Dual-sprayable, multi-functional hydrogel for effective prevention of peritoneal adhesions

Over 90% of patients experience peritoneal adhesions after abdominal surgery, necessitating the use of anti-adhesion barriers. To effectively prevent tissue adhesions, strategies that combine physical and chemical blocking are essential. A self-healing hydrogel presents physical blocking by ensuring prolonged retention at the target site. To achieve this, dynamic covalent bonds (DCBs) between polyvinyl alcohol (PVA) and amino phenylboronic acid (APBA) are introduced. In this study, PVA and chondroitin sulfate type C (CS(C)) conjugated with APBA (CS_APBA) are employed to develop a dual-sprayable, self-healing, and anti-inflammatory hydrogel barrier. The hydrogel offers both physical barrier and anti-inflammatory benefits, facilitated by ROS scavenging effect of APBA and macrophage polarization effect of CS(C). As a result, in vivo rat studies show that dual-spraying CS_APBA and PVA forms a self-healing hydrogel that effectively prevents adhesions through both physical and chemical mechanisms. These results demonstrate that the PVA/CS_APBA hydrogel is a promising candidate for preventing post-surgical adhesions.