Surgical Adhesives Targeting Specific Tissue Properties for Improved Stickiness

Tissue adhesives for surgical procedures are becoming more and more popular, because they are commonly used as a replacement for suturing. Improving the quality of these adhesives can be achieved if the material is custom tuned to the tissue type that it will be sticking to. Now MIT researchers, in collaboration with investigators from Brigham and Women’s Hospital and Universitat Ramon Llull in Barcelona, have developed a line of glues, each targeting a different tissue type.
From the MIT announcement:

“The delineation of tissue-specific mechanisms for material adhesion leads the way for tailoring materials to individual needs and applications. This exciting work may well change the clinical use and continued evolution of soft-tissue sealants and adhesive materials,” said Elazer R. Edelman, principal investigator and MIT’s Thomas D. and Virginia W. Cabot Professor of Health Sciences and Technology.
Adhesive sealants could improve patient care and reduce healthcare costs by cutting medical complications after surgery, such as leakage through incisions, and improved wound healing, according to Natalie Artzi, a postdoctoral associate who led the research in Edelman’s lab.
Although there is already a billion-dollar market for such adhesives, “they haven’t reached their true potential,” Artzi said. Existing materials have limitations that often force doctors to compromise between adhesion strength and tissue reaction. For example, said Artzi, for a given tissue, the material may be adhesive but release toxins that could affect healing. Alternatively, the material could be quite tissue compatible, but degrade quickly, becoming non-adhesive. If the glue doesn’t work, a doctor must switch to sutures or staples.
The problem, according to the MIT team is that while surgical adhesives rely on intimate interactions between the adhesive and the tissue in question, the properties of the target tissue have been largely ignored in designing adhesives. Instead, “one general formulation is proposed for application to the full range of soft tissues across diverse clinical applications,” Artzi and colleagues wrote in their Advanced Materials paper.
The new work characterized a variety of interactions between one kind of glue (hyrogels composed of polyethylene glycol and dextran aldehyde, or PEG: dextran for short) and tissue from a rat’s heart, lung, liver and duodenum (the first section of the intestine). The team found, for example, that the glue worked well with tissue from the duodenum, but poorly with that from the lung.
They then went on to “identify the functional groups in the material that are responsible for adhesion with tissue functional groups, and created a model to optimize adhesion for each tissue,” Artzi said. In particular the paper explains how variation of chemical reactive groups in the material could be matched to the variability in the density of respective reactive groups on different tissues to regulate tissue-material interaction.

Press release: MIT team aims to tailor surgical glues for specific applications
Image: interface between a surgical glue (green) and tissue samples (red, blue and black) from the heart, lung, liver, and duodenum. The glue works best with duodenum tissue (note smooth interface), and worst with lung tissue (pockmarked with holes).
Abstract in Advanced Materials: Aldehyde-Amine Chemistry Enables Modulated Biosealants with Tissue-Specific Adhesion