New Bandage Could Seal Hole in the Heart

A Band-Aid® adhesive bandage is an effective treatment for stopping external bleeding from skin wounds, but an equally viable option for internal bleeding does not yet exist. Surgical glues are often used inside the body instead of traditional wound closure techniques like stitches, staples, and clips because they reduce the patient’s time in the hospital and lower the risk of secondary injury/damage at the wound site. An effective surgical glue needs to be strong, flexible, non-toxic, and able to accommodate movement, yet there are no adhesives currently available that have all of those properties. Researchers at the Wyss Institute (Harvard University) have developed a new super-strong hydrogel adhesive inspired by the glue secreted by a common slug that is biocompatible, flexible, and can stick to dynamically moving tissues even in the presence of blood.

The hydrogel itself is a hybrid of two different types of polymers: a seaweed extract called alginate that is used to thicken food, and polyacrylamide, which is the main material in soft contact lenses. When these relatively weak polymers become entangled with each other, they create a molecular network that demonstrates unprecedented toughness and resilience for hydrogel materials – on par with the body’s natural cartilage. When combined with an adhesive layer containing positively-charged polymer molecules (chitosan), the resulting hybrid material is able to bind to tissues stronger than any other available adhesive, stretch up to 20 times its initial length, and attach to wet tissue surfaces undergoing dynamic movement (e.g., a beating heart).

Studies of the hydrogel adhesive demonstrated that it is capable of withstanding three times the amount of tension that disrupts the best current medical adhesives, maintaining its stability and adhesion when implanted into rats for two weeks, and sealing a hole in a pig heart that was subjected to tens of thousands of cycles of pumping. Additionally, it caused no tissue damage or adhesions to surrounding tissues when applied to a liver hemorrhage in mice.

The hydrogel adhesive has numerous potential applications in the medical field, either as a patch that can be cut to desired sizes and applied to many tissues including bone, cartilage, tendon, or pleura, or as an injectable solution for deeper injuries. It can also be used to attach medical devices to their target structures, such as an actuator to support heart function. While the current iteration is designed to be a permanent structure, it could be made to biodegrade over time as the body heals from injury.


Glue Seals Bleeding Organs in Seconds

Inspired by the sticky substance that barnacles use to cling to rocks, MIT engineers have designed a strong, biocompatible glue that can seal injured tissues and stop bleeding. The new paste can adhere to surfaces even when they are covered with blood, and can form a tight seal within about 15 seconds of application. Such a glue could offer a much more effective way to treat traumatic injuries and to help control bleeding during surgery, the researchers say.

We are solving an adhesion problem in a challenging environment, which is this wet, dynamic environment of human tissues. At the same time, we are trying to translate this fundamental knowledge into real products that can save lives,” says Xuanhe Zhao, a professor of mechanical engineering and civil and environmental engineering at MIT and one of the senior authors of the study. Finding ways to stop bleeding is a longstanding problem that has not been adequately solved, Zhao says. Sutures are commonly used to seal wounds, but putting stitches in place is a time-consuming process that usually isn’t possible for first responders to perform during an emergency situation. Among members of the military, blood loss is the leading cause of death following a traumatic injury, and among the general population, it is the second leading cause of death following a traumatic injury.

In recent years, some materials that can halt bleeding, also called hemostatic agents, have become commercially available. Many of these consist of patches that contain clotting factors, which help blood to clot on its own. However, these require several minutes to form a seal and don’t always work on wounds that are bleeding profusely. Zhao’s lab has been working to address this problem for several years

For their new tissue glue, the researchers once again drew inspiration from the natural world. This time, they focused their attention on the barnacle, a small crustacean that attaches itself to rocks, ship hulls, and even other animals such as whales. These surfaces are wet and often dirty — conditions that make adhesion difficult. “This caught our eye,” Yuk says. “It’s very interesting because to seal bleeding tissues, you have to fight with not only wetness but also the contamination from this outcoming blood. We found that this creature living in a marine environment is doing exactly the same thing that we have to do to deal with complicated bleeding issues.” The researchers’ analysis of barnacle glue revealed that it has a unique composition. The sticky protein molecules that help barnacles attach to surfaces are suspended in an oil that repels water and any contaminants found on the surface, allowing the adhesive proteins to attach firmly to the surface.

The MIT team decided to try to mimic this glue by adapting an adhesive they had previously developed. This sticky material consists of a polymer called poly(acrylic acid) embedded with an organic compound called an NHS ester, which provides adhesion, and chitosan, a sugar that strengthens the material. The researchers froze sheets of this material, ground it into microparticles, and then suspended those particles in medical grade silicone oil.

Christoph Nabzdyk, a cardiac anesthesiologist and critical care physician at the Mayo Clinic in Rochester, Minnesota, is also a senior author of the paper, which appears today in Nature Biomedical Engineering. MIT Research Scientist Hyunwoo Yuk and postdoc Jingjing Wu are the lead authors of the study.