@article {1576536,
	title = {A novel two-component, expandable bioadhesive for exposed defect coverage: Applicability to prenatal procedures},
	journal = {J Pediatr Surg},
	volume = {56},
	number = {1},
	year = {2021},
	month = {2021 Jan},
	pages = {165-169},
	abstract = {BACKGROUND/PURPOSE: We sought to test select properties of a novel, expandable bioadhesive composite that allows for enhanced adhesion control in liquid environments.

METHODS: Rabbit fetuses (n = 23) underwent surgical creation of spina bifida on gestational day 22-25 (term 32-33 days). Defects were immediately covered with a two-component tough adhesive consisting of a hydrogel made of a double network of ionically crosslinked alginate and covalently crosslinked polyacrylamide linked to a bridging chitosan polymer adhesive. Animals were euthanized prior to term for different analyses, including hydraulic pressure testing.

RESULTS: Hydrogels remained adherent in 70\% (16/23) of the recovered fetuses and in all of the last 14 fetuses as the procedure was optimized. Adherent hydrogels showed a median two-fold (IQR: 1.7-2.4) increase in area at euthanasia, with defect coverage confirmed by ultrasound and histology. The median maximum pressure to repair failure was 15 mmHg (IQR: 7.8-55.3), exceeding reported neonatal cerebrospinal fluid pressures.

CONCLUSIONS: This novel bioadhesive composite allows for selective, stable attachment of an alginate-polyacrylamide hydrogel to specific areas of the spina bifida defect in a fetal rabbit model, while the hydrogel expands with the defect over time. It could become a valuable alternative for the prenatal repair of spina bifida and possibly other congenital anomalies.

TYPE OF STUDY: N/A (animal and laboratory study).

LEVEL OF EVIDENCE: N/A (animal and laboratory study).},
	keywords = {Alginates, Animals, Biological Dressings, Disease Models, Animal, Female, Fetal Diseases, Fetoscopy, Fetus, Hydrogels, Pregnancy, Prenatal Care, Rabbits, Spinal Dysraphism},
	issn = {1531-5037},
	doi = {10.1016/j.jpedsurg.2020.09.030},
	author = {Lazow, Stefanie P and Labuz, Daniel F and Freedman, Benjamin R and Rock, Anna and Zurakowski, David and Mooney, David J and Fauza, Dario O}
}
