Engineering injectable bioadhesives with sealing and anti-fouling properties for postoperative anti-adhesion

Postoperative adhesion is a common complication that follows various types of surgeries, causing patients suffering and increasing healthcare costs. Current anti-adhesion barriers fail to provide satisfactory therapeutic outcomes mainly due to their weak retention, inability to prevent fluid leakage, and potential foreign body reactions. In the present study, we fabricated a serine-modified bioadhesive (SESAgel) with improved sealing and anti-fouling properties for postoperative adhesion prevention. The resulting SESAgel exhibited good injectability and in-situ adhesion ability, forming a stable membranous anti-adhesion barrier on the wound surface. Innovatively, it possessed efficient sealing properties, effectively stopping the leakage of tissue fluid and blood, which triggers tissue adhesion formation in the early stage. On this basis, the anti-fouling property derived from the serine in this physical barrier can further prevent the accumulation of inflammatory cells and foreign body reactions, thereby minimizing tissue adhesion. Two animal models were used to demonstrate that SESAgel effectively inhibited postoperative adhesion in different surgeries. With its natural design and good biocompatibility, SESAgel is a promising anti-adhesion biomaterial for clinical translation and practice.