Although cyanoacrylates are known for their high adhesive strength and fast curing time (they polymerize in seconds at room temperature), 19 potential risks for infection, cytotoxicity and tissue necrosis have been reported when they are used for internal applications. 9, 18Ĭyanoacrylate and various polymer hydrogels represent the synthetic adhesives and sealants that have been proposed to make up for the weak mechanical strength of biologically derived glues. 9 Because most fibrin and matrix-protein-based products are derived from animal and human tissues, they are more expensive and have limited availability compared with synthetics such as cyanoacrylates adhesives. 17 Moreover, because biologically derived glues exhibit limited tensile and adhesion strengths when used as adhesive or sealant, they are commonly used in conjunction with sutures. 16 Although these biologically derived products are beneficial because of their good biodegradability, they involve risks of possible viral transmission and hypersensitive reactions. 15 Fibrin glue has been shown to significantly decrease operating time and recurrence rate with no difference in complication rate compared with suture treatments. Fibrin glues are the only material available in the United States that is approved by the Food and Drug Administration (FDA) for indications in adhesive, sealant, and hemostat. The two main types of biologically derived tissue adhesives and sealants are fibrin glue and matrix protein adhesives, which are effective in many applications, including graft attachment, colon, vascular and lung sealing, and as hemostatic agents in all surgery applications. Biologically derived adhesives and sealants Moreover, staples have been shown to create a greater risk of developing infections and a higher failure rate compared with sutures. Although staples are an alternative to sutures for a faster application, they also cause damage to the surrounding tissue. 12 In many situations, sutures are time-consuming for long or multiple lacerations. 9 Incorrect suture positioning or tightness might lead to the development of fibrous scar tissue caused by epidermal ingrowth along the suture track 11 or loss of tensile strength before the intended degradation time of the suture. In addition, the accuracy of positioning may be compromised when working in tight areas during laparoscopic and robotic surgeries. 1 One of the main issues sutures present is traumatic punctures to surrounding tissue from the needle, which is especially detrimental for vital organs such as liver or lung, where stopping leaks of blood and air by suturing is difficult. However, surgeons predominantly choose sutures because of their great tensile strength and low failure rate despite the many shortcomings. Currently, there is not a universal solution for every type of wound because each treatment option has its individual advantages and limitations.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |