Solution blow spun polymer: A novel preclinical surgical sealant for bowel anastomoses

Abstract

Background Solution blow spinning is a technique for depositing polymer fibers with promising potential use as a surgical sealant. This study assessed the feasibility and efficacy of solution blow spun polymer (BSP) for sealing bowel perforations in a mouse model of partial cecal transection. We then evaluated its use for reinforcing a surgical anastomosis in a pre-clinical piglet model. Methods Three commercially available surgical sealants (fibrin glue, polyethylene glycol (PEG) hydrogel, and cyanoacrylate) were compared to BSP in the ability to seal partially transected cecum in mice. For anastomosis feasibility testing in a piglet model, piglets were subjected to small bowel transection with sutured anastomosis reinforced with BSP application. Outcome measures included anastomotic burst pressure, anastomotic leak rate, 14-day survival, and complication rate. Results For the mouse model, the survival rates for the sealants were 30% for fibrin glue, 20% for PEG hydrogel, 78% for cyanoacrylate, and 67% for BSP. Three of 9 mice died after BSP administration due to perforation leak, failure to thrive with partial obstruction at the perforation site, and unknown causes. All other mice died of perforation leak. The mean burst pressure at 24 hours was significantly higher for BSP (81mmHg) when compared to fibrin glue (6mmHg, p=0.047) or PEG hydrogel (10mmHg, p=0.047), and comparable to cyanoacrylate (64mmHg, p=0.91). For piglets, 4 of 4 animals survived at 14 days. Mean burst pressures at time of surgery were 37±5mmHg for BSP and 11±9mmHg for suture-only controls (p=0.09). Conclusions Solution blow spinning may be an effective technique as an adjunct for sealing of gastrointestinal anastomosis. Further preclinical testing is warranted to better understand BSP properties and alternative surgical applications.

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