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. 2023 Jul 1;95(1):55-61.
doi: 10.1097/TA.0000000000003910. Epub 2023 Mar 6.

Pectin based biologic Velcro effectively seals traumatic solid organ and small bowel injuries

James Williams  1 , Beau Prey, Andrew Francis, Michael Weykamp, Betty Liu, Michael Parsons, Michael Vu, Jace Franko, Erik Roedel, Michael Lallemand, Jason Bingham, Steven Mentzer, John Kuckelman
Affiliations

Pectin based biologic Velcro effectively seals traumatic solid organ and small bowel injuries

James Williams et al. J Trauma Acute Care Surg. .

Abstract

Introduction: Injuries to the liver and small bowel are common in multiple injuries. While there are currently a variety of accepted damage-control techniques to expeditiously manage such injuries, morbidity and mortality remain high. Pectin polymers have previously been shown to effectively seal visceral organ injuries ex vivo through physiochemical entanglement with the glycocalyx. We sought to compare the standard of care for the management of penetrating liver and small bowel injuries with a pectin-based bioadhesive patch in a live animal model.

Methods: Fifteen adult male swine underwent a laparotomy with standardized laceration to the liver. Animals were randomized to one of three treatment arms: packing with laparotomy pads (n = 5), suture repair (n = 5), or pectin patch repair (n = 5). Following 2 hours of observation, fluid was evacuated from the abdominal cavity and weighed. Next, a full-thickness small bowel injury was created, and animals were randomized to either a sutured repair (n = 7) or pectin patch repair (n = 8). The segment of bowel was then pressurized with saline, and the burst pressure was recorded.

Results: All animals survived the protocol to completion. There were no clinically significant differences between groups regarding baseline vitals or laboratory studies. On one-way analysis of variance, there was a statistically significant difference between groups regarding blood loss after liver repair (26 mL suture vs. 33 mL pectin vs. 142 mL packing, p < 0.01). On post hoc analysis, there was no statistically significant difference between suture and pectin ( p = 0.9). After repair, small bowel burst pressures were similar between pectin and suture repair (234 vs. 224 mm Hg, p = 0.7).

Conclusion: Pectin-based bioadhesive patches performed similarly to the standard of care for the management of liver lacerations and full-thickness bowel injuries. Further testing is warranted to assess the biodurability of a pectin patch repair, as it may offer a simple option to effectively temporize traumatic intra-abdominal injuries.

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Conflict of interest statement

Disclosure

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Liver injury and pectin patch repair. A) Standardized liver laceration with bleeding noted from wound. B) Pectin patch repair, applied to the liver laceration is shown.
Figure 2.
Figure 2.
Small bowel injury and pectin patch repair. A) Standardized full thickness injury to the antimesenteric border of the bowel. B) Pectin patch repair, applied to the injury prior to pressure testing is shown.
Figure 3.
Figure 3.
Post-observation blood following liver laceration repair.
Figure 4.
Figure 4.
Post repair burst pressure.
See this image and copyright information in PMC

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