Hemostatic Agents in Trauma Care

Uncontrolled bleeding remains the principal preventable cause of death following traumatic injury. Hemostatic agents are materials or formulations designed to arrest haemorrhage rapidly by enhancing the body’s natural clotting processes. They range from simple powders and dressings to advanced polymers and composites that combine procoagulant surfaces, fluid absorption and bioactive functionalities. Key strategies include concentration of clotting factors at the wound site, activation of platelets and fibrin cross-linking. Recent innovations focus on fully absorbable systems that degrade in situ, antimicrobial dressings that prevent infection, and shape-adaptive materials for irregular wound geometries. Such developments promise to improve survival in both prehospital and surgical settings worldwide by reducing blood loss, minimising secondary tissue damage and simplifying field application.

Research from Nature Portfolio

Recent studies have introduced absorbable nanofibrous hydrogels formed by imprinting chitosan within a degradable β-cyclodextrin polyester template. The resulting honeycomb-like mats present a greatly enlarged chitosan surface area to promote platelet adhesion and accelerate clot formation. In vivo experiments demonstrate significantly reduced blood loss and faster time to haemostasis compared with leading commercial dressings. Following physiological degradation of the polyester scaffold, only biocompatible chitosan remains, eliminating the need for dressing removal and reducing procedural time during emergency care.

Hemostatic Agents in Trauma Care publication trend

The graph below shows the total number of articles in hemostatic agents in trauma care across all publications each year (not limited to Nature Index journals).

Technical terms

Hemostasis: The physiological process of blood coagulation and vessel constriction that stops bleeding.

Hydrogel: A three-dimensional network of hydrophilic polymers capable of absorbing large volumes of water or biological fluids, used as wound dressings.

Polyurethane foam: A porous polymeric matrix that absorbs blood, concentrates clotting elements and provides structural support during haemostasis.

Thrombogenicity: The intrinsic ability of a material surface to initiate or propagate blood clot formation.

Biocompatibility: The characteristic of a material to interact with living tissue without eliciting adverse immune or toxic responses.

References

1. Absorbable hemostatic hydrogels comprising composites of sacrificial templates and honeycomb-like nanofibrous mats of chitosan. Nature Communications (2019).
2. Multifunctional Hydrogels Based on γ-Polyglutamic Acid/Polyethyleneimine for Hemostasis and Wound Healing. Biomaterials Research (2024).
3. Rapid synthesis of degradable ester/thioether monomers and their incorporation into thermoset polyurethane foams for traumatic wound healing. Acta Biomaterialia (2025).