Figure 5.

Simulation of surgical injury ex vivo. (A) Uninjured serosa (i) was perforated with a no. 15 scalpel blade (Swann-Morton, Sheffield, England) stab enterotomy followed by application of the pectin patch (ii). The patch repair was exposed to 12 cm H₂O static pressure for 1 h with no detectable leak (iii). (B) A 3 cm linear enterotomy was created in a 30 cm porcine small bowel segment. The enterotomy was sealed with a pectin patch and various surgical sealants including SepraFilm (Baxter, Deerfield, IL, USA), DuraSeal (Integra Life Sciences, Plainsboro, NJ, USA), Evicel (Ethicon, Somerville, NJ, USA), Surgicel (Ethicon), and Coseal (Baxter). The intraluminal pressure of the bowel segment was increased with a 10 s ramp to a 100 cm H₂O plateau pressure for 10 min. Most sealants failed to reach plateau pressures; the label denotes the time (seconds) to pressure reversal in a representative segment as shown.