A shape-transforming hemostatic system for lethal massive hemorrhage via a confine-and-concentrate mechanism.

Uncontrolled bleeding remains a critical clinical challenge in trauma, surgery, and other clinical scenarios due to the risk of rapid blood loss and associated complications. This study develops a bio-based hemostatic combination (SCT) that undergoes morphology-driven transformation to enable blood confinement, capture, and tissue adhesion. The hemostatic gauze (SCCVF) provides a physical barrier to limit blood spreading, while the hemostatic gel (GTG) with 100-200 µm porous structures and abundant hydrophilic functional groups contributes to rapid blood capture and strong tissue adhesion (interfacial toughness >100 J m-2). The incorporation of polyphenols provides antibacterial activity and antioxidant capability, with antibacterial activity exceeding 99% and DPPH radical scavenging activity reaching 93.5% under the tested conditions. Optimized GTG and SCT combinations were determined by evaluating multiple hemostatic-related properties. In animal hemorrhage models, SCT significantly reduced blood loss and hemostasis time compared with commercial hemostatic materials, while promoting diabetic wound healing. SCT also demonstrates favorable biocompatibility and storage stability. This work provides a promising bio-based strategy for rapid management of severe bleeding in clinical applications.