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Then came the pigs. Yuk Mayo joined a team at the clinic, which was better equipped to operate on large animals. The team wanted to avoid relying on the blood’s natural clotting ability, as many people who undergo surgery themselves have clotting problems. So before any experiment, all three pigs received heparin, which was thinner in blood. The researchers cut three holes, 1 centimeter wide and 1 centimeter deep in each animal’s liver, and then treated the nine wounded with a paste or TachoSil patch.
Veterinarian Tiffany Sarrafian said she has never seen glue work like this. “We just put the pasta in, and we’re counting it,” Sarrafian says in a few seconds, recalling the procedure. “Take your hand off and you’re like,‘ Wait, there’s no blood! “It was pretty amazing.”
Sarrafian predicted that within three minutes the commercial comparison patch would not work, that he would reverse the anticoagulant to keep the pigs alive and then coagulate and heal naturally. But he added another step to stop the bleeding faster: tightening the size of a pea of experimental glue. “It’s amazing, somehow,” he says.
In fact, coagulant patches like TachoSil are not designed to stop heavy blood flow with non-tissue damage. But in medicine, it is an unmet need, says Christoph Nabzdy, a surgeon in the Mayo team. “As the population ages, you have more patients who have bleeding disorders or end up in blood thinners,” he says. “The issue of bleeding and bleeding control is fundamental.”
He and Saraffian add that having cheap glue that stops heavy bleeding and goes already on wet surfaces would save lives for patients and would be especially useful in places where there are not many surgical resources, such as desert areas, battlefields or less developed countries.
“There’s nothing new in the material out there, but this concept is very nice and unusual,” says biomedical engineer Shrike Zhang, who runs the laboratory at Harvard Medical School. Although materials like silicone oil and adhesive components are common, their combination it does something exciting. “It’s pretty early, but the animal data is pretty strong,” he continues.
But, says Wang, who lives in cardiothoracic surgery at Stanford, there are still elements that need to be optimized so that the adhesive can be used in humans. A glue balloon that seals damaged tissue in an emergency or sticks to nearby healthy tissue can complicate subsequent surgery. “The question is, will you be able to act in that area?” he asks.
Yuk’s team came up with a solution to turn this type of adhesive seal around and beforehand results in rats they are hopeful.
They also want to know how long that stamp lasts; Ideally, it should not dissolve until the tissue has healed on its own, but it should not last forever. New research shows that the paste dissolves within 12 weeks, based on microscope images in a separate experiment using rats. Depending on the injury and the healing response, this can be a lot.
Another challenge is that over time other types of sealants kill fabrics. Wang and Yuk have warned that a long-term study will be essential. So far, the longest observation they have made in the bleeding organs is about a month after applying the glue, using pigs from the Mayo Clinic test.
And even if many years passed, until the sealed adhesive replaced the reliable suture, surgeons and mechanical engineers would welcome patients to re-attach it quickly so that the body could function like oiled machines again.
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