Hydrogel sealants in hemostasis: A review of natural, synthetic, and composite biological macromolecules

Hemostasis is a critical component in trauma management and surgical procedures. Advanced hemostatic technologies not only significantly reduce blood loss and lower the incidence of postoperative complications but also promote tissue repair, thereby improving patient outcomes. Despite the widespread clinical use of traditional hemostatic materials, they still exhibit notable limitations in terms of efficacy and safety. In recent years, sealants, as a new generation of hemostatic materials, have gained extensive clinical application due to their unique advantages, including rapid hemostasis, reduced infection risk, and enhanced tissue regeneration. Among these, hydrogel sealants stand out for their superior physicochemical properties and biocompatibility, making them highly promising. This review systematically explores the latest research advancements in hydrogel sealants for hemostasis, focusing on their mechanisms of action, material design strategies, and current clinical applications. Hydrogel sealants are categorized into three types-natural, synthetic, and composite-for comparative analysis. Furthermore, we delve into the pivotal roles of hydrogel sealants in various clinical scenarios. Finally, we address the challenges encountered in the translation of hydrogel sealants from fundamental research to clinical practice, aiming to propel their innovation and advance into the next stage.