Forced hemostasis via enhanced erythrocyte adhesion: A procyanidin-based composite sponge for managing hemorrhage in coagulopathic conditions

and the polyphenol-modified surface, which markedly enhances protein adsorption and erythrocyte adhesion, without altering the intrinsic or extrinsic coagulation pathways. In a rat femoral artery injury model, PG3 significantly reduced bleeding time and blood loss by 62.3% in healthy rats and by 47.0% in heparinized coagulopathy rats, outperforming commercial GS. Additionally, PG3 exhibited excellent cytocompatibility, antioxidant capacity, and biodegradability. This work highlights a simple yet effective strategy for developing composite hemostatic materials, promising for the clinical management of severe bleeding, especially in challenging coagulopathic scenarios.