Multifunctional Hydrogel Patches for Anastomotic Leakage Management: From Mechanistic Insights to Clinical Translation

Anastomotic leakage (AL) is a dangerous complication after surgery. The typical treatment for AL is surgical suturing, which is often unsatisfactory due to the risk of recurrence, further tissue damage, and the requirement for advanced surgical skills. Recently, hydrogel patches for leakage sealing and wound healing have attracted considerable attention and exhibited outstanding efficiency owing to their superior tissue adhesion, biocompatibility, and ability to deliver therapeutics. However, AL fundamentally differs from superficial wounds, which require simultaneously robust leakage sealing (to prevent fluid leakage), dynamic contractility (to mitigate tissue tension), drug intervention (to modulate inflammation or promote wound healing), and real-time monitoring. Conventional hydrogel patches are inadequate in addressing these requirements, whereas recent breakthroughs in materials science, biomedical engineering, and interdisciplinary integration have propelled the emergence of multifunctional/smart hydrogel patches suitable for AL. To facilitate the research and clinical translation of hydrogel patches for AL, this paper discusses the pathology of AL, existing managements, the design and characterization of hydrogel patches, and the recent advances of hydrogel patches that can adequately meet the therapeutic requirements of AL. This review may provide critical insights to inspire the design of next-generation hydrogel patches with enhanced functionality and clinical applicability for AL.