Background: Traumatic injuries cause millions of deaths annually, with intra-abdominal hemorrhage as a leading cause. Achieving hemostasis remains challenging. This study evaluates the hemostatic properties of a novel biocompatible cyanoacrylate–polylactic acid patch. Methods: Thirty-six male Wistar rats were randomized into three groups (control, study, and TachoSil^®) and underwent a standardized liver resection. The hemostasis times were recorded, and blood samples were drawn to assess hemoglobin, hematocrit, and cytokine levels (IL-6 and TNF-α) using validated assays. Results: In the study group, a median time to hemostasis of 94 s was recorded, compared with 256 s for electrocautery (p < 0.001) and 120 s for TachoSil^® (p = 0.010). Hemoglobin levels significantly decreased postoperatively in all groups, with the TachoSil^® group showing the lowest median value (from 15.4 g/dL to 11.9 g/dL, p = 0.006). Furthermore, only the TachoSil^® group exhibited a marked inflammatory response with a significant rise in IL-6 (from 15.6 to 26.8 pg/mL, p = 0.04) and TNF-α (from 9.8 to 28.6 pg/mL, p = 0.01). Conclusions: The results demonstrated that the novel cyanoacrylate–polylactic acid patch achieved rapid hemostasis and was associated with reduced inflammatory responses compared with both electrocautery and TachoSil^®. These findings suggest that this hybrid material may offer a safer and more effective hemostatic alternative.

Background and Objectives: Although cyanoacrylate–polylactic acid (CA + PLA) patches shorten the time to hemostasis after partial hepatectomy, their long-term biocompatibility remains uncertain. We compared the 5-month histopathological footprint of a novel CA + PLA patch (Study group) with a licensed fibrinogen/thrombin matrix (TachoSil^® group) and electrocautery (Control group). Methods: Thirty-three male Wistar rats underwent a 3 × 1.5 cm hepatic segment resection and were randomized to the Control (n = 5), Study (n = 14), or TachoSil^® (n = 14) group. The animals were sacrificed on postoperative day (POD) 50, 100, or 150. Blinded semiquantitative scoring (0–3) was used to capture inflammation intensity, and the number of neutrophils (PMNs), lymphocytes (Ly’s), isolated histiocytes, and foreign-body giant cells (FBGCs). Results: The proportions of animals in each group across the different sacrifice time points were homogeneous (χ² = 4.34, p = 0.36). The median inflammation remained mild (2 [IQR 1–2]) in the Control and Study groups but lower in the TachoSil^® group (1 [1–2], p = 0.47). The FBGC scores differed markedly (score ≥ 2: 64% in Study, 0% in Control, 14% in TachoSil^®; p < 0.001). Fibrosis occurred almost exclusively in the Study group (79% vs. 0%; χ² = 22.4, p < 0.001). Mature vessels were most frequently observed in the TachoSil^® group (50%, aOR = 5.1 vs. Study, p = 0.04). Abscesses only developed in the Study group (29%, p = 0.046). Within the TachoSil^® group, inflammation (ρ = −0.62, p = 0.019) and Ly infiltration (ρ = −0.76, p = 0.002) declined with time; no significant temporal trends emerged in the Study group. Conclusions: At the five-month follow-up, there was an exuberant foreign-body reaction, dense collagen deposition, and a higher abscess rate around the CA + PLA patch compared with both TachoSil^® and cautery. Conversely, TachoSil^® evolved toward a mature, well-vascularized scar with waning inflammation. These findings underscore the importance of chronic-phase evaluation before clinical adoption of new hemostatic biomaterials.

Background/Objectives: Objective end-product assessment of microsurgical anastomoses is intensive and partly subjective. Vision-capable large language models (LLMs) may enable standardized image-based scoring, but their agreement with expert assessment remains uncertain. Methods: We studied 200 end-to-end femoral artery anastomoses, performed on chicken legs by novice, intermediate, and experienced microsurgeons. Images were scored independently by two blinded expert panels; disagreements were adjudicated by a third senior reviewer to establish expert consensus. Two LLMs, ChatGPT 5.2 Thinking Extended and Gemini 3.1 Pro, were evaluated using the exact same prompt and rubric. Each image was analyzed three times per model. Final scores were aggregated by median for numeric items and majority vote for categorical items. The primary endpoint was exact-match agreement with expert consensus. Agreement within ±1 was also assessed for numeric items. Agreement was measured using simple percentage agreement, Light’s kappa, and Krippendorff’s alpha; Bland–Altman analysis was used for numeric count items. Results: LLM 1 achieved a higher overall exact-match agreement than LLM 2 (0.659 vs. 0.539). Both models performed better on categorical than numeric items (0.713 vs. 0.610 and 0.651 vs. 0.445, respectively). LLM 1 showed the greatest advantages for gaps, knots, oblique stitches, and wide bites. Krippendorff’s alpha was positive for most endpoints with LLM 1, whereas LLM 2 showed negative values throughout. Allowing a ±1 tolerance for numeric items greatly improved agreement, suggesting only minor counting discrepancies, from 0.610 to 0.900 for LLM 1 and from 0.445 to 0.826 for LLM 2. Conclusions: Under a constrained scoring workflow, LLMs partially approximated intraluminal microsurgical end-product scoring. LLM 1 outperformed LLM 2, but agreement remained insufficient to replace the expert assessment entirely. These models can be assistive tools within a human-in-the-loop framework.

Background/Objectives: Mesenchymal stem cells (MSCs), due to their regenerative and multipotent properties, have emerged as promising therapeutic agents in tissue repair and regeneration. These biological characteristics might contribute to optimized anastomotic healing and to a reduction in postoperative complications following digestive surgery. The present study aimed to evaluate whether intraperitoneal or perianastomotic administration of MSCs provides superior healing outcomes in colonic anastomoses in Wistar rats. Methods: MSCs were isolated from inguinal adipose tissue harvested from 2 Wistar rats. Thirty male Wistar rats were allocated to 3 groups: (i) the control group, with regular anastomosis, (ii) peri-anastomotic injection of MSCs, and (iii) intraperitoneal injection of MSCs. The animals were sacrificed on postoperative day 14. The evaluated outcomes included clinical evolution, adhesion index, histological characteristics, and tissue hydroxyproline content. Results: The incidence of anastomotic leakage and the mortality rate were 0%. Therefore, the present study primarily demonstrates changes in surrogate markers of healing, including inflammatory response, collagen deposition, adhesion formation, and hydroxyproline content. The adhesion index was similar in the groups receiving MSC administration (p = 0.05); however, intraperitoneal administration demonstrated superior outcomes when compared to standard anastomosis in reducing adhesion formation (p = 0.002). Histopathological analysis showed a decreased inflammatory process and an increased collagen deposition at the anastomotic site following MSC administration (p < 0.05). Moreover, tissue hydroxyproline levels were significantly increased after both perianastomotic (0.831 ± 0.02, p < 0.05) and intraperitoneal (0.54 ± 0.02, p < 0.05) MSC administration compared with the control group (0.251 ± 0.006). Conclusions: These results suggest that MSC administration may improve histological and biochemical markers associated with colonic anastomotic healing in a non-ischemic experimental model. The experimental model used is suitable for further studies aimed at determining the optimal indications, routes of administration, and adjunctive agents that may potentiate the effects of MSCs.