Recent Advances in Tissue Adhesives for Clinical Medicine

Abstract

Tissue adhesives have attracted more attention to the applications of non-invasive wound closure. The purpose of this review article is to summarize the recent progress of developing tissue adhesives, which may inspire researchers to develop more outstanding tissue adhesives. It begins with a brief introduction to the emerging potential use of tissue adhesives in the clinic. Next, several critical mechanisms for adhesion are discussed, including van der Waals forces, capillary forces, hydrogen bonding, static electric forces, and chemical bonds. This article further details the measurement methods of adhesion and highlights the different types of adhesive, including natural or biological, synthetic and semisynthetic, and biomimetic adhesives. Finally, this review article concludes with remarks on the challenges and future directions for design, fabrication, and application of tissue adhesives in the clinic. This review article has promising potential to provide novel creative design principles for the generation of future tissue adhesives.

Keywords: applications; biomimetic adhesives; natural adhesives; synthetic adhesives; tissue adhesives.

Figure 1

The schematic illustration of preparing multifunctional GelMA-TA hydrogel with high stiffness, super-elasticity, deformability (A), and in vivo self-healing and adhesive property (B). Biomedical applications of GelMA-TA gel for skin wound closure (C), sutureless gastric surgery (D). ⁴⁹ Copyright 2018, Elsevier.

Figure 2

The types of peel tests, including 180 degrees peel (A), peel wheel (B), T-peel (C), Floating roller (115 degrees) (D), floating roller or (without rollers) moving table (E). The schematic of lap shear tests (F). Citing from http://www.mecmesin.com/peel-test-adhesion-testing.

Figure 3

(A) Chemical structure of cPEG adhesive precursor. Photographs of precursor solution in phosphate-buffered saline before (B) and after (C) addition of aqueous sodium periodate solution; gel formation occurred within 20–30 s. (D) Analysis of islet graft and cPEG adhesive explants. Top row: photographic images of the site of cPEG adhesive-mediated 150-islet transplantation at the epididymal fat pad and liver surface, immediately before graft explant on day 112. Immobilized islet bolus is visible on the external liver surface. Black arrows, cPEG adhesive. Middle row: representative light micrographs of hematoxylin and eosin (H&E)-stained graft explants. Adhesive, AD; islet, IS; epididymal fat tissue, EF; liver tissue, L. Scale bars: 100 mm. Bottom row: representative fluorescent micrographs of the immunohistochemical triple stain of graft explants. Insulin, green; OX-41 (macrophage marker), blue; CD31 (endothelial cell marker), red. White arrows, non-specific cPEG labeling. All images, scale bar: 100 mm. ¹⁰⁸ Copyright 2010, Elsevier.

Figure 4

(A) Schematic fabrication of DCTA: in one pot, the gelatin–dopamine gluing macromers are first rapidly crosslinked by Fe3+ (first crosslink), at the same time, which are gradually crosslinked with genipin (second crosslink). (B) Gross view of the DCTA implants (with murine skins) extracted on day 4, 14, and 28, respectively, after subcutaneous implantation in mice. (C) Degradation of DCTA over time after implantation. H&E staining of the tissues surrounding DCTA after 4 (D), 14 (E), and 28 (F) days’ implantation; the DCTA is marked with an asterisk. scale bar:100 μm. ¹²⁹ Copyright 2016, Elsevier.