Mechanically Trained Calcium Alginate Ionic Hydrogels for Enhanced Abdominal Wall Defect Repair

Abdominal wall defects, often caused by trauma, infection, or tumor resection, pose significant clinical challenges, typically leading to organ protrusion and chronic pain. Current repair materials like polypropylene (PP) and expanded polytetrafluoroethylene (ePTFE) meshes offer mechanical stability but can trigger foreign body reaction, leading to visceral adhesions and inflammation. While calcium alginate ionic hydrogels (CAIHs) present a biocompatible alternative, but lack the mechanical strength needed for abdominal wall defects repair. This work develops a two perpendicular directions mechanically trained CAIH (PDMT-CAIH) by cyclic stretching, enhancing its mechanical properties and stability without introducing any additional chemical elements. In vitro and in vivo assessments show that PDMT-CAIH supports cell proliferation, promotes tissue regeneration, and significantly reduces visceral adhesion formation compared to PP meshes. Additionally, PDMT-CAIH demonstrates superior resistance to degradation, maintaining structural integrity over time. These findings highlight PDMT-CAIH as a promising, safer alternative for abdominal wall repair, reducing complications and improving clinical outcomes without the need for chemical additives.