All-in-one extracellular matrix-based powders with instant self-assembly and multiple bioactivities integrate hemostasis and in-situ tissue functional repair

Non-compressible hemorrhage poses a severe threat to life globally, yet achieving effective hemostasis and facilitating tissue repair remain a significant challenge and desired requirement. Herein, the all-in-one extracellular matrix (ECM)-based powder, composed of modified small intestinal submucosa (SIS) and sodium alginate, was ingeniously designed to realize one-stop management for non-compressible hemorrhage. Specifically, upon contact bleeding site, the powder's extreme liquid absorption allows for the rapid removal of interfacial blood. Simultaneously, based on the instant self-assembly strategy of covalent/non-covalent interaction, the powder can transform to wet bio-adhesive hydrogel within 5 s, effectively sealing the wound. Using the inherent bioactivities, the ECM-based powder exhibits satisfactory biocompatibility, enhanced cell recruitment, angiogenesis and endothelial cell functions. Ulteriorly, excellent hemostasis performance have verified in rabbit liver non-compressible hemorrhage and heart/artery massive hemorrhage models, significantly reducing the blood loss. More importantly, after hemostasis, the impaired liver demonstrates functional restoration that the more vessels and bile ducts formation, facilitated by the biodegradation of ECM-derived powders in vivo and the multi-biological cues response. Collectively, leveraging the merits of powder and hydrogel, this novel powder fulfills the all-in-one need for both non-compressible hemorrhage control and subsequent tissue repair, signifying it a valuable material in first aid.