Emergent and long-term hemorrhage control is requisite and beneficial for reducing global mortality and postoperative complications (e.g., second bleeding and adverse tissue adhesion). Despite recent advance in injectable hydrogels for hemostasis, achieving rapid gelation, strong tissue-adhesive property and stable mechanical strength under fluid physiological environment is still challenging. Herein, we developed a novel chitosan hydrogel (CCS@gel) via dynamic Schiff base reaction and mussel-inspired catechol chemistry. The hydrogel possessed high gelation rate (<10 s), strong wet adhesiveness, excellent self-healing performance and biocompatibility. More importantly, the CCS@gel exhibited saline-induced contractile performance and mechanical enhancement, promoting its mechanical property in moist internal conditions. In vivo studies demonstrated its superior hemostatic efficacy for diverse anticoagulated visceral and carotid bleeding scenarios, compared to commercialized fibrin glue. The hydrogel-treated rats survived for 8 weeks with minimal inflammation and postoperative adhesion. These results revealed that the promising CCS@gel would be a facile, efficient and safe sealant for clinical hemorrhage control.

紧急和长期的出血控制对于降低总体死亡率和术后并发症（例如，二次出血和不良组织粘连）是必要且有益的。尽管近年来用于止血的可注射水凝胶取得了进展，但在流体生理环境下实现快速凝胶化、强组织粘附性和稳定的机械强度仍然具有挑战性。在此，我们通过动态席夫碱反应和受贻贝启发的儿茶酚化学开发了一种新型壳聚糖水凝胶（CCS@gel）。该水凝胶具有高凝胶速率（<10 s）、强湿粘附性、优异的自修复性能和生物相容性。更重要的是，CCS@gel 表现出盐水诱导的收缩性能和机械增强，提高了其在潮湿内部条件下的机械性能。体内研究表明，与商业化的纤维蛋白胶相比，其对于各种抗凝内脏和颈动脉出血情况具有卓越的止血功效。水凝胶治疗的大鼠存活了 8 周，炎症和术后粘连最小。这些结果表明，有前途的 CCS@gel 将成为一种用于临床出血控制的简便、有效和安全的密封剂。