Abstract

Postoperative tendon adhesion is a significant clinical challenge that impairs functional recovery. Current anti-adhesion barriers often fail due to a mismatch between their mechanical properties and the dynamic in vivo environment, leading to structural instability and functional degradation. Inspired by the natural tendon sheath, this study reports a biomimetic, fiber-gel composite patch (NFGL) with a stable, interlocking, one-piece structure. By integrating a lubricating hyaluronic acid/polyvinyl alcohol (HA/PVA) hydrogel with electrospun chitosan/polycaprolactone (CS/PCL) nanofibers through mechanical interlocking and supramolecular interactions, the NFGL patch replicates the native tissue's J-shaped stress-strain behavior, exhibiting the toe-region modulus of 4.54 ± 2.62 MPa within a 6.14 ± 0.86% strain range and a high linear modulus (8.95 ± 0.89 MPa) to maintain the integrity of the patch. The integrated design ensures robust interfacial adhesion between the layers (135.64 ± 2.48 N/m), preventing delamination and maintaining structural integrity. Beyond its barrier function, the matched mechanical microenvironment prevents pathological activation of myofibroblasts, maintaining tendon repair within a low-immunity environment that promotes orderly collagen fiber regeneration. This study proposes a promising bionic strategy for developing high-performance anti-adhesion barriers capable of withstanding the dynamic mechanical environment of healing tendons while providing an optimal microenvironment for tissue repair.