A Multilayer-Functionalized Acellular Dermal Scaffold for Improved Abdominal Wall Reconstruction

Biological scaffolds derived from porcine dermis offer favorable compatibility for abdominal wall reconstruction, yet their clinical performance may be impaired by bacterial contamination, oxidative injury, prolonged inflammation, insufficient durability, and postoperative tissue adhesion. Here, we designed a multifunctional scaffold by constructing alternating molecular layers of quaternized chitosan and polydopamine on porcine acellular dermal matrix. Ascorbic acid was introduced during the coating process to reinforce the free-radical-neutralizing capacity of the material.

Surface engineering did not disrupt the collagen-rich architecture of the original matrix but substantially improved its wettability, tensile performance, and resistance to collagenase-mediated breakdown. The optimized scaffold exhibited a water contact angle of 58.3°, compared with 95.4° for untreated matrix. It suppressed more than 90% of both Staphylococcus aureus and Escherichia coli and showed approximately 90% scavenging activity against hydroxyl and DPPH radicals. Under hydrogen peroxide-induced oxidative stress, the modified scaffold improved fibroblast survival, reduced malondialdehyde accumulation, and restored cellular redox balance. It also maintained cell proliferation above 90% and produced minimal hemolysis. Following implantation, the engineered matrix retained better structural integrity, limited visceral adhesion, reduced inflammatory infiltration, and supported tissue reconstruction. Lower levels of TNF-α, IL-6, and CD86, together with increased CD206 expression, suggested a shift from a pro-inflammatory macrophage phenotype toward a reparative phenotype.

These findings indicate that multilayer surface functionalization can transform porcine acellular dermal matrix into a mechanically stable and biologically active implant capable of simultaneously controlling infection, oxidative stress, inflammation, degradation, and adhesion during abdominal wall repair.