An animal study comparing electrocautery and nanopeptide scaffold in neurosurgical haemostasis

Abstract

INTRODUCTION: Bipolar electrocautery is commonly used in neurosurgery but it may also cause additional tissue injury. A search for novel biomaterials that are conducive to haemostasis and healing is needed. RADA16-I, a type I self-assembling peptide nanofibre scaffold (SAPNS), is a novel biomaterial and a potential alternative haemostatic agent for clinical use. OBJECTIVE: To investigate the haemostatic property of RADA16-I, and to compare it with bipolar electrocautery. MATERIALS AND METHODS: Adult female Sprague Dawley (SD) rats (220g – 250g) were craniotomized and a cortical vessel was transected. Animals were randomized to receive (i) bipolar electrocautery; (ii) RADA16-1 for haemostasis. A third group received electrocoagulated lesions bilaterally, with RADA16-I added on the left. The extent of tissue necrosis, cellular infiltration, and adjacent neuronal degeneration were studied. RESULTS: RADA16-I achieved haemostasis instantaneously. Its use resulted in significantly less tissue necrosis when compared with electrocautery on magnetic resonance imaging studies and histological examinations. It was also associated with less astrocyte and macrophage infiltration in the surrounding brain. CONCLUSION: RADA16-I achieves neurosurgical haemostasis effectively and its use is associated with less tissue damage when compared with bipolar electrocautery. Whether this would translate into better preservation of function and/or better recovery of deficit requires further analysis using another injury model on eloquent cortex and functional outcome analysis. This pilot study demonstrates that a nanopeptide-based biomaterial may be exploited as a potential alternative to electrocautery for clinical use.