Scheme 1.

Scheme showing engineering of a self-healing adhesive hydrogel with antioxidant properties for IUA prevention. The adhesive was fabricated by mixing Bi-PEG-SS and gelatin. The mixed adhesive hydrogels were injected into the injured uterine cavity, and adhesion was achieved by the ammonolysis reaction between amino groups from tissue and succinimidyl succinate (active ester) from the adhesive hydrogels. The self-healing properties of adhesive hydrogels were conferred by non-covalent bonds in the network, including hydrogen bonds and electrostatic interactions. Because of the inherent antioxidant properties, the adhesive hydrogels could reduce free radicals to down-regulate TGF-β1 and VEGF to modulate extracellular matrix (ECM) deposition and myofibroblast activation for IUA prevention.