Engineering Layer‐by‐Layer Modified Porcine Acellular Dermal Matrix for Abdominal Wall Repair: A Multifunctional Approach to Overcome Infection, Inflammation, and Adhesion Challenges

ABSTRACT Abdominal wall defects pose serious clinical challenges due to poor self‐repair capacity and risks of infection, inflammation, and adhesion. Porcine acellular dermal matrix (pADM), known for its biocompatibility, is commonly used for repair but faces limitations from postoperative complications. In this study, we developed a multifunctional (HTCC‐PDA) 10 ‐PDA‐pADM patch using a layer‐by‐layer (LbL) self‐assembly strategy. By alternately depositing cationic N‐(2‐hydroxy) propyl‐3‐trimethylammonium chitosan chloride (HTCC) and anionic polydopamine (PDA) onto the pADM surface through electrostatic interactions, we constructed a bioactive coating that integrates four core functionalities: broad‐spectrum antibacterial activity, synergistic antioxidant capacity, anti‐inflammatory immune modulation, and anti‐adhesion effects. The addition of ascorbic acid further enhanced reactive oxygen species (ROS) scavenging. Characterization confirmed the LbL‐modified pADM preserved its natural structure while improving mechanical strength, hydrophilicity, and resistance to degradation. In vitro tests demonstrated effective antibacterial and antioxidant properties. In vivo experiments using a rat abdominal wall defect model showed reduced inflammatory cytokines (TNF‐α, IL‐6), increased M2 macrophage polarization, minimized adhesion formation, and enhanced tissue regeneration. This study presents a novel and translationally promising surface modification strategy that endows pADM with multifunctionality, addressing key challenges in abdominal wall repair and paving the way for improved clinical outcomes.