Ultrafast self-gelling powder mediates robust wet adhesion to promote healing of gastrointestinal perforations

Iron-based driven chitosan quaternary ammonium salt self-gelling powder: Sealing uncontrollable bleeding and promoting wound healing

Uncontrollable bleeding poses a significant risk of death and cost in wars, vehicle accidents, and first aid. Hence, in order to seal uncontrollable bleeding and promote wound healing, the Fe3+-driven chitosan quaternary ammonium salt self-gelling powder (QPF) was prepared using 5%QCS/AA/Fe3+ with the 52.72 % ± 0.30 % yield. As demonstrated by the results, the QPF had a high liquid absorption rate, mechanical properties, reactive oxygen species scavenging capacity, and bacteriostatic ability. Furthermore, QPF has excellent self-healing characteristics and underwater adherence, making it appropriate for a wide range of wound types. Importantly, this property is influenced by variations in Fe3+ concentration. In the in vitro coagulation experiment, QPF can rapidly capture blood cells, resulting in coagulation within 30s. After applying the QPF to different bleeding models, it immediately formed the self-gel (<2 s) that adheres securely to the hemorrhage site. Subsequently, the bleeding site could be promptly closed within 30s, and no blood leaking occurred within 10 min. Compared to CS, QPF (200 mg) improves wound healing by closing the wound gap, activating M2-type macrophage polarization, increasing neovascularization, and hastening granulation tissue proliferation (1046.0 μm ± 41.9 μm). In conclusion, iron-based driven self-gelling powders offer significant promise for limiting uncontrolled bleeding and promoting wound healing.

Sensorable zwitterionic antibacterial hydrogel for wound electrostimulation therapy

Wound healing process has always been a focal point of concern, with a plethora of hydrogel dressings available; however, their therapeutic efficacy remains a hindrance to wound closure. This article reports on a dual-network conductive system, PEDOT:PSS-co-PSBMA/XLG (PPSX) hydrogel dressing, Constructed using poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT: PSS) in combination with zwitterionic N, N-dimethyl-N-(2-methacryloyloxyethyl)-N- (3-sulfopropyl) ammonium betaine (SBMA) and nanoclay-synthesized lithium magnesium silicate (XLG). The hydrogel powder produced from it can absorb interfacial water within 30 s via physical interactions to spontaneously form hydrogels of arbitrary shapes. With a conductivity of 1.8 s/m, it can be utilized for developing flexible sensing bioelectronic devices to monitor human activities (facial expressions, blinking, swallowing, speaking, joint movements), as well as constructing electrodes for monitoring muscle movements and motorial intensity. More importantly, PPSX hydrogel effectively inhibits bacterial growth and promotes cell proliferation, thus facilitating wound healing and presenting extensive application prospects in the medical field.

Nano zero-valent iron driven sodium alginate/poly (acrylic acid) composite hydrogel powder for rapid hemostasis and wound healing

Uncontrollable bleeding resulting from warfare, traffic accidents, and various high-risk industries poses a serious issue. In this study, we develop a nano-zero-valent iron (nZVI)-driven sodium alginate (SA)/polyacrylic acid (PAA) composite hydrogel (SA/PAA/nZVI, SPI), which is subsequently fabricated into a powder to achieve rapid hemostasis and promote wound healing. The redox system comprising nZVI/ammonium persulfate (APS) efficiently generates significant quantities of free radicals and Fe3+ under both room and low temperatures (4 °C), thereby significantly accelerating hydrogel formation. The SPI hydrogel exhibits excellent mechanical properties and adhesion due to its interpenetrating network structure, enabling it to resist various degrees of bending and folding. Notably, the SPI hydrogel powder, obtained through drying and grinding processes, possesses self-gelling properties and can effectively adhere to wet tissues. This is attributed to the strong hygroscopic properties of the hydrogel and the abundant dynamic bonds within its structure. These powders can rapidly absorb significant volumes of blood, including blood cells and coagulation factors, and demonstrate superior hemostatic efficacy over commercial chitosan powders (CCS) in diverse bleeding scenarios. Furthermore, the SPI hydrogel powder markedly improved skin wound healing compared to CCS in a rat full-thickness skin wound model. In conclusion, the SA/PAA composite hydrogel, driven by nZVI, demonstrates significant potential for facilitating hemostasis and wound healing.

Wet adhesives for hard tissues

The development of wet adhesives capable of bonding in aqueous environments, particularly for hard tissues such as bone, tooth, and cartilage, remains a significant challenge in material chemistry and biomedical research. Currently available hard tissue adhesives in clinical practice lack well-defined wet adhesion properties. Nature offers valuable inspiration through the adhesive mechanisms of marine organisms, advancing the design of bioinspired wet adhesives. Beyond biomimetic approaches, alternative strategies have emerged for the design of wet adhesives. This review systematically summarizes the current design strategies for wet adhesives, focusing on their applications to hard tissues. Then, the unique chemical, physical, mechanical, and biological requirements for wet adhesives applied to hard tissues are also discussed. The importance of understanding natural adhesion mechanisms and the need for high-performance materials that can meet the complex demands of hard tissue adhesion in a complex and delicate physiological microenvironment are highlighted. Finally, this review clarifies the future research directions that can further facilitate the clinical application of wet adhesives for hard tissues. STATEMENT OF SIGNIFICANCE: The significance of this review lies in its comprehensive analysis of wet adhesives for hard tissues, a field that has been largely overlooked despite its critical importance in biomedical applications. The insights gained from studying natural adhesives and the translation of these mechanisms into synthetic materials have the potential to revolutionize medical procedures involving hard tissue repair and regeneration. This review meticulously addresses the distinct challenges and specific requirements of hard tissue adhesives, providing an exhaustive roadmap for researchers striving to develop wet adhesives that can endure the demanding physiological conditions inside the human body. In doing so, it aims to facilitate the transition from laboratory findings to practical clinical applications.

Electrostatically Enhanced Biomimetic Asymmetric Hydrogel with a Dung Beetle-Inspired Pattern for Internal Trauma Sealing

Herein, a biologically asymmetric adhesion-patterned hydrogel induced by the dung beetle surface was proposed for internal trauma sealing. The electrostatic interaction-enhanced dual networks endowed the hydrogel patch with superior mechanical performance, thus achieving a favorable sealing ability. Poly(acrylic acid) (pAA), chitooligosaccharide (COS), and gelatin were used as the composition of our hydrogel system. Concurrently, the bionic raised structure enabled a significant adhesion drop effect. The surface waviness function, fitted to the curved bumps, showed the design direction of the patterned bumps, which was indicative of subsequent research. Also, the microparticle deposition method could exert a synergistic effect with the patterned surface, which together contributed to the asymmetry of the adhesive hydrogel patch. Following simulation experiments such as in vitro bursting tests, we conducted a rat gastric trauma model to validate the application potential of this bionic asymmetric patterned patch. The asymmetric adhesion hydrogel patch had an excellent sealing effect, antiadhesive properties, and operability and was expected to have a promising application prospect, providing a strategy for the design of subsequent in vivo trauma-sealing biomaterials.

A multifunctional biomimetic double-layer composite hydrogel with wet adhesion and antioxidant activity for dural repair

Cerebrospinal fluid (CSF) leakage caused by accidents or diseases resulting from traumatic brain injury, inflammation, tumor erosion and surgery can lead to many complications. In this study, a multifunctional composite double-layer hydrogel was designed by simulating the structure of native dura mater, which was composed of polyacrylic acid (PAA), polyethyleneimine (PEI), sodium alginate (SA), β-cyclodextrin (β-CD) and edaravone (Ed). The PAA/PEI layer had strong wet adhesion characteristics, while the PEI/SA@β-CD/Ed layer exhibited significant antioxidant, drug release and biocompatibility properties. By controlling the concentration of Ca2+, the gelation time can be adjusted rapidly within 95-215 s. Specifically, the final PAA/PEI/SA@β-CD/Ed composite hydrogel exhibited a porous network structure with high porosity and low swelling rate, improved tensile strength, sufficient biodegradability, favourable adhesion performance, enhanced DPPH and ABTS radicals scavenging abilities, and sustained Ed release capacity. In addition, the resulting hydrogel also showed excellent biocompatibility and protective effect on H2O2-induced oxidative damage in SH-SY5Y cells. These results preliminarily suggested that the PAA/PEI/SA@β-CD/Ed composite hydrogel would appear to be a promising candidate for dural repair.

Unveiling the Diverse Principles for Developing Sprayable Hydrogels for Biomedical Applications

Sprayable hydrogels have emerged as a transformative innovation in biomedical technology, offering a versatile, efficient, and minimally invasive platform for various clinical applications. They form gels in situ upon tissue contact, enabling seamless application on even complex surfaces. This property is especially useful in wound care, drug delivery, and tissue engineering, where localized and sustained release of therapeutics is essential. Formulations can be customized to include various bioactive compounds, such as growth factors, antibiotics, and anti-inflammatory agents, thereby enhancing targeted treatment outcomes. This review delves into the fundamental principles governing sprayable hydrogels, emphasizing critical mechanisms such as in situ cross-linking, shear-thinning properties, and thermoresponsive behavior. Furthermore, it highlights recent advancements since 2020, including the strategic incorporation of bioactive agents to augment therapeutic efficacy. By examining these core mechanisms and design strategies, this review provides a comprehensive perspective on the engineering of sprayable hydrogels for modern medical applications.

Development of self-gelling powder combining chitosan/ bentonite nanoclay/ sodium polyacrylate for rapid hemostasis: In vitro and in vivo study

Although hemostatic powders are commonly used in clinical and emergency settings, they frequently show poor absorption, raise cytotoxicity issues, and are not effective for fatal non-compressible bleeding. The purpose of this research is to create a self-gelling hemostatic powder based on chitosan, bentonite, and sodium polyacrylate (CBS) to improve the hemostatic effect. When liquid comes into contact with CBS powders, they can fuse and form a stable hydrogel in less than 30s. Here, the concentration of the superabsorbent polymer is the primary determinant of the self-gel's creation. CBS groups exhibited excellent in vitro biocompatibility and hemocompatibility. In terms of bleeding and hemostatic time, the in vivo hemostatic results demonstrate the superiority of CBS-3 powder (∼57 s in rat liver avulsion model) and (∼64 s in rat tail amputation model) over a commercial product group called ARISTA. Additionally, the fabricated CBS powders can quickly absorb large amounts of blood, which can also aggregate platelets and blood cells. After four weeks of rat liver implantation, CBS-3 significantly accelerated the angiogenesis and wound healing processes. Thus, the hemostatic CBS self-gelling powder could be an effective solution for treating blood loss and liver wounds.

Adaptive Phase-Locked E-Skin for Sports Physiology and Medicine

The pursuit of creating materials that replicate the flexibility, stability, and advanced perceptual capabilities of human skin, attributes honed through natural evolution, represents a long-term objective in pioneering fields such as electronic skin (e-skin) research. However, conventional e-skin often struggles with stability and functionality in harsh sports environments, resulting in the degradation of the intimate interface over time. Inspired by the innate biphasic structure of human subcutaneous tissue, an adaptive phase-locked e-skin (APLE) is presented, designed to seamlessly conform to dynamic sports environments, offering robust applications in sports physiology and medical contexts without malfunctioning. The APLE allows one to laminate onto the skin with consistent homeostasis, providing a foundation for advancing data-driven sports physiology and creating personalized sports plans. Additionally, APLE offers immediate on-site medical treatment for common sports injuries, including hemostasis and sutureless wound closure. Ultimately, the reported multifunctional e-skin can provide significant value in managing sport-related burdens through digital and people-centered physiology monitoring, along with real-time sport healthcare.

A bionic 3D-printed hydrogel microneedle of composite mesh for abdominal wall defect repair

The use of mesh repair is a frequently employed technique in the clinical management of abdominal wall defects. However, for intraperitoneal onlay mesh (IPOM), the traditional mesh requires additional fixation methods, and these severely limit its application in the repair of abdominal wall defects. We drew inspiration from the adhesion properties of mussels for the present study, functionalized carboxymethyl cellulose (CMC) with dopamine (DA), and added polyvinyl alcohol (PVA) to the composite to further improve the wet adhesive ability of hydrogels. The CMC-DA/PVA hydrogel microneedles (MNs) were fabricated using an inverse molding technique, incorporating a 3D-printed thermoplastic polyurethane mesh to enhance mechanical strength. The tensile test and porcine skin adhesion test demonstrated that the hydrogel mesh exhibited satisfactory mechanical properties and adhesion in vitro, thus replacing the traditional fixed mesh in the treatment of rat full-thickness abdominal wall defects. The results of animal experiments revealed that the hydrogel mesh promoted the growth of new granulation tissue and inhibited inflammatory responses, thereby paving the way for a novel approach in treating full-thickness abdominal wall defects.

Adhesive polyelectrolyte coating through UV-triggered polymerization on PLGA particles for enhanced drug delivery to inflammatory intestinal mucosa

Administering medication precisely to the inflamed intestinal sites to treat ulcerative colitis (UC), with minimized side effects, is of urgent need. In UC, the inflammation damaged mucosa contains a large number of amino groups which are positively charged, providing new opportunities for drug delivery system design. Here, we report an oral drug delivery system utilizing the tacrolimus-loaded poly (lactic-co-glycolic acid) (TAC/PLGA) particles with an adhesion coating by in situ UV-triggered polymerization of polyacrylic acid and N-hydroxysuccinimide (PAA-NHS). The negatively charged carboxyl groups effectively interact with the positively charged focal mucosa, and the NHS ester groups form the covalent bonds with the amino groups, thereby synergically enhancing the adhesion of the PLGA particles to the focal mucosa. Our findings reveal that, compared to the naked particles, the PAA-NHS coating increases the adhesion of particles to the inflammatory intestine. In a dextran sulfate sodium-induced acute colitis mouse model, the TAC/PLGA particles with PAA-NHS coating exhibits substantial retention of TAC within the inflammatory intestine, enhancing drug delivery efficiency and therapeutic effects. This approach holds promise for UC management, minimizing systemic side effects and optimizing therapeutic outcomes.

Development of low-molecular-weight polysaccharide-based wound dressings for full-thickness cutaneous wound healing via coacervate formation

The development of polysaccharide-based wound dressings that are easy to prepare, adhere to tissue, adapt to diverse shapes and exhibit tunable mechanical properties holds significant clinical interest. This study introduced a simple spontaneous liquid-liquid phase separation technique employing low-molecular-weight and high polyion concentration of chitosan (CS) and hyaluronic acid (HA) to fabricate CS/HA coacervates. Upon increasing the molecular weight of chitosan from 7 kDa to 250 kDa, a transition in the CS/HA coacervates from liquid-like state to an elastic liquid and eventually to a solid-like state was observed. The resulting CS/HA coacervates demonstrated robust water resistance and adhesion to skin tissue. Notably, the molecular weight of chitosan significantly influenced the mechanical properties and hydration levels of the CS/HA coacervates. Moreover, in vivo studies using a full-thickness cutaneous defect model revealed that the CS/HA coacervates, prepared using 100 kDa chitosan, markedly accelerate wound healing. The coacervates' ease of preparation, wet adhesion, heterogeneous structure, suitability for irregularly shaped wounds, and exceptional wound healing promotion of the coacervates qualify them as an optimal wound dressing.

Ultrafast Self-Gelling, Adhesive, Anti-Bacterial Coacervate-Based Powders for Enhanced Hemostasis and Wound Healing

Uncontrolled hemorrhage, especially in non-compressible and deep wounds, remains a critical issue in emergency and surgical care. Existing hemostatic powders often lack rapid gelation, mechanical robustness, and adequate adherence, increasing the risk of rebleeding under high-pressure blood flow. To address these limitations, PQPP, a novel self-gelling hemostatic material composed of polyacrylamide/quaternized chitosan coacervates and polydopamine nanoparticles is developed. PQPP can rapidly absorb blood within 2 s, undergoes in situ gelation, and forms a robust adhesive hydrogel to effectively seal wounds. Its efficacy stems from the electrostatic adsorption and catechol functional groups of polydopamine nanoparticles. Importantly, PQPP exhibits high burst pressure resistance, excellent blood cell aggregation capability, outstanding biocompatibility, and antibacterial properties. Comprehensive in vitro and in vivo studies, including cytotoxicity and blood compatibility tests, as well as trials in mouse liver, heart, and vascular injury models, demonstrate PQPP's superior hemostatic performance under high-pressure conditions without causing inflammation. With its rapid gelation, robust adhesion, and mechanical integrity, PQPP represents a promising hemostatic material for immediate wound management in surgical and emergency applications.

Multifunctional Adhesive Hydrogels: From Design to Biomedical Applications

Adhesive hydrogels characterized by structural properties similar to the extracellular matrix, excellent biocompatibility, controlled degradation, and tunable mechanical properties have demonstrated significant potential in biomedical applications, including tissue engineering, biosensors, and drug delivery systems. These hydrogels exhibit remarkable adhesion to target substrates and can be rationally engineered to meet specific requirements. In recent decades, adhesive hydrogels have experienced significant advancements driven by the introduction of numerous multifunctional design strategies. This review initially summarizes the chemical bond-based design strategies for tissue adhesion, encompassing static covalent bonds, dynamic covalent bonds, and non-covalent interactions. Subsequently, the multiple functionalities imparted by these diverse design strategies, including highly stretchable and tough performances, responsiveness to microenvironments, anti-freezing/heating properties, conductivity, antibacterial activity, and hemostatic properties are discussed. In addition, recent advances in the biomedical applications of adhesive hydrogels, focusing on tissue repair, drug delivery, medical devices, and wearable sensors are reviewed. Finally, the current challenges are highlighted and future trends in this rapidly evolving field are discussed.

Enhanced adhesive hydrogel for emergency hemostasis by balancing adhesion and cohesion

Hydrogel adhesives have broad application prospects in biomedical fields such as tissue engineering and emergency rescue. However, due to the high water content and defective network structure, their inherent mechanical strength is low, which seriously hinders their application. In the present work, enhanced adhesive hydrogels could be synthesized by balancing cohesion and adhesion forces. The adhesive hydrogel composed of acryloyl aspartic acid and glycine shows a more dense mesh structure through intermolecular hydrogen bond interactions. As a result, the adhesive hydrogel exhibits enhanced tissue adhesion strength, which benefit from the balance between cohesion and adhesion.

Sticky Science: Using Complex Coacervate Adhesives for Biomedical Applications

Tissue adhesives are used for various medical applications, including wound closure, bleeding control, and bone healing. Currently available options often show weak adhesion or cause adverse effects. Recently, there has been an increasing interest in complex coacervates as medical adhesives. Complex coacervates are formed by mixing oppositely charged macromolecules that associate and undergo liquid-liquid phase separation, in which the dense bottom phase is the complex coacervate. Complex coacervates are strong and often biocompatible, and show strong underwater adhesion. The properties of the resulting materials are tunable by intrinsic factors such as polymer chemistry, molecular weight, charge density, and topology of the macromolecules, as well as extrinsic factors such as temperature, pH, and salt concentration. Therefore, complex coacervates are interesting new candidates for medical adhesives. In this review, it is described how complex coacervates form and how different factors influence their behavior. Next, an overview of recent studies on complex coacervates in the context of medical adhesives is presented. The application of complex coacervates as hemostatic or embolic agents, skin or bone repair adhesives, and soft tissue sealants is discussed. Lastly, additional possibilities for utilizing these materials in the future are discussed.

3D Nanofabrication via Directed Material Assembly: Mechanism, Method, and Future

Fabrication of complex three-dimensional (3D) structures at nanoscale is the core of nanotechnology, as it enables the creation of various micro-/nano-devices such as micro-robots, metamaterials, sensors, photonic devices, etc. Among most 3D nanofabrication strategies, the guided material assembly, an efficient bottom-up approach capable of directly constructing designed structures from precise integration of material building blocks, possesses compelling advantages in diverse material compatibility, sufficient driving forces, facile processing steps, and nanoscale resolution. In this review, we focus on assembly-based fabrication methods capable of creating complex 3D nanostructures (instead of periodic or 2.5D-only structures). Recent advances are classified based on the different assembly mechanisms, i.e., assembly driven by chemical reactions, physical interactions, and the synergy of multiple microscopic interactions. The design principles of representative fabrication strategies with an emphasis on their respective advantages, e.g., structural design flexibility, material compatibility, resolution, or applications are analyzed. In the summary and outlook, existing challenges, as well as possible paths to solutions for future development are reviewed. We believe that with recent advances in assembly-based nanofabrication strategies, 3D nanofabrication has achieved tremendous progress in resolution, material generality, and manufacturing cost, for it to make a greater impact in the near future.

Magneto-Thermal Hydrogel Swarms for Targeted Lesion Sealing

Magnetic microswarms capable of performing navigation to targeted lesions show great potential for in vivo medical applications. However, using the swarms for lesion cavity filling encounters challenges from precise delivery and sealing. Herein, this work develops a magneto-thermal hydrogel swarm consisting of magnetic hydrogel particles, which can perform phase transition induced by temperature change. The particles are prepared using a temperature-responsive hydrogel matrix, tissue adhesive monomers, and magnetic microparticles. The swarms can be remolded to various shapes, and it can be used to seal perforation in phantom and gastric tissue. The swarms can also serve as drug carriers, and their drug release profiles induced by temperature changes are characterized. Finally, the targeted delivery, adaptive filling, and sealing of a gastric ulcer using the swarms are achieved in ex vivo and in vivo environments.

Fabricating a SFMA/BAChol/PAA/ZnCl2 Hydrogel with Excellent Versatile Comprehensive Properties and Stable Sensitive Freezing-Tolerant Conductivity for Wearable Sensors

Flexible wearable sensors have obtained tremendous interest in various fields and conductive hydrogels are a promising candidate. Nevertheless, the insufficient mechanical properties, the low electrical conductivity and sensitivity, and the limited functional properties prevent the development of hydrogels as wearable sensors. In this study, an SFMA/BAChol/PAA/ZnCl2 hydrogel was fabricated with high mechanical strength and versatile comprehensive properties. Specifically, the obtained hydrogel displayed excellent adhesion and mechanical stability, cryophylactic ability, stable sensitive freezing-tolerant conductivity, and feasible electrical conduction under a wide temperature range, demonstrating the high application potential as a flexible wearable sensor for movement behavior surveillance, even under harsh environments. Furthermore, the mechanical strength of the hydrogel could easily be regulated by varying the copolymer content. The molecular mechanisms of the hydrogel formation and the reversible adhesion during the wet-dry transition were proposed. The non-covalent interactions, including the electrostatic interaction, hydrogen bond interaction and hydrophobic association, and coordination interaction, were dynamically presented in the hydrogel network and hence supported the versatile comprehensive properties of the hydrogel. This study provides a strategy for designing novel hydrogels to promote the development of flexible sensors with stable sensitive freezing-tolerant conductivity.

Self-gelling, tunable adhesion, antibacterial and biocompatible quaternized cellulose/tannic acid/polyethylene glycol/montmorillonite composite powder for quick hemostasis

Hemostatic powders are widely used in incompressible or irregularly shaped bleeding wounds, but traditional hemostatic powders exhibit low adhesion, unsatisfactory hemostatic effect, limited infection control, and are not suitable for clinical or emergency situations. This study developed a novel self-gelling hemostatic powder (QTPM) consisting of quaternized cellulose (QC)/ tannic acid (TA)/ polyethylene glycol (PEG)/ montmorillonite (MMT). QTPM could absorb interfacial liquid hydrating to a stable hydrogel which form a switchable adhesion to tissues. Moreover, QTPM exhibits excellent antibacterial property by the synergistic effect of QC and TA. Furthermore, QTPM directly activate intrinsic and extrinsic coagulation hemostatic pathways to enhance hemostasis, and it concentrate coagulation factors. In vivo hemostasis study results show that QTPM significantly accelerated hemostasis and reduced blood loss compared with the blank group (>75 % reduction in hemostatic time, >85 % reduction in blood loss) in liver bleeding model (hemostasis time of 71.67 ± 7.09 s, blood loss of 19.23 ± 2.60 mg) and tail amputation model (hemostasis time of 91.03 ± 12.05 s, blood loss of 15.24 ± 1.77 mg). Therefore, the advantages of QTPM including rapid and effective hemostasis, easy usage, easy storability and adaptability make it a potential biomaterial for rapid hemostasis direction in the clinical setting.

Ionically assembled hemostatic powders with rapid self-gelation, strong acid resistance, and on-demand removability for upper gastrointestinal bleeding

Upper gastrointestinal bleeding (UGIB) is bleeding in the upper part of the gastrointestinal tract with an acidic and dynamic environment that limits the application of conventional hemostatic materials. This study focuses on the development of N-[(2-hydroxy-3-trimethylammonium) propyl] chitosan chloride/phytic acid (HTCC/PA, HP) powders with fast hemostatic capability and strong acid resistance, for potential applications in managing UGIB. Upon contact with liquids within 5 seconds, HP powders rapidly transform into hydrogels, forming ionic networks through electrostatic interactions. The ionic crosslinking process facilitates the HP powders with high blood absorption (3.4 times of self-weight), sufficient tissue adhesion (5.2 and 6.1 kPa on porcine skin and stomach, respectively), and hemostasis (within 15 seconds for in vitro clotting). Interestingly, the PA imparts the HP powders with strong acid resistance (69.8% mass remaining after 10 days of incubation at pH 1) and on-demand removable sealing while HTCC contributes to fast hemostasis and good wet adhesion. Moreover, the HP powders show good biocompatibility and promote wound healing. Therefore, these characteristics highlight the promising clinical potential of HP powders for effectively managing UGIB.

A Dry Patch with In Situ Solid-to-Gel Transformation for All-in-One Skin Wound Care

Hydrogel-based dressing materials offer significant potential in expediting skin wound healing. Nevertheless, they face several challenges: poor adhesion to wound tissues, difficulties in preservation under ambient conditions, and limited multifunctionality to support all wound healing stages. In this work, a dry patch is designed to address these persistent issues by featuring an in situ solid-to-gel transformation and Janus wet tissue adhesiveness. The HGP patch integrates a wet adhesive layer combining dopamine-conjugated hyaluronic acid (HD) and poly(acrylic acid) (PAA), a drug-loading layer comprising gelatin (Gel), and a nonadhesive gelation layer of poly(vinyl alcohol) (PVA) and sodium alginate (SA). This hierarchical structural design confers exceptional wound adhesion, hemostatic capabilities, and antibacterial and antioxidant activities, as well as immune regulatory properties. These attributes collectively support accelerated skin wound healing, particularly in cases complicated by bacterial infections. This research charts an approach to engineer hydrogel-based wound dressings through on-site hydrogel formation, thus advancing the treatment of wounds afflicted with complex infections.

A rapid and robust organ repair polyacrylamide/alginate adhesive hydrogel mediated via interfacial adhesion-trigger molecules

Adhesive hydrogels have been widely explored as tissue adhesives for wound sealing and repair. However, developing adhesive hydrogels with simple preparation techniques and strong adhesion to internal organs in a short time remains a challenge. In this study, we developed a strategy for robust and rapid tissue adhesion of internal organ sealing and repair by an interfacial adhesion-molecule triggered hydrogel system. In this system, polyphenol molecules act as adhesion-trigger reagents to achieve fast and strong adhesion of polyacrylamide/alginate hydrogels on the surface of wound tissue by rapidly forming abundant hydrogen bonds at the interface. The adhesion energy is significantly enhanced by 45 times under the mediation of polyphenol adhesion-trigger molecules, resulting in a robust (> 600 J m-2) tissue adhesion in just 30 s. This interfacial adhesion system demonstrates good biocompatibility, strong sealing performance on multiple organs (porcine heart, lung, stomach, and intestine), and excellent repair properties in gastric perforation wounds of rabbits in vivo. Moreover, immunocytochemical and transcriptomic analyses reveal that this interfacial adhesion system significantly promotes vascular regeneration and inhibits inflammatory responses during wound repairing. The proposed hydrogel provides a facile strategy for rapid and robust tissue adhesion, and shows potential applications in organ sealing and repair.

A tough Janus poly(vinyl alcohol)-based hydrogel for wound closure and anti postoperative adhesion

Traditional adhesive hydrogels perform well in tissue adhesion but they fail to prevent postoperative tissue adhesion. To address this challenge, a biodegradable Janus adhesive hydrogel (J-AH) was designed and fabricated by the assembly of three different functional layers including anti-adhesive layer, reinforceable layer, and wet tissue adhesive layer. Each layer of J-AH serves a specific function: the top zwitterionic polymeric anti-adhesive layer shows superior resistance to cell/protein and tissue adhesion; the middle poly(vinyl alcohol)/tannic acid reinforceable matrix layer endows the hydrogel with good mechanical toughness of ∼2.700 MJ/m3; the bottom poly(acrylic acid)/polyethyleneimine adhesive layer imparts tough adhesion (∼382.93 J/m2 of interfacial toughness) to wet tissues. In the rat liver and femoral injury models, J-AH could firmly adhere to the bleeding tissues to seal the wounds and exhibit impressive hemostatic efficiency. Moreover, in the in vivo adhesion/anti-adhesion assay of J-AH between the defected cecum and peritoneal walls, the top anti-adhesive layer can effectively inhibit undesired postoperative abdominal adhesion and inflammatory reaction. Therefore, this research may present a new strategy for the design of advanced bio-absorbable Janus adhesive hydrogels with multi-functions including tissue adhesion, anti-postoperative adhesion and biodegradation. STATEMENT OF SIGNIFICANCE: Despite many adhesive hydrogels with tough tissue adhesion capability have been reported, their proclivity for undesired postoperative adhesion remains a serious problem. The postoperative adhesion may lead to major complications and even endanger the lives of patients. The injectable hydrogels can cover the irregular wound and suppress the formation of postoperative adhesion. However, due to the lack of adhesive properties with tissue, it is difficult for the hydrogels to maintain on the wound surface, resulting in poor anti-postoperative adhesion effect. Herein, we design a Janus adhesive hydrogel (J-AH). J-AH integrates together robust wet tissue adhesion and anti-postoperative adhesion. Therefore, this research may present a new strategy for the design of advanced bio-absorbable Janus adhesive hydrogels.

Formulation-Property Effects in Novel Injectable and Resilient Natural Polymer-Based Hydrogels for Soft Tissue Regeneration

The development of injectable hydrogels for soft tissue regeneration has gained significant attention due to their minimally invasive application and ability to conform precisely to the shape of irregular tissue cavities. This study presents a novel injectable porous scaffold based on natural polymers that undergoes in situ crosslinking, forming a highly resilient hydrogel with tailorable mechanical and physical properties to meet the specific demands of soft tissue repair. By adjusting the formulation, we achieved a range of stiffness values that closely mimic the mechanical characteristics of native tissues while maintaining very high resilience (>90%). The effects of gelatin, alginate, and crosslinker concentrations, as well as porosity, on the hydrogel's properties were elucidated. The main results indicated a compression modulus range of 2.7-89 kPa, which fits all soft tissues, and gelation times ranging from 5 to 30 s, which enable the scaffold to be successfully used in various operations. An increase in gelatin and crosslinker concentrations results in a higher modulus and lower gelation time, i.e., a stiffer hydrogel that is created in a shorter time. In vitro cell viability tests on human fibroblasts were performed and indicated high biocompatibility. Our findings demonstrate that these injectable hydrogel scaffolds offer a promising solution for enhancing soft tissue repair and regeneration, providing a customizable and resilient framework that is expected to support tissue integration and healing with minimal surgical intervention.

Wet tissue adhesive polymeric powder hydrogels for skeletal muscle regeneration

Volumetric muscle loss (VML) frequently results from traumatic incidents and can lead to severe functional disabilities. Hydrogels have been widely employed for VML tissue regeneration, which are unfortunately ineffective because of the lack of intimate contact with injured tissue for structural and mechanical support. Adhesive hydrogels allow for strong tissue connections for wound closure. Nevertheless, conventional adhesive hydrogels exhibit poor tissue adhesion in moist, bleeding wounds due to the hydration layer at the tissue-hydrogel interfaces, resulting in insufficient performance. In this study, we developed a novel, biocompatible, wet tissue adhesive powder hydrogel consisting of dextran-aldehyde (dex-ald) and gelatin for the regeneration of VML. This powder absorbs the interfacial tissue fluid and buffer solution on the tissue, spontaneously forms a hydrogel, and strongly adheres to the tissue via various molecular interactions, including the Schiff base reaction. In particular, the powder composition with a 1:4 ratio of dex-ald to gelatin exhibited optimal characteristics with an appropriate gelation time (258 s), strong tissue adhesion (14.5 kPa), and stability. Dex-ald/gelatin powder hydrogels presented strong adhesion to various organs and excellent hemostasis compared to other wet hydrogels and fibrin glue. A mouse VML injury model revealed that the dex-ald/gelatin powder hydrogel significantly improved muscle regeneration, reduced fibrosis, enhanced vascularization, and decreased inflammation. Consequently, our wet-adhesive powder hydrogel can serve as an effective platform for repairing various tissues, including the heart, muscle, and nerve tissues.

Introductory Review of Soft Implantable Bioelectronics Using Conductive and Functional Hydrogels and Hydrogel Nanocomposites

Interfaces between implantable bioelectrodes and tissues provide critical insights into the biological and pathological conditions of targeted organs, aiding diagnosis and treatment. While conventional bioelectronics, made from rigid materials like metals and silicon, have been essential for recording signals and delivering electric stimulation, they face limitations due to the mechanical mismatch between rigid devices and soft tissues. Recently, focus has shifted toward soft conductive materials, such as conductive hydrogels and hydrogel nanocomposites, known for their tissue-like softness, biocompatibility, and potential for functionalization. This review introduces these materials and provides an overview of recent advances in soft hydrogel nanocomposites for implantable electronics. It covers material strategies for conductive hydrogels, including both intrinsically conductive hydrogels and hydrogel nanocomposites, and explores key functionalization techniques like biodegradation, bioadhesiveness, injectability, and self-healing. Practical applications of these materials in implantable electronics are also highlighted, showcasing their effectiveness in real-world scenarios. Finally, we discuss emerging technologies and future needs for chronically implantable bioelectronics, offering insights into the evolving landscape of this field.

Novel Functional Dressing Materials for Intraoral Wound Care

Intraoral wounds represent a particularly challenging category of mucosal and hard tissue injuries, characterized by the unique structures, complex environment, and distinctive healing processes within the oral cavity. They have a common occurrence yet frequently inflict significant inconvenience and pain on patients, causing a serious decline in the quality of life. A variety of novel functional dressings specifically designed for the moist and dynamic oral environment have been developed and realized accelerated and improved wound healing. Thoroughly analyzing and summarizing these materials is of paramount importance in enhancing the understanding and proficiently managing intraoral wounds. In this review, the particular processes and unique characteristics of intraoral wound healing are firstly described. Up-to-date knowledge of various forms, properties, and applications of existing products are then intensively discussed, which are categorized into animal products, plant extracts, natural polymers, and synthetic products. To conclude, this review presents a comprehensive framework of currently available functional intraoral wound dressings, with an aim to provoke inspiration of future studies to design more convenient and versatile materials.

Effects of a semi-interpenetrating network hydrogel loaded with oridonin and DNase-I on the healing of chemoradiotherapy-induced oral mucositis

The aim of this study was to develop a semi-interpenetrating network (IPN) hydrogel system suitable for the oral environment, capable of controlled release of DNase-I and oridonin (ORI), to exert antimicrobial, anti-inflammatory, and reparative effects on chemoradiotherapy-induced oral mucositis (OM). This IPN was based on the combination of ε-polylysine (PLL) and hetastarch (HES), loaded with DNase-I and ORI (ORI/DNase-I/IPN) for OM treatment. In vitro studies were conducted to evaluate degradation, adhesion, release analysis, and bioactivity including cell proliferation and wound healing assays using epidermal keratinocyte and fibroblast cell lines. Furthermore, the therapeutic effects of ORI/DNase-I/IPN were investigated in vivo using Sprague-Dawley (SD) rats with chemoradiotherapy-induced OM. The results demonstrated that the IPN exhibited excellent adhesion to wet mucous membranes, and the two drugs co-encapsulated in the hydrogel were released in a controlled manner, exerting inhibitory effects on bacteria and degrading NETs in wound tissues. The in vivo wound repair effect, microbiological assays, H&E and Masson staining supported the non-toxicity of ORI/DNase-I/IPN, as well as its ability to accelerate the healing of oral ulcers and reduce inflammation. Overall, ORI/DNase-I/IPN demonstrated a therapeutic effect on OM in rats by significantly accelerating the healing process. These findings provide new insights into possible therapies for OM.

Tissue-adhesive, stretchable and compressible physical double-crosslinked microgel-integrated hydrogels for dynamic wound care

Integrated wound care through sequentially promoting hemostasis, sealing, and healing holds great promise in clinical practice. However, it remains challenging for regular bioadhesives to achieve integrated care of dynamic wounds due to the difficulties in adapting to dynamic mechanical and wet wound environments. Herein, we reported a type of dehydrated, physical double crosslinked microgels (DPDMs) which were capable of in situ forming highly stretchable, compressible and tissue-adhesive hydrogels for integrated care of dynamic wounds. The DPDMs were designed by the rational integration of the reversible crosslinks and double crosslinks into micronized gels. The reversible physical crosslinks enabled the DPDMs to integrate together, and the double crosslinked characteristics further strengthen the formed macroscopical networks (DPDM-Gels). We demonstrated that the DPDM-Gels simultaneously possess outstanding tensile (∼940 kJ/m3) and compressive (∼270 kJ/m3) toughness, commercial bioadhesives-comparable tissue-adhesive strength, together with stable performance under hundreds of deformations. In vivo results further revealed that the DPDM-Gels could effectively stop bleeding in various bleeding models, even in an actual dynamic environment, and enable the integrated care of dynamic skin wounds. On the basis of the remarkable mechanical and appropriate adhesive properties, together with impressive integrated care capacities, the DPDM-Gels may provide a new approach for the smart care of dynamic wounds. STATEMENT OF SIGNIFICANCE: Integrated care of dynamic wounds holds great significance in clinical practice. However, the dynamic and wet wound environments pose great challenges for existing hydrogels to achieve it. This work developed robust adhesive hydrogels for integrated care of dynamic wounds by designing dehydrated, physical double crosslinked microgels (DPDMs). The reversible and double crosslinks enabled DPDMs to integrate into macroscopic hydrogels with high mechanical properties, appropriate adhesive strength and stable performance under hundreds of external deformations. Upon application at the injury site, DPDM-Gels efficiently stopped bleeding, even in an actual dynamic environment and showed effectiveness in integrated care of dynamic wounds. With the fascinating properties, DPDMs may become an effective tool for smart wound care.

Tranexamic acid-loaded catechol-modified hyaluronic acid/carboxymethyl chitosan double cross-linked porous gel micropowders for rapid hemostasis and wound healing

Acquiring rapid and effective hemostasis remains a critical clinical challenge. Current researches focus on concentrating blood components to speed up the hemostatic while ignore the effect of anti-fibrinolysis in promoting blood coagulation. Herein, we designed a novel tranexamic acid (TA)-loaded physicochemical double cross-linked multifunctional catechol-modified hyaluronic acid-dopamine/carboxymethyl chitosan porous gel micropowders (TA&Fe3+@HA-DA/CMCS PGMs) for rapid hemostasis and wound healing. TA&Fe3+@HA-DA/CMCS PGMs exhibited high water absorption rate (505.9 ± 62.1 %) and rapid hemostasis (79 ± 4 s) in vivo. Catechol groups, Fe3+ and the protonated amino groups of CMCS induced bacterial death. Moreover, TA&Fe3+@HA-DA/CMCS PGMs displayed sufficient adhesion to a variety of wet rat tissues. TA&Fe3+@HA-DA/CMCS PGMs on various bleeding wounds, including rat liver injury and tail severed models showed excellent hemostasis performance. The TA&Fe3+@HA-DA/CMCS PGMs could promote the healing of full-thickness skin wounds on the backs of rats. The advantages of TA&Fe3+@HA-DA/CMCS PGMs including rapid hemostasis, effective wound healing, good tissue adhesion, antibacterial properties and ease of use make it potentially valuable in clinical application.

Cation-π Interaction-Enhanced Self-Healing Injectable Hydrogels for Gastric Perforation Repair

Surgical operations are the preferred treatment for gastric perforation (GP) but incur postoperative complications such as gastrointestinal adhesions and bacterial infections, leading to inefficient wound healing and serious complications that may even threaten the life of the patient. Developing hydrogel dressings capable of adapting to the gastric environment (acid) and decreasing visceral adhesions and bacterial infections after GP treatment is crucial. In this article, we developed an injectable, self-healing hydrogel using cation-π interactions between protonated amines and aromatic rings under acidic conditions and explored it for GP repair. The hydrogels demonstrate exceptional self-healing capabilities under acidic conditions and can be effectively tailored for the gastric environment. In addition, the hydrogel demonstrated significant efficacy in preventing gastrointestinal adhesion, reducing inflammation, promoting angiogenesis, and effectively facilitating wound healing in a rat GP model. This novel hydrogel demonstrates adaptability to the gastric environment, rendering it highly promising for potential applications in gastric trauma healing.

Biomimetic and Wound Microenvironment-Modulating PEGylated Glycopolypeptide Hydrogels for Arterial Massive Hemorrhage and Wound Prohealing

Despite great progress in the hydrogel hemostats and dressings, they generally lack resistant vascular bursting pressure and intrinsic bioactivity to meet arterial massive hemorrhage and proheal wounds. To address the problems, we design a kind of biomimetic and wound microenvironment-modulating PEGylated glycopolypeptide hydrogels that can be easily injected and gelled in ∼10 s. Those glycopolypeptide hydrogels have suitable tissue adhesion of ∼20 kPa, high resistant bursting pressure of ∼150 mmHg, large microporosity of ∼15 μm, and excellent biocompatibility with ∼1% hemolysis ratio and negligible inflammation. They performed better hemostasis in rat liver and rat and rabbit femoral artery bleeding models than Fibrin glue, Gauze, and other hydrogels, achieving fast arterial hemostasis of <20 s and lower blood loss of 5-13%. As confirmed by in vivo wound healing, immunofluorescent imaging, and immunohistochemical and histological analyses, the mannose-modified hydrogels could highly boost the polarization of anti-inflammatory M2 phenotype and downregulate pro-inflammatory tumor necrosis factor-α to relieve inflammation, achieving complete full-thickness healing with thick dermis, dense hair follicles, and 90% collagen deposition. Importantly, this study provides a versatile strategy to construct biomimetic glycopolypeptide hydrogels that can not only resist vascular bursting pressure for arterial massive hemorrhage but also modulate inflammatory microenvironment for wound prohealing.

Robust Gradient Hydrogel-Loaded Nanofiber Fleshy Artificial Skin Via A Coupled Microfluidic Electrospinning-Reactive Coating Strategy

Skin regeneration attracts tremendous interest due to the important role of skin for human protection and beauty. Thus, methods allowing artificial skin to be carried out in a controllable fashion are potentially important for wound healing, which involves an intersection of materials, medicine, biology, and other disciplines. Herein, aiming at a new general methodology for fleshy materials, a new hydrogel-loaded hydrophobic-hydrophilic nanofiber fleshy artificial skin is designed and fabricated. The gradient hydrogel-loaded nanofiber artificial skin integrates both advantages of nanofiber and hydrogel, exhibiting fleshy feature (comparability to real skin in terms of appearance, texture, and function), excellent air permeability, compatibility, and good mechanical and antibacterial property. Interestingly, the efficient transport channels are formed throughout the hydrogel-loaded nanofiber structure, which is beneficial for water absorption and transfer. These advantages enable the establishment of a moist and favorable microenvironment; thus, greatly accelerating wound healing process. This work couples microfluidic electrospinning with reactive coating technique, which is in favor of material design and fabrication with controllable and uniform structures. The hydrogel-loaded nanofiber fleshy artificial skin shows comparability to real skin in terms of beauty, texture, and function, which would definitely provide new opportunities for the further optimization and upgrading of artificial skin.

Photothermally responsive graphene hybrid dry powders for diabetic wound healing

The treatment of diabetic wounds remains a significant challenge in the medical field. In this study, we present a novel approach using photothermally responsive graphene hybrid dry powders for the treatment of diabetic wounds. These powders, derived from polyacrylic acid (PAA) and polyethyleneimine (PEI), exhibit rapid water absorption at the interface, leading to thein situformation of physically crosslinked hydrogels due to interactions between polymers. Furthermore, by incorporating graphene into the PAA/PEI powder mixture, we establish a multifunctional platform with capabilities such as photothermal antibacterial effects and drug release. Given the outstanding performance of this hybrid material, we demonstrate its potential in wound healing by incorporating the tumor necrosis factor-alpha (TNF-α) inhibitor Etanercept into the PAA/PEI powder. This intervention resulted in a significant improvement in the wound healing process in diabetic rats, as evidenced by the downregulation of inflammatory factors, promotion of collagen deposition, and enhanced vascularization. These remarkable attributes underscore the enormous potential value of the presented hydrogel patches in the field of biomedicine.

Bioinspired nanostructured hydroxyapatite-polyelectrolyte multilayers for stone conservation

Stone-built cultural heritage faces threats from natural forces and anthropogenic pollutants, including local climate, acid rain, and outdoor conditions like temperature fluctuations and wind exposure, all of which impact their structural integrity and lead to their degradation. The development of a water-based, environmentally-friendly protective coatings that meet a combination of requirements posed by the diversity of the substrates, different environmental conditions, and structures with complex geometries remains a formidable challenge, given the numerous obstacles faced by current conservation strategies. Here we report the structural, electrical, and mechanical characterization, along with performance testing, of a nanostructured hydrophilic and self-healing hybrid coating based on hydroxyapatite (HAp) nanocrystals and polyelectrolyte multilayers (PEM), formed in-situ on Greek marble through a simple spray layer-by-layer surface functionalization technique. The polyelectrolyte-hydroxyapatite multilayer (PHM) structure resembled the design of naturally forming trabecular bone, attained at a short procedural time. It exhibited chemical affinity, aesthetical compatibility and resistance to weathering while offering reversibility. The proposed method is able to generate micron-sized coatings with controlled properties, such as adhesion and self-healing, leading to less weathered surfaces. Our results show that the PHM is a highly effective protective material that can be applied for stone protection and other similar applications.

Hybrid Double-Sided Tape with Asymmetrical Adhesion and Burst Pressure Tolerance for Abdominal Injury Treatment

Patients with open abdominal (OA) wounds have a mortality risk of up to 30%, and the resulting disabilities would have profound effects on patients. Here, we present a novel double-sided adhesive tape developed for the management of OA wounds. The tape features an asymmetrical structure and employs an acellular dermal matrix (ADM) with asymmetric wettability as a scaffold. It is constructed by integrating a tissue-adhesive hydrogel composed of polydopamine (pDA), quaternary ammonium chitosan (QCS), and acrylic acid cross-linking onto the bottom side of the ADM. Following surface modification with pDA, the ADM would exhibit characteristics resistant to bacterial adhesion. Furthermore, the presence of a developed hydrogel ensures that the tape not only possesses tissue adhesiveness and noninvasive peelability but also effectively mitigates damage caused by oxidative stress. Besides, the ADM inherits the strength of the skin, imparting high burst pressure tolerance to the tape. Based on these remarkable attributes, we demonstrate that this double-sided (D-S) tape facilitates the repair of OA wounds, mitigates damage to exposed intestinal tubes, and reduces the risk of intestinal fistulae and complications. Additionally, the D-S tape is equally applicable to treating other abdominal injuries, such as gastric perforations. It effectively seals the perforation, promotes injury repair, and prevents the formation of postoperative adhesions. These notable features indicate that the presented double-sided tape holds significant potential value in the biomedical field.

Silk fibroin-based hemostatic powders with instant and robust adhesion performance for sutureless sealing of gastrointestinal defects

Powder-based hemostatic technology has offered unprecedented opportunities in surgical sealing and repair of irregularly shaped and noncompressible wounds. Despite their routine use, existing clinical hemostatic powders are challenged either by poor mechanical properties or inadequate adhesion to bleeding tissues in biological environments. Here, inspired by the mussel foot proteins' fusion assembly strategy, a novel silk fibroin-based hemostatic powder (named as SF/PEG/TA) with instant and robust adhesion performance is developed. Upon absorbing interfacial liquids, the SF/PEG/TA powders rapidly swell into micro-gels and subsequently contact with each other to transform into a macroscopically homogeneous hydrogel in situ, strengthening its interfacial bonding with various substrates in fluidic environments. The in vitro and in vivo results show that the SF/PEG/TA powder possesses ease of use, good biocompatibility, strong antibacterial activities, and effective blood clotting abilities. The superior hemostatic sealing capability of the SF/PEG/TA powder is demonstrated in the rat liver, heart, and gastrointestinal injury models. Moreover, in vivo investigation of rat skin incision and gastrointestinal perforation models validates that the SF/PEG/TA powder promotes wound healing and tissue regeneration. Taken together, compared to existing clinical hemostatic powders, the proposed SF/PEG/TA powder with superior wound treatment capabilities has high potential for clinical hemostasis and emergency rescue.

Bionic double-crosslinked hydrogel of poly (γ-glutamic acid)/poly (N-(2-hydroxyethyl) acrylamide) with ultrafast gelling process and ultrahigh burst pressure for emergency rescue

Injectable adhesive hydrogels combining rapid gelling with robust adhesion to wet tissues are highly required for fast hemostasis in surgical and major trauma scenarios. Inspired by the cross-linking mechanism of mussel adhesion proteins, we developed a bionic double-crosslinked (BDC) hydrogel of poly (γ-glutamic acid) (PGA)/poly (N-(2-hydroxyethyl) acrylamide) (PHEA) fabricated through a combination of photo-initiated radical polymerization and hydrogen bonding cross-linking. The BDC hydrogel exhibited an ultrafast gelling process within 1 s. Its maximum adhesion strength to wet porcine skin reached 254.5 kPa (9 times higher than that of cyanoacrylate (CA) glue) and could withstand an ultrahigh burst pressure of 626.4 mmHg (24 times higher than that of CA glue). Notably, the BDC hydrogel could stop bleeding within 10 s from a rat liver incision 10 mm long and 5 mm deep. The wound treated with the BDC hydrogel healed faster than the control groups, underlining the potential for emergency rescue and wound care scenarios.

Dough-Kneading-Inspired Design of an Adhesive Cardiac Patch to Attenuate Cardiac Fibrosis and Improve Cardiac Function via Regulating Glycometabolism

Recently, hydrogel adhesive patches have been explored for treating myocardial infarction. However, achieving secure adhesion onto the wet beating heart and local regulation of pathological microenvironment remains challenging. Herein, a dough-kneading-inspired design of hydrogel adhesive cardiac patch is reported, aiming to improve the strength of prevalent powder-formed patch and retain wet adhesion. In mimicking the polysaccharide and protein components of natural flour, methacrylated polyglutamic acid (PGAMA) is electrostatically interacted with hydroxypropyl chitosan (HPCS) to form PGAMA/HPCS coacervate hydrogel. The PGAMA/HPCS hydrogel is freeze-dried and ground into powders, which are further rehydrated with two aqueous solutions of functional drug, 3-acrylamido phenylboronic acid (APBA)/rutin (Rt) complexes for protecting the myocardium from advanced glycation end product (AGEs) injury by reactive oxygen species (ROS) -responsive Rt release, and hypoxanthine-loaded methacrylated hyaluronic acid (HAMA) nanogels for enhancing macrophage targeting ability to regulate glycometabolism for combating inflammation. The rehydrated powders bearing APBA/Rt complexes and HAMA-hypoxanthine nanogels are repeatedly kneaded into a dough-like gel, which is further subjected to thermal-initiated crosslinking to form a stabilized and sticky patch. This biofunctional patch is applied onto the rats' infarcted myocardium, and the outcomes at 28 days post-surgery indicate efficient restoration of cardiac functions and attenuation of cardiac fibrosis.

A low-swelling hydrogel as a multirole sealant for efficient dural defect sealing and prevention of postoperative adhesion

Dural defects and subsequent complications, including cerebrospinal fluid (CSF) leakage, are common in both spine surgery and neurosurgery, and existing clinical treatments are still unsatisfactory. In this study, a tissue-adhesive and low-swelling hydrogel sealant comprising gelatin and o-phthalaldehyde (OPA)-terminated 4-armed poly(ethylene glycol) (4aPEG-OPA) is developed via the OPA/amine condensation reaction. The hydrogel shows an adhesive strength of 79.9 ± 12.0 kPa on porcine casing and a burst pressure of 208.0 ± 38.0 cmH2O. The hydrogel exhibits a low swelling ratio at physiological conditions, avoiding nerve compression in the limited spinal and intracranial spaces. In rat and rabbit models of lumbar and cerebral dural defects, the 4aPEG-OPA/gelatin hydrogel achieves excellent performance in dural defect sealing and preventing CSF leakage. Moreover, local inflammation, epidural fibrosis and postoperative adhesion in the defect areas are markedly reduced. Thus, these findings establish the strong potential of the hydrogel sealant for the effective watertight closure of dural defects.

A Nature-Derived, Hetero-Structured, Pro-Healing Bioadhesive Patch for High-Performance Sealing of Wet Tissues

Tissue adhesives are promising alternatives to sutures and staples to achieve wound closure and hemostasis. However, they often do not work well on tissues that are soaked in blood or other biological fluids, and organs that are typically exposed to a variety of harsh environments such as different pH values, nonhomogeneous distortions, continuous expansions and contractions, or high pressures. In this study, a nature-derived multilayered hetero-bioadhesive patch (skin secretion of Andrias davidianus (SSAD)-Patch) based on hydrophilic/hydrophobic pro-healing bioadhesives derived from the SSAD is developed, which is designed to form pressure-triggered strong adhesion with wet tissues. The SSAD-Patch is successfully applied for the sealing and healing of tissue defects within 10 s in diverse extreme injury scenarios in vivo including rat stomach perforation, small intestine perforation, fetal membrane defect, porcine carotid artery incision, and lung lobe laceration. The findings reveal a promising new type of self-adhesive regenerative SSAD-Patch, which is potentially adaptable to broad applications (under different pH values and air or liquid pressures) in sutureless wound sealing and healing.

Infant friendly adhesive film containing glucose for neonatal hypoglycemia

Neonatal hypoglycemia is a common disease in newborns, which can precipitate energy shortage and follow by irreversible brain and neurological injury. Herein, we present a novel approach for treating neonatal hypoglycemia involving an adhesive polyvinylpyrrolidone/gallic acid (PVP/GA) film loading glucose. The PVP/GA film with loose cross-linking can be obtained by mixing their ethanol solution and drying complex. When depositing this soft film onto wet tissue, it can absorb interfacial water to form a hydrogel with a rough surface, which facilitates tight contact between the hydrogel and tissue. Meanwhile, the functional groups in the hydrogels and tissues establish both covalent and non-covalent bonds, leading to robust bioadhesion. Moreover, the adhered PVP/GA hydrogel can be detached without damaging tissue as needed. Furthermore, the PVP/GA films exhibit excellent antibacterial properties and biocompatibility. Notably, these films effectively load glucose and deliver it to the sublingual tissue of newborn rabbits, showcasing a compelling therapeutic effect against neonatal hypoglycemia. The strengths of the PVP/GA film encompass excellent wet adhesion in the wet and highly dynamic environment of the oral cavity, on-demand detachment, antibacterial efficacy, biocompatibility, and straightforward preparation. Consequently, this innovative film holds promise for diverse biomedical applications, including but not limited to wearable devices, sealants, and drug delivery systems.

Analyzing Mushroom Structural Patterns of a Highly Compressible and Expandable Hemostatic Foam for Gastric Perforation Repair

Nature presents the most beautiful patterns through evolving. Here, a layered porous pattern in golden ratio (0.618) is reported from a type of mushroom -Dictyophora Rubrovalvata stipe (DRS). The hierarchical structure shows a mathematical correlation with the golden ratio. This unique structure leads to superior mechanical properties. The gradient porous structure from outside to innermost endows it with asymmetrical hydrophilicity. A mathematical model is then developed to predict and apply to 3D printed structures. The mushroom is then explored to repair gastric perforation because the stomach is a continuous peristaltic organ, and the perforated site is subject to repeated mechanical movements and pressure changes. At present, endoscopic clipping is ineffective in treating ulcerative perforation with fragile surrounding tissues. Although endoscopic implant occlusion provides a new direction for the treatment of gastric ulcers, but the metal or plastic occluder needs to be removed, requiring a second intervention. Decellularized DRS (DDRS) is found with asymmetric water absorption rate, super-compressive elasticity, shape memory, and biocompatibility, making it a suitable occluder for the gastric perforation. The efficacy in blocking gastric perforation and promoting healing is confirmed by endoscopic observation and tissue analysis during a 2-month study.

Bioinspired Photoelectronic Synergy Coating with Antifogging and Antibacterial Properties

Optically transparent glass with antifogging and antibacterial properties is in high demand for endoscopes, goggles, and medical display equipment. However, many of the previously reported coatings have limitations in terms of long-term antifogging and efficient antibacterial properties, environmental friendliness, and versatility. In this study, inspired by catfish and sphagnum moss, a novel photoelectronic synergy antifogging and antibacterial coating was prepared by cross-linking polyethylenimine-modified titanium dioxide (PEI-TiO2), polyvinylpyrrolidone (PVP), and poly(acrylic acid) (PAA). The as-prepared coating could remain fog-free under hot steam for more than 40 min. The experimental results indicate that the long-term antifogging properties are due to the water absorption and spreading characteristics. Moreover, the organic-inorganic hybrid of PEI and TiO2 was first applied to enhance the antibacterial performance. The Staphylococcus aureus and the Escherichia coli growth inhibition rates of the as-prepared coating reached 97 and 96% respectively. A photoelectronic synergy antifogging and antibacterial mechanism based on the positive electrical and photocatalytic properties of PEI-TiO2 was proposed. This investigation provides insight into designing multifunctional bioinspired surface materials to realize antifogging and antibacterial that can be applied to medicine and daily lives.

Biomimetic Materials for Skin Tissue Regeneration and Electronic Skin

Biomimetic materials have become a promising alternative in the field of tissue engineering and regenerative medicine to address critical challenges in wound healing and skin regeneration. Skin-mimetic materials have enormous potential to improve wound healing outcomes and enable innovative diagnostic and sensor applications. Human skin, with its complex structure and diverse functions, serves as an excellent model for designing biomaterials. Creating effective wound coverings requires mimicking the unique extracellular matrix composition, mechanical properties, and biochemical cues. Additionally, integrating electronic functionality into these materials presents exciting possibilities for real-time monitoring, diagnostics, and personalized healthcare. This review examines biomimetic skin materials and their role in regenerative wound healing, as well as their integration with electronic skin technologies. It discusses recent advances, challenges, and future directions in this rapidly evolving field.

Preparation and Application of Hemostatic Hydrogels

Hemorrhage remains a critical challenge in various medical settings, necessitating the development of advanced hemostatic materials. Hemostatic hydrogels have emerged as promising solutions to address uncontrolled bleeding due to their unique properties, including biocompatibility, tunable physical characteristics, and exceptional hemostatic capabilities. In this review, a comprehensive overview of the preparation and biomedical applications of hemostatic hydrogels is provided. Particularly, hemostatic hydrogels with various materials and forms are introduced. Additionally, the applications of hemostatic hydrogels in trauma management, surgical procedures, wound care, etc. are summarized. Finally, the limitations and future prospects of hemostatic hydrogels are discussed and evaluated. This review aims to highlight the biomedical applications of hydrogels in hemorrhage management and offer insights into the development of clinically relevant hemostatic materials.

A grape seed protein-tannic acid powder to transform various non-adhesive hydrogels into adhesive gels

Realizing adhesion between wet materials remains challenging because of the interfacial water. Current strategies depend on complicated surface modifications, resulting in limited functions. Herein, a facile strategy based on the powder of grape seed protein and tannic acid (GSP-TA) was reported to endow various non-adhesive hydrogels adhesion without chemical modifications for both hydrogels and adherents. The GSP-TA powder has the capability to absorb interfacial water, form an adhesive layer on the hydrogel surface, diffusion into the underneath hydrogel matrix, and establish the initial adhesion within 5 s. By forming multiple non-covalent interactions between powders and substrates, the GSP-TA powder served as an efficient surface treating agent, enabling robust adhesion to solid substrates (wood, cardboard, glass, iron, and rubber) and wet tissues (pigskin, muscle, liver and heart). The adhesive strength for wood, cardboard, glass, iron, and rubber was 145.92 ± 5.93, 123.93 ± 15.98, 66.24 ± 7.67, 98.22 ± 4.13, and 80.83 ± 7.48 kPa, respectively. Because of reversible interactions, the adhesion was also repeatable. Due to the merits of grape seed protein and plant polyphenol, it could be completely degraded within 11 days. Bearing several merits, this strategy has promising applications in wound patches, tissue repair, and sensors.

Emerging polymeric materials for treatment of oral diseases: design strategy towards a unique oral environment

Oral diseases are prevalent but challenging diseases owing to the highly movable and wet, microbial and inflammatory environment. Polymeric materials are regarded as one of the most promising biomaterials due to their good compatibility, facile preparation, and flexible design to obtain multifunctionality. Therefore, a variety of strategies have been employed to develop materials with improved therapeutic efficacy by overcoming physicobiological barriers in oral diseases. In this review, we summarize the design strategies of polymeric biomaterials for the treatment of oral diseases. First, we present the unique oral environment including highly movable and wet, microbial and inflammatory environment, which hinders the effective treatment of oral diseases. Second, a series of strategies for designing polymeric materials towards such a unique oral environment are highlighted. For example, multifunctional polymeric materials are armed with wet-adhesive, antimicrobial, and anti-inflammatory functions through advanced chemistry and nanotechnology to effectively treat oral diseases. These are achieved by designing wet-adhesive polymers modified with hydroxy, amine, quinone, and aldehyde groups to provide strong wet-adhesion through hydrogen and covalent bonding, and electrostatic and hydrophobic interactions, by developing antimicrobial polymers including cationic polymers, antimicrobial peptides, and antibiotic-conjugated polymers, and by synthesizing anti-inflammatory polymers with phenolic hydroxy and cysteine groups that function as immunomodulators and electron donors to reactive oxygen species to reduce inflammation. Third, various delivery systems with strong wet-adhesion and enhanced mucosa and biofilm penetration capabilities, such as nanoparticles, hydrogels, patches, and microneedles, are constructed for delivery of antibiotics, immunomodulators, and antioxidants to achieve therapeutic efficacy. Finally, we provide insights into challenges and future development of polymeric materials for oral diseases with promise for clinical translation.

MFGE8 in exosomes derived from mesenchymal stem cells prevents esophageal stricture after endoscopic submucosal dissection in pigs

BACKGROUND

Endoscopic submucosal dissection (ESD) is the current standard treatment for early-stage esophageal neoplasms. However, the postoperative esophageal stricture after extensive mucosal dissection remains a severe challenge with limited effective treatments available. In this study, we introduced a chitosan/gelatin (ChGel) sponge encapsulating the adipose mesenchymal stem cells (ADMSCs)-derived exosomes (ChGelMSC-Exo) for the prevention of esophageal stenosis after ESD in a porcine model.

RESULTS

Pigs were randomly assigned into (1) ChGelMSC-Exo treatment group, (2) ChGelPBS group, and (3) the controls. Exosome treatments were applied immediately on the day after ESD as well as on day 7. Exosome components crucial for wound healing were investigated by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and small RNA sequencing. ChGelMSC-Exo treatment significantly reduced mucosal contraction on day 21, with less fiber accumulation and inflammatory infiltration, and enhanced angiogenesis when compared with the control and ChGelPBS groups. The anti-fibrotic effects following MSC-Exo treatment were further found to be associated with the anti-inflammatory M2 polarization of the resident macrophages, especially within the M2b subset characterized by the reduced TGFβ1 secretion, which sufficiently inhibited inflammation and prevented the activation of myofibroblast with less collagen production at the early stage after ESD. Moreover, the abundant expression of exosomal MFGE8 was identified to be involved in the transition of the M2b-macrophage subset through the activation of MFGE8/STAT3/Arg1 axis.

CONCLUSIONS

Our study demonstrates that exosomal MFGE8 significantly promotes the polarization of the M2b-macrophage subset, consequently reducing collagen deposition. These findings suggest a promising potential for MSC-Exo therapy in preventing the development of esophageal stricture after near-circumferential ESD.