Polysaccharide-based hemostats: recent developments, challenges, and future perspectives

Excessive hemorrhage is a leading cause of death to trauma patients, especially in combat and civilian accidents. The main priority in the medical treatment of trauma patients is to reduce excessive blood loss by applying an appropriate hemostat. However, some issues concerning biological safety, hemostatic efficacy, and the high cost of commercial products limit their adequate applications. Thus, the hemostats that are easily portable and effectively applied at the injury site must be used in military and critical care situations. The development of hemostatic products from polysaccharides for their promising application in wound healing is of immense academic and biomedical interest. This comprehensive review presents the most significant advancements in polysaccharide-based hemostats in the decade regarding their hemostatic mechanisms, the advantages and limitations, and the factors influencing the efficacy. The primary focus is on the progress in naturally derived polysaccharides such as cellulose, chitosan, starch, alginate, dextran, and hyaluronic acid and their derivatives for its hemostasis in wound healing. Future trends towards developing the polysaccharide-based hemostats and novel fabrication techniques such as electrospinning and 3D printing have been proposed with the challenges and promising opportunities in the wound healing hemostasis research. This review may serve as a guideline for future work to develop a hemostat with the rapid and efficient treatment of severe hemorrhage. Graphic abstract