A chitosan/gelatin/aldehyde hyaluronic acid hydrogel coating releasing calcium ions and vancomycin in pH response to prevent the formation of bacterial biofilm

Osteomyelitis is a refractory disease of orthopedics, part of which is caused by medical implants. The main difficulties in treatment are the barrier effect after the formation of bacterial biofilm, and the difficulty in achieving sustained antibiotic intervention. In view of this situation, we studied a hydrogel coating that can release CaCl₂ and vancomycin in pH-responsive manner. We used nano-TiO₂ to modify Chitosan/ Gelatin/Aldehyde Hyaluronic Acid (CS/Gel/AHA) hydrogel, and combined with the dip-coating technique, prepared a coating with good mechanical strength. The hydrogel-loaded zeolitic imidazolate framework (ZIF) decomposes under acidic conditions, and the released Ca²⁺ act on the bacterial Bap protein to inhibit the formation of biofilm, and the released vancomycin kills free bacteria. The antibacterial coating achieved good bactericidal effect in both in vitro experiments and rat subcutaneous implant model. These results not only provide a new way to enhance the strength of hydrogels to prepare coatings, but also utilize a new approach to responsively inhibit the formation of biofilms, showing the promising application prospects of the coating in antibacterial treatment of medical implants.