Robust closure of post-endoscopic submucosal dissection perforation by microparticle-based wound dressing
Shima Ito1, Akihiro Nishiguchi2, Fumisato Sasaki3
1Polymers and Biomaterials Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan; Graduate School of Science and Technology, Degree Programs in Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
Summary
This study introduces a new microparticle wound dressing made from hydrophobically-modified gelatin to seal perforations after endoscopic submucosal dissection (ESD). This innovative dressing effectively prevents complications from gastrointestinal cancer treatments.
Area of Science:
- Biomaterials Science
- Gastroenterology
- Surgical Innovation
Background:
- Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastrointestinal cancers.
- Perforations and delayed complications can occur after ESD, especially in thin tissues like the duodenum and large intestine.
Purpose of the Study:
- To develop and evaluate a novel microparticle-based wound dressing for sealing post-ESD perforations.
- To enhance the mechanical properties and efficacy of gelatin-based wound dressings.
Main Methods:
- Hydrophobically-modified gelatin microparticles were synthesized using a coacervation method.
- Hydrogel formation and mechanical strength (burst strength) were assessed in ex vivo perforation models.
- In vivo degradability was evaluated in rat subcutaneous implantation models.
Main Results:
- Optimized hydrophobic modification improved the mechanical strength of the gelatin hydrogel.
- The microparticle hydrogels demonstrated superior burst strength in ex vivo models of the duodenum, large intestine, and stomach under wet conditions.
- In vivo studies showed the microparticle hydrogels degraded within 14 days.
Conclusions:
- Hydrophobically-modified gelatin microparticles form a robust hydrogel effective in closing ESD-induced perforations.
- This microparticle wound dressing shows promise for preventing delayed perforations after gastrointestinal endoscopic submucosal dissection.
