Double network crosslinked antibacterial and antioxidant cellulose-based hydrogel capable of healing wound for protecting open abdomen.

Abstract

Open abdomen (OA) is a life-saving surgical intervention commonly performed in patients with severe pancreatitis, intra-abdominal infection, or major trauma. However, abdominal exposure after OA inevitably leads to continuous fluid and heat loss, making temporary abdominal closure (TAC) indispensable in these cases. Conventional materials, such as polypropylene (PP) mesh, can prevent abdominal wall retraction. However, they may cause intestinal abrasions, which can lead to enteroatmospheric fistulas. Thus, the development of wound dressings that combine structural support and bioactivity is highly important. In this study, we developed a multifunctional composite hydrogel by combining gelatin methacryloyl (GelMA) with TEMPO-oxidized cellulose nanofibers (TC) and further crosslinking with zinc ions (Zn²⁺) coordination to form Zn-TC-GelMA (Zn-TCG). The Zn-TCG hydrogel exhibited tunable mechanical properties, excellent injectability, and sustained Zn²⁺ release. It exhibited good hemocompatibility, suppressed reactive oxygen species (ROS) accumulation, and inhibited bacterial proliferation. In vitro, Zn-TCG significantly enhanced fibroblast migration and HUVEC tube formation. In vivo, it markedly accelerated re-epithelization, collagen deposition, and angiogenesis compared to the control treated with GelMA and PP mesh. Mechanistic studies confirmed the activation of the MAPK/ERK signaling pathway and upregulation of epidermal differentiation markers (Krt10, Loricrin, and Tgm1). RNA-seq further revealed enrichment in keratinization and immune-related pathways. In conclusion, the Zn-TCG hydrogel represents a promising strategy for temporary abdominal closure and wound management.