A Tough Bioadhesive Hydrogel Supports Sutureless Sealing of the Dural Membrane in Porcine and Ex Vivo Human Tissue

Authors

• Kyle C Wu
• Benjamin R Freedman
• Phoebe S Kwon
• Matthew Torre
• Daniel O Kent
• Wenya Linda Bi
• David J Mooney

Language

English

Publication Date

3-20-2024

Journal

Science Translational Medicine

DOI

10.1126/scitranslmed.adj0616

PMID

38507468

PMCID

PMC11145396

PubMedCentral® Posted Date

6-3-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Complete sequestration of central nervous system tissue and cerebrospinal fluid by the dural membrane is fundamental to maintaining homeostasis and proper organ function, making reconstruction of this layer an essential step during neurosurgery. Primary closure of the dura by suture repair is the current standard, despite facing technical, microenvironmental, and anatomic challenges. Here, we apply a mechanically tough hydrogel paired with a bioadhesive for intraoperative sealing of the dural membrane in rodent, porcine, and human central nervous system tissue. Tensile testing demonstrated that this dural tough adhesive (DTA) exhibited greater toughness with higher maximum stress and stretch compared with commercial sealants in aqueous environments. To evaluate the performance of DTA in the range of intracranial pressure typical of healthy and disease states, ex vivo burst pressure testing was conducted until failure after DTA or commercial sealant application on ex vivo porcine dura with a punch biopsy injury. In contrast to commercial sealants, DTA remained adhered to the porcine dura through increasing pressure up to 300 millimeters of mercury and achieved a greater maximum burst pressure. Feasibility of DTA to repair cerebrospinal fluid leak in a simulated surgical context was evaluated in postmortem human dural tissue. DTA supported effective sutureless repair of the porcine thecal sac in vivo. Biocompatibility and adhesion of DTA was maintained for up to 4 weeks in rodents after implantation. The findings suggest the potential of DTA to augment or perhaps even supplant suture repair and warrant further exploration.

Keywords

Humans, Animals, Swine, Hydrogels, Cerebrospinal Fluid Leak, Neurosurgical Procedures, Dura Mater, Central Nervous System, Tissue Adhesives

Published Open-Access

yes

Recommended Citation

Wu, Kyle C; Freedman, Benjamin R; Kwon, Phoebe S; et al., "A Tough Bioadhesive Hydrogel Supports Sutureless Sealing of the Dural Membrane in Porcine and Ex Vivo Human Tissue" (2024). Duncan NRI Faculty and Staff Publications. 259.
https://digitalcommons.library.tmc.edu/duncar_nri_pub/259