Adhesive biomaterials for tissue reconstruction

Abstract

Tissue reconstruction and wound closure rely on sutures, staples and clips in current surgical procedures. These traditional devices are nonetheless unable to prevent leakage of fluids from a variety of tissue including blood vessels and dura mater. Furthermore, sutures are usually difficult to apply during minimal invasive surgery and often induce detrimental scarring that may impair healing. To overcome these disadvantages, biocompatible and biodegradable glues based on fibrin, polyethylene glycol (PEG) and cyanoacrylate have recently been used in patients to seal and repair tissue wounds. Cyanoacrylate glues create typically very strong tissue bonds but have mostly been applied externally for skin wound closure because of their residual cytotoxicity. Other adhesive biomaterials are also emerging; these glues and adhesives are usually based on proteins such as albumin and collagen or polysaccharides like chitosan; these are irradiated with coherent or non-coherent light to trigger their adhesion to tissue. These biomaterial based devices offer significant advantages over sutures, such as their sealing or repairing ability, easy application modality and delivery in situ of compounds for accelerating wound healing. This paper reviews different tissue reconstruction strategies employing adhesive biomaterials currently used in surgical and experimental procedures.

Nerve repair: toward a sutureless approach

“…Furthermore, PEG has the potential to act as a blank slate, to which cell-specific bioactive ligands can be covalently incorporated to enhance regeneration, while the tubular shaped glue once around the nerve ends can be photopolymerised with visible light, making it a simple and fast procedure [17]. When PEG glue was compared to fibrin glue, it was noted to have reduced scar tissuing around application and comparable tensile strength [38]. Minimal long term studies completed, application needs refinement.…”

“…Laser-activated solders for nerve repair are conventionally supported by protein derivatives, most commonly: albumin, fibrinogen and collagen [41]. Albumin solders are the most researched and successfully applied, relying on laser energy heating water molecules and subsequently denaturing its proteinaceous structure [34], intertwining and linking sterically with the collagen fibres in the epineurium [38]. Albumin solders have shown more reliable results than LTW alone, with improved weld strengths, while decreasing thermal damage locally [35].…”

A bio-inspired swellable microneedle adhesive for mechanical interlocking with tissue

“…However, these adhesives often cure too fast or too slowly and release toxic degradation products such as formaldehyde, leading to an intense inflammatory response 3 . While clinically utilized fibrin glue can effectively bond to wet tissue without a significant inflammatory response, it exhibits low strength of adhesion due to poor cohesive properties 4 , and can be challenging to apply as the polymerization time is difficult to control during placement. Alternatively, biocompatible hydrogel adhesives 5, 6 that covalently bond to specific tissues can achieve a significant level of adhesion yet their effectiveness depends on the presence of surface biomolecules with specific functional groups (ex, NH 2 , SH, or COOH).…”

Sealants (Adhesives) to Prevent Bleeding

“…4.10 . These monomers rapidly polymerize when in contact with water or hydroxyl groups on the actual surface being glued [ 55 ] . These create strong and fl exible fi lms as sealants to bond apposed wound edges.…”