A Laparoscopically Compatible Rapid-Adhesion Bioadhesive for Asymmetric Adhesion, Non-Pressing Hemostasis, and Seamless Seal.

Bioadhesive hydrogels offer unprecedented opportunities in hemostatic agents and tissue sealing; however, the application of existing bioadhesive hydrogels through narrow spaces to achieve strong adhesion in fluid-rich physiological environments is challenged either by undesired indiscriminate adhesion or weak wet tissue adhesion. Here, a laparoscopically compatible asymmetric adhesive hydrogel (aAH) composed of sprayable adhesive hydrogel powders and injectable anti-adhesive glue is proposed for hemostasis and to seal the bloody tissues in a non-pressing way, allowing for preventing postoperative adhesion. The powders can seed on the irregular bloody wound to rapidly absorb interfacial fluid, crosslink, and form an adhesive hydrogel to hemostatic seal (blood clotting time and tissue sealing in 10 s, ≈200 mm Hg of burst pressure in sealed porcine tissues). The aAH can be simply formed by crosslinking the upper powder with injectable glue to prevent postoperative adhesion (adhesive strength as low as 1 kPa). The aAH outperforms commercial hemostatic agents and sealants in the sealing of bleeding organs in live rats, demonstrating superior anti-adhesive efficiency. Further, the hemostatic seamless sealing by aAH succeeds in shortening the time of warm ischemia, decreasing the blood loss, and reducing the possibility of rebleeding in the porcine laparoscopic partial nephrectomy model.

Predictive value of soluble fibrinogen-like protein 2 for survival in traumatic patients with sepsis.

BACKGROUND: Despite significant advances in the diagnosis and management of sepsis and trauma over the past few decades, severe infection and injury continue to represent major public health challenges. Fibrinogen-like protein 2 (FGL2), a member of the fibrinogen family, can be expressed as a membrane-associated protein with coagulation activity or in a secreted form possessing unique immune suppressive functions. In this study, we evaluated whether soluble fibrinogen-like protein 2 (sFGL2) can serve as a biomarker to predict the development of sepsis in trauma patients. METHODS: sFGL2 concentrations were determined by ELISA assays in sera of 75 trauma patients clinically classified into non-sepsis group and sepsis group. For comparison, 15 age- and sex-matched healthy individuals were included. RESULTS: sFGL2 concentrations were dramatically elevated in trauma patients compared to healthy controls. In the patient group, the patients with sepsis showed a significant increase in sFGL2 concentrations compared with non-septic patients. Moreover, non-survivors of septic patients displayed higher sFGL2 concentrations compared with survivors. In addition, sFGL2 concentrations were positively correlated with Sequential Organ Failure Assessment (SOFA) scores, serum IL-8 and IL-10 concentrations, but reversely correlated with Glasgow coma scale (GCS) scores, platelet and lymphocyte counts. Furthermore, sFGL2 was found to be an independent predictor of 28-day mortality in traumatic patients with sepsis by logistic regression analysis. CONCLUSION: sFGL2 concentrations were significantly correlated with the development and mortality of sepsis in traumatic patients. Thus, sFGL2 may serve as a potential indicator for traumatic patients with sepsis.