A Multifunctional Bilayer Hydrogel for Effective Pancreatic Fistula Prevention and Post-Surgical Adhesion Control

Area of Science:

• Biomaterials Science
• Surgical Innovation
• Regenerative Medicine

Background:

• Clinical translation of hydrogels for pancreatic fistula management is hindered by moist surgical environments and complex post-pancreatectomy pathophysiology.
• Postoperative pancreatic fistula (POPF) and adhesive intestinal obstruction are significant complications following distal pancreatectomy (DP).

Purpose of the Study:

• To develop a multifunctional, asymmetric bilayer hydrogel (BH) patch for preventing DP-POPF and postoperative adhesions.
• To enhance wet-tissue adhesion and provide anti-inflammatory and proangiogenic properties for improved surgical outcomes.

Main Methods:

• Developed an asymmetric BH patch with an adhesive pancreatic layer (APL) for wet-tissue adhesion and an anti-adhesion layer (AAL) to prevent fibrosis.
• Incorporated Ceffe (cell-free fat extract) into the BH hydrogel for its anti-inflammatory and proangiogenic benefits.
• Evaluated BH patch performance through in vitro and in vivo studies in rat models, including a DP rat model.

Main Results:

• The BH patch demonstrated robust wet-tissue adhesion, mechanical strength, prolonged adhesion retention, and enzymatic resistance.
• In vivo studies showed the Ceffe@BH group had significantly reduced POPF incidence compared to control groups.
• The Ceffe@BH group exhibited attenuated inflammation, enhanced angiogenesis, and effective adhesion prevention in the DP rat model.

Conclusions:

• The suture-free, multifunctional BH hydrogel patch presents a standardized and effective solution for managing POPF.
• This hydrogel technology holds broad potential for various wet-tissue surgical applications, addressing critical clinical needs.