Silk Fibroin With Enhanced Hemostatic Property by the Introduction of Carboxyl Moieties and Preservation of Micrometer Scale Fiber Architecture

In the realm of clinical surgery, the unceasing pursuit of hemostatic materials with rapid hemostasis, excellent biocompatibility, degradability, wound-healing promotion, and economic viability is of utmost importance. This study, inspired by the preparation and hemostatic mechanism of Surgicel®, a prevalent surgical hemostatic agent, low-cost silk fibroin (SF) was modified. By adding carboxyl groups while maintaining the SF micron-fiber structure, the modified SF showed enhanced water and blood absorption, as well as a significantly improved Ca²⁺ transport capacity compared to unmodified SF. In vitro coagulation tests revealed that the modified SF had excellent hemostatic efficacy, with the quickest time at 76.75 ± 2.17 s. In the animal bleeding model, its fastest hemostatic time was 93 ± 9.63 s, with a mean blood loss of 0.28 ± 0.05 g, similar to Surgicel® (100.64 ± 2.87 s, 0.24 ± 0.05 g). Moreover, the modified SF hemostatic yarns exhibited favorable blood, cell, and biocompatibility, making them a promising option for surgical wound hemostasis, especially in organ surgery.