A coenzyme-based self-stabilized Janus adhesive patch for spatiotemporal regulation of sutureless diabetic tendon healing.

Chronic inflammation and adhesion formation severely impede the healing process of diabetic tendons, while current surgical sutures and pharmacological interventions often fail to restore microenvironmental homeostasis. Here, we report a coenzyme-based self-stabilized Janus adhesive patch for spatiotemporal regulation of sutureless diabetic tendon healing. Unlike strategies relying on exogenous agents, we utilized the strong hydrogen bonding interactions between endogenous coenzyme α-lipoic acid (LA) and its potassium salt (LAK) to engineer a stable binary supramolecular adhesive layer (P (Lx-Ky)) without exogenous additives, enabling sustained release of bioactive LAK molecules. Temporally, the P (Lx-Ky) adhesive layer tightly adhered to injured diabetic tendons. The sustainably released LAK could directly scavenge ROS and provide antibacterial protection, thereby driving the polarization of macrophages from the pro-inflammatory M1 phenotype to the reparative M2 phenotype. Spatially, the poly (lactic-co-glycolic acid) barrier layer (PLGA) provides mechanical support and prevents fibroblast infiltration and the formation of peritendinous adhesions. The Janus adhesive patch achieves a paradigm shift from exogenous drug delivery to endogenous spatiotemporal metabolic regulation in diabetic tendon healing. It offers a promising sutureless solution for diabetic tissue regeneration.