Multiscale design strategies for high-performance hemostatic bioadhesives

hemorrhagic environment is severely compromised by factors including tissue heterogeneity, hemodynamic washout, organ motion, and interfacial hydration. There is a lack of a systematic framework integrating cross-scale design strategies. This review presents multiscale design strategies for hemostatic bioadhesives tailored to complex internal bleeding scenarios: at the macroscopic scale, it emphasizes adapting material forms and mechanical properties to specific wound geometries; at the micro/nanoscale, it elucidates how structural strategies enhance energy dissipation and adhesion strength; and at the sub-nanometer scale, it categorizes bonding modes of covalent and non-covalent interactions. Through representative case studies, we demonstrate how multiscale integration achieves synergistic functionalities beyond the reach of single scale optimization. This hierarchical framework provides a rational roadmap for the development of next-generation high-performance hemostatic bioadhesives.