Development and Analysis of a Collagen-Based Hemostatic Adhesive

DOTAGEL: a hydrogen and amide bonded, gelatin based, tunable, antibacterial, and high strength adhesive synthesized in an unoxidized environment

The development of bioadhesives that concurrently exhibit high adhesion strength, biocompatibility, and tunable properties and involve simple fabrication processes continues to be a significant challenge. In this study, a novel bioadhesive named DOTAGEL is synthesized by crosslinking gelatin (GA), dopamine (DA), and tannic acid (TA) in an unoxidized environment due to the advantage of controlling the degree of protonation in GA and TA, as well as controlling the degree of intermolecular amide and hydrogen bonding in the acidic medium. DOTAGEL (DA + TA + GA) shows superior adhesion strengths of 104.6 ± 46 kPa on dry skin and 35.6 ± 4.5 kPa on wet skin, up to 13 attachment-detachment cycles, retains adhesion strength under water for up to 10 days and is capable of joining two cut parts of internal organs of mice. Moreover, DOTAGEL shows strong antibacterial properties, self-healing, and biocompatibility since it contains TA, a natural and antibacterial cross-linker with abundant hydroxyl groups and the capability of forming non-covalent bonds in an unoxidized environment, and dopamine hydrochloride, a mussel inspired biomaterial containing both the amine and catechol groups for amide bonding and hydrogen bonding with TA and GA. The cross-linking among 20% (w/v) GA, 0.2% (w/v) DA, and 20% (w/v) TA is done by the centrifugation process at room temperature. Two different acids, hydrochloric acid and acetic acid, were used for tuning the pH of the medium, which led to two different samples named DOTAGEL/AA and DOTAGEL/HCL. The degree of cross-linking and mechanical and biochemical properties, like adhesion strength, degradation rate, antibacterial properties, stickiness, etc., are tuned by adjusting the pH of the medium. DOTAGEL/HCL showed 6.5 times faster degradation in 10 days, a faster release rate in the antibacterial study, 2 times adhesion strength in a dry medium, and more stickiness. The novelty lies not only in increased adhesion strength but also in the single-step fabrication process of the adhesive in the acidic medium. This research proposes the formation of a tunable antibacterial adhesive that is capable of working on wet surfaces within the body and that has the potential to become a successful tissue adhesive with a wide range of possibilities in controlled drug delivery at wound sites and other biomedical applications.

Underwater Adhesives from Redox-Responsive Polyplexes of Thiolated Polyamide Polyelectrolytes

We report the fabrication of optically clear underwater adhesives using polyplexes of oppositely charged partially-thiolated polyamide polyelectrolytes (TPEs). The thiol content of the constituent PEs was varied to assess its influence on the adhesive properties of the resulting glues. These catechol-free, redox-responsive TPE-adhesives were formulated in aquo and exhibited high optical transparency and strong adhesion even on submerged or moist surfaces of diverse polar substrates such as glass, aluminium, wood, and bone pieces. The adhesives could be cured under water through oxidative disulphide crosslinking of the constituent TPEs. The polyamide backbone provided multi-site H-bonding interactions with the substrates while the disulphide crosslinking provided the cohesive strength to the glue. Strong adhesion of mammalian bones (load bearing capacity upto 7 kg/cm2 ) was achieved using the adhesive containing 30 mol % thiol residues. Higher pH and use of oxidants such as povidone-iodine solution enhanced the curing rate of the adhesives, and so did the use of Tris buffer instead of Phosphate buffer. The porous architecture of the adhesive and its progressive degradation in aqueous medium over the course of three weeks bode well for diverse biomedical applications where temporary adhesion of tissues is required.

A New, Biomimetic Collagen-Apatite Wound-Healing Composite with a Potential Regenerative and Anti-Hemorrhagic Effect in Dental Surgery

The aim of this work was to obtain and characterize composite biomaterials containing two components, namely carbonated hydroxyapatite, which was substituted with Mg²⁺ and Zn²⁺ ions, and natural polymer-collagen protein. The following two different types of collagen were used: lyophilized powder of telocollagen from bovine Achilles tendon and atelocollagen solution from bovine dermis. The obtained 3D materials were used as potential matrices for the targeted delivery of tranexamic acid for potential use in wound healing after tooth extractions. Tranexamic acid (TXA) was introduced into composites by two different methods. The physicochemical analyses of the obtained composites included Fourier-transform infrared spectroscopy (FT-IR), inductively coupled plasma-optical emission spectroscopy (ICP-OES), transmission electron microscopy (TEM), scanning electron microscopy (SEM), powder X-ray diffraction (PXRD), release kinetics tests, swelling test, and cytotoxicity assays. The studies showed that the proposed synthetic methods yielded biomaterials with favorable physicochemical properties, as well as the expected release profile of the drug and ions from the matrices.

Anticancer effect of locally applicable aptamer-conjugated gemcitabine-loaded atelocollagen patch in pancreatic cancer patient-derived xenograft models

We investigated the anticancer effect of the aptamer-conjugated gemcitabine-loaded atelocollagen patch in a pancreatic cancer patient-derived xenograft (PDX) model to propose a future potential adjuvant surgical strategy during curative pancreatic resection for pancreatic cancer. A pancreatic cancer PDX model was established. Animals were grouped randomly into a no-treatment control group; treatment group treated with intraperitoneal gemcitabine injection (IP-GEM) or aptamer-conjugated gemcitabine (APT:GEM); and transplant with three kinds of patches: atelocollagen-aptamer-gemcitabine (patch I), atelocollagen-inactive aptamer-gemcitabine (patch II), and atelocollagen-gemcitabine (patch III). Tumor volumes and response were evaluated based on histological analysis by H&E staining and Immunohistochemistry (IHC) was performed. Anticancer therapy-related toxicity was evaluated by hematologic findings. The patch I group showed the most significant reduction of tumor growth rate, compared with the no-treatment group (p < 0.05). However, other treatment groups were not found to show significant reduction in tumor growth rate (0.05 < p < 0.1). There was no microscopic evidence suggesting potential toxicity, such as inflammation, nor necrotic changes in liver, lung, kidney, and spleen tissue. In addition, no leukopenia, anemia, or neutropenia was observed in the patch I group. This implantable aptamer-drug conjugate system is thought to be a new surgical strategy to augment the oncologic significance of margin-negative resection in treating pancreatic cancer in near future.

Engineering a naturally derived hemostatic sealant for sealing internal organs

Controlling bleeding from a raptured tissue, especially during the surgeries, is essentially important. Particularly for soft and dynamic internal organs where use of sutures, staples, or wires is limited, treatments with hemostatic adhesives have proven to be beneficial. However, major drawbacks with clinically used hemostats include lack of adhesion to wet tissue and poor mechanics. In view of these, herein, we engineered a double-crosslinked sealant which showed excellent hemostasis (comparable to existing commercial hemostat) without compromising its wet tissue adhesion. Mechanistically, the engineered hydrogel controlled the bleeding through its wound-sealing capability and inherent chemical activity. This mussel-inspired hemostatic adhesive hydrogel, named gelatin methacryloyl-catechol (GelMAC), contained covalently functionalized catechol and methacrylate moieties and showed excellent biocompatibility both in vitro and in vivo. Hemostatic property of GelMAC hydrogel was initially demonstrated with an in vitro blood clotting assay, which showed significantly reduced clotting time compared to the clinically used hemostat, Surgicel®. This was further assessed with an in vivo liver bleeding test in rats where GelMAC hydrogel closed the incision rapidly and initiated blood coagulation even faster than Surgicel®. The engineered GelMAC hydrogel-based seaalant with excellent hemostatic property and tissue adhesion can be utilized for controlling bleeding and sealing of soft internal organs.

An Injectable Hybrid Gelatin Methacryloyl (GelMA)/Phenyl Isothiocyanate-Modified Gelatin (Gel-Phe) Bioadhesive for Oral/Dental Hemostasis Applications

Biomaterials are widely used for effectively controlling bleeding in oral/dental surgical procedures. Here, gelatin methacryloyl (GelMA) was synthesized by grafting methacrylic anhydride on gelatin backbone, and phenyl isothiocyanate-modified gelatin (Gel-Phe) was synthesized by conjugating different gelatin/phenyl isothiocyanate molar ratios (G/P ratios) (i.e., 1:1, 1:5, 1:10, 1:15, 1:25, 1:50, 1:100, and 1:150) with gelatin polymer chains. Afterward, we combined GelMA and Gel-Phe as an injectable and photo-crosslinkable bioadhesive. This hybrid material system combines photo-crosslinking chemistry and supramolecular interactions for the design of bioadhesives exhibiting a highly porous structure, injectability, and regulable mechanical properties. By simply regulating the G/P ratio (1:1-1:15) and UV exposure times (15-60 s), it was possible to modulate the injectability and mechanical properties of the GelMA/Gel-Phe bioadhesive. Moreover, we demonstrated that the GelMA/Gel-Phe bioadhesive showed low cytotoxicity, a highly porous network, and the phenyl-isothiourea and amine residues on Gel-Phe and GelMA polymers with synergized hemostatic properties towards fast blood absorption and rapid clotting effect. An in vitro porcine skin bleeding and an in vitro dental bleeding model confirmed that the bioadhesive could be directly extruded into the bleeding site, rapidly photo-crosslinked, and reduced blood clotting time by 45%. Moreover, the in situ crosslinked bioadhesive could be easily removed from the bleeding site after clotting, avoiding secondary wound injury. Overall, this injectable GelMA/Gel-Phe bioadhesive stands as a promising hemostatic material in oral/dental surgical procedures.

Controllable performance of a dopamine-modified silk fibroin-based bio-adhesive by doping metal ions

Bio-adhesives are essential for wound healing because of their convenience and safety. Although widely used as biomaterials, silk fibroin's (SF's) further application as bio-adhesive is hindered due to its weak stickiness with tissue and slow gelation speed. Here, a dopamine-modified SF-based bio-adhesive is fabricated by using genipin as the chemical cross-linking agent. Furthermore, metal ions have been used to adjust the adhesion property of the bio-adhesive. The experimental results shows that the dopamine-modified SF-based composite holds a better stickiness except slow gelation speed. The doping of Cu²⁺and Fe³⁺can accelerate the gelation of the bio-adhesive. Compared with Cu²⁺, Fe³⁺has a stronger effect on the gelation speed of the bio-adhesive, which is positive correlative to the concentration of Fe³⁺. The adhesive has injectability and degradability. In addition, the SF-based adhesive has good biocompatibility and good improvement for cell migrationin vitro. The SF-based bio-adhesive holds potential application in the field of rapid fixation of wounds.

Enzyme Catalyzed Hydrogel as Versatile Bioadhesive for Tissue Wound Hemostasis, Bonding, and Continuous Repair

Developing a versatile bioadhesive which is biocompatible, adhesive, hemostatic, and therapeutic is of great significance to promote wound sealing and healing. Herein, an adhesive (GTT-3 hydrogel) is fabricated by catalysis of tannic acid modified gelatin (Gel-TA) with transglutaminase (TG). The hydrogen bonding, imine linking, and acyl-transfer reaction between GTT-3 hydrogel and tissue enable efficient hydrogel integration and adhesion to tissue instantly, so as to seal the wound and stop bleeding. Moreover, the intrinsic wound healing ability of gelatin and the antibacterial properties of TA provide favorable conditions for wound healing after adhesion. In vitro mechanical property testing and cell experimental results determine the elasticity, adhesion, and biocompatibility of the GTT-3 hydrogel. The wound operation in mouse models and pathological sectioning results indicate that GTT-3 adhesive obviously accelerates hemostasis, wound bonding, and healing. With the special property of instant adhesion and excellent hemostatic and therapeutic repair effects, GTT-3 hydrogel may provide a new option for surgical operation.

Recent Advances in Tissue Adhesives for Clinical Medicine

Tissue adhesives have attracted more attention to the applications of non-invasive wound closure. The purpose of this review article is to summarize the recent progress of developing tissue adhesives, which may inspire researchers to develop more outstanding tissue adhesives. It begins with a brief introduction to the emerging potential use of tissue adhesives in the clinic. Next, several critical mechanisms for adhesion are discussed, including van der Waals forces, capillary forces, hydrogen bonding, static electric forces, and chemical bonds. This article further details the measurement methods of adhesion and highlights the different types of adhesive, including natural or biological, synthetic and semisynthetic, and biomimetic adhesives. Finally, this review article concludes with remarks on the challenges and future directions for design, fabrication, and application of tissue adhesives in the clinic. This review article has promising potential to provide novel creative design principles for the generation of future tissue adhesives.

Comprehensive assessment of Nile tilapia skin collagen sponges as hemostatic dressings

Nile tilapia skin collagen sponge was fabricated by lyophilization and cross-linked with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide in the presence of N-hydroxysuccinimide (EDC/NHS). The physicochemical properties were examined. The EDC/NHS cross-linked collagen sponge presented an enhanced water absorption capacity. In addition, biocompatibility and hemostatic efficiency were evaluated by acute systemic toxicity assay, dermal irritation test, intradermal reaction test, sensitization test, cytotoxicity, blood clotting assay in vitro, and liver and femoral artery hemorrhage models in vivo. Results showed that the produced collagen sponges before and after EDC/NHS cross-linking had excellent biocompatibility. Furthermore, EDC/NHS cross-linking promoted fibroblast cells viability and proliferation reflected by the MTT reduction assay. Meanwhile, EDC/NHS cross-linked collagen sponge exhibited the best blood clotting ability and hemostatic efficiency in rat femoral artery hemorrhage model in comparison with non-crosslinked and commercial collagen sponges. Our results demonstrated that the fabricated collagen sponges could be used as perfect hemostatic dressings.

Reinforced collagen with oxidized microcrystalline cellulose shows improved hemostatic effects

Sponges composed of different levels of composite collagen/oxidized microcrystalline cellulose (collagen/OMCC), denoted M1-M4, were studied to improve the hemostatic effect of single-collagen sponges. Surface morphological observations showed that structural combinations and intermolecular interactions occurred between collagen and OMCC in the composites. M2 presented the best physical properties and platelet activation and was thus selected for the investigations of the in vitro coagulation time and hemostatic and biological effects on animals. The results illustrated that M2 could reduce the length of the activated partial thromboplastin time (APTT) and thrombin time (TT) and presented rapid hemostatic efficiency in the two injury models (P<0.05). These findings were used to evaluate the hemostatic mechanism of M2, which can promote blood absorption and platelet activation and could be directly involved in the intrinsic coagulation pathway to accelerate hemostasis. Furthermore, M2 was not cytotoxic and was completely biodegraded in subcutaneous tissue within 28days.

Functional improvement of hemostatic dressing by addition of recombinant batroxobin

Although a number of natural materials have been used as hemostatic agents, many substances do not act quickly enough. Here, we created a novel dressings using collagen and chitosan with recombinant batroxobin (r-Bat) to promote faster and more effective hemostasis. We hypothesized that r-Bat would promote synergetic blood coagulation because it contains a blood coagulation active site different than those of collagen and chitosan. Our results suggest that each substances can maintain hemostatic properties while in the mixed dressings and that our novel hemostatic dressings promotes potent control of bleeding, as demonstrated by a whole blood assay and rat hemorrhage model. In a rat femoral artery model, the scaffold with a high r-Bat concentration more rapidly controlled excessive bleeding. This novel dressings has enormous possible for rapidly controlling bleeding and it improves upon the effect of collagen and chitosan used alone. Our novel r-Bat dressings is a possible candidate for improving preoperative care and displays promising properties as an absorbable agent in hemostasis.

STATEMENT OF SIGNIFICANCE

Despite the excellent hemostatic properties of collagen and chitosan pads, they reported to brittle behavior and lack sufficient hemostatic effect within relevant time. Therefore, we created a novel pad using collagen and chitosan with recombinant batroxobin (r-Bat). r-Bat acts as a thrombin-like enzyme in the coagulation cascade. Specifically, r-Bat, in contrast to thrombin, only splits fibrinopeptide A off and does not influence other hemostatic factors or cells, which makes it clinically useful as a stable hemostatic agent. Also the materials in the pad have synergetic effect because they have different hemostatic mechanisms in the coagulation cascade. This report propose the novel hemostatic pad isreasonable that a great potential for excessive bleeding injury and improve effects of natural substance hemostatic pad.

Hemostatic Efficacy of Nanofibrous Matrix in Rat Liver Injury Model

This present study examined the hemostatic efficacy of nanofibrous matrix in a rat liver model. The nanofibrous matrix comprising gelatin and polycaprolactone was prepared by electrospinning method. Twelve animals underwent surgery and were followed-up for a month. Time taken to cease bleeding, activated partial thromboplastin time, prothrombin time, and fibrinogen concentration were measured. Histopathological examination of liver was also done of treated and control animals. All test animals showed very rapid hemostasis after application of electrospun sheet. Histopathological study showed quick recovery of liver wound in the test group as compared to the control group. The nanofibrous matrix has proven to be not only safe and effective as hemostat but has also shown its potential for liver regeneration.

Processing, characterization and hemostatic mechanism of a ultraporous collagen/ORC biodegradable composite with excellent biological effectiveness

To overcome the hemostatic limitations, ultraporous Col/ORC composites were prepared in this paper.

Microspheres of carboxymethyl chitosan, sodium alginate and collagen for a novel hemostatic in vitro study

To develop biocompatible composite microspheres for novel hemostatic use, we designed and prepared a novel biomaterial, composite microspheres consisting of carboxymethyl chitosan, sodium alginate, and collagen (CSCM). The ultra-structure of CSCM was investigated by scanning electron microscopy assay. In hemostatic function experiment, it was found that CSCM could facilitate platelet adherence, platelet aggregation, and platelet activation in vitro. Besides, the maximum swelling of CSCM submerged in PBS for 50 min was over 300% of that exhibited by commercial hemostatic compound microporous polysaccharide haemostatic powder (CMPHP). In addition, CSCM exhibited good biodegradability and non-cytotoxicity. These results demonstrated that CSCM may be useful in platelet plug formation, and this study would provide important information for further research on hemostasis experiment in vivo.

Feasibility study of the natural derived chitosan dialdehyde for chemical modification of collagen

The aim of this study is to evaluate the chemical crosslinking effects of the natural derived chitosan dialdehyde (OCS) on collagen. Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC) and circular dichroism (CD) measurements suggest that introducing OCS might not destroy the natural triple helix conformation of collagen but enhance the thermal-stability of collagen. Meanwhile, a denser fibrous network of cross-linked collagen is observed by atomic force microscopy. Further, scanning electron microscopy (SEM) and aggregation kinetics analysis confirm that the fibrillation process of collagen advances successfully and OCS could lengthen the completion time of collagen fibrillogenesis but raise the reconstitution rate of collagen fibrils or microfibrils. Besides, the cytocompatibility analysis implies that when the dosage of OCS is less than 15%, introducing OCS into collagen might be favorable for the cell's adhesion, growth and proliferation. Taken as a whole, the present study demonstrates that OCS might be an ideal crosslinker for the chemical fixation of collagen.

Bio-mimetic mineralization potential of collagen hydrolysate obtained from chromium tanned leather waste

Hydroxyapatite (HA) ceramics serve as an alternative to autogenous-free bone grafting by virtue of their excellent biocompatibility. However, chemically synthesized HA lacks the strong load-bearing capacity as required by bone. The bio-mimetic growth of HA crystals on collagen surface provides a feasible solution for synthesizing bone substitutes with the desired properties. This study deals with the utilization of the collagen hydrolysate recovered from leather waste as a substrate for promoting HA crystal growth. Bio-mimetic growth of HA was induced by subjecting the hydrolysate to various mineralization conditions. Parameters that would have a direct effect on crystal growth were varied to determine the optimal conditions necessary. Maximum mineralization was achieved with a combination of 10mM of CaCl2, 5mM of Na2HPO4, 100mM of NaCl and 0.575% glutaraldehyde at a pH of 7.4. The metal-protein interactions leading to formation of HA were identified through Fourier-transform infrared (FTIR) spectroscopy and x-ray diffraction (XRD) studies. The crystal dimensions were determined to be in the nanoscale range by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The size and crystallinity of bio-mimetically grown HA indicate that hydrolysate from leather waste can be used as an ideal alternative substrate for bone growth.

Surgical Materials: Current Challenges and Nano-enabled Solutions

Surgical adhesive biomaterials have emerged as substitutes to sutures and staples in many clinical applications. Nano-enabled materials containing nanoparticles or having a distinct nanotopography have been utilized for generation of a new class of surgical materials with enhanced functionality. In this review, the state of the art in the development of conventional surgical adhesive biomaterials is critically reviewed and their shortcomings are outlined. Recent advancements in generation of nano-enabled surgical materials with their potential future applications are discussed. This review will open new avenues for the innovative development of the next generation of tissue adhesives, hemostats, and sealants with enhanced functionality for various surgical applications.

Enhanced hemostatic performance of tranexamic acid-loaded chitosan/alginate composite microparticles

Novel microparticles based on chitosan and sodium alginate were prepared using emulsification and cross-linking technologies. The spherical microparticles had a porous surface and a diameter of 2 ~ 40 μm. In simulated body fluid, these microparticles quickly swelled but gradually degraded. The results of the MTT assay revealed that a slight inhibition of cell proliferation was observed on day 2 and then gradually decreased afterward. No cell morphology changes were observed. By loading tranexamic acid, the hemostatic performance of the microparticles was obviously improved. Using fast-acting styptic powder (Flashclot) as the control, the hemostatic efficiency was investigated in rabbits using a liver transection bleeding model. It was found that both Flashclot and the microparticles achieved hemostasis in 3.07 ± 0.84 min and 2.48 ± 0.88 min, respectively; however, the tranexamic acid-loaded microparticles stopped the bleeding in 1.90 ± 0.75 min (P < 0.05). Additionally, Flashclot resulted in heat injury to the experimental livers, while the microparticles did not. Thus, with their biodegradability, safety, and superior hemostatic efficiency, tranexamic acid-loaded microparticles might be a promising new powdered hemostatic agent with a wide range of potential applications.

Nanomechanical characterization of chemical interaction between gold nanoparticles and chemical functional groups

We report on how to quantify the binding affinity between a nanoparticle and chemical functional group using various experimental methods such as cantilever assay, PeakForce quantitative nanomechanical property mapping, and lateral force microscopy. For the immobilization of Au nanoparticles (AuNPs) onto a microscale silicon substrate, we have considered two different chemical functional molecules of amine and catecholamine (here, dopamine was used). It is found that catecholamine-modified surface is more effective for the functionalization of AuNPs onto the surface than the amine-modified surface, which has been shown from our various experiments. The dimensionless parameter (i.e., ratio of binding affinity) introduced in this work from such experiments is useful in quantitatively depicting such binding affinity, indicating that the binding affinity and stability between AuNPs and catecholamine is approximately 1.5 times stronger than that between amine and AuNPs. Our study sheds light on the experiment-based quantitative characterization of the binding affinity between nanomaterial and chemical groups, which will eventually provide an insight into how to effectively design the functional material using chemical groups.

A method to screen and evaluate tissue adhesives for joint repair applications

BACKGROUND

Tissue adhesives are useful means for various medical procedures. Since varying requirements cause that a single adhesive cannot meet all needs, bond strength testing remains one of the key applications used to screen for new products and study the influence of experimental variables. This study was conducted to develop an easy to use method to screen and evaluate tissue adhesives for tissue engineering applications.

METHOD

Tissue grips were designed to facilitate the reproducible production of substrate tissue and adhesive strength measurements in universal testing machines. Porcine femoral condyles were used to generate osteochondral test tissue cylinders (substrates) of different shapes. Viability of substrates was tested using PI/FDA staining. Self-bonding properties were determined to examine reusability of substrates (n = 3). Serial measurements (n = 5) in different operation modes (OM) were performed to analyze the bonding strength of tissue adhesives in bone (OM-1) and cartilage tissue either in isolation (OM-2) or under specific requirements in joint repair such as filling cartilage defects with clinical applied fibrin/PLGA-cell-transplants (OM-3) or tissues (OM-4). The efficiency of the method was determined on the basis of adhesive properties of fibrin glue for different assembly times (30 s, 60 s). Seven randomly generated collagen formulations were analyzed to examine the potential of method to identify new tissue adhesives.

RESULTS

Viability analysis of test tissue cylinders revealed vital cells (>80%) in cartilage components even 48 h post preparation. Reuse (n = 10) of test substrate did not significantly change adhesive characteristics. Adhesive strength of fibrin varied in different test settings (OM-1: 7.1 kPa, OM-2: 2.6 kPa, OM-3: 32.7 kPa, OM-4: 30.1 kPa) and was increasing with assembly time on average (2.4-fold). The screening of the different collagen formulations revealed a substance with significant higher adhesive strength on cartilage (14.8 kPa) and bone tissue (11.8 kPa) compared to fibrin and also considerable adhesive properties when filling defects with cartilage tissue (23.2 kPa).

CONCLUSION

The method confirmed adhesive properties of fibrin and demonstrated the dependence of adhesive properties and applied settings. Furthermore the method was suitable to screen for potential adhesives and to identify a promising candidate for cartilage and bone applications. The method can offer simple, replicable and efficient evaluation of adhesive properties in ex vivo specimens and may be a useful supplement to existing methods in clinical relevant settings.

Treatment of the liver cross section following hepatectomy

The incidence of complications after hepatectomy has been considerably reduced over the last 20 years. Better knowledge of liver anatomy and liver regeneration, and methods preventing bleeding during surgery have resulted in morbidity rates below 20% and mortality rates less than 5%. The treatment of the liver cross section remains controversial. Experimental studies have reported convincing biological effects of fibrin sealants or compresses when applied on the liver to decrease hemorrhagic or biliary complications. However, clinical studies are very heterogeneous, providing conflicting results compromising recommendations for routine use.

Isocyanate-functional adhesives for biomedical applications. Biocompatibility and feasibility study for vascular closure applications

Biodegradable isocyanate-functional adhesives based on poly(ethylene glycol)-adipic acid esters were synthesized, characterized, and evaluated in vitro and in vivo. Two types of formulations, P2TT and P2MT, were developed by functionalization with 2,4-tolylene diisocyanate (TDI) or 4,4'-methylene-bis(phenyl isocyanate) (MDI), respectively, and branching with 1,1,1-trimethylolpropane (TMP). The biocompatibility of the synthesized adhesive formulations was evaluated as per ISO 10993. Cytotoxicity, systemic toxicity, pyrogenicity, genotoxicity (reverse mutation of Salmonella typhimurium and Escherichia coli), hemolysis, intracutaneous reactivity, and delayed-type hypersensitivity were evaluated. All formulations met the requirements of the conducted standard tests. The biological behavior and ability of the adhesive formulations to close an arteriotomy and withstand arterial pressure following partial approximation with a single suture were evaluated in a rat abdominal aorta model. Animals were evaluated at 1, 2, 3, and 4 weeks after surgery. Macroscopic and histopathologic evaluation of explanted arteries suggested that the P2TT formulation had better in vivo performance than the P2MT formulation. Additionally, the P2TT formulation resulted in less tissue reaction than P2MT formulation. To our knowledge, this is the first study demonstrating the potential of this new class of isocyanate-functional degradable adhesives for vascular applications.

Biomedical Applications of Biodegradable Polymers

Utilization of polymers as biomaterials has greatly impacted the advancement of modern medicine. Specifically, polymeric biomaterials that are biodegradable provide the significant advantage of being able to be broken down and removed after they have served their function. Applications are wide ranging with degradable polymers being used clinically as surgical sutures and implants. In order to fit functional demand, materials with desired physical, chemical, biological, biomechanical and degradation properties must be selected. Fortunately, a wide range of natural and synthetic degradable polymers has been investigated for biomedical applications with novel materials constantly being developed to meet new challenges. This review summarizes the most recent advances in the field over the past 4 years, specifically highlighting new and interesting discoveries in tissue engineering and drug delivery applications.