Interfacial fluid transport is a key to hydrogel bioadhesion

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.

Poroviscoelastic relaxations and rate-dependent adhesion in gelatin

Hydrogels, polymeric networks swollen with water, exhibit time/rate-dependent adhesion due to their poroviscoleastic constitution. In this study, we conducted probe-tack experiments on gelatin and investigated the influence of dwelling times and unloading rates on pull-off forces and work of adhesion. We utilized in situ contact imaging to monitor separation kinematics and interfacial crack velocities. We found that the crack velocities scaled nonlinearly with the unloading rate, in a power law with an exponent of 0.8 and were independent of dwelling time. At maximum unloading rates corresponding to subsonic interfacial crack speeds, we observed an order of magnitude enhancement in the apparent work of adhesion. The enhancement of adhesion and the crack velocities were related by a power law with an exponent of 0.39. The maximum vertical extension during unloading, a measure of crack opening, exhibited linear correlation with the enhancement of adhesion. Both correlations were in line with the rate-dependent work of fracture modeled for viscoelastic solids (e.g., Persson and Brener model). We explored the links between dwelling times corresponding to varying degrees of poroelastic diffusion and the adhesion. We found 40% additional enhancement in adhesion at the highest unloading rate. This enhancement is due to the unbalanced osmotic pressure, also known as the suction effect. The influence of dwelling times on adhesion was negligible for the interfacial cracks propagating slower than the diffusive time scales. These results identify viscoelastic relaxations as the dominant mechanism governing the rate-dependent enhancement of adhesion, and hence pave the way for tuning rate-dependent adhesion in soft multiphasic materials.

Highly efficient semiconductor modules making controllable parallel microchannels for non-compressible hemorrhages

Nature makes the most beautiful solution to involuted problems. Among them, the parallel tubular structures are capable of transporting fluid quickly in plant trunks and leaf stems, which demonstrate an ingenious evolutionary design. This study develops a mini-thermoelectric semiconductor P-N module to create gradient and parallel channeled hydrogels. The modules decrease quickly the temperature of polymer solution from 20 °C to -20 °C within 5 min. In addition to the exceptional liquid absorption rate, the foams exhibited shape memory mechanics. Our mini device universally makes the inspired structure in such as chitosan, gelatin, alginate and polyvinyl alcohol. Non-compressible hemorrhages are the primary cause of death in emergency. The rapid liquid absorption leads to fast activation of coagulation, which provides an efficient strategy for hemostasis management. We demonstrated this by using our semiconductor modules on collagen-kaolin parallel channel foams with their high porosity (96.43%) and rapid expansion rate (2934%). They absorb liquid with 37.25 times of the own weight, show 46.5-fold liquid absorption speed and 24-fold of blood compared with random porous foams. These superior properties lead to strong hemostatic performance in vitro and in vivo.

Water-Mediated On-Demand Detachable Solid-State Adhesive of Porous Hydroxyapatite for Internal Organ Retractions

Novel adhesives for biological tissues offer an advanced surgical approach. Here, the authors report the development and application of solid-state adhesives consisting of porous hydroxyapatite (HAp) biocompatible ceramics as novel internal organ retractors. The operational principles of the porous solid-state adhesives are experimentally established in terms of water migration from biological soft tissues into the pores of the adhesives, and their performance is evaluated on several soft tissues with different hydration states. As an example of practical medical utility, HAp adhesive devices demonstrate the holding ability of porcine livers and on-demand detachability in vivo, showing great potential as internal organ retractors in laparoscopic surgery.

Tunable Hydrogel Electronics for Diagnosis of Peripheral Neuropathy

Peripheral neuropathy characterized by rapidly increasing numbers of patients is commonly diagnosed via analyzing electromyography signals obtained from stimulation-recording devices. However, existing commercial electrodes have difficulty in implementing conformal contact with skin and gentle detachment, dramatically impairing stimulation/recording performances. Here, this work develops on-skin patches with polyaspartic acid-modified dopamine/ethyl-based ionic liquid hydrogel (PDEH) as stimulation/recording devices to capture electromyography signals for the diagnosis of peripheral neuropathy. Triggered by a one-step electric field treatment, the hydrogel achieves rapid and wide-range regulation of adhesion and substantially strengthened mechanical performances. Moreover, hydrogel patches assembled with a silver-liquid metal (SLM) layer exhibit superior charge injection and low contact impedance, capable of capturing high-fidelity electromyography. This work further verifies the feasibility of hydrogel devices for accurate diagnoses of peripheral neuropathy in sensory, motor, and mixed nerves. For various body parts, such as fingers, the elderly's loose skin, hairy skin, and children's fragile skin, this work regulates the adhesion of PDEH-SLM devices to establish intimate device/skin interfaces or ensure benign removal. Noticeably, hydrogel patches achieve precise diagnoses of nerve injuries in these clinical cases while providing extra advantages of more effective stimulation/recording performances. These patches offer a promising alternative for the diagnosis and rehabilitation of neuropathy in future.

A 3D printable tissue adhesive

Tissue adhesives are promising alternatives to sutures and staples for joining tissues, sealing defects, and immobilizing devices. However, existing adhesives mostly take the forms of glues or hydrogels, which offer limited versatility. We report a direct-ink-write 3D printable tissue adhesive which can be used to fabricate bioadhesive patches and devices with programmable architectures, unlocking new potential for application-specific designs. The adhesive is conformable and stretchable, achieves robust adhesion with wet tissues within seconds, and exhibits favorable biocompatibility. In vivo rat trachea and colon defect models demonstrate the fluid-tight tissue sealing capability of the printed patches, which maintained adhesion over 4 weeks. Moreover, incorporation of a blood-repelling hydrophobic matrix enables the printed patches to seal actively bleeding tissues. Beyond wound closure, the 3D printable adhesive has broad applicability across various tissue-interfacing devices, highlighted through representative proof-of-concept designs. Together, this platform offers a promising strategy toward developing advanced tissue adhesive technologies.

Surface hydrophobization of hydrogels via interface dynamics-induced network reconfiguration

Effective and easy regulation of hydrogel surface properties without changing the overall chemical composition is important for their diverse applications but remains challenging to achieve. We report a generalizable strategy to reconfigure hydrogel surface networks based on hydrogel-substrate interface dynamics for manipulation of hydrogel surface wettability and bioadhesion. We show that the grafting of hydrophobic yet flexible polymeric chains on mold substrates can significantly elevate the content of hydrophobic polymer backbones and reduce the presence of polar groups in hydrogel surface networks, thereby transforming the otherwise hydrophilic hydrogel surface into a hydrophobic surface. Experimental results show that the grafted highly dynamic hydrophobic chains achieved with optimal grafting density, chain length, and chain structure are critical for such substantial hydrogel surface network reconfiguration. Molecular dynamics simulations further reveal the atomistic details of the hydrogel network reconfiguration induced by the dynamic interface interactions. The hydrogels prepared using our strategy show substantially enhanced bioadhesion and transdermal delivery compared with the hydrogels of the same chemical composition but fabricated via the conventional method. Our findings provide important insights into the dynamic hydrogel-substrate interactions and are instrumental to the preparation of hydrogels with custom surface properties.

Degradable Bioadhesives Based on Star PEG-PLA Hydrogels for Soft Tissue Applications

Tissue adhesives are interesting materials for wound treatment as they present numerous advantages compared to traditional methods of wound closure such as suturing and stapling. Nowadays, fibrin and cyanoacrylate glues are the most widespread commercial biomedical adhesives, but these systems display some drawbacks. In this study, degradable bioadhesives based on PEG-PLA star-shaped hydrogels are designed. Acrylate, methacrylate, and catechol functional copolymers are synthesized and used to design various bioadhesive hydrogels. Various types of mechanisms responsible for adhesion are investigated (physical entanglement and interlocking, physical interactions, chemical bonds), and the adhesive properties of the different systems are first studied on a gelatin model and compared to fibrin and cyanoacrylate references. Hydrogels based on acrylate and methacrylate reached adhesion strength close to cyanoacrylate (332 kPa) with values of 343 and 293 kPa, respectively, whereas catechol systems displayed higher values (11 and 19 kPa) compared to fibrin glue (7 kPa). Bioadhesives were then tested on mouse skin and human cadaveric colonic tissue. The results on mouse skin confirmed the potential of acrylate and methacrylate gels with adhesion strength close to commercial glues (15-30 kPa), whereas none of the systems led to high levels of adhesion on the colon. These data confirm that we designed a family of degradable bioadhesives with adhesion strength in the range of commercial glues. The low level of cytotoxicity of these materials is also demonstrated and confirm the potential of these hydrogels to be used as surgical adhesives.

Advanced Functional Polymers for Unmet Medical Challenges

A significant part of medicine relies on biomaterials, which are designed to interact with biological tissues for therapeutic or diagnostic purposes. A number of major trends can be distinguished in the multidisciplinary field of biomaterials science, including the precise synthesis of biomaterial building blocks, elucidation of biomaterial processing-structure-property correlations, as well as clarification of the interactions between living tissues and biomaterials. Moreover, advances in biofabrication facilitate the development of tailored implants with improved functionality, whereas recent achievements in medical imaging allow for a detailed evaluation of the performance and spatiotemporal behavior of medical devices and nanomedicine formulations.

Development of polydopamine functionalized porous starch for bleeding control with the assistance of NIR light

Efficient hemorrhage control of severe wound injuries is an urgent medical need, deserving agents with promising blood coagulation and biocompatible characteristics. Current work developed polydopamine (PDA) functionalized porous starch powder (PS-PDA) for emergency bleeding treatment. The micro-morphology and elements, chemical groups, and porosity of PS-PDA were systematically characterized. Its comparison with porous starch (PS) revealed the promising potential of this composite in medical practice. On one hand, PS-PDA showed superior surface area and biomineralization affinity over PS, along with comparable hemo/cyto-compatibility. On the other hand, the photothermal effect of PDA under near Infrared (NIR) light paved the possibility to accelerate blood coagulation in situ. In vivo studies indicated PS-PDA can significantly reduce blood loss and improvement of hemostasis efficiency accompanied by NIR light exposure. These results suggest that this newly developed PS-PDA powder can serve as a promising hemostatic material for bleeding wound control.

Progress in construction and release of natural polysaccharide-platinum nanomedicines: A review

Natural polysaccharides are natural biomaterials that have become candidate materials for nano-drug delivery systems due to their excellent biodegradability and biocompatibility. Platinum (Pt) drugs have been widely used in the clinical therapy for various solid tumors. However, their extensive systemic toxicity and the drug resistance acquired by cancer cells limit the applications of platinum drugs. Modern nanobiotechnology provides the possibility for targeted delivery of platinum drugs to the tumor site, thereby minimizing toxicity and optimizing the efficacies of the drugs. In recent years, numerous natural polysaccharide-platinum nanomedicine delivery carriers have been developed, such as nanomicelles, nanospheres, nanogels, etc. Herein, we provide an overview on the construction and drug release of natural polysaccharide-Pt nanomedicines in recent years. Current challenges and future prospectives in this field are also put forward. In general, combining with irradiation and tumor microenvironment provides a significant research direction for the construction of natural polysaccharide-platinum nanomedicines and the release of responsive drugs in the future.

Catechol-chitosan/carboxymethylated cotton-based Janus hemostatic patch for rapid hemostasis in coagulopathy

Uncontrolled bleeding is the leading cause of death, and the death risk of bleeding from coagulopathy is even higher. By infusing the relevant coagulation factors, bleeding in patients with coagulopathy can be clinically treated. However, there are not many emergency hemostatic products accessible for coagulopathy patients. In response, a Janus hemostatic patch (PCMC/CCS) with a two-layer structure of partly carboxymethylated cotton (PCMC) and catechol-grafted chitosan (CCS) was developed. Ultra-high blood absorption (4000 %) and excellent tissue adhesion (60 kPa) were both displayed by PCMC/CCS. The proteomic analysis revealed that PCMC/CCS has significantly contributed to the creative generation of FV, FIX, and FX, as well as to the substantial enrichment of FVII and FXIII, re-paving the initially blocked coagulation pathway of coagulopathy to promote hemostasis. The in vivo bleeding model of coagulopathy demonstrated that PCMC/CCS was substantially more effective than gauze and commercial gelatin sponge at achieving hemostasis in just 1 min. The study provides one of the first investigations on procoagulant mechanisms in anticoagulant blood conditions. Rapid hemostasis in coagulopathy will be significantly affected by the results of this experiment.

Mussel Foot Protein Inspired Tape-Type Adhesive with Water-Responsive, High Conformal, Tough, and On-Demand Detachable Adhesion to Wet Tissue

Wet adhesion is highly demanded in noninvasive wound closure, tissue repair, and biomedical devices, but it is still a big challenge for developing biosafe and tough wet bioadhesives due to low or even nonadhesion in the wet state for conventional adhesives. Inspired by the wet-adhesion-contributing factors of mussel foot proteins, a water-responsive dry robust tissue adhesive PAGU tape is made with thickness of <0.5 mm through fast UV-initiated copolymerization of acrylic acid (AA), gelatin (Gel), and hexadecenyl-1,2-catechol (UH). The tape shows strong cohesive mechanical properties and strong interfacial adhesion bonds. Upon application onto wet tissue, the adhesive tape can conform to the tissue, quickly dry tissue surface through absorbing surface/interfacial water and then allows formation of interfacial bonding with a high interfacial toughness of ≈818 J m-2 . Furthermore, it can be readily detached by treating with aq. urea solution. A highly efficient avenue is provided here for producing conformable, tough, and easy detachable wet bioadhesive tapes.

A triple-network carboxymethyl chitosan-based hydrogel for hemostasis of incompressible bleeding on wet wound surfaces

Hydrogel is a kind of hemostatic agent with good application prospect. However, the water molecules on the wound made the hydrogel less adhesive to wet wound tissue. Herein, the carboxymethyl chitosan (CMCS)/oxidized dextran (OD)/γ-polyglutamic acid (γ-PGA) hydrogel was prepared using a double-barreled syringe for hemostasis of diffuse and incompressible wound bleeding. The hydrogel formation was based on the intramolecular lactam bonds, intermolecular amide bonds, and Schiff base bonds. In the hydrogel, the super hydrophilic γ-PGA could drain the surface moisture of the wound and create a local dry environment for enhanced surface adhesion. In vivo study showed that the CMCS/ODex/γ-PGA hydrogel possesses a good biosafety and biodegradability. Interestingly, the CMCS/ODex/γ-PGA hydrogel exhibited excellent hemostatic abilities in dynamic humid environment and resisted a high blood pressure of 238 mmHg, which exceeds the threshold systolic blood pressure of healthy adults (i.e., 120 mmHg). Together with the antibacterial and reactive nitrogen species scavenging activities, this study is expected to provide a new method to design the wet-surface adhesives for the efficient hemostatic application.

Water-driven noninvasively detachable wet tissue adhesives for wound closure

Tissue adhesive with on-demand detachment feature is critically important since it can minimize hurt to patient when it is stripped away. Herein, a water-driven noninvasively detachable wet tissue adhesive hydrogel (w-TAgel) was produced by UV-initiated radical copolymerization of N-isopropylacrylamide (NIPAM), acrylamide (AAm), gelatin methacrylate (GelMA), and urushiol. As a w-TAgel, its robust and tough mechanical property makes it suitable for dynamic wound tissue. The polyurushiol segments of it are crucial to the formation of tough adhesion interface with various wet tissues, while polyNIPAM units play an indispensable role in on-demand detachment via thermo-responsive swelling behavior because the hydrophobic aggregation among isopropyl groups is destroyed upon water treatment with temperature of 25 ​°C or less. Additionally, it exhibits multiple merits including good hemocompatibility, cytocompatibility as well as pro-coagulant activity and hemostasis. Therefore, our w-TAgel with strong adhesion and facile detachment is an advanced prospective dressing for wound closure and rapid hemostasis. The wet tissue adhesion and water-driven detachable mechanism may shed new light on the development of on-demand noninvasively detachable wet tissue adhesives.

Instant and Tough Adhesives for Rapid Gastric Perforation and Traumatic Pneumothorax Sealing

Hydrogel adhesives are hot spots due to their ubiquity and practical relevance. However, achieving a robust wet adhesion is still a challenge due to the preferential formation of hydrogen bonds between interfacial fluids and bulk hydrogel, as well as targeted substrates. Herein, a half-dry adhesive consisting of a silk fibroin (SF) semi-interpenetrating network and poly(acrylic acid) covalent network, which can allow a rapid liquid adsorption and repulsion process encountering a wet tissue, is reported. The remaining water enables excellent hydrogel flexibility to a dynamic surface, while the β-sheet fold endows its tough bulk strength under the peeling-off process. Notably, the wet adhesion energy versus porcine skin is 1440 J m^-2 due to the combination of hydrogen bonds, electrostatic interactions, and chain entanglement derived from SF. In particular, both in vitro and in vivo outcomes indicate excellent hemostatic effects and result in incision closure of skin, artery, gastric perforation, and lung. After the first-stage closure, polyacrylic-silk fibroin adhesive (PSA) sealants can detach from the lung surface, fitting well to the healing period. By virtue of the reliable adhesion and good noncytotoxicity, PSA may be a prospective candidate for tissue sealant and drug carrier applications.

Regulation of the Inevitable Water-Responsivity of Silk Fibroin Biopolymer by Polar Amino Acid Activation

In nature, water is vital for maintaining homeostasis. Particularly, organisms (e.g., plant leaf, bird feather) exploit water fluidics for motions. Hydration-adaptive crystallization is the representative water-responsive actuation of biopolymers. This crystallization has inspired the development of intelligent human-robot interfaces. At the same time, it hinders the consistent adhesion of tissue adhesive. As hydration-adaptive crystallization is inevitable, the on-demand control of crystallization is desirable in the innovative biopolymeric biomedical systems. To this end, this study developed an amino acid-based technology to artificially up- or down-regulate the inevitable crystallization of silk fibroin. A case II diffusion model was constructed, and it revealed that the activity of polar amino acid is related to crystallization kinetics. Furthermore, the water dynamics study suggested that active amino acid stabilizes crystallization-triggering water molecules. As a proof-of-concept, we verified that a 30% increase in the activity of serine resulted in a 50% decrease in the crystallization rate. Furthermore, the active amino acid-based suppression of hydration-adaptive crystallization enabled the silk fibroin to keep its robust adhesion (approximately 160 kJ m^-3) by reducing the water-induced loss of adhesive force. The proposed silk fibroin was demonstrated as a stable tissue adhesive applied on ex vivo porcine mandible tissue. This amino acid-based regulation of hydration-adaptive crystallization will pioneer next-generation biopolymer-based healthcare.

Adhesion of fluid infused silicone elastomer to glass

Elastomers swollen with non-polar fluids show potential as anti-adhesive materials. We study the effect of oil fraction and contact time on the adhesion between swollen spherical probes of PDMS (polydimethylsiloxane) and flat glass surfaces. The PDMS probes are swollen with pre-determined amount of 10 cSt silicone oil to span the range where the PDMS is fluid free (via solvent extraction) up to the limit where it is oil saturated. Probe tack measurements show that adhesion decreases rapidly with an increase in oil fraction. The decrease in adhesion is attributed to excess oil present at the PDMS-air interface. Contact angle measurements and optical microscopy images support this observation. Adhesion also increases with contact time for a given oil fraction. The increase in adhesion with contact time can be interpreted through different competing mechanisms that depend on the oil fraction where the dominant mechanism changes from extracted to fully swollen PDMS. For partially swollen PDMS, we observe that adhesion initially increases because of viscoelastic relaxation and at long times increases because of contact aging. In contrast, adhesion between fully swollen PDMS and glass barely increases over time and is mainly due to capillary forces. While the relaxation of PDMS in contact is well-described by a visco-poroelastic model, we do not see evidence that poroelastic relaxation of the PDMS contributes to an increase of adhesion with glass whether it is partially or fully swollen.

Liquid-infused microstructured bioadhesives halt non-compressible hemorrhage

Non-compressible hemorrhage is an unmet clinical challenge that accounts for high mortality in trauma. Rapid pressurized blood flows under hemorrhage impair the function and integrity of hemostatic agents and the adhesion of bioadhesive sealants. Here, we report the design and performance of bioinspired microstructured bioadhesives, formed with a macroporous tough xerogel infused with functional liquids. The xerogel can rapidly absorb interfacial fluids such as whole blood and promote blood clotting, while the infused liquids facilitate interfacial bonding, sealing, and antibacterial function. Their synergy enables the bioadhesives to form tough adhesion on ex vivo human and porcine tissues and diverse engineered surfaces without the need for compression, as well as on-demand instant removal and storage stability. We demonstrate a significantly improved hemostatic efficacy and biocompatibility in rats and pigs compared to non-structured counterparts and commercial products. This work opens new avenues for the development of bioadhesives and hemostatic sealants.

Non‐compressible wounds are a major source of high mortality in trauma victims. Here the authors report on the creation of xerogels impregnated with liquid adhesives which can rapidly absorb fluids promoting blood clotting while forming adhesions to tissue and demonstrate the xerogel in ex vivo and in vivo models.

Robust Hydrogel Adhesion by Harnessing Bioinspired Interfacial Mineralization

Hydrogels have gained intensive interest in biomedical and flexible electronics, and adhesion of hydrogels to substrates or devices is indispensable in these application scenarios. Although numerous hydrogel adhesion strategies have been developed, it is still challenging to achieve a hydrogel with robust adhesion interface through a universal yet simple method. Here, a strategy for establishing strong interfacial adhesion between various hydrogels and a wide variety of substrates (i.e., soft hydrogels and rigid solids, including glass, aluminum, PET, nylon and PDMS) even under wet conditions, is reported. This strong interfacial adhesion is realized by constructing a bioinspired mineralized transition layer through ion diffusion and subsequent mineral deposition. This strategy is not only generally applicable to a broad range of substrates and ionic pairs, but also compatible with various fabrication approaches without compromising their interfacial robustnesses. This strategy is further demonstrated in the application of single-electrode triboelectric nanogenerators (TENG), where a robust interface between the hydrogel and elastomer layers is enabled to ensure a reliable signal generation and output.

Tissue Adhesives in Reconstructive and Aesthetic Surgery—Application of Silk Fibroin-Based Biomaterials

Tissue adhesives have been successfully used in various kind of surgeries such as oral and maxillofacial surgery for some time. They serve as a substitute for suturing of tissues and shorten treatment time. Besides synthetic-based adhesives, a number of biological-based formulations are finding their way into research and clinical application. In natural adhesives, proteins play a crucial role, mediating adhesion and cohesion at the same time. Silk fibroin, as a natural biomaterial, represents an interesting alternative to conventional medical adhesives. Here, the most commonly used bioadhesives as well as the potential of silk fibroin as natural adhesives will be discussed.

Polydopamine nanoparticles and hyaluronic acid hydrogels for mussel-inspired tissue adhesive nanocomposites

Bioadhesives are intended to facilitate the fast and efficient reconnection of tissues to restore their functionality after surgery or injury. The use of mussel-inspired hydrogel systems containing pendant catechol moieties is promising for tissue attachment under wet conditions. However, the adhesion strength is not yet ideal. One way to overcome these limitations is to add polymeric nanoparticles to create nanocomposites with improved adhesion characteristics. To further enhance adhesiveness, polydopamine nanoparticles with controlled size prepared using an optimized process, were combined with a mussel-inspired hyaluronic acid (HA) hydrogel to form a nanocomposite. The effects of sizes and concentrations of polydopamine nanoparticles on the adhesive profiles of mussel-inspired HA hydrogels were investigated. Results show that the inclusion of polydopamine nanoparticles in nanocomposites increased adhesion strength, as compared to the addition of poly (lactic-co-glycolic acid) (PLGA), and PLGA-(N-hydroxysuccinimide) (PLGA-NHS) nanoparticles. A nanocomposite with demonstrated cytocompatibility and an optimal lap shear strength (47 ± 3 kPa) was achieved by combining polydopamine nanoparticles of 200 nm (12.5% w/v) with a HA hydrogel (40% w/v). This nanocomposite adhesive shows its potential as a tissue glue for biomedical applications.

Injectable hydrogel with nucleus pulposus-matched viscoelastic property prevents intervertebral disc degeneration

Background/Objective

Intervertebral disc (IVD) degeneration (IVDD) that greatly affected by regional biomechanical environment is a major cause of low back pain. Injectable hydrogels have been commonly studied for treatment of IVDD due to their capability of mimicking extracellular matrix structure to support cellular behavior and clinical prospects in minimally invasive treatment. However, most hydrogels suffer from complicated chemistry, potential uncertainty and toxicity from in-situ gelation, and mismatch with IVD mechanical environment that limit their therapeutic effects or clinical translation in IVDD or intervertebral disc defect repair. For IVD lesion repair, the study aims to develop a novel hydrogel with shear-thinning enabled injectability, high bio-safety, and mechanical properties adaptable to the IVD environment, using a simple chemistry and method. And therapeutic efficacy of the novel hydrogel in the treatment of IVDD or intervertebral disc defect will be revealed.

Methods

A glycerol cross-linked PVA gel (GPG) was synthesized based on multiple H-bonds formation between glycerol molecules and PVA chains. The rheological and mechanical properties were tested. The swelling ratio was measured. The micro-architecture was observed through scanning and transmission electron microscopes. Nucleus pulposus (NP) cells were cultured in GPG-coated plates or silicone chambers treated under hydrostatic or dynamic loading in vitro, and examined for proliferation, vitality, apoptosis, expression of catabolic and anabolic markers. GPG was injected in needle puncture (IDD) or NP discectomy (NPD) models in vivo, and examined through magnetic resonance imaging, micro-computed tomography scanning and histological staining.

Results

GPG had a highly porous structure consisting of interconnected pores. Meanwhile, the GPG had NP-like viscoelastic property, and was able to withstand the cyclic deformation while exhibiting a prominent energy-dissipating capability. In vitro cell tests demonstrated that, the hydrogel significantly down-regulated the expression of catabolic markers, maintained the level of anabolic markers, preserved cell proliferation and vitality, reduced apoptotic rate of NP cells under pathologically hydrostatic and dynamic loading environments compared to cells cultured on untreated plate or silicone chamber. In vivo animal studies revealed that injection of GPG efficiently maintained NP structural integrity, IVD height and relative water content in IDD models, and stimulated the fibrous repair in NPD models.

Conclusion

This study showed that GPG, with high injectability, NP-like viscoelastic characteristics, good energy-dissipating properties and swelling capacities, preserved NP cells vitality against pathological loading, and had therapeutic effects on IVD repair in IDD and NPD models.

The translational potential of this article

Effective clinical strategy for treatment of intervertebral disc degeneration (IVDD) is still lacking. This study demonstrates that injection of a hydrogel with nucleus pulposus-matched viscoelastic property could remarkably prevent the IVDD progress. Prepared with simple chemistry and procedure, the cell/drug-free GPG with high bio-safety and shear-thinning enabled injectability bears great translational potential for the clinical treatment of IVDD via a minimally invasive approach.

Electrostatic-Mechanical Synergistic In Situ Multiscale Tissue Adhesion for Sustainable Residue-Free Bioelectronics Interfaces

Recent studies on soft adhesives have sought to deeply understand how their chemical or mechanical structures interact strongly with living tissues. The aim is to optimally address the unmet needs of patients with acute or chronic diseases. Synergistic adhesion involving both electrostatic (hydrogen bonds) and mechanical interactions (capillarity-assisted suction stress) seems to be effective in overcoming the challenges associated with long-term unstable coupling to tissues. Here, an electrostatically and mechanically synergistic mechanism of residue-free, sustainable, in situ tissue adhesion by implementing hybrid multiscale architectonics. To deduce the mechanism, a thermodynamic model based on a tailored multiscale combinatory adhesive is proposed. The model supports the experimental results that the thermodynamically controlled swelling of the nanoporous hydrogel embedded in the hierarchical elastomeric structure enhances biofluid-insensitive, sustainable, in situ adhesion to diverse soft, slippery, and wet organ surfaces, as well as clean detachment in the peeling direction. Based on the robust tissue adhesion capability, universal reliable measurements of electrophysiological signals generated by various tissues, ranging from rodent sciatic nerve, the muscle, brain, and human skin, are successfully demonstrated.

Linear shrinkage of hydrogel coatings exposed to flow: interplay between dissolution of water and advective transport

We investigate the shrinkage of a surface-grafted water-swollen hydrogel under shear flows of oils by laser scanning confocal microscopy. Interestingly, external shear flows of oil lead to linear dehydration and shrinkage of the hydrogel for all investigated flow conditions irrespective of the chemical nature of the hydrogel. The reason is that the finite solubility of water in oil removes water from the hydrogel continuously by diffusion. The flow advects the water-rich oil, as demonstrated by numerical solutions of the underlying convection-diffusion equation. In line with this hypothesis, shear does not cause gel shrinkage for water-saturated oils or non-solvents. The solubility of water in the oil will tune the dehydration dynamics.

Coatings of hydroxyapatite–bioactive glass microparticles for adhesion to biological tissues

Adsorption of particles across interfaces has been proposed as a way to create adhesion between hydrogels and biological tissues. Here, we explore how this particle bridging approach can be applied to attach a soft polymer substrate to biological tissues, using bioresorbable and nanostructured hydroxyapatite–bioactive glass microparticles. For this, microparticles of aggregated flower-like hydroxyapatite and bioactive glass (HA–BG) were synthesized via a bioinspired route. A deposition technique using suspension spreading was developed to tune the coverage of HA–BG coatings at the surface of weakly cross-linked poly(beta-thioester) films. By varying the concentration of the deposited suspensions, we produced coatings having surface coverages ranging from 4% to 100% and coating densities ranging from 0.02 to 1.0 mg cm⁻². The progressive dissolution of these coatings within 21 days in phosphate-buffered saline was followed by SEM. Ex vivo peeling experiments on pig liver capsules demonstrated that HA–BG coatings produce an up-to-two-fold increase in adhesion energy (9.8 ± 1.5 J m⁻²) as compared to the uncoated film (4.6 ± 0.8 J m⁻²). Adhesion energy was found to increase with increasing coating density until a maximum at 0.2 mg cm⁻², well below full surface coverage, and then it decreased for larger coating densities. Using microscopy observations during and after peeling, we show that this maximum in adhesion corresponds to the appearance of particle stacks, which are easily separated and transferred onto the tissue. Such bioresorbable HA–BG coatings give the possibility of combining particle bridging with the storage and release of active compounds, therefore offering opportunities to design functional bioadhesive surfaces.

Coatings of hydroxyapatite–bioactive glass microparticles are proposed as a way to create adhesion between hydrogels and biological tissues using adsorption of the microparticles across the interface.

A Tissue-Like Soft All-Hydrogel Battery

To develop wearable and implantable bioelectronics accommodating the dynamic and uneven biological tissues and reducing undesired immune responses, it is critical to adopt batteries with matched mechanical properties with tissues as power sources. However, the batteries available cannot reach the softness of tissues due to the high Young's moduli of components (e.g., metals, carbon materials, conductive polymers, or composite materials). The fabrication of tissue-like soft batteries thus remains a challenge. Here, the first ultrasoft batteries totally based on hydrogels are reported. The ultrasoft batteries exhibit Young's moduli of 80 kPa, perfectly matching skin and organs (e.g., heart). The high specific capacities of 82 mAh g^-1 in all-hydrogel lithium-ion batteries and 370 mAh g^-1 in all-hydrogel zinc-ion batteries at a current density of 0.5 A g^-1 are achieved. Both high stability and biocompatibility of the all-hydrogel batteries have been demonstrated upon the applications of wearable and implantable. This work illuminates a pathway for designing power sources for wearable and implantable electronics with matched mechanical properties.

Challenges and recent trends with the development of hydrogel fiber for biomedical applications

Hydrogel is the most emblematic soft material which possesses significantly tunable and programmable characteristics. Polymer hydrogels possess significant advantages including, biocompatible, simple, reliable and low cost. Therefore, research on the development of hydrogel for biomedical applications has been grown intensely. However, hydrogel development is challenging and required significant effort before the application at an industrial scale. Therefore, the current work focused on evaluating recent trends and issues with hydrogel development for biomedical applications. In addition, the hydrogel's development methodology, physicochemical properties, and biomedical applications are evaluated and benchmarked against the reported literature. Later, biomedical applications of the nano-cellulose-based hydrogel are considered and critically discussed. Based on a detailed review, it has been found that the surface energy, intermolecular interactions, and interactions of hydrogel adhesion forces are major challenges that contribute to the development of hydrogel. In addition, compared to other hydrogels, nanocellulose hydrogels demonstrated higher potential for drug delivery, 3D cell culture, diagnostics, tissue engineering, tissue therapies and gene therapies. Overall, nanocellulose hydrogel has the potential for commercialization for different biomedical applications.

Skin-Integrated Devices with Soft, Holey Architectures for Wireless Physiological Monitoring, With Applications in the Neonatal Intensive Care Unit

Continuous monitoring of vital signs is an essential aspect of operations in neonatal and pediatric intensive care units (NICUs and PICUs), of particular importance to extremely premature and/or critically ill patients. Current approaches require multiple sensors taped to the skin and connected via hard-wired interfaces to external data acquisition electronics. The adhesives can cause iatrogenic injuries to fragile, underdeveloped skin, and the wires can complicate even the most routine tasks in patient care. Here, materials strategies and design concepts are introduced that significantly improve these platforms through the use of optimized materials, open (i.e., "holey") layouts and precurved designs. These schemes 1) reduce the stresses at the skin interface, 2) facilitate release of interfacial moisture from transepidermal water loss, 3) allow visual inspection of the skin for rashes or other forms of irritation, 4) enable triggered reduction of adhesion to reduce the probability for injuries that can result from device removal. A combination of systematic benchtop testing and computational modeling identifies the essential mechanisms and key considerations. Demonstrations on adult volunteers and on a neonate in an operating NICUs illustrate a broad range of capabilities in continuous, clinical-grade monitoring of conventional vital signs, and unconventional indicators of health status.

Diving beetle-like miniaturized plungers with reversible, rapid biofluid capturing for machine learning-based care of skin disease

Recent advances in bioinspired nano/microstructures have received attention as promising approaches with which to implement smart skin-interfacial devices for personalized health care. In situ skin diagnosis requires adaptable skin adherence and rapid capture of clinical biofluids. Here, we report a simple, all-in-one device consisting of microplungers and hydrogels that can rapidly capture biofluids and conformally attach to skin for stable, real-time monitoring of health. Inspired by the male diving beetle, the microplungers achieve repeatable, enhanced, and multidirectional adhesion to human skin in dry/wet environments, revealing the role of the cavities in these architectures. The hydrogels within the microplungers instantaneously absorb liquids from the epidermis for enhanced adhesiveness and reversibly change color for visual indication of skin pH levels. To realize advanced biomedical technologies for the diagnosis and treatment of skin, our suction-mediated device is integrated with a machine learning framework for accurate and automated colorimetric analysis of pH levels.

Covalently Crosslinked Hydrogels via Step-Growth Reactions: Crosslinking Chemistries, Polymers, and Clinical Impact

Hydrogels are an important class of biomaterials with the unique property of high-water content in a crosslinked polymer network. In particular, chemically crosslinked hydrogels have made a great clinical impact in past years because of their desirable mechanical properties and tunability of structural and chemical properties. Various polymers and step-growth crosslinking chemistries are harnessed for fabricating such covalently crosslinked hydrogels for translational research. However, selecting appropriate crosslinking chemistries and polymers for the intended clinical application is time-consuming and challenging. It requires the integration of polymer chemistry knowledge with thoughtful crosslinking reaction design. This task becomes even more challenging when other factors such as the biological mechanisms of the pathology, practical administration routes, and regulatory requirements add additional constraints. In this review, key features of crosslinking chemistries and polymers commonly used for preparing translatable hydrogels are outlined and their performance in biological systems is summarized. The examples of effective polymer/crosslinking chemistry combinations that have yielded clinically approved hydrogel products are specifically highlighted. These hydrogel design parameters in the context of the regulatory process and clinical translation barriers, providing a guideline for the rational selection of polymer/crosslinking chemistry combinations to construct hydrogels with high translational potential are further considered.

Polymeric Tissue Adhesives

Polymeric tissue adhesives provide versatile materials for wound management and are widely used in a variety of medical settings ranging from minor to life-threatening tissue injuries. Compared to the traditional methods of wound closure (i.e., suturing and stapling), they are relatively easy to use, enable rapid application, and introduce minimal tissue damage. Furthermore, they can act as hemostats to control bleeding and provide a tissue-healing environment at the wound site. Despite their numerous current applications, tissue adhesives still face several limitations and unresolved challenges (e.g., weak adhesion strength and poor mechanical properties) that limit their use, leaving ample room for future improvements. Successful development of next-generation adhesives will likely require a holistic understanding of the chemical and physical properties of the tissue-adhesive interface, fundamental mechanisms of tissue adhesion, and requirements for specific clinical applications. In this review, we discuss a set of rational guidelines for design of adhesives, recent progress in the field along with examples of commercially available adhesives and those under development, tissue-specific considerations, and finally potential functions for future adhesives. Advances in tissue adhesives will open new avenues for wound care and potentially provide potent therapeutics for various medical applications.

Hydrogel-Tissue Adhesion Using Blood Coagulation Induced by Silica Nanoparticle Coatings

The fixation of hydrogels to biological tissues is a major challenge conditioning the development of implants and surgical techniques. Here, coatings of procoagulant nanoparticles are devised which use the presence of blood to create adhesion between hydrogels and soft internal organs. Those nanostructured coatings are simply adsorbed at the hydrogel surfaces and can rapidly activate the formation of an interfacial blood clot acting as an adhesive joint. This concept is demonstrated on pig liver capsules with model poly(ethylene-glycol) membranes that are intrinsically poorly adhesive. In the absence of blood, ex vivo peeling tests show that coatings with aggregates of bare silica nanoparticles induce a 2- to 4-fold increase in adhesion energy as compared to the uncoated membrane (3 ± 2 J m^-2). This effect is found to scale with the specific surface area of the coating. The highest adhesion energies produced by these nanoparticle-coated membranes (10 ± 5 J m^-2) approach the value obtained with cyanoacrylate glue (33 ± 11 J m^-2) for which tearing of the tissue is observed. Ex vivo pull-off tests show an adhesion strength of coated membranes around 5 ± 1 kPa, which is significantly reduced when operating in vivo (1.0 ± 0.5 kPa). Nevertheless, when blood is introduced at the interface, the in vivo adhesion strength can be improved remarkably with silica coatings, reaching 4 ± 2 kPa after 40 min contact. In addition, these silica-coated membranes can seal and stop the bleeding produced by liver biopsies very rapidly (<30 s). Such a combination of coagulation and particle bridging opens promising routes for better biointegrated hydrogel implants and improved surgical adhesives, hemostats, and sealants.

The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes

Hydrogels are extraordinarily versatile by design and can enhance repair in diseased and injured musculoskeletal tissues. Biological fixation of these constructs is a significant determinant factor that is critical to the clinical success and functionality of regenerative technologies for musculoskeletal repair. In the context of an intervertebral disc (IVD) herniation, nucleus pulposus tissue protrudes through the ruptured annulus fibrosus (AF), consequentially impinging on spinal nerve roots and causing debilitating pain. Discectomy is the surgical standard of care to treat symptomatic herniation; however these procedures do not repair AF defects, and these lesions are a significant risk factor for recurrent herniation. Advances in tissue engineering utilize adhesive hydrogels as AF sealants; however these repair strategies have yet to progress beyond preclinical animal models because these biomaterials are often plagued by poor integration with AF tissue and lead to large variability in repair outcomes. These critical barriers to translation motivate this article to review the material composition of hydrogels that have been evaluated in situ for AF repair, proposed mechanisms of how these biomaterials interface with AF tissue, and their functional outcomes after treatment in order to inform the development of new hydrogels for AF repair. In this systematic review, we identify 18 hydrogel formulations evaluated for AF repair, all of which demonstrate large heterogeneity in their interfacing mechanisms and reported outcome measures to assess the effectiveness of repair. Hydrogels that covalently bond to AF tissue were found to be the most successful in improving IVD biomechanical properties from the injured state, but none were able to restore properties to the intact state suggesting that new repair strategies with innovative surface chemistries are an important future direction. We additionally review biomechanical evaluation methods and recommend standardization in the field of AF tissue engineering to establish mechanical benchmarks for translation and ensure clinical feasibility.

Supramolecular Cross-Links in Mussel-Inspired Tissue Adhesives

Here we introduce a tissue-adhesive patch with orthogonal cohesive and adhesive chemistries; supramolecular ureido-4-pyrimidinone (UPy) cross-links provide cohesive strength, and catechols provide mussel-inspired tissue adhesion. In the development of tissue-adhesive biomaterials, prior research has focused on forming strong adhesive interfaces in wet conditions, leaving the use of supramolecular cross-links for cohesive strength underexplored. In developing this adhesive patch, the influence of the comonomers' composition and amphiphilicity on adhesion was investigated by lap shear adhesion to wet tissue. We determined failed lap joints' failure mechanism using catechol-specific Arnow's stain and identified formulations with improved cohesive strength. The adhesive materials were cytocompatible in mammalian cell conditioned media viability studies. We found that using orthogonal motifs to independently control adhesives' cohesive and adhesive strengths resulted in stronger tissue adhesion. The design principles presented here advance the development of wet tissue adhesives and could allow for the future design of biomaterials with desirable stimuli-responsive properties.

CaproGlu: Multifunctional tissue adhesive platform

Driven by the clinical need for a strong tissue adhesive with elastomeric material properties, a departure from legacy crosslinking chemistries was sought as a multipurpose platform for tissue mending. A fresh approach to bonding wet substrates has yielded a synthetic biomaterial that overcomes the drawbacks of free-radical and nature-inspired bioadhesives. A food-grade liquid polycaprolactone grafted with carbene precursors yields CaproGlu. The first-of-its-kind low-viscosity prepolymer is VOC-free and requires no photoinitiators. Grafted diazirine end-groups form carbene diradicals upon low energy UVA (365 nm) activation that immediately crosslink tissue surfaces; no pre-heating or animal-derived components are required. The hydrophobic polymeric environment enables metastable functional groups not possible in formulations requiring solvents or water. Activated diazirine within CaproGlu is uniquely capable of crosslinking all amino acids, even on wet tissue substrates. CaproGlu undergoes rapid liquid-to-biorubber transition within seconds of UVA exposure-features not found in any other bioadhesive. The exceptional shelf stability of CaproGlu allows gamma sterilization with no change in material properties. CaproGlu wet adhesiveness is challenged against current unmet clinical needs: anastomosis of spliced blood vessels, anesthetic muscle patches, and human platelet-mediating coatings. The versatility of CaproGlu enables both organic and inorganic composites for future bioadhesive platforms.

Instant tough bioadhesive with triggerable benign detachment

Bioadhesives such as tissue adhesives, hemostatic agents, and tissue sealants have potential advantages over sutures and staples for wound closure, hemostasis, and integration of implantable devices onto wet tissues. However, existing bioadhesives display several limitations including slow adhesion formation, weak bonding, low biocompatibility, poor mechanical match with tissues, and/or lack of triggerable benign detachment. Here, we report a bioadhesive that can form instant tough adhesion on various wet dynamic tissues and can be benignly detached from the adhered tissues on demand with a biocompatible triggering solution. The adhesion of the bioadhesive relies on the removal of interfacial water from the tissue surface, followed by physical and covalent cross-linking with the tissue surface. The triggerable detachment of the bioadhesive results from the cleavage of bioadhesive's cross-links with the tissue surface by the triggering solution. After it is adhered to wet tissues, the bioadhesive becomes a tough hydrogel with mechanical compliance and stretchability comparable with those of soft tissues. We validate in vivo biocompatibility of the bioadhesive and the triggering solution in a rat model and demonstrate potential applications of the bioadhesive with triggerable benign detachment in ex vivo porcine models.

Locally coupled electromechanical interfaces based on cytoadhesion-inspired hybrids to identify muscular excitation-contraction signatures

Coupling myoelectric and mechanical signals during voluntary muscle contraction is paramount in human-machine interactions. Spatiotemporal differences in the two signals intrinsically arise from the muscular excitation-contraction process; however, current methods fail to deliver local electromechanical coupling of the process. Here we present the locally coupled electromechanical interface based on a quadra-layered ionotronic hybrid (named as CoupOn) that mimics the transmembrane cytoadhesion architecture. CoupOn simultaneously monitors mechanical strains with a gauge factor of ~34 and surface electromyogram with a signal-to-noise ratio of 32.2 dB. The resolved excitation-contraction signatures of forearm flexor muscles can recognize flexions of different fingers, hand grips of varying strength, and nervous and metabolic muscle fatigue. The orthogonal correlation of hand grip strength with speed is further exploited to manipulate robotic hands for recapitulating corresponding gesture dynamics. It can be envisioned that such locally coupled electromechanical interfaces would endow cyber-human interactions with unprecedented robustness and dexterity.

Catechol-functionalized hydrogels: biomimetic design, adhesion mechanism, and biomedical applications

Hydrogels are a unique class of polymeric materials that possess an interconnected porous network across various length scales from nano- to macroscopic dimensions and exhibit remarkable structure-derived properties, including high surface area, an accommodating matrix, inherent flexibility, controllable mechanical strength, and excellent biocompatibility. Strong and robust adhesion between hydrogels and substrates is highly desirable for their integration into and subsequent performance in biomedical devices and systems. However, the adhesive behavior of hydrogels is severely weakened by the large amount of water that interacts with the adhesive groups reducing the interfacial interactions. The challenges of developing tough hydrogel-solid interfaces and robust bonding in wet conditions are analogous to the adhesion problems solved by marine organisms. Inspired by mussel adhesion, a variety of catechol-functionalized adhesive hydrogels have been developed, opening a door for the design of multi-functional platforms. This review is structured to give a comprehensive overview of adhesive hydrogels starting with the fundamental challenges of underwater adhesion, followed by synthetic approaches and fabrication techniques, as well as characterization methods, and finally their practical applications in tissue repair and regeneration, antifouling and antimicrobial applications, drug delivery, and cell encapsulation and delivery. Insights on these topics will provide rational guidelines for using nature's blueprints to develop hydrogel materials with advanced functionalities and uncompromised adhesive properties.

Hydration Control of Gel-Adhesion and Muco-Adhesion

Protective mucin gel layers established by epithelial cell surfaces in biology have water contents above 90% and provide a low-shear stress nonadhesive interfacial boundary on epithelial surfaces throughout the body. Adhesion between gels and mucin layers, muco-adhesion, is an important aspect of drug delivery, biocompatibility, and the prevention of damage during insertion, use, and removal of medical devices in contact with moist epithelial surfaces. This manuscript develops a simple mathematical model to suggest that gel-adhesion and muco-adhesion are controlled by dehydration. For a fully swollen gel, the osmotic pressure is balanced by the elastic stress in the polymer gel, and differences in the elastic modulus are used to calculate dehydration stresses. A model based on Winkler contact mechanics gives a closed form expression for the force of adhesion that is dependent on the contact radius and gel thickness, inversely proportional to the mucin layer stiffness, and proportional to the square of the differences in elastic modulus. Submerged contact experiments conducted on Gemini gel interfaces of polyacrylamide aqueous gels showed increasing adhesion with increasing dehydration of the probe. Additionally, experiments conducted against mucinated epithelial cell monolayers found mucin transfer onto the most dehydrated gels and no transfer on swollen gels. The model and experiments reveal that high water content fully swollen gels are not intrinsically muco-adhesive, which is consistent with previous tribological experience showing increased lubricity with increasing water content and mesh size.