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水凝胶基黏附贴片的研制及其在开放性眼球损伤中的封闭作用。

Development and characterization of a hydrogel-based adhesive patch for sealing open-globe injuries.

机构信息

Department of Ophthalmology, Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, United States.

Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA 90095, United States.

出版信息

Acta Biomater. 2022 Jan 1;137:53-63. doi: 10.1016/j.actbio.2021.10.021. Epub 2021 Oct 19.

Abstract

Full-thickness wounds to the eye can lead to serious vision impairment. Current standards of care (from suturing to tissue transplantation) usually require highly skilled surgeons and use of an operating theater. In this study, we report the synthesis, optimization, and in vitro and ex vivo testing of photocrosslinkable hydrogel-based adhesive patches that can easily be applied to globe injuries or corneal incisions. According to the type and concentration of polymers used in the adhesive formulations, we were able to finely tune the physical properties of the bioadhesive including viscosity, elastic modulus, extensibility, ultimate tensile strength, adhesion, transparency, water content, degradation time, and swellability. Our in vitro studies showed no sign of cytotoxicity of the hydrogels. Moreover, the hydrogel patches showed higher adhesion on freshly explanted pig eyeballs compared to a marketed ocular sealant. Finally, ex vivo feasibility studies showed that the hydrogel patches could seal complex open-globe injuries such as large incision, cruciform injury, and injury associated with tissue loss. These results suggest that our photocrosslinkable hydrogel patch could represent a promising solution for the sealing of open-globe injuries or surgical incisions. STATEMENT OF SIGNIFICANCE: Current management of severe ocular injuries require advanced surgical skills and access to an operating theater. To address the need for emergent management of wounds that cannot be handled in the operating room, surgical adhesives have gained popularity, but none of the currently available adhesives have optimal bioavailability, adhesive or mechanical properties. This study describes the development, optimization and testing of a light-sensitive adhesive patch that can easily be applied to the eye. After solidification using visible light, the patch shows no toxicity and is more adherent to the tissue than a marketed sealant. Thus this technology could represent a promising solution to stabilize ocular injuries in emergency settings before definitive surgical repair.

摘要

全层眼球伤口可导致严重视力损害。目前的治疗标准(从缝合到组织移植)通常需要高技能的外科医生和手术室。在这项研究中,我们报告了光交联水凝胶基胶粘剂贴片的合成、优化以及体外和离体测试,该贴片可轻松应用于眼球损伤或角膜切口。根据胶粘剂配方中使用的聚合物的类型和浓度,我们能够精细调整生物胶粘剂的物理性能,包括粘度、弹性模量、延展性、极限拉伸强度、附着力、透明度、含水量、降解时间和溶胀性。我们的体外研究表明水凝胶没有细胞毒性的迹象。此外,与市售的眼用密封剂相比,水凝胶贴片在新鲜取出的猪眼球上表现出更高的附着力。最后,离体可行性研究表明,水凝胶贴片可密封复杂的开放性眼球损伤,如大切口、十字形损伤和伴有组织损失的损伤。这些结果表明,我们的光交联水凝胶贴片可能是密封开放性眼球损伤或手术切口的一种有前途的解决方案。

意义声明

目前严重眼外伤的治疗需要先进的手术技能和手术室的通道。为了解决无法在手术室处理的伤口的紧急处理需求,外科用胶粘剂已经受到欢迎,但目前可用的胶粘剂都没有最佳的生物利用度、胶粘剂或机械性能。本研究描述了一种光敏感胶粘剂贴片的开发、优化和测试,该贴片可以轻松应用于眼睛。使用可见光固化后,贴片没有毒性,比市售的密封剂更能附着在组织上。因此,这项技术可能是在进行确定性手术修复之前稳定急诊眼部损伤的一种很有前途的解决方案。

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