摘要/Abstract
手术线缝合和订皮钉固定是外科手术中修复组织损伤的常规方法，但是对于相对脆弱的软组织，使用组织粘合剂是代替常规组织修复的重要方法之一.尽管合成的组织粘合剂已经得到广泛应用，但是仍然存在一些缺点，例如湿润环境中粘合性差和潜在毒性等.纤维蛋白胶具有良好的止血性能，但是存在拉伸性和粘附性差、价格昂贵等缺点.仿生粘合剂作为组织粘附剂、止血剂或密封剂在临床手术中应用广泛.然而，在组织创伤的修复应用中，发展耐水粘附、具有生物相容性，多功能一体化的医用粘合剂是近年来研究的热点和难点.自从Messersmith课题组报道了受贻贝启发的多功能聚多巴胺涂层以来，含有酚羟基的材料由于其抗氧化、抗菌消炎等功效，被广泛地应用于医学、食品、化妆品和水处理等领域.仿贻贝水凝胶具有优异的组织粘附性、止血抑菌性、生物安全性和可塑性，是理想的医用粘合剂材料.概述了多酚-合成高分子水凝胶、多酚-生物大分子水凝胶、多酚-无机纳米材料复合水凝胶以及聚多巴胺纳米颗粒复合水凝胶在组织粘附、止血抑菌等方面的研究进展和在组织愈合中的应用探索.总结了多酚水凝胶作为医用组织粘附剂、止血剂、密封剂仍需解决的关键问题，并对此领域的发展趋势进行了展望，有助于推动仿贻贝水凝胶作为新兴生物粘合剂在医学领域中的应用.
关键词: 多酚, 水凝胶, 生物粘合剂, 伤口止血, 组织愈合
Surgical sutures, staples and clips have been widely used for wound closure, tissue reconstruction and tissue adhesives are one of the versatile alternatives especially for friable tissues. Some synthetic and semisynthetic tissue adhesives are available elsewhere. However, there are some drawbacks, such as poor adhesion on wet substrates and potential toxicity, for the reported tissue adhesives. Fibrin glues as biological tissue adhesives are effective hemostatic agents while presenting relatively weak tensile and adhesion strengths and being expensive. Biomimetic adhesives as tissue adhesives, hemostatic agents, or tissue sealants have attracted great attention for clinical operations in last three decades. However, engineering of bio-adhesive materials with good water resistance, high adhesive strength, and good biocompatibility and multi-functionality remains a challenge for tissue healing. Since the first report of mussel-inspired surface chemistry for functional coatings of polydopamine by the Messersmith group in 2007, materials containing plenty of phenolic hydroxyl groups have been widely used in medical applications, food, cosmetics, water treatment and so on, due to the antioxidant, antibacterial, and anti-inflammatory effects of polyphenols. Polyphenol-based hydrogel is an ideal bio-adhesive material due to its good tissue adhesion even on wet substrates, hemostatic and antimicrobial capabilities. Moreover, these hydrogels with porous structures have similar physiochemical properties to that of natural extracellular matrix and different shapes from nanometer to centimeter scales can be remolded to seal irregular defects on tissues. In this review, we report the recent progress of the engineering of polyphenol-synthetic polymer hydrogels, polyphenol-biomacromolecule hydrogels, polyphenol-inorganic nanocomposite hydrogels, and polydopamine nanoparticle composite hydrogels, as well as their applications of tissue adhesives, hemostasis, antimicrobials for wound closure and tissue regeneration. The challenges as well as prospects for future development of polyphenol-based tissue adhesives, sealants, hemostatic agents are also summarized and discussed, which is helpful to promote the next generation of tissue adhesives for biomedical applications.
Key words: polyphenol, hydrogel, bio-adhesive, hemostasis, tissue healing
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