Synergistic cross-linking and mineralization for wet-tough, biocompatible collagen-based hernia patches

Natural polymer-based hernia patches exhibit biocompatibility and biodegradability compared with non-degradable polypropylene (PP) meshes; however, their clinical translation has been severely hampered by inadequate mechanical strength under wet conditions. To address these challenges, we developed a composite membrane (COL/γ-PGA/CNF/CS-M) via a simple fabrication strategy that primarily involves sequential soaking mineralization and multi-point cross-linking. Under wet conditions, the tensile strength, fracture energy, and burst strength of the COL/γ-PGA/CNF/CS-M were enhanced by factors of 7.48, 22.84, and 2.77, respectively, relative to those of pure collagen membrane (COL). Moreover, the swelling rate of COL/γ-PGA/CNF/CS-M decreased by 35.7% compared to COL. Biocompatibility and hemocompatibility assays confirmed its non-toxicity and suitability for tissue regeneration. In vitro degradation tests revealed a residual mass of 58.27% after 42 days, ensuring sustained mechanical support while enabling complete degradation to prevent long-term complications. In vivo experiments validated its ability to promote tissue repair, minimize inflammation, and stimulate angiogenesis. Significantly, during a long-term post-operative observation (29 weeks), COL/γ-PGA/CNF/CS-M was found to be effective in reducing intra-abdominal adhesions. With its tunable wet-state mechanical performance, biodegradability, and excellent biocompatibility, the COL/γ-PGA/CNF/CS-M emerges as a promising biomaterial, holding significant potential for the treatment of abdominal wall defects.