Allicin-loaded hydrogel enhances the viability of multiterritory perforator flap.

The multiterritory perforator flap has gained increasing clinical adoption in limb reconstruction and wound repair due to its procedural simplicity and distinct clinical advantages. Allicin, a multifunctional phytochemical renowned for its potent antioxidant properties, faces significant limitations due to rapid metabolic clearance, which substantially diminishes its therapeutic efficacy. Recent advances in hydrogel technology have highlighted their potential as advanced wound dressings, particularly through their capacity for sustained drug release. Our research synthesized HAMA-400K-Allicin (a hyaluronic acid methacryloyl hydrogel incorporating allicin), aiming to improve perforator flaps' survival rate by long-term oxidative stress alleviation. Characterization studies demonstrated that the synthesized hydrogel exhibits a densely crosslinked network architecture, robust tissue adhesion, and photosensitive properties. Notably, HAMA-400K-Allicin exhibited excellent biocompatibility and facilitated sustained allicin release for up to one week. Experimental validation revealed that both allicin and HAMA-400K-Allicin significantly improved perforator flap survival rates in rat models, with the hydrogel formulation demonstrating superior therapeutic outcomes. Mechanistic investigations further suggested that HAMA-400K-Allicin promotes flap survival through dual activation of the PI3K/AKT and HO-1/NRF2 signaling pathways. Ultimately, in a rat model, HAMA-400K-Allicin exhibited a robust effect in promoting perforator flap survival. In conclusion, this hydrogel system combines straightforward manufacturing processes with high clinical efficacy, positioning it as a promising solution for complex wound management scenarios.