Peritoneum inspired Janus barrier with unilateral lubrication, programmable adhesion and antiinflammation for preventing postoperative abdominal adhesion

Postoperative abdominal adhesion, coupled with adverse effects, threatens to patient’s life. However, most bioadhesives as anti-tissue adhesion barrier encounter unreliable adhesion towards slippery abdominal wall along with accidental mispositioning during use, even overlook the impact of frictional stimuli and inflammation on abdominal adhesion. Herein, inspired by lubricated peritoneum, a programmable adhesive dual-layer Janus patch (DJP) barrier with unilateral lubrication and anti-inflammation integrating lubricated layer and adhesive matrix is developed to prevent postoperative abdominal adhesion. Programmable adhesion of DJP rapidly establishes adhesion interface between barrier and tissue primarily through noncovalent interaction, then enhances the interfacial stability of 2.81-fold through covalent interaction. This timescale-dependent adhesion can also allow the mispositioned bioadhesive to be repositioned on tissue in short time, improving surgical fault tolerance. Hydration of micron-scale poly sulfobetaine methacrylamide brush on DJP surface imitates peritoneal lubrication with low coefficient of friction (0.06), diminishing frictional stimuli towards injured tissue. Meanwhile, anti-inflammation of DJP by the antioxidative catechol-containing copolymer is demonstrated in vitro. Further, a rat model indicates that DJP adhering to injured site reduces deposited collagen between abdominal wall and cecum, preventing abdominal adhesion and facilitating tissue healing compared with commercial barriers. Overall, this work provides a notable guiding reference in development of antiadhesive biomaterials.