Rapid Hemostasis and Antiadhesion Gauze Based on a Structured Hydrophobic Surface Engineered by an Inorganic LDH Array

Uncontrolled hemorrhage causes 30% of trauma deaths. Conventional gauze has limitations in rapid hemostasis and tissue adhesion. Here, we introduce Gauze@LDH, a hemostatic gauze modified with magnesium/aluminum layered double hydroxide nanosheets via a one-step hydrothermal synthesis. This surface engineering transforms the gauze from hydrophilic to hydrophobic, reducing blood absorption. Gauze@LDH exhibits excellent biocompatibility with a 0.209% hemolysis rate and minimal cytotoxicity. It accelerates clotting to 1 min in recalcification models, three times faster than conventional gauze. In simulated vascular rupture, blood loss decreased to 121 mg compared to 160 mg with plain gauze. In vivo liver defect and tail-vein transection models confirmed the immediate hemostatic efficacy. A liver-penetrating injury model demonstrated 100% survival and no organ adhesions, unlike plain gauze, which caused extensive adhesions. By integrating rapid hemostasis, biocompatibility, and antiadhesion properties, Gauze@LDH addresses key limitations of current hemostatic agents, offering a cost-effective solution for trauma care.