Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.
Department of General Surgery, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou, China.
Adv Healthc Mater. 2023 Nov;12(28):e2301379. doi: 10.1002/adhm.202301379. Epub 2023 Aug 30.
Colon leakage is one of the most severe complications in abdominal trauma or surgery cases. It can lead to severe abdominal infection and abdominal adhesions, resulting in prolonged hospital stays and increased mortality. In this study, a photosensitive hydrogel is proposed, which can swiftly form a strong adhesion coating on the damaged colon after UV irradiation, to realize quick cure and suture-free repair of colon leakage. The newly developed biological gel consists of hyaluronic acid methacryloyl (HAMA) and hyaluronic acid o-nitroso benzaldehyde (HANB) in the optimal ratio of 3: 1, which exerts both the rapid photocuring properties of HAMA and the strong tissue adhesion properties of HANB. HAMA/HANB shows excellent adhesion stability on wet surfaces, presenting controllable mechanical properties, ductility, adhesion stability, and chemical stability; it also evades foreign body response, which relieves the degree of abdominal adhesion. The underlying mechanism for HAMA/HANB promoting wound healing in colon leakage involves the reconstruction of the colon barrier, as well as the regulation of the immune reaction and neovascularization. In all, HAMA/HANB is a promising alternative suture-free approach for repairing colon leakage; it has a reliable healing effect and is expected to be extended to clinical application for other organ injuries.
肠漏是腹部创伤或手术中最严重的并发症之一。它可导致严重的腹部感染和粘连,导致住院时间延长和死亡率增加。在这项研究中,提出了一种光敏水凝胶,它可以在紫外线照射后迅速在受损的结肠上形成强粘附涂层,实现结肠漏的快速愈合和无缝合修复。新开发的生物凝胶由透明质酸甲基丙烯酰酯(HAMA)和透明质酸邻硝基苯甲醛(HANB)以最佳比例 3:1 组成,同时具有 HAMA 的快速光固化特性和 HANB 的强组织粘附特性。HAMA/HANB 在湿表面上表现出优异的粘附稳定性,具有可控的机械性能、延展性、粘附稳定性和化学稳定性;它还避免了异物反应,减轻了腹部粘连的程度。HAMA/HANB 促进肠漏伤口愈合的潜在机制涉及结肠屏障的重建,以及免疫反应和新血管生成的调节。总之,HAMA/HANB 是一种有前途的无缝合修复方法,用于修复肠漏;它具有可靠的愈合效果,有望扩展到其他器官损伤的临床应用。