Albumin-genipin solder for laser tissue repair

Background: Laser tissue soldering (LTS) is an alternative technique to suturing for tissue repair that avoids foreign body reaction and provides immediate sealing of the wound. One of the major drawbacks of LTS, however, is the weak tensile strength of the solder welds when compared to sutures. In this study, a crosslinking agent of low cytotoxicity was investigated for its ability to enhance the bond strength of albumin solders with sheep intestine. Study Design/Materials and Methods: Solder strips were welded onto rectangular sections of sheep small intestine using a diode laser. The laser delivered in continuous mode a power of 170 ± 10 mW at λ = 808 nm, through a multimode optical fiber (core size= 200 μm) to achieve a dose of 10.8 ± 0.5 J/mg. The solder thickness and surface area were kept constant throughout the experiment (thickness = 0.15 ± 0.01 mm, area = 12 ± 1.2 mm²). The solder was composed of 62% bovine serum albumin (BSA), 0.38% genipin, 0.25% indocyanin green dye (IG), and water. Tissue welding was also performed with a BSA solder without genipin, as a control group. The repaired tissue was tested for tensile strength by a calibrated tensiometer. Murine fibroblasts were also cultured in extracted media from heat-denatured genipin solder to assess cell growth inhibition in a 48 hours period. Results: The tensile strength of the genipin solder was doubled that of the BSA solder (0.21 ± 0.04 N and 0.11 ± 0.04 N, respectively; P=10^-15 unpaired t-test, N=30). Media extracted from crosslinked genipin solder showed negligible toxicity to fibroblast cells under the culture conditions examined here. Conclusion: Addition of a chemical crosslinking agent, such as genipin, significantly increased the tensile strength of adhesive-tissue bonds. A proposed mechanism for this enhanced bond strength is the synergistic action of mechanical adhesion with chemical crosslinking by genipin.