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At least 37 records · Page 2Linked to original sources

PubMed1989

Oligomers with pendant isocyanate groups as tissue adhesives: II. Adhesion to bone and other tissues.

The adhesive properties of a series of oligomers prepared from 2-isocyanatoethyl methacrylates (IEM) and/or m-isopropenyl-alpha,alpha-dimethylbenzyl isocyanate (TMI) and various acrylates or methacrylates were studied. The bond strength of bone, dentin, or soft tissue specimens joined with these oligomers respectively to bone, dental composite restorative, or denture base resin were determined by tensile adhesion or shear tests. These oligomers are more effective in forming stronger bonds to bone than are other tissue adhesives. Fracture occurs cohesively, usually within the bone. Thermocycling in water for 1 week between 5 degrees C and 55 degrees C did not decrease adhesion indicating that exposure to water or thermal shock produced no deterioration of the bond. Tensile adhesion of bovine or human dentin joined to composite restorative resin by means of the oligomers is similar to that of the best dental bonding agents such as Gluma (glutaraldehyde and 2-hydroxyethyl methacrylate) or ferric oxalate + N-phenylglycine + dimethylacryloxyethyl-pyromellitate. These oligomers also strongly bond soft tissues and calfskin and to acrylic resins and composites.

Biopolymers↗

PubMed1998

Tissue adhesives in cardiovascular surgery.

Tissue adhesives are increasingly being used in cardiovascular surgery as adjuncts to obtain more rapid hemostasis, as tissue reinforcing agents, as carriers for prolonged local release of antibiotics, to spatially fix long saphenous vein grafts that could otherwise possibly kink, and to promote endothelialization of prosthetic graft surfaces. The available tissue adhesives, their current indications for use, and possible future trends are discussed.

Blood Banks↗

PubMed1980

[Use of tissue adhesives in the reconstruction of the frontal sinus].

Fractures of the anterior wall of the frontal sinus, complicated by impression of bone fragments, can cause serious functional and cosmetic disturbances. Surgeons often remove those fragments and obliterate the sinus. But disfigurement from the operation will be worse than that caused by original lesion and can only be corrected by further plastic surgery. Some surgeons use the technique of joining bone fragments by metal or thread sutures but it is only possible when the fragment are not too small. We present four patients treated over a period of 1975-1979 with the reconstruction of the frontal sinus from its fragments using cyanoacrylic tissue adhesive (Chirurcoll-Polfa). One patient was operated immediately after an accident, two patients one month after a trauma and another after six months. The adhesive tissue was applied in single drops directly on the edges of dry surface of bone fragments. The fragments can be joined only in some points because the tissue adhesive can not make an isolation layer between them. The tissue adhesive speeds up the processes of ossification. We observed no interference with wound healing, no detrimental effect of this method in the postoperative course and no pathologic local and general reactions. The adhesive tissue makes manipulation in the operative field easier. The functional and esthetic results were satisfactory and further corrective surgery was not necessary.

Adult↗

PubMedDate not supplied

[Costs and benefits of the use of tissue adhesives in wounds in children].

Costs and benefits of the repair in Emergency Room of skin lacerations by tissue adhesive in children are reported. In 1987-88 2150 children under 16 were referred to our Institute because of lacerations. About one of three of them needed repair by subcutaneous suture; in the others, sutures or sterile stripes or adhesive tissue could be employed. Adhesive tissue use increased significantly during 1988 because of its advantages: no need of local anesthesia, syringes, sterile suture instruments and dressing materials; no further dressing; no suffering of children during the treatment; good aesthetic results. Now it is the first choice treatment of the lacerations in which subcutaneous suture is not necessary. Moreover this technique is cheap, and reduced significantly 1988 costs for laceration repair in our department.

Adolescent↗

PubMed2001

Fibrin sealant: clinical use and the development of the University of Virginia Tissue Adhesive Center.

The utilization of fibrin sealants to augment hemostasis, seal tissues, and facilitate targeted delivery of drugs is increasing. In 1985, a hospital-based program was established to provide autologous and allogeneic cryoprecipitate that serves as a fibrin sealant when combined with bovine thrombin. To date, more than 4,000 patients have been treated with this product at our institution, with an efficacy rate greater than 90%. Collaboration among surgical services and the blood bank fostered multispecialty expertise with this product that led, in 1997, to the establishment of the University of Virginia Tissue Adhesive Center. The Tissue Adhesive Center is a multidisciplinary center whose physician director and nursing and administrative support staff facilitate basic research, laboratory investigation, and preclinical and clinical trials with collaborators throughout the university. The Tissue Adhesive Center also provides educational programs and clinical consultation, and tracks and participates in peer review of sealant use. The licensure of a commercially produced, virally inactivated, pooled-plasma fibrin sealant in May 1998 provided an alternative source of adhesive. Utilization of the commercial product surpassed use of the blood bank product in April 1999. At present, use of the commercial product is approximately 3 times that of the blood bank-produced sealant. This report reviews the clinical uses of fibrin sealant, its regulatory history, the production of fibrin sealants, the evolution of a blood bank fibrin sealant program, the development of the Tissue Adhesive Center, and the utilization of commercial and blood bank-produced sealant at our university hospital.

Education, Medical, Continuing↗

PubMed2003

Clinical experience with N-butyl cyanoacrylate tissue adhesive in fungal keratitis.

PURPOSE: To evaluate the role of tissue adhesive in the management of corneal thinning or perforation associated with active fungal keratitis. DESIGN: Retrospective noncomparative interventional case series. METHODS: Seventy-three eyes of 73 patients with microbiologically proven keratomycosis associated with thinning or perforation participated in the study. N-Butyl cyanoacrylate tissue adhesive (medical grade) and bandage contact lens were applied in addition to topical and systemic antifungal therapy. Our outcome measures included resolution of the infiltrate and preservation of the structural integrity of the globe. RESULTS: Outcome data were available for 66 eyes. The infiltrate resolved with scar formation in 42 (63.6%) eyes. In an additional eight (12.1%) eyes, tissue adhesive maintained the structural integrity of the globe while the patients awaited penetrating keratoplasty. Sixteen (24.2%) eyes showed progressive worsening or persistence of the infiltrate after application of tissue adhesive. Twenty-five (37.8%) eyes required multiple applications of tissue adhesive. The outcome was better in cases where the infiltrate measured less than 30 mm2 at the time of presentation and application of tissue adhesive (P < 0.01). CONCLUSION: In view of the poor outcome of penetrating keratoplasty in active fungal keratitis, N-butyl cyanoacrylate tissue adhesive is a useful modality for the management of progressive thinning or perforation associated with active fungal keratitis. However, close observation is mandatory to assess the progression of disease.

Antifungal Agents↗

PubMed2000

Ossicular chain reconstruction using a new tissue adhesive.

HYPOTHESIS: A new medical-grade cyanoacrylate tissue adhesive will improve the results of ossicular chain reconstruction in a rat model. BACKGROUND: An ideal tissue adhesive has long been awaited by otologists. Studies examining the older cyanoacrylates have demonstrated variable efficacy and toxicity. Octylcyanoacrylate is a new tissue adhesive that has many ideal properties for otologic surgery. METHODS: Thirteen female C-D rats were anesthetized, and preoperative auditory brainstem response (ABR) testing was performed. A left antrotomy was performed, and the incus was removed. In the adhesive group, the incus was dipped in octylcyanoacrylate and interposed between the tympanic membrane and the stapes; no adhesive was used in the control group. At 8 weeks, postoperative ABR was performed, the integrity of the ossicular chain inspected, and histopathologic analysis of the temporal bones performed. Statistical comparison of ABR results was performed with the Mann-Whitney test. RESULTS: Seven rats were randomized to the adhesive group and six to the control group, of which four survived. There were no histopathologic differences in the temporal bones of the animals other than the presence of mild foreign body reaction around the ossicular chain of the animals in the adhesive group. The ossicular chain was not intact in two of the four controls, whereas the rest were intact at 8 weeks. Postoperative air conduction ABR results (mean dB sound pressure level) (62.5 control versus 34.3 adhesive, p = 0.010) and air-bone gaps (47.5 control versus 18.9 adhesive, p = 0.008) were significantly better in the adhesive group. CONCLUSIONS: This new medical-grade tissue adhesive improves the hearing results of ossicular chain reconstruction, with no apparent histotoxicity in this animal model.

Animals↗

PubMed2005

The effect of autologous fibrin tissue adhesive on postoperative cerebrospinal fluid leak in spinal cord surgery: a randomized controlled trial.

STUDY DESIGN: A prospective randomized study evaluating the efficacy of autologous fibrin tissue adhesive for decreasing postoperative cerebrospinal fluid (CSF) leak in spinal cord surgery. OBJECTIVE: To compare postoperative CSF leak in 3 groups (i.e., autologous fibrin tissue adhesive used, commercial fibrin glue used, and no fibrin tissue adhesive used) of patients undergoing spinal surgery who needed dural incision. SUMMARY OF BACKGROUND DATA: Spinal cord operations, particularly when dural incision is inevitable, sometimes involve postoperative CSF leak. Because CSF leak is a serious complication, countermeasure is necessary to prevent it after dural suture. Commercial fibrin tissue adhesive was formerly used. Because the possibility of prion infection was widely noticed, commercial fibrin tissue adhesive containing animal components has been used less often. METHODS: In 13 of 39 cases in which dural incision would be made, 400 mL whole blood was drawn, and autologous fibrin tissue adhesive was made of plasma. Cases were divided into 3 groups: (1) dural closure alone, (2) use of autologous fibrin tissue adhesive after dural closure, and (3) use of commercial fibrin tissue adhesive after dural closure. The primary outcome measure was determined as postoperative (3 days) volume of drainage fluid, and results were analyzed using the analysis of variance. The secondary outcome measure was general blood test, coagulation assay, and plasma fibrinogen, and these were analyzed also using the analysis of variance. RESULTS: There was a significant difference in the primary outcome between the autologous and control groups. No complications such as infection or continuous CSF leak were observed in any case. The mean volume of drainage fluid was 586.2 mL in the group with autologous fibrin tissue adhesive and 1026.1 mL in the group without fibrin tissue adhesive. The volume of drainage fluid was significantly lower in the former group than that in the latter group. There was no statistical difference between the volumes of the group with autologous adhesive and with commercial adhesive (639.2 mL). CONCLUSIONS: We used autologous fibrin tissue adhesive as a new sealant after dural closure instead of commercial fibrin tissue adhesive. No definitive CSF leak was observed, and the volume of drainage fluid was significantly lower in the group with autologous fibrin tissue adhesive than that in the group without fibrin tissue adhesive. The use of autologous fibrin tissue adhesive was superior to that of commercial fibrin tissue adhesive in cost.

Adult↗

PubMed2004

Tissue adhesives for closure of surgical incisions.

BACKGROUND: Sutures, staples and adhesive tapes are the traditional methods of wound closure, whilst tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables meticulous closure, but sutures may induce tissue reactivity and they usually require removal. Tissue adhesives offer the advantages there are no sutures to remove later for the patient and no risk of needlestick injury to the surgeon. Tissue adhesives have been used primarily in emergency rooms but this review looks at the use of tissue adhesives in the operating room where surgeons are increasingly using these for the closure of surgical skin incisions. OBJECTIVES: To determine the relative effects of various tissue adhesives and conventional skin closure techniques on the healing of surgical wounds. SEARCH STRATEGY: The Cochrane Wounds Group Specialised Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Bibliographies of review articles were checked for studies outside the handsearched journals and wound care product manufacturers were contacted. SELECTION CRITERIA: Randomised controlled clinical trials only. DATA COLLECTION AND ANALYSIS: Screening of eligible studies and data extraction was conducted independently and in triplicate whilst assessment of the methodological quality of the trials was conducted independently and in duplicate. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk with 95% confidence intervals for dichotomous outcomes. Heterogeneity was investigated including both clinical and methodological factors. MAIN RESULTS: Eight RCTs were included (630 patients). No statistically significant differences were found between various tissue adhesives and sutures (8 trials) for dehiscence, infection, satisfaction with cosmetic appearance when assessed by patients' or surgeons' general satisfaction. Nor were differences found between a tissue adhesive and tapes (2 trials) for infection, patients' assessment of cosmetic appearance, patient satisfaction or surgeon satisfaction. However a statistically significant difference was found for surgeons' assessment of cosmetic appearance with mean difference 13 (95%CI 5 to 21), the higher mean rating for the tissue adhesive group. REVIEWERS' CONCLUSIONS: Surgeons may consider the use of tissue adhesives as an alternative to sutures or adhesive tape for the closure of incisions in the operating room. There is a need for trials in all areas but in particular to include patients that require incision closure in areas of high tension and patients of general health that may impair wound healing.

Bandages↗

PubMed1995

Comparison of tensile strength of cyanoacrylate tissue adhesive closure of lacerations versus suture closure.

STUDY OBJECTIVE: To compare the tensile strength of lacerations closed with cyanoacrylate tissue adhesive, with suture, and with a combination of tissue adhesive and suture. DESIGN: Randomized, controlled animal model study. SETTING: Animal care facility. PARTICIPANTS: Sixteen albino guinea pigs. INTERVENTIONS: Four incisions to deep fascia were created on the dorsum of each animal. Lacerations were closed with either tissue adhesive alone, tissue adhesive with subcutaneous suture, percutaneous suture alone, or percutaneous suture with subcutaneous suture. After 4 days, the breaking strengths of all wound closures were measured. RESULTS: Wound closures made with cyanoacrylate tissue adhesive alone exhibited significantly less tensile strength at 4 days than closures made by the other three methods. Wound closures made with combined percutaneous and subcutaneous sutures were significantly stronger than all other groups. CONCLUSION: Wound closures made with cyanoacrylate tissue adhesive alone have less tensile strength at 4 days than those made with tissue adhesive and subcutaneous suture or those closed by traditional suture methods.

Animals↗

PubMed1986

Extended experimental and preliminary surgical findings with autologous fibrin tissue adhesive made from patients own blood.

A surgical tissue adhesive can be made from the patient's own blood. We have been refining the procedures for manufacturing autologous fibrin tissue adhesive to facilitate its use in the operating room and to increase its bonding strength. Fibrin tissue adhesive efficacy depends on fibrinogen concentration. We found that fibrinogen precipitation using the ammonium sulfate method produced the highest concentration. Bonding power was compared with that of the commercial glue 10 minutes and 30 minutes after glueing two pieces of 1 X 1 cm2 human dura together. Bonding strength of the autologous product was close to that of the commercial product. Comparisons of fibrinolysis inhibition time of autologous fibrin tissue adhesive and commercial glue in experiments on rats over a period of one hour to six days after subcutaneous injection are described.

Aminocaproates↗

PubMed2004

Tailoring lactide/caprolactone co-oligomers as tissue adhesives.

This article introduces novel biocompatible tissue adhesives that do not involve any chemical or biochemical reactions, during their application in vivo. The use of these new adhesives is based exclusively on their temperature-dependent rheological properties. Since biocompatibility and biodegradability are additional crucial attributes of tissue adhesives, the polymers were tailored so that they as well as their degradation products are non-toxic. Branched oligomers consisting of a core molecule and biodegradable chains bound to it were synthesized and the relationship between their composition and their adhesive properties under in vitro conditions, was investigated. The oligomers comprised trimethylolpropane as the trifunctional central molecule, while lactoyl and caprolactone units formed the biodegradable segments. Oligomers with glass transition temperatures in the 20-25 degrees C range, were found to perform better. A strong connection was found between the length of the PLA blocks, the glass transition temperature (T(g)) of the different materials and their Adhesive Failure Strength (AFS) at 37 degrees C. The remarkable flexibilizing effect of the caprolactone units incorporated along the PLA blocks, allowed to generate longer biodegradable chains and to improve, therefore, the adhesive strength of the oligomers, while keeping their T(g) within the appropriate temperature interval. The TMP(LA(16)-CL(2)-LA(16)-CL(2)-LA(16))(3) oligomer attained especially high AFS values under in vitro conditions.

Biocompatible Materials↗

PubMed1999

Role of autologous fibrin tissue adhesive in abdominal surgery.

Fibrin tissue adhesive (FTA) is an agent developed for achieving better hemostasis and adhesion of living tissue. FTA appears to have no tissue toxicity, promotes a firm seal in seconds to minutes, is reabsorbed in days to weeks following application, and appears to promote local tissue growth and repair. It can be used in various surgical procedures. It has been used preoperatively, perioperatively and postoperatively in abdominal surgical procedures. There were no side effects. Improvement of surgical hemostasis was obvious in all patients. Anastomotic leakages were closed in a shorter time without surgical intervention. Sero-lymphatic drainage after surgical procedures that include extensive lymph node dissections was less. Use of FTA in treatment of fistula in ano was successful. The data would indicate that use of FTA may be a good alternative in solving various conditions in every day clinical practice, although a bigger randomized series, and longer follow up is needed.

Abdomen↗

PubMed1994

Surgical tissue adhesives in otolaryngology-head and neck surgery.

The primary surgical tissue adhesives used in otolaryngology-head and neck surgery include the cyanoacrylate derivatives and the fibrin tissue adhesives. The cyanoacrylate derivatives are effective for superficial skin closure. Use of this material below the level of the skin can result in acute and chronic inflammation and tissue necrosis. Fibrin tissue adhesives can be used for wound closure, tissue sealing, and hemostasis. Drawbacks noted with the fibrin tissue adhesives include method of preparation, relatively low binding strength, and variable resorption time. This article discusses the properties, methods of preparation, and clinical indications of the cyanoacrylate derivatives and fibrin tissue adhesives.

Cyanoacrylates↗

PubMed2005

Fibrin sealant tissue adhesive--review and update.

The field of surgical tissue adhesives is rapidly developing, with multiple products now available. Fibrin sealant, the first widely available tissue adhesive, continues to be used in traditional as well as in new and creative ways. The product is now fully mature as a hemostatic agent in cardiac, liver, and spleen surgery. It is also useful as a sealant in a variety of clinical applications, including procedures such as colonic anastomosis, as well as in seroma prevention following soft tissue dissection. Newer uses such as reduced suture vascular and intestinal anastomosis, fistula closure, surgery in patients with hemophilia, and laparoscopic/endoscopic procedures are being studied in both laboratory and clinical settings. The most recent additions to the capabilities of fibrin sealant include the use of this tissue adhesive as a slow-release drug delivery system and as a substrate for cellular growth and tissue engineering. This article will review the basis of fibrin sealant effectiveness and will also cover the recent developments in the rapidly evolving employment of this material.

Algorithms↗

PubMed1985

Autologous fibrin tissue adhesive.

Various methods of making fibrin tissue adhesive from a patient's own blood were evaluated. The method using ammonium sulfate for fibrinogen preparation produced the greatest bonding strength. The average bonding strength of the commercially manufactured adhesive and of the autologous fibrin tissue adhesive were compared at 10 minutes and 30 minutes after glueing together 1 X 1 cm samples of fresh human dura. Results indicate the commercial glue holding 57 gms/cm2 at 10 minutes and 123 gms/cm2 at 30 minutes, while autologous glue prepared with the "ammonium sulfate method" has a bonding strength of 41 gms/cm2 at 10 minutes and 217 gms/cm2 at 30 minutes.

Ammonium Sulfate↗

PubMed2005

Clinical inquiries. How does tissue adhesive compare with suturing for superficial lacerations?

Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection and dehiscence, may be lower with tissue adhesives. Wound closure of superficial lacerations by tissue adhesives is quicker and less painful compared with conventional suturing (strength of recommendation: A, systematic reviews of randomized trials).

Humans↗

PubMedDate not supplied

Newly designed tissue adhesion prevention technology based on photocurable mucopolysaccharides. In vivo evaluation.

Tissue adhesion after surgery occasionally causes serious complications. The authors have been developing photocurable mucopolysaccharides for a tissue adhesion prevention material that meets requirements such as nonadherent surface characteristics, biocompatibility, biodegradability in accordance with the wound healing rate, and nontoxicity. Mucopolysaccharides (hyaluronic acid and chondroitin sulfate) partially derived with photoreactive groups, such as cinnamate or thymine, were subjected to ultraviolet (UV) irradiation to produce water insoluble gels via intermolecular photodimerization of photoreactive groups. Photocured films that covered injured liver surfaces of rats were implanted for as long as 4 weeks and histologically evaluated. In vivo performance, including tissue adhesion prevention, biodegradability, and mechanical flexibility of the films, was found to be controlled by the type of mucopolysaccharides, the type of photoreactive groups, and their degrees of substitution (DS). Photocured films with lower DS, which had high water swellability and flexibility, prevented tissue adhesion and exhibited enhanced biodegradability. As an increase in DS occurred, tissue adhesion prevention, biodegradability, and mechanical flexibility were reduced. Control of the biodegradation rate was feasible. Minimum inflammatory reaction was noticed.

Animals↗