Zhu Tengjiao, Wang Hufei, Jing Zehao, Fan Daoyang, Liu Zhongjun, Wang Xing, Tian Yun
Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.
Beijing Key Laboratory of Spinal Disease Research, Beijing, 100191, China.
Bioact Mater. 2021 Jun 27;8:12-19. doi: 10.1016/j.bioactmat.2021.06.022. eCollection 2022 Feb.
Advances in meticulous dural closure technique remain a great challenge for watertight dural closure in the aged society, because the cerebrospinal fluid (CSF) leakage after spinal surgery is often accompanied with the disgusting wound infection, meningitis and pseudomeningocele. Here, a tetra-poly (ethylene glycol) (PEG)-based hydrogel sealant is developed with collective advantages of facile operation, high safety, quick set time, easy injectability, favorable mechanical strength and powerful tissue adhesion for effective sutureless dural closure during the surgery procedure. Impressively, this tetra-PEG sealant can instantaneously adhere to the irregular tissue surfaces even in a liquid environment, and effectively prevent or block off the intraoperative CSF leakage for sutureless dural closure and dura regeneration. Together, this sutureless tetra-PEG adhesive can be utilized as a very promising alternative for high-efficient watertight dural closure of the clinical patients who incidentally or deliberately undergo the durotomy during the spinal surgery.
在老龄化社会中,精细硬脑膜闭合技术的进展仍然是实现防水性硬脑膜闭合的巨大挑战,因为脊柱手术后脑脊液(CSF)漏常常伴随着令人厌恶的伤口感染、脑膜炎和假性脑脊膜膨出。在此,开发了一种基于四聚(乙二醇)(PEG)的水凝胶密封剂,其具有操作简便、安全性高、凝固时间短、易于注射、机械强度良好和组织粘附力强等综合优势,可在手术过程中实现有效的无缝合硬脑膜闭合。令人印象深刻的是,这种四聚PEG密封剂即使在液体环境中也能瞬间粘附于不规则组织表面,并有效防止或阻断术中脑脊液漏,以实现无缝合硬脑膜闭合和硬脑膜再生。总之,这种无缝合四聚PEG粘合剂可作为一种非常有前景的替代方法,用于在脊柱手术中偶然或有意进行硬脑膜切开术的临床患者的高效防水性硬脑膜闭合。