{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:51:34Z","timestamp":1790373094660,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["advanced.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Adv Healthcare Materials"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Despite remarkable advancements in hydrogel\u2010based medical applications in recent years, their clinical translation for pancreatic fistula management remains challenging owing to the moist surgical environment and complex post\u2010pancreatectomy pathophysiology. To address the clinical need for reliable wet\u2010adhesion materials to prevent postoperative pancreatic fistula after distal pancreatectomy (DP\u2010POPF) and postoperative adhesive intestinal obstruction, we developed an asymmetric bilayer hydrogel (BH) patch that integrates an adhesive pancreatic layer (APL) and an anti\u2010adhesion layer (AAL). The APL combines\n                    <jats:italic>N\u2010<\/jats:italic>\n                    hydroxysuccinimide\u2010mediated covalent bonding with xanthan gum\u2010driven interfacial dehydration for robust wet\u2010tissue adhesion, the AAL, composed of poly(sulfobetaine methacrylate)\u2010carboxymethyl chitosan, prevents fibrosis via surface hydration; the BH hydrogel incorporates Ceffe, a cell\u2010free fat extract possessing anti\u2010inflammatory and proangiogenic properties. The BH patch exhibits exceptional mechanical strength, prolonged post\u2010swelling adhesion retention, and enzymatic resistance. In vitro and in vivo studies confirm its outstanding biocompatibility, antibacterial efficacy, and adhesion prevention in rat models. In a DP rat model, the Ceffe@BH group displayed significantly reduced POPF incidence versus the normal saline and hand\u2010sewn anastomosis groups, as demonstrated by reduced drain fluid amylase, attenuated inflammation (\u2193TNF\u2010\u03b1\/IL\u20106), enhanced angiogenesis, and effective adhesion prevention. This suture\u2010free, multifunctional hydrogel presents a standardized solution for POPF with broad potential for wet\u2010tissue surgical applications.\n                  <\/jats:p>","DOI":"10.1002\/adhm.202503972","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:58:07Z","timestamp":1765609087000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Multifunctional Bilayer Hydrogel for Effective Pancreatic Fistula Prevention and Post\u2010Surgical Adhesion Control"],"prefix":"10.1002","volume":"15","author":[{"given":"Hao","family":"She","sequence":"first","affiliation":[{"name":"Ningbo Medical Center Li Huili Hospital, Health Science Center, Ningbo University Ningbo 315000 P. R. 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