Injectable polyphenol hydrogel prevents peritoneal adhesion intensified by intraperitoneal microbial infection

Surgical procedures involving the abdominal cavity often necessitate extensive manipulation of the microbe-rich intestines. The inevitable gut microbial infection often leads to complications within the abdominal cavity and an increase in postoperative adhesions. The current approach for treating postoperative adhesion is to focus on the physical barrier, with minimal consideration given to the role of microbial infection. In this work, a multifunctional hydrogel (EMCGA) can be easily obtained by copolymerization of the complex formed by epigallocatechin-3-gallate and chondroitin sulfate derivative, and 2-methacryloyloxyethyl phosphorylcholine. Owing to the zwitterionic and catechol groups, the resulting hydrogel exhibits excellent antifouling and antibacterial abilities. We constructed peritoneal adhesion using a microbial infection model to demonstrate the antiadhesion and antibacterial efficiencies of the EMCGA hydrogel in different animal species (e.g., rat, rabbit). Using transcriptomics and reverse transcription polymerase chain reaction, we demonstrated that microbial infection can drive epidermal growth factor receptor (EGFR) signaling to promote mesothelial-to-mesenchymal transition. Administration of EMCGA hydrogel resulted in a remarkable inhibition of EGFR and PANoptosis signaling, accompanied by a considerable reduction in adhesion formation and excessive inflammation. Collectively, the dual effect of EMCGA hydrogel, acting a physical barrier and an EGFR inhibitor, emphasizes its promising potential for application in clinical medicine.