Surface-functionalized design of blood-contacting biomaterials for preventing coagulation and promoting hemostasis

The anticoagulation and hemostatic properties of blood-contacting materials are opposite lines of research, but their realization mechanisms are inspired by each other. Contact between blood and implantable biomaterials is a classic problem in tribological research, as both antithrombotic and hemostatic materials are closely associated with this problem. Thrombus formation on the surfaces of blood-contacting biomedical devices can detrimentally affect their performance and patient life, so specific surface functionalization is required. Currently, intensive research has focused on the development of super-lubricated or super-hydrophobic coatings, as well as coatings that deliver antithrombotic drugs. In addition, hemostatic biomaterials with porous structures, biochemical substances, and strongly adhesive hydrogels can be used to achieve rapid and effective hemostasis via physical or biochemical mechanisms. This article reviews methods of preparing anticoagulant coatings on material surfaces and the current status of rapid hemostatic materials. It also summarizes fundamental concepts for the design and synthesis of anticoagulant and hemostatic materials by discussing thrombosis and hemostasis mechanisms in biomedical devices and normal organisms. Because there are relatively few reports reviewing the progress in surface-functionalized design for anticoagulation and hemostasis, it is anticipated that this review can provide a useful summary of the applications of both bio-adhesion and bio-lubrication techniques in the field of biomedical engineering.