Sealing fistulas with regenerative immiscible bioglue
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A Korean research team has recently developed an innovative vesicovaginal fistula treatment method using the mussel adhesive protein (MAP) that can effectively seal fistulas in organs even when exposed to urine.

Fistula refers to an abnormal opening between the organs consisting of two spaces, such as blood vessels or intestines. This not only impairs the patients' quality of life, but female fistulas are stigmatized in many developing countries, affecting the human rights and dignity of women.

Currently, a physical suture method is typically used for treating vesicovaginal fistulas. However, this technique has multiple limitations since the surgeries are difficult, and the repetitive contraction and expansion of the bladder damage the tissue, which results in delayed healing of the wound.

A research team has improved the underwater adhesive using mussel protein and applied it to a pig model that simulated a vesicovaginal fistula. As a result, it was confirmed that the fistula was sealed much quicker and more effectively than the conventional treatment method that uses sutures, and its treatment efficacy was proven to be superior.

With no immune response or inflammation observed around the sealed fistula, low surgical difficulty, and easy access to large quantities of materials, the adhesive is anticipated to be used widely in developing countries with poor medical facilities.

"Vesicovaginal fistula is a disorder difficult to treat and it significantly impacts the patient's quality of life," remarked the author. "We expect the newly developed treatment method to be applicable to minimally-invasive surgical methods such as robotic surgery and endoscopic surgery as well as open surgeries in the future based on its excellent water-immiscibility and underwater adhesion."

Acta Biomaterialia