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Medicine

Closing Surgical Incisions With a Paintbrush and Nanoparticles 56

Posted by timothy
from the when-superglue-just-feels-cheap dept.
New submitter BiancaM (3582365) writes "A group of chemists has shown the power of nanoparticles for closing and healing surgical wounds. Using no more than a paintbrush they are able to close surgical openings as well as classical techniques such as sutures. However in fragile deep tissues such as liver even more remarkable results were found- normally fatal damage to internal organs is repaired in seconds using a nanoparticle glue. The results show that closing after surgery can be faster and simpler using nanomaterials to glue wounds shut." For something between the above linked abstract and the research paper, there's this write-up at PhysOrg, and a video of the technique in action.
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Closing Surgical Incisions With a Paintbrush and Nanoparticles

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  • Re:Sucky Surgeon (Score:3, Interesting)

    by sumdumass (711423) on Sunday April 20, 2014 @02:52AM (#46798291) Journal

    I've had a good share of sutures in my life. Many of them was given while I was awake and watching too. I was thinking the same thing about how this guy sucks at it. But it likely isn't his full time job. I can lay carpet and do electrical work but I'm slow as snot compared to the pros.

    On the other hand, I like the concept of the glue way better but fear it would turn my random $500 ER visits into a $5000 visit. But then again, I wouldn't have the pleasure of the ER doctor's jokes about how my arm or finger or whatever reminds him of his wife's meatloaf while they are stitching me up.

  • by TheMeuge (645043) on Sunday April 20, 2014 @09:55AM (#46799137)

    I AM a physician, and yes, whoever does the demonstration takes quite a bit away from the demonstration by being pretty horrific at suturing... like 2nd year medical student who hasn't practiced bad. If they are going to compare quality of tissue approximation between sutures and their glue, they should probably use proper technique. A plastic surgeon would have laid out 10 sutures or more into the same space, probably in half the time. I am sure there's a senior surgery resident out there who wouldn't mind getting a few hundred bucks to tie a few sutures on camera.

    That being said, there are some structures in the body that are very fragile, and difficult to sew. Also, the elderly and the chronically ill have tissues that just fall apart, limiting the usefulness of many surgeries in managing their illness. If we could create seams that don't rely as much on tissue strength, we could probably operate on quite a few more people.

  • Re:Sucky Surgeon (Score:5, Interesting)

    by quantumghost (1052586) on Sunday April 20, 2014 @10:22AM (#46799211) Journal

    Is it just me, or does that guy really suck at suturing? I'm not a physician (never even played one), but I've watched instructional videos, and that didn't look like how the pros do it. The pros can suture and tie a knot way faster. If you suture like that then obviously glue would be better!

    I felt really bad for whatever mammal that was (dog? rabbit?), especially because of the suturing job..

    FWIW, the animal did appear to be adequately anesthetized as it did not flinch with the incision or suturing, and, no, he was not good, he barely knew what he was doing:
    - wrong scalpel. That was a 10 blade used for long linear incision (e.g. > 10-40 mm). He should have used an 11 or 15 blade which are smaller and better suited to precision cuts, which these were not - he hacked at the skin instead if cleanly incising (so the technique was bad, the blade was dull, and he used the wrong blade).
    - he did not use a pair of forceps to grasp the skin putting him self at risk of a needle-stick injury.
    - needle entry was not perpendicular to the skin
    - he used PDS suture (it looked purple) , which is _never_ used on skin (especially externalized). Prolene is used for an external knot, or vicryl or monocryl for a subcuticular suture
    - the suture looks to be a 3-0 or 4-0....that's what I would use to close an adult human (5-0,which is smaller, for the face). Should probably be using 5-0 or 6-0 here. Then again, this guy would probably break that suture since he doesn't have the manual dexterity or technique. - he should have used a horizontal or 2 vertical mattress sutures to close the defect, not a single simple suture
    - he didn't tie square knots and his tying was worse than a medical student's (who don't know how to suture either)
    So I may just be nitpicking but, then again, that's what I do as an academic surgeon who trains upcoming surgeons.

    But to actually address the article: It looks promising. I have questions about:
    A) potential toxicity (nanoparticles can behave in less predictable way in-vivo) [large volumes of iron can be toxic to the body hemosiderin leading to iron overload [wikipedia.org]], also silica is sometimes not well tolerated by the body
    B) I would like to see this applied in a larger model (porcine would be good), with a large volume hemorrhage (analogous to a human GSW or stabbing wound) to see if the tensile strength of this seal scales up and to see if a large volume of blood will wash it away rendering it useless.
    C) Does it withstand the detergent like properties of bile?
    D) What percentage of normal tensile strength does this technique afford? Sutures physically hold tissue together to prevent separation under shear stress - how much strength does this stuff afford?
    E) Does the substance affect normal wound healing (scar tissue is a normal, appropriate response, in an adult, to tissue injury; less scar may mean abnormal or poorer wound healing)
    F) Will it be scalable (yes you can produce it in a lab easily enough, but can you make medical grade easily?)
    G) Can it cause injury to adjoining tissue? The edge of the wound is hypoxic (low oxygen concentration), will this be toxic to these at risk tissues?

    It is a long way from the lab to clinical use, but this appears promising. Look forward to seeing how the technology plays out. And no....it won't put me out of a job, but if it works out it may make my job easier and give better outcomes.

  • by Karellen (104380) on Sunday April 20, 2014 @11:42AM (#46799567) Homepage

    Really? As if all nano-scale particles have some kind of magical properties? (On top of those relating to branding and getting hits on your press-release?)

    From TFA:

    Silica nanoparticles (SiO2NP) with radius of about 50 nm (Supporting Information, Figure S3) were synthesized by the Stöber method and applied as a solution in deionized water at concentration of 30 wt% (pH 8.5) or, when indicated, as a powder. Iron oxide Fe2O3 nanoparticles (Fe2O3NP) were purchased from Alfa Aeser, stabilized by citric acid, peptized, and used in aqueous solution in milli-Q water at 42 gL-1

    That's not nanotech, that's fucking chemistry.

    I doubt that should even count as your basic type-IV nanomaterials or type-V biopolymer nanotech [metamodern.com]. There's nothing "nano" to see here except for the 18th-century tech known as "molecules", and it's certainly not worthy of 61 separate uses of "nano-" words in the paper.

    No wonder any discussion around "real" nanotechnology (i.e. atomically precise manufacturing - the technology the word was invented to describe) is so damn confusing.

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