Decellularized pomelo albedo powder as a potential eco-friendly hemostatic material for treating non-compressible concealed hemorrhage.

Current research on hemostatic materials primarily focuses on controlling bleeding. However, occult bleeding, an unavoidable internal bleeding following trauma or surgery, can lead to a rapid decline in the haemoglobin levels, progressing to anemia or even death. In this study, we propose the use of cellulose-rich pomelo albedo powder (PP) as a potential eco-friendly hemostatic agent for treating occult bleeding. First, the cellulose-rich pomelo albedo was decellularized to remove cellular contents (including nucleic acids, intracellular proteins, and pectin), resulting in a loose, porous, and honeycomb-like structure. The pomelo was subsequently cryo-ground and sieved to produce decellularized pomelo albedo powder (DPP) in various particle sizes. In vitro cell experiments demonstrated the good biocompatibility of DPP across particle sizes. Upon contact with blood at tissue surfaces, DPP rapidly absorbs fluids and concentrates coagulation factors, while its surface charge and bioactive components promote platelet aggregation and thrombin generation. In vitro bleeding assays showed that DPP exhibited significantly enhanced procoagulant performance due to rapid blood-cell aggregation. Moreover, in models of liver injury, femoral vein injury, and tail amputation, the DPP200 treatment group showed reduced bleeding volume and suppressed occult bleeding. These findings indicate that DPP can serve as an inexpensive, eco-friendly, and effective hemostatic material, offering a novel approach for treating occult bleeding.