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PubMed1995

Autologous fibrin tissue adhesive in endoscopic sinus surgery.

Endoscopic sinus surgery may be complicated by bleeding, formation of synechia, and infection. This study investigated the application of autologous fibrin tissue adhesive during endoscopic sinus surgery in an attempt to avoid packing, to decrease complications, and to improve healing. Fibrin tissue adhesive from pooled human blood is a hemostatic and bacteriostatic agent. Autologous fibrin tissue adhesive avoids the potential infectious and immunologic risks of the pooled blood product. Twelve patients undergoing bilateral endoscopic sinus surgery participated in the study. Phlebotomy and preparation of the adhesive were performed during the procedure. Fibrin tissue adhesive was applied to only one side, with the contralateral side used as a control. Bacitracin ointment was applied to the adhesive-treated side, and packing coated with bacitracin was placed on the contralateral side. Patients were observed for a minimum of 3 months, and results were documented with photographic and video recordings. A uniformly high degree of patient satisfaction was achieved because of the elimination of packing and a sensation of increased nasal airway patency on the fibrin-treated side. Fibrin tissue adhesive provided hemostasis, decreased crusting, accelerated mucosal healing, and diminished synechia. Autologous fibrin tissue adhesive is beneficial in endoscopic sinus surgery, and its application should be considered, especially when the risk of hemorrhage or synechia is increased.

Adult↗

PubMed2002

Cyanoacrylate tissue adhesive for treatment of refractory corneal ulceration.

Isobutyl cyanoacrylate tissue adhesive (BCTA) was used in the treatment of refractory superficial corneal ulcers in 17 dogs, one cat, and one rabbit, present 2 weeks to 7 months (mean 6.8 weeks +/- 6.1) prior to referral. Little to no sedation was required in the majority of cases, with only topical anesthetic applied prior to debridement and BCTA application. The presence of the tissue adhesive caused mild discomfort for several days after application, as reported by the owners. The ulcers healed, and the tissue adhesive sloughed in approximately 3 weeks (+/- 1 week). Mild neovascularization of the cornea resolved with topical corticosteroids. The use of BCTA offers a simple, safe and noninvasive treatment for refractory corneal ulcers.

Animals↗

PubMed1988

Autologous fibrin tissue adhesive: factors influencing bonding power.

Bonding power of Autologous Fibrin Tissue Adhesive (AFTA) is directly related to its fibrinogen concentration. By increasing the ammonium sulfate concentration 100% during fibrinogen precipitation, the bonding power of two glued 1-cm2 pieces of human dura almost doubled. No relationship between blood fibrinogen level and bonding power was demonstrated. Comparing AFTA with Fibrin Sealant, the commercial fibrin tissue adhesive, shearing strength between two glued pieces of human dura with AFTA was less 10 minutes and greater 30 minutes after gluing. Gluing a TORP (Richards) to a 1-cm2 piece of human dura yielded generally somewhat greater bonding power when using Fibrin Sealant. Autologous Fibrin Tissue Adhesive provides bonding power adequate for middle-ear surgery, eliminates transmission of viral diseases and, unlike Fibrin Sealant, AFTA is available in the United States.

Ammonium Sulfate↗

PubMed2003

Novel visible-light-induced photocurable tissue adhesive composed of multiply styrene-derivatized gelatin and poly(ethylene glycol) diacrylate.

A novel photocurable tissue adhesive glue, which is composed of styrene-derivatized (styrenated) gelatin, poly(ethylene glycol) diacrylate (PEGDA), and carboxylated camphorquinone in phosphate-buffered saline (PBS), was prepared. The prototype formulation suitable for arterial repair was determined based on the gel yield, degree of swelling, tissue adhesive strength, and breaking (or burst) strength in vitro. The formulated photocurable tissue adhesive glue with an appropriate viscosity was converted to a water-swollen gel within 1 min of visible light irradiation. The tissue adhesive glue, which was coated on a rat abdominal aorta incised with a pair of scissors, was immediately converted to a swollen gel upon subsequent irradiation with visible light, and concomitantly hemostasis was completed. Histological examination showed that the produced gel was tightly adhered to the artery shortly after photoirradiation. The gel gradually degraded with time and was completely absorbed within 4 weeks after treatment. These results indicate that the photocurable glue developed here may serve as a tissue adhesive glue applicable to vascular surgery.

Animals↗

PubMedDate not supplied

Safety and efficacy of currently available fibrin tissue adhesives.

PURPOSE: The purpose of this study is to review preparation methods, bonding power, preparation time, and costs associated with currently available autologous and homologous fibrin tissue adhesive preparations. METHODS: Two autologous fibrin tissue adhesive preparations (AFTA-A and AFTA-E), a single-donor homologous preparation, and 2 multiple-donor pooled homologous fibrin tissue adhesives, Vi-Guard and Tisseel, were evaluated and compared in relation to bonding power, preparation time, cost, bicompatibility, and biodegradability. RESULTS: Vi-Guard and Tisseel showed significantly greater bonding strengths than their single-donor counterparts. AFTA-C offers the quickest preparation time. All preparations were found to be similar in biocompatibility and biodegradability in soft tissue tests. Histology showed no infection or tissue reaction from adhesive exposure in any of the preparations. CONCLUSION: The optimal choice of a fibrin tissue adhesive is determined by the particular clinical indication. Currently available fibrin tissue adhesives vary appreciably in their bonding strength, cost, level of exposure risk, and preparation methods and times. Autologous preparations, which offer optimal safety, lack the strength and availability characteristics found with the multiple-donor preparations.

Absorbable Implants↗

PubMedDate not supplied

Clinical experience with cyanoacrylate tissue adhesive.

In this paper 385 cases treated with cyanoacrylate tissue adhesive during the years 1980-1995 are studied. The indications, outcomes and complications of cyanoacrylate adhesive are investigated and the results are analysed. It is encouraging that except for three cases of ocular hypotony and two cases of microbial infection no other complications occurred. Even in desperate cases with corneal perforation greater than 3 mm and ocular infection, enucleation was avoided. The early use of a bandage contact lens, inserted just after the glue application and the coverage with topical antibiotics switched every 15 days until the removal of the glue, may explain the small incidence of infection. Our experience from the use of cyanoacrylate tissue adhesive in cases with corneal perforation greater than 3 mm is very encouraging. In these cases a running 10.0 nylon suture was used to create a reticulum over the space of the corneal perforation upon which the glue was applied. The use of cyanoacrylate tissue adhesive offers to the clinician a safe technique for healing corneal wounds that avoids tectonic penetrating keratoplasty with its associated complications.

Adolescent↗

PubMed2000

Wound glue: a comparative study of tissue adhesives.

UNLABELLED: The purpose of this study was to determine which single-use wound adhesive is the most appropriate in terms of ease of use, minimal pain on application, adequate bonding time and wound closure. The three wound adhesives audited were Indermil (n-butyl cynoacrylate), Liquiband (n-butyl cynoacrylate) and Dermabond (octylcyanoacrylate). SAMPLE AND SETTING: The study was conducted in an urban paediatric emergency department treating over 39,000 patients annually. The sample was taken from the client population presenting with lacerations requiring tissue adhesive closure, within the limitations of the study (n = 63). METHODOLOGY: A non-blinded comparative study was performed. Children presenting with an appropriate laceration were assigned to receive either Indermil, Dermabond or Liquiband. The wounds were closed following the guidelines stated by the individual manufacturers. The nurses administering the tissue adhesive were asked to complete the audit form post closure and to comment on the procedure in descriptive terms. RESULTS: Scalp wounds accounted for 79% (n = 50) of all the lacerations closed in the study. None of the glues were reported to be completely pain-free. However, the Liquiband tissue adhesive produced an average pain score of only 0.1, whereas the Dermabond tissue adhesive scored the highest at 0.97. The nurses using the tissue adhesives reported that Liquiband was the best tissue adhesive in terms of wound closure and ease of use. However, the only tissue adhesive to report a 100% success rate was Indermil. DISCUSSION AND RECOMMENDATIONS: All of the tissue adhesives examined produced satisfactory results in terms of wound closure and ease of use. However, the Liquiband tissue adhesive produced the most consistent results, scoring higher in most of the categories when compared with the other tissue adhesives.

Attitude of Health Personnel↗

PubMed1980

A critical study on the preparation and application of gelatin-resorcinol tissue adhesive crosslinked by formaldehyde.

A tissue adhesive composed of gelatin-resorcinol-formaldehyde was prepared. The factors, influencing its properties were discussed and compared with other preparation methods. Incised rat skin wounds were unified with adhesive applied between the wound edges or on the wound surface. Sutured skin wounds served as controls. After a week, the skin wounds with adhesive on their surface had a tensile strength twice as much as the sutured wounds. The granulation tissue was narrow, scarcely was inflammation reaction, no formaldehyde necrosis occurred.

Animals↗

PubMed2004

A prospective, randomized, controlled clinical trial of tissue adhesive (2-octylcyanoacrylate) versus standard wound closure in breast surgery.

BACKGROUND: Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations and incisional surgical wounds leads to cosmetic outcome comparable to conventional sutures. To date, no studies have investigated tissue adhesive in breast surgery and costs. Our aim was to compare the tissue adhesive 2-octylcyanoacrylate (OCA) with standard suture in breast surgery. METHODS: A prospective randomized study was conducted in which 151 patients were assessed for eligibility, and 133 were randomly allocated to skin closure with OCA adhesive or monofilament suture. Cosmetic outcome with blinded assessment, wound management by the patients, complication rates, and economic outcome were recorded. RESULTS: There was no difference in cosmetic score in the 2 groups, nor in complications at the early, 6-month, and 1-year follow-up. Patient satisfaction with the wound closed with OCA was rated significantly higher when compared with standard suture (P <.0001). The application of the tissue adhesive was significantly faster than that for standard suture (P <.001). In economic terms total costs were less in the tissue adhesive group, mainly due to lower postoperative costs of physician and assistant services (P <.001). CONCLUSIONS: OCA is effective and reliable in skin closure for breast surgery, yielding similar cosmetic results to standard suture. OCA is faster than standard wound closure and offers several practical advantages over suture repair for patients. Cost analysis has found that OCA adhesive can significantly decrease health care costs.

Adult↗

PubMed1986

[The efficacy of a tissue adhesive agent (BI 0.022) in urinary tract surgery--application to pyelo- and ureterolithotomy].

To evaluate the effect of a tissue adhesive agent (BI 0.022) on renal pelvic and ureteral surgery, the adhesive was applied for 44 patients with urolithiasis. The conventional suture method was performed in 87 patients as a control. The tissue adhesive is composed of fibrinogen, thrombin, factor XIII, aprotinin and CaCl2. The number of sutures for closure of the incision made on the rental pelvis and the ureter was significantly reduced by the use of the tissue adhesive (p less than 0.01). There was no tendency of increase in urinary leakage following the application of the method in comparison with the control. Furthermore, it was noteworthy that 10 in cases with less than a 1 cm ureteral incision were completely closed by the use of the adhesive agent. This tissue adhesive agent should be valuable for renal pelvic and ureteral surgery as a simple substitute for the conventional suture method.

Adult↗

PubMedDate not supplied

Tissue adhesive wound repair revisited.

The purpose of this experimental study was to compare the effect of a tissue adhesive, N-butyl-2-cyanoacrylate, on the wound's ability to resist infection and gain strength to the effect of percutaneous polypropylene suture. Percutaneous sutures damaged host defenses, inviting the growth of bacteria to a level that was significantly greater than that encountered with the tissue adhesive. Immediately after wound closure, percutaneous sutures provided a more secure closure, as measured by breaking strength, than did tissue adhesives. Seven days later, the breaking strengths of wounds closed by tissue adhesives did not differ significantly from those repaired with percutaneous sutures. Tissue adhesive closure requires less psychomotor skills than suture closure and is accomplished more rapidly than suture closure.

Animals↗

PubMed1976

Tissue adhesives: their use in urology.

Tissue adhesives have certain advantages and should be used only for nephropexy and urethropexy but not for orchiopexy. Because of possible incrustation it should be avoided in the urinary collecting system.

Cryptorchidism↗

PubMed1997

A simple, inexpensive method for precise application of cyanoacrylate tissue adhesive.

The use of cyanoacrylate tissue adhesives is well described in the literature for closure of skin wounds. The main problem with their application in my hands is that the glue tends to flow/run away from the point of application, making precise application difficult even when the supplied plastic tube is used. This problem is inherent to the low viscosity of the adhesive. I hereby describe a simple, inexpensive technique whereby a "blue" needle is fitted to the tip of the Histoacryl tube and used to apply the adhesive in a precise, fine, and predictable manner to the specific area or point required, reducing any "running" of the glue to undesired adjacent areas. A fast, simple, and elegant way of insetting a skin graft using cyanoacrylate glue is also described.

Cyanoacrylates↗

PubMed1976

Punctal occlusion with n-butyl cyanoacrylate tissue adhesive.

N-butyl cyanoacrylate tissue adhesive can be easily placed in the lid puncta to serve as a temporary method for punctal occlusion. Such a procedure is a useful therapeutic trial in borderline cases of keratoconjunctivitis sicca being considered for further permanent punctal occlusion or in patients where a temporary dry eye condition is expected to be resolved in the near future.

Adult↗

PubMed1981

[Superselective embolisation in the urogenital tract with tissue adhesives (author's transl)].

The tissue adhesive butyl-2-cyanoacrylate mixed with lipiodol and tantulum powder is an excellent agent for superselective catheter embolisation of small vessels. The mixture is low viscous and can be injected through fine catheters. Occlusion is independent of blood clotting and is permanent. A coaxial catheter technique is recommended or, in cases of difficulty, a ballon catheter can be floated in. Super-selective embolisation was used in 15 patients, in seven for the kidney in eight for the pelvis. Indications were bleeding from the kidney, partial defunctioning of the kidney, tumours in single kidneys and bleeding from carcinomas in the bladder, prostate or cervix.

Adenocarcinoma↗

PubMed2006

Modified microkeratome-assisted posterior lamellar keratoplasty using a tissue adhesive.

OBJECTIVE: To compare graft stability and astigmatic change using suture vs tissue adhesive in an experimental model of microkeratome-assisted posterior lamellar keratoplasty. METHODS: A 300-microm-thick partial flap keratectomy was performed in human donor corneoscleral rims using an artificial anterior chamber and a manual microkeratome. The flap stopped at the left central opening border, providing a wide hinge to add stability. After flap reflection, a 6.25-mm trephination was performed to obtain a disc of posterior stroma, Descemet membrane, and endothelium. The disc was positioned in a sutureless fashion, and the flap secured with either 5 interrupted sutures or a chondroitin-sulfate-aldehyde-based adhesive. Increasing intrachamber pressures were created to detect graft stability. Videokeratographic data were recorded to evaluate astigmatic change. RESULTS: The mean (SD) astigmatic change was 3.08 (0.84) diopters (D) in the sutured group and 1.13 (0.55) D in the glued group (P = .008). Mean (SD) resisted pressures were 95.68 (27.38) mm Hg and 82.45 (18.40) mm Hg in the sutured and glued groups, respectively (P = .97). CONCLUSION: This modified technique of microkeratome-assisted posterior lamellar keratoplasty showed excellent graft stability in both groups. Flaps sealed with the novel tissue adhesive had reduced astigmatic changes in our experimental model. CLINICAL RELEVANCE: Sutureless microkeratome-assisted posterior lamellar keratoplasty using tissue adhesive may become a new alternative in the surgical treatment of corneal endothelial disorders.

Aged↗

PubMed1989

Comparison between fibrin tissue adhesive, epineural suture and natural union in intratemporal facial nerve of cats.

Our objective was to study intratemporal anastomosis of the facial nerve in cats. Clinical, electrophysiological and histological results of the use of fibrin tissue adhesive, epineural suture and natural adhesion were compared. The 30 adult cats studied had undergone mastoidectomy exposure, and section of the facial nerve 1 cm before its exit from the stylomastoid foramen. Anastomosis was then undertaken, using epineural suture combined with stabilization through fibrinic tissue adhesive, and union of the stumps without stabilizing them. Each type of anastomosis was carried out in 10 animals. Clinical, electrophysiological and histological assessments of both the site of anastomosis and the ventral branch of the facial nerve followed the aforementioned procedures. By means of statistical analysis, the authors reached the following conclusions: 1) Considering the clinical assessment per se, both groups with fibrinic tissue adhesive and suture showed similar features and results, which in both cases were better than those following natural union. 2) Considering the electrophysiological results per se, the use of fibrin tissue adhesive was superior to any other method used. 3) Considering the histological examination per se, both groups with fibrin tissue adhesive and suture revealed similar features which were more favourable than those shown by natural union. 4) In the overall comparison of the various parameters in the three groups, the use of fibrin tissue adhesive achieved better results than any other method. Based on the results of this study, the authors conclude that the use of fibrin tissue adhesive has technical advantages, and that the results of this use outweigh those achieved with both epineural suture and natural union. The authors recommend this technique as the most beneficial to be resorted to, for intrapetrous anastomosis of the facial nerve.

Anastomosis, Surgical↗

PubMedDate not supplied

Mechanical properties of biomimetic tissue adhesive based on the microbial transglutaminase-catalyzed crosslinking of gelatin.

Fibrin sealants are a type of soft tissue adhesive that employs biochemical reactions from the late stages of the blood coagulation cascade. Intrinsic to these adhesives are a structural protein and a transglutaminase crosslinking enzyme. We are investigating an alternative biomimetic adhesive based on gelatin and a calcium-independent microbial transglutaminase (mTG). Rheological measurements show that mTG catalyzes the conversion of gelatin solutions into hydrogels, and gel times are on the order of minutes depending on the gelatin type and concentration. Tensile static and dynamic loading of the adhesive hydrogels in bulk form demonstrated that the Young's modulus ranged from 15 to 120 kPa, and these bulk properties were comparable to those reported for hydrogels obtained from fibrin-based sealants. Lap-shear adhesion tests of porcine tissue were performed using a newly published American Society for Testing and Materials (ASTM) standard for tissue adhesives. The gelatin-mTG adhesive bound the opposing tissues together with ultimate adhesive strengths of 12-23 kPa which were significantly higher than the strength observed for fibrin sealants. Even after failure, strands of the gelatin-mTG adhesive remained attached to both of the opposing tissues. These results suggest that gelatin-mTG adhesives may offer the benefits of fibrin sealants without the need for blood products.

Animals↗