Polymer-Based Antibacterial Hemostatic Sponges: Modification Strategies, Antibacterial Mechanisms, and Clinical Translation

Abstract

In trauma emergencies, rapid hemostasis and effective infection control are critical strategies to reduce mortality, as uncontrolled bleeding and infection remain the primary causes of early death in trauma patients. Antibacterial hemostatic sponges, as a class of promising biomaterials, have been extensively investigated and clinically applied over the past decade, which may provide simultaneous control of bleeding and local bacterial burden, and may contribute to improved wound management. This review systematically summarizes recent advances in two major categories of polymeric hemostatic sponges: those with intrinsic antibacterial activity derived from the inherent properties of polymer matrices, and polymer-based sponges functionalized with exogenous antibacterial agents. We focus on elaborating their fabrication strategies, optimized component formulations, in vitro and in vivo antibacterial efficacy, hemostatic performance, and biological performance, including hemocompatibility, cytotoxicity, and tissue compatibility. Moreover, we further discuss the current challenges and bottlenecks faced by such materials, such as the trade-off between high antibacterial activity and good biocompatibility, insufficient mechanical strength in wet environments, and lack of long-term antibacterial durability. This work aims to provide comprehensive insights and theoretical guidance for the rational design and development of next-generation high-performance antibacterial hemostatic sponges for clinical translation.