The Use of Cyanoacrylate Adhesives in the Management of Congenital Vascular Malformations
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This article outlines the use of liquid acrylic adhesives in the management of congenital vascular malformations. Specifically, the chemical features of cyanoacrylates, including the physical and chemical properties, exovascular use of cyanoacrylates, and the techniques for use of these agents, are discussed.Keywords:
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The cyanoacrylate adhesives are a biologically heterogenous group, some of which are potentially valuable additions to the neurosurgical armamentarium. The commercially available cyanoacrylates usually contain the more toxic methyl and ethyl monomers. The safe butyl monomer, isobutyl 2-cyanoacrylate, is approved in the United States by the Food and Drug Administration for investigational use only. Isobutyl 2-cyanoacrylate may prove to be useful for the extravascular reinforcement of intracranial aneurysms and for the intravascular occlusion of carotid-cavernous fistulae. Safe and effective alternatives exist for the management of these two problems. The sealing of certain cerebrospinal fluid fistulae and the intravascular occlusion of certain arteriovenous malformations may be more effectively accomplished with isobutyl 2-cyanoacrylate than with other currently available techniques. The ultimate role of this and of other as yet untested cyanoacrylates in neurosurgery remains to be determined.
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This article outlines the use of liquid acrylic adhesives in the management of congenital vascular malformations. Specifically, the chemical features of cyanoacrylates, including the physical and chemical properties, exovascular use of cyanoacrylates, and the techniques for use of these agents, are discussed.
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Abstract A series of tests permitting evaluations of cyanoacrylates as tissues adhesives is presented. Closed coaption of skin is an effective, rapid screening test capable of identifying weak and strong adhesives under use conditions, and is more sensitive for this purpose than bond strength determinations employing aortic lap joints. Tensile strength testing employing skin incisions closed with cyanoacrylates permits evaluation of the continuing effects of cyanoacrylate upon healing skin. In this test system, a number of alkyl cyanoacrylates provides results equivalent to those obtained with sutures. The incorporation of cyanoacrylates into subcutaneous implants permits evaluation of the effects of these materials upon fibroplasia and collagen elaboration, the most critical aspects of wound repair. Implant testing also permits estimation of rates of resportion of cyanoacrylates from subcutaneous deposits.
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Abstract Four novel cyanoacrylates, 2‐cyanoethyl 2‐cyanoacrylate, 1‐cyanoethyl 2‐cyanoacrylate, trideuteromethyl 2‐cyanoacrylate and pentadeuteroethyl 2‐cyanoacrylate have been synthesized using a Diels‐Alder protection/deprotection route involving anthracene. The common route for the synthesis of alkyl 2‐cyanoacrylates was found to be unsatisfactory for the production of small quantities of the targeted cyanoacrylates, which have potential as reagents for the mid‐infrared spectral imaging of fingerprints on difficult surfaces. © 2010 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2010
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Background: Despite advances in incision care and surgical dressings, surgical site infections remain a common complication. Post-operative contamination of a surgical site is believed to play a role in many of these infections. Most surgical dressings adhere to the skin with pressure-sensitive adhesives. Cyanoacrylate tissue adhesives bond to skin with much greater strength and have inherent antimicrobial properties. This study was designed to compare the microbial barrier properties of common pressure-sensitive adhesives to medical-grade cyanoacrylate tissue adhesives (2-octyl cyanoacrylate and N-butyl cyanoacrylate). Methods: Samples of cyanoacrylate tissue adhesives and pressure-sensitive adhesives were placed on solid culture media. Five common bacterial pathogens were used to contaminate 50 cyanoacrylate samples and 150 pressure-sensitive adhesive samples. Each plate was evaluated for bacterial growth underneath the adhesive sample daily for a total of 72 hours. Results: No penetration was seen through any of the cyanoacrylate adhesive samples at 72 hours. In sharp contrast, bacteria penetrated 99.3% of the pressure-sensitive adhesive samples at 72 hours. Conclusions: Medical grade cyanoacrylate tissue adhesives provide a superior microbial barrier compared with common pressure-sensitive adhesives. Consideration could be given to the use of these adhesives for the securement of surgical dressings.
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Abstract Higher chained alkyl cyanoacrylates have potential to function efficiently as space filling, hydrophobic, viscoelastic, biocompatible, and rapidly polymerizing bone adhesives. Hence they may be useful in applications where a void has to be filled, such as replacement of the intervertebral disc. To assess their applicability as space filling material in such an pplication, three alkyl cyanoacrylates; methoxyethyl cyanoacrylate, isobutyl cyanoacrylate, and isoamyl cyanoacrylate have been evaluated in this study. The bonding strength of these cyanoacrylates to bone in a space filling situation have been measured. The results indicate the bond strength of isoamyl cyanoacrylate (0.13 MPa) to be significantly ( p < 0.05) lower compared with methoxyethyl cyanoacrylate (0.33 MPa) and isobutyl cyanoacrylate (0.37 MPa). There was no significant difference in the bond strengths of isobutyl cyanoacrylate and methoxyethyl cyanoacrylate.
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AbstractSutures have traditionally been considered the preferred choice for the mechanical closure of tissue injuries. However, suturing implies an additional trauma to the wound. The search for a quick, painless method with good aesthetic results has prompted a number of publications and studies that have evaluated the effectiveness of synthetic tissue adhesives (cyanoacrylate adhesives) and other biological sealants (fibrin glue and others) as an alternative to standard suturing. The therapeutic applications covered by the literature on cyanoacrylate-based adhesives are most varied. This literature review seeks to show the evolution over time of the methods and results obtained by scientific research on the use of biological adhesives for dermal closure, by collecting existing data on aspects relative to cyanoacrylates and their application on dermal lesions from papers published over the past 50 years. Such a review is novel in the existing literature. In recent decades, the use of cyanoacrylate-based adhesives for the closure of dermal lesions in different surgical areas has spread thanks to the positive results reported by the vast majority of the studies. New avenues for tissue adhesive production are being explored currently. The prospects for these adhesives are positively appraised, though potential disadvantages and contraindications must be borne in mind.Keywords: tissue adhesivescyanoacrylatesdermal lesions
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The cyanoacrylates were first synthesized in 1949 by H. Coover. They are used in medicine for over 50 years. The main advantage of synthetic tissue adhesives is cheap and simple production process, which gives possibility of using the cyanoacrylates in many surgical disciplines of medicine. That makes also synthetic tissue adhesives better than biological tissue glue (for example fibrin- based adhesives) which preparation is much more complicated and expensive. Nowadays the cyanoacrylates are often used in ophthalmology, mostly in treatment diseases of the anterior segment--for example corneal thinning, ulceration and perforation of cornea. In this paper possible uses of cyanoacrylate tissue adhesives in ophthalmology are presented. The method of application of the cyanoacrylates on the surface of damaged cornea is presented. On base of analysis provided in many clinical centres, the advantages, disadvantages and clinical effects of using tissue adhesives are discussed in this paper. The latest results of using cyanoacrylate tissue adhesives in anterior segment surgery, especially in closing corneal incisions made during cataract operation are presented too. The article contains also information about experimental researches relating to application tissue glue in vitreoretinal surgery and operative glaucoma treatment.
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Abstract Cynnoacrylates were first synthesized by Ardis in 1949. However, it was not until Coover in 1959 discovered their adhesive properties that an interest arose in using these substances in surgical procedures. Over the past two decades the use of cyanoacrylates has been varied and widespread among the surgical specialties. Methyl 2‐cyanoacrylate (Eastman 910 Monomer), Isobutyl‐cyanoacrylate (Bucrylate®), and 2‐cyano‐butyl‐acrylate (Histoacryl®) were the most widely used. Because of its tissue toxicity methyl 2‐cyanoacrylate was discarded. The consensus of various investigators was that the higher homologues, in particular Histoacryl® could be safely used in human applications. The authors thought it would be important to ascertain how the academic departments of Otolaryngology perceived the role of cyanoacrylates within their specialty. A questionnaire was distributed to 115 academic centers: 47% of the departments responded and, of those, 34% indicated a current working knowledge of the cyanoacrylates. This response confirmed a very active interest in these tissue adhesives despite a lack of F.D.A. approval. The otologic applications of these adhesives has been well documented, but the literature is devoid of studies using cyanoacrylates in other aspects of Otolaryngology. The authors feel that these adhesives (in particular Histoacryl®) have a role as an adjunctive technique in facial reconstructive and cosmetic surgery for autogenous cartilage grafting. A study using rabbits was designed to determine if Histoacryl® could be used safely to overcome the technical difficulties (graft migration during healing and cartilage fracture during suturing) often encountered when performing autogenous onlay cartilage grafting. On the left ear of each rabbit, a cartilage graft was harvested and reimplanted at a second site on the same ear by suturing the perichondrium of the graft to the perichondrium of the donor site. On the right ear the graft was secured to the donor site with Histoacryl.® The histological analysis of the rabbits' ears sacrificed at weekly intervals from 1 week to 1 month failed to demonstrate cartilage damage or tissue toxicity in the ears where Histoacryl® was used. In conclusion, the authors contend that a role exists for the use of Histoacryl® as an adjunctive technique in facial reconstructive and cosmetic surgery. The study will be continued to assess the long‐term results of using Histoacryl® for autogenous onlay cartilage grafting.
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