Abstract:We assessed the effects of terminal moist-heat sterilization on the structure of poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P34HB) microspheres and the composite hydrogels with hyaluronic acid (HA), aiming to define an acceptable process window. According to pharmacopeial and sterilization standards, we selected 121 ℃ as the sterilization temperature and set holding time of 10, 20, and 30 min, with non-sterilized samples as controls. P34HB microspheres were first blended with HA and then subjected to moist-heat sterilization (co-sterilization). Gel permeation chromatography (GPC), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), particle size analysis, and scanning electron microscopy (SEM) were employed to characterize the changes in molecular weight, thermal properties, chemical structure, and morphology of microspheres. The injectability and stability of the composite hydrogels were assessed based on oscillatory rheology, extrusion force, cohesiveness, and centrifugation stability. In addition, bioburden and sterility tests were carried out. After sterilization at 121 ℃ for 10-20 min, P34HB microspheres showed a slight decrease in molecular weight and basically unchanged melting temperature, particle size, and morphology, and the composite hydrogels retained suitable viscoelasticity and a steady extrusion force of 12-15 N. After sterilization for 30 min, the microspheres showed a significantly decreased molecular weight and enhanced cold crystallization and double melting peaks in DSC, and the composite hydrogels presented increased fluctuations in elastic modulus and extrusion force as well as signs of phase separation. All sterilized groups passed sterility testing. We conclude that moist-heat sterilization at 121 ℃ for 10-20 min is effective while retaining the complete structure of P34HB microspheres and good injectability of the composite hydrogels, and it is thus suitable as the condition for terminal moist-heat sterilization. Compared with literature data for polycaprolactone (PCL) and poly(L-lactide) (PLLA), P34HB shows superior tolerance to moist-heat and appears to be a promising material for prefilled ready-to-use soft tissue filler injections. The findings provide practical guidance for formulation and process design.