Janus Composite Hydrogels with Directional Exudate Management and Microenvironmental Homeostasis Regulation Effects for Peristomal Skin Protection

Abstract Peristomal skin post‐intestinal stoma surgery is chronically exposed to a complex microenvironment (intestinal fluid erosion, bacterial overgrowth, chronic inflammation), leading to peristomal skin complications (PSCs). Herein, this study first constructed a Janus composite hydrogel as an ostomy bag wafer for peristomal skin protection. This material integrates wet adhesion, directional exudate management, broad‐spectrum antibacterial activity, antioxidant capacity, and anti‐inflammatory properties to improve the peristomal skin microenvironment and reduce PSCs. Its core structure is a tannic acid (TA)‐polyvinyl alcohol (PVA)‐polyacrylic acid (PAA) double‐network hydrogel embedded with a Janus film (asymmetric wettability on the skin side). TA's phenolic hydroxyl groups endow long‐lasting, moist adhesion and sustained bacteriostasis. The Janus film enables directional migration and retention of leaked intestinal fluid, preventing prolonged skin erosion. Overall, this TPPP hydrogel provides a new strategy for peristomal skin protection with clinical prospects, enhancing patient quality of life.