Concrete Structure Inspired 3D-Printed Framework Mechanically Reinforced Zwitterionic Hydrogel for Efficient Postoperative Abdominal Adhesion Prevention.

Zwitterionic hydrogels, which have been demonstrated to hold great potential in preventing abdominal adhesion, are hindered in clinical translation by their inherent mechanical fragility and structural instability. Inspired by the framework-reinforced composite structure of concrete in building construction, herein, a 3D-printed polymeric framework reinforced zwitterionic lubricating hydrogel (abbreviated as 3DF-LH) is developed, which features high tensile strength internally and optimal lubrication externally. Just like the establishment process of concrete, 3DF-LH is fabricated by infiltrating hydrogel precursor solution, that consisted of GelMA and zwitterionic sulfobetaine methacrylate (SBMA), into the pores of a 3D-printed PCL framework (3DF), followed by UV curing. In vitro studies demonstrated that the 3DF-LH composite exhibited superior structural stability, mechanical robustness, and biocompatibility, along with significantly suppressing fibroblast adhesion. In an SD rat cecal-abdominal wall postoperative adhesion model, 3DF-LH attenuated the inflammatory microenvironment, which involved the suppression of the TGF-β/Smad signaling pathway, thereby effectively inhibiting abdominal adhesion formation. These findings demonstrate that developed 3DF-LH effectively addresses the mechanical limitations of zwitterionic hydrogels and thus holds great potential for future clinical translation.