Multifunctional, modular tissue-engineered patch with ECM and synthetic adhesive for sutureless gastrointestinal...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Gastroenterology

Background:

• Gastrointestinal wall defects pose significant clinical challenges, including leakage, infection, and adhesions.
• Current synthetic patches often exhibit poor biocompatibility, leading to inflammation and inadequate tissue integration.

Purpose of the Study:

• To develop and evaluate a multifunctional tissue-engineered gastrointestinal patch (TEGIP) for sutureless repair of gastrointestinal defects.
• To address limitations of existing synthetic patches by enhancing biocompatibility and reducing postoperative adhesions.

Main Methods:

• A tri-layer TEGIP was constructed using acellular dermal matrix (ADM), methacrylated hyaluronic acid (HAMA) hydrogel, and polyethyleneimine/polyacrylic acid (PEI/PAA) adhesive.
• In vitro mechanical testing, cell adhesion assays, and burst pressure measurements were performed.
• In vivo evaluation utilized a rat acute gastric perforation model to assess sealing efficacy, adhesion reduction, and tissue response.

Main Results:

• The TEGIP demonstrated robust mechanical durability (11.6 ± 2.0 MPa) and high burst pressure (155 ± 22 mmHg) for sealing 10-mm perforations.
• The HAMA layer effectively reduced cell adhesion, while the PEI/PAA adhesive showed bonding strength comparable to fibrin glue.
• In vivo studies showed effective defect sealing, significantly reduced postoperative adhesions, and potential for guided tissue repair with no observed hepato-renal toxicity.

Conclusions:

• The tri-layer TEGIP presents a promising sutureless solution for gastrointestinal defect repair.
• It offers robust sealing, enhanced biocompatibility, and mitigation of adhesion-related complications.
• The TEGIP facilitates tissue repair and demonstrates sustained biocompatibility, positioning it as an advancement in gastrointestinal surgery.