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2008-09-15 Surgery without stitches

A thin polymer film that seals surgical wounds could make sutures a relic of medical history. Made from crab shell extract – a blood-clotting substance in bandages used by combat soldiers – the biodegradable material is placed on a surgical wound and heated by an infrared laser, causing it to bond with the tissue and seal the wound.

Early test results reveal that the technology, known as Surgilux, has strong potential for use in brain and nerve surgery because it avoids the disadvantages of stitches, which sometimes fail to seal and can act as a source of infection. Up to 11 percent of brain surgery patients have to return for repeat surgery due to leakage of cerebro-spinal fluid and other complications arising from sutures. Surgical sutures date back some 4,000 years, so a new approach is long overdue, according to one of the inventors and leader of the UNSW Biopolymer Research Group, John Foster.

"Others have tried surgical glues but they are mainly gel-like, so bonding to the tissue is uneven, often resulting in leakages. Also, the strongest of the surgical glues is so toxic that it's limited to external applications," Dr Foster says. "Some other technologies use ultra-violet light to effect rather poor wound sealing, but UV rays are damaging to living cells. The beauty of Surgilux is that infrared laser doesn't cause any tissue damage. Better still, it has anti-microbial properties, which deters post-operative infections."

Foster and his team are working with neurosurgeon Marcus Stoodley who specialises in nerve repair. Based at Sydney's Prince of Wales Hospital, Stoodley is excited about early test results. "Surgilux is well suited to repairing damaged nerves because the gold standard - sutures - inevitably causes damage to nerves and there is always some permanent loss of function," says Dr Stoodley. "Our test results with rats have shown some degree of permanent nerve recovery within six weeks of operating."

The global market for tissue sealants in 2008 is estimated at US$460 million, with an eight percent annual compound growth rate. The main components of Surgilux are approved for medical applications by the Food and Drug Administration in the US, potentially shortening and streamlining the approval process for the new product. NewSouth Innovations, UNSW's commercialization organization, manages and owns the intellectual property concerning the use and design of Surgilux.

"NSi and the inventors of Surgilux are seeking partners to clinically and commercially develop this proprietary technology," says NSi Business Development Manager, Dr Alfredo Martinez-Coll. "The nature of the investment would be through collaborative research and/or a licence deal."

Research and development is progressing on a second-generation version of Surgilux, which incorporates growth factors and perhaps stem cells to regenerate tissues.

Associate Professor John Foster heads UNSW's Biopolymer Research Group, which focuses on the production, characterisation and potential applications of novel biopolymers in medical and environmental areas. He researches the development and degradation of biopolymer-based materials, and their applications as bioplastics, anti-fouling coatings and proactive scaffolds for tissue engineering.

Commercial enquiries: Dr Alfredo Martinez-Coll, NSi, +61 2 9385 4679, Media enquiries: Dan Gaffney, NSi, +61 411 156 015.