Advances in Hydrogel Adhesives for Gastrointestinal Wound Closure and Repair

Abstract

Millions of individuals undergo gastrointestinal (GI) tract surgeries each year with common postoperative complications including bleeding, perforation, anastomotic leakage, and infection. Today, techniques such as suturing and stapling seal internal wounds, and electrocoagulation stops bleeding. These methods induce secondary damage to the tissue and can be technically difficult to perform depending on the wound site location. To overcome these challenges and to further advance wound closure, hydrogel adhesives are being investigated to specifically target GI tract wounds because of their atraumatic nature, fluid-tight sealing capability, favorable wound healing properties, and facile application. However, challenges remain that limit their use, such as weak underwater adhesive strength, slow gelation, and/or acidic degradation. In this review, we summarize recent advances in hydrogel adhesives to treat various GI tract wounds, with a focus on novel material designs and compositions to combat the environment-specific challenges of GI injury. We conclude with a discussion of potential opportunities from both research and clinical perspectives.

Engineered Synthetic Matrices for Human Intestinal Organoid Culture and Therapeutic Delivery

“…Hydrogels have also been used in other intestinal applications as drug delivery vehicles, [165,166] wound repair adhesives, [167,168] and imaging agents. [169] Hydrogel adhesion to the intestinal tissue, understanding degradation profile and mechanisms, and non-toxic byproducts are material properties that can be translated to engineering an in vivo intestinal organoid hydrogel vehicle.…”

Endoscopic Vacuum-Assisted Closure (E-VAC) in Septic Shock from Perforated Duodenal Ulcers with Abscess Formations

“…Currently, several surgical techniques are available, with the choice of minimally invasive approaches increasing due to some distinct advantages [7][8][9][10]. In the case of a small perforation in a stable patient, conservative treatment can be an option [5][6][7]10].…”

“…For larger perforations or situations where the patient's condition is deteriorating, surgical intervention is the therapy of choice. The surgical approach could either be laparotomy, laparoscopic, or endoscopic [8][9][10]. Laparotomy and laparoscopy incorporate the same direct closure techniques, that of sutures, clips, omental patches, or, recently, the use of hydrogels [8][9][10][11].…”

“…The surgical approach could either be laparotomy, laparoscopic, or endoscopic [8][9][10]. Laparotomy and laparoscopy incorporate the same direct closure techniques, that of sutures, clips, omental patches, or, recently, the use of hydrogels [8][9][10][11].…”

Sprayable Hydrogel Sealant for Gastrointestinal Wound Shielding

“…[ 13,14 ] The most common adverse event is delayed bleeding and its occurrence is dictated by multiple factors such as the size and location of the excised polyp, resection technique, and other comorbidities. [ 15–17 ] Bleeding can occur after patient discharge, making complications harder to detect and treat in time, [ 15,18 ] leading to severe blood loss and potential need for blood transfusion. When intestinal wall perforation ensues, emergency surgery and prolonged hospitalization are required.…”