title: Solution blow spun polymer: A novel preclinical surgical sealant for bowel anastomoses.
abstract: BACKGROUND
  Solution blow spinning is a technique for depositing polymer fibers with promising potential use as a surgical sealant. This study assessed the feasibility and efficacy of solution blow spun polymer (BSP) for sealing bowel perforations in a mouse model of partial cecal transection. We then evaluated its use for reinforcing a surgical anastomosis in a preclinical piglet model.
  
  
  METHODS
  Three commercially available surgical sealants (fibrin glue, polyethylene glycol (PEG) hydrogel, and cyanoacrylate) were compared to BSP in the ability to seal partially transected cecum in mice. For anastomosis feasibility testing in a piglet model, piglets were subjected to small bowel transection with sutured anastomosis reinforced with BSP application. Outcome measures included anastomotic burst pressure, anastomotic leak rate, 14-day survival, and complication rate.
  
  
  RESULTS
  For the mouse model, the survival rates for the sealants were 30% for fibrin glue, 20% for PEG hydrogel, 78% for cyanoacrylate, and 67% for BSP. Three of 9 mice died after BSP administration because of perforation leak, failure to thrive with partial obstruction at the perforation site, and unknown causes. All other mice died of perforation leak. The mean burst pressure at 24h was significantly higher for BSP (81mm Hg) when compared to fibrin glue (6mm Hg, p=0.047) or PEG hydrogel (10mm Hg, p=0.047), and comparable to cyanoacrylate (64mm Hg, p=0.91). For piglets, 4 of 4 animals survived at 14days. Mean burst pressures at time of surgery were 37±5mm Hg for BSP and 11±9mm Hg for suture-only controls (p=0.09).
  
  
  CONCLUSIONS
  Solution blow spinning may be an effective technique as an adjunct for sealing of gastrointestinal anastomosis. Further preclinical testing is warranted to better understand BSP properties and alternative surgical applications.
authors.affiliation: Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA; Department of Urology, University of Virginia Health System, PO Box 800422, Charlottesville, VA 22908, USA. Electronic address: ngl2z@virginia.edu.
authors.forename: Nora G
authors.initials: NG
authors.lastname: Kern
authors.affiliation: Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Behrens
authors.affiliation: Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Srinivasan
authors.affiliation: Department of Pathology, Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Rossi
authors.affiliation: Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Daristotle
authors.affiliation: Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kofinas
authors.affiliation: Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Sandler
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D057868:Anastomotic Leak / Q000517:prevention & control*; D000818:Animals; D001672:Biocompatible Materials / Q000008:administration & dosage*; D002432:Cecum / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004195:Disease Models, Animal; D005240:Feasibility Studies; D005260:Female; D051379:Mice; D008810:Mice, Inbred C57BL; D011108:Polymers / Q000008:administration & dosage*; D013552:Swine; D014014:Tissue Adhesives / Q000008:administration & dosage*
chemical_list: D001672:Biocompatible Materials; D011108:Polymers; D014014:Tissue Adhesives
keywords: Bowel anastomosis; Surgical sealant