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Hsu CC, Lee LC, Chang HC, Chen YH, Hsieh MW, Chien KH. A Comparison between 2-Octyl Cyanoacrylate and Conventional Suturing for the Closure of Epiblepharon Incision Wounds in Children: A Retrospective Case-Control Study. J Clin Med 2024; 13:3475. [PMID: 38930002 PMCID: PMC11204930 DOI: 10.3390/jcm13123475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/23/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Tissue adhesive has been widely used in ophthalmic surgery for various procedures, proving both effective and safe. However, no studies have compared the surgical efficacy of the tissue adhesive 2-octyl cyanoacrylate (SurgiSeal®) to that of traditional suture closure in Asian children undergoing surgery for lower lid epiblepharon. Methods: This is a single-center retrospective case-control study. Surgical correction for epiblepharon was performed on 22 patients from November 2019 to May 2023. A total of 20 patients who were followed up for at least 1 month were included for analysis. After standardized epiblepharon surgery, group A underwent wound closure with a subcuticular suture and 2-octyl cyanoacrylate, and group B underwent closure with a 6-O fast-absorbing surgical gut suture. Patients were followed up at 1, 4, and 12 weeks post-surgery. Results: A total of 10 patients (20 eyes) underwent skin closure with tissue adhesives (group A), and 10 patients (18 eyes) underwent wound closure using conventional suture material (group B). No significant differences in the sex ratio, mean age at operation, pre- and postoperative best-corrected visual acuity (BCVA), or average surgical time were observed between groups. Both groups exhibited improved postoperative BCVA, with symptom relief and a significant decrease in the severity of keratopathy after surgery. Neither recurrence nor complications were reported during follow-up. The aesthetic results were similar between groups, while caregivers of children in the tissue adhesive group expressed high satisfaction regarding the ease of postoperative care. Conclusions: Successful closure of lower lid epiblepharon surgery wounds in children can be performed using 2-octyl cyanoacrylate (SurgiSeal®). This method is simple, safe, and effective when compared to conventional sutures.
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Affiliation(s)
- Chia-Chen Hsu
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (C.-C.H.); (L.-C.L.); (Y.-H.C.)
| | - Lung-Chi Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (C.-C.H.); (L.-C.L.); (Y.-H.C.)
| | - Hsu-Chieh Chang
- Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei 110, Taiwan
- Department of Nursing, Tri-Service General Hospital Beitou Branch, Taipei 112, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (C.-C.H.); (L.-C.L.); (Y.-H.C.)
| | - Meng-Wei Hsieh
- Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
| | - Ke-Hung Chien
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (C.-C.H.); (L.-C.L.); (Y.-H.C.)
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2
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Shrivas S, Samaur H, Yadav V, Boda SK. Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration. ACS Biomater Sci Eng 2024; 10:1966-1987. [PMID: 38530973 DOI: 10.1021/acsbiomaterials.3c01555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.
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Affiliation(s)
- Sangeeta Shrivas
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Harshita Samaur
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Vinod Yadav
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Sunil Kumar Boda
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
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Wu KC, Freedman BR, Kwon PS, Torre M, Kent DO, Bi WL, Mooney DJ. A tough bioadhesive hydrogel supports sutureless sealing of the dural membrane in porcine and ex vivo human tissue. Sci Transl Med 2024; 16:eadj0616. [PMID: 38507468 PMCID: PMC11145396 DOI: 10.1126/scitranslmed.adj0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
Complete sequestration of central nervous system tissue and cerebrospinal fluid by the dural membrane is fundamental to maintaining homeostasis and proper organ function, making reconstruction of this layer an essential step during neurosurgery. Primary closure of the dura by suture repair is the current standard, despite facing technical, microenvironmental, and anatomic challenges. Here, we apply a mechanically tough hydrogel paired with a bioadhesive for intraoperative sealing of the dural membrane in rodent, porcine, and human central nervous system tissue. Tensile testing demonstrated that this dural tough adhesive (DTA) exhibited greater toughness with higher maximum stress and stretch compared with commercial sealants in aqueous environments. To evaluate the performance of DTA in the range of intracranial pressure typical of healthy and disease states, ex vivo burst pressure testing was conducted until failure after DTA or commercial sealant application on ex vivo porcine dura with a punch biopsy injury. In contrast to commercial sealants, DTA remained adhered to the porcine dura through increasing pressure up to 300 millimeters of mercury and achieved a greater maximum burst pressure. Feasibility of DTA to repair cerebrospinal fluid leak in a simulated surgical context was evaluated in postmortem human dural tissue. DTA supported effective sutureless repair of the porcine thecal sac in vivo. Biocompatibility and adhesion of DTA was maintained for up to 4 weeks in rodents after implantation. The findings suggest the potential of DTA to augment or perhaps even supplant suture repair and warrant further exploration.
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Affiliation(s)
- Kyle C. Wu
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Neurosurgery, Wexner Medical Center and James Cancer Hospital, Ohio State University, Columbus, OH 43210, USA
| | - Benjamin R. Freedman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02215, USA
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Phoebe S. Kwon
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02215, USA
| | - Matthew Torre
- Department of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Daniel O. Kent
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02215, USA
- Department of General Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - David J. Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02215, USA
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4
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Wu N, Li L. A review on wound management strategies in enhanced recovery after craniotomy: An in-depth analysis of their influence on patient recovery and surgical outcomes. Int Wound J 2024; 21:e14595. [PMID: 38272808 PMCID: PMC10789584 DOI: 10.1111/iwj.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024] Open
Abstract
Craniotomy, an essential neurosurgical operation, poses distinct difficulties in the realm of post-operative care, specifically with regard to the management of wounds. Efficient wound management is critical in order to optimize the surgical outcomes, reduce complications and facilitate a speedier recovery. The purpose of this comprehensive review was to assess contemporary wound management approaches as they pertain to improved recovery following craniotomy. This was achieved by contrasting conventional methods with more recent and innovative techniques and analysing the effects of these approaches on patient recovery and surgical results. An exhaustive literature search was undertaken, comprising narrative reviews, clinical studies, peer-reviewed articles and expert opinions. The emphasis was on the evolution of wound management strategies and techniques utilized after cranial section, as well as their contributions to patient recovery. The analysis reveals that while conventional wound management methods, including suturing and antiseptics, continue to be essential, innovative strategies such as negative pressure wound therapy, skin adhesives and advanced pain management protocols are becoming increasingly recognized. It has been demonstrated that these novel approaches improve recovery by decreasing the incidence of infections, enhancing patient comfort and producing superior cosmetic results. Nevertheless, obstacles continue to endure, including patient-specific variables, technological and financial considerations and the enduring consequences of recovery. Thus the treatment of wounds during craniotomy recuperation necessitates an integrated strategy that incorporates conventional techniques alongside contemporary advancements. Progress in this domain necessitates the customization of approaches to suit the unique requirements of each patient, the resolution of identified obstacles and an emphasis on ongoing investigation and interdisciplinary cooperation. The ever-changing terrain of wound management approaches underscores the ever-changing character of neurosurgical treatment and the continuous endeavour to enhance patient results following cranial resection.
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Affiliation(s)
- Nan Wu
- Nursing Department, Sir Run Run Shaw HospitalZhejiang University School of MedicineZhejiangHangzhouChina
| | - Luping Li
- Nursing Department, Sir Run Run Shaw HospitalZhejiang University School of MedicineZhejiangHangzhouChina
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Guo Z, Xiong Y, Zhang S, Yuan T, Xia J, Wei R, Chen L, Sun W. Naturally derived highly resilient and adhesive hydrogels with application as surgical adhesive. Int J Biol Macromol 2023; 253:127192. [PMID: 37793510 DOI: 10.1016/j.ijbiomac.2023.127192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Abstract
The inadequacy of conventional surgical techniques for wound closure and repair in soft and resilient tissues may lead to poor healing outcomes such as local tissue fibrosis and contracture. Therefore, the development of adhesive and resilient hydrogels that can adhere firmly to irregular and dynamic wound interfaces and provide a "tension-free proximity" environment for tissue regeneration has become extremely important. Herein, we describe an integrated modeling-experiment-application strategy for engineering a promising hydrogel-based bioadhesive based on recombinant human collagen (RHC) and catechol-modified hyaluronic acid (HA-Cat). Molecular modeling and simulations were used to verify and explore the hypothesis that RHC and HA-Cat can form an assembly complex through physical interactions. The complex was synergistically crosslinked via a catechol/o-quinone coupling reaction and a carbodiimide coupling reactions, resulting in superior hydrogels with strong adhesion and resilience properties. The application of this bioadhesive to tissue adhesion and wound sealing in vivo was successfully demonstrated, with an optimum collagen index, epidermal thickness, and lowest scar width. Furthermore, subcutaneous implantation demonstrated that the bioadhesive exhibited good biocompatibility and degradability. This newly developed hydrogel may be a highly promising surgical adhesive for medical applications, including wound closure and repair.
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Affiliation(s)
- Zhongwei Guo
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Yahui Xiong
- Department of Burn, Wound Repair & Reconstruction, Laboratory of General Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China; Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shiqiang Zhang
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Tianying Yuan
- Department of Mechanical Engineering and Mechanics, Tsinghua University, Beijing 100084, China
| | - Jingjing Xia
- Department of Mechanical Engineering and Mechanics, Tsinghua University, Beijing 100084, China.
| | - Ronghan Wei
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou 450001, China.
| | - Lei Chen
- Department of Burn, Wound Repair & Reconstruction, Laboratory of General Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China; Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
| | - Wei Sun
- Department of Mechanical Engineering and Mechanics, Tsinghua University, Beijing 100084, China; Department of Mechanical Engineering, Drexel University, Philadelphia, PA 19104, United States.
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Wu SJ, Zhao X. Bioadhesive Technology Platforms. Chem Rev 2023; 123:14084-14118. [PMID: 37972301 DOI: 10.1021/acs.chemrev.3c00380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.
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Affiliation(s)
- Sarah J Wu
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Xuanhe Zhao
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
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7
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Monteiro LPG, Rodrigues JMM, Mano JF. In situ generated hemostatic adhesives: From mechanisms of action to recent advances and applications. BIOMATERIALS ADVANCES 2023; 155:213670. [PMID: 37952461 DOI: 10.1016/j.bioadv.2023.213670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
Conventional surgical closure techniques, such as sutures, clips, or skin closure strips, may not always provide optimal wound closure and may require invasive procedures, which can result in potential post-surgical complications. As result, there is a growing demand for innovative solutions to achieve superior wound closure and improve patient outcomes. To overcome the abovementioned issues, in situ generated hemostatic adhesives/sealants have emerged as a promising alternative, offering a targeted, controllable, and minimally invasive procedure for a wide variety of medical applications. The aim of this review is to provide a comprehensive overview of the mechanisms of action and recent advances of in situ generated hemostatic adhesives, particularly protein-based, thermoresponsive, bioinspired, and photocrosslinkable formulations, as well as the design challenges that must be addressed. Overall, this review aims to enhance a comprehensive understanding of the latest advancements of in situ generated hemostatic adhesives and their mechanisms of action, with the objective of promoting further research in this field.
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Affiliation(s)
- Luís P G Monteiro
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
| | - João M M Rodrigues
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - João F Mano
- Department of Chemistry, CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal.
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8
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Valsamidis TN, Rasmussen T, Eriksen JD, Iversen LH. The role of tissue adhesives and sealants in colorectal anastomotic healing-a scoping review. Int J Colorectal Dis 2023; 38:265. [PMID: 37935974 DOI: 10.1007/s00384-023-04554-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Anastomotic leakage (AL) after colorectal resection is a serious postoperative complication with grave consequences for patients. Despite several efforts to reduce its incidence, AL is still seen among 2-20% of colorectal cancer patients receiving an anastomosis. The use of tissue adhesives and sealants as an extra layer of protection around the anastomosis has shown promising results. We conducted a scoping review to provide an overview of the current knowledge on the effect of tissue adhesives and sealants on colorectal anastomosis healing, as well as their effect on the postoperative outcome. METHODS The databases of PubMed, Embase, and Cochrane Library were systematically searched on 14/10/2022. Studies addressing the use of a tissue adhesive or tissue sealant applied around a colorectal anastomosis, with the goal to prevent AL or to decrease AL-related complications, were included. We presented an overview of the available studies and summarized their results narratively. RESULTS Seven studies were included out of the 846 screened. All authors reported the rate of AL in their interventions group. Five of the studies found a decreased rate of AL compared to the control group. One study had no incidences of AL, while the last study had a seemingly low rate of AL but no comparison group. Information on secondary outcomes was sparingly reported, but the results hinted at a positive effect. CONCLUSION Tissue adhesives and sealants might have a beneficial effect on colorectal anastomosis healing. The literature is sparse, and this review has shown the need for further clinical studies.
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Affiliation(s)
- Thomas Nikolas Valsamidis
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus C, Denmark.
| | - Tine Rasmussen
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus C, Denmark
| | - Jacob Damgaard Eriksen
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus C, Denmark
| | - Lene Hjerrild Iversen
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Denmark
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Cipolato O, Dosnon L, Rosendorf J, Sarcevic S, Zäch M, Bondi A, Liska V, Schlegel AA, Herrmann IK. Nanothermometry-Enabled Intelligent Laser Tissue Soldering. SMALL METHODS 2023; 7:e2300693. [PMID: 37592160 DOI: 10.1002/smtd.202300693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/27/2023] [Indexed: 08/19/2023]
Abstract
While often life-saving, surgical resectioning of diseased tissues puts patients at risk for post-operative complications. Sutures and staples are well-accepted and routinely used to reconnect tissues, however, their mechanical mismatch with biological soft tissue and invasiveness contribute to wound healing complications, infections, and post-operative fluid leakage. In principle, laser tissue soldering offers an attractive, minimally-invasive alternative for seamless soft tissue fusion. However, despite encouraging experimental observations, including accelerated healing and lowered infection risk, critical issues related to temperature monitoring and control during soldering and associated complications have prevented their clinical exploitation to date. Here, intelligent laser tissue soldering (iSoldering) with integrated nanothermometry is introduced as a promising yet unexplored approach to overcome the critical shortcomings of laser tissue soldering. It demonstrates that adding thermoplasmonic and nanothermometry nanoparticles to proteinaceous solders enables heat confinement and non-invasive temperature monitoring and control, offering a route to high-performance, leak-tight tissue sealing even at deep tissue sites. The resulting tissue seals exhibit excellent mechanical properties and resistance to chemically-aggressive digestive fluids, including gastrointestinal juice. The iSolder can be readily cut and shaped by surgeons to optimally fit the tissue defect and can even be applied using infrared light from a medically approved light source, hence fulfilling key prerequisites for application in the operating theatre. Overall, iSoldering enables reproducible and well-controlled high-performance tissue sealing, offering new prospects for its clinical exploitation in diverse fields ranging from cardiovascular to visceral and plastic surgery.
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Affiliation(s)
- Oscar Cipolato
- Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, 8092, Zurich, Switzerland
- Particles Biology Interactions Laboratory, Department of Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), 9014, St. Gallen, Switzerland
| | - Lucas Dosnon
- Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, 8092, Zurich, Switzerland
- Particles Biology Interactions Laboratory, Department of Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), 9014, St. Gallen, Switzerland
| | - Jachym Rosendorf
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
| | - Sima Sarcevic
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
| | - Marius Zäch
- Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, 8092, Zurich, Switzerland
| | - Alice Bondi
- Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, 8092, Zurich, Switzerland
| | - Vaclav Liska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300, Pilsen, Czech Republic
| | - Andrea A Schlegel
- Swiss HPB and Transplant Center, University Hospital Zurich, 8091, Zurich, Switzerland
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Centre of Preclinical Research, 20122, Milan, Italy
- Transplantation Center, Digestive Disease and Surgery Institute and Department of Immunity and Inflammation, Lerner Research Institute, Cleveland Clinic, 44106, OH, Cleveland, United States
| | - Inge K Herrmann
- Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, 8092, Zurich, Switzerland
- Particles Biology Interactions Laboratory, Department of Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), 9014, St. Gallen, Switzerland
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Neiman A, Eshkol-Yogev I, Keren A, Foox M, Pinkas O, Goldstein N, Gilhar A, Zilberman M, Ullmann Y. Closure of Long Surgical Incisions with Hemostatic Tissue Adhesive in a Porcine Skin Model. Adv Skin Wound Care 2023; 36:1-10. [PMID: 37729169 DOI: 10.1097/asw.0000000000000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Skin adhesives offer many advantages over traditional wound-closure devices. Recently, the current research group reported on tissue adhesives composed of natural polymers (gelatin and alginate), which are biocompatible with mechanical properties suitable for tissue adhesion. The objective of the present study was to conduct clinical and histologic assessment of this hemostatic bioadhesive in the healing of long skin incisions (≥4 cm) in comparison with traditional and commercially available methods. METHODS Researchers created 24 long incisions on the ventral side of two domestic pigs to compare four different treatment modalities: two topical bioadhesives based on gelatin and alginate combined with the hemostatic agent kaolin, nylon sutures, and commercial tissue adhesive N-butyl-2-cyanoacrylate. The bioadhesive compounds were spread on the incision surface and then mixed either manually or with a double-headed syringe. After 14 days, clinical and histologic measurements were performed to evaluate the healing phase of the wounds. RESULTS The bioadhesive formulation that contained a relatively low crosslinker concentration demonstrated superior results to the formulation that contained a standard crosslinker concentration. However, no significant statistical differences were observed compared with the control incisions (sutures and commercial adhesive N-butyl-2-cyanoacrylate). This was verified by immunohistochemical analysis for epithelial integrity and scar formation as well as by clinical assessment. CONCLUSIONS This newly developed bioadhesive demonstrated suitable properties for the closure of long incisions in a porcine skin model.
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Affiliation(s)
- Ariel Neiman
- Ariel Neiman, MD, is Attending Plastic Surgeon and Head of Breast Reconstruction and Microsurgery, Meir Health Center, Kfar Saba, Israel. Inbar Eshkol-Yogev, DMD, PhD, is Clinical Lecturer, Eastman Dental Institute, UCL, London, UK. Aviad Keren, PhD, is Lab Manager, Israel Institute of Technology, Haifa. Maytal Foox, PhD, is Director of Food Technology and Product Development, Aleph Farms, Rehovot, Israel. Oded Pinkas, PhD, is Director of Process Development, NanoGhost, Netanya, Israel. Nyra Goldstein, BSc, is Researcher, Biond Biologics, Misgave Industrial Park, Israel. Also at Israel Institute of Technology, Amos Gilhar, MD, is Director, Skin Research Laboratory, Ruth & Bruce Rappaport Faculty of Medicine. Meital Zilberman, PhD, is Professor of Biomedical Engineering, Tel-Aviv University. Yehuda Ullmann, MD, is Director of the Surgical Division, Rambam Health Care Campus, Haifa
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Lisong H, Lianfu W, Jinhong Y, Haibin Z. Clinical effect analysis of using medical glue versus conventional suturing to treat dog bite in children's maxillofacial region after negative pressure sealing drainage: A randomized trial. Medicine (Baltimore) 2023; 102:e34837. [PMID: 37713853 PMCID: PMC10508562 DOI: 10.1097/md.0000000000034837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/28/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children's maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and patient satisfaction. METHODS From May 2020 to July 2022, 68 children with a dog bite in the maxillofacial region were randomly divided into medical glue and conventional suturing groups. The patients in both groups were treated with conventional debridement, tetanus and/or rabies immunization, and antibiotic therapy. The medical glue group was treated with VSD after the first-stage of the loose suture of the wound. After 5 days, the suture was removed, and the wound was tightly bonded with medical glue again. The conventional suturing group was treated with VSD after the first-stage of loose suture of the wound. The primary outcomes were the operation time and satisfaction of the 2 groups, and the secondary outcomes was the wound infection rate. RESULTS The operation time of the medical glue group was significantly lower than that of the conventional suturing group. However, there was no significant difference between the 2 groups in the wound infection rate. Still, the patient satisfaction was significantly better in the medical glue group than the conventional suturing group with statistically significant difference (P < .05). CONCLUSION In conclusion, applying medical glue after using negative pressure sealing drainage in treating maxillofacial dog bites can reduce surgeons work intensity, lessen children's pain, and improve the clinical treatment effect.
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Tsai YC, Huang DW, Chou YY, An YC, Cheng YS, Chen PH, Tzeng YS. Comparative Evaluation of Tissue Adhesives and Sutures in the Management of Facial Laceration Wounds in Children. J Pers Med 2023; 13:1350. [PMID: 37763118 PMCID: PMC10532459 DOI: 10.3390/jpm13091350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This study evaluated tissue adhesives in comparison to sutures for treating facial lacerations in children. METHODS We retrospectively analyzed data from September 2017 to August 2022 involving pediatric facial lacerations managed with either tissue adhesives or sutures. RESULTS Among 50 children, 20 received tissue adhesives, and 30 received sutures. Both methods showed comparable outcomes in terms of wound complications such as dehiscence (adjusted odds ratio = 1.56, 95% CI = 0.08-31.25) and infection (adjusted odds ratio = 2.17, 95% CI = 0.08-58.80). The cosmetic outcomes, assessed using the Hollander Wound Evaluation Score, were also consistent between groups (adjusted beta = -0.55, 95% CI = -1.15-0.05). Notably, those treated with tissue adhesives reported greater satisfaction (adjusted beta = 1.13, 95% CI = 0.63 -1.63) and experienced significantly less pain (adjusted beta = -3.03, 95% CI = -4.15--1.90). CONCLUSIONS Both techniques displayed similar rates of infection, dehiscence, and cosmetic outcomes. However, tissue adhesives were associated with increased patient comfort, especially in terms of reduced pain and greater satisfaction.
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Affiliation(s)
- Yu-Chi Tsai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Dun-Wei Huang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Yu Chou
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Chin An
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yung-Sheng Cheng
- Division of Pediatric Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Po-Huang Chen
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yuan-Sheng Tzeng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Department of Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 813204, Taiwan
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13
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Suter B, Anthis AHC, Zehnder A, Mergen V, Rosendorf J, Gerken LRH, Schlegel AA, Korcakova E, Liska V, Herrmann IK. Surgical Sealant with Integrated Shape-Morphing Dual Modality Ultrasound and Computed Tomography Sensors for Gastric Leak Detection. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2301207. [PMID: 37276437 PMCID: PMC10427398 DOI: 10.1002/advs.202301207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/26/2023] [Indexed: 06/07/2023]
Abstract
Postoperative anastomotic leaks are the most feared complications after gastric surgery. For diagnostics clinicians mostly rely on clinical symptoms such as fever and tachycardia, often developing as a result of an already fully developed, i.e., symptomatic, surgical leak. A gastric fluid responsive, dual modality, electronic-free, leak sensor system integrable into surgical adhesive suture support materials is introduced. Leak sensors contain high atomic number carbonates embedded in a polyacrylamide matrix, that upon exposure to gastric fluid convert into gaseous carbon dioxide (CO2 ). CO2 bubbles remain entrapped in the hydrogel matrix, leading to a distinctly increased echogenic contrast detectable by a low-cost and portable ultrasound transducer, while the dissolution of the carbonate species and the resulting diffusion of the cation produces a markedly reduced contrast in computed tomography imaging. The sensing elements can be patterned into a variety of characteristic shapes and can be combined with nonreactive tantalum oxide reference elements, allowing the design of shape-morphing sensing elements visible to the naked eye as well as artificial intelligence-assisted automated detection. In summary, shape-morphing dual modality sensors for the early and robust detection of postoperative complications at deep tissue sites, opening new routes for postoperative patient surveillance using existing hospital infrastructure is reported.
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Affiliation(s)
- Benjamin Suter
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Alexandre H. C. Anthis
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Anna‐Katharina Zehnder
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
| | - Victor Mergen
- Diagnostic and Interventional RadiologyUniversity Hospital ZurichUniversity of ZurichRämistrasse 100Zürich8091Switzerland
| | - Jachym Rosendorf
- Department of SurgeryFaculty of Medicine in PilsenCharles UniversityAlej Svobody 923/80Pilsen32300Czech Republic
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
| | - Lukas R. H. Gerken
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Andrea A. Schlegel
- Department of Surgery and TransplantationSwiss HPB CentreUniversity Hospital ZurichRämistrasse 100Zurich8091Switzerland
- Fondazione IRCCS Ca' GrandaOspedale Maggiore PoliclinicoCentre of Preclinical ResearchMilan20122Italy
- Transplantation Center, Digestive Disease and Surgery Institute and Department of Immunity and Inflammation, Lerner Research InstituteCleveland Clinic9620 Carnegie AveClevelandOH44106United States
| | - Eva Korcakova
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
- Department of Imaging MethodsFaculty of Medicine in Pilsen, Charles UniversityAlej Svobody 80Pilsen30460Czech Republic
| | - Vaclav Liska
- Department of SurgeryFaculty of Medicine in PilsenCharles UniversityAlej Svobody 923/80Pilsen32300Czech Republic
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
| | - Inge K. Herrmann
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
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14
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Fitzgerald DM, Colson YL, Grinstaff MW. Synthetic Pressure Sensitive Adhesives for Biomedical Applications. Prog Polym Sci 2023; 142:101692. [PMID: 37273788 PMCID: PMC10237363 DOI: 10.1016/j.progpolymsci.2023.101692] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Pressure sensitive adhesives are components of everyday products found in homes, offices, industries, and hospitals. Serving the general purpose of fissure repair and object fixation, pressure sensitive adhesives indiscriminately bind surfaces, as long as contact pressure is administered at application. With that being said, the chemical and material properties of the adhesive formulation define the strength of a pressure sensitive adhesive to a particular surface. Given our increased understanding of the viscoelastic material requirements as well as the intermolecular interactions at the binding interface required for functional adhesives, pressure sensitive adhesives are now being explored for greater use. New polymer formulations impart functionality and degradability for both internal and external applications. This review highlights the structure-property relationships between polymer architecture and pressure sensitive adhesion, specifically for medicine. We discuss the rational, molecular-level design of synthetic polymers for durable, removable, and biocompatible adhesion to wet surfaces like tissue. Finally, we examine prevalent challenges in biomedical wound closure and the new, innovative strategies being employed to address them. We conclude by summarizing the progress of current research, identifying additional clinical opportunities, and discussing future prospects.
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Affiliation(s)
- Danielle M. Fitzgerald
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA 02115
| | - Yolonda L. Colson
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02214
| | - Mark W. Grinstaff
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA 02115
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15
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Guo J, Ye L, Gao Y, Li S, Zhang L, Liu W, Peng T, Mou Y, Wu C, Xie C, Hu B, Deng X. Hybrid Dry Powders for Rapid Sealing of Gastric Perforations under an Endoscope. ACS NANO 2023; 17:9521-9528. [PMID: 37129870 DOI: 10.1021/acsnano.3c02083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Effective wound sealing is key to prevent postoperative complications arising from gastric endoscopic submucosal dissection (ESD). Accurate delivery of the adhesive to wet and dynamic tissues and rapid action of the adhesive onsite should be considered for endoscopic operation. A hybrid dry powder (HDP) strategy, characterized by decoupling of powder gelation and tissue adhesion, for rapid sealing of wet tissues is presented. HDPs carrying oppositely charged polyelectrolytes become a hydrogel layer over the target tissue by absorbing the surrounding water and forming strong electrostatic interactions between heterogeneous components. Strong adhesion is realized through hydrogen bonding between the adhesive component, poly(acrylic acid), and the tissue. Wet tissue adhesion can be achieved in a few seconds (adhesion strength of ∼30 kPa to porcine skin). Notably, the HDP-assembled hydrogel can maintain a low swelling rate and resist degradation in acidic aqueous environments (pH 1). Furthermore, HDPs can be delivered to target tissues by spraying via an endoscope. The results of in vivo experiments indicate that healing of gastric ESD perforations by sealing with the powder-assembled hydrogel is as effective as that by sealing with clips. This strategy is expected to facilitate the development of fast-acting hydrogel-based adhesives for endoscopic operation.
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Affiliation(s)
- Junchang Guo
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Liansong Ye
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuan Gao
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shuangyang Li
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Lifan Zhang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wei Liu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tingfa Peng
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yi Mou
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chuncheng Wu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chaoming Xie
- Key Lab of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xu Deng
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu 610054, China
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16
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Harman M, Champaigne K, Cobb W, Lu X, Chawla V, Wei L, Luzinov I, Mefford OT, Nagatomi J. A Novel Bio-Adhesive Mesh System for Medical Implant Applications: In Vivo Assessment in a Rabbit Model. Gels 2023; 9:372. [PMID: 37232966 PMCID: PMC10217475 DOI: 10.3390/gels9050372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/08/2023] [Accepted: 04/13/2023] [Indexed: 05/27/2023] Open
Abstract
Injectable surgical sealants and adhesives, such as biologically derived fibrin gels and synthetic hydrogels, are widely used in medical products. While such products adequately adhere to blood proteins and tissue amines, they have poor adhesion with polymer biomaterials used in medical implants. To address these shortcomings, we developed a novel bio-adhesive mesh system utilizing the combined application of two patented technologies: a bifunctional poloxamine hydrogel adhesive and a surface modification technique that provides a poly-glycidyl methacrylate (PGMA) layer grafted with human serum albumin (HSA) to form a highly adhesive protein surface on polymer biomaterials. Our initial in vitro tests confirmed significantly improved adhesive strength for PGMA/HSA grafted polypropylene mesh fixed with the hydrogel adhesive compared to unmodified mesh. Toward the development of our bio-adhesive mesh system for abdominal hernia repair, we evaluated its surgical utility and in vivo performance in a rabbit model with retromuscular repair mimicking the totally extra-peritoneal surgical technique used in humans. We assessed mesh slippage/contraction using gross assessment and imaging, mesh fixation using tensile mechanical testing, and biocompatibility using histology. Compared to polypropylene mesh fixed with fibrin sealant, our bio-adhesive mesh system exhibited superior fixation without the gross bunching or distortion that was observed in the majority (80%) of the fibrin-fixed polypropylene mesh. This was evidenced by tissue integration within the bio-adhesive mesh pores after 42 days of implantation and adhesive strength sufficient to withstand the physiological forces expected in hernia repair applications. These results support the combined use of PGMA/HSA grafted polypropylene and bifunctional poloxamine hydrogel adhesive for medical implant applications.
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Affiliation(s)
- Melinda Harman
- 301 Rhodes Engineering Research Center, Bioengineering Department, Clemson University, Clemson, SC 29634, USA
- School of Medicine Greenville, Prisma Health Upstate, University of South Carolina, Greenville, SC 29605, USA
| | - Kevin Champaigne
- 301 Rhodes Engineering Research Center, Bioengineering Department, Clemson University, Clemson, SC 29634, USA
- Circa Bioscience, Charleston, SC 29412, USA
| | - William Cobb
- School of Medicine Greenville, Prisma Health Upstate, University of South Carolina, Greenville, SC 29605, USA
| | - Xinyue Lu
- 301 Rhodes Engineering Research Center, Bioengineering Department, Clemson University, Clemson, SC 29634, USA
| | | | - Liying Wei
- Materials Science & Engineering Department, Clemson University, Clemson, SC 29634, USA
| | - Igor Luzinov
- Materials Science & Engineering Department, Clemson University, Clemson, SC 29634, USA
| | - O. Thompson Mefford
- 301 Rhodes Engineering Research Center, Bioengineering Department, Clemson University, Clemson, SC 29634, USA
- Materials Science & Engineering Department, Clemson University, Clemson, SC 29634, USA
| | - Jiro Nagatomi
- 301 Rhodes Engineering Research Center, Bioengineering Department, Clemson University, Clemson, SC 29634, USA
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17
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Bremer L, Hagemeister K, Moss M, Ernst L, Tolba RH, Jockenhoevel S, Apel C. Long-Term Degradation Assessment of a Polyurethane-Based Surgical Adhesive-Assessment and Critical Consideration of Preclinical In Vitro and In Vivo Testing. J Funct Biomater 2023; 14:jfb14030168. [PMID: 36976092 PMCID: PMC10058192 DOI: 10.3390/jfb14030168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/08/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
Tissue adhesives constitute a great possibility to improve conventional wound closure. In contrast to sutures, they enable nearly immediate hemostasis and can prevent fluid or air leaks. In the present study, a poly(ester)urethane-based adhesive was investigated which already proved to be suitable for different indications, such as reinforcing vascular anastomosis and sealing liver tissue. Using in vitro and in vivo setups, the degradation of the adhesives was monitored over a period of up to 2 years, to evaluate long-term biocompatibility and determine degradation kinetics. For the first time, the complete degradation of the adhesive was documented. In subcutaneous locations, tissue residues were found after 12 months and in intramuscular locations, tissue degradation was complete after about 6 months. A detailed histological evaluation of the local tissue reaction revealed good biocompatibility throughout the different degradation stages. After full degradation, complete remodeling to physiological tissue was observed at the implant locations. In addition, this study critically discusses common issues related to the assessment of biomaterial degradation kinetics in the context of medical device certification. This work highlighted the importance and encouraged the implementation of biologically relevant in vitro degradation models to replace animal studies or at least reduce the number of animals in preclinical testing prior to clinical studies. Moreover, the suitability of frequently used implantation studies based on ISO 10993-6 at standard locations was critically discussed, especially in light of the associated lack of reliable predictions for degradation kinetics at the clinically relevant site of implantation.
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Affiliation(s)
- Lisanne Bremer
- Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | | | - Michaela Moss
- Institute for Laboratory Animal Science & Experimental Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Lisa Ernst
- Institute for Laboratory Animal Science & Experimental Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - René H Tolba
- Institute for Laboratory Animal Science & Experimental Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Christian Apel
- Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
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18
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Gholizadeh S, Chen X, Yung A, Naderi A, Ghovvati M, Liu Y, Farzad A, Mostafavi A, Dana R, Annabi N. Development and optimization of an ocular hydrogel adhesive patch using definitive screening design (DSD). Biomater Sci 2023; 11:1318-1334. [PMID: 36350113 DOI: 10.1039/d2bm01013e] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Adhesive hydrogels based on chemically modified photocrosslinkable polymers with specific physicochemical properties are frequently utilized for sealing wounds or incisions. These adhesive hydrogels offer tunable characteristics such as tailorable tissue adhesion, mechanical properties, swelling ratios, and enzymatic degradability. In this study, we developed and optimized a photocrosslinkable adhesive patch, GelPatch, with high burst pressure, minimal swelling, and specific mechanical properties for application as an ocular (sclera and subconjunctival) tissue adhesive. To achieve this, we formulated a series of hydrogel patches composed of different polymers with various levels of methacrylation, molecular weights, and hydrophobic/hydrophilic properties. A computerized multifactorial definitive screening design (DSD) analysis was performed to identify the most prominent components impacting critical response parameters such as adhesion, swelling ratio, elastic modulus, and second order interactions between applied components. These parameters were mathematically processed to generate a predictive model that identifies the linear and non-linear correlations between these factors. In conclusion, an optimized formulation of GelPatch was selected based on two modified polymers: gelatin methacryloyl (GelMA) and glycidyl methacrylated hyaluronic acid (HAGM). The ex vivo results confirmed adhesion and retention of the optimized hydrogel subconjunctivally and on the sclera for up to 4 days. The developed formulation has potential to be used as an ocular sealant for quick repair of laceration type ocular injuries.
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Affiliation(s)
- Shima Gholizadeh
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Xi Chen
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Ann Yung
- Schepens Eye Research Institute, Mass Eye and Ear, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
| | - Amirreza Naderi
- Schepens Eye Research Institute, Mass Eye and Ear, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
| | - Mahsa Ghovvati
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Yangcheng Liu
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Ashkan Farzad
- Sanquin Product Support and Development, Sanquin Plasma Products B.V., Amsterdam, The Netherlands
| | - Azadeh Mostafavi
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
| | - Reza Dana
- Schepens Eye Research Institute, Mass Eye and Ear, Harvard Medical School, Department of Ophthalmology, Boston, MA, USA
| | - Nasim Annabi
- Chemical and Biomolecular Engineering Department, University of California - Los Angeles, Los Angeles, CA, USA.
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, CA, USA
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19
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Szymanski L, Gołaszewska K, Małkowska J, Gołębiewska M, Kaczyńska J, Gromadka B, Matak D. Safety and performance of surgical adhesives. PLoS One 2022; 17:e0271531. [PMID: 36006958 PMCID: PMC9409600 DOI: 10.1371/journal.pone.0271531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tissue adhesives are an alternative to conventional surgical sutures to reduce the time and cost of wound closure and to improve patient comfort. The use of tissue adhesives does not require any subsequent intervention and significantly lowers the volume and rate of blood loss, and reduces the need for transfusions during and after surgery. However, based on their formulation, tissue adhesives' safety profile and functional properties may differ. Therefore, this study aimed to evaluate the basic safety and performance of NE'X Glue® Surgical Sealant, BioGlue® Surgical Sealant, and PREVELEAKTM Surgical Sealant in vitro. METHODS The basic safety of commercially available tissue adhesives was evaluated using MEM elution assay according to ISO 10993-5 and endotoxin level according to 85. USP. The in vitro performance was evaluated using lap-shear by tension loading test, burst strength test, degradation, and swelling assays. RESULTS NE'X Glue®, BioGlue®, and PREVELEAKTM did not cause cytotoxicity in MEM elution assay. All surgical adhesives are below the general limit of endotoxin contamination of 20 EU/device. NE'X Glue® and BioGlue® showed the highest and comparable strength properties in lap shear and burst strength tests compared to PREVELEAKTM. NE'X Glue® and PREVELEAKTM are characterized by lower degradation potential than BioGlue®. PREVELEAKTM is characterized by the highest swelling when compared to NE'X Glue® and BioGlue®. CONCLUSIONS NE'X Glue® is most versatile in terms of functional properties while maintaining the same safety profile as BioGlue® and PREVELEAKTM.
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Affiliation(s)
- Lukasz Szymanski
- Department of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Science, Magdalenka, Poland
- European Biomedical Institute, Jozefow, Poland
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20
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Medical Adhesives and Their Role in Laparoscopic Surgery—A Review of Literature. MATERIALS 2022; 15:ma15155215. [PMID: 35955150 PMCID: PMC9369661 DOI: 10.3390/ma15155215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/15/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023]
Abstract
Laparoscopic surgery is undergoing rapid development. Replacing the traditional method of joining cut tissues with sutures or staples could greatly simplify and speed up laparoscopic procedures. This alternative could undoubtedly be adhesives. For decades, scientists have been working on a material to bond tissues together to create the best possible conditions for tissue regeneration. The results of research on tissue adhesives achieved over the past years show comparable treatment effects to traditional methods. Tissue adhesives are a good alternative to surgical sutures in wound closure. This article is a review of the most important groups of tissue adhesives including their properties and possible applications. Recent reports on the development of biological adhesives are also discussed.
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21
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Glue Embolization Without Surgical Resection for Orbital Venolymphatic Malformation. J Craniofac Surg 2022; 33:e538-e541. [DOI: 10.1097/scs.0000000000008650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
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22
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Abstract
Intraoperative bleeding and postoperative bleeding are major surgical complications. Tissue sealants, hemostats, and adhesives provide the armamentarium for establishing hemostatic balance, including the tissue sealant fibrin. Fibrin sealants combine advantages including instantaneous effect, biocompatibility, and biodegradability. However, several challenges remain. This review summarizes current fibrin product generations and highlights new trends and potential strategies for future improvement.
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Affiliation(s)
- Matthias Beudert
- Institute of Pharmacy and Food Chemistry, Julius-Maximilians-University Würzburg, Am Hubland, 97074 Würzburg, Germany
| | - Marcus Gutmann
- Institute of Pharmacy and Food Chemistry, Julius-Maximilians-University Würzburg, Am Hubland, 97074 Würzburg, Germany
| | - Tessa Lühmann
- Institute of Pharmacy and Food Chemistry, Julius-Maximilians-University Würzburg, Am Hubland, 97074 Würzburg, Germany
| | - Lorenz Meinel
- Institute of Pharmacy and Food Chemistry, Julius-Maximilians-University Würzburg, Am Hubland, 97074 Würzburg, Germany.,Helmholtz Institute for RNA-based Infection Research, Josef-Schneider-Straße 2, 97080 Würzburg, Germany
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23
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Raja BS, Choudhury AK, Paul S, Gowda AKS, Kalia RB. No Additional Benefits of Tissue Adhesives for Skin Closure in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Arthroplasty 2022; 37:186-202. [PMID: 34419313 DOI: 10.1016/j.arth.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/07/2021] [Accepted: 07/24/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This systematic review is aimed to compare the performance of tissue adhesives (TA) as an adjunct or closure method with traditional wound closure methods for cutaneous closure in arthroplasty and evaluate whether they have any added benefits in terms of decreasing wound complications and increasing postoperative patient satisfaction. METHODS Cochrane Library, PubMed, and EMBASE were searched until February 2021. Randomized controlled trials (RCTs) comparing outcomes of TA with emphasis on skin closure time, in-hospital stay, complication rates, cosmetic scoring systems, and patient satisfaction scores (PSS) compared to subcuticular sutures (SCS) and skin staples (ST) in arthroplasty. The quality of RCTs was assessed using the National Institutes of Health quality assessment tool. RESULTS Ten RCTs were included. The pooled and the subgroup analysis revealed no significant difference in the wound infection rates, discharge rates, dehiscence rates, and PSS between TA (as an adjunct or closure method) and SCS or ST. TA (as an adjunct or closure method) was significantly (P < .00001) associated with a longer time to closure compared to ST and a shorter time compared to SCS as a closure method. Length of stay was comparable in all groups. CONCLUSION Using TA in combination with subcuticular sutures or ST or as a cutaneous method of closure does not provide additional benefits in terms of decreased hospital stay, decreased infection rates, or wound discharge rates. The PSS and pain scores of the scars also appear to be comparable to standard wound closure methods. No clear conclusion could be drawn regarding cosmetic scoring systems, because of the paucity of data. LEVEL OF EVIDENCE Level I (Meta-analysis of RCTs).
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Affiliation(s)
- Balgovind S Raja
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Souvik Paul
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Aditya K S Gowda
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Roop Bhushan Kalia
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
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Ghimire S, Sarkar P, Rigby K, Maan A, Mukherjee S, Crawford KE, Mukhopadhyay K. Polymeric Materials for Hemostatic Wound Healing. Pharmaceutics 2021; 13:2127. [PMID: 34959408 PMCID: PMC8708336 DOI: 10.3390/pharmaceutics13122127] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 02/04/2023] Open
Abstract
Hemorrhage is one of the greatest threats to life on the battlefield, accounting for 50% of total deaths. Nearly 86% of combat deaths occur within the first 30 min after wounding. While external wound injuries can be treated mostly using visual inspection, abdominal or internal hemorrhages are more challenging to treat with regular hemostatic dressings because of deep wounds and points of injury that cannot be located properly. The need to treat trauma wounds from limbs, abdomen, liver, stomach, colon, spleen, arterial, venous, and/or parenchymal hemorrhage accompanied by severe bleeding requires an immediate solution that the first responders can apply to reduce rapid exsanguinations from external wounds, including in military operations. This necessitates the development of a unique, easy-to-use, FDA-approved hemostatic treatment that can deliver the agent in less than 30 s and stop bleeding within the first 1 to 2 min at the point of injury without application of manual pressure on the wounded area.
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Affiliation(s)
- Suvash Ghimire
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Pritha Sarkar
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Kasey Rigby
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Aditya Maan
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
- Department of Chemistry, University of Central Florida, Orlando, FL 32816, USA
| | - Santanu Mukherjee
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
| | - Kaitlyn E. Crawford
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
- Department of Chemistry, University of Central Florida, Orlando, FL 32816, USA
- NanoScience Technology Center, University of Central Florida, Orlando, FL 32816, USA
- Biionix Cluster, University of Central Florida, Orlando, FL 32816, USA
| | - Kausik Mukhopadhyay
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA; (S.G.); (P.S.); (K.R.); (A.M.); (S.M.)
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25
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Zhang W, Bao B, Jiang F, Zhang Y, Zhou R, Lu Y, Lin S, Lin Q, Jiang X, Zhu L. Promoting Oral Mucosal Wound Healing with a Hydrogel Adhesive Based on a Phototriggered S-Nitrosylation Coupling Reaction. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2105667. [PMID: 34605063 DOI: 10.1002/adma.202105667] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/19/2021] [Indexed: 06/13/2023]
Abstract
The wet and highly dynamic environment of the mouth makes local treatment of oral mucosal diseases challenging. To overcome this, a photo-crosslinking hydrogel adhesive is developed inspired by the success of light-curing techniques in dentistry. The adhesive operates on a fast (within 5 s) phototriggered S-nitrosylation coupling reaction and employs imine anchoring to connect to host tissues. Unlike other often-used clinical agents that adhere weakly and for short durations, this thin, elastic, adhesive, and degradable cyclic o-nitrobenzyl-modified hyaluronic acid gel protects mucosal wounds from disturbance by liquid rinsing, oral movement, and friction for more than 24 h. The results from both rat and pig oral mucosa repair models demonstrate that this new gel adhesive creates a favorable microenvironment for tissue repair and can shorten tissue healing time. This study thus illustrates a therapeutic strategy with the potential to advance the treatment of oral mucosal defects in the clinic.
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Affiliation(s)
- Wenjie Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Bingkun Bao
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, 200240, China
| | - Fei Jiang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, 639 Zhizaoju Road, Shanghai, 200011, China
- Jiangsu Key Laboratory of Oral Diseases, Department of General Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 140, Han Zhong Road, Nanjing, 210029, P. R. China
| | - Yiqing Zhang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Collaborative Innovation Center for Biomanufacturing Technology, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
- School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
| | - Renjie Zhou
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Collaborative Innovation Center for Biomanufacturing Technology, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
- School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
| | - Yuezhi Lu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Sihan Lin
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Qiuning Lin
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, 200240, China
| | - Xinquan Jiang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Linyong Zhu
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, 200240, China
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Collaborative Innovation Center for Biomanufacturing Technology, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
- School of Chemistry and Molecular Engineering, East China University of Science and Technology, 130 Mei Long Road, Shanghai, 200237, China
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26
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Fang W, Yang L, Hong L, Hu Q. A chitosan hydrogel sealant with self-contractile characteristic: From rapid and long-term hemorrhage control to wound closure and repair. Carbohydr Polym 2021; 271:118428. [PMID: 34364568 DOI: 10.1016/j.carbpol.2021.118428] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/14/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022]
Abstract
Emergent and long-term hemorrhage control is requisite and beneficial for reducing global mortality and postoperative complications (e.g., second bleeding and adverse tissue adhesion). Despite recent advance in injectable hydrogels for hemostasis, achieving rapid gelation, strong tissue-adhesive property and stable mechanical strength under fluid physiological environment is still challenging. Herein, we developed a novel chitosan hydrogel (CCS@gel) via dynamic Schiff base reaction and mussel-inspired catechol chemistry. The hydrogel possessed high gelation rate (<10 s), strong wet adhesiveness, excellent self-healing performance and biocompatibility. More importantly, the CCS@gel exhibited saline-induced contractile performance and mechanical enhancement, promoting its mechanical property in moist internal conditions. In vivo studies demonstrated its superior hemostatic efficacy for diverse anticoagulated visceral and carotid bleeding scenarios, compared to commercialized fibrin glue. The hydrogel-treated rats survived for 8 weeks with minimal inflammation and postoperative adhesion. These results revealed that the promising CCS@gel would be a facile, efficient and safe sealant for clinical hemorrhage control.
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Affiliation(s)
- Wen Fang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Ling Yang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Liangjie Hong
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Qiaoling Hu
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
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27
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Wang Y, Guo J, Li B, Li D, Meng Z, Sun SK. Biocompatible therapeutic albumin/genipin bioglue for postoperative wound adhesion and residual tumor ablation. Biomaterials 2021; 279:121179. [PMID: 34700226 DOI: 10.1016/j.biomaterials.2021.121179] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 01/23/2023]
Abstract
Surgical adhesives have partly replaced traditional sutures to seal and reattach tissues due to their superiorities in preventing liquids leakage and avoiding secondary damage in the surrounding wound area. Most of the existing adhesives are committed to promoting wound healing and functional recovery. A therapeutic adhesive that assists in clearing the residual tumors in the surgical area is undoubtedly meaningful to obtain a better clinical outcome. Herein, enlightened by commercial BioGlue (albumin/glutaraldehyde sealant), a biocompatible therapeutic albumin/genipin bioglue is designed for postoperative wound adhesion and tumor ablation. The albumin/genipin bioglue is formed by simple mixing of bovine serum albumin (BSA) and genipin (GP) under a 35 °C water bath for 24 h without further purification. The obtained dark-blue fluorescent adhesive exhibits a significant temperature increase accompanied by heating-induced curing once irradiated with an 808-nm laser. This unique characteristic allows BSA-GP a therapeutic adhesive for postoperative wound adhesion and photothermal elimination of residual tumors under laser irradiation. Moreover, its easy injectability and impressive photothermal efficacy also make it feasible for in situ tumor photothermal ablation. The ultrasimple synthetic strategy by mimicking BioGlue endows BSA-GP adhesive with large-scale production capacity and clinical transformation potential, which is a successful paradigm for reforming existing clinical products.
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Affiliation(s)
- Yaqiong Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jingjing Guo
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300350, China
| | - Bingjie Li
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Dong Li
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Shao-Kai Sun
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300203, China.
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28
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Chen S, Gil CJ, Ning L, Jin L, Perez L, Kabboul G, Tomov ML, Serpooshan V. Adhesive Tissue Engineered Scaffolds: Mechanisms and Applications. Front Bioeng Biotechnol 2021; 9:683079. [PMID: 34354985 PMCID: PMC8329531 DOI: 10.3389/fbioe.2021.683079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
A variety of suture and bioglue techniques are conventionally used to secure engineered scaffold systems onto the target tissues. These techniques, however, confront several obstacles including secondary damages, cytotoxicity, insufficient adhesion strength, improper degradation rate, and possible allergic reactions. Adhesive tissue engineering scaffolds (ATESs) can circumvent these limitations by introducing their intrinsic tissue adhesion ability. This article highlights the significance of ATESs, reviews their key characteristics and requirements, and explores various mechanisms of action to secure the scaffold onto the tissue. We discuss the current applications of advanced ATES products in various fields of tissue engineering, together with some of the key challenges for each specific field. Strategies for qualitative and quantitative assessment of adhesive properties of scaffolds are presented. Furthermore, we highlight the future prospective in the development of advanced ATES systems for regenerative medicine therapies.
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Affiliation(s)
- Shuai Chen
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Carmen J. Gil
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Liqun Ning
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Linqi Jin
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Lilanni Perez
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Gabriella Kabboul
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Martin L. Tomov
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
| | - Vahid Serpooshan
- Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
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29
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Bon S, Chiesa I, Degli Esposti M, Morselli D, Fabbri P, De Maria C, Morabito A, Coletta R, Calamai M, Pavone FS, Tonin R, Morrone A, Giorgi G, Valentini L. Carbon Nanotubes/Regenerated Silk Composite as a Three-Dimensional Printable Bio-Adhesive Ink with Self-Powering Properties. ACS APPLIED MATERIALS & INTERFACES 2021; 13:21007-21017. [PMID: 33934601 PMCID: PMC8153539 DOI: 10.1021/acsami.1c03288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/18/2021] [Indexed: 05/21/2023]
Abstract
In this study, regenerated silk (RS) obtained from Bombyx Mori cocoons is compounded with carboxyl-functionalized carbon nanotubes (f-CNTs) in an aqueous environment for the fabrication of functional bio-adhesives. Molecular interactions between RS and carboxyl groups of CNTs result in structural increase of the β-sheet formation, obtaining a resistant adhesive suitable for a wet biological substrate. Moreover, the functionalization of CNTs promotes their dispersion in RS, thus enabling the production of films with controlled electrical conductivity. The practical utility of such a property is demonstrated through the fabrication of a piezoelectric device implanted in a rat to monitor the breathing in vivo and to be used as a self-powered system. Finally, RS/f-CNTs were used as a printable biomaterial ink to three dimensionally print bilayer hollow tubular structures composed of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and RS. Initial tests carried out by seeding and growing human skin fibroblasts demonstrated that the 3D printed bilayer hollow cylindrical structures offer a suitable surface for the seeded cells to attach and proliferate. In general, the herein proposed RS/f-CNT composite serves as a versatile material for solvent-free dispersion processing and 3D printing, thus paving a new approach to prepare multifunctional materials with potential applications of great interest in sealing biological substrates and implantable devices for regenerative medicine.
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Affiliation(s)
- Silvia
Bittolo Bon
- Dipartimento
di Ingegneria Civile e Ambientale, Università
degli Studi di Perugia, Strada di Pentima 4, Terni 05100, Italy
- Italian
Consortium for Science and Technology of Materials (INSTM), Via Giusti 9, Firenze 50121, Italy
| | - Irene Chiesa
- Department
of Ingegneria dell’Informazione and Research Center E. Piaggio, University of Pisa, Largo Lucio Lazzarino 1, Pisa 56122, Italy
| | - Micaela Degli Esposti
- Italian
Consortium for Science and Technology of Materials (INSTM), Via Giusti 9, Firenze 50121, Italy
- Department
of Civil Chemical, Environmental and Materials Engineering (DICAM), Università; di Bologna, Via Terracini 28, Bologna 40131, Italy
| | - Davide Morselli
- Italian
Consortium for Science and Technology of Materials (INSTM), Via Giusti 9, Firenze 50121, Italy
- Department
of Civil Chemical, Environmental and Materials Engineering (DICAM), Università; di Bologna, Via Terracini 28, Bologna 40131, Italy
| | - Paola Fabbri
- Italian
Consortium for Science and Technology of Materials (INSTM), Via Giusti 9, Firenze 50121, Italy
- Department
of Civil Chemical, Environmental and Materials Engineering (DICAM), Università; di Bologna, Via Terracini 28, Bologna 40131, Italy
| | - Carmelo De Maria
- Department
of Ingegneria dell’Informazione and Research Center E. Piaggio, University of Pisa, Largo Lucio Lazzarino 1, Pisa 56122, Italy
| | - Antonino Morabito
- Department
of Pediatric Surgery, Meyer Children’s
Hospital, Viale Pieraccini
24, Firenze 50139, Italy
- Dipartimento
Neuroscienze, Psicologia, Area del Farmaco e della Salute del Bambino
NEUROFARBA, Università degli Studi
di Firenze, Viale Pieraccini
6, Firenze 50121, Italy
| | - Riccardo Coletta
- Department
of Pediatric Surgery, Meyer Children’s
Hospital, Viale Pieraccini
24, Firenze 50139, Italy
- School
of Health and Society, University of Salford, Salford M5 4WT, United Kingdom
| | - Martino Calamai
- European
Laboratory for Non-linear Spectroscopy (LENS), University of Florence, Sesto
Fiorentino (FI) 50129, Italy
- National
Institute of Optics -National Research Council (CNR-INO), Sesto Fiorentino (FI) 50129, Italy
| | - Francesco Saverio Pavone
- European
Laboratory for Non-linear Spectroscopy (LENS), University of Florence, Sesto
Fiorentino (FI) 50129, Italy
- Department
of Physics, University of Florence, Sesto Fiorentino (FI) 50121, Italy
| | - Rodolfo Tonin
- Molecular
and Cell Biology Laboratory, Paediatric Neurology Unit
and Laboratories, Neuroscience Department, Meyer Children’s Hospital, Firenze 50139, Italy
| | - Amelia Morrone
- Dipartimento
Neuroscienze, Psicologia, Area del Farmaco e della Salute del Bambino
NEUROFARBA, Università degli Studi
di Firenze, Viale Pieraccini
6, Firenze 50121, Italy
- Molecular
and Cell Biology Laboratory, Paediatric Neurology Unit
and Laboratories, Neuroscience Department, Meyer Children’s Hospital, Firenze 50139, Italy
| | - Giacomo Giorgi
- Dipartimento di Ingegneria Civile e Ambientale (DICA), Università degli Studi di Perugia, Via G. Duranti 93, Perugia 06125, Italy
- CNR-SCITEC, Perugia I-06123, Italy
| | - Luca Valentini
- Dipartimento
di Ingegneria Civile e Ambientale, Università
degli Studi di Perugia, Strada di Pentima 4, Terni 05100, Italy
- Italian
Consortium for Science and Technology of Materials (INSTM), Via Giusti 9, Firenze 50121, Italy
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30
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Ghosh S, Tripathi A, Gayen P, Sinha Roy R. Peptide-based topical agents and intravenous hemostat for rapid hemostasis. RSC Med Chem 2020; 11:1100-1111. [PMID: 33479616 PMCID: PMC7651999 DOI: 10.1039/d0md00204f] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/14/2020] [Indexed: 01/25/2023] Open
Abstract
Traumatic coagulopathy due to severe external injury and internal hemorrhage is life-threatening to accident victims and soldiers on the battlefield, causing considerable number of deaths worldwide. Patients with inherited bleeding disorders (such as haemophilia, von Willebrand disease, inherited qualitative platelet defects, and afibrinogenemia) also contribute to the vast number of deaths due to abnormal bleeding, and these patients are difficult to handle during surgery. Platelets and different plasma proteins play an essential role in blood coagulation and in the maintenance of the body's hemostatic balance. The improper function or deficiency of these factors cause abnormal bleeding. To address such bleeding disorders, external clotting agents (such as extracellular protein-inspired natural and synthetic peptide-based sealants and peptide-functionalized polymer/liposome-based sealants) have been developed by different groups of researchers. The primary focus of this review is to provide molecular insights into the existing biologically inspired peptide-based sealants, highlighting the advantages and limitations of such reported designed sealants to handle blood clotting, and also provide insights into the design of improved next-generation surgical sealants.
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Affiliation(s)
- Snehasish Ghosh
- Department of Chemical Sciences , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India
| | - Archana Tripathi
- Department of Biological Sciences , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India .
| | - Paramita Gayen
- Department of Biological Sciences , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India .
| | - Rituparna Sinha Roy
- Department of Biological Sciences , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India .
- Centre for Advanced Functional Materials , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India
- Centre for Climate and Environmental Studies , Indian Institute of Science Education and Research Kolkata , Mohanpur - 741246 , India
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31
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Bannerman AD, Davenport Huyer L, Montgomery M, Zhao N, Velikonja C, Bender TP, Radisic M. Elastic Biomaterial Scaffold with Spatially Varying Adhesive Design. ADVANCED BIOSYSTEMS 2020; 4:e2000046. [PMID: 32567253 PMCID: PMC7665997 DOI: 10.1002/adbi.202000046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/08/2020] [Indexed: 12/20/2022]
Abstract
In order to secure biomaterials to tissue surfaces, sutures or glues are commonly used. Of interest is the development of a biomaterial patch for applications in tissue engineering and regeneration that incorporates an adhesive component to simplify patch application and ensure sufficient adhesion. A separate region dedicated to fulfilling the specific requirements of an application such as mechanical support or tissue delivery is also desirable. Here, the design and fabrication of a unique patch are presented with distinct regions for adhesion and function, resulting in a biomaterial patch resembling the Band-Aid. The adhesive region contains a novel polymer, synthesized to incorporate a molecule capable of adhesion to tissue, dopamine. The desired polymer composition for patch development is selected based on chemical assessment and evaluation of key physical properties such as swelling and elastic modulus, which are tailored for use in soft tissue applications. The selected polymer formulation, referred to as the adhesive patch (AP) polymer, demonstrates negligible cytotoxicity and improves adhesive capability to rat cardiac tissue compared to currently used patch materials. Finally, the AP polymer is used in the patch, designed to possess distinct adhesive and nonadhesive domains, presenting a novel design for the next generation of biomaterials.
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Affiliation(s)
- A Dawn Bannerman
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Toronto General Research Institute, University Health Network, Toronto, Ontario, M5G 2C4, Canada
| | - Locke Davenport Huyer
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Toronto General Research Institute, University Health Network, Toronto, Ontario, M5G 2C4, Canada
| | - Miles Montgomery
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Toronto General Research Institute, University Health Network, Toronto, Ontario, M5G 2C4, Canada
| | - Nicholas Zhao
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
| | - Claire Velikonja
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
| | - Timothy P Bender
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
| | - Milica Radisic
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3G9, Canada
- Toronto General Research Institute, University Health Network, Toronto, Ontario, M5G 2C4, Canada
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Mussel-inspired antimicrobial gelatin/chitosan tissue adhesive rapidly activated in situ by H 2O 2/ascorbic acid for infected wound closure. Carbohydr Polym 2020; 247:116692. [PMID: 32829820 DOI: 10.1016/j.carbpol.2020.116692] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/16/2020] [Accepted: 06/24/2020] [Indexed: 02/05/2023]
Abstract
The development of minimally invasive surgery has created a demand for ideal medical adhesives exhibiting biocompatibility, biodegradability, antimicrobial activity, and strong adhesion to tissues in wet environments. However, as clinically approved surgical tissue glues suffer from poor adhesion activation, limited adhesion strength, and toxicity, novel tissue glues are highly sought after. Herein, a mussel-inspired injectable hydrogel was prepared from catechol- and methacrylate-modified chitosan/gelatin and shown to exhibit biocompatibility, inherent antimicrobial activity, and good adhesion to wet tissues. Moreover, as this gel could be applied onto tissue surfaces and cured in situ within seconds of body contact by a biocompatible and multifunctional redox initiator (H2O2-ascorbic acid), it was concluded to be a promising surgical sealant and wound dressing (even for infected wounds) accelerating wound healing.
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Love CJ, Serban BA, Katashima T, Numata K, Serban MA. Mechanistic insights into silk fibroin's adhesive properties via chemical functionalization of serine side chains. ACS Biomater Sci Eng 2019; 5:5960-5967. [PMID: 32529029 DOI: 10.1021/acsbiomaterials.9b01014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Bombyx mori-derived silk fibroin (SF) has recently gained interest for its intrinsic or engineered adhesive properties. In a previous study by our group, the mechanism of the protein's intrinsic adhesiveness to biological substrates such as leather has been hypothesized to rely on hydrogen bond formation between amino acid side chains of SF and the substrate. In this study, the serine side chains of SF were chemically functionalized with substituents with different hydrogen bonding abilities. The effect of these changes on adhesion to leather was investigated along with protein structural assessments. The results confirm our hypothesis that adhesive interactions are mediated by hydrogen bonds and indicate that the length and nature of the side chains are important for both adhesion and secondary structure formation.
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Affiliation(s)
- Cooper J Love
- Pre-Medical Sciences, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA
| | - Bogdan A Serban
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA
| | - Takuya Katashima
- Biomacromolecules Research Team, RIKEN Center for Sustainable Resource Science, 2-1 Hirosawa, Wako-shi, Saitama 351-0198, Japan
| | - Keiji Numata
- Biomacromolecules Research Team, RIKEN Center for Sustainable Resource Science, 2-1 Hirosawa, Wako-shi, Saitama 351-0198, Japan
| | - Monica A Serban
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA.,Department of Chemistry and Biochemistry, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA
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Mamede AA, Martinez EF, Basting RT. Mechanical and histological evaluation of a titanium device for orthodontic anchorage, placed with or without cyanoacrylate adhesive. Dental Press J Orthod 2019; 24:71-78. [PMID: 31390453 PMCID: PMC6677335 DOI: 10.1590/2177-6709.24.3.071-078.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/15/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of the present study was to perform a histological evaluation of a titanium mini-implant for orthodontic anchorage. Shear strength and fracture patterns that occurred immediately, 30 and 60 days after insertion with or without N-2-butyl-cyanoacrylate adhesive were evaluated. METHODS Ninety-six mini-implants (Arrow, Peclab, Brazil) were placed in the tibia of 9 male rabbits, with or without an adhesive (Vetbond™, 3M, USA). Histological evaluation was done by optical light microscope. Shear strength testing was performed, followed by fracture analysis with visual inspection. RESULTS Close contact between the newly formed bone and the device was evidenced in the group without adhesive, whereas gaps in the group with adhesive were found. Tukey test showed similar values in both groups at the immediate time point (20.70 N without adhesive and 24.69 N with adhesive), and higher values for the non-adhesive group, after 30 and 60 days (43.98 N and 78.55 N, respectively). The values for the adhesive group were similar for the immediate time point (24.69 N), 30 days (18.23 N) and 60 days (31.98 N). The fractures were adhesive for both groups at the immediate time point. The fractures were cohesive in bone for the non-adhesive group after 30 and 60 days. CONCLUSIONS The mini-implants showed close bone contact and required higher shear strength for removal at 30 and 60 days for the non-adhesive group. Further studies are needed to assess the proper way to remove the orthodontic anchorage without cohesive fractures in bone.
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Pascual G, Mesa-Ciller C, Rodríguez M, Pérez-Köhler B, Gómez-Gil V, Fernández-Gutiérrez M, San Román J, Bellón JM. Pre-clinical assay of the tissue integration and mechanical adhesion of several types of cyanoacrylate adhesives in the fixation of lightweight polypropylene meshes for abdominal hernia repair. PLoS One 2018; 13:e0206515. [PMID: 30388135 PMCID: PMC6214531 DOI: 10.1371/journal.pone.0206515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Lightweight (LW) polypropylene (PP) meshes better adapt to host tissue, causing less fibrosis and inflammatory responses than high-density meshes. Mesh fixation using tissue adhesives (TA) that replace conventional sutures may improve the process of hernia repair and tissue trauma. This preclinical study compares the behavior of different cyanoacrylate-based adhesives in the fixation of LW-PP meshes for hernia repair. METHODS Partial abdominal wall defects were repaired using LW-PP Optilene meshes in New Zealand rabbits. The following groups were established according to the mesh fixation method: Suture (control), Glubran 2 (n-butyl), Ifabond (n-hexyl), SafetySeal (n-butyl) and Evobond (n-octyl). At 14, 90 and 180 days after surgery, the recovered implants were examined to assess the host tissue integration, the macrophage response and the biomechanical strength. RESULTS All the groups showed optimal host tissue incorporation regardless of the fixation procedure. Significantly increased levels of collagen 1 and collagen 3 gene expression (p<0.001) were observed at 14 days compared to the medium- and long-term durations, where the Suture and Glubran groups showed the highest expression of collagen 1. All the adhesives increased the macrophage reaction (p<0.001) compared to sutures at all implant times. Maximal macrophage response was observed in the short-term Glubran group (p<0.01) compared to the rest of the groups. Although SafetySeal and Evobond did not reach the biomechanical resistance of sutures at 14 days, all the adhesives did reach this level in the medium- to long-term periods, providing significantly higher resistance (p<0.05). CONCLUSIONS All the cyanoacrylates, despite inducing a significantly increased macrophage response versus sutures, showed optimal host tissue integration and long-term mechanical behavior; thus, they might be good choices for LW-PP mesh hernia repairs.
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Affiliation(s)
- Gemma Pascual
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- * E-mail:
| | - Claudia Mesa-Ciller
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Marta Rodríguez
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Bárbara Pérez-Köhler
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Verónica Gómez-Gil
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Mar Fernández-Gutiérrez
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Polymer Biomaterials Group, Polymer Science and Technology Institute-Consejo Superior de Investigaciones Científicas (ICTP-CSIC), Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Julio San Román
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Polymer Biomaterials Group, Polymer Science and Technology Institute-Consejo Superior de Investigaciones Científicas (ICTP-CSIC), Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Juan M. Bellón
- Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
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Johnston ER, Miyagi Y, Chuah JA, Numata K, Serban MA. The interplay between silk fibroin's structure and its adhesive properties. ACS Biomater Sci Eng 2018; 4:2815-2824. [PMID: 30911674 DOI: 10.1021/acsbiomaterials.8b00544] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bombyx mori-derived silk fibroin (SF) is a well-characterized protein employed in numerous biomedical applications. Structurally, SF consists of a heavy chain (HC) and a light chain (LC), connected via a single disulfide bond. The HC sequence is organized into 12 crystalline domains interspersed with amorphous regions that can transition between random coil/alpha helix and beta-sheet configurations, giving silk its hallmark properties. SF has been reported to have adhesive properties and shows promise for development of medical adhesives; however, the mechanism of these interactions and the interplay between SF's structure and adhesion is not understood. In this context, the effects of physical parameters (i.e., concentration, temperature, pH, ionic strength) and protein structural changes on adhesion were investigated in this study. Our results suggest that amino acid side chains that have functionalities capable of coordinate (dative) bond or hydrogen bond formation (such as those of serine and tyrosine), might be important determinants in SF's adhesion to a given substrate. Additionally, the data suggest that fibroin amino acids involved in beta-sheet formation are also important in the protein's adhesion to substrates.
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Affiliation(s)
- Erik R Johnston
- Materials Science Program, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA
| | - Yu Miyagi
- Biomacromolecules Research Team, RIKEN Center for Sustainable Resource Science, 2-1 Hirosawa, Wako-shi, Saitama 351-0198, Japan
| | - Jo-Ann Chuah
- Biomacromolecules Research Team, RIKEN Center for Sustainable Resource Science, 2-1 Hirosawa, Wako-shi, Saitama 351-0198, Japan
| | - Keiji Numata
- Biomacromolecules Research Team, RIKEN Center for Sustainable Resource Science, 2-1 Hirosawa, Wako-shi, Saitama 351-0198, Japan
| | - Monica A Serban
- Materials Science Program, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA.,Department of Biomedical and Pharmaceutical Sciences, University of Montana, 32 Campus Dr., Missoula, MT 59812, USA
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Takagi T, Tsujimoto H, Torii H, Ozamoto Y, Hagiwara A. Two-layer sheet of gelatin: A new topical hemostatic agent. Asian J Surg 2018; 41:124-130. [DOI: 10.1016/j.asjsur.2016.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/30/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022] Open
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Annabi N, Zhang YN, Assmann A, Sani ES, Cheng G, Lassaletta AD, Vegh A, Dehghani B, Ruiz-Esparza GU, Wang X, Gangadharan S, Weiss AS, Khademhosseini A. Engineering a highly elastic human protein-based sealant for surgical applications. Sci Transl Med 2017; 9:eaai7466. [PMID: 28978753 PMCID: PMC11186511 DOI: 10.1126/scitranslmed.aai7466] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/11/2017] [Accepted: 08/17/2017] [Indexed: 04/28/2024]
Abstract
Surgical sealants have been used for sealing or reconnecting ruptured tissues but often have low adhesion, inappropriate mechanical strength, cytotoxicity concerns, and poor performance in biological environments. To address these challenges, we engineered a biocompatible and highly elastic hydrogel sealant with tunable adhesion properties by photocrosslinking the recombinant human protein tropoelastin. The subcutaneous implantation of the methacryloyl-substituted tropoelastin (MeTro) sealant in rodents demonstrated low toxicity and controlled degradation. All animals survived surgical procedures with adequate blood circulation by using MeTro in an incisional model of artery sealing in rats, and animals showed normal breathing and lung function in a model of surgically induced rat lung leakage. In vivo experiments in a porcine model demonstrated complete sealing of severely leaking lung tissue in the absence of sutures or staples, with no clinical or sonographic signs of pneumothorax during 14 days of follow-up. The engineered MeTro sealant has high potential for clinical applications because of superior adhesion and mechanical properties compared to commercially available sealants, as well as opportunity for further optimization of the degradation rate to fit desired surgical applications on different tissues.
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Affiliation(s)
- Nasim Annabi
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115-5000, USA.
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Yi-Nan Zhang
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alexander Assmann
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
- Department of Cardiovascular Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf 40225, Germany
| | - Ehsan Shirzaei Sani
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115-5000, USA
| | - George Cheng
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Antonio D Lassaletta
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Andrea Vegh
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Bijan Dehghani
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Guillermo U Ruiz-Esparza
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Xichi Wang
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Sidhu Gangadharan
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Anthony S Weiss
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales 2006, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales 2006, Australia
- Bosch Institute, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Ali Khademhosseini
- Biomaterials Innovation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02139, USA.
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
- Department of Physics, King Abdulaziz University, Jeddah 21569, Saudi Arabia
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Abstract
Controlling perioperative bleeding is of critical importance to minimize hemorrhaging and fatality. Patients on anticoagulant therapy such as heparin have diminished clotting potential and are at risk for hemorrhaging. Here we describe a self-assembling nanofibrous peptide hydrogel (termed SLac) that on its own can act as a physical barrier to blood loss. SLac was loaded with snake-venom derived Batroxobin (50 μg/mL) yielding a drug-loaded hydrogel (SB50). SB50 was potentiated to enhance clotting even in the presence of heparin. In vitro evaluation of fibrin and whole blood clotting helped identify appropriate concentrations for hemostasis in vivo. Batroxobin-loaded hydrogels rapidly (within 20s) stop bleeding in both normal and heparin-treated rats in a lateral liver incision model. Compared to standard of care, Gelfoam, and investigational hemostats such as Puramatrix, only SB50 showed rapid liver incision hemostasis post surgical application. This snake venom-loaded peptide hydrogel can be applied via syringe and conforms to the wound site resulting in hemostasis. This demonstrates a facile method for surgical hemostasis even in the presence of anticoagulant therapies.
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Affiliation(s)
- Vivek A Kumar
- Departments of Chemistry and Bioengineering, Rice University, 6100 Main Street, Houston, Texas 77030, United States
| | - Navindee C Wickremasinghe
- Departments of Chemistry and Bioengineering, Rice University, 6100 Main Street, Houston, Texas 77030, United States
| | - Siyu Shi
- Departments of Chemistry and Bioengineering, Rice University, 6100 Main Street, Houston, Texas 77030, United States
| | - Jeffrey D Hartgerink
- Departments of Chemistry and Bioengineering, Rice University, 6100 Main Street, Houston, Texas 77030, United States
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