Researchers develop sutureless conductive patch with enhanced biostability and effect on heart conduction velocity.

Poly(ethylene dioxythiophene) with functional pendant groups bearing double bonds is synthesized and employed for the fabrication of electroactive hydrogels with advantageous characteristics: covalently cross-linked porous 3D scaffolds with notable swelling ratio, appropriate mechanical properties, electroactivity in physiological conditions, and suitability for proliferation and differentiation of C2C12 cells. This is a new approach for the fabrication of conductive engineered constructs.

Tissue reconstruction and wound closure rely on sutures, staples and clips in current surgical procedures. These traditional devices are nonetheless unable to prevent leakage of fluids from a variety of tissue including blood vessels and dura mater. Furthermore, sutures are usually difficult to apply during minimal invasive surgery and often induce detrimental scarring that may impair healing. To overcome these disadvantages, biocompatible and biodegradable glues based on fibrin, polyethylene glycol (PEG) and cyanoacrylate have recently been used in patients to seal and repair tissue wounds. Cyanoacrylate glues create typically very strong tissue bonds but have mostly been applied externally for skin wound closure because of their residual cytotoxicity. Other adhesive biomaterials are also emerging; these glues and adhesives are usually based on proteins such as albumin and collagen or polysaccharides like chitosan; these are irradiated with coherent or non-coherent light to trigger their adhesion to tissue. These biomaterial based devices offer significant advantages over sutures, such as their sealing or repairing ability, easy application modality and delivery in situ of compounds for accelerating wound healing. This paper reviews different tissue reconstruction strategies employing adhesive biomaterials currently used in surgical and experimental procedures.

Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

BackgroundPhotochemical tissue bonding (PTB) is a promising sutureless technique for tissue repair. PTB is often achieved by applying a solution of rose bengal (RB) between two tissue edges, which are irradiated by a green laser to crosslink collagen fibers with minimal heat production. In this study, RB has been incorporated in chitosan films to create a novel tissue adhesive that is laser-activated.MethodsAdhesive films, based on chitosan and containing ~0.1 wt% RB were manufactured and bonded to calf intestine by a solid state laser (λ = 532 nm, Fluence~110 J/cm2, spot size~0.5 cm). A single-column tensiometer, interfaced with a personal computer, tested the bonding strength. K-type thermocouples recorded the temperature (T) at the adhesive-tissue interface during laser irradiation. Human fibroblasts were also seeded on the adhesive and cultured for 48 hours to assess cell growth.ResultsThe RB-chitosan adhesive bonded firmly to the intestine with adhesion strength of 15 ± 2 kPa, (n = 31). The adhesion strength dropped to 0.5 ± 0.1 (n = 8) kPa when the laser was not applied to the adhesive. The average temperature of the adhesive increased from 26°C to 32°C during laser exposure. Fibroblasts grew confluent on the adhesive without morphological changes.ConclusionA new biocompatible chitosan adhesive has been developed that bonds photochemically to tissue with minimal temperature increase.