Trauma Surgery

Self-gelling particulate embolic provides precise, durable occlusion in collateralized hemorrhagic vessels (preclinical)

This study introduces a hydration-driven self-gelling polyethylenimine/poly(acrylic acid) particulate embolic (PP/DMSO/I) for hemorrhagic vessels with collateral circulation. DMSO delivers size-sieved particles to target vessels, where they become mechanically trapped, then hydrate and fuse into a continuous in situ hydrogel cast. In a rabbit mesenteric collateral hemorrhage model, PP/DMSO/I achieved lower blood loss than commercial particulates and matched liquid embolic hemostatic efficacy. Unlike liquid embolics, PP/DMSO/I avoided nontarget embolization and distal infarction while maintaining stable luminal occlusion. These findings suggest a potential future option for endovascular control of complex hemorrhage requiring both precision and durable vessel closure. 1

Ultrasound-guided injectable hydrogel achieves hemostasis in deep, incompressible visceral wounds (preclinical)

Investigators developed an injectable bio-based hydrogel (OPH) for ultrasound-guided hemostasis in deep, non-compressible visceral injuries. OPH forms instantly at room temperature via Schiff-base cross-linking in a dual-syringe system, without heat or light activation. The material reached wet adhesion around 45 kPa, withstood 123 mmHg bursting pressure in intestinal wounds, and showed antibacterial activity against common pathogens. In rabbit lethal liver injury models, ultrasound-guided OPH injection effectively sealed wounds and controlled bleeding, performing comparably or better than commercial hemostats. These data support injectable, image-guided hydrogels as a platform concept for managing torso hemorrhage when rapid surgical exposure is limited. 2

Biomarker-enriched KDIGO kidney protection bundles reduce moderate-to-severe AKI after major surgery

This individual participant data meta-analysis combined four randomized trials of KDIGO-based kidney protection strategies after major surgery. High-risk patients, identified using renal biomarkers, were randomized to a kidney protection bundle or usual care. The bundle included hemodynamic and fluid optimization, nephrotoxin and contrast avoidance, close kidney function monitoring, and glycemic control. Among 1,851 patients, stage ≥2 AKI within 72 hours occurred in 17.7% with the bundle versus 27.1% with standard care (OR 0.55, 95% CI 0.44–0.70). When reported, the intervention also tended to reduce persistent AKI and renal tubular stress biomarkers. These results support implementing structured kidney protection protocols in biomarker-identified high-risk perioperative patients, including trauma and emergency surgery populations. 3