Multifunctional Janus hemostatic dressings tailored for complex coagulation processes

The development of highly efficient hemostatic materials is of great significance for trauma treatment. Hemostasis occurs through the synchronous interaction of the following three mechanisms: vasoconstriction, platelet aggregation and blood coagulation. During the blood coagulation phase, the coagulation cascade converts fibrinogen into fibrin, forming a stable blood clot. This process involves the interaction of various plasma proteins, clotting factors, calcium ions (Ca²⁺), and platelets. To synergistically enhance vascular compression, platelet activation, and acceleration of the coagulation cascade, researchers have employed material compositing or modification to improve the functionality of hemostatic dressings. However, the isotropic hybrid materials struggle to perform their respective functions without interference. Janus materials, with their distinct chemical compartmentalization, can independently perform distinct functions on each side. Herein, we first provide a concise overview of the hemostatic process and mechanisms to establish the theoretical foundation for developing Janus hemostatic dressings and then focus on the latest research advances and development prospects of Janus-structured materials in the field of hemostatic management. Additionally, it discusses the future opportunities and challenges associated with Janus hemostatic dressing.