Patients recuperating from gastrointestinal surgery may soon find their lives saved by a little, straightforward sticker.
Researchers led by Northwestern University and Washington University School of Medicine in St. Louis have developed a new, first-of-its-kind sticker that enables clinicians to monitor the health of patients' organs and deep tissues with a simple ultrasound device.
BioSum, an acronym for "Bioresorbable, Shape-adaptive, Ultrasound-readable Materials," was created by Northwestern University's Prof. John A. Rogers and postdoctoral fellow Jiaqi Liu. Dr. Hammill initiated the study, and led the evaluation of the prototype.
The BioSUM takes the form of a thin, flexible, biocompatible sticker, made up of several spaced-apart metal discs embedded in a pH-responsive hydrogel base. When attached to an organ, the soft, tiny sticker changes in shape in response to the body's changing pH levels, which can serve as an early warning sign for post-surgery complications such as anastomotic leaks. Clinicians then can view these shape changes in real time through ultrasound imaging. As long as no leakages occur, the BioSUM stays in its default state, reports NewAtlas.
Currently, no existing methods can reliably and non-invasively detect anastomotic leaks - a life-threatening condition that occurs when gastrointestinal fluids escape the digestive system. By revealing the leakage of these fluids with high sensitivity and high specificity, the non-invasive sticker can enable earlier interventions than previously possible. Then, when the patient has fully recovered, the biocompatible, bioresorbable sticker simply dissolves away; bypassing the need for surgical extraction.
"These leaks can arise from subtle perforations in the tissue, often as imperceptible gaps between two sides of a surgical incision," said Northwestern's John A. Rogers, who led device development with postdoctoral fellow Jiaqi Liu. "These types of defects cannot be seen directly with ultrasound imaging tools. They also escape detection by even the most sophisticated CT and MRI scans. We developed an engineering approach and a set of advanced materials to address this unmet need in patient monitoring. The technology has the potential to eliminate risks, reduce costs and expand accessibility to rapid, non-invasive assessments for improved patient outcomes."
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"Right now, there is no good way whatsoever to detect these kinds of leaks," said gastrointestinal surgeon Dr. Chet Hammill, who led the clinical evaluation and animal model studies at Washington University with collaborator Dr. Matthew MacEwan, an assistant professor of neurosurgery. "The majority of operations in the abdomen; when you have to remove something and sew it back together; carry a risk of leaking. We can't fully prevent those complications, but maybe we can catch them earlier to minimize harm. Even if we could detect a leak 24- or 48-hours earlier, we could catch complications before the patient becomes really sick. This new technology has potential to completely change the way we monitor patients after surgery."
To evaluate the efficacy of the new sticker, Hammill's team tested it in both small and large animal models. In the studies, ultrasound imaging consistently detected changes in the shape-shifting sticker -; even when it was 10 centimeters deep inside of tissues. When exposed to fluids with abnormally high or low pH levels, the sticker altered its shape within minutes.
Rogers and Hammill imagine that the device could be implanted at the end of a surgical procedure. Or, because it's small and flexible, the device also fits (rolled up) inside a syringe, which clinicians can use to inject the tag into the body.