Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
Adv Mater. 2021 Mar;33(11):e2007667. doi: 10.1002/adma.202007667. Epub 2021 Feb 1.
For decades, bioadhesive materials have garnered great attention due to their potential to replace sutures and staples for sealing tissues during minimally invasive surgical procedures. However, the complexities of delivering bioadhesives through narrow spaces and achieving strong adhesion in fluid-rich physiological environments continue to present substantial limitations to the surgical translation of existing sealants. In this work, a new strategy for minimally invasive tissue sealing based on a multilayer bioadhesive patch, which is designed to repel body fluids, to form fast, pressure-triggered adhesion with wet tissues, and to resist biofouling and inflammation is introduced. The multifunctional patch is realized by a synergistic combination of three distinct functional layers: i) a microtextured bioadhesive layer, ii) a dynamic, blood-repellent hydrophobic fluid layer, and iii) an antifouling zwitterionic nonadhesive layer. The patch is capable of forming robust adhesion to tissue surfaces in the presence of blood, and exhibits superior resistance to bacterial adhesion, fibrinogen adsorption, and in vivo fibrous capsule formation. By adopting origami-based fabrication strategies, it is demonstrated that the patch can be readily integrated with a variety of minimally invasive end effectors to provide facile tissue sealing in ex vivo porcine models, offering new opportunities for minimally invasive tissue sealing in diverse clinical scenarios.
几十年来，由于生物黏附材料具有替代缝线和钉书钉用于微创外科手术密封组织的潜力，因此受到了极大的关注。然而，通过狭窄空间输送生物黏附剂并在富含液体的生理环境中实现牢固黏附，这一复杂性仍然对现有密封剂的外科转化带来了实质性的限制。在这项工作中，引入了一种基于多层生物黏附贴片的微创组织密封新策略，该贴片旨在排斥体液，与湿组织形成快速、压力触发的黏附，并抵抗生物污垢和炎症。该多功能贴片通过三种不同功能层的协同组合来实现：i）微纹理生物黏附层，ii）动态、抗血液疏水流体层，和 iii）抗污的两性离子非黏附层。该贴片能够在有血液存在的情况下与组织表面形成牢固的黏附，并表现出对细菌黏附、纤维蛋白原吸附和体内纤维囊形成的优异抗性。通过采用折纸制造策略，证明了该贴片可以很容易地与各种微创末端执行器集成，以在离体猪模型中提供简便的组织密封，为各种临床情况下的微创组织密封提供了新的机会。
