Injectable PRP-Enriched photosensitive hydrogel: Enhanced prevention and infection control in anastomotic leaks

Abstract

The occurrence of anastomotic leakage (AL) could lead to leakage of digestive fluid, which erodes surrounding organs, subsequently causing severe intra-abdominal infections, hemorrhaging, and even death. Preventing AL was crucial for significantly enhancing patient quality of life. Thus, we developed an injectable photosensitive hydrogel enriched with platelet-rich plasma (PRP) aimed at preventing AL. This study utilized the Schiff-base crosslinking reaction between photosensitive methacryloyl-substituted gelatin (GM) and oxidized dextran (OD), incorporating PRP to create a multifunctional, tri-crosslinked hydrogel (GM/OD@PRP) that effectively promotes AL healing. This GM/OD@PRP exhibited excellent mechanical properties, biocompatibility, and self-healing capabilities. The hydrogel was loaded with PRP, which was rich in various growth factors that stimulate fibroblast proliferation and angiogenesis, thereby increasing cell proliferation, vascular regeneration, and formation and ultimately promoting healing at the anastomotic site. Furthermore, the superior antimicrobial properties of GM/OD@PRP provide a relatively sterile environment at the healing site, reducing the possibility of abdominal infections. In a rat model of AL, the GM/OD@PRP notably enhanced anastomotic healing prevented the occurrence of fistulae, and demonstrated significant advantages in reducing abdominal adhesions. This GM/OD@PRP holds substantial potential for use in preventing AL and represents a promising new composite material for improving patient quality of life.