An ultra-expansible chitosan-silk fibroin miniaturized sponge loaded with tranexamic acid modified gelatin for...

The coagulation abnormalities, including complex and irregular bleeding surfaces and underlying coagulopathies in patients, are significant clinical cause of uncontrollable hemorrhage and death in accidental trauma. Herein, we have developed an ultra-expansible chitosan-silk fibroin miniaturized sponge (MS-GT) for delivering antifibrinolytic drug - tranexamic acid (TXA) to achieve in situ hemostasis of the first-aid wounds. TXA-modified gelatin was combined with the highly compressed functional chitosan-based sponge through strong hydrogen bonds, which stabilized sponge's compression state and made it easier to undergo thermosensitive dissolution to release its expansion potential. The MS-GT (∼ 3 mm³, thickness < 1 mm) could achieve a volume expansion of over 11 times within five seconds to seal complex and irregular deep wounds without the need for additional specialized instruments. In addition, the loaded TXA promoted the formation of fibrin to enhance hemostatic efficacy for overcoming the bleeding in coagulation disorders, including disseminated intravascular coagulation (DIC) and hemophilia B model, with significantly superior hemostatic effect comparing with bulk sponge and clinical collagen sponge. This chitosan-based MS-GT alleviated the formation of fibrous capsules in the liver during the post-hemostasis regeneration process, offering new insights for the development of emergency hemostatic materials.