Wound adhesion after any abdominal and gastrointestinal surgery is as high as 90 %, and if the adhesion is severe, it will be fatal. During the operation, various methods are used to avoid the adhesion of organs, such as reducing surgical wound area and using hydrogel products with short gelation time. However, these gels might cause allergy, and the gels are unsuitable for long-lasting recovery processes because the body absorbs them too quickly to avoid sticking. Hence, we developed a long-lasting, temperature-sensitive hydrogel using arginyl-glycyl-aspartic acid to help heal postoperative wounds. The hydrogel formed at 37 °C, degraded in 7 days up to 50 % and provided a practicable anti-adhesion function. As the cell and animal tests indicated, the hydrogel exhibited preferable biocompatibility and was proven to effectively avoid adhesion behavior after abdominal surgery while boosting tissue proliferation; animal experiments have confirmed that hydrogel can effectively avoid adhesion after abdominal surgery and help tissue proliferation. This hydrogel inhibits SMAD, P38, and PI3K pathways by blocking fibrosis cytokines and TGF-β downstream signaling. This TGF-β inhibition promotes histoarchitecture remodeling and reduces cecum tissue fibrosis. Our hydrogel provides a new option for anti-sticking products and can be applied to versatile medical uses in the future.
Keywords: Anti-adhesion; Arginyl-glycyl-aspartic acid; Chitosan; Hydrogel; TGF-β1/SMAD signaling pathway; Thermosensitive.
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