Multifunctional wet-adhesive chitosan/acrylic conduit for sutureless repair of peripheral nerve injuries

Meng Zhang; Heng An; Zhen Gu; Yi-Chong Zhang; Teng Wan; Hao-Ran Jiang; Feng-Shi Zhang; Bao-Guo Jiang; Na Han; Yong-Qiang Wen; Pei-Xun Zhang

doi:10.1016/j.ijbiomac.2023.126793

Multifunctional wet-adhesive chitosan/acrylic conduit for sutureless repair of peripheral nerve injuries

Int J Biol Macromol. 2023 Dec 31;253(Pt 6):126793. doi: 10.1016/j.ijbiomac.2023.126793. Epub 2023 Sep 13.

Authors

Meng Zhang¹, Heng An², Zhen Gu³, Yi-Chong Zhang⁴, Teng Wan⁵, Hao-Ran Jiang⁶, Feng-Shi Zhang⁷, Bao-Guo Jiang⁸, Na Han⁹, Yong-Qiang Wen¹⁰, Pei-Xun Zhang¹¹

Affiliations

¹ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: mengzh2008@bjmu.edu.cn.
² Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China. Electronic address: hengan@xs.ustb.edu.cn.
³ Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China. Electronic address: guzhen@ustb.edu.cn.
⁴ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: Gilbert5766@outlook.com.
⁵ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: tengwan.med@hotmail.com.
⁶ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: haoranjiangjhr@163.com.
⁷ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: xmx066@pku.edu.cn.
⁸ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: jiangbaoguo@vip.sina.com.
⁹ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: hannaqa@hotmail.com.
¹⁰ Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China. Electronic address: wyq_wen@ustb.edu.cn.
¹¹ Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China. Electronic address: zhangpeixun@bjmu.edu.cn.

PMID: 37709238
DOI: 10.1016/j.ijbiomac.2023.126793

Abstract

The incidence of peripheral nerve injury (PNI) is high worldwide, and a poor prognosis is common. Surgical closure and repair of the affected area are crucial to ensure the effective treatment of peripheral nerve injuries. Despite being the standard treatment approach, reliance on sutures to seal the severed nerve ends introduces several limitations and restrictions. This technique is intricate and time-consuming, and the application of threading and punctate sutures may lead to tissue damage and heightened tension concentrations, thus increasing the risk of fixation failure and local inflammation. This study aimed to develop easily implantable chitosan-based peripheral nerve repair conduits that combine acrylic acid and cleavable N-hydroxysuccinimide to reduce nerve damage during repair. In ex vivo tissue adhesion tests, the conduit achieved maximal interfacial toughness of 705 J m^-2 ± 30 J m^-2, allowing continuous bridging of the severed nerve ends. Adhesive repair significantly reduces local inflammation caused by conventional sutures, and the positive charge of chitosan disrupts the bacterial cell wall and reduces implant-related infections. This promises to open new avenues for sutureless nerve repair and reliable medical implants.

Keywords: Nerve growth factor; Peripheral nerve regeneration; Small gap injury; Sutureless; Wet adhesion.

MeSH terms

Adhesives
Chitosan*
Humans
Inflammation
Nerve Regeneration
Peripheral Nerve Injuries* / surgery
Peripheral Nerves / surgery
Sutureless Surgical Procedures*

Substances

Chitosan
Adhesives