Abstract
Traumatic injuries in resource-limited settings, such as remote, rural, or disaster-affected environments, require wound care solutions that can effectively address hemorrhage, infection, and pain outside of traditional clinical infrastructure. We developed a field-polymerizable hydrogel wound dressing capable of delivering tranexamic acid (hemostatic), vancomycin and tobramycin (broad-spectrum antibiotics), and lidocaine (analgesic) directly to the site of injury. Using computational modeling, we designed a lightweight, rugged hydrogel that polymerizes rapidly with potable water and conforms to irregular wound beds. The system demonstrated burst release of hemostatic and analgesic agents and sustained antibiotic release over four days. In vitro and in vivo testing confirmed the hydrogel’s ability to stabilize clots, prevent fibrinolysis, and eradicate polymicrobial gram-positive and gram-negative bacterial infections in a murine model of open fracture. Large animal studies further validated its translational potential in a large, complex wound. This modular, multifunctional platform provides a field-ready solution for wound management in austere environments, with the potential to reduce infection, control bleeding, and improve wound stabilization when access to definitive care is delayed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-37521-y.