A novel PVA/QCS/AgNP hydrogel with antibacterial and healing-promoting efficacy for preventing postoperative pancreatic fistula in rats.

Postoperative pancreatic fistula (POPF), a life-threatening complication following pancreatic surgery, demands innovative biomaterials to prevent infection and promote healing simultaneously. Traditional sealants lack controlled degradation, mechanical robustness, and antibacterial efficacy. Here, we developed a multifunctional hydrogel composed of polyvinyl alcohol (PVA), quaternized chitosan (QCS), and silver nanoparticles (AgNPs) to address these challenges. The PVA/QCS/AgNP hydrogel was synthesized via UV-induced reduction of Ag⁺ and freeze‒thaw cycles, yielding a mechanically stable network with a uniform AgNP dispersion. In vitro, the hydrogel exhibited broad-spectrum antibacterial activity against Staphylococcus aureus, Escherichia coli, and other pathogens while maintaining > 90 % fibroblast viability. Its controlled AgNP release profile balanced antimicrobial potency and biocompatibility. In a rat pancreatic fistula model, the hydrogel significantly reduced fluid leakage and inflammation, accelerated collagen deposition, and normalized serum amylase levels within 14 days. A transcriptomic analysis revealed the upregulation of the cell cycle and extracellular matrix remodeling pathways, in addition to the suppression of proinflammatory cytokines, elucidating its dual roles in infection control and tissue regeneration. By integrating robust sealing, enzymatic resistance, and immunomodulatory properties, this hydrogel represents a clinically translatable solution for POPF management, outperforming conventional therapies and advancing the design of multifunctional biomaterials for complex surgical applications.