Natural coagulation inspired RBCs-structural inheritance microgels hybrid featured with quasi-bicontinuous structure for junctional hemostasis.

Junctional hemorrhage is a major prehospital care challenge, causing 67 % of preventable deaths. In addition, the high risk of secondary hemorrhage during transportation remains a challenge for long-term wound protection. Present hemostatic materials can't simultaneously achieve "anti-high-pressure, fast hemostasis and stable blockage". Inspired by coagulation process, positively charged dense cross-linked structure-inherited microgels (PEDM) were prepared. PEDM hybrid blood form quasi-bicontinuous composite structure (Q-Bi CS), utilizing blood realize rapid anti-high-pressure hemostasis and stable protection. PEDM can self-gel within 15 s when contact with blood, mimicking primary hemostasis to form a quick mechanical blockage. Blood cells are concentrated within 50 s, which promotes the Q-Bi CS formed in 120 s. Compared to PEDM-PBS, the compression modulus of PEDM-blood is improved by 5.4 times, achieving robust blockage. Q-Bi CS showed stable dynamic adhesion with strength maintained at 90.1 % after 200 cycles. In the rabbit femoral artery hemorrhage model, PEDM can achieve rapid hemostasis within 61 s and prevent secondary hemorrhage. PEDM even controlled porcine iliac artery hemorrhage within 30 s. In this paper, the self-gelling of PEDM matches with coagulation process, and blood is incorporated as the reinforcing phase into the Q-Bi CS, overcoming the difficulty of junctional hemostasis.