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

Abstract

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

Recent advances in adhesive materials used in the biomedical field: adhesive properties, mechanism, and applications

“…By adding silk fibroin to a polyacrylic acid network, Yu et al developed an adhesive hydrogel with excellent bulk strength and interface adhesion. 40 Animal studies showed that the obtained silk fibroin-based hydrogel PSA-2 can stably adhere to rat skin and had a significant effect on the healing of full-thickness skin wounds (Fig. 10).…”

Advances in Hydrogel Adhesives for Gastrointestinal Wound Closure and Repair

“…Non-surgical management of perforation usually involves analgesia, intravenous antibiotics, and proton pump inhibitory medications (PPIs), but faces the risk of higher mortality rate if it fails [ 55 ]. Therefore, current treatment primarily relies on endoscopic closure and laparotomy for perforations less than 10 mm and open surgery for larger perforations [ 55 , 57 ]. Direct closure of the perforation with interrupted sutures and an omental pedicle plug is the most commonly used technique.…”

“…Additionally, the degradation and mechanical properties of the network are controlled by tuning the composition of the biopolymer component [ 40 ]. To integrate both strategies of wet adhesion, Liu et al describe a half-dry adhesive for rapid gastric perforation and traumatic pneumothorax sealing [ 57 ]. The hydrogel first repels the majority of interfacial liquid based on its moderate hydrophilicity, then absorbs trapped residues and vicinal tissue fluid to enhance topological adhesion, and finally bonds to the tissue surface through physical interactions [ 57 ].…”

“…To integrate both strategies of wet adhesion, Liu et al describe a half-dry adhesive for rapid gastric perforation and traumatic pneumothorax sealing [ 57 ]. The hydrogel first repels the majority of interfacial liquid based on its moderate hydrophilicity, then absorbs trapped residues and vicinal tissue fluid to enhance topological adhesion, and finally bonds to the tissue surface through physical interactions [ 57 ]. With the combined strategy, the PAA-silk fibroin (SF) based adhesive achieves excellent adhesion energy (600 J/m 2 ) and burst pressure (1500 mmHg) for more than 24 h.…”

“…Silk fibroin (SF) is a natural multi-domain protein that is also being incorporated into IPN hydrogel adhesives owing to its superior strength and stretchability [ 68 ]. Liu et al report a half-dry adhesive for wet adhesion consisting of a SF semi-interpenetrating network and a PAA covalent network [ 57 ]. After the addition of acrylic acid, the heavy chains of SF can rearrange from α -helical conformations to antipolar-antiparallel beta-sheets ( β -sheets), providing additional physical crosslinks and enhancing the bulk toughness of the hydrogel [ 57 ].…”