The Use of Isobutylcyanoacrylate as a Tissue Adhesive in Abdominal Surgery

Fotiadis, C; Leventis, I; Adamis, S; Gorgoulis, Vassilis G.; Domeyer, Philip; Zografos, George; Sechas, M; Skalkeas, G

doi:10.1080/00015458.2005.11679743

Cited by 24 publications

(24 citation statements)

References 14 publications

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“…They found similar inflammatory reactions in their two groups, but noted that in both groups the animals presented adhesions in the injured area 1 week after the operation. Biondo-Simões et al [18] also reported that the group in which CyA was applied to the liver parenchyma had the highest number of adhesions, coinciding with previous findings [41,42]. …”

Section: Discussionsupporting

confidence: 77%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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Background: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. Methods: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing. The animals were divided into five groups: (1) sham (n = 3); (2) control (n = 6), untreated, standard punch injury created on the anterior left kidney; (3) TachoSil® (n = 27), punch injury treated with TachoSil®; (4) GelitaSpon® (n = 27), punch injury treated with GelitaSpon®, and (5) Adhflex® (n = 27), punch injury treated with the new elastic CyA adhesive. The parameters studied were bleeding time, peritoneal adhesions, and histopathological evaluation of wound healing on days 2, 6, and 18, including measurements of the gap between wound edges, inflammatory reaction (CD68), and vascular neoformation (CD31). Results: The bleeding time was significantly shorter (27.7 ± 12.9 s) in the Adhflex® group than in the control (135.8 ± 11.6 s; p < 0.01), TachoSil® (77.5 ± 7.4 s; p < 0.05), and GelitaSpon® (82.5 ± 14.4 s; p < 0.05) groups. The incidence of intraperitoneal adhesions in the animals treated with Adhflex® was 3.6 times higher than in the non-treated group. It was also higher (p < 0.04) than in the groups treated with TachoSil® and GelitaSpon®. The time point with the largest gap between the wound edges and most abundant granulation tissue was at day 6. The largest gap after 18 days was reported for the Adhflex® adhesive. With regard to the markers CD31 and CD68, Adhflex® showed the largest areas 2 days after surgery, but no differences were found after 6 and 18 days versus the other treatments. The expression of the immunomarkers on the renal samples treated with Adhflex® was consistent with a normal healing process. Conclusions: In this experimental model of renal injuries, the new elastic CyA (Adhflex®) resulted in the shortest bleeding time. It offers rapid sealing of the bleeding produced by renal injuries, fixation to adjacent tissues, and reduced occurrences of relapse. The evolution of the scarring is similar to other procedures. Given that traumatic renal injuries are always an emergency due to haemorrhage, Adhflex® might offer additional benefits over conventional treatment methods in human clinical practice.

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Section: Discussionsupporting

confidence: 77%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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“…Upon application of these agents, a mild chronic inflammation with multinuclear foreign matter giant cell was observed. Various in vitro and in vivo tests have not indicated any carcinogenic property of these tissue adhesives [13] .…”

Section: Discussionmentioning

confidence: 97%

“…There are numerous studies of the use of CA in repairing dermal lacerations [11] , in the fixation of synthetic grafts in conventional and laparoscopic hernia surgery [12] , in repairing lacerations of parenchymal organs such as the liver, kidney, pancreas and spleen to aid hemostasis and tissue repair [13] , in vascular operations in the inguinal area [14] , and in the reinforcement of gastrointestinal anastomoses [15][16][17][18][19] . The use of NB2CA in anastomoses in place of, or as a support to, the suture material was introduced in studies carried out during the 1980s.…”

Section: Discussionmentioning

confidence: 99%

Effects of N-Butyl-2-Cyanoacrylate on High-Level Jejunojejunostomy

Ensari

Genç²,

Çakmak³

et al. 2009

Eur Surg Res

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Background: Morbidity and mortality due to anastomotic complications in gastrointestinal surgery remain important problems. The tissue adhesive N-butyl-2-cyanoacrylate (NB2CA) is used in many fields of surgery. This study was designed to assess the effects of NB2CA on high-level jejunojejunostomy. Materials and Methods: Forty male albino Wistar rats were divided into 4 groups of 10 each. The groups were treated as follows: group 1 underwent only a jejunojejunostomy, group 2 underwent jejunojejunostomy followed by NB2CA application around the anastomosis, group 3 underwent jejunojejunostomy after a 60-min ischemia and a 60-min reperfusion, and group 4 underwent jejunojejunostomy after a 60-min ischemia and a 60-min reperfusion followed by NB2CA application around the anastomosis. At postoperative day 7, the subjects in all groups were sacrificed. Intra-abdominal adhesions, anastomotic complications and anastomotic burst pressures (ABP) were recorded. Results: The analysis of all the groups for adhesion scores and ABP showed statistical significance (p < 0.001). Conclusions: The use of NB2CA had positive effects in terms of increasing ABP both with and without the initial ischemia- reperfusion insult. However, it had the adverse effect of significantly increasing the number of intra-abdominal adhesions.

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“…As we known, alpha-cyanoacrylate has successfully used in various operations for adhesiveness and haemostasis [17,18]. Many scholars have verified the advantages of alpha-cyanoacrylate, including good biocompatibility, absorbability, non-toxic, non-teratogenic, no antigen and carcinogenic, it also can be degradated gradually in the period of 3-4 weeks and no remains in body [19][20][21][22]. This study also showed that alpha-cyanoacrylate could be degradated in 3 weeks.…”

Section: Discussionmentioning

confidence: 63%

Effectiveness and safety of CEUS-guided haemostatic injection for blunt splenic trauma: an animal experiment

Tang

et al. 2010

Radiol med

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The aim of this study was to investigate whether complications occur after haemostatic agents are injected into blunt splenic injuries. After undergoing ultrasound (US), contrast-enhanced US (CEUS) and contrast-enhanced computed tomography (CECT) examinations, dogs with grade III-IV injury received the minimally invasive therapy. After treatment, CEUS was performed to observe changes in the regions treated. In the immediate group, dogs underwent laparotomy 30 min after treatment to observe the haemostatic effect. In the survival group, animals underwent CEUS and CECT examinations to observe the short-term healing outcome and complications at 3, 7, 14, and 21 days after the injection. After undergoing CEUS and CECT examinations, 12 dogs with grade III-IV injury received the minimally invasive therapy. Before injection, CEUS examinations showed anechoic and/or hypoechoic perfusion defects and active bleeding at the injury sites, and CECT showed traumatic lesions as low-density regions without enhancement. After treatment, CEUS demonstrated the disappearance of active bleeding, and hyperechoic spots emerged at the injury sites. Uneven density regions were displayed on CECT. Treated areas were covered by blood clots and glue membrane in the immediate-group animals. Three weeks later, CEUS showed a decrease of hyperechoic spots in the survival group, and the splenic parenchyma enhanced uniformly on CECT. Laparotomy showed that the greater omentum had moved upwards and partly covered the wound in four animals, and the injury sites had completely healed. Histopathological examination showed that fibrous connective tissue covered the splenic capsule and that the haemostatic glue had degraded. No complication occurred, such as delayed splenic haemorrhage, splenic abscesses, splenic pseudoaneurysms, intestinal obstruction or intestinal adhesions. CEUS-guided haemostatic injection is not only effective in stopping active bleeding immediately, but it is also safe in that no complications occurred during the 3 weeks of follow-up. This study indicates that CEUS-guided percutaneous injection may provide a safe, feasible and effective therapy for blunt splenic trauma.

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The Use of Isobutylcyanoacrylate as a Tissue Adhesive in Abdominal Surgery

Abstract: Isobutyl-2-cyanoacrylate proved to be a very effective tissue adhesive for both solid and hollow organs, even for high risk surgical operations.

Cited by 24 publications

References 14 publications

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Effects of N-Butyl-2-Cyanoacrylate on High-Level Jejunojejunostomy

Effectiveness and safety of CEUS-guided haemostatic injection for blunt splenic trauma: an animal experiment

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