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Hydrophilic hemostatic sponge plays an important role in trauma bleeding control because of its robust coagulant functions. However, its strong tissue adhesion can easily result in wound tear and rebleeding during removing the sponge. Herein, the design of a hydrophilic anti-adhesive chitosan/graphene oxide composite sponge (CSAG) that possesses stable mechanical strength, rapid liquid absorption and strong intrinsic/extrinsic coagulation stimulations, is reported. For one thing, CSAG exhibits outstanding hemostatic performance, which significantly outperforms two commercial hemostats in two in vivo serious bleeding models. For another, CSAG shows low tissue adhesion; its peeling force is approximately 79.3 % lower than the commercial gauze. Moreover, in the peeling process, CSAG triggers partial detachment of the blood scab, because of the exist of bubbles or cavities at the interface, allowing the CSAG to be easily and safely peeled off from the wound without rebleeding. This study opens new avenues in constructing anti-adhesive trauma hemostatic materials. [Display omitted] [ABSTRACT FROM AUTHOR]

Effective hemostasis for noncompressible bleeding has been a key challenge because of the deep, narrow, and irregular wounds. Swellable gelatin is an available hemostatic material but is limited by weak mechanical strength and slow liquid absorption. Herein, the design of a gelatin and graphene oxide (GO) composite sponge (GP-GO) that possesses stable cross-linked networks and excellent absorbability, is reported. The GP-GOs are constructed via the thermal radical polymerization technique, using methacrylate gelatin (Gel-MA) and poly(ethylene glycol) diacrylate (PEGDA) as the crosslinker, while GO is uniformly fixed in the network via the curing reaction to further strengthen the stability. The optimized GP-GO 5 with GO addition (5 wt%) exhibits high porosity (> 90%), distinguished liquid absorption rate (106 ms), rapidly responsive swelling (422% expansion within 10 s), and stable mechanical properties. The addition of GO effectively reinforces coagulation stimulation of GP-GOs though the stimulation of platelets and the enrichment effect at the interface, significantly reducing the blood coagulation index (BCI) (< 17.5%). Hemostatic mechanism study indicated the liquid absorbability of GP-GOs is the critical foundation to trigger the subsequent physical expansion, blood cells enrichment, and coagulation stimulations. Besides, GP-GO 5 exhibits excellent biosafety assessed by hemolysis and cytotoxicity. Under the synergistic effects, the biocompatible GP-GO 5 showed excellent hemostatic properties in the hemostasis of severe bleeding and noncompressible wounds compared with a pure gelatin sponge (GP) and the commercial hemostatic agent Celox™. This study demonstrated a promising candidate for practical application of noncompressible wound hemostasis. [Display omitted] • A series of GP-GOs with stable covalently cross-linked networks are prepared. • GO efficiently reinforces liquid absorption and coagulation stimulation of GP-GO. • Absorbability of GP-GO is critical for its multi-mechanism synergistic hemostasis. • Hemostasis of GP-GO for noncompressible wound significantly outperforms the hemostat. [ABSTRACT FROM AUTHOR]