Development and Characterization of Biodegradable Polyurethane-Urea-Based Hydrogels for the Prevention of Postoperative Peritoneal Adhesions

Postoperative peritoneal adhesions occur after more than 60% of abdominal surgeries and can cause severe long-term side effects, such as chronic pain, infertility, and intestinal obstructions. However, currently available products for adhesion prophylaxis often lack efficiency or are too heavy to handle. Hydrogels are promising materials to be used for adhesion prevention as they show good mechanical stability and biocompatibility. Herein, we present a novel two-component sprayable, biodegradable, fast-curing, and shape-adaptive polyurethane urea (PUU) hydrogel system and the establishment of a full characterization approach to investigate its suitability for adhesion prophylaxis according to predefined chemical, mechanical, and biological criteria. We demonstrate that this PUU hydrogel system exhibits a fast-curing behavior, is resilient toward mechanical forces, is biocompatible, and reveals a degradation behavior within a desired time frame to reliably avoid the formation of adhesions. In addition, the PUU hydrogel system functions as an effective barrier for invading cells in vitro. Overall, we propose a guideline for the development and in vitro characterization of synthetic hydrogels for application in minimally invasive adhesion prophylaxis.