Chondroitin Sulfate–Chitosan Degradable Scaffold Prevents Intrauterine Adhesion in Rats

Intrauterine adhesion often leads to complications such as miscarriage and infertility. Owing to the limitations of current mechanical/hormonal interventions, such as risk of retrograde infection and rapid barrier degradation, intrauterine adhesion remains a therapeutic challenge. In this study, a degradable hydrogel film composed of chondroitin sulfate (CS) and chitosan (CHT) was developed. CS has anti-inflammatory functions, while CHT provides antibacterial activity and inhibits cellular fibrosis. The optimized CS/CHT hydrogel, designed to degrade over 7–14 d, exhibited mechanical stability matching the window for endometrial repair. In rat curettage models, the proposed hydrogel significantly reduced endometrial fibrosis, increased endometrial thickness, suppressed pro-inflammatory cytokines (IL-6 and TNF-α), and restored fertility. Its broad-spectrum antibacterial activity further validates its clinical potential. This dual-functional barrier works in synergy with mechanical support and biological activity regulation, providing an innovative solution for intrauterine prevention.