Shear-thinning Catechol-modified Chitosan Hydrogel Loaded with Silver Nanoparticles for Endoscopic Submucosal Dissection

Shear-thinning hydrogels have emerged for endoscopic submucosal dissection, while wound intervention after surgery has rarely been mentioned. Herein, a catechol-modified chitosan hydrogel with shear-thinning property was developed for simultaneously facilitating endoscopic submucosal dissection and postoperative wound healing. Benefiting from the shear-thinning and self-healing characteristics, the asprepared hydrogel showed easily endoscopic injectability. It also performed very well as submucosal cushion, which could remain above 70% after injection for 120 min in ex vivo porcine large intestine model. In fact, the cushion height of normal saline dramatically decreased to 46% of the initial height at 30 min. Ag nanoparticles encapsulated into the network endowed the hydrogel with almost reached 100% antibacterial effect against E. coli and S. aureus. The hemolysis ratio of the hydrogel was calculated to be as low as 0.8%. Combined with good hemocompatibility and cytocompatibility, the as-prepared hydrogel displayed much higher in vivo wound closure and healing efficacy than normal saline. These results demonstrated the superiority of the shear-thinning chitosan hydrogel in facilitating clinical endoscopic submucosal dissection surgery.