A Janus dural patch constructed with hyaluronic acid bioadhesive on electrospun fibers for self-tight sealing, antibacterial and anti-tissue adhesion therapy.

Cerebrospinal fluid (CSF) leakage is a prevalent complication following dural injury, necessitating prompt implantation of dural patches. However, postoperative bacterial infections and tissue adhesion frequently compromise surgical outcomes and may lead to secondary complications. To address these challenges, an innovative self-adhesive Janus dural patch is developed by integrating drug-loaded fibrous meshes with a layer of tissue adhesive hydrogel. Vancomycin and mitomycin C are co-loaded into the meshes to provide antibacterial and anti-tissue adhesion functions, respectively. The hydrophobicity of the electrospun fibers can make the patch effectively preventing CSF leakage. The tissue adhesive hydrogel is made of oxidized hyaluronic acid methylacrylate (OHAMA), whose aldehyde groups can react with amino groups to form robust tissue adhesion (40 kPa adhesive strength). As a whole, the patch shows a high burst pressure resistance (35 kPa). In repairing dural defects using rat models, the patch achieves rapid and suture-free self-tight sealing of dural defects. The sustained release of vancomycin and mitomycin C effectively prevents bacterial infection and postoperative adhesion to brain tissue. Promisingly, this Janus dural patch combines immediate mechanical sealing with multiple biological activities, offering a potential solution for dural repair.