A Self‐Curling Si ₃ N ₄ ‐Biofunctionalized Nerve Wrap for Suture‐Free Peripheral Nerve Repair with Multimodal Regenerative Bioregulation

Abstract The treatment of peripheral nerve injury (PNI) faces dual challenges: inadequate bioactive regulation and suture‐induced inflammatory responses from mechanical stress concentration, critically impairing axonal regeneration. An integrated therapeutic system featuring a Si ₃ N ₄ (SN)‐reinforced bioactive collagen nerve wrap (SNC) combined with a nerve adhesive tape (NA) composed of polyethylene glycol diacrylate/dopamine‐grafted gelatin dual‐network hydrogel is developed. Through hydration‐activated shape memory and a staged adhesion mechanism, the SNC‐NA wrap system achieves instantaneous conduit formation, intraoperative repositioning, and stable nerve‐end approximation upon application to transected nerves. The sustained hydrolysis of SN generates bioactive ions (NH ₄ ⁺ and SiO ₄ ⁴⁻ ) that orchestrate multi‐targeted regulation, including immunomodulation, angiogenesis promotion, and Schwann cells (SCs) reprogramming. In vitro analyses revealed SN‐mediated SCs reprogramming modulation via MAPK, TNF‐α, and VEGF signaling pathways, enhancing cellular plasticity, immune coordination, and axonal regrowth guidance. In vivo results showed SN incorporation markedly enhanced nerve regeneration, with improved histology, electrophysiology, and functional recovery. The SNC‐NA wrap system achieved motor function restoration equivalent to autograft performance while providing unique surgical advantages through self‐curling adaptability and suture‐free application. This integrated approach addresses both mechanical and biological limitations of current PNI treatments, demonstrating SN bioactive ceramics as potent multi‐modal bioregulators with transformative clinical potential for nerve repair strategies.