(28g) Novel Light Activated Biomaterial Based Films for Intestinal Tissue Sealing

Anastomotic Leakages present one of the most detrimental complications occurring after gastrointestinal anastomosis/ surgeries. The incidence rate for such complications has been reported to be between 2% and 19% worldwide. Extended hospital stays, secondary interventions, postoperative morbidity, and mortality are some of the aftereffects of anastomotic leakages. An estimated cost of $28.6 million per year is associated with such cases per 1000 patients undergoing gastrointestinal surgeries. Early detection and intervention can reduce the risk of such issues; however, current approaches are non-specific and often uninformative despite advances in diagnostic tools. This calls for the development of better anastomotic closure techniques, which can lead to a further reduction in their occurrence. Sutures, staples, tissue sealants, and adhesives are some of the conventionally used techniques for performing anastomotic closure. However, none of these methods are proven to be effective clinically in ensuring proper sealing of the gastrointestinal tract and can lead to leakages and further difficulties. Development of an efficient sealant that can be applied easily has sturdy adhesion to intestinal tissue, adequate biocompatibility, controlled swelling properties, and possesses the potential to be functionalized for bioactive delivery for facilitating the repair and healing process is the need of the hour. Chitosan is a well-known mucoadhesive biomaterial with several applications ranging from wound dressings to drug delivery systems. Its natural affinity to bind to mucosal surfaces/ mucous makes it an ideal candidate for producing materials that can perform well in the intestinal space.

In the present work, we have developed light-activated chitosan-based sealants integrated with a near-infrared absorbing dye, Indocyanine green (ICG), to achieve the sealing of incisional colorectal defects. ICG absorbs NIR laser light and converts it to heat energy, leading to adhesion of the Light-Activated SEalant (LASE) at the incision site and sealing of the incision. The swelling behavior of the generated LASE can be controlled by crosslinking to reduce swelling, leading to better sealing efficiency and lessened sealant failure. Our studies demonstrate that employing LASE followed by laser sealing resulted in better wound closure strength than Tachosil closed intestine. The results also show improved leak pressure values compared to sutures under ex vivo conditions. To enhance the adhesion quality of the LASE to the intestines, further modifications are being made to the base material-chitosan, followed by an extensive examination of the adhesion capabilities and wound closure strength. The generated LASEs can be used as a tissue sealant alone or in conjunction with suture/ staples as secondary reinforcement.