PuraStat synthetic peptide hydrogel improved re-epithelialization and reduced wound size by 33% after endoscopic resections in a randomized pig study, with no adverse events.
33% wound size reductionPuraStat-treated endoscopic resection sites showed significantly smaller wounds at 8 days compared to saline controls in a randomized pig study (p=0.001)
What the researchers found
Across 84 lesions in 21 pigs, PuraStat-treated wounds showed significantly greater re-epithelialization-to-defect ratios versus controls (p = 0.03), particularly after EMR. Endoscopic measurements showed 33% mean wound size reduction in the PuraStat group (p = 0.001). Histopathological analysis of defect area reduction approached but did not reach significance (p = 0.055). No adverse events were observed. The effect was more pronounced in EMR-induced lesions than ESD-induced lesions.
Why it matters
Endoscopic resection of GI tumors is increasingly common, but post-procedural bleeding and poor wound healing remain significant complications, sometimes requiring repeat procedures or hospitalization. PuraStat is already CE-marked and used clinically for hemostasis during endoscopy. This study suggests an expanded role — not just stopping bleeding, but actively promoting wound healing — which could improve patient outcomes and reduce healthcare costs associated with post-procedural complications.
How the study worked
Prospective, randomized, evaluator-blinded preclinical study in 21 pigs. Each animal underwent 2 EMR and 2 ESD procedures in the esophagus and stomach (84 total lesions). Lesions were randomized to PuraStat or saline application. Healing was evaluated at 8 days via follow-up endoscopy, gross pathology, and histopathological analysis. Primary endpoint was re-epithelialization-to-defect ratio.
What this study cannot tell us
This is an animal study in healthy pig tissue, which may not represent healing dynamics in diseased human tissue (e.g., tissue with prior radiation or chronic inflammation). The 8-day follow-up is short and doesn't capture complete healing. Endoscopic wound measurements have an estimated ±10% error margin. The histopathological difference between groups approached but did not reach statistical significance (p=0.055). The study was not powered for clinical outcomes like bleeding rates or stricture formation.
How to read the evidence
This is a well-designed randomized, evaluator-blinded preclinical study in a relevant large animal model. While the porcine GI tract is considered a good model for human endoscopic procedures, translation to human clinical outcomes requires clinical trials.
When this study was published
Published in 2026, this study expands the evidence for PuraStat beyond its established hemostatic use, exploring a new wound-healing indication that is directly relevant to current endoscopic practice.
The bigger picture
Self-assembling peptide hydrogels represent a versatile class of biomaterials finding applications across medicine. PuraStat (based on RADA16 peptide) was originally developed for hemostasis, but its scaffold-like properties also create an environment conducive to cell migration and tissue repair. This dual functionality — stopping bleeding AND promoting healing — exemplifies how peptide-based biomaterials can provide multiple therapeutic benefits from a single application, a concept increasingly relevant in minimally invasive surgery.
Questions still open
- Would PuraStat show the same wound-healing benefit in human patients with diseased tissue after tumor removal?
- Does the accelerated re-epithelialization translate into fewer delayed bleeding events or strictures in clinical practice?
- Why was the healing benefit more pronounced after EMR than ESD — is it related to wound depth?
Common questions
What is PuraStat and how does it work?
Why is wound healing after endoscopic tumor removal important?
Read the original research
Potential role of a synthetic peptide hydrogel in accelerating mucosal defect healing: evidence from a porcine model.
Surgical endoscopy, 40(2), 1549-1558
Citation
Tachecí, Ilja; Šembera, Štěpán; Zimandlová, Dana; Morávková, Paula; Vejvalková, Kateřina Geisler; Radochová, Věra; Ryška, Aleš; Cyrany, Jiří. (2026). Potential role of a synthetic peptide hydrogel in accelerating mucosal defect healing: evidence from a porcine model.. Surgical endoscopy, 40(2), 1549-1558. https://doi.org/10.1007/s00464-025-12374-0