Photo-crosslinked carboxymethyl cellulose/collagen hydrogel-infused mesh for preventing postoperative pelvic adhesions in a rat model.

Abstract

Postoperative adhesion formation remains a critical challenge in abdominal and pelvic surgeries involving mesh implantation. In this study, we developed an anti-adhesion hydrogel by photo-crosslinking methacrylated carboxymethyl cellulose (CMCMA) with maleated collagen (ColME), which was infused into surgical meshes for anti-adhesion. The CMCMA/ColME hydrogel exhibited shear-thinning behavior, high water content, and tunable mechanical properties, as well as good cytocompatibility. In a rat cecal abrasion model, the hydrogel reduced intra-abdominal adhesion scores to 0 compared to untreated group 3&#xa0;&#xb1;&#xa0;2.07 (p&#xa0;<&#xa0;0.05). When applied to surgical polypropylene mesh in a rat pelvic implantation model, the hydrogel-infused mesh demonstrated significantly lower adhesion scores (mean score 0.17&#xa0;&#xb1;&#xa0;0.41 vs. 4&#xa0;&#xb1;&#xa0;0.76, p&#xa0;<&#xa0;0.001) and minimal tissue inflammatory. Histological and immunohistochemical analyses revealed diminished collagen deposition and macrophage infiltration around the hydrogel-infused mesh. These findings indicate that the CMCMA/ColME hydrogel provides an effective barrier to prevent postoperative adhesions, with high biocompatibility and potential clinical applicability in abdominal and pelvic repair procedures.