Tuning adhesion failure strength for tissue-specific applications

Hydrogel-tissue adhesion by particle bridging: sensitivity to interfacial wetting and tissue composition

Solid particles placed at the interface between hydrogels and biological tissues can create an adhesive joint through the adsorption of macromolecules onto their surfaces. Here, we investigated how this adhesion by particle bridging depends on the wetting of tissue surfaces and on the heterogeneities in tissue composition. Ex vivo peeling experiments were performed using poly(ethylene glycol) films coated with aggregates of silica nanoparticles deposited on the internal tissues of porcine liver. We show that the adhesion produced by particle bridging is altered by the presence of fluid wetting the tissue-hydrogel interface. For both uncoated and coated films, a transition from lubricated to adhesive contact was observed when all the interfacial fluid was drained. The presence of a silica nanoparticle coating shifted the transition towards more hydrated conditions and significantly enhanced adhesion in the adhesive regime. After 5 min of contact, the adhesion energy achieved on liver parenchyma with the coated films (7.7 ± 1.9 J m-2) was more than twice that of the uncoated films (3.2 ± 0.3 J m-2) or with a surgical cyanoacrylate glue (2.9 ± 1.9 J m-2). Microscopic observations during and after peeling revealed different detachment processes through either particle detachment or cohesive fracture in the tissue. These mechanisms could be directly related to the microanatomy of the liver parenchyma. The effects of both interfacial wetting and tissue composition on adhesion may provide guidelines to tailor the design of tissue adhesives using particle bridging.

Sprayable Hydrogel Sealant for Gastrointestinal Wound Shielding

Naturally occurring internal bleeding, such as in stomach ulcers, and complications following interventions, such as polyp resection post-colonoscopy, may result in delayed (5-7 days) post-operative adverse events-such as bleeding, intestinal wall perforation, and leakage. Current solutions for controlling intra- and post-procedural complications are limited in effectiveness. Hemostatic powders only provide a temporary solution due to their short-term adhesion to GI mucosal tissues (less than 48 h). In this study, a sprayable adhesive hydrogel for facile application and sustained adhesion to GI lesions is developed using clinically available endoscopes. Upon spraying, the biomaterial (based on polyethyleneimine-modified Pluronic micelles precursor and oxidized dextran) instantly gels upon contact with the tissue, forming an adhesive shield. In vitro and in vivo studies in guinea pigs, rabbits, and pig models confirm the safety and efficacy of this biomaterial in colonic and acidic stomach lesions. The authors' findings highlight that this family of hydrogels ensures prolonged tissue protection (3-7 days), facilitates wound healing, and minimizes the risk of delayed complications. Overall, this technology offers a readily adoptable approach for gastrointestinal wound management.

A polyethylene glycol-grafted pullulan polysaccharide adhesive improves drug loading capacity and release efficiency

In this study, polyethylene glycol was grafted onto pullulan polysaccharides, resulting in the development of a novel adhesive termed PLUPE, offering superior drug loading capacity and rapid release efficiency. The efficacy of PLUPE was rigorously evaluated through various tests, including the tack test, shear strength test, 180° peel strength test, and human skin adhesion test. The results demonstrated that PLUPE exhibited a static shear strength that was 4.6 to 9.3 times higher than conventional PSAs, ensuring secure adhesion for over 3 days on human skin. A comprehensive analysis, encompassing electrical potential evaluation, calculation of interaction parameters, and FT-IR spectra, elucidated why improved the miscibility between the drug and PSAs, that the significant enhancement of intermolecular hydrogen bonding in the PLUPE structure. ATR-FTIR, rheological, and thermodynamic analyses further revealed that the hydrogen bonding network in PLUPE primarily interacted with polar groups in the skin. This interaction augmented the fluidity and free volume of PSA molecules, thereby promoting efficient drug release. The results confirmed the safety profile of PLUPE through skin irritation tests and MTT assays, bolstering its viability for application in TDDS patches. In conclusion, PLUPE represented a groundbreaking adhesive solution for TDDS patches, successfully overcoming longstanding challenges associated with PSAs.

Recent advances in biopolymer-based hemostatic materials

Hemorrhage is the leading cause of trauma-related deaths, in hospital and pre-hospital settings. Hemostasis is a complex mechanism that involves a cascade of clotting factors and proteins that result in the formation of a strong clot. In certain surgical and emergency situations, hemostatic agents are needed to achieve faster blood coagulation to prevent the patient from experiencing a severe hemorrhagic shock. Therefore, it is critical to consider appropriate materials and designs for hemostatic agents. Many materials have been fabricated as hemostatic agents, including synthetic and naturally derived polymers. However, compared to synthetic polymers, natural polymers or biopolymers, which include polysaccharides and polypeptides, have greater biocompatibility, biodegradability, and processibility. Thus, in this review, we focus on biopolymer-based hemostatic agents of different forms, such as powder, particles, sponges, and hydrogels. Finally, we discuss biopolymer-based hemostats currently in clinical trials and offer insight into next-generation hemostats for clinical translation.

A low-swelling and toughened adhesive hydrogel with anti-microbial and hemostatic capacities for wound healing

Hydrogel-based wound dressings with tissue adhesion abilities are widely used for wound closure. However, currently developed hydrogel adhesives are still poor at continuing to seal wounds while bleeding is ongoing. Herein, we demonstrate an antibacterial and hemostatic hydrogel adhesive with low-swelling properties and toughness for wound healing. The hydrogel was composed of Pluronic F127 diacrylate, quaternized chitosan diacrylate, silk fibroin, and tannic acid, and it was not only able to maintain good tissue adhesion abilities in a moist environment but it also showed guaranteed tissue adhesion and mechanical strength after absorbing water due to its low-swelling and toughness properties. Furthermore, in vitro and in vivo tests demonstrated that the hydrogel also had antibacterial, antioxidant, and hemostatic properties, which could promote tissue regeneration. All these findings demonstrate that this hydrogel with multifunctional properties is a promising material for clinical wound healing applications.

Tissue adhesive hydrogel bioelectronics

Flexible bioelectronics have promising applications in electronic skin, wearable devices, biomedical electronics, etc. Hydrogels have unique advantages for bioelectronics due to their tissue-like mechanical properties and excellent biocompatibility. Particularly, conductive and tissue adhesive hydrogels can self-adhere to bio-tissues and have great potential in implantable wearable bioelectronics. This review focuses on the recent progress in tissue adhesive hydrogel bioelectronics, including the mechanism and preparation of tissue adhesive hydrogels, the fabrication strategies of conductive hydrogels, and tissue adhesive hydrogel bioelectronics and applications. Some perspectives on tissue adhesive hydrogel bioelectronics are provided at the end of the review.

Recent Advances on Synthetic and Polysaccharide Adhesives for Biological Hemostatic Applications

Rapid hemostasis and formation of stable blood clots are very important to prevent massive blood loss from the excessive bleeding for living body, but their own clotting process cannot be completed in time for effective hemostasis without the help of hemostatic materials. In general, traditionally suturing and stapling techniques for wound closure are prone to cause the additional damages to the tissues, activated inflammatory responses, short usage periods and inevitable second operations in clinical applications. Especially for the large wounds that require the urgent closure of fluids or gases, these conventional closure methods are far from enough. To address these problems, various tissue adhesives, sealants and hemostatic materials are placed great expectation. In this review, we focused on the development of two main categories of tissue adhesive materials: synthetic polymeric adhesives and naturally derived polysaccharide adhesives. Research of the high performance of hemostatic adhesives with strong adhesion, better biocompatibility, easy usability and cheap price is highly demanded for both scientists and clinicians, and this review is also intended to provide a comprehensive summarization and inspiration for pursuit of more advanced hemostatic adhesives for biological fields.

Development of a two-part biomaterial adhesive strategy for annulus fibrosus repair and ex vivo evaluation of implant herniation risk

Intervertebral disc (IVD) herniation causes pain and disability, but current discectomy procedures alleviate pain without repairing annulus fibrosus (AF) defects. Tissue engineering strategies seal AF defects by utilizing hydrogel systems to prevent recurrent herniation, however current biomaterials are limited by poor adhesion to wetted tissue surfaces or low failure strength resulting in considerable risk of implant herniation upon spinal loading. Here, we developed a two-part repair strategy comprising a dual-modified (oxidized and methacrylated) glycosaminoglycan that can chemically adsorb an injectable interpenetrating network hydrogel composed of fibronectin-conjugated fibrin and poly (ethylene glycol) diacrylate (PEGDA) to covalently bond the hydrogel to AF tissue. We show that dual-modified hyaluronic acid imparts greater adhesion to AF tissue than dual-modified chondroitin sulfate, where the degree of oxidation is more strongly correlated with adhesion strength than methacrylation. We apply this strategy to an ex vivo bovine model of discectomy and demonstrate that PEGDA molecular weight tunes hydrogel mechanical properties and affects herniation risk, where IVDs repaired with low-modulus hydrogels composed of 20kDa PEGDA failed at levels at or exceeding discectomy, the clinical standard of care. This strategy bonds injectable hydrogels to IVD extracellular matrix proteins, is optimized to seal AF defects, and shows promise for IVD repair.

Improving the adhesion, flexibility, and hemostatic efficacy of a sprayable polymer blend surgical sealant by incorporating silica particles

Commercially available surgical sealants for internal use either lack sufficient adhesion or produce cytotoxicity. This work describes a surgical sealant based on a polymer blend of poly(lactic-co-glycolic acid) (PLGA) and poly(ethylene glycol) (PEG) that increases wet tissue adherence by incorporation of nano-to-microscale silica particles, without significantly affecting cell viability, biodegradation rate, or local inflammation. In functional studies, PLGA/PEG/silica composite sealants produce intestinal burst pressures that are comparable to cyanoacrylate glue (160 mmHg), ∼2 times greater than the non-composite sealant (59 mmHg), and ∼3 times greater than fibrin glue (49 mmHg). The addition of silica to PLGA/PEG is compatible with a sprayable in situ deposition method called solution blow spinning and decreases coagulation time in vitro and in vivo. These improvements are biocompatible and cause minimal additional inflammation, demonstrating the potential of a simple composite design to increase adhesion to wet tissue through physical, noncovalent mechanisms and enable use in procedures requiring simultaneous occlusion and hemostasis. STATEMENT OF SIGNIFICANCE: Incorporating silica particles increases the tissue adhesion of a polymer blend surgical sealant. The particles enable interfacial physical bonding with tissue and enhance the flexibility of the bulk of the sealant, without significantly affecting cytotoxicity, inflammation, or biodegradation. These studies also demonstrate how silica particles decrease blood coagulation time. This surgical sealant improves upon conventional devices because it can be easily deposited with accuracy directly onto the surgical site as a solid polymer fiber mat. The deposition method, solution blow spinning, allows for high loading in the composite fibers, which are sprayed from a polymer blend solution containing suspended silica particles. These findings could easily be translated to other implantable or wearable devices due to the versatility of silica particles.

A self-healable and tough nanocomposite hydrogel crosslinked by novel ultrasmall aluminum hydroxide nanoparticles

Self-healing hydrogels like tissues or organs which are repaired automatically in response to damage show great promise. However, it remains a challenge to develop novel functional nanoparticles as crosslinkers to prepare tough and self-healing nanocomposite hydrogels. Here, we report the preparation of water-soluble ultrasmall aluminum hydroxide nanoparticles with a diameter of 2-3 nm through a simple sol-gel method. Furthermore, a tough nanocomposite hydrogel is prepared by the in situ copolymerization of acylamide and 2-acrylamido-2-methyl propane sulfonic acid in the presence of aluminum hydroxide nanoparticles. The resulting hydrogels exhibit high compressive strength of 18.9 MPa and an elongation at break of ∼2100%. Importantly, the Al-NC gel displayed a high self-healing efficiency of 86% without any external stimulus at room temperature. Moreover, we found an interesting multi-hierarchical porous morphology of the Al-NC gel depending on the contents of the aluminum hydroxide nanoparticles. The tough nanocomposite hydrogel might provide a novel promising avenue for designing advanced self-healable soft materials for various biomedical applications.

Design and development of polysaccharide hemostatic materials and their hemostatic mechanism

The formation of stable blood clots or hemostasis is essential to prevent major blood loss and death from excessive bleeding.

Surgical sealants with tunable swelling, burst pressures, and biodegradation rates

We developed two types of polyethylene glycol (PEG)-based surgical sealants, which we have termed the PER and PRO series. In one, the PRO series, an 8-arm PEG containing activated carbonyl end-groups was reacted with a 4-armed amino-PEG. In the second, the PER series, a 4-arm PEG containing bi-functional end groups with four azides and four activated esters was reacted by strain-promoted alkyne-azide cycloaddition with a 4-arm cyclooctyne-PEG to give a near-ideal Tetra-PEG hydrogel. The sealants showed predictably tunable strength, swelling, adhesion, and gelation properties. The gels were compared to commercially available PEG-based sealants and exhibit physical properties equivalent to or better than the standards. Variants of each gel-format were prepared that contained a β-eliminative cleavable linker in the crosslinks to control degradation rate. Linkers of this type self-cleave with half-lives spanning from hours to years, and offer the unique ability to precisely tune the degradation to match the healing process. In addition, these linkers could serve as cleavable tethers for controlled drug release. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1602-1611, 2017.

Personalizing Biomaterials for Precision Nanomedicine Considering the Local Tissue Microenvironment

New advances in (nano)biomaterial design coupled with the detailed study of tissue-biomaterial interactions can open a new chapter in personalized medicine, where biomaterials are chosen and designed to match specific tissue types and disease states. The notion of a "one size fits all" biomaterial no longer exists, as growing evidence points to the value of customizing material design to enhance (pre)clinical performance. The complex microenvironment in vivo at different tissue sites exhibits diverse cell types, tissue chemistry, tissue morphology, and mechanical stresses that are further altered by local pathology. This complex and dynamic environment may alter the implanted material's properties and in turn affect its in vivo performance. It is crucial, therefore, to carefully study tissue context and optimize biomaterials considering the implantation conditions. This practice would enable attaining predictable material performance and enhance clinical outcomes.

Injectable bioadhesive hydrogels with innate antibacterial properties

Surgical site infections cause significant postoperative morbidity and increased healthcare costs. Bioadhesives used to fill surgical voids and support wound healing are typically devoid of antibacterial activity. Here, we report novel syringe-injectable bioadhesive hydrogels with inherent antibacterial properties prepared from mixing polydextran aldehyde (PDA) and branched polyethylenimine (PEI). These adhesives kill both Gram-negative and Gram–positive bacteria, while sparing human erythrocytes. An optimal composition of 2.5 wt % oxidized dextran and 6.9 wt % PEI sets within seconds forming a mechanically rigid (~1700 Pa) gel offering a maximum adhesive stress of ~ 2.8 kPa. A murine infection model showed that the adhesive is capable of killing S. pyogenes introduced subcutaneously at the bioadhesive’s surface, with minimal inflammatory response. The adhesive was also effective in a cecal ligation and puncture model, preventing sepsis and significantly improving survival. These bioadhesives represent novel, inherently antibacterial materials for wound filling applications.

Single and dual crosslinked oxidized methacrylated alginate/PEG hydrogels for bioadhesive applications

A degradable, cytocompatible bioadhesive can facilitate surgical procedures and minimize patient pain and post-surgical complications. In this study a bioadhesive hydrogel system based on oxidized methacrylated alginate/8-arm poly(ethylene glycol) amine (OMA/PEG) has been developed, and the bioadhesive characteristics of the crosslinked OMA/PEG hydrogels evaluated. Here we demonstrate that the swelling behavior, degradation profiles, and storage moduli of crosslinked OMA/PEG hydrogels are tunable by varying the degree of alginate oxidation. The crosslinked OMA/PEG hydrogels exhibit cytocompatibility when cultured with human bone marrow-derived mesenchymal stem cells. In addition, the adhesion strength of these hydrogels, controllable by varying the alginate oxidation level and measured using a porcine skin model, is superior to commercially available fibrin glue. This OMA/PEG hydrogel system with controllable biodegradation and mechanical properties and adhesion strength may be a promising bioadhesive for clinical use in biomedical applications, such as drug delivery, wound closure and healing, biomedical device implantation, and tissue engineering.

Polymer films with surfaces unmodified and modified by non-thermal plasma as new substrates for cell adhesion

The surface properties of biomaterials, such as wettability, polar group distribution, and topography, play important roles in the behavior of cell adhesion and proliferation. Gaseous plasma discharges are among the most common means to modify the surface of a polymer without affecting its properties. Herein, we describe the surface modification of poly(styrene) (PS) and poly(methyl methacrylate) (PMMA) films using atmospheric pressure plasma processing through exposure to a dielectric barrier discharge (DBD). After treatment the film surface showed significant changes from hydrophobic to hydrophilic as the water contact angle decreasing from 95° to 37°. All plasma-treated films developed more hydrophilic surfaces compared to untreated films, although the reasons for the change in the surface properties of PS and PMMA differed, that is, the PS showed chemical changes and in the case of PMMA they were topographical. Excellent adhesion and cell proliferation were observed in all films. In vitro studies employing flow cytometry showed that the proliferation of L929 cells was higher in the film formed by a 1:1 mixture of PS/PMMA, which is consistent with the results of a previous study. These findings suggest better adhesion of L929 onto the 1:1 PS/PMMA modified film, indicating that this system is a new candidate biomaterial for tissue engineering.

The photocrosslinkable tissue adhesive based on copolymeric dextran/HEMA

We developed a copolymeric bioadhesive system with the potential to be used as a tissue adhesive based on biopolymer dextran. Copolymeric hydrogels comprising a urethane dextran (Dex-U) and 2-hydroxyethyl methacrylate (HEMA) were prepared and crosslinked under the ultraviolet (UV) irradiation. In this study, the photopolymerization process was monitored by real time infrared spectroscopy (RTIR). The adhesion strength was evaluated by lap-shear-test. The surface tension, viscosity of the solutions and the cytotoxicity assays were investigated. Compared to Dex-U system, the addition of HEMA remarkably improved the properties of Dex-H system especially the adhesion strength and the nontoxicity. And materials variation could be tailored to match the need of tissues. The copolymeric tissue adhesives demonstrated promising adhesion strength and nontoxicity. The maximum adhesion strength reached to 4.33±0.47 Mpa which was 86 times higher than that of Tisseel. The obtained products have the potential to serve as tissue adhesive in the future.

Adhesive properties and biocompatibility of tissue adhesives composed of various hydrophobically modified gelatins and disuccinimidyl tartrate

Adhesives comprising hydrophobically modified gelatin and disuccinimidyl tartrate were prepared with the aim of developing novel tissue adhesives with tissue-penetrating capability and biocompatibility. The hydrophobic groups employed were hexanoyl (Hx; C6), palmitoyl (Pam; C16), stearoyl (Ste; C18), and oleoyl (Ole; C18 unsaturated) groups. The bonding strength of the resulting tissue adhesives against fresh arterial media increased with increasing chain length of the saturated hydrocarbon up to C18 (Ste) when the degree of substitution of hydrocarbons in the hydrophobically modified gelatin molecule was 10% (10Ste) with a fixed succinimidyl group:amino group ratio of 1:1. The 10Ole–disuccinimidyl tartrate adhesive showed slightly lower bonding strength compared with 10Ste–disuccinimidyl tartrate adhesive. In contrast, the use of hydrophobically modified gelatin with a high substitution ratio (50%) showed lower bonding strength compared with the original gelatin. The peeling strength of 10Ste–disuccinimidyl tartrate and 10Ole–disuccinimidyl tartrate adhesives was similar and high compared with other adhesives. Based on the quantitative determination of biocompatibility, using nuclear factor-kappa B/luciferase transgenic mice (BALB/C-Tg (NF-κB-RE-luc)-Xen), the level of inflammation associated with 10Ste–disuccinimidyl tartrate adhesive was quite low compared with commercial aldehyde-based adhesive. From these results, 10Ste–disuccinimidyl tartrate adhesive possesses excellent biocompatibility as well as high bonding/peeling strength and, therefore, has potential use in clinical applications.