Exploration of a new method of a biopatch based on the central concept of the multi-layer repair

Abstract

This letter discusses the findings of Pang et al retrospective study on omental patch repair as a balanced treatment for gastric ulcer perforation. We acknowledge its clinical value while highlighting a critical limitation: Conventional mechanical closure often results in fibrotic scarring and functional impairment across the mucosal, muscular, and neurovascular layers. To address this, we propose the innovative concept of “multi-layer repair” and present a proof-of-concept three-dimensional bioprinted functional biopatch. This patch features a multilayer structure: An inner layer laden with gastric mucosal organoids and an outer layer containing primary gastric muscle cells, both integrated onto a wet-adhesive electrospun membrane. Preliminary animal studies have yielded encouraging results, supporting its potential to promote functional restoration beyond mechanical sealing.

Keywords: Gastric perforation; Omental patch; Surgery; Biopatch; Hydrogel

Core Tip: We propose a novel “multi-layer repair” concept addressing the limitations of traditional omental patch repair for gastric ulcer perforation. Utilizing three-dimensional bioprinting technology, we engineered a biologically functional patch that recapitulates native gastric layering: An inner mucosal organoid-containing region and an outer smooth muscle cell layer. Preliminary results from animal studies indicated that this approach, which aimed to restore physiological structural-functional coupling of the stomach, appears to facilitate a repair that extends beyond mere mechanical closure, showing promise for achieving true anatomical and functional recovery.