A robust asymmetric bioadhesive patch for sutureless intestinal repair to prevent anastomotic leakage and
Ruiqi Gao1, Fangfang Su2, Xiaohua Li1
1Department of Gastrointestinal Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, Shaanxi, P. R. China.
Rationale:
Anastomotic leakage (AL) remains a major surgical challenge that is difficult to address using hand-sewn closure alone. Robust, rapidly acting bioadhesive patches offer a promising alternative to conventional sutures and staples. However, the development of bioadhesive patches that achieve instantaneous wet-tissue adhesion while minimizing postoperative adhesion remains challenging. Innovative material designs and interdisciplinary translational strategies are therefore needed to advance bioadhesion technologies toward clinical application.
Methods:
Herein, we developed a translational asymmetric bioadhesive patch (ABP) that integrates a blood-repelling, hydrophobic, HBP oil-infused anti-adhesive top surface with a bioadhesive bottom surface capable of absorbing interfacial water. The physicochemical properties, mechanical performance, wet-tissue adhesion, and hemostatic capacity of the ABP were systematically evaluated through in vitro and in vivo assays. Its therapeutic efficacy for sutureless intestinal repair was further assessed in a rat colon defect model.
Results:
The ABP exhibited instantaneous and robust adhesion to various biological wet tissues (~10 times stronger than FDA-approved sealant Tisseel). The patch also showed excellent stretchability, sustaining more than 1000% strain without loss of elasticity. Moreover, ABP enables rapid hemostasis in injured tissues and achieved sutureless sealing and repair of intestinal defects in a rat colon injury model. Importantly, the asymmetric design reduced postoperative adhesions and attenuated foreign body reactions.
Conclusions:
The proposed ABP patch provides an effective solution for intestinal defects repair by enabling immediate wet-tissue attachment, non-invasive defect closure, and durable tissue sealing without the need for device removal. By combining strong bioadhesion with an anti-adhesive outer surface, this patch offers a promising translational platform for preventing anastomotic leakage while reducing postoperative adhesions and foreign body responses.
