A Sandwiched Patch for Prevention of Pelvic Adhesion After Uterine Operation.

Abstract

The prevention of postoperative adhesions remains a critical clinical challenge in gynecological surgery, as these pathological formations may lead to intestinal obstruction, chronic pelvic pain, and reproductive complications. Regarding the clinical application of anti-adhesion barriers, current products including but not limited to Interceed and chitosan-based dressings have demonstrated suboptimal efficacy in practice. We developed a triple-layer patch comprising: (1) a tissue-adhesive inner layer of polyacrylic acid-gelatin composite, (2) a mechanically dissipative intermediate layer of polyglycine, and (3) an anti-adhesive external layer of polyzwitterionic polymer. In this study, we investigated the antiadhesion effect of the triple-layer patch by using a uterine operation model in rats and reported that the triple-layer patch can inhibit the production of tumor necrosis factor-α and transforming growth factor beta 1, upregulate tissue-type plasminogen activator, and downregulate plasminogen activator inhibitor to inhibit inflammation and fibrosis. These findings substantiate that the triple-layer patch may have broad applicability to prevent postoperative adhesions through inhibition of inflammatory responses and fibrotic processes, demonstrating promising translational potential in gynecological surgery.