The number of surgical procedures is increasing worldwide over the years, being the most common ones the cataract surgery, caesarean, and transluminal coronary angioplasty. Every surgery has a risk for the patient, that can be related to the anesthesia, bleeding, blood clots, infections, and other factors. An important step of a surgery is the closing part, because it will allow the closure of the surgical incision. The current surgical closure techniques lead to secondary tissue damage, infections, scars, and other consequences due to the use of sutures, staples, or surgical glue.
For this reason, there is a need of new technologies that can overcome this side effects since the closure of a surgical incision or wound is crucial for the success of the surgical intervention. An option that has been studied in the past years, is the use of pressure-sensitive adhesives (PSA). These adhesives are non-reactive and when pressure is applied, they form a bond. The main positive points comparing to the current surgical closure are the reduction of induced trauma in the surrounding tissues, their biodegradation, unnecessary post-surgical removal and speed and ease of application.
However, there are some challenges when producing PSA: the need of polymerization in a moist environment and the formation of biocompatible products as a result of their degradation. To overcome these challenges, is necessary to develop adhesives based on biodegradable and biocompatible polymers.
The synthetic aliphatic polyesters are a potential polymer, being the polylactic acid (PLA) the most used. Usually, PLA is combined with other polymers that have higher degradation rates, such as unsaturated polyesters (UP).
Furthermore, the UP can enhance the hydrophilicity, biocompatibility and bio adhesion of the materials synthesized. However, despite PLA being widely used, its application as a tissue adhesive needs to be studied in more detail, to overcome potential issues. Can you imagine a life without staples? With PSA that can really be a possibility in the future!
Source: Bhagat, V. & Becker, M. L. Degradable Adhesives for Surgery and Tissue Engineering. (2017) doi:10.1021/acs.biomac.7b00969.
Cernadas, T. M. et al. Preparation of biodegradable functionalized polyesters aimed to be used as surgical adhesives. Eur. Polym. J. 117, 442–454 (2019).