Soon, a surgery without stitches

Australian researchers at the University of New South Wales (UNSW) are looking to make sutures a relic of medical history by developing a thin polymer bio-film that seals surgical wounds.

Measuring just 50 microns thick – one micron is a millionth of a metre – the film is placed on a surgical wound and exposed to an infrared laser, which heats the film just enough to meld it and the tissue, thus perfectly sealing the wound.

Known as Surgilux, the device's raw material – named chitosan – is extracted from crab shells and is used in other medical applications as well, such as blood-clotting bandages.

Early test results indicate that it has strongest potential for use in brain and nerve surgery because it can avoid the numerous disadvantages of invasive stitches or sutures, which fail to seal and can act as a source of infection.

Up to 11 per cent of brain surgery patients have to return for repeat surgery due to leakage of cerebrospinal fluid (CSF) 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 device's inventors, UNSW scientist Dr John Foster.

"Others have tried surgical glues but these are mainly gel-like; so bonding to the tissue is uneven, often resulting in leakages. Also, they're not easy to use. The strongest surgical glue is so toxic that it's limited to external applications," says Foster. "Other devices use ultra-violet light to effect rather poor sealing, but UV rays are damaging to living cells."

"The beauty of this is that infra-red laser doesn't cause any tissue damage. Better still, Surgilux has anti-microbial properties, which deters post-operative infections."

Foster and his team are working with micro-surgeon Marcus Stoodley who specialises in nerve repair. Based at the 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 cause damage to nerves and there is always some permanent loss of function," he says. "Our test results with rats have shown some degree of permanent nerve recovery within six weeks of operating."

The researchers – who are looking for commercial backing to initiate clinical trials – are now planning a second generation version of Surgilux that incorporates growth factors and perhaps stem cells to regenerate nerves.