Bio-adhesive barrier with active ROS-scavenging ability for simultaneous management of dura tear and epidural inflammatory fibrosis

Management of dura tear during spine surgery remain challenging due to the complex focal environment. Current sealants could hardly independently repair dura tear while simultaneously regulate epidural inflammation and fibrosis induced by oxidative stress. A bioadhesive hydrogel sealant with active reactive oxygen species (ROS)-scavenging potential for suppression of epidural inflammation and fibrosis was designed to provide a versatile tool for spine surgeon. In order to achieve such goal, tannic acid-functionalized black phosphorus nanosheets with better ambient stability were incorporated and integrated into network of hydrogel sealant. Such integration was found to bring improved mechanical strength and sealing performance as evidenced by higher burst pressure and effective sealing of dura tear under in vivo environment. Moreover, instead of merely acting as a physical sealing barrier, the hydrogel sealant was also found with active ROS-scavenging capability. Effective inhibition on oxidative stress-mediated epidural inflammation and fibrosis was observed with employment of hydrogel sealant as revealed by both in vitro and in vivo studies. The proposed hydrogel sealant could provide a potential candidate for sealing of dura tear, and may hopefully provide a promising strategy for prevention of epidural fibrosis.