized cellulose, followed by calcium ion cross-linking. The fabric demonstrated significant antibacterial efficay against both gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria, validated through assays such as colony counting, minimum inhibitory concentration (MIC), scanning electron microscopy, and fluorescent staining using Acridine Orange and Propidium Iodide. In vitro assessments demonstrated superior performance compared to commercial alternatives in red blood cell attachment (90%), blood clotting index (6%), platelet adhesion, and clotting time (20s) (P-value < 0.001). In vivo studies using a Wistar rat liver injury model confirmed the fabric's effectiveness, reducing bleeding time (3.1 and 6.2-fold) and blood loss (1.2 and 5.48-fold) compared to available commercial hemostatic agents. Pathological, hematological, and biochemical analyses demonstrated the biocompatibility and biodegradability of our developed material with no evidence of systemic toxicity, significant localized inflammatory reactions in the liver, renal, or skin tissues, or vascular thrombosis stimulation.