New range of light-activated surgical adhesives for tissue repair
Moser, D.L.; Riley, J.N.; Sorg, B.S.; Welch, A.J.; McNally-Heintzelman, K.M.
Biomedical Sciences Instrumentation 37: 441-449
2001
ISSN/ISBN: 0067-8856 PMID: 11347432 Document Number: 538505
A new range of light-activated surgical adhesives has been developed for laser-assisted tissue repair. The surgical adhesive is composed of a polymer scaffold doped with the traditional protein solder mix of serum albumin and a chromophoric dye. Problems associated with inflexibility in conforming to various tissue geometries, instability in a hydrated environment due to non-uniform tissue adhesive denaturation, and solubility in physiological fluids prior to denaturation are overcome using the adhesives. The new adhesives offer a viable alternative to conventional fasteners, including sutures, staples and clips, currently used for tissue repair. In addition, it could be possible to use patches prepared from the adhesive in the field as a simple and effective method to stop bleeding and repair tissue quickly in an emergency situation. First, studies were conducted to improve the flexibility of traditional protein solders to enable them to be tailored to a wide range of clinically relevant geometry's including tubes, crescents and tape. Second, the creation of a chromophore concentration gradient across the thickness of the adhesive was investigated as a means to allow control of the heat source gradient through the adhesive. Increased deposition of the laser energy near the vital solder/tissue interface was thus achieved. Finally, predenaturation of the adhesive was investigated as a means for enhancing its stability in a hydrated environment thus improving the handling characteristics of the adhesive for clinical application. The application of the new surgical adhesives to augment laser tissue repairs is shown to enhance edge co-optation, improve repair strength and to reduce thermal tissue injury. The moldable, absorption controllable and flexible nature of the new adhesives greatly improves the clinical applicability of laser-solder tissue repair.