Fabrication of an NIR-II fluorescence-visible indocyanine green-BioGlue for precision surgical adhesion with intraoperative leakage prevention

Bioadhesives are being increasingly used in clinical practice, but pose significant health risks due to their uncontrollable intraoperative leakage. Nevertheless, there is currently a critical lack of effective solutions. Herein, we propose a second near-infrared window (NIR-II) fluorescence-visible indocyanine green (ICG)-BioGlue adhesive for precision surgical adhesion with intraoperative leakage prevention. The fabricated ICG-BioGlue adhesive based on the non-covalent interaction exhibits nearly 100% fluorescence labeling efficiency and maintains long-term stable NIR-II fluorescence for up to 3 months. During surgery, ICG-BioGlue adhesive enables real-time visualization of wound adhesion in various fields such as aortic dissection adhesion and liver or kidney wound hemostasis, preventing leakage into surrounding tissues. Moreover, the stable fluorescence of ICG-BioGlue adhesive allows effective imaging-guided removal of long-term adhesive fragments in the body when they cause compression symptoms after surgery. Considering it consists solely of Food and Drug Administration-approved drugs ICG and BioGlue, with a straightforward synthesis method and versatile applicability, ICG-BioGlue adhesive holds excellent potential for clinical translation. Our study provides a leakage-preventing strategy to enhance biosafety and promote the widespread application of bioadhesives in clinical settings.