Injectable gallic acid-engineered zwitterionic hydrogel for preventing postoperative adhesions in thyroid surgery...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Surgical Innovation

Background:

• Postoperative adhesions after thyroid surgery cause significant morbidity, including dysphagia and reoperation.
• Existing anti-adhesion barriers have limitations such as poor conformity, short retention, and inadequate microenvironment regulation.

Purpose of the Study:

• To develop and evaluate an injectable SAG adhesive hydrogel for preventing postoperative thyroid adhesions.
• To assess the hydrogel's ability to provide a physical barrier and modulate the local microenvironment.

Main Methods:

• Development of SAG hydrogel integrating gallic acid and a zwitterionic polymer.
• In vitro and in vivo studies in rat thyroid surgery models.
• Assessment of adhesion formation, fibrosis, inflammation, and functional recovery.
• Transcriptomic analysis to elucidate molecular mechanisms.

Main Results:

• SAG hydrogel demonstrated excellent injectability, biodegradability, and anti-fouling properties.
• Hydrogel suppressed pro-inflammatory cytokines and oxidative stress in vitro and in vivo.
• Reduced tissue fibrosis and prevented adhesions by physical barrier and microenvironment modulation (downregulating COL-1/TGF-β, IL-6/TNF-α).
• Improved respiratory and swallowing function restoration observed.

Conclusions:

• The SAG hydrogel offers a dual-action strategy for preventing thyroid surgery adhesions.
• It combines physical wound separation with modulation of the pathological microenvironment.
• This innovative hydrogel shows promise for improving surgical outcomes and patient quality of life.