Double-network structure sponge with enhanced mechanical properties, procoagulant potential, and 3D printability for acute hemorrhage

In pre-hospital care, achieving rapid and effective hemostasis for arterial rupture and visceral perforation wounds remains a critical challenge. Herein, we have developed a macroporous sponge with double-network structure using foaming technique, chemical and physical crosslinking reactions, and lyophilization. The prepared sponge not only demonstrates outstanding water absorption and water-triggered shape recovery capacity, but also exhibits significantly enhanced mechanical properties due to the construction of double-network structure. Simultaneously, the sponge shortens blood clotting time (from 1354.3 ± 41 s to 473 ± 28 s) by concentrating blood components and regulating coagulation pathways. Particularly, the sponge possesses excellent 3D printability and can be additively manufactured through DIW technique while maintaining favorable physical properties and procoagulant potential. Animal experiments have shown that sponges prepared by different processing method exhibit desirable hemostatic performance in SD rat/rabbit liver volume defect and artery complete transection hemorrhage. The construction of double-network provides promising avenue for developing high-performance sponge for massive and noncompressible hemorrhage, and the proposed DIW printing strategy for hemostatic sponge may revolutionize processing methods and provide a potentially feasible approach for designing and preparing customized sponges.