Sutureless full-thickness skin grafting using a dual drug-in-bioadhesive coacervate

Conventional skin grafting procedures such as suturing and stapling are accompanied by pathologic scarring with functional and psychological sequelae; severe scars need a prolonged recovery period, increasing the chance of wound infections or graft contraction. The present study develops a novel bioadhesive delivering dual drugs to minimize scar formation and accelerate wound healing during full-thickness skin grafting. The bioadhesive is prepared via coacervation of a mussel protein and shows high adhesive strength in both porcine skin and in vivo rodent models; furthermore, it sustainably releases dual drugs (allantoin and epithelial growth factor) to enhance re-epithelialization and collagen deposition while simultaneously reducing scar formation. The proposed dual-drug-in-bioadhesive coacervate may ideally meet the requirements of the wound healing process and is a promising candidate for sutureless full-thickness skin grafting.