53. Next Generation Tissue Adhesives for Effective Elimination of Surgical Dead Space

INTRODUCTION: Surgical procedures such as abdominoplasty frequently result in dead space, which predisposes patients to complications like hematomas and seromas due to fluid accumulation. This has been mitigated through surgical drains. However, drains can compromise patient comfort, present a risk for infection, and have questionable efficacy. Current trends lean towards drainless procedures, which employ meticulous multi-layered suturing of the abdominal wall to eliminate dead space. While effective, this approach can cause tissue trauma, leading to issues such as tension, dimpling, and compromised blood flow. There is a critical need for innovative techniques in abdominoplasty that can effectively eliminate dead space while minimizing complications. MATERIALS AND METHODS: We developed novel powder-based tissue adhesives for abdominoplasty procedures. These adhesives possess functional groups, including carboxyl and N-hydrosuccinimide ester, which facilitate rapid crosslinking with amino groups in tissue extracellular matrix. The biocompatibility and efficacy of adhesives are being assessed in a rat model, where seroma formation is monitored by ultrasound imaging. Histological analyses are conducted to evaluate tissue response and healing. RESULTS AND DISCUSSION: Our tissue adhesives, in powder format, enables efficient tissue penetration, forming strong bonds across various tissue types. We controlled the swelling ratios by modulating the fraction of poly(α-lipoic acid). We tailored antioxidative properties by adjusting the fraction of disulfide and thioether bonds in the polymer backbone. Mechanical testing, including shear, peel, and tensile strength tests on pig skin, indicated that our adhesive exhibits adhesion properties comparable to cyanoacrylate-based Dermabond. We developed a rat model for abdominoplasty procedures. Seroma formation was observed at post-operative day (POD) 1, with an aspirated fluid volume of 0.8 mL. Ultrasound imaging revealed a gradual reduction in seroma size, though it persisted for up to 6 weeks. Without treatment, scar tissue and seroma were noted at the lesion site. This abdominoplasty rat model replicates the human surgical environment, providing a relevant platform for evaluating the performance and benefits of our tissue adhesive. CONCLUSIONS: By modifying the adhesive’s biodegradability, antioxidative properties, and adhesive strength, we provide a versatile solution for abdominoplasty and potentially other surgical procedures. Eliminating surgical dead space and sealing tissue layers with our tissue adhesive will reduce potential morbidity and optimize efficiency.