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However, in addition to material\u2010related limitations, one of the most serious challenges associated with these devices is the risk of infection. To address this issue, an innovative hydrogel is presented to prevent infection at the source during orthopedic surgery. This hydrogel combines polyhexamethylene biguanide (PHMB), a positively charged agent with proven broad\u2010spectrum antimicrobial activity, with a thermosensitive polymer. The resulting formulation provides suitable viscosity for application or dip\u2010coating onto orthopedic devices, thereby forming a stable physical and chemical barrier. The new hydrogel exhibits temperature\u2010responsive viscosity, which enhances both adherence and controlled release at body temperature. Additionally, the hydrogel demonstrates antibacterial effectiveness against both Gram\u2010positive and Gram\u2010negative bacteria, along with low cytotoxicity, minimal immune response, and excellent anti\u2010biofouling properties. These features make the developed hydrogel well suited for orthopedic surgical procedures and support its potential as a complementary approach to reducing the risk of postoperative infections.<\/jats:p>","DOI":"10.1002\/adhm.71686","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T15:00:47Z","timestamp":1788706847000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Polyhexamethylene Biguanide Antibacterial Gel Coating of Orthopedic Implants in Infection Control and Immune Modulation"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-4222","authenticated-orcid":false,"given":"Ji Hye","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Anam Hospital Korea University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Nanobiomarker\u2010Based Medicine Korea University  Seoul 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