Silk Fibroin-Based Hemostatic Sealant with Robust Wet Adhesion and High Burst Pressure Resistance for Arterial Bleeding Control.

High-pressure arterial bleeding is a life-threatening condition that can rapidly lead to hemorrhagic shock or death. However, effective noncompressive hemostatic strategies for managing such bleeding remain a significant clinical challenge. To address this, we developed a Janus-structured silk fibroin-based sealant (designated SFM@STF) for rapid hemostasis. The SFM@STF sealant features a bilayer structure: an adhesive silk fibroin/tannic acid/fibrin (STF) layer and a supportive silk fibroin membrane (SFM) layer. The STF layer, designed to mimic the underwater adhesion of mussel proteins via a double-network hydrogel incorporating hydrophobic and catechol groups, ensures robust bonding to wet tissues. In contrast, the SM layer, comprising densely packed crystalline β-sheet structures, offers mechanical robustness. The resulting SFM@STF sealant demonstrated remarkable wet tissue adhesion strength (43.43 ± 8.42 kPa), coupled with superior structural stability, high burst pressure resistance, and a low swelling ratio. Excellent cytocompatibility and a low hemolysis rate were also confirmed. In arterial injury models, SFM@STF rapidly achieved hemostasis in high-pressure wounds. Furthermore, it continuously promoted endothelial regeneration without inducing thrombosis. This Janus-structured SFM@STF sealant, with its robust wet adhesion and rapid hemostatic performance, presents a promising strategy for managing high-pressure arterial bleeding in clinical settings.