Buckypaper (bp) as absorbable adhesive for surgical application in abdominal wall defects

TOPICS: Biotecnologia ed innovazioni tecnologiche. Le proposte italiane nella ricerca. BUCKYPAPER (BP) AS ABSORBABLE ADHESIVE FOR SURGICAL APPLICATION IN ABDOMINAL WALL DEFECTS Massimo Chiaretti(1), Andrea Martinelli(2), Giovanna Angela Carru(3), Emanuela D’Amore(4), Alessandra Maria Chiaretti(5), Fabio Faiola(6), Paola Consentino(7), Eleonora Valente(8), Annalisa Italia Chiaretti(1) (1)Department of General Surgery “Paride Stefanini”, Sapienza University of Rome, Viale del Policlinico 155, Rome, 00161 (Italy) (2)Department of Chemistry, Sapienza University of Rome, P.le Aldo Moro 5, Rome, 00185 (Italy) (3)Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 - Rome (Italy) (4)National Health Institute, Viale Regina Elena 299, 00161 - Rome (Italy) (5) Istitute of Genetic Risearch G. Salvatore, “Consorzio Interuniversitario di Scienze e Tecnologie Genetiche Biogem”; (6)Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 324, Rome, 00161 (Italy) (7)Appialab Srl V. Latina, 286 00179 Rome (+39) 067825111www.appialab.it (8)Policlinico Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma E-mail: massimo.chiaretti@uniroma1.it Keywords: buckypaper, BP, MWCNTs, medical application, abdominal wall defects surgery, wet adhesion, absorbable adhesive device. Introduction: One of the main problems related to the abdominal prosthetic surgery is the mesh fixation. Mesh displacement, improper and blind application of metal tacks and staples in laparoscopy surgery are the main causes of complications such as seroma, postoperative pain and recurrence[6-9]. The use of fibrin glue between the prosthesis and the damaged tissue, although it has become a well-established surgical procedure, represents a possible risk associated to the transmission of unknown diseases related to the use of human blood-derived materials [9]. Moreover, it was observed that an increased incidence of postoperative seroma is associated to the use of fibrin glue for mesh fixation[10]. Surfaces able to adhere promptly and strongly on wet biological tissue may represent an effective alternative to the conventional prosthesis fixation methods. This study realized on animal model proposes the application of the nature inspired micro- or nano-patterned adhesive surfaces, by exploiting the scaling effect, according to which the adhesion strength can be enhanced through the reduction of interface adhesive contact size[12]. We experimented evidences on the potential applicability on biological tissue of the BP as an adhesive tape, a self-standing felt composed of entangled multi-walled carbon nanotubes. In vitro bench surgery, mechanical peeling, and shear adhesion tests, and In vivo tests were tested with prosthetic meshes[2,3,4,10]. BP shows a stronger adhesion, but only on wet tissues[12] much better than both self-gripping commercial mesh and fibrin-glue non-gripping meshes and fabrics. Prompted by these results, we implanted BP in pigs, to assess BP effectiveness as adhesive absorbable prosthetic device and its biocompatibility. After 90 days from the operation we observed no pig behavioral alteration. BP samples preserved their position in the implantation site and mechanical adhesion was enhanced, both in laparoscopy and laparotomic procedure. Materials and Methods. Operated 30 Lantrace female 40-50 Kg pigs, 15 in laparoscopic procedure and 15 in laparotomic procedure. Operated and control subjects did not show mortality or morbidity, no significant neurovegetative or behavioral differences. Results and Discussion. Body weight monitoring graph do not showed any significant difference between BP and control group. The Hematoxilin and Eeosin stained implant section reported BP surface fragmentation that shows the formation of a capsule of loose fibrous tissue, consisting of fibroblasts and collagen fibers, indicative of a weak inflammation reaction. The necroscopy examination showed that the implanted BP favors a cicatrisation process, the mesh appearing wrapped in the inflammatory reaction. Conclusions: a strong BP adhesion on wet biological tissue was measured. In view of a possible application as adhesive absorbable tape in surgery, preliminary in vivo experiments were carried out on big pig model. Necroscopical and histological investigations enlighten that as 90 days after the implantation the BP elicits minimal adverse tissue response. Nanometric carbon nanotube aggregates were phagocytised by macrophages and observed in Bowman's urinary space. The assessment of the BP debris, possible toxicity or confinement or metabolism and accumulation or excretion mechanism needs further studies. References 1. L. Liu, W. Ma, Z. Zhang,Small 2011, 7, 1504 2. M. Chiaretti, G. Mazzanti, S. Bosco, S. Bellucci, A. Cucina, F. Le Foche, G. A. Carru, S. Mastrangelo, A. Di Sotto, R. Masciangelo, A. M. Chiaretti, C. Balasubramanian, G. De Bellis, F. Micciulla, N. Porta, G. Deriu, A. Tiberia, J. Phys.: Condens. Matter 2008,20, 474203 3. A. Di Sotto, M. Chiaretti, G. A. Carru, S. Bellucci, G. Mazzanti, Toxicol. Lett. 2009, 184, 192 4. S. Bellucci, M. Chiaretti, A. Cucina, G.A. Carru,A.I. Chiaretti, Nanomedicine 2009, 4, 531 5. a) The mean equivalent radius was evaluated by wicking tests carried out in water, assuming a water contact angle of about 80°; b) G. Callegari, I. Tyomkin, K. G. Kornev, A.V. Neimark, Y-L. Hsieh, J. 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