Efficient and safe hemostatic materials are pivotal in emergency trauma care and clinical surgery. Polyurethane （PU）， a block copolymer characterized by a distinct microphase-separated structure， has emerged as a premier candidate for advanced hemostatic dressings， owing to its exceptional biocompatibility， mechanical tunability， and chemical design versatility. This review first outlines the physiological mechanisms of hemostasis and explores PU synthesis processes， specifically the “gelling-blowing” competitive reaction kinetics of polyurethane foam （PUF）. Significant emphasis is placed on the unique advantages of PUF regarding biosafety， programmable biodegradability， and shape memory effects. Furthermore， recent advancements in specialized applications， such as deep-tissue hemostasis， nasal packing， intelligent exudate management （Janus structures）， and sustainable bio-based PU developments are detailed. Finally， it is suggested that future research should focus on the covalent integration of bioactive molecules to construct “hemostasis-antimicrobial-regeneration” integrated intelligent therapeutic platforms， enabling full-cycle regulation of the wound healing process.

Contents

1 Introduction

2 Mechanism of hemostasis

2.1 Physiological hemostasis

2.2 Hemostatic mechanisms of hemostasis and material design strategies

2.3 Performance evaluation system for hemostatic materials

3 Fundamental of polyurethane

3.1 Development of polyurethane

3.2 Synthesis raw materials and preparation methods for polyurethane

3.3 Properties of polyurethane

4 Applications of polyurethane foam in hemostasis and wound healing

4.1 Shape-memory hemostatic performance for complex wound surfaces

4.2 Nasal implant： combining antibacterial properties with biodegradability

4.3 Payload： PUF containing bioactive ingredients

4.4 Exudate management： intelligent Janus structure with photothermal synergy

4.5 Sustainable development： green synthesis of biomass polyurethane

5 Conclusion and outlook