Chemically Stable, Strongly Adhesive Sealant Patch for Intestinal Anastomotic Leakage Prevention

Intestinal anastomotic leaking, which involves the discharge of chemically aggressive, non-sterile fluids into the abdomen, remains one of the most dreaded postoperative complications of abdominal surgery. Depending on the site and the patient condition, incidence ranging between 4% and 21% and mortality rates up to 27% are reported. Currently available surgical sealants only poorly address the issue, especially since most commonly used fibrin glues fail due to insufficient adhesion and chemical instability. Here, a chemically highly resistive, leak-tight, and mucoadhesive hydrogel sealant, which is grafted on the surface of the intestinal wall using a mutually interpenetrating network that traverses hydrogel and tissue is presented. In contrast to clinically used fibrin-based sealants (including Tachosil), the developed adhesive poly(acrylamide-methyl acrylate-acrylic acid) patch does not degrade and exhibits strong tissue adhesion even when exposed to intestinal fluid. The biocompatible hydrogel patch effectively seals anastomotic leaks in ex vivo intestinal models, greatly surpassing commercial sealants (time to patch-failure >24 h compared to 5 min for commonly used Tachosil). Importantly, the developed adhesive patch paves the way for the application of both mechanically and chemically robust sealants suitable for the treatment and prevention of intestinal leaks.

Automated summary

Intestinal anastomotic leaking is a serious complication of abdominal surgery, with current surgical sealants often inadequate. A chemically resistive, leak-tight hydrogel patch shows promise in effectively sealing leaks and surpassing commercial sealants.