In the realm of postoperative care, a significant breakthrough has emerged from the labs of Sun Yat-sen University, Guangzhou, China. Researchers, led by Lingling Ren from the School of Pharmaceutical Sciences, have developed a novel hydrogel that could revolutionize the prevention of postoperative abdominal adhesions, a complication affecting up to 90% of abdominal surgery patients. This innovative solution, detailed in a recent study published in *Bioactive Materials* (which translates to *活性材料* in Chinese), leverages advanced materials science and biochemistry to address a longstanding clinical challenge.
Postoperative abdominal adhesions occur when internal tissues stick together, often leading to severe complications such as chronic pain, bowel obstruction, and infertility. Despite various strategies to mitigate this issue, current solutions have yielded unsatisfactory results. Ren and her team have engineered a reactive oxygen species (ROS)-responsive double-network hydrogel, dubbed PD-OHN, designed to intelligently respond to the body’s healing environment.
The hydrogel’s unique structure combines two distinct networks: one formed by phenylborate ester bonds between a novel ROS-cleavable monomer (DPBA) and polyvinyl alcohol (PVA), and another by acylhydrazone bonds between oxidized hyaluronic acid (OHA) and adipic acid dihydrazide-modified hyaluronic acid (HA-ADH). This dual-network design endows the hydrogel with exceptional mechanical properties, including a storage modulus of approximately 20 kPa and a tissue adhesion strength of around 8 kPa. “The hydrogel’s ability to form a uniform, stretchable film upon application is crucial for its effectiveness,” explains Ren. “It adheres well to tissues and remains in place for about 21 days, providing sustained protection during the critical healing period.”
One of the most groundbreaking aspects of PD-OHN is its ROS-scavenging capability. The hydrogel contains DPBA, which cleaves in response to ROS, releasing dithiothreitol (DTT). This process not only neutralizes harmful oxidative stress but also induces a shift in macrophage polarization from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype. “By modulating the immune response, the hydrogel helps to reduce inflammation and fibrosis, creating a more favorable environment for tissue healing,” Ren notes.
The study demonstrated the hydrogel’s efficacy in a cecum-sidewall abrasion rat model, showing significant prevention of adhesion formation. The findings suggest that PD-OHN could serve as a promising bioactive barrier for postoperative adhesion prevention, offering a comprehensive solution that addresses multiple aspects of the healing process.
The commercial implications of this research are substantial. Postoperative adhesions impose a significant burden on healthcare systems, leading to extended hospital stays, additional surgeries, and increased costs. A hydrogel like PD-OHN, with its multifunctional properties and proven efficacy, could become a game-changer in postoperative care. “This technology has the potential to transform the way we manage postoperative complications,” Ren says. “By providing a more effective and intelligent solution, we can improve patient outcomes and reduce healthcare costs.”
As the field of biomaterials continues to evolve, innovations like PD-OHN highlight the importance of interdisciplinary research. The integration of materials science, biochemistry, and clinical needs paves the way for smarter, more responsive medical devices. This study not only advances our understanding of postoperative adhesion prevention but also sets a precedent for future developments in bioactive materials. With further research and clinical trials, PD-OHN could soon become a standard tool in surgical care, benefiting millions of patients worldwide.