A Micromesh-At-Grid Integrated Cotton (MAGIC) Gauze with Pressure-Responsive Pore Gating Enables Sustainable Hemostasis via Spatiotemporally Coordinated Coagulation.

Achieving effective and economical hemostats requires a robust clot-wound interface constructed by spatiotemporally coordinated coagulation. However, accumulated interfacial blood causes delayed clotting in adhesion-reliant dense hemostats, and rapid but off-site coagulation in absorptive porous materials. Here, we present MAGIC (Micromesh-At-Grid Integrated Cotton) gauze, which leverages a reversible transition between dense and porous states to precisely coordinate the spatial and temporal dynamics of coagulation. This transition is achieved by a pressure-responsive micromesh composed of supramolecular procoagulant microparticles. Spatially, blood-derived ions trigger the gelation of these procoagulant particles on the gauze surface, laterally repelling interfacial blood to ensure on-site coagulation. Temporally, applied pressure induces micromesh dissociation to re-expose the gauze macropores for wicking residual fluid, followed by the rapid co-assembly of sol-state procoagulant particles with blood components. This tightly synchronized process seals the cleared wound with a robust clot. Consequently, a single MAGIC pad arrested lethal porcine femoral artery hemorrhage within 30 s. Compared to standard gauze, it reduced blood loss by 98%, cotton consumption by 96%, treatment costs by 83%, and lifecycle CO2 emissions by 84%. Collectively, MAGIC gauze delivers exceptional preclinical first aid efficacy while pioneering a viable pathway for the decarbonization of surgical consumables.