Wet Adhesive Hydrogels to Correct Malacic Trachea (Tracheomalacia): A Proof of Concept

Abstract

Tracheomalacia (TM) is a condition in which the anterior part of the trachea consisting of cartilage and/or the posterior part consisting muscle are too soft to ensure its mechanical support. This situation may result in an excessive and potentially lethal collapse of the airway in the newborns. Current treatment techniques include tracheal reconstruction, tracheoplasty, endo- and extra-luminal stents, but are all facing important limitations. To reduce the shortcomings of actual TM treatments, this work proposes a new strategy by wrapping an adhesive hydrogel patch extraluminally around a malacic trachea. To validate this approach, first a numerical model revealed that a hydrogel patch with sufficient mechanical and adhesion strength can potentially preserve the trachea's physiological shape. Accordingly, a new hydrogel formulation was synthesized employing the hydroxyethyl acrylamide (HEAam) and polyethylene glycol methacrylate (PEGDMA) as main polymer network and crosslinker, respectively. These hydrogels provide excellent adhesion on wet tracheal surfaces, thanks to a two-step photo-polymerization approach. Ex vivo experiments revealed that the developed adhesive hydrogel patches can restrain the collapsing of malacic trachea under applied negative pressure. This study, to be confirmed by in vivo studies, is open to the possibility of a new treatment in the difficult clinical situation of tracheomalacia in newborns.