The role of nanoscale structures in the development of topical hemostatic agents

Hemorrhage, or severe blood loss, is one of the main causes of death in trauma, childbirth, and complex surgeries. Bleeding management in the first hour after injury using topical hemostatic agents is the key to minimize the consequent mortality and morbidity. Since the dawn of civilization, numerous topical hemostatic agents have been developed from materials with inherited hemostatic properties. However, the applications of these agents are hampered due to their shortcomings, such as weak hemostatic performance in the presence of coagulopathies and blood disorders, causing bystander cell damage and non-biodegradability. The present article firstly reviews the current market of topical hemostatic agents and their shortcomings. Then, it elaborates on how nanomaterials enabled us to enhance the current hemostatic materials in two aspects; (i) overcoming the drawbacks of current hemostatic materials and (ii) producing new hemostatic agents from materials regardless of their procoagulant properties on the macroscale. Additionally, a particular focus is placed on blood-material interactions to highlight the role of nanoscale structures.