[Experimental evaluation of efficacy of cyanoacrylate glue MK-6 as a method for prevention of arrosive hemorrhages in vascular surgery].
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Keywords:
GLUE
Cyanoacrylates
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Background: Amongst all the causes wound disruption, suture material plays a very significant role and the surgeon's interest therefore in this subject is obvious. In surgery the choice of suture material has been largely empirical. One learns the art and craft of surgery from one's chief and tendency is to use the suture material used by him. The objective of the study was to study the efficacy of cyanoacrylate glue in operative wound closure. Methods: This comparative study of efficacy of cyanoacrylate glue in operative wound closure was carried out at S. R. T. R. Government medical college, Ambajogai, Maharashtra, India for a period of two years. The study consisted of 100 patients all of whom underwent elective surgical procedures. They were divided into two groups: in group I patients (n = 50) cyanoacrylate glue was used for wound closure and in group II patients (n = 50) the wound was closed with interrupted silk sutures. Results: 54 were males and 46 were females. The most common operative procedure in this study was appendicectomy (28%). Maximum numbers of patients i.e. 42 were seen in the age group of 21-30 years. Time taken in the closure of wound by cyanoacrylate in group I was considerably lesser than the time taken in the closure of wound by silk suture in group II. The incidence of wound infection or dehiscence was also significantly lower in group I. The incidence of dehiscence in group I was 4% compared to 8% in group II. Conclusions: Use of cyanoacrylate glue was found to be more effective and conventional suturing.
GLUE
Wound Closure
Wound dehiscence
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In an attempt to find the ideal surgical technique for mesh fixation during laparoscopic total extraperitoneal inguinal hernia repair, we evaluate the use of a synthetic surgical glue (N-butyl-cyanoacrylate—Glubran 2) in an effort to reduce postoperative pain and the complications associated with the use of staples. We have prospectively evaluated 61 consecutive patients (73 hernias) with a minimum follow-up period of 18 months and an average of 29.7 months, without any significant complications present. The majority (59%) only required low dosages of painkillers during the first 24 hours after surgery and have not experienced any cases of chronic pain or recurring hernias in the time period described. On the basis of this initial experience, the use of the surgical glue used to repair inguinal hernias with the laparoscopic total extraperitoneal technique has been proved to be a simple and effective surgical method for mesh fixation.
GLUE
Hernia Repair
Surgical mesh
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Cyanoacrylate-based tissue glue has been widely used for many years around the world, and was recently approved for use in the United States, mainly for skin cuts and lacerations. Other applications were described, in different surgical situations. Although ideal for small, clean incisions, its use in laparoscopic surgery is currently limited. Over a year period, 100 patients with more 250 trocar site wounds had their wounds glued using histoacryl. Infection rate was extremely low (one case), and partial dehiscence of the wound happened in two patients, where wound edge approximation was not optimal. Cosmetic results were excellent and patient satisfaction was high, as no sutures had to be removed. Glue application is easy and quick, with no risk of needle sticks, and it is a viable option for laparoscopic wound closure.
GLUE
Wound dehiscence
Wound Closure
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BACKGROUND AND OBJECTIVES:
Fistula in ano is a commonly seen surgical problem; fistulotomy is the gold standard treatment in the management of low anal fistula. But fistulotomy is associated with discomfort and incontinence. This study was designed to evaluate the effectiveness of cyanoacrylate glue in the management of low anal fistula. We present our short term results with a 6 month follow up.
MATERIALS AND METHODS:
Thirty patients were enrolled in our study. Patients were analyzed clinically and then subjected to fistulogram. The fistula tracks were probed and washed with saline and excessive granulation tissue was curetted. The glue was then injected in to fistulous track from a syringe nozzle through an infant feeding tube. Patients were further examined in the outpatient department until 6 months.
RESULTS:
Five of thirty patients (16.6%) healed with glue treatment. Twenty of thirty (66.7%) patients got recurrence; five patients are lost follow up.
CONCLUSION:
Patients were followed up for a period of 6 months after glue instillation. Post operative pain, discomfort, incontinence were absent in case of glue instillation.
Early ambulation and less time of stay in hospital were added advantage in case of glue instillation. Recurrence rate is high in case of cyanoacrylate glue instillation in our study.
Fistulotomy
GLUE
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The aim of this retrospective study was to compare the results of two different mesh fixation methods in laparoscopic transabdominal preperitoneal hernioplasty (TAPP): tacker vs. synthetic cyanoacrylate glue.The study group includes 70 patients with bilateral and monolateral recurrent inguinal hernia undergoing transabdominal preperitoneal repair (TAPP) in the period 2011-2013. A polypropylene mesh was fixed in group A (N.=35) with titanium tacks (EndoUniversal stapler, Covidien) or in group B (N.=35) with synthetic cyanoacrylate glue (Glubran-2, GEM). Patient outcome was assessed by the following variables: sex, mean age, ASA score, intra- and postoperative morbidity, hospitalization, postoperative acute and chronic pain, recurrence rate. The observation period was 24 months, with a mean follow-up of 10.5 months (range, 1-23) for Group A and 11 months (range, 2-24) for Group B.No difference between the two groups was observed with respect to mean operative time and hospitalization. In all cases, surgery was successfully concluded laparoscopically. Intraoperative complications occurred in 1 patient of the group A and consisted of a urinary bladder injury, which was immediately sutured. Postoperative complication rate was 5.7% (4 patients, of whom 3 in group A and 1 in group B). In each group we detected one recurrence within 6 (group A) and 18 months (group B) postsurgery; both patients were treated with a re-TAPP. Postoperative pain at 6 months from surgery, measured by visual analogue score (VAS), was reported by 4 patients in the group A and in no case of the group B (P=0.04).Data from this study demonstrate the advantages of synthetic cyanoacrylate glue for mesh fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair, compared to titanium tacks. The use of this surgical glue was associated with a significantly reduced risk for developing chronic groin pain and a shortened hospital stay. Nevertheless, further studies with longer follow-up periods are needed to confirm our encouraging results.
GLUE
Urinary retention
Group B
Hernia Repair
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Background: Tissue glues have been present for over twenty years and are used in surgery for a variety of indications.Use of N butyl-2-cyanoacrylate based in inguinal hernia surgery were practiced for the first time in the mid-nineties.These non-suture techniques was aimed to decrease the chronic groin pain after hernioplasty without adversely affecting the outcomes Aim of the work: this study was designed to compare the operative outcomes of mesh fixation with glue versus that with suture.The primary objective was to compare pain in the immediate postoperative period and also to compare chronic postoperative pain.Patients and Methods: This prospective randomized study was performed Between January 2018 and January 2019 on 40 patients with unilateral inguinal hernia for whom open hernioplasty was done in the Department of surgery, Al-Azhar University Hospital, Damietta.Results: in the present study, there was significant difference in postoperative pain perception at 24 hours, at one week and at one month (p < 0.05) between glue group and suture group with lesser pain perception in the glue group.After the first month the difference between the two groups was non-significant.The mean operative time which was 44.35 min in the glue group and 57.33 min in suture group showed significant difference.As regard to the postoperative complications, the postoperative hematoma, infection and seroma were lesser in glue group but the difference was not significant.There was no recurrence in both groups.Conclusions: Cyanoacrylate glue for mesh fixation in Lichtenstein repair of adult inguinal hernia shows advantages over mesh fixation by sutures in terms of immediate and chronic post-operative pain, operative time, and postoperative complications.
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The adequate repair of intraoperative CSF leaks during transsphenoidal surgery remains a challenge. The authors describe the application of N-butyl 2-cyanoacrylate (cyanoacrylate) tissue glue for repair of CSF fistulas during transsphenoidal surgery.The authors retrospectively reviewed the records of 221 consecutive patients who underwent transsphenoidal surgery during 1998-2007. Among these patients, 52 (24%) experienced detectable intraoperative CSF leakage. The CSF fistulas were graded on a scale of 1-3, according to the amount of CSF loss and extent of diaphragmatic disruption. 39 patients who had an average leak scale of 1.28 received cyanoacrylate glue to seal the floor. The remaining 13 patients who were not part of this report received other dura sealant substitutes, including Tisseel and Dura Seal, or fat/cartilage grafts without any additional glue material.4 of 221 patients (2%) who underwent surgery had postoperative CSF fistula. Of the 39 patients who underwent repair of their fistula using fat graft, cartilage/bone buttress and cyanoacrylate reconstruction, 2 (5.13%) developed postoperative CSF fistulas without any other side effects. The average intraoperative leak grade in these 2 patients was 2.00.The authors used cyanoacrylate glue for intraoperative repair of higher grade CSF fistulas. As an adjunct to careful sellar reconstruction, cyanoacrylate glue appears to be effective and safe in preventing postoperative CSF leakage after transsphenoidal surgery.
Transsphenoidal surgery
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To examine a novel technique for periocular skin graft and flap stabilization using cyanoacrylate glue applied to the host bed around the perimeter of the graft or flap to create an immobile cast in the immediate postoperative period to promote successful graft take and stable anatomic position.Retrospective review was performed of a single surgeon's patients who underwent periocular skin graft or flap between August 1, 2011, and February 29, 2016, in which cyanoacrylate glue was applied postoperatively for graft stabilization. Data examined included indication for procedure, location and size of graft, postoperative complications, and length of follow up postoperatively.Of 164 cases reviewed, 9 cases were identified in which cyanoacrylate glue was used as the sole means of graft or flap stabilization. Indications for surgery included repair of cicatricial ectropion (3 cases) and repair of Mohs defect status after excision of basal or squamous cell carcinoma (6 cases). All cases involved reformation of the lower eyelid. Five cases employed full-thickness skin grafts and 4 cases employed adjacent tissue rearrangement. Size of defect repaired ranged from 8 mm to 35 mm when largest diameter was measured. Complications included mild residual ectropion or mild punctal ectropion in 2 patients who was asymptomatic and did not require further surgery. No cases were complicated by hematoma, infection, or graft necrosis.Cyanoacrylate glue can be used to successfully stabilize skin grafts and flaps in the immediate postoperative period.
Ectropion
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Groin
GLUE
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A split-thickness skin graft (STSG) is a very effective method for reconstructing skin defects in the lower extremities; however, suturing all graft margins during surgery is time-consuming. As an alternative, 2-octyl cyanoacrylate glue attaches the epidermal layer of an STSG to normal skin and functions like a suture. In this study, we assessed 2-octyl cyanoacrylate glue as a time-saving step in STSG procedures. We reviewed the charts of 87 patients who underwent STSG between May 2018 and August 2020. For the 10 patients who consented to the STSG procedure with 2-octyl cyanoacrylate glue, we evaluated the treatment site for complications and engraftment every 2 days for 14 days. The STSGs were successfully engrafted in all cases. Seroma, hematoma, wound dehiscence, or infection were not documented. No additional revision surgery was required. The use of 2-octyl cyanoacrylate glue in STSG margin fixation was safe, effective, convenient, and time-saving. This study found 2-octyl cyanoacrylate glue a good option for lower extremity skin defect reconstruction.
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Seroma
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