Novel Acid-Tolerant Bioadhesive for Gastric Perforation
A NOVEL injectable acid-tolerant bioadhesive, composed of FDA-approved components, for sutureless repair of large gastric perforation has been unveiled by scientists.
The groundbreaking OSSA hydrogel, formed using Octa-PEG-NH2 and Octa-PEG-SSA, holds significant promise for the clinical treatment of digestive diseases, researchers reported.
Gastric Perforation at 4 mm
Adhesion to wet surfaces is paramount for effective wound healing in cases of gastric perforation because of harsh gastric juice, researchers reported.
The OSSA hydrogel was injected to seal a 4 mm hole on a porcine colon.
The pressure required to burst the adhesive far exceeded commercially available treatments: Coseal, Fibrin glue, and Histoacryl.
Further, the OSSA hydrogel did not break with significant motion, only violent puncture and peeling.
Gastric Perforation at 10 mm
Researchers then deposited the OSSA hydrogel in situ on the damaged tissues of a larger, approximately 10 mm, incision on a porcine stomach, which was subsequently filled with more than 5 kg of water.
There was no fluid leakage and the OSSA hydrogel was physically robust, not just adhesive.
Gastric Perforation at 20 mm
Next, researchers created an incision of around 20 mm in an isolated porcine stomach.
Again, they injected the adhesive in situ, pre-stained with blue dye.
They observed ultrafast gelation, instant adhesion, fluid-tight capacity, and no significant glue leakage.
The adhesive remained firm for more than 72 hours, even when the porcine stomach was submerged in putrid water, researchers reported.
In fact, in human gastric juices, the adhesion onto damaged tissues lasted even longer, remaining robust for more than 2 weeks.
Performance Against Surgical Suture
Researchers compared OSSA, Coseal, and Histoacryl sealants, alongside surgical suture.
Firstly, the sealants were easily delivered and robustly adhered within a short amount of time, whereas surgical suture took more than 15 minutes.
There were no observable leakages of gastric contents after all treatments.
However, the OSSA bioadhesive achieved a superior repair efficacy compared with the clinical suture.
On top of this, it exhibited significantly lower levels of abdominal adhesions at repair sites and in surrounding tissues.
A New Treatment for Gastric Perforation?
OSSA hydrogel marks a significant potential treatment option in gastrointestinal repair and postoperative adhesion prevention, researchers stressed.
It enabled strong adhesion in fluidically, chemically, and mechanically dynamic gastric environments.
Despite being in early developmental stages, the bioadhesive provides a promising clinical therapeutic opportunity for both large gastric perforation and other digestive injuries via minimally invasive techniques, scientists concluded.