An Injectable Rapid-Adhesion and Self-Expanding Underwater Hydrogel Adhesive with Biodegradation and Reinforced Hemostasis for Deep Noncompressible Hemorrhage Management

Advanced underwater adhesives with injectability and robustness show great promise in enhancing surgical success and improving patient outcomes. However, the development of hemostatic adhesives that are quick-acting, highly adhesive, long- lasting, and biocompatible remains a challenge when addressing hemorrhage. To tackle the problem, here, a novel idea is presented to develop a robust injectable hydrogel adhesive through continuous structural inheritance strategy made from a combination of biopolymers and crosslinked poly(acrylic acid). The sequential crosslinking strategy can make strong and tough interfaces with wet tissues to achieve fast and repeatable adhesion and outperform commercial hemostatic agents. The chemically-physically crosslinked hybrid nanocomposite underwater adhesive, characterized by its robustness and injectability, has shown promising results as an effective and safe sealant for improving the treatment of bleeding tissues in animal models such as rats, rabbits, and pigs. It is anticipated that our research introduces a novel strategy for developing desirable and promising adhesive hemostat candidates for diverse biological tissues in clinics.