Suture tissue adhesives

The extent to which these new tissue adhesives and hemostats will influence surgical procedures can be seen in the following analogy. An effective carpenter cannot create a masterpiece without a saw to cut wood, nails to ensure local fixation of separate pieces of wood, and glue to cause broad surface apposition between wood surfaces. Similarly, the surgeon presently uses a scalpel to cut and divide tissues as well as a suture to create local fixation of tissues, but until... 

Quinn, J., Drzewiecki, A., Li, M., Stiell, I., Sutcliffe, T., Elmsiie, T. and Wood, W., A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations. Ann. Emerg. Med., 22, 1130-1135 (1993). 

Tissue adhesives are generally applied to simple lacerations where they give similar cosmetic results to suturing. It is essential that the wound edges are accurately apposed to ensure that no adhesive passes between them. There have been no reports of carcinogenicity or toxicity when they are used topically. They should not be used over joints as repetitive movement will cause the adhesive to peel off. 

In the past few decades, tiiere has been a great deal of interest in using tissue adhesives in many surgical procedures in favor of sutures and staples for a variety of reasons, including ... 

Using an incisional rat skin wound model, performance of absorbable tissue adhesives was compared against (1) sutures and staples and (2) a commercial, nonabsorbable tissue adhesive. 

This tissue adhesive may be used as a stand-alone closure method or in conjunction with sutures or staples. 

Development of absorbable cyanoacrylate tissue adhesives with comparable or superior properties to their clinically accepted, nonabsorbable coxmter-parts, presents a milestone in sutureless woxmd repair. As was the case in the suture area, the absorbable tissue adhesives are expected to replace their non-absorbable coxmterparts in their most important topical applications. Moreover, the absorbable tissue adhesives, and not the non-absorbable ones, are expected to be used for infernal wound repairs. This is provided thaf a practical sterilization method is developed to achieve product sterility. 

Cyanoacrylates are regarded as devices and are used in tissue adhesives to minimize the need for sutures and staples. Varying cyanoacrylates have varying toxicity profiles according to tiieir compositions and use. In the application of adhesives and other devices, where free monomer is present, the monomer is toxic. - The degradation products of some of these materials have also been formd to be toxic. 

Adhesive material can be used as sealant for minor dural defects while large dural defects require patches. In the case of minor dural defects, sutures or adhesives are used as dural sealants. However, suture alone are quick but do not provide adequate sealing of approximated tissue. The implantation of neural prosthetic devices such as deep brain stimulators and penetrating cortical electrodes for motor and... 

Cyanoacrylate adhesives n. alkyl -2-cyano-crylates polymerize rapidly via anionic initiation in the presence of weak bases (water, alcohol) at ambient temperatures highly exothermic reaction yielding brittle polymers very useful for quickly setting anaerobic adhesives also useful for suture less topical tissue adhesives (e.g.. Derma-bond ) and industrial grades are commonly known as super glue . 

Abstract Biotextile sterilization presents unique challenges. The chapter describes the principles of sterilization and the way in which sterility assurance levels are defined and demonstrated.Traditional thermal, chemical and radiation sterilization methods are described, as well as newer methods such as plasma and microwave sterilization, and applications for which each is suitable. The advantages of the emerging technology of radiochemical sterilization are described, together with some of its successful applications, such as surgical sutures and tissue adhesive and the results of recent comparative studies of radiochemical and other sterilization methods for absorbable materials. Projected future trends in sterilization technology are also outlined. 

Ideally, a knot should not only be secure but also small. One way to achieve this objective is to couple the energy from an auxiliary source with the restraint obtained from the mechanical interlacing of a small knot. In limited work involving thermal energy from a CO2 laser or chemical energy from a cyanoacrylate tissue adhesive, it has been shown that the KHF of a small (two- or three-throw) knot could be enhanced. While benefits were noted in most materials, in some they tended to be optimum. As knot security and strength continue to be very important parameters in sutures, further work using techniques such as these should be pursued. 

Aukerman, D.F., SebastianelU, W.J., Nashelsky, J., 2005. Clinical inquiries. How does tissue adhesive compare with suturing for superficial lacerations J. Fam. Pract. 54, 378. 

Appiications adhesives, coatings, foams, laminates, medical (bone fixation devices, cardiovascular, drug delivery, orthopedics, plastic surgery, sutures, tissue engineering) ... 

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