A robust asymmetric bioadhesive patch for sutureless intestinal repair to prevent anastomotic leakage and postoperative adhesion.

Abstract

Rationale: Anastomotic leakage (AL) remains a major surgical challenge that is difficult to address using hand-sewn closure alone. Robust, rapidly acting bioadhesive patches offer a promising alternative to conventional sutures and staples. However, the development of bioadhesive patches that achieve instantaneous wet-tissue adhesion while minimizing postoperative adhesion remains challenging. Innovative material designs and interdisciplinary translational strategies are therefore needed to advance bioadhesion technologies toward clinical application.

Methods: Herein, we developed a translational asymmetric bioadhesive patch (ABP) that integrates a blood-repelling, hydrophobic, HBP oil-infused anti-adhesive top surface with a bioadhesive bottom surface capable of absorbing interfacial water. The physicochemical properties, mechanical performance, wet-tissue adhesion, and hemostatic capacity of the ABP were systematically evaluated through in vitro and in vivo assays. Its therapeutic efficacy for sutureless intestinal repair was further assessed in a rat colon defect model.

Results: The ABP exhibited instantaneous and robust adhesion to various biological wet tissues (~10 times stronger than FDA-approved sealant Tisseel). The patch also showed excellent stretchability, sustaining more than 1000% strain without loss of elasticity. Moreover, ABP enables rapid hemostasis in injured tissues and achieved sutureless sealing and repair of intestinal defects in a rat colon injury model. Importantly, the asymmetric design reduced postoperative adhesions and attenuated foreign body reactions.

Conclusions: The proposed ABP patch provides an effective solution for intestinal defects repair by enabling immediate wet-tissue attachment, non-invasive defect closure, and durable tissue sealing without the need for device removal. By combining strong bioadhesion with an anti-adhesive outer surface, this patch offers a promising translational platform for preventing anastomotic leakage while reducing postoperative adhesions and foreign body responses.