Natural Products and Biomaterial Strategies for Preventing Post-Surgical Adhesions: Emerging Anti-Fibrotic Agents and Mechanistic Insights

Abstract Purpose Post-operative adhesions develop in most abdominal and pelvic surgeries and cause pain, bowel obstruction, infertility, and reoperation. Current measures such as Seprafilm ® and NSAIDs provide only partial protection and may cause adverse effects. This review evaluates natural products and biomaterial platforms as potential strategies for adhesion prevention. Methods A structured literature search was performed in PubMed, Scopus, and Google Scholar. Peer-reviewed English-language in vitro, animal, and clinical studies, as well as relevant reviews and meta-analyses, were considered. Studies focusing on natural products and biomaterial-based delivery systems for post-surgical adhesion prevention were screened for mechanistic relevance and translational value, with emphasis on publications from 2015 to 2025. Results Curcumin, resveratrol, epigallocatechin-3-gallate, bromelain, and vitamin E demonstrated antioxidant, anti-inflammatory, and anti-fibrotic actions that interfere with TGF-β, ROS, cytokines, and extracellular matrix deposition. Hydrogels, bioresorbable films, and nanosystems enhanced local release and added barrier effects. Preclinical data are promising, but clinical evidence is scarce, and issues of bioavailability, safety, and standardisation remain. Conclusion Natural products combined with biomaterial platforms represent a promising strategy for adhesion prevention, but robust clinical trials are needed to confirm safety and efficacy.