Summary:
For anastomoses in the digestive tract, titanium (Ti) staples are most-commonly used because of good
mechanical strength and ductility but are not biodegradable. Their life-time presence may interfere with
imaging examinations and impede growth especially in young patients. The long-term existence would
also increase the chance of clinical complications such as leakage, stricture, chronic inflammation,
foreign body response, bleeding and infection. A second revision/removal surgery must be performed
if the situation gets worse. Biodegradable polymer materials such as PLA-PGA based staples are
available but largely for subcuticular applications. Their poor mechanical properties restrain their
applications in gastrointestinal (GI) anastomoses which need high closure strength. Thus, these
identified inadequacies in the properties of Ti and polymer staples open opportunities for bioresorbable
metal (i.e., zinc) as a new generation of anastomotic staples for the digestive tract. The use of metallic
Zn as an alternative bioresorbable staple could offer some distinct advantages. The higher strength of
Zn makes it ideal for GI anastomoses while its bioresorbable nature may minimize the chance of
anastomotic leakage and stricture and will not impede growth or cause chronic inflammation, bleeding
and infection. Plus, Zn is an essential and natural element for life, its toxicity should be of minimal
concern. In fact, evidence showed that Zn implants could promote stem cell recruiting and
differentiation. Zn is also a natural antimicrobial biomaterial that can minimize potential infection after
surgical wound-closure as GI mucus is home to trillions of microbes. Additionally, their degradation
speed and mechanical strength can be further manipulated through alloying. The goal hereby is to
develop bioresorbable Zn-based staples for anastomoses in the digestive tract and to validate their
efficacy in cells and animal models through biodegradation, biocompatibility, antimicrobial testing, stem
cell differentiation, as well as wound healing including the GI mucus barrier regeneration.