Efficacy evaluation of an in situ forming tissue adhesive hydrogel as sealant for lung and vascular injury
Efficacy evaluation of an in situ forming tissue adhesive hydrogel as sealant for lung and vascular injury
复制标题
DOI：
10.1088/1748-605x/abfbbf
复制
发表时间：
2021-07-01
影响因子：
4
通讯作者：
Jayakrishnan, Athipettah
中科院分区：
文献类型：
--
作者：
Balakrishnan, Biji;Payanam, Umashanker;Jayakrishnan, Athipettah
基于生物聚合物的原位成型组织粘合剂在生物相容性、生物降解性、易于使用以及改善患者依从性和舒适度方面比传统缝合线和U形钉具有优势。在这里，我们描述了基于右旋糖酐二醛（DDA）的原位胶凝水凝胶系统的评估，该系统是通过右旋糖酐和盐酸壳聚糖（CH）的高碘酸氧化获得的，作为组织粘合剂。该水凝胶是通过席夫反应将 DDA 中的醛官能团与 CH 中的氨基官能团反应而制备的。凝胶化反应是瞬时的，只需要 4 秒。在绵羊肺实质损伤模型和猪主动脉模型上对 DDA-CH 水凝胶作为组织粘合剂进行了评估，并与市售的组织密封剂 Bioglue (R) 进行了比较。即使在气道压力为 30 cm H2O 的情况下，DDA-CH 胶也可以完全密封羊肺切口部位，并且在任何动物的切口部位 (n = 8) 均未观察到漏气。两周后组织学分析显示轻度炎症，与 Bioglue (R) 相当。 3个月后观察到测试材料被巨细胞吸收，对肺实质没有不利影响。 DDA-CH 胶在密封猪模型 (n = 4) 的主动脉切口方面也非常有效，没有失败和动脉瘤。在所有病例中，密封切口的腔内表面均显示完整的对位，并且切口充分愈合。肉眼未见组织坏死或内皮表面炎症。我们的研究表明，DDA-CH 水凝胶可以作为一种有效的密封剂，用于预防肺和血管手术后的空气和血液泄漏。
In situ forming tissue adhesives based on biopolymers offer advantages over conventional sutures and staples in terms of biocompatibility, biodegradability, ease of application and improved patient compliance and comfort. Here, we describe the evaluation of in situ gelling hydrogel system based on dextran dialdehyde (DDA) obtained by periodate oxidization of dextran and chitosan hydrochloride (CH) as tissue adhesive. The hydrogel was prepared by reacting aldehyde functions in DDA with the amino functions in CH via Schiff's reaction. The gelation reaction was instantaneous and took just 4 s. The DDA-CH hydrogel as tissue adhesive was evaluated on a sheep lung parenchymal injury model and a pig aortic model and was compared with the commercially available tissue sealant, Bioglue (R). The DDA-CH glue could completely seal the sheep lung incision site even at inflation with air way pressure of 30 cm of H2O with no air leak observed in the incision sites (n = 8) in any of the animals. Histological analyses showed mild inflammation after 2 weeks, comparable to Bioglue (R). Resorption of test material by giant cells with no adverse effect on lung parenchyma was seen after 3 months. The DDA-CH glue was also very effective in sealing aortic incisions in a pig model (n = 4) with no failures and aneurisms. The endoluminal surface of the sealed incision in all cases showed intact apposition with adequate healing across the incision. No tissue necrosis or inflammation of endothelial surface could be seen grossly. Our studies show that the DDA-CH hydrogel could function as an effective sealant for the prevention of air and blood leaks following lung and vascular surgery.