Hydrogel Adhesives for Gastrointestinal Perforation: Design Principles and Applications

Gastrointestinal (GI) perforation, as an acute digestive condition, is difficult to heal spontaneously and requires prompt surgical intervention or bioactive adhesives to promote wound closure. Among various types of tissue adhesives, hydrogel adhesives have attracted tremendous attention and have been used in the clinic due to their atraumatic nature, good biocompatibility, and tunable physicochemical properties. Despite their promise, the bioadhesive applications with engineered hydrogels still face challenges in the wet and acidic gastric environment. This review outlines the mainstream design approaches of hydrogel adhesives through covalent and noncovalent molecular interactions, illustrating the underlying adhesive mechanisms and material properties. Representative GI applications of hydrogel adhesives are also summarized. Finally, we discuss future perspectives on the clinical translations of hydrogel adhesives in the management of GI perforations.