Optimized Damage-Control Hydrogel for Wound and Organ Management in Emergency Abdominal Trauma.

Abdominal trauma remains a major cause of preventable death, primarily due to uncontrolled hemorrhage and infection. Conventional hemostatic agents often prove inadequate for noncompressible wounds and can cause secondary damage. To address this, we developed a bioinspired multifunctional hydrogel by engineering quaternized carboxymethyl chitosan (QCMCS) and oxidized hyaluronic acid (OHA). QCMCS enhanced cationic hemostasis, significantly reducing blood loss and accelerating clotting versus a commercial sponge. Dopamine-grafted OHA (OHA-Dop) provided strong wet tissue adhesion. The hydrogel demonstrated rapid hemorrhage control in rat liver models and potent antibacterial activity (>99% reduction against E. coli and S. aureus). It also promoted tissue healing by fostering a regenerative microenvironment and activating relevant signaling pathways. This design effectively bridges emergency hemostasis with infection prevention, offering a promising strategy for managing complex abdominal trauma.