Nerve repair demands complex microsurgical suturing skills. Maria Pereira, co-founder of TISSIUM, explains how biomorphic materials are changing the landscape of surgical repair.
For decades, we have tried to repair the human body with materials and solutions that don’t heal with it.
Sutures or staples, though all innovative in their own right, can result in trauma to the underlying tissue and can be technically complex in certain surgical scenarios, impacting the consistency of patient outcomes and limiting surgical innovation.
Designing for living tissue
While completing my PhD, I worked with a team exploring how tissue could be repaired beyond traditional fixation methods. Our initial academic focus was on closing holes in the hearts of newborn babies, an area where existing approaches can be too damaging in an incredibly delicate process.
The result was a biomorphic biopolymer that could effectively seal and bind to tissue. This material can be directly applied to wet tissue and activated on demand when and where the surgeon wants. The material biodegrades over time but maintains its function long enough to support tissue repair.
From the early days, it was obvious that the potential of this innovation was beyond the original academic work.
When repairing a severed peripheral nerve, for instance, existing approaches such as sutures require specialised technical skills, can create trauma and inflammation to the underlying delicate tissue.
In contrast, the biomorphic polymer has been used to design an atraumatic and sutureless solution to avoid unnecessary trauma and fundamentally change how procedures are executed.
Consistency in the operating room
By reducing the complexity intricate to procedures like peripheral nerve repair through a bioabsorbable polymer with a dedicated delivery and coaptation system, this innovation aims to provide more consistent patient outcomes.
The process of nerve repair is highly complex, requiring a year of specialised training to perform microsuturing.
Furthermore, there is a diversity of procedures and surgical conditions associated with the diversity of peripheral nerve injury. Integrating critical procedural steps into one atraumatic surgical system aims to reduce the variability and minimise tissue trauma, two factors that can significantly influence patient recovery.
By becoming less reliant on hyper-specific techniques, surgical workflows can be reproducible across different clinical settings and reduce the barrier of variability.
When technology is leveraged to advance a specialised skill set, the medical industry can strengthen consistency in practice, improve the reliability of complex procedures, and continue to drive positive patient outcomes.
The human impact
The implications of this innovation are very promising, especially at the patient level.
In TISSIUM’s first-in-human study of this atraumatic sutureless repair, procedural success was achieved for all patients, defined as successful atraumatic sutureless coaptation using the polymer-assisted coaptation device, with all patients regaining full flexion and extension of the injured digit and reporting no pain 12 months after the procedure.
For the humans behind these operations, this means reclaiming their own sense of autonomy, without living in the shadow of chronic pain or impaired function.
An atraumatic solution
The precision of a needle can be unforgiving and requires special artistry to wield it. A new generation of biomaterials is gaining traction, designed to bring consistency to the operating room.
These biomorphic polymers are being developed to transform surgery from a necessary trauma into an opportunity for guided repair that can be achieved even in the most complex surgical scenarios.
