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Advanced Biomaterials and Devices in Medicine
December 2015, Volume 2, Issue 2, pp 70–78
In vivo efficacy of novel bioadhesives for closure of surgical incisions: Evaluation in a porcine model
M. Foox1, A. Keren2,3, O. Pinkas4, E. Cohen3, N. Goldstein2,3, A. Gilhar2,
M. Zilberman1,4*, Y. Ullmann2,3
1 Dept. of Biomedical Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel
2 Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 32000, Israel
3 Dept. of Plastic Surgery and the Burn Unit, Rambam Health Care Campus, Haifa, Israel
4 Dept. of Materials Science and Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel
* Corresponding author: Prof. Meital Zilberman, e-mail: meitalz@eng.tau.ac.il
Abstract
Surgical and traumatic wounds, including skin lacerations, comprise a major public health concern worldwide, with significant costs. In the last decades, the development of tissue bioadhesives as an alternative to sutures or staples for closing skin lacerations has intensified due to many advantages, including less pain and rapid application. Novel bioadhesives comprised of gelatin and alginate crosslinked with carbodiimide and N-hydroxysuccinimide were previously developed and studied by our research group. Based on our thorough in vitro study, four formulations of these novel bioadhesives were selected for the in vivo study in a porcine skin laceration model. Clinical, histological and immunohistochemical measurements were performed in order to evaluate the healing phase of wounds closed using our bioadhesives compared to stitches or Histoacryl® Blue. The results showed that incisions treated with formulations with a relatively low crosslinking agent content yielded better results in the healing phase compared to incisions treated with the basic formulation, i.e. no redness or scabs at the incisions area, similarly to the sutured incisions. The Histoacryl® Blue group was found in the least advanced phase and the treated incisions still had scabs. Histological and immunohistochemical analysis showed similar results of our bioadhesive formulations and stitches. In conclusion, our novel bioadhesives demonstrate a promising potential for use in wound closure applications. They were found to be superior to Histoacryl® Blue in most of the tests and presented an outcome similar to that obtained using stitches.
Keywords: gelatin, alginate, carbodiimide, climdamycin, bioadhesive, kaolin
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