Bioinspired Hemostatic Dressings for Rapid and Safe Bleeding Control Via Nanofiber Bridging of Kaolin and Cotton.

Emergency hemostasis during prehospital care significantly reduces trauma-related mortality. Nanoclay exhibits potent procoagulant properties, but its detachment from the substrate leads to non-negligible adverse reactions and diminished hemostatic efficiency, hindering its clinical application. Despite improved immobilization via polymer incorporation, irreversible surface encapsulation undermines the procoagulant efficacy of nanoclays. Here, inspired by the anchoring mechanism of fish scales to skin via collagen fibers, we introduce a nanofiber-bridged design that enables robust immobilization of nanoclay and maximized loading density, while also achieving its full exposure for optimal hemostatic performance. The microfiber-derived nanofiber network expands the interfacial contact area and anchors nanosheet inner surfaces via synergistic covalent and non-covalent interactions, effectively redistributing stress to resist dynamic shear forces. The resulting kaolin-cotton hemostatic dressing demonstrates superior physical stability (no detectable kaolin leakage) and enhanced hemostatic efficacy in rat (62%), rabbit (58%), and pig (35%-43%) hemorrhage models compared with conventional hemostatic agents. Importantly, no leakage-induced chronic inflammation was observed. Moreover, laboratory-scale preparation and processing of 5 kg products demonstrate the feasibility of industrial-scale production, making them further processable into various cotton-based materials. This bioinspired dressing offers improved efficacy and safety, along with affordability, underscoring its potential for clinical translation.