Sponges with Janus Character from Nanocellulose: Preparation and Applications in the Treatment of Hemorrhagic Wounds.

The development of a rapid and effective hemostatic dressing is highly desired in the treatment of hemorrhagic wounds. In this study, sponges with Janus character are developed using cellulose nanofibers (CNFs) that exhibit materials facets of different wettability characteristics using heterogeneous mixing and freeze-drying. The bonding of the interface between the hydrophilic and hydrophobic facets is achieved by using interpenetrating chemical cross-linking between CNFs and organosilanes. The hydrophilic layer absorbs water from blood and works synergistically with the inherent hemostatic chitosan-rich complementary layer to accelerate blood clotting, displaying both active and passive hemostatic mechanisms. The hydrophobic layer prevents blood penetration into the construct and exerts proper pressure on the wound. Compared with the hydrophilic control samples and commercial gauzes, the Janus sponges can achieve effective bleeding control with nearly 50% less blood loss in a femoral artery injury model and prolong the survival time in a carotid artery injury model. Compared with the only hydrophilic layer, the time to hemostasis of Janus sponge are reduced from 165 ± 20 to 131 ± 26 s in femoral artery injury model and from 102 ± 21 to 83 ± 15 s in liver femoral artery injury model.