Abstact: Uncontrolled hemorrhage is the leading factor causing death in military trauma and clinical practice and is usually accompanied with bacterial infection. The fabrication of a functional hemostatic sponge for combating bacteria is of vital importance. Poly(hexamethylene biguanide) hydrochloride (PHMB) has been shown to have a remarkable bactericide effect. However, PHMB after use might have a toxic effect on humans. Herein, a powerful surface-adaptive, on-demand antibacterial hemostatic sodium alginate/gelatin sponge is fabricated by sequential spray-assisted layer-by-layer assembly of PHMB and hyaluronic acid (HA). The HA upper layer could endow the coating surface with better biocompatibility under physiological conditions. Once bacteria invade, the secreted hyaluronidase could degrade the upper HA layer, and then the exposed PHMB layer could kill the bacteria. The coated sponge shows excellent biocompatibility, as negatively charged HA can prevent the exposure of bactericidal PHMB. Moreover, the coated sponge exhibited excellent hemostatic properties in vitro and in vivo by aggregating and activating blood cells. Our strategy provides a novel approach to the design of surface-adaptive and on-demand bactericidal coatings on the surface of hemostatic sponges, which has the advantage of avoiding infection complications during hemostasis.

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