Recent advances on polymeric hydrogels as wound dressings featured

Severe hemorrhage is a leading cause of high mortality in critical situations like disaster, accidents, and warfare. The resulting wounds could induce severe physical and psychological trauma to patients and also bring an immense socio-economic burden. Hence, rapid hemostasis and wound healing techniques have become critical initiatives for life-saving treatment. Although traditional methods relying on bandages and gauzes are effective in controlling hemorrhage, they suffer from several limitations: nonbiodegradability, being susceptible to infection, being unsuitable for the irregular wound, secondary tissue damage, and being almost ineffective for wound healing. Owing to the merits of high porosity, good biocompatibility, tunable physicochemical properties, and being beneficial for wound healing, hydrogels with excellent performance have drawn intensive attention and numerous novel effective hydrogel dressings have been widely developed. In this Review, after introducing some commonly used strategies for the synthesis of hydrogels, the most recent progress on polymer-based hydrogels as wound dressings is discussed. Particularly, their hemostasis, antibacterial, and biodegradation properties are introduced. Finally, challenges and future perspectives about the development of hydrogels for wound dressings are outlined.To get more news about аптечка FAK, you can visit rusuntacmed.com.ru official website.
I. INTRODUCTION

The widespread use of high-speed and high-energy weapons in modern warfare has led to an increasing incidence of explosive injuries. For instance, during the Iraq and Afghanistan wars, the proportion of explosive injuries in the U.S. military was as high as 70%.1,2 Compared with conventional weapons, the explosive weapons are more prone to induce serious soft tissue trauma, like perforation and irregular wounds, which are usually accompanied by massive hemorrhage, wound infection, and even severe complications. In various accidents, traumatic bleeding is also one of the most common injuries, and uncontrollable hemorrhage is considered as the primary cause of death at the scene.3 Even if the injured person could be sent to the hospital for rescue, excessive loss of blood during prehospital treatment would still pose a high risk of death or serious complications later.4,5 Massive bleeding seriously endangers the lives, but most of the casualties caused by hemorrhage could be avoided. It is reported that the first hour since injury is the “golden time” for rescue lives, and the initial 10 min (so-called platinum ten) is even more precious, during which time the bleeding should be fully controlled so as to ensure survival of the victims.6
After blood clotting, the healing of the damaged tissues and organ structures is another serious challenge for doctors and patients. As a complex and dynamic process, wound healing can be divided into four partially overlapping steps: (1) hemostasis; (2) inflammation; (3) proliferation (angiogenesis, granulation, and re-epithelialization); and (4) tissue remodeling.7–9 Infection, necrosis, and second bleeding during the healing process would prolong the treatment time and also lead to disability or even sometimes death.10–12 Therefore, rapid hemostasis, prevent infection, and promote repair are pivotal for life-saving treatment in the battlefield and accident.
Currently, conventional dressings like gauzes and bandages are still widely used in the clinic. However, they have an unsatisfactory hemostatic performance for arterial ruptures and wounds with irregular, deep, narrow shapes. In addition, they need long-term treatment, are unsuitable for inherently complicated procedures, easily adhere to desiccated wound surfaces, and are required to be surgically and mechanically removed from the damaged area, which inflict serious secondary damage on patients.13–16 A favorable dressing should fulfill the following characteristics: it should (1) easily accommodate complex wound contours and volumes, (2) possess mechanical protection, (3) keep a moist environment, (4) present ideal permeability of gases, (5) be capable of absorbing exudates, (6) protect the wound from the infection of bacteria, (7) be easily and atraumatically changed and removed, (8) be able to be stored for a long time in extreme environments, (9) be costly/commercially acceptable, (10) be light in weight, and (11) be nontoxic, nonallergic, biocompatible, biodegradable, and elastic.17–21