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Woelfle CA, Shah RP, Neuwirth AL, Herndon CL, Levine WN, Cooper HJ. 2-Octyl-Cyanoacrylate Mesh Dressings for Total Joint Arthroplasty: Dressing Design Influences Risks of Wound Complications. J Arthroplasty 2024:S0883-5403(24)00650-8. [PMID: 38914145 DOI: 10.1016/j.arth.2024.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Recent liquid adhesive skin closure systems with a mesh patch and a 2-octyl cyanoacrylate liquid formula have shown promising results in total joint arthroplasty. Chemical accelerators are typically included to promote the rapid polymerization of 2-octyl cyanoacrylate. The goal of the study is to distinguish designs and wound complication differences between 2 similar systems. METHODS An 18-week retrospective study was conducted from July to December 2023, including 207 total hip arthroplasty and 212 total knee arthroplasty cases from 4 attending surgeons at 1 institution that used 1 of 2 dressing designs. Both dressings had a 2-octyl cyanoacrylate liquid adhesive formula that applied topically to a polyester-based mesh overlaying the wound. Mesh A (used in 274 cases) included an accelerator, a quaternary ammonium salt, on the mesh patch, whereas Mesh B (used in 145 cases) included a similar accelerator within the adhesive applicator. RESULTS Wound complications (3.2 versus 7.6%; X2 = 3.86; df = 1; P = .049), early periprosthetic joint infections (0 versus 2.8%; X2 = 7.63; df = 1; P = .006), and 90-day reoperations for wound complications (0.4 versus 3.4%; X2 = 6.39; df = 1; P = .011) were significantly lower in patients who received Mesh A versus B, respectively. There was no difference in superficial surgical site infections (0.7 versus 0%; X2 = 1.06; df = 1; P = .302) or allergy rates (3.3 versus 4.1%; X2 = 0.12; df = 1; P = .655) between Mesh A and B. CONCLUSIONS We observed significantly different performance in wound complications, early postoperative periprosthetic joint infections, and 90-day reoperation between the 2 designs. Having the accelerator in the applicator rather than on the mesh patch may lead to premature polymerization before bonding appropriately with the mesh to create the desired wound closure and seal. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Catelyn A Woelfle
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | - Roshan P Shah
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | - Alexander L Neuwirth
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | - Carl L Herndon
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | - William N Levine
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
| | - H John Cooper
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
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Kim KE, Jeon YR, Bae SU, Jeong WK, Baek SK. Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea. JOURNAL OF MINIMALLY INVASIVE SURGERY 2024; 27:14-22. [PMID: 38494182 PMCID: PMC10961233 DOI: 10.7602/jmis.2024.27.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
Purpose This study was performed to evaluate the safety and feasibility of skin adhesives and to compare postoperative and cosmetic outcomes after wound closure in single-port laparoscopic appendectomy (SPLA) between skin adhesives and steri-strips. Methods This was a single-center retrospective study. We included 22 and 47 patients in whom skin adhesive and steri-strips were used respectively, for skin closure after subcuticular suturing in SPLA between August 2014 and 2020. The patient scar assessment questionnaire (PSAQ) was completed postoperatively to assess postoperative cosmetic outcomes. Results On the postoperative day, patients in whom skin adhesive was used had significantly lower numeric rating scores than in whom steri-strips were used (2.8 ± 0.8 vs. 3.9 ± 0.8, p < 0.001). The frequency of analgesic administration within 24 hours and between 24 and 48 hours after surgery was significantly lower in the skin adhesive group compared to the wound closure strip group (1.4 ± 0.8 vs. 2.7 ± 1.2, p = 0.013 and 0.2 ± 0.4 vs. 0.7 ± 0.9, p = 0.002, respectively). In the PSAQ, "satisfaction with appearance" and "satisfaction with symptoms" subitem scores were significantly lower in patients in whom skin adhesive was used (11.3 ± 3.0 vs. 15.1 ± 4.5, p = 0.006 and 6.5 ± 1.8 vs. 9.5 ± 3.3, p = 0.003), whereas, "appearance" and "consciousness" subitems revealed no statistically significant differences between the groups. Conclusion Liquid skin adhesive closures seem to be safe and feasible and cause less postoperative pain, resulting in greater patient satisfaction with postoperative scars than wound closure strip closure after subcuticular suturing in SPLA.
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Affiliation(s)
- Kyeong Eui Kim
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Ra Jeon
- Department of Surgery, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu, Korea
| | - Sung Uk Bae
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Woon Kyung Jeong
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Seong Kyu Baek
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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Ren H, Zhang Z, Chen X, He C. Stimuli-Responsive Hydrogel Adhesives for Wound Closure and Tissue Regeneration. Macromol Biosci 2024; 24:e2300379. [PMID: 37827713 DOI: 10.1002/mabi.202300379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/27/2023] [Indexed: 10/14/2023]
Abstract
Sutures and staplers, as gold standards for clinical wound closure, usually cause secondary tissue injury and require professional technicians and equipment. The noninvasive hydrogel adhesives are used in various biomedical applications, such as wound closure, tissue sealing, and tissue regeneration, due to their remarkable properties. Recently-developed hydrogel adhesives, especially stimuli-responsive hydrogels, have shown great potential owing to their advantages in regulating their performance and functions according to the wound situations or external conditions, thus allowing the wounds to heal gradually. However, comprehensive summary on stimuli-responsive hydrogels as tissue adhesives is rarely reported to date. This review focuses on the advances in the design of various stimuli-responsive hydrogel adhesives over the past decade, including the systems responsive to pH, temperature, photo, and enzymes. Their potential biomedical applications, such as skin closure, cardiovascular and liver hemostasis, and gastrointestinal sealing, are emphasized. Meanwhile, the challenges and future development of stimuli-responsive hydrogel adhesives are discussed. This review aims to provide meaningful insights for the further design of next-generation of hydrogel adhesives for wound closure and tissue regeneration.
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Affiliation(s)
- Hui Ren
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Zhen Zhang
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Xuesi Chen
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Chaoliang He
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui, 230026, China
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Agrawal S, Pant VP, Pandey A, Acharya S, Sitaula S, Rayamajhi A, Pant DR. Social media influenced self-application of cyanoacrylate for double chin reduction in an adolescent girl: an unusual case of post-inflammatory hyperpigmentation. Ann Med Surg (Lond) 2024; 86:1814-1817. [PMID: 38463102 PMCID: PMC10923298 DOI: 10.1097/ms9.0000000000001806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Cyanoacrylate, used as a topical adhesive for wound closure in clinical settings, can result in poor cosmetic outcome on application to skin. Lack of formal medical or dermatological training among social media influencers poses risks of improper diagnosis, incorrect treatments, ineffective home remedies, and potential self-injury or long-term skin effects, especially among adolescents. Case presentation The authors present a case of a young girl with a persistent post-inflammatory hyperpigmentation after using cyanoacrylate on her chin as a home remedy to reduce her double chin problem after learning from a video on social media. Biopsy findings were consistent with post-inflammatory hyperpigmentation in dermis. Clinical discussion Application of cyanoacrylate over skin can result in allergic reactions, burn injuries, infections, itching, skin blistering, and aesthetic issues. Persistent post-inflammatory hyperpigmentation can be a poor cosmetic outcome on application of cyanoacrylate over skin. Conclusion Inadequate social media safety regulations require healthcare professionals to be aware of social trends among adolescents and to encourage them for open conversations and professional help-seeking during times of distress in this digital era.
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Affiliation(s)
- Saurav Agrawal
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine
| | | | - Anup Pandey
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine
| | - Sabin Acharya
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine
| | - Seema Sitaula
- Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital, Kathmandu
| | - Aadesh Rayamajhi
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine
| | - Deepak Raj Pant
- Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital, Kathmandu
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Yu L, Liu Z, Tong Z, Ding Y, Qian Z, Wang W, Mao Z, Ding Y. Sequential-Crosslinking Fibrin Glue for Rapid and Reinforced Hemostasis. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308171. [PMID: 38072663 PMCID: PMC10870078 DOI: 10.1002/advs.202308171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 02/17/2024]
Abstract
Achieving hemostasis effectively is essential for surgical success and excellent patient outcomes. However, it is challenging to develop hemostatic adhesives that are fast-acting, strongly adherent, long-lasting, and biocompatible for treating hemorrhage. In this study, a sequential crosslinking fibrin glue (SCFG) is developed, of which the first network of the fibrin glue forms in situ within 2 s to act as an initial physical barrier and locks the gelatin methacryloyl precursor for tight construction of the second network to enhance wet adhesion and durability for tissues covered with blood. The sequential crosslinking glue can provide large pressures (≈280 mmHg of burst pressure), makes strong (38 kPa of shear strength) and tough (≈60 J m-2 of interfacial toughness) interfaces with wet tissues, and outperforms commercial hemostatic agents and gelatin methacryloyl. SCFG are demonstrated as an effective and safe sealant to enhance the treatment outcomes of bleeding tissues in rat, rabbit, and pig models. The ultrafast gelation, strong adhesion and durability, excellent compatibility, and easy manufacture of SCFG make it a promising hemostatic adhesive for clinical applications.
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Affiliation(s)
- Lisha Yu
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceHangzhouZhejiang310009China
| | - Zhaodi Liu
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceHangzhouZhejiang310009China
- Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceHangzhouZhejiang310009China
- National Innovation Center for Fundamental Research on Cancer MedicineHangzhouZhejiang310009China
- Cancer CenterZhejiang UniversityHangzhouZhejiang310058China
- ZJU‐Pujian Research & Development Center of Medical Artificial Intelligence for Hepatobiliary and Pancreatic DiseaseHangzhouZhejiang310058China
| | - Zongrui Tong
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceHangzhouZhejiang310009China
| | - Yihang Ding
- MOE Key Laboratory of Macromolecular Synthesis and FunctionalizationDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Zhefeng Qian
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceHangzhouZhejiang310009China
- MOE Key Laboratory of Macromolecular Synthesis and FunctionalizationDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Weilin Wang
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceHangzhouZhejiang310009China
- Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceHangzhouZhejiang310009China
- National Innovation Center for Fundamental Research on Cancer MedicineHangzhouZhejiang310009China
- Cancer CenterZhejiang UniversityHangzhouZhejiang310058China
- ZJU‐Pujian Research & Development Center of Medical Artificial Intelligence for Hepatobiliary and Pancreatic DiseaseHangzhouZhejiang310058China
| | - Zhengwei Mao
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceHangzhouZhejiang310009China
- MOE Key Laboratory of Macromolecular Synthesis and FunctionalizationDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhouZhejiang310027China
| | - Yuan Ding
- Department of Hepatobiliary and Pancreatic SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang310009China
- Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceHangzhouZhejiang310009China
- Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceHangzhouZhejiang310009China
- National Innovation Center for Fundamental Research on Cancer MedicineHangzhouZhejiang310009China
- Cancer CenterZhejiang UniversityHangzhouZhejiang310058China
- ZJU‐Pujian Research & Development Center of Medical Artificial Intelligence for Hepatobiliary and Pancreatic DiseaseHangzhouZhejiang310058China
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Sofii I, Fauzi AR. Comparing the effect of tissue adhesive and suturing material on collagen I/III ratio in abdominal skin wounds: an experimental study. Ann Med Surg (Lond) 2023; 85:5450-5453. [PMID: 37915667 PMCID: PMC10617816 DOI: 10.1097/ms9.0000000000001206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/08/2023] [Indexed: 11/03/2023] Open
Abstract
Background The skin closure procedure should be technically simple, acceptable, quick, and cost-effective. Sutures remain the technique's mainstay, however tissue adhesive is becoming more used in clinical practice. Collagen ratios of types I and III play a significant role as postoperative wound healing parameters. Here, the authors aim to examine the collagen I/III ratio of tissue adhesive vs. non-absorbable sutures for abdominal skin closure in Wistar albino rats. Material and methods The authors allocated 20 rats into four experimental groups. Wounds in groups 1 and 3 were sealed with tissue adhesive (cyanoacrylate), while those in groups 2 and 4 were closed using suture material (monofilament non-absorbable nylon). Groups 1 and 2 were sacrificed on postoperative day (POD) 4, while those in groups 3 and 4 were euthanized on POD 7. Skin samples (1×0.5 cm) were collected for analysis, and the collagen I/III ratios were determined using immunohistochemistry staining techniques. Results The levels of collagen I and III expression did not exhibit statistically significant differences between tissue adhesive and nylon suture groups at either POD 4 (P=0.052, P=0.513) or POD 7 (P=0.125, P=0.80). Similarly, the collagen I/III ratio did not significantly differ between the two groups at POD 4 (1.23±2.26 vs. 0.70±0.24; P=0.47) or POD 7 (0.68±0.96 vs. 0.77±1.22; P=0.857). Conclusions There were no statistical significance difference in collagen I/III ratio between the tissue adhesive and suture material groups, suggesting that the choice of wound closure material may not influence the abdominal skin closure.
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Affiliation(s)
- Imam Sofii
- Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta
| | - Aditya Rifqi Fauzi
- Department of Surgery, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta 104401, Indonesia
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Park YH, Son SW, Han SR, Kim HJ. Comparison of 2-octyl cyanoacrylate and n-octyl cyanoacrylate topical skin adhesives for wound closure after ankle fracture surgery: a prospective randomized trial. Sci Rep 2023; 13:17099. [PMID: 37816764 PMCID: PMC10564768 DOI: 10.1038/s41598-023-43471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023] Open
Abstract
To date, only a few clinical studies have investigated the differences between 2-octyl cyanoacrylate and n-octyl cyanoacrylate topical skin adhesives (TSAs). This study aimed to compare the outcomes of the two TSAs for wound closure after ankle fracture surgeries. Fifty-six patients were randomized to receive either a 2-octyl or n-octyl cyanoacrylate TSA. At 3 and 6 months after surgery, wound cosmetic outcomes were assessed using the Hollander Wound Evaluation Scale (HWES), and patient satisfaction for wound cosmesis was assessed using the visual analog scale (VAS) and 5-item Likert scale. Functional outcomes at 6 months after surgery were assessed using the Olerud-Molander Ankle Score (OMAS). Fifty-five patients completed the study protocol. Within the follow-up period, no differences were found between the two groups in terms of HWES, VAS, 5-item Likert scale, and OMAS. 2-octyl cyanoacrylate TSA and n-octyl cyanoacrylate TSA were comparable options for wound closure after ankle fracture surgeries in terms of wound cosmesis, patient satisfaction, and functional outcome.
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Affiliation(s)
- Young Hwan Park
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Sei Wook Son
- Department of Orthopedic Surgery, Korea University Medical Center, Seoul, Republic of Korea
| | - Sang Roc Han
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hak Jun Kim
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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Cui X, Zhang Y, Wang N, Chen Y, Xu J, Hou J. The outcome of sutured wounds compared with tissue adhesive for paediatric wound closure: A meta-analysis. Int Wound J 2023; 20:3298-3306. [PMID: 37221969 PMCID: PMC10502276 DOI: 10.1111/iwj.14210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/25/2023] Open
Abstract
A meta-analysis investigation was executed to measure the outcome of sutured wounds (SWs) compared with tissue adhesive (TA) for paediatric wound closure (PWC). A comprehensive literature inspection till February 2023 was applied and 2018 interrelated investigations were reviewed. The 18 chosen investigations enclosed 1697 children with PWC in the chosen investigations' starting point, 977 of them were utilising SWs, and 906 were utilising TA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of SWs compared with TA for PWC by the dichotomous approaches and a fixed or random model. SWs had significantly higher wound cosmetic (WC) scores (mean deviation [MD], 1.70; 95% CI, 0.57-2.84, P = .003), lower wound dehiscence (WD) (OR 0.60; 95% CI, 0.06-0.43, P < .001), and lower cost (MD, -10.22; 95% CI, -10.94 to -9.50, P < .001) compared with those with TA in PWC. No significant difference was found between children utilising SWs and TA in wound infection (WI) (OR, 0.45; 95% CI, 0.15-1.30, P = .14) with no heterogeneity (I2 = 0%) in PWC. SWs had significantly higher WC scores, lower WD, and lower cost, yet, no significant difference was found in WI compared with those with TA in PWC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations and the low number of selected investigations for the meta-analysis.
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Affiliation(s)
- Xiaomei Cui
- School of PediatricsHenan University of Traditional Chinese MedicineZhengzhouHenanChina
| | - Yuanbo Zhang
- Department of SurgeryThe Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Na Wang
- Institutes of Integrative MedicineFudan UniversityShanghaiChina
| | - Yafang Chen
- Department of PediatricsZhumadian Hospital of Traditional Chinese MedicineZhengzhouHenanChina
| | - Jin Xu
- Second School of Clinical MedicineThe Second Affiliated Hospital of Henan University of Chinese MedicineZhengzhouHenanChina
| | - Jianghong Hou
- Second School of Clinical MedicineThe Second Affiliated Hospital of Henan University of Chinese MedicineZhengzhouHenanChina
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Chang S, Liu Y, Guo J, Bi X. Bi's purse-string suture: an effective method for presacral venous bleeding. Updates Surg 2023; 75:2043-2046. [PMID: 37432569 DOI: 10.1007/s13304-023-01586-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
Presacral venous bleeding (PSVB) is an intractable situation during rectal mobilization. Till now, various methods for PSVB are introduced, but each of them has limitations. This article aims to introduce an effective approach for PSVB, which is created by Professor Xiaogang Bi. In the case of PSVB, a purse-string suture which highlighted each stitch penetrates periosteum of sacrum was performed around the bleeding site. After that, the branches of presacral venous plexus around the bleeding site were compressed to the sacrum when the stitches were tightened, the blood flow of the venous branches was blocked by the thread across them, the bleeding was controlled, and then, the knot was tied. From April 24th 2017 to November 6th 2022, ten patients who suffered PSVB during surgery accepted Bi's suture. With Bi's suture, all of the ten cases of PSVB were controlled effectively. Nine of ten cases were controlled immediately only by Bi's suture, one case which accompanied with blood oozing of sacrum wound was controlled by Bi's suture, bone wax, and pelvic gauze packing. Bi's suture is an effective approach for PSVB. It could be easily performed without the need of special materials.
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Affiliation(s)
- Shaofei Chang
- Department of Gastroenteropancreas, Shanxi Provincial People's Hospital, Shuangta Street, Yingze District, Taiyuan, 030012, China
- Department of Pancreatic Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Center For Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Yaohua Liu
- Department of Ultrasound, The Second People's Hospital of Shanxi Province, Kouzhuangxi Road, Yingze District, Taiyuan, 030012, China
- Shanxi Medical University, Daxue Street, Yuci District, Jinzhong, 030600, China
| | - Jien Guo
- Department of Gastroenteropancreas, Shanxi Provincial People's Hospital, Shuangta Street, Yingze District, Taiyuan, 030012, China
| | - Xiaogang Bi
- Department of Gastroenteropancreas, Shanxi Provincial People's Hospital, Shuangta Street, Yingze District, Taiyuan, 030012, China.
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Tsai YC, Huang DW, Chou YY, An YC, Cheng YS, Chen PH, Tzeng YS. Comparative Evaluation of Tissue Adhesives and Sutures in the Management of Facial Laceration Wounds in Children. J Pers Med 2023; 13:1350. [PMID: 37763118 PMCID: PMC10532459 DOI: 10.3390/jpm13091350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This study evaluated tissue adhesives in comparison to sutures for treating facial lacerations in children. METHODS We retrospectively analyzed data from September 2017 to August 2022 involving pediatric facial lacerations managed with either tissue adhesives or sutures. RESULTS Among 50 children, 20 received tissue adhesives, and 30 received sutures. Both methods showed comparable outcomes in terms of wound complications such as dehiscence (adjusted odds ratio = 1.56, 95% CI = 0.08-31.25) and infection (adjusted odds ratio = 2.17, 95% CI = 0.08-58.80). The cosmetic outcomes, assessed using the Hollander Wound Evaluation Score, were also consistent between groups (adjusted beta = -0.55, 95% CI = -1.15-0.05). Notably, those treated with tissue adhesives reported greater satisfaction (adjusted beta = 1.13, 95% CI = 0.63 -1.63) and experienced significantly less pain (adjusted beta = -3.03, 95% CI = -4.15--1.90). CONCLUSIONS Both techniques displayed similar rates of infection, dehiscence, and cosmetic outcomes. However, tissue adhesives were associated with increased patient comfort, especially in terms of reduced pain and greater satisfaction.
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Affiliation(s)
- Yu-Chi Tsai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Dun-Wei Huang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Yu Chou
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Chin An
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yung-Sheng Cheng
- Division of Pediatric Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Po-Huang Chen
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yuan-Sheng Tzeng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Department of Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 813204, Taiwan
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Ren H, Zhang Z, Cheng X, Zou Z, Chen X, He C. Injectable, self-healing hydrogel adhesives with firm tissue adhesion and on-demand biodegradation for sutureless wound closure. SCIENCE ADVANCES 2023; 9:eadh4327. [PMID: 37585520 PMCID: PMC10431709 DOI: 10.1126/sciadv.adh4327] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023]
Abstract
Tissue adhesives have garnered extensive interest as alternatives and supplements to sutures, whereas major challenges still remain, including weak tissue adhesion, inadequate biocompatibility, and uncontrolled biodegradation. Here, injectable and biocompatible hydrogel adhesives are developed via catalyst-free o-phthalaldehyde/amine (hydrazide) cross-linking reaction. The hydrogels demonstrate rapid and firm adhesion to various tissues, and an o-phthalaldehyde-mediated tissue adhesion mechanism is established. The hydrogel adhesives show controlled degradation profiles of 6 to 22 weeks in vivo through the incorporation of disulfide bonds into hydrogel network. In liver and blood vessel injury, the hydrogels effectively seal the incisions and rapidly stop bleeding. In rat and rabbit models of full-thickness skin incision, the hydrogel adhesives quickly close the incisions and accelerate wound healing, which exhibit efficacies superior to those of commercially available fibrin glue and cyanoacrylate glue. Thus, the hydrogel adhesives show great potential for sutureless wound closure, hemostasis sealing, and prevention of leakage in surgical applications.
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Affiliation(s)
- Hui Ren
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Zhen Zhang
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Xueliang Cheng
- Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130014, China
| | - Zheng Zou
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Xuesi Chen
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Chaoliang He
- CAS Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
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Erdi M, Sandler A, Kofinas P. Polymer nanomaterials for use as adjuvant surgical tools. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1889. [PMID: 37044114 PMCID: PMC10524211 DOI: 10.1002/wnan.1889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/03/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023]
Abstract
Materials employed in the treatment of conditions encountered in surgical and clinical practice frequently face barriers in translation to application. Shortcomings can be generalized through their reduced mechanical stability, difficulty in handling, and inability to conform or adhere to complex tissue surfaces. To overcome an amalgam of challenges, research has sought the utilization of polymer-derived nanomaterials deposited in various fashions and formulations to improve the application and outcomes of surgical and clinical interventions. Clinically prevalent applications include topical wound dressings, tissue adhesives, surgical sealants, hemostats, and adhesion barriers, all of which have displayed the potential to act as superior alternatives to current materials used in surgical procedures. In this review, emphasis will be placed not only on applications, but also on various design strategies employed in fabrication. This review is designed to provide a broad and thought-provoking understanding of nanomaterials as adjuvant tools for the assisted treatment of pathologies prevalent in surgery. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery.
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Affiliation(s)
- Metecan Erdi
- Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, Maryland, USA
| | - Anthony Sandler
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Joseph E. Robert Jr. Center for Surgical Care, Children's National Medical Center, Washington, DC, USA
| | - Peter Kofinas
- Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, Maryland, USA
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Charoenlux P, Utoomprurkporn N, Seresirikachorn K. Cyanoacrylate Tissue Adhesives Compared With Sutures on Facial and Neck Wounds: A Meta-analysis. OTO Open 2023; 7:e73. [PMID: 37693830 PMCID: PMC10487314 DOI: 10.1002/oto2.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Objective To compare the effectiveness between cyanoacrylate tissue adhesives (CTAs) and sutures for skin closure on the face and neck. Data Sources Embase, Medline, Scopus, Central, Web of Science. Review Methods Randomized controlled trials comparing CTAs versus sutures for skin closure on the face and neck were included. Primary outcomes were cosmetic outcomes. Secondary outcomes were scar depth, scar width, pain, closure time, cost, and adverse events. Subgroup analyses were performed by wound locations, type of CTAs, type of sutures, age groups, and type of wounds. Physicians and patients evaluated the cosmetic outcomes. Results Eighteen studies (1020 patients) were included. CTAs offered better cosmetic outcomes by Wound Registry Scale at ≤1 month (physician: mean difference [MD]: -1.50, 95% confidence interval, CI: -2.42 to -0.58). The cosmetic outcomes assessed by Visual Analog Scale were comparable at >1 to ≤3 months (physicians: standard mean difference [SMD], -0.01, 95% CI, -0.25 to 0.23, patients: SMD, -0.02, 95% CI, -0.84 to 0.79). The cosmetic outcomes by the Patient and Observer Scar Assessment Scale favored sutures at >3 to 12 months (physician: MD 4.26, 95% CI, 2.02-6.50). Subgroup analyses revealed no differences. CTAs offered less scar depth, scar width, pain, closure time, and total cost of closure. Adverse events were similar. Conclusion Based on the wound healing process, the cosmetic outcomes exhibited a favorable inclination toward CTAs at <1 month while demonstrating comparable results between CTAs and sutures at >1 to ≤3 months. Subsequently, sutures exhibited superior cosmetic outcomes compared to CTAs at >3 to 12 months.
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Affiliation(s)
- Prapitphan Charoenlux
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
| | - Nattawan Utoomprurkporn
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
- Faculty of Brain Science, UCL Ear InstituteUniversity College LondonLondonUK
| | - Kachorn Seresirikachorn
- Department of OtolaryngologyFaculty of Medicine, Chulalongkorn UniversityBangkokThailand
- Endoscopic Nasal and Sinus Surgery Excellence CenterKing Chulalongkorn Memorial HospitalBangkokThailand
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Terschuur JA, Coomer RPC, Handel I, Pressanto MC, McKane SA. Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses. Vet Rec 2023; 192:e2732. [PMID: 36809672 DOI: 10.1002/vetr.2732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.
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Affiliation(s)
| | | | - Ian Handel
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Roslin, Midlothian, UK
| | | | - Shaun A McKane
- Cotts Equine Hospital, Robeston Wathen, Narberth, Wales, UK
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15
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Microbubbles for human diagnosis and therapy. Biomaterials 2023; 294:122025. [PMID: 36716588 DOI: 10.1016/j.biomaterials.2023.122025] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023]
Abstract
Microbubbles (MBs) were observed for the first time in vivo as a curious consequence of quick saline injection during ultrasound (US) imaging of the aortic root, more than 50 years ago. From this serendipitous event, MBs are now widely used as contrast enhancers for US imaging. Their intrinsic properties described in this review, allow a multitude of designs, from shell to gas composition but also from grafting targeting agents to drug payload encapsulation. Indeed, the versatile MBs are deeply studied for their dual potential in imaging and therapy. As presented in this paper, new generations of MBs now opens perspectives for targeted molecular imaging along with the development of new US imaging systems. This review also presents an overview of the different therapeutic strategies with US and MBs for cancer, cardiovascular diseases, and inflammation. The overall aim is to overlap those fields in order to find similarities in the MBs application for treatment enhancement associated with US. To conclude, this review explores the new scales of MBs technologies with nanobubbles development, and along concurrent advances in the US imaging field. This review ends by discussing perspectives for the booming future uses of MBs.
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Xu K, Wu X, Zhang X, Xing M. Bridging wounds: tissue adhesives' essential mechanisms, synthesis and characterization, bioinspired adhesives and future perspectives. BURNS & TRAUMA 2022; 10:tkac033. [PMID: 36225327 PMCID: PMC9548443 DOI: 10.1093/burnst/tkac033] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/29/2022] [Indexed: 11/05/2022]
Abstract
Bioadhesives act as a bridge in wound closure by forming an effective interface to protect against liquid and gas leakage and aid the stoppage of bleeding. To their credit, tissue adhesives have made an indelible impact on almost all wound-related surgeries. Their unique properties include minimal damage to tissues, low chance of infection, ease of use and short wound-closure time. In contrast, classic closures, like suturing and stapling, exhibit potential additional complications with long operation times and undesirable inflammatory responses. Although tremendous progress has been made in the development of tissue adhesives, they are not yet ideal. Therefore, highlighting and summarizing existing adhesive designs and synthesis, and comparing the different products will contribute to future development. This review first provides a summary of current commercial traditional tissue adhesives. Then, based on adhesion interaction mechanisms, the tissue adhesives are categorized into three main types: adhesive patches that bind molecularly with tissue, tissue-stitching adhesives based on pre-polymer or precursor solutions, and bioinspired or biomimetic tissue adhesives. Their specific adhesion mechanisms, properties and related applications are discussed. The adhesion mechanisms of commercial traditional adhesives as well as their limitations and shortcomings are also reviewed. Finally, we also discuss the future perspectives of tissue adhesives.
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Affiliation(s)
- Kaige Xu
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Xiaozhuo Wu
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Xingying Zhang
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
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Sharma V, Manhas A, Gupta S, Dikshit M, Jagavelu K, Verma RS. Fabrication, characterization and in vivo assessment of cardiogel loaded chitosan patch for myocardial regeneration. Int J Biol Macromol 2022; 222:3045-3056. [DOI: 10.1016/j.ijbiomac.2022.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 11/05/2022]
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Bath MF, Davies J, Suresh R, Machesney MR. Surgical site infections: a scoping review on current intraoperative prevention measures. Ann R Coll Surg Engl 2022; 104:571-576. [PMID: 36044920 PMCID: PMC9433173 DOI: 10.1308/rcsann.2022.0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION Surgical site infections (SSIs) remain a significant cause of morbidity for surgical patients worldwide and with growing rates of antibiotic resistance, the development of new nonantimicrobial techniques to target SSI reduction is crucial. This review aimed to explore available nonantibiotic intraoperative interventions to reduce the risk of SSI. METHODS A literature search was undertaken using Medline, Web of Science, Embase, and Cochrane Library databases. Any study published from 1 January 1980 to 1 September 2021 that described any nonantibiotic intraoperative physical technique aiming to reduce SSI rates, with a primary or secondary outcome of SSI rates, was included. FINDINGS A total of 45 articles were included in the final scoping review. The current nonantibiotic intraoperative interventions advised for use include chlorhexidine skin preparation with alcohol, pressurised wound irrigation, Triclosan-coated sutures for skin closure, and negative pressure wound therapy. Many other widely used surgical practices do not have the supporting evidence to validate their routine use in clinical practice to reduce SSI rates. CONCLUSIONS We identified several techniques that can be used in the operating theatre to provide additional opportunities to reduce SSI rates. However, strict adherence to current established SSI prevention guidelines remains the mainstay of ensuring SSI rates remain low.
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Affiliation(s)
- MF Bath
- Whipps Cross Hospital, Barts Health NHS Trust, UK
| | - J Davies
- Whipps Cross Hospital, Barts Health NHS Trust, UK
| | - R Suresh
- Whipps Cross Hospital, Barts Health NHS Trust, UK
| | - MR Machesney
- Whipps Cross Hospital, Barts Health NHS Trust, UK
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Horvath-Pereira BDO, Paulini F, Sotelo MO, Leardini EG, Tavares DC, Almeida GHDR, da Silva Júnior LN, Pinho LBM, Miglino MA, Araujo MS. Case report: An innovative non-invasive technique to manage shell injuries in C. carbonarius. Front Vet Sci 2022; 9:930419. [PMID: 35982919 PMCID: PMC9379249 DOI: 10.3389/fvets.2022.930419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Shell fractures are one of the most traumatic and recurrent injuries observed in chelonians during clinical practice. The most common causes of fractures are falling, being run over by automobiles, being burned, and wild animal bites. Epoxy, acrylic resin, polyester, fiber-grass blanket, and screw fixation are among the current techniques used to treat fractures. Regarding the difficulty of fracture repair in the carapace, this case report aimed to report a procedure that is effective, less time-consuming, accessible, affordable, and safe for shell fractures in C. carbonarius. During the physical examination, the animal showed two fractures, in the dorsal region of the carapace and right lateral side of the bridge, with subcutaneous tissue exposure and loss of a small piece of dorsocranial carapace. To treat these injuries, the animal was submitted to a resin application. The procedure consists of using ethyl-cyanoacrylate associated with sodium bicarbonate, which produces a more resistant resin that is bactericidal, non-toxic, and easy to apply in a low surgery time compared to the common methods used to fix shell fractures. The resin application was successfully done, and the animal was under care for a month after the fracture reduction. It was observed that the treatment was effective, presenting reduction of the fracture. A month after the procedure, the animal showed no intercurrence. Three years after the procedure, the animal still presents part of the material still fixed to the shell, normal growth, without interference in locomotor capacity. This resin proved to be an innovative and promising alternative way to treat fractures, suggesting the development of new non-invasive approaches for several tissues and different animal species.
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Affiliation(s)
| | - Fernanda Paulini
- Department of Physiological Sciences, Institute of Biological Sciences, University of Brasilia, Brasília, Brazil
| | | | | | | | | | | | - Letícia Beatriz Mazo Pinho
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maria Angelica Miglino
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Michelle Silva Araujo
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
- School of Veterinary Medicine, UniEduk University Center, Indaiatuba, Brazil
- *Correspondence: Michelle Silva Araujo
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Larpbunphol N, Chanamuangkon T, Thamrongananskul N. The fluoride release, abrasion resistance, and cytotoxicity to hGFs of a novel cyanoacrylate-based fluoride varnish compared with conventional fluoride varnish. Dent Mater J 2022; 41:757-766. [PMID: 35793940 DOI: 10.4012/dmj.2022-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The important factors contributing to the effectiveness of fluoride varnish are the amount of fluoride ion release and the retention time of the varnish on the tooth surface. Commercial fluoride varnishes are susceptible to mechanical removal; therefore, patients are informed to avoid eating or performing oral hygiene for at least 12-24 h, which results in patient inconvenience. However, cyanoacrylate-based fluoride varnish would not have these disadvantages. This study compared the daily fluoride ion release, abrasion resistance to brushing, and toxicity to human gingival fibroblasts (hGFs) between a newly-developed cyanoacrylate-based fluoride varnish and conventional fluoride varnish (Duraphat varnish). The results demonstrated that the cyanoacrylate varnish had a significantly higher fluoride release for 9 days after application, higher abrasion resistance to brushing, and slightly less toxicity to hGFs compared with Duraphat varnish. This novel cyanoacrylate varnish could be an alternative fluoride varnish for preventing dental caries.
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21
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Bu Y, Pandit A. Cohesion mechanisms for bioadhesives. Bioact Mater 2022; 13:105-118. [PMID: 35224295 PMCID: PMC8843969 DOI: 10.1016/j.bioactmat.2021.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 02/08/2023] Open
Abstract
Due to the nature of non-invasive wound closure, the ability to close different forms of leaks, and the potential to immobilize various devices, bioadhesives are altering clinical practices. As one of the vital factors, bioadhesives' strength is determined by adhesion and cohesion mechanisms. As well as being essential for adhesion strength, the cohesion mechanism also influences their bulk functions and the way the adhesives can be applied. Although there are many published reports on various adhesion mechanisms, cohesion mechanisms have rarely been addressed. In this review, we have summarized the most used cohesion mechanisms. Furthermore, the relationship of cohesion strategies and adhesion strategies has been discussed, including employing the same functional groups harnessed for adhesion, using combinational approaches, and exploiting different strategies for cohesion mechanism. By providing a comprehensive insight into cohesion strategies, the paper has been integrated to offer a roadmap to facilitate the commercialization of bioadhesives. Bioadhesive are altering clinical practices. Bioadhesives for medical applications needs different cohesion strategies. Better understanding of cohesion mechanism can design suitable bioadhesives.
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22
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Zhao JJ, Tashi S, Lim EJ, Wong SY, Wang YW, Sultana R, Leong S, Chua JME, Too CW, Chandramohan S. Octyl cyanoacrylate skin adhesive with or without subcuticular suture for skin closure after implantable venous port placement for oncology patients: a propensity-score matching analysis. Clin Radiol 2022; 77:628-635. [PMID: 35659114 DOI: 10.1016/j.crad.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/21/2022] [Indexed: 11/03/2022]
Abstract
AIM To compare peri-operative outcomes of skin closure with octyl cyanoacrylate (OCA) skin adhesive (Dermabond) with or without subcuticular sutures after deep dermal suturing for implantable venous port placement closure. MATERIALS AND METHODS Seven hundred and ninety-two single-lumen implantable venous port insertions for chemotherapy were reviewed from September 2019 to March 2021 in a retrospective single-centre study. Propensity-score matching by a 1:1 nearest neighbour algorithm was conducted to control for confounding baseline differences. Distances were determined by logistic regression. Propensity-score matching was performed based on the following variables: age at procedure, gender, race, operator's seniority, use of anchoring polypropylene suture (PROLENE), port model, and volume of intra-operative local analgesia. The primary outcome was wound dehiscence at the first follow-up (∼1 week). RESULTS The 792 port insertions were conducted in 302 males (38.1%), median age 63 years (IQR: 54-69). Of the 656 wounds closed with subcuticular sutures and skin adhesive, 136 were matched in a 1:1 fashion against procedures closed without a subcuticular suture. No significant differences were demonstrated in pain scores, bleeding, swelling, bruising, fever, wound dehiscence, and discharge at postoperative day 1 (POD1) and at first follow-up between the groups (all p>0.05). Of note, no significant differences in wound dehiscence at first follow-up was found in both unmatched (p=0.133) and matched cohorts (McNemar-Bowker's χ2 = 1.167, p=0.761). CONCLUSION These findings suggest that the omission of subcuticular sutures during implantable venous port closure may not compromise peri-operative outcomes when OCA skin adhesives were used.
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Affiliation(s)
- J J Zhao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - S Tashi
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - E J Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - S Y Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Y W Wang
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - R Sultana
- Center of Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore
| | - S Leong
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - J M E Chua
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - C W Too
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - S Chandramohan
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore.
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Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials. Dermatitis 2022; 34:191-200. [PMID: 35481860 DOI: 10.1097/der.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.
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McQuillan TJ, Vora M, Hawkins J, Kenney D, Diaz R, Ladd AL. Adhesive Taping Shows Better Cosmetic Outcomes Than Tissue Adhesives for Sutured Upper Extremity Incisions: A Single-Blind Prospective Randomized Controlled Trial. Orthopedics 2022; 45:e42-e46. [PMID: 34734780 DOI: 10.3928/01477447-20211101-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adhesive taping is commonly used to reinforce wound closure and approximate minor lacerations. Recently, tissue adhesives such as 2-octylcyanoacrylate have gained popularity because of their high tensile strength, bacteriostatic properties, and spontaneous peeling. We sought to evaluate the cosmetic result of upper extremity incisions closed primarily by subcuticular suture, randomizing the application of tissue adhesive vs adhesive taping to different halves of the same surgical incision. Subjects were recruited from patients undergoing common procedures at the senior surgeon's hand surgery clinic. After primary closure, we applied either quarter-inch adhesive tape or tissue adhesive to the proximal and distal aspects of the wounds, based on a preoperative randomization protocol. We assessed the scars at approximately 3 months (range, 2-5 months). Subjects completed a validated scar assessment questionnaire, and a blinded photograph was obtained to allow 2 independent surgeons to assess the scar. Mean age was 63 years (SD, 11.8 years; range, 21-88 years); 56% of patients were women, and 44% were men. Most of the incisions were open carpal tunnel release and thumb carpometacarpal arthroplasty (14 each). Adhesive taping showed a better overall mean score based on evaluation by the hand surgeons, a finding that was statistically significant. The greatest differences were observed between color and size, but no subcategories were significantly different. Patients reported nonstatistical, but slightly better overall cosmetic outcomes with adhesive taping rather than tissue adhesive. Adhesive strips provide a modest but significant improvement in cosmetic outcomes vs more expensive tissue adhesive. Future evaluation of closure methods that evaluate cost, speed of application, suture technique, and dressing will optimize scar appearance. [Orthopedics. 2022;45(1):e42-e46.].
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Shetty R, Chitnis A, Puppala P, Mistry G, Shetty O. Comparative evaluation of the efficacy of two medical grade adhesives for the retention of extraoral maxillofacial prosthesis. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/2321-8568.334589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tao C, Jin M, Yao H, Wang DA. Dopamine based adhesive nano-coatings on extracellular matrix (ECM) based grafts for enhanced host-graft interfacing affinity. NANOSCALE 2021; 13:18148-18159. [PMID: 34709280 DOI: 10.1039/d1nr06284k] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Interfacing affinity between grafts and host tissues is an urgent issue that needs to be addressed for the clinical translation of tissue engineered extracellular matrix (ECM) based grafts. Dopamine is known as a universal adhesive, the catechol groups on which could form chelating bonds with metal ions. Herein we developed an adhesive nano-coating on ECM based grafts which could crosslink in situ with ferric ions for fixation with surrounding tissues after implantation without affecting the porous structures of the grafts. Therefore, decellularized living hyaline cartilage graft (dLhCG), a model ECM-based graft, with dopamine based natural biological material adhesive coatings was manufactured to address the interfacing affinity issue between ECM-based grafts and cartilage. A macromolecule backbone was needed for the coating material to avoid the formation of a rigid crosslinking system and adverse effects caused by small molecules of dopamine. Chondroitin sulfate (CS), a cartilage derived sulfated GAG, was chosen as the backbone to fabricate dopamine modified CS (CSD) with no impurities introduced to the joint. Dopamine modified serum albumin (BCD) was also chosen for the favorable biocompatibility of albumin. Both dLhCG coated with CSD and dLhCG coated with BCD showed enhanced adhesive strength with cartilage after chelating with ferric ions in situ compared to dLhCG and further potential in improving the interfacing affinity of dLhCG with cartilage.
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Affiliation(s)
- Chao Tao
- Karolinska Institutet Ming Wai Lau Centre for Reparative Medicine, HKSTP, Sha Tin, Hong Kong SAR.
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR
| | - Min Jin
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR
| | - Hang Yao
- School of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225009, Jiangsu, P. R. China.
| | - Dong-An Wang
- Karolinska Institutet Ming Wai Lau Centre for Reparative Medicine, HKSTP, Sha Tin, Hong Kong SAR.
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR
- Shenzhen Research Institute, City University of Hong Kong, Shenzhen, P. R. China
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Comparison of Polymeric Cyanoacrylate Adhesives with Suturing in Free Gingival Graft Stability: A Split Mouth Trial. Polymers (Basel) 2021; 13:polym13203575. [PMID: 34685335 PMCID: PMC8539045 DOI: 10.3390/polym13203575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/10/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
The aim is to compare the use of Cyanoacrylate adhesives (CAA) to the conventional suturing technique in terms of free gingival grafts (FGG) stability and healing in lower anterior and premolar regions. A split mouth design was initiated on 22 participants. Each side (from 2nd premolar to central incisor) was randomized to either the control or test groups. In the control group, sutures were used to stabilize the FGG, while, in the test group, the FGG was stabilized with butyl-cyanoacrylate. Full-periodontal clinical parameters were employed to assess the periodontal health. FGG-related parameters assessed included the keratinized tissue width (KTW), gingival tissue thickness (GTT), FGG shrinkage% and pain using the VAS score. No significant differences in the mean values of the KTW nor FGG shrinkage% across six time points (p < 0.05) were observed, whereas highly significant differences in the mean values of GTT across six time points (F = 3.32; p = 0.008) were observed. The use of CAA in FGG stability and healing is comparable to conventional suturing for soft tissue grafts in terms of success outcomes. With its cost effectiveness, lesser time consumption, post-operative pain and comparable graft stability and dimensions, the use of CAA may be a promising alternative for conventional and microsurgical techniques for the stabilization of FGG in the oral cavity.
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Adl H, Henkelman E, Goldman RD. Topical skin adhesives for laceration repair in children. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:260-262. [PMID: 33853912 DOI: 10.46747/cfp.6704260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
QUESTION A 4-year-old child presented to my office recently with a 2-cm forehead laceration. The child had needle phobia and was very upset, so suturing in the office might have been very challenging. The parents were also concerned about the use of suture. Can topical skin adhesives (TSAs) be used instead of sutures, and what factors should be considered? ANSWER Lacerations in children are common and TSAs are useful alternatives to sutures. They achieve comparable outcomes to suturing in appropriately selected wounds. Appropriate lacerations are small, superficial, appropriately cleaned, and have well approximated edges that are not under tension. Complications such as wound dehiscence and infection are rare and cosmetic outcomes are comparable to sutures. Using TSAs can also save time, minimize patient anxiety, and eliminate the need for suture removal.
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Kumar A, Domb AJ. Polymerization Enhancers for Cyanoacrylate Skin Adhesive. Macromol Biosci 2021; 21:e2100143. [PMID: 34268867 DOI: 10.1002/mabi.202100143] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/27/2021] [Indexed: 11/07/2022]
Abstract
Cyanoacrylate glues are a renowned synthetic tissue sealant that cures rapidly through polymerization at room temperature, felicitating medical glues to treat skin wounds and surgical openings. Despite a wide range of cyanoacrylates available, only 2-octyl cyanoacrylates (OCA) provides the best biocompatibility. In this study, the polymerization and adhesive properties of 2-octyl cyanoacrylates (OCA) are explored in the presence of a highly biocompatible and biochemically inert polymer, poly(ethylene glycol) polyhedral oligomeric silsesquioxane (PEG-POSS). The effect of PEG-POSS on the polymerization of OCA is examined on a plastic surface and over pig skin. A peel-test is performed to evaluate the strength of OCA adhesive properties between two pieces of pig skin samples. Additionally, thin films of OCA are prepared using different fillers and evaluated for tear test. The results reveal that when applied on the plastic or pig skin, PEG-POSS initiated polymerization in OCA yields a high molecular weight OCA polymer with much better adhesive properties compared to commercially available cyanoacrylate adhesives. The relative change in the molecular weights of OCA compared to commercially available cyanoacrylate bioadhesives such as Dermaflex is much higher. The pig skin peeling test shows that OCA needs higher peeling force than Dermaflex.
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Affiliation(s)
- Awanish Kumar
- Institute of Drug Research, Alex Grass Centre for Drug Design and Novel Therapeutics, School of Pharmacy-Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, 91120, Israel
| | - Abraham J Domb
- Institute of Drug Research, Alex Grass Centre for Drug Design and Novel Therapeutics, School of Pharmacy-Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, 91120, Israel
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Ma Z, Bao G, Li J. Multifaceted Design and Emerging Applications of Tissue Adhesives. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2007663. [PMID: 33956371 DOI: 10.1002/adma.202007663] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/04/2020] [Indexed: 05/24/2023]
Abstract
Tissue adhesives can form appreciable adhesion with tissues and have found clinical use in a variety of medical settings such as wound closure, surgical sealants, regenerative medicine, and device attachment. The advantages of tissue adhesives include ease of implementation, rapid application, mitigation of tissue damage, and compatibility with minimally invasive procedures. The field of tissue adhesives is rapidly evolving, leading to tissue adhesives with superior mechanical properties and advanced functionality. Such adhesives enable new applications ranging from mobile health to cancer treatment. To provide guidelines for the rational design of tissue adhesives, here, existing strategies for tissue adhesives are synthesized into a multifaceted design, which comprises three design elements: the tissue, the adhesive surface, and the adhesive matrix. The mechanical, chemical, and biological considerations associated with each design element are reviewed. Throughout the report, the limitations of existing tissue adhesives and immediate opportunities for improvement are discussed. The recent progress of tissue adhesives in topical and implantable applications is highlighted, and then future directions toward next-generation tissue adhesives are outlined. The development of tissue adhesives will fuse disciplines and make broad impacts in engineering and medicine.
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Affiliation(s)
- Zhenwei Ma
- Department of Mechanical Engineering, McGill University, Montréal, QC, H3A 0C3, Canada
| | - Guangyu Bao
- Department of Mechanical Engineering, McGill University, Montréal, QC, H3A 0C3, Canada
| | - Jianyu Li
- Department of Mechanical Engineering, McGill University, Montréal, QC, H3A 0C3, Canada
- Department of Biomedical Engineering, McGill University, Montréal, QC, H3A 2B4, Canada
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Yuan H, Zhang YZ, Jie H, Li SL. The Application of Tissue Glue in Eyelid Laceration Repair in Children During the Coronavirus Disease 2019 Pandemic Lockdown in Wuhan. Clin Cosmet Investig Dermatol 2021; 14:541-546. [PMID: 34045878 PMCID: PMC8146746 DOI: 10.2147/ccid.s308092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To discuss a rapid and effective treatment used for children with eyelid lacerations during the COVID-19 lockdown in Wuhan to limit the risk of cross-infection. METHODS A comparative study was conducted of forty-five patients with eyelid lacerations who attended the Ophthalmology Department of Wuhan Children's Hospital between January 23, 2020 and March 6, 2020. The tissue glue Histoacryl was used to bond the wounds in 24 cases, while the traditional suture method was used for 21 cases. The wound healing time, complications, treatment satisfaction, and number of visits of the two groups were compared. RESULTS The two groups had similar baseline characteristics. The wound healing time (from wound disinfection to wound dressing) was shorter in the tissue glue group (4.35 ± 0.47min versus 11.71 ± 1.85 min, P< 0.01). There was 1 case of wound dehiscence in the tissue glue group. Twenty-two cases in the tissue glue group were satisfied, 2 cases were basically satisfied, and 0 were dissatisfied. Eleven cases in the traditional suture group were satisfied, 9 cases were basically satisfied, and 1 case was dissatisfied. The difference was statistically significant (P < 0.05). In terms of the number of visits, the tissue glue group visited (1.54 ± 0.88) times, while the traditional suture group visited (2.38 ± 0.59) times. The difference between the two groups was statistically significant (P < 0.01). The real-time reverse transcriptase polymerase chain tests for severe acute respiratory syndrome coronavirus 2 of all medical staff in the ophthalmology emergency room were negative. CONCLUSION Compared with the traditional suture method, tissue glue used in eyelid laceration in children has the advantages of painlessness, shorter operation duration, higher safety and satisfaction, greater ease of care, and fewer hospital visits. Tissue glue can be widely used to reduce the risk of cross-infection.
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Affiliation(s)
- Hua Yuan
- Department of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People’s Republic of China
| | - Yu-Zhao Zhang
- Department of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People’s Republic of China
| | - Hong Jie
- Department of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People’s Republic of China
| | - Shi-Lian Li
- Department of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People’s Republic of China
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Tandon S, Smale M, Pacilli M, Nataraja RM. Tissue adhesive and adhesive tape for pediatric wound closure: A systematic review and meta-analysis. J Pediatr Surg 2021; 56:1020-1029. [PMID: 32888718 DOI: 10.1016/j.jpedsurg.2020.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tissue adhesive (TiA), adhesive tape (AdT), and sutures can be used to close surgical wounds and lacerations in children. However, it is unclear which technique produces the best results. METHODS In this prospectively registered study, the PubMed, Ovid MEDLINE, Cochrane Library, Centre for Reviews and Dissemination Database, and ScienceDirect databases were searched. English language studies published between January 1980 and August 2017 evaluating TiA and/or AdT for primary skin closure of surgical wounds or lacerations in patients aged ≤18 years were included. Study endpoints included clinician-rated wound cosmesis and incidence of wound complications. RESULTS Thirty-one studies were included in the systematic review and 16 studies in the meta-analysis. Amongst heterogeneous studies, AdT yielded marginally better cosmetic outcomes than TiA (p = 0.04). There was no difference in cosmesis between sutured wounds and those closed with TiA (p = 0.2). No difference in overall risk of wound infection or dehiscence was identified when comparing TiA with AdT (p = 0.3), and TiA with sutures (p = 0.9 and 0.3 respectively). CONCLUSIONS TiA, AdT, and sutures can all be used for wound closure with equivalent risk of wound infection and dehiscence. AdT appears to convey better cosmesis. Further adequately powered studies directly comparing techniques are required. LEVELS OF EVIDENCE Level IV.
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Affiliation(s)
- Sarthak Tandon
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Matthew Smale
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Maurizio Pacilli
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia; Department of Paediatrics & Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Ramesh M Nataraja
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia; Department of Paediatrics & Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia.
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Guo J, Zhang F, Guo J, Guo L, Gu Y, Huang Y. A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins. Phlebology 2021; 36:597-608. [PMID: 33870789 DOI: 10.1177/02683555211008762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to systemically review and analyze the efficacy of cyanoacrylate ablation (CA) in comparison with endovenous thermal ablation (ETA) for the treatment of incompetent saphenous veins. METHODS A systematic literature search was conducted using databases of Pubmed, Embase, and Cochrane Library from the times of their inception to April 2020. Studies were selected based on inclusion and exclusion criteria after assessing the risk of bias in comparative studies with Cochrane and rating quality of evidence with the GRADE methodology. The meta-analysis was carried out using the Review Manager 5.4 program to conduct homogeneity tests. RESULTS One cohort study and three randomized controlled trials (RCT), including a total of 1457 participants were included in the meta-analysis. ETA included endovenous laser ablation (ELVA) and radiofrequency ablation (RFA) in the selected studies. Comparison between CA and a combination of EVLA and RFA or RFA alone were carried out in two of RCTs, while comparison between CA with EVLA was conducted in one RCT and the cohort study. There was no statistical difference in closure rates between CA and ETA after pooled analysis. Similar symptom alleviation observed between different groups. However, the CA group showed a lower ecchymosis rate than RFA and a significantly lower incidence of adverse events, such as ecchymosis, phlebitis and paresthesia, than EVLA. Compared with ETA, the patients received CA treatment exhibited lower pain scores in a shorter procedure duration without needing compression stocking, returned to normal life sooner, and had significantly better quality of care. There was no significant difference in the number needed to treat for additional therapy after three months of follow-up between groups. CONCLUSIONS This meta-analysis indicates that CA has better overall outcomes than ETA and offers superior clinical benefits in the treatment of incompetent saphenous veins.
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Affiliation(s)
- Julong Guo
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fan Zhang
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianming Guo
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lianrui Guo
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongquan Gu
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Huang
- Department of Vascular Surgery, 71044Xuanwu Hospital, Capital Medical University, Beijing, China
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Zhong Y, Hu H, Min N, Wei Y, Li X, Li X. Application and outlook of topical hemostatic materials: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:577. [PMID: 33987275 DOI: 10.21037/atm-20-7160] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Bleeding complications can cause significant morbidities and mortalities in both civilian and military conditions. The formation of stable blood clots or hemostasis is essential to prevent major blood loss and death from excessive bleeding. However, the body's self-coagulation process cannot accomplish timely hemostasis without the assistance of hemostatic agents under some conditions. In the past two decades, topical hemostatic materials and devices containing platelets, fibrin, and polysaccharides have been gradually developed and introduced to induce faster or more stable blood clot formation, updating or iterating traditional hemostatic materials. Despite the various forms and functions of topical hemostatic materials that have been developed for different clinical conditions, uncontrolled hemorrhage still causes over 30% of trauma deaths across the world. Therefore, it is important to fabricate fast, efficient, safe, and ready-to-use novel hemostatic materials. It is necessary to understand the coagulation process and the hemostatic mechanism of different materials to develop novel topical hemostatic agents, such as tissue adhesives and sealants from various natural and synthetic materials. This review discusses the structural features of topical hemostatic materials related to the stimulation of hemostasis, summarizes the commercially available products and their applications, and reviews the ongoing clinical trials and recent studies concerning the development of different hemostatic materials.
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Affiliation(s)
- Yuting Zhong
- Department of General Surgery, Chinese PLA Hospital & Chinese PLA Medical School, Beijing, China
| | - Huayu Hu
- School of Medicine, Nankai University, Tianjin, China
| | - Ningning Min
- School of Medicine, Nankai University, Tianjin, China
| | - Yufan Wei
- School of Medicine, Nankai University, Tianjin, China
| | - Xiangdong Li
- State Key Laboratory of Agrobiotechnology, College of Biological Sciences, China Agricultural University, Beijing, China
| | - Xiru Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
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Abstract
Polymeric tissue adhesives provide versatile materials for wound management and are widely used in a variety of medical settings ranging from minor to life-threatening tissue injuries. Compared to the traditional methods of wound closure (i.e., suturing and stapling), they are relatively easy to use, enable rapid application, and introduce minimal tissue damage. Furthermore, they can act as hemostats to control bleeding and provide a tissue-healing environment at the wound site. Despite their numerous current applications, tissue adhesives still face several limitations and unresolved challenges (e.g., weak adhesion strength and poor mechanical properties) that limit their use, leaving ample room for future improvements. Successful development of next-generation adhesives will likely require a holistic understanding of the chemical and physical properties of the tissue-adhesive interface, fundamental mechanisms of tissue adhesion, and requirements for specific clinical applications. In this review, we discuss a set of rational guidelines for design of adhesives, recent progress in the field along with examples of commercially available adhesives and those under development, tissue-specific considerations, and finally potential functions for future adhesives. Advances in tissue adhesives will open new avenues for wound care and potentially provide potent therapeutics for various medical applications.
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Affiliation(s)
- Sungmin Nam
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts 02134, United States.,Wyss Institute for Biologically Inspired Engineering, Cambridge, Massachusetts 02115, United States
| | - David Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts 02134, United States.,Wyss Institute for Biologically Inspired Engineering, Cambridge, Massachusetts 02115, United States
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Escobar M, Pauletto P, Benfatti CAM, Cruz ACC, Flores-Mir C, Henriques BAPC. Effect of cyanoacrylate tissue adhesive in postoperative palatal pain management: a systematic review. Clin Oral Investig 2020; 25:3609-3622. [PMID: 33200283 DOI: 10.1007/s00784-020-03683-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management. MATERIALS AND METHODS Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed. RESULTS Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment. CONCLUSIONS Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG. CLINICAL RELEVANCE The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.
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Affiliation(s)
- Mario Escobar
- Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Patrícia Pauletto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ariadne Cristiane Cabral Cruz
- Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil. .,Laboratory of Applied Virology, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Martinez-Lopez J, Brown JA, Werre SR. Incisional complications after skin closure with n-butyl cyanoacrylate or stainless-steel skin staples in horses undergoing colic surgery. Vet Surg 2020; 50:186-195. [PMID: 33107618 DOI: 10.1111/vsu.13534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/12/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare the prevalence of incisional complications after skin closure with n-butyl cyanoacrylate (NBC) or stainless-steel skin staples (SS) after ventral midline celiotomy for colic surgery in the horse. STUDY DESIGN Retrospective study (2014-2018). ANIMALS Two hundred eighteen horses. METHODS Medical records of horses that underwent exploratory celiotomy for colic were included when the skin was closed with NBC or SS and the horse survived ≥15 days after surgery. Records and a follow-up questionnaire were used to determine in-hospital and posthospital discharge incisional complications. Associations between variables were assessed by using bivariable and multivariable analysis. RESULTS The cutaneous incision was closed with SS in 113 of 218 (51.8%) horses and with NBC in 105 of 218 (48.2%) horses. Follow-up information was available in 166 of 218 horses. Five horses with incisional complications prior to discharge but without follow-up were included in the overall analysis. Incisional complications were recorded in 17.5% (30/171) of horses, including 19.1% (17/89) of closures with SS and 15.9% (12/82) of closures with NBC (P = .54). Complications occurred before discharge in 14 of 218 (6.4%) horses and after discharge in 16 of 166 (9.6%) horses. Four horses with in-hospital incisional complications (surgical site infection) developed a second complication after discharge (hernia). Packed cell volume was a risk factor for in-hospital incisional complications (P = .04), and in-hospital incisional complications were associated with posthospital discharge incisional complications (P = .01). CONCLUSION Occurrence of incisional complications did not differ between NBC and SS. CLINICAL SIGNIFICANCE N-butyl cyanoacrylate is a suitable alternative to SS to close the cutaneous incision for ventral midline celiotomy for colic surgery in the horse.
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Affiliation(s)
- Javier Martinez-Lopez
- Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, Virginia
| | - James A Brown
- Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, Virginia
| | - Stephen R Werre
- Population Health Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Population Health Sciences, Blacksburg, Virginia
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Ochiai AM, Araújo NM, Moraes SDTA, Caroci-Becker A, Sparvoli LG, Teixeira TT, Carvalho RR. The use of non-surgical glue to repair perineal first-degree lacerations in normal birth: A non-inferiority randomised trial. Women Birth 2020; 34:e514-e519. [PMID: 33071207 DOI: 10.1016/j.wombi.2020.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PROBLEM Surgical glue has been indicated for uncomplicated operatory wounds; however, it has a considerable cost. Non-surgical glue, a commercially available and cheaper product, has not been studied for repairing postpartum lacerations. AIM To compare non-surgical glue to traditional sutures on perineal first-degree lacerations after normal birth. METHODS In a prospective, open-label, non-inferiority, randomised controlled trial, we selected childbearing women who were admitted for normal term births and in whom skin lacerations occurred. They were assigned to laceration repair using either non-surgical glue (ethyl 2-cyanoacrylate; Glue group) or catgut sutures (Suture group). The primary endpoint was the occurrence of dehiscence >3mm. Secondary endpoints were procedure runtime, pain score, satisfaction level, and aspects of perineal repair by the REEDA score (hyperaemia, oedema, ecchymosis, exudation, and coaptation) immediately (T0), 24-48h (T1), and 7-10 days (T2) after childbirth. FINDINGS We included 126 women, 63 in each group, and found a non-inferiority dehiscence rate in the Glue Group compared to the Control group (T1=1.6% vs. 1.6%, P=0.999 and P<0.001 for non-inferiority; and T2=2.2% vs. 4.3%, P=0.557). In the Glue Group, the procedure runtime was shorter, pain score was lower, and women's satisfaction was greater. No women had any allergic reaction in the study. CONCLUSIONS Non-surgical glue was not inferior to traditional sutures to repair postpartum first-degree lacerations. In addition, non-surgical glue was associated with less pain and greater satisfaction. Brazilian Clinical Trials Registry (www.ensaiosclinicos.gov.br/rg/RBR-5Z8MKC).
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Affiliation(s)
- A M Ochiai
- University of São Paulo, School of Arts, Sciences and Humanities, São Paulo, São Paulo, Brazil.
| | - N M Araújo
- University of São Paulo, School of Arts, Sciences and Humanities, São Paulo, São Paulo, Brazil
| | - S D T A Moraes
- "Amador Aguiar" Municipal Hospital and Maternity, Osasco, São Paulo, Brazil
| | - A Caroci-Becker
- University of São Paulo, School of Arts, Sciences and Humanities, São Paulo, São Paulo, Brazil
| | - L G Sparvoli
- University of São Paulo, School of Pharmaceutical Sciences, São Paulo, São Paulo, Brazil
| | - T T Teixeira
- "Casa Angela" Freestanding Birth Centre, São Paulo, São Paulo, Brazil
| | - R R Carvalho
- "Casa Angela" Freestanding Birth Centre, São Paulo, São Paulo, Brazil
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Li D, Chen J, Wang X, Zhang M, Li C, Zhou J. Recent Advances on Synthetic and Polysaccharide Adhesives for Biological Hemostatic Applications. Front Bioeng Biotechnol 2020; 8:926. [PMID: 32923431 PMCID: PMC7456874 DOI: 10.3389/fbioe.2020.00926] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
Rapid hemostasis and formation of stable blood clots are very important to prevent massive blood loss from the excessive bleeding for living body, but their own clotting process cannot be completed in time for effective hemostasis without the help of hemostatic materials. In general, traditionally suturing and stapling techniques for wound closure are prone to cause the additional damages to the tissues, activated inflammatory responses, short usage periods and inevitable second operations in clinical applications. Especially for the large wounds that require the urgent closure of fluids or gases, these conventional closure methods are far from enough. To address these problems, various tissue adhesives, sealants and hemostatic materials are placed great expectation. In this review, we focused on the development of two main categories of tissue adhesive materials: synthetic polymeric adhesives and naturally derived polysaccharide adhesives. Research of the high performance of hemostatic adhesives with strong adhesion, better biocompatibility, easy usability and cheap price is highly demanded for both scientists and clinicians, and this review is also intended to provide a comprehensive summarization and inspiration for pursuit of more advanced hemostatic adhesives for biological fields.
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Affiliation(s)
- Dawei Li
- Eighth Medical Center of the General Hospital of the Chinese People’s Liberation Army, Beijing, China
| | - Jing Chen
- Department of Orthopedics, Aerospace Center Hospital, Beijing, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Mingming Zhang
- The People’s Liberation Army Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Chunlin Li
- Eighth Medical Center of the General Hospital of the Chinese People’s Liberation Army, Beijing, China
| | - Jin Zhou
- Eighth Medical Center of the General Hospital of the Chinese People’s Liberation Army, Beijing, China
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Dasrilsyah RA, Kalok A, Ng BK, Ali A, Teik Chew K, Lim PS. Perineal skin tear repair following vaginal birth; skin adhesive versus conventional suture - a randomised controlled trial. J OBSTET GYNAECOL 2020; 41:242-247. [PMID: 32530340 DOI: 10.1080/01443615.2020.1740917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This was a prospective randomised controlled trial comparing the effects of first-degree perineal tear repair using adhesive glue versus conventional suturing in terms of pain score, wound complication and patient's satisfaction. One hundred and twenty one women were randomised. The skin adhesive group had a significantly lower pain score at rest as well as during sitting, walking and micturition during the first week of delivery compared to the suture group. The time taken to become pain free was significantly shorter in the tissue adhesive group (3.18 vs. 8.65 days, p < .001). Only two patients who had skin glue experienced wound gaping. No significant difference was observed in the level of satisfaction between the adhesive and suture groups. Tissue adhesive is better than subcuticular suture for repairing first-degree perineal tear as it causes less pain and has shorter recovery time.Impact statementWhat is already known on this subject. First- and second-degree tears following vaginal delivery are common and involved a third of women. Suturing of these tears is advocated to avoid wound gaping and poor healing.What the results of this study add. For first-degree tear repair, tissue adhesive is better than conventional suture in terms of pain reduction and recovery time.What the implications are of these findings for clinical practice and/or further research. Skin adhesive is an ideal method for first-degree perineal tear repair especially in out of hospital settings such as home birth or midwifery-led centre. A larger scale study is needed to establish its feasibility for second- and third-degree tears repair.
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Affiliation(s)
- Rima Anggrena Dasrilsyah
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.,Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Aida Kalok
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Beng Kwang Ng
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Anizah Ali
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Kah Teik Chew
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Pei Shan Lim
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Hu Z, Zhang D, Swai J, Liu T, Liu S. Risk of rebleeding from gastroesophageal varices after initial treatment with cyanoacrylate; a systematic review and pooled analysis. BMC Gastroenterol 2020; 20:181. [PMID: 32517718 PMCID: PMC7285616 DOI: 10.1186/s12876-020-01333-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022] Open
Abstract
Background Cyanoacrylate alone or in combination with other interventions, can be used to achieve variable rates of success in preventing rebleeding. Our study aims to assess the pooled risk of gastric and esophageal varices rebleeding after an initial treatment with cyanoacrylate alone and/or in combination with other treatments, by a systematic review of the literature and pooled analysis. Methods PubMed, EMBASE, SCOPUS, and the Cochrane library were searched for studies that reported the risk of rebleeding during the follow-up period after treatment of gastric or esophageal varices with either cyanoacrylate alone or in combination with other treatments. Standard error, upper and lower confidence intervals at 95% confidence interval for the risk were obtained using STATA Version 15 which was also used to generate forest plots for pooled analysis. The random or fixed effect model was applied depending on the heterogeneity (I2). Results A total of 39 studies were found to report treatment of either gastric or esophageal varices with either cyanoacrylate alone or in combination with other treatments. When gastric varices are treated with cyanoacrylate alone, the risk of rebleeding during the follow-up period is 0.15(Confidence Interval: 0.11–0.18). When combined with lipiodol; polidocanol or sclerotherapy the rebleeding risks are 0.13 (CI:0.03–0.22), 0.10(CI:0.02–0.19), and 0.10(CI:0.05–0.18), respectively. When combined with percutaneous transhepatic variceal embolization; percutaneous transhepatic variceal embolization; endoscopic ultrasound guided coils; or with ethanolamine, the rebleeding risk are 0.10(CI:0.03–0.17), 0.10(CI:0.03–0.17), 0.07(CI:0.03–0.11) and 0.08(CI:0.02–0.14), respectively. When esophageal varices are treated with cyanoacrylate alone, the risk of rebleeding is 0.29(CI:0.11–0.47). When combined with percutaneous transhepatic variceal embolization; sclerotherapy; or band ligation, the risks of rebleeding are 0.16(CI:0.10–0.22), 0.12(CI:0.04–0.20) and 0.10(CI:0.04–0.24), respectively. When combined with a transjugular intrahepatic portosystemic shunt; or ethanolamine, the risks of rebleeding are 0.06(CI: − 0.01-0.12) and 0.02 (CI: − 0.02-0.05), respectively. Conclusion In treating both gastric and esophageal varices, cyanoacrylate produces better results in terms of lower risk of rebleeding when combined with other treatments than when used alone. The combination of cyanoacrylate with ethanolamine or with endoscopic ultrasound guided coils produces the lowest risk of rebleeding in esophageal and gastric varices, respectively. We call upon randomized trials to test these hypotheses.
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Affiliation(s)
- Zixuan Hu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha city, Hunan, P.R. China
| | - Decai Zhang
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha city, Hunan, P.R. China
| | - Joel Swai
- Department of Nephrology and Rheumatology, The Third Xiangya Hospital of Central South University, Changsha city, Hunan, P.R. China. .,Department of Internal Medicine, Benjamin Mkapa Hospital, Dodoma city, East-Africa, Tanzania.
| | - Tao Liu
- Department of Cardiothoracic Surgery, The Third Xiangya Hospital of Central South University, Changsha city, Hunan, P.R. China
| | - Shaojun Liu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha city, Hunan, P.R. China.
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Ptaszek LM, Portillo Lara R, Shirzaei Sani E, Xiao C, Roh J, Yu X, Ledesma PA, Hsiang Yu C, Annabi N, Ruskin JN. Gelatin Methacryloyl Bioadhesive Improves Survival and Reduces Scar Burden in a Mouse Model of Myocardial Infarction. J Am Heart Assoc 2020; 9:e014199. [PMID: 32458746 PMCID: PMC7428984 DOI: 10.1161/jaha.119.014199] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Delivery of hydrogels to the heart is a promising strategy for mitigating the detrimental impact of myocardial infarction (MI). Challenges associated with the in vivo delivery of currently available hydrogels have limited clinical translation of this technology. Gelatin methacryloyl (GelMA) bioadhesive hydrogel could address many of the limitations of available hydrogels. The goal of this proof-of-concept study was to evaluate the cardioprotective potential of GelMA in a mouse model of MI. Methods and Results The physical properties of GelMA bioadhesive hydrogel were optimized in vitro. Impact of GelMA bioadhesive hydrogel on post-MI recovery was then assessed in vivo. In 20 mice, GelMA bioadhesive hydrogel was applied to the epicardial surface of the heart at the time of experimental MI. An additional 20 mice underwent MI but received no GelMA bioadhesive hydrogel. Survival rates were compared for GelMA-treated and untreated mice. Left ventricular function was assessed 3 weeks after experimental MI with transthoracic echocardiography. Left ventricular scar burden was measured with postmortem morphometric analysis. Survival rates at 3 weeks post-MI were 89% for GelMA-treated mice and 50% for untreated mice (P=0.011). Left ventricular contractile function was better in GelMA-treated than untreated mice (fractional shortening 37% versus 26%, P<0.001). Average scar burden in GelMA-treated mice was lower than in untreated mice (6% versus 22%, P=0.017). Conclusions Epicardial GelMA bioadhesive application at the time of experimental MI was performed safely and was associated with significantly improved post-MI survival compared with control animals. In addition, GelMA treatment was associated with significantly better preservation of left ventricular function and reduced scar burden.
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Affiliation(s)
- Leon M Ptaszek
- Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA
| | - Roberto Portillo Lara
- Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA
- Department of Chemical Engineering Northeastern University Boston MA
- Tecnologico de Monterrey Escuela de Ingeniera y Ciensias Zapopan Mexico
| | - Ehsan Shirzaei Sani
- Department of Chemical Engineering Northeastern University Boston MA
- Department of Chemical and Biomolecular Engineering University of California, Los Angeles CA
| | - Chunyang Xiao
- Cardiovascular Research Center Massachusetts General Hospital Boston MA
| | - Jason Roh
- Cardiovascular Research Center Massachusetts General Hospital Boston MA
| | - Xuejing Yu
- Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA
| | - Pablo A Ledesma
- Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA
| | - Chu Hsiang Yu
- Department of Chemical Engineering Northeastern University Boston MA
| | - Nasim Annabi
- Department of Chemical Engineering Northeastern University Boston MA
- Department of Chemical and Biomolecular Engineering University of California, Los Angeles CA
- Center for Minimally Invasive Therapeutics California NanoSystems Institute University of California, Los Angeles CA
| | - Jeremy N Ruskin
- Cardiac Arrhythmia Service Massachusetts General Hospital Boston MA
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Desai MS, Chen M, Hong FHJ, Lee JH, Wu Y, Lee SW. Catechol-Functionalized Elastin-like Polypeptides as Tissue Adhesives. Biomacromolecules 2020; 21:2938-2948. [DOI: 10.1021/acs.biomac.0c00740] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Malav S. Desai
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720, United States
- Tsinghua Berkeley Shenzhen Institute, Berkeley, California 94720, United States
- Biological Systems and Engineering, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Min Chen
- Tsinghua Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518055, China
| | - Farn Hing Julio Hong
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720, United States
| | - Ju Hun Lee
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720, United States
- Biological Systems and Engineering, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Yaojiong Wu
- Tsinghua Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518055, China
| | - Seung-Wuk Lee
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720, United States
- Tsinghua Berkeley Shenzhen Institute, Berkeley, California 94720, United States
- Biological Systems and Engineering, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
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Comparison of 2-Octylcyanoacrylate Versus 5-0 Fast-Absorbing Gut During Linear Wound Closures and the Effect on Wound Cosmesis. Dermatol Surg 2020; 46:628-634. [DOI: 10.1097/dss.0000000000002076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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45
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Atam C, Orhan Z, Toplu G, Serin M, Karaduman ZO, Öztürk A. Comparison of peripheral nerve repair using ethyl-cyanoacrylate and conventional suture technique in a rat sciatic nerve injury model. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:330-336. [PMID: 32544069 DOI: 10.5152/j.aott.2020.03.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate or conventional microsuture technique in a rat peripheral nerve injury model. METHODS In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomly divided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventional microsuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No further intervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumatic nylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography (EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conduction velocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolar degeneration, fibrosis, and foreign body reaction histopathologically. RESULTS In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2 (1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and 3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3 (2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCV was 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant difference between groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathological evaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obvious difference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2, and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reaction score was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743). CONCLUSION Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathological results as compared to the conventional microsuture repair.
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Affiliation(s)
- Camettin Atam
- Clinic of Orthopedics and Traumatology, Kırklareli State Hospital, Kırklareli, Turkey
| | - Zafer Orhan
- Department of Orthopedics and Traumatology, Düzce University, School of Medicine, Düzce, Turkey
| | - Gaye Toplu
- Deparment of Plastic Surgery, Health Sciences University, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Merdan Serin
- Deparment of Plastic Surgery, Health Sciences University, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Z Okan Karaduman
- Department of Orthopedics and Traumatology, Düzce University, School of Medicine, Düzce, Turkey
| | - Ayhan Öztürk
- Deparment of Neurology, Düzce University, School of Medicine, Düzce, Turkey
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Michalowitz A, Comrie R, Nicholas C, Wagner M, Kehoe J. Wound Complications after 2-Octyl Skin Closure Systems for Total Joint Arthroplasty. J Bone Jt Infect 2020; 5:101-105. [PMID: 32455101 PMCID: PMC7242402 DOI: 10.7150/jbji.42079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/23/2020] [Indexed: 01/05/2023] Open
Abstract
Introduction: Total joint arthroplasty is projected to expand rapidly by 2030. With large numbers of patients undergoing TJA, the choice of incisional closure has come into question. We compared the 2-Ocyl cyanoacrylate closure system of Dermabond ® Prineo ® with Exofin Fusion ® to compare rates of adverse wound outcomes after total joint arthroplasty. Secondary outcome measures were age, sex, and medical comorbidities between groups. Methods: We retrospectively reviewed adverse wound outcomes with skin closure in TJA in 281 patients (160 Dermabond Prineo and 121 Exofin Fusion). Clinical charts were analyzed out to the 6-week post-op visit. Results: The rate of overall adverse superficial wound outcomes was similar between the two groups with Dermabond Prineo (N=20) and Exofin Fusion (N=19). The rate of cellulitis was significantly higher for Dermabond Prineo when compared to Exofin Fusion (P=0.033). No other significant differences were found for rate of superficial or deep wound complications or for secondary outcomes. Conclusions: The two 2-octyl wound closure systems had similar adverse superficial wound complications. Except for Dermabond Prineo having a higher rate of post-operative cellulitis, there were no statistically significant differences for other superficial or deep adverse wound outcomes or secondary outcomes. A future randomized control trial or prospective cohort study is needed for a more robust analysis.
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Plá Sánchez F, Rial R, Cernuda Artero I, Ruíz Álvarez P, Moñux Ducajú G, Martínez López I, Cabrero Fernández M, Uclés Cabeza O, Serrano Hernando FJ. Free skin micrografts with cyanoacrylate as outpatient treatment for venous leg ulcers. J Wound Care 2020; 28:670-675. [PMID: 31600105 DOI: 10.12968/jowc.2019.28.10.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The present study describes an ambulatory, free skin micrograft technique with cyanoacrylate as a coadjuvant venous leg ulcer (VLU) healing strategy and its outcomes after one month. METHODS This prospective study involved Comprehensive Classification System for Chronic Venous Disorders (CEAP) stage C6 patients with good granulation tissue and negative culture results, consecutively recruited in January 2017 in the Hospital Clinico San Carlos. A skin micrograft was harvested from the anterior surface of the patient's thigh with a 0.4cm punch (0.12cm2). The graft was adhered to the ulcer bed with cyanoacrylate. Anti-adherent dressing and double-layer bandaging was applied, with weekly replacements. Measurements were obtained of the surface of the VLU and graft progression (in cm2) using a photographic grid. RESULTS A total of 12 VLUs in 12 patients were included, with a mean treated surface of 20.32±13.9cm2. A total of 18 grafts were placed and all were found to be viable after one week. Average graft growth was not noticeable after one week but was found to be 0.25±0.08cm2 after week two, 0.41±0.98cm2 after week three, and 0.70±0.15cm2 after week four (p<0.001). There were no complications in the donor zone. CONCLUSION The findings of this study show that free skin micrografting with cyanoacrylate as outpatient treatment for VLUs was simple, rapid and without complication in this study, and may contribute to its wider application in clinical use.
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Affiliation(s)
- Ferrán Plá Sánchez
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | - Rodrigo Rial
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | - Iñaki Cernuda Artero
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | - Pilar Ruíz Álvarez
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | - Guillermo Moñux Ducajú
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | - Isaac Martínez López
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
| | | | - Oscar Uclés Cabeza
- Department of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain
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Chen X, Taguchi T. Enhanced Skin Adhesive Property of Hydrophobically Modified Poly(vinyl alcohol) Films. ACS OMEGA 2020; 5:1519-1527. [PMID: 32010825 PMCID: PMC6990645 DOI: 10.1021/acsomega.9b03305] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/18/2019] [Indexed: 05/05/2023]
Abstract
Hydrophobically modified poly(vinyl alcohol) (hm-PVA) films with various alkyl chain lengths were prepared. Their surface/mechanical properties, cytocompatibility, and porcine skin adhesion strength were evaluated. hm-PVAs had 10 °C higher glass transition temperature than poly(vinyl alcohol) (PVA) (33.4 ± 2.5 °C). The water contact angle of the hm-PVA films increased with alkyl chain length and/or hydrophobic group modification ratio. The tensile strength of the hm-PVA films decreased with increasing alkyl chain length and/or hydrophobic group modification ratio. hm-PVA with short chain lengths (4 mol % propanal-modified PVA; 4C3-PVA) had low cytotoxicity compared with long alkyl chain length hm-PVAs (4 mol % hexanal and nonanal-modified PVA; 4C6-PVA and 4C9-PVA). The 4C3-PVA film had the highest porcine skin adhesion strength. Thus, the 4C3-PVA film is promising as an adhesive for wearable medical devices.
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Affiliation(s)
- Xi Chen
- Graduate
School of Pure and Applied Sciences, University
of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
- Biomaterials
Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Tetsushi Taguchi
- Graduate
School of Pure and Applied Sciences, University
of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
- Biomaterials
Field, Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
- E-mail: . Phone: +81-29-851-4498. Fax: +81-29-860-4752
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Liu H, Yuan M, Sonamuthu J, Yan S, Huang W, Cai Y, Yao J. A dopamine-functionalized aqueous-based silk protein hydrogel bioadhesive for biomedical wound closure. NEW J CHEM 2020. [DOI: 10.1039/c9nj04545g] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The functionalization of a PEGylated silk protein hydrogel with dopamine significantly improved its wet adhesive strength.
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Affiliation(s)
- Han Liu
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education
- National Engineering Lab for Textile Fiber Materials and Processing Technology
- School of Materials Science and Engineering, Zhejiang Sci-Tech University
- Hangzhou 310018
- China
| | - Meihua Yuan
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education
- National Engineering Lab for Textile Fiber Materials and Processing Technology
- School of Materials Science and Engineering, Zhejiang Sci-Tech University
- Hangzhou 310018
- China
| | - Jegatheeswaran Sonamuthu
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education
- National Engineering Lab for Textile Fiber Materials and Processing Technology
- School of Materials Science and Engineering, Zhejiang Sci-Tech University
- Hangzhou 310018
- China
| | - Sheng Yan
- Department of Plastic Surgery
- Zhejiang Provincial People's Hospital
- People's Hospital of Hangzhou Medical College
- Hangzhou 310014
- China
| | - Wei Huang
- Hangzhou Singclean Medical Products Co., Ltd
- Hangzhou 310018
- China
| | - Yurong Cai
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education
- National Engineering Lab for Textile Fiber Materials and Processing Technology
- School of Materials Science and Engineering, Zhejiang Sci-Tech University
- Hangzhou 310018
- China
| | - Juming Yao
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education
- National Engineering Lab for Textile Fiber Materials and Processing Technology
- School of Materials Science and Engineering, Zhejiang Sci-Tech University
- Hangzhou 310018
- China
| |
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