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Lee C. The Novel Surgical Technique in the Cyanoacrylate Closure for Incompetent Great Saphenous Veins. Vasc Endovascular Surg 2024; 58:486-490. [PMID: 38155556 DOI: 10.1177/15385744231225910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The current Instructions for Use (IFU) of cyanoacrylate closure (CAC) is to start initial injection with the catheter tip positioned 5 cm distal to the sapheno-femoral junction (SFJ) to prevent endovenous glue-induced thrombosis (EGIT). However, this defensive design is responsible for the relatively long stump length. Although clinical studies on the long-term recurrence rate are still lacking, the long stump length can predict a higher long-term recurrence rate compared to other surgical methods. The author developed a novel surgical technique that can overcome the weakness of CAC, and the initial outcomes of this technique are described in this article. METHODS This study retrospectively reviewed 25 great saphenous vein (GSV) in 20 patients who underwent CAC for incompetent GSV at our hospital. The procedure from puncturing the GSV to insertion of the catheter is the same as the conventional method. Place the catheter tip 2-3 cm below the SFJ before cyanoacrylate injection. After confirming the position of the SFJ with the longitudinal view of the ultrasound, press the GSV directly above the SFJ transversely with the second to fifth fingertips of the left hand. Then, the ultrasound probe is placed against the distal part of the fingertips, and CA injection is performed while GSV is monitored in real time. RESULTS The mean stump length immediately after surgery was 19.3 (± 7.8) mm, with a range of .0-38.4 mm. The mean stump length after 1 week was 12.3 (± 7.4) mm and the range was .1-35.4 mm. The mean stump length after 1 month was 15.4 (± 10.1) mm, and the range was .0-35.4 mm. There was no case with EGIT or recanalization. CONCLUSIONS The author confirmed the possibility of safely reducing stump length with this novel surgical technique, and expect that this method can help overcome the weakness of CAC.
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Affiliation(s)
- Changhun Lee
- Department of Vascular Surgery, Chung-Ang University H.C.S Hyundae Hospital, Gyeonggi-do, Korea
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Trisca R, Oprea V, Toma M, Bucuri CE, Stancu B, Grad O, Gherman C. The Effectiveness of Cyanoacrylates versus Sutures for Mesh Fixation after Lichtenstein Repair (SCyMeLi STUDY) A Systematic Review and Meta-Analyze of Randomized Controlled Trials. Chirurgia (Bucur) 2024; 119:87-101. [PMID: 38465719 DOI: 10.21614/chirurgia.2024.v.119.i.1.p.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/12/2024]
Abstract
Background: Chronic postoperative inguinal pain (CPIP) is still the most frequent complication after open Lichtenstein repair and any strategy to reduce its incidence and implications is a step forward to better outcomes. Between the means of mesh fixation atraumatic glue fixation has been explored as such possibility. A meta-analysis of randomized controlled trials comparing the performance of cyanoacrylate glue versus sutures fixation was conducted. Methods: the meta-analysis was conducted according to the PRISMA guidelines. Randomized controlled trials (RCTs) published between January 2000 and December 2021 were searched for in MEDLINE, PubMed, Web of Science, and Google Scholars. The quality of RCTs and the potential risk of bias were assessed using MINORS criteria and the Cochrane risk of bias tool. Results: of 269 papers the meta-analysis was performed on 19 RCTs including 3578 patients. In the glue fixation group, the operation was shorter (mean pooled difference 6 minutes; SE = 0.47; 95% CI = - 6.77 - - 4.92; t test = -12.36; p 0.0001) and immediate postoperative pain was lower (2.37% vs 13.3%OR - 0.158; 95% CI = 0.064 0.386; p = 0.0001). There was no difference in terms of chronic pain, recurrence rate and wound events. Conclusion: glue fixation of mesh in elective Lichtenstein repair of inguinal hernia seems to be a valid choice for a painful and safe procedure without increasing risk of recurrence.
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Santos AJF, Monteiro JLGC, Moraes SLD, Vasconcelos BCE, Pellizzer EP. Clinical comparison of conventional suture and tissue adhesive in third molar surgeries: a systematic review. Gen Dent 2023; 71:25-29. [PMID: 37595079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
The use of cyanoacrylate tissue adhesive for surgical wound closure has become increasingly popular in recent years and has shown efficacy. Therefore, the aim of this systematic review was to compare the effectiveness of cyanoacrylate adhesive as a substitute for conventional suture placement after extraction of impacted third molars. The PubMed/MEDLINE, Scopus, Cochrane, and gray literature databases were searched for randomized or controlled prospective clinical trials published up to October 2022 that compared the use of cyanoacrylate adhesive and conventional silk suture in third molar surgeries. The risk of bias of each study was assessed using the RoB 2 tool (revised Cochrane risk of bias tool for randomized trials). Five randomized clinical trials with a total of 236 patients were included. The most commonly evaluated outcomes were pain and bleeding. The type of adhesive used varied and included ethyl-2-cyanoacrylate, isoamyl 2-cyanoacrylate, and a mixture of n-butyl cyanoacrylate and 2-octyl cyanoacrylate. Compared with 3-0 silk suture, cyanoacrylate tissue adhesive resulted in lower levels of postoperative pain in 3 studies and lower rates of bleeding in all 5 studies. Thus, cyanoacrylate can be a good substitute for silk sutures for wound closure in intraoral surgeries.
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da Silva PHS, Lopes CEB, Stallmach LB, Ferreira LDO, Pimentel PAB, Giuliano A, Freitas PMC, Horta RDS. Comparison of Different Pneumorrhaphy Methods after Partial Pulmonary Lobectomy in Dogs. Animals (Basel) 2023; 13:2732. [PMID: 37684995 PMCID: PMC10486489 DOI: 10.3390/ani13172732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Pulmonary loborraphy can be performed using manual sutures and staples, although other methods, such as tissue adhesives, are also cited in the veterinary literature. Although the surgery is well tolerated in the canine species, failure in pulmonary aerostasis is still a reality since all the methods described so far eventually lead to air leakage after the use of the partial lobectomy technique in the lungs. Within this context, the aim of this research was to compare the effectiveness of different hermetic sealing methods after partial lobectomy of the right caudal lung lobe (RCLL) in dogs. 30 cadavers models were divided in 6 groups: G1-cobbler suture associated with simple continuous; G2-overlapping continuous suture associated with simple continuous suture; G3-Ford interlocking suture; G4-Stapling device; G5-Tissue glue (cyanoacrylate). After performing the sealing techniques, the lungs were submerged in water and inflated with oxygen at positive ventilatory pressures at physiological (up to 14.7 mmHg, which is equivalent to up to 20 cmH2O) and supraphysiological levels (above 14.7 mmHg) to evaluate the performance of the sealing methods. At physiological ventilatory pressure levels, there was no difference between groups. Sealing with surgical glue was superior to interlocking sutures and stapling devices at supraphysiological levels of ventilatory pressure.
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Affiliation(s)
- Paloma Helena Sanches da Silva
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Carlos Eduardo Bastos Lopes
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Larissa Bueno Stallmach
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Lucas de Oliveira Ferreira
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Pedro Antônio Bronhara Pimentel
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Antonio Giuliano
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong, China
| | - Patrícia Maria Coletto Freitas
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Rodrigo dos Santos Horta
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
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Loffroy R, Guillen K, Salet E, Marcelin C, Comby PO, Midulla M, Grenier N, Chevallier O, Petitpierre F. Prostate Artery Embolization Using N-Butyl Cyanoacrylate Glue for Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Valid Alternative to Microparticles? J Clin Med 2021; 10:3161. [PMID: 34300327 DOI: 10.3390/jcm10143161] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/18/2022] Open
Abstract
Our goal was to evaluate the feasibility, safety, and short-term outcomes of prostate artery embolization (PAE) with N-butyl cyanoacrylate (NBCA) glue as the only embolic agent in patients with benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTSs). A two-center retrospective study of 50 patients (mean age, 67.6 ± 7.4 years; range, 54-85 years) treated with NBCA between 2017 and 2020 was conducted. PAE was performed using a mixture of Glubran 2 glue and Lipiodol in a 1:8 ratio, under local anesthesia, on an outpatient basis, after cone-beam computed tomography vascular mapping. Mean total injected NBCA/Lipiodol volume was 0.9 ± 0.3 mL, total injection time was 21.9 ± 7.8 s, and total radiation dose was 18,458 ± 16,397 mGy·cm. Statistically significant improvements over time occurred for the International Prostate Symptoms Score (9.9 ± 6.8 versus 20.5 ± 6.7, p = 0.0001), quality-of-life score (2.2 ± 1.5 versus 4.9 ± 1.0, p = 0.0001), prostate-specific antigen level (4.6 ± 3.0 versus 6.4 ± 3.7, p = 0.0001), and prostate volume (77.3 ± 30.5 versus 98.3 ± 40.2, p = 0.0001) at a median of 3 months versus baseline. Minor adverse events developed in 11/50 (22%) patients, but no major complications occurred. The International Index of Erectile Function did not change significantly. PAE with NBCA is feasible, safe, fast, and effective for patients with BPH-related LUTSs. Prospective comparative studies with longer follow-ups are warranted.
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Chevallier O, Guillen K, Comby PO, Mouillot T, Falvo N, Bardou M, Midulla M, Aho-Glélé LS, Loffroy R. Safety, Efficacy, and Outcomes of N-Butyl Cyanoacrylate Glue Injection through the Endoscopic or Radiologic Route for Variceal Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10112298. [PMID: 34070534 PMCID: PMC8198169 DOI: 10.3390/jcm10112298] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
We performed a systematic review and meta-analysis of published studies to assess the efficacy, safety, and outcomes of N-butyl cyanoacrylate (NBCA) injection for the treatment of variceal gastrointestinal bleeding (GIB). The MEDLINE/PubMed, EMBASE, and SCOPUS databases were searched for English-language studies published from January 1980 to December 2019 and including patients who had injection of NBCA for variceal GIB. Two independent reviewers extracted and evaluated the data from eligible studies. Exclusion criteria were sample size < 5, article reporting the use of NBCA with other embolic agents, no extractable data, and duplicate reports. NBCA was injected during endoscopy in 42 studies and through a direct percutaneous approach for stomal varices in 1 study. The study’s endpoints were: Technical success, 30-day rebleeding, and 30-day overall and major complications. The estimated overall rates were computed with 95% confidence intervals, based on each study rate, weighted by the number of patients involved in each study. In total, 43 studies with 3484 patients were included. The technical success rate was 94.1% (95% CI: 91.6–96.1%), the 30-day rebleeding rate was 24.2% (18.9–29.9%), and 30-day overall and major complications occurred in 15.9% (11.2–21.3%) and 5.3% (3.3–7.8%) of patients, respectively. For treating variceal GIB, NBCA injection is a safe and effective method that demonstrates high technical success rate and very low major complication rate.
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Affiliation(s)
- Olivier Chevallier
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (N.F.); (M.M.)
| | - Kévin Guillen
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (N.F.); (M.M.)
| | - Pierre-Olivier Comby
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France;
| | - Thomas Mouillot
- Department of Gastroenterology and Hepatology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (T.M.); (M.B.)
| | - Nicolas Falvo
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (N.F.); (M.M.)
| | - Marc Bardou
- Department of Gastroenterology and Hepatology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (T.M.); (M.B.)
| | - Marco Midulla
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (N.F.); (M.M.)
| | - Ludwig-Serge Aho-Glélé
- Department of Biostatistics and Epidemiology, François-Mitterrand University Hospital, 14 Rue Paul, Gaffarel, BP 77908, 21079 Dijon, France;
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, ImViA Laboratory-EA 7535, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (N.F.); (M.M.)
- Correspondence: ; Tel.: +33-380-293-358
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Kubat E, Ünal CS, Geldi O, Çetin E, Keskin A, Karapınar K. Comparison of different approaches to small saphenous vein reflux treatment: a retrospective study in two centers. SAO PAULO MED J 2020; 138:98-105. [PMID: 32491084 PMCID: PMC9662839 DOI: 10.1590/1516-3180.2019.0230.r1.06112019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of small saphenous vein (SSV) insufficiency is of utmost importance for relieving chronic venous insufficiency symptoms. OBJECTIVES To investigate the efficacy and safety of five different treatment approaches among patients with SSV insufficiency. DESIGN AND SETTING Two-center retrospective clinical study, conducted at cardiovascular surgery clinics in a local training and research hospital and a state hospital. METHODS A total of 282 extremities of 268 patients with SSV insufficiency alone who were treated for symptomatic varicose veins between January 2012 and January 2017 were included in the study. All extremities included in the study were divided into five groups as follows: high ligation + stripping; radiofrequency ablation (RFA); cyanoacrylate closure (CAC); and endovenous laser ablation (EVLA) at the wavelengths 980 nm and 1,470 nm. RESULTS Although the recurrence rate at six months was similar among the treatment groups, we found significant differences in recurrence rates at one year, with lower rates in the CAC, RFA and 1,470 nm EVLA groups, compared with the other treatments (P = 0.005). No sural neuritis was observed in the CAC group. The pigmentation rate was higher in the two EVLA groups (980 nm and 1,470 nm). CONCLUSIONS Our study results showed that although CAC, RFA and EVLA at 1,470 nm seemed to be effective methods for treating SSV insufficiency alone, CAC and RFA had better aesthetic results than EVLA at 1,470 nm. We consider that endovenous non-thermal techniques for treating SSV insufficiency may be preferable because of relatively low risk of nerve injury.
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Affiliation(s)
- Emre Kubat
- MD. Attending Physician, Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey.
| | - Celal Selçuk Ünal
- MD. Assistant Professor, Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey.
| | - Onur Geldi
- MD. Attending Physician, Department of Cardiovascular Surgery, Zonguldak Atatürk State Hospital, Zonguldak, Turkey.
| | - Erdem Çetin
- MD. Assistant Professor, Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey.
| | - Aydin Keskin
- MD. Attending Physician, Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey.
| | - Kasım Karapınar
- MD. Professor, Department of Cardiovascular Surgery, Karabük Training and Research Hospital, Karabük, Turkey.
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Durukan AB, Akbay E, Ünlü A, Özdemir A, Onur MAO. The cytotoxic properties and apoptotic potential of N-butyl and 2-octyl cyanoacrylates used in surgical treatment of chronic venous insufficiency. Turk Gogus Kalp Damar Cerrahisi Derg 2019; 27:185-91. [PMID: 32082851 DOI: 10.5606/tgkdc.dergisi.2019.17091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/06/2019] [Indexed: 11/21/2022]
Abstract
Background This study aims to investigate the cytotoxic effects and apoptotic potential of N-butyl cyanoacrylate and 2-octyl cyanoacrylate used in surgical treatment of chronic venous insufficiency. Methods N-butyl cyanoacrylate and 2-octyl cyanoacrylate were cultured in cell-culture using human umbilical endothelial cell-line. Cytotoxicity and viability were assessed at 24 and 72 hours with lactate dehydrogenase and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, respectively. Apoptotic potential was documented at 24 and 72 hours with relative caspase-3 activity. Results The mean cytotoxicity at 24 and 72 hours were: N-butyl cyanoacrylate with an area of dot/line: 37.0±3.9%/29.3±2.7% and 46.4±1.6%/45.1±7.1%, 2-octyl cyanoacrylate with an area of dot/line: 39.0±7.0%/37.3±4.6% and 47.0±2.3%/40.7±7.5%. Cytotoxicity increased by time in each group (p<0.05). The mean viability at 24 and 72 hours were: N-butyl cyanoacrylate with an area of dot/line: 53.4±7.7%/72.0±5.7% and 35.7±1.9%/37.8±3.7%, 2-octyl cyanoacrylate with an area of dot/line: 54.3±4.4%/73.5±19.9% and 33.6±2.8%/30.7±4.5%. The mean viability decreased by time in each group (p<0.05). The mean relative caspase-3 activity at 24 and 72 hours were: control group: 0.084±0.006 and 0.065±0.002, N-butyl cyanoacrylate with an area of dot/line: 0.940±0.037/0.924±0.053 and 0.999±0.072/1.056±0.015, 2-octyl cyanoacrylate with an area of dot/line: 0.900±0.044/0.928±0.018 and 0.989±0.084/0.999±0.072. The mean relative caspase-3 activity was higher than control group in each group at each time interval (p<0.05) and activity increased by time in N-butyl cyanoacrylate line and in 2-octyl cyanoacrylate line groups (p<0.05). Conclusion Our findings indicate that N-butyl cyanoacrylate and 2-octyl cyanoacrylate cause cytotoxicity in cell-culture media. We may also postulate that they induce apoptosis in cell-culture media.
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Abstract
OBJECTIVE Neurosurgery presents unique surgical challenges arising from delicate neural structures, limited accessibility, and the risk of CSF leakage that can lead to CNS infections. Sutures and staples may have limited applicability in the complex anatomical constraints of cranial and spinal surgeries, especially in trauma settings when time is of the essence. Surgical bioadhesives are emerging as attractive alternatives because they avoid traumatic application methods, provide a stress-distributed fixation, and provide good cosmesis and outcomes. This article presents the history of the development of surgical bioadhesives, and is also a review of current applications of commercial surgical bioadhesives within neurosurgical procedures and the unmet clinical needs that should be addressed in bioadhesives technologies. METHODS A PubMed literature search was performed using the terms "(glue OR bioadhesive OR fibrin OR tisseel OR evicel OR tachosil OR cyanoacrylate OR duraseal OR bioglue) AND (neurosurgery OR spine OR spinal OR dural OR microvascular decompression OR transsphenoidal OR endovascular)." Of 2433 records screened, 168 studies were identified that described the use of bioadhesives in neurosurgical procedures. RESULTS The greatest number of studies describing the use of bioadhesives in neurosurgery were identified for endovascular embolization, followed by dural closure and transsphenoidal surgeries. Other common areas of application were for microvascular decompression, skin closure, peripheral nerve repair, and other novel uses. Numerous case reports were also identified describing complications associated with bioadhesive use. CONCLUSIONS Despite the paucity of approved indications, surgical bioadhesive use in neurosurgical procedures is prevalent. However, current bioadhesives still each have their own limitations and research is intense in the development of novel solutions.
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Affiliation(s)
- Liming Qiu
- 1Department of Neurosurgery, National Neuroscience Institute, Singapore
- 2Department of Neurosurgery, Singapore General Hospital, Singapore
- 3School of Materials Science & Engineering, Nanyang Technological University, Singapore; and
| | - Angela An Qi See
- 1Department of Neurosurgery, National Neuroscience Institute, Singapore
- 2Department of Neurosurgery, Singapore General Hospital, Singapore
| | - Terry W J Steele
- 3School of Materials Science & Engineering, Nanyang Technological University, Singapore; and
| | - Nicolas Kon Kam King
- 1Department of Neurosurgery, National Neuroscience Institute, Singapore
- 2Department of Neurosurgery, Singapore General Hospital, Singapore
- 4Duke-NUS Medical School, Singapore
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Ilgenfritz J, Aydos RD, Silva IS, Takita LC, de Abreu AC, Silva CAC, Faleiros KB, Santiago EMDL, Ramalho RT. Use of cyanoacrylate-based surgical adhesives associated to the macroporous tape in skin synthesis in rats. Acta Cir Bras 2019; 34:e201900701. [PMID: 31531536 PMCID: PMC6746563 DOI: 10.1590/s0102-865020190070000001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/11/2019] [Accepted: 06/08/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare the use of new cyanoacrylate surgical adhesive associated with macroporous tapes in cutaneous synthesis. METHODS Male Wistar rats with a longitudinal incision of 4cm were used on the back, divided into four groups: GI used octyl-cyanoacrylate (Dermabond®), GII used N-2-butylcyanoacrylate, GIII used octyl-cyanoacrylate and macroporous tape and GIV used N-2-butyl cyanoacrylate and macroporous tape. On the fourteenth day, the rats were submitted to euthanasia, were divided in two parts, and a layer of skin subcutaneous tissue through an area of operative healing was removed. One part was submitted to the study of rupture strength with the use of tensiometer, and in the other part histological examination was performed. RESULTS No force test was similar between groups I and II, being different from groups III and IV (P <0.001), which were identical to each other (P> 0.05). The units were compared among the studied groups, and they were different with the use of macroporous tapes (P> 0.05). CONCLUSIONS The purpose of macroporous tapes is associated with CA adhesives in cutaneous tissues that provide more resistant scars. The use of a combination of macroporous tapes leads to complete re-epithelialization, without provoking foreign body reaction, has hemostatic properties and does not cause an absorptive reaction.
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Affiliation(s)
- João Ilgenfritz
- MD, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande-MS, Brazil. Conception and design of the study, technical procedures, analysis and interpretation of data, manuscript writing
| | - Ricardo Dutra Aydos
- PhD, Associate Professor of Surgery, Postgraduate Program in Health and Development in the Midwest Region, UFMS, Campo Grande-MS, Brazil. Conception and design of the study, interpretation of data, final approval
| | - Iandara Schettert Silva
- Full Professor, Postgraduate Program in Health and Development in the Midwest Region, UFMS, Campo Grande-MS, Brazil. Intellectual and scientific content of the study
| | - Luiz Carlos Takita
- PhD, Assistant Professor, Department of Surgery, UFMS, Campo Grande-MS, Brazil. Histopathological examinations
| | - Antônio Carlos de Abreu
- Fellow Master degree, Postgraduate Program in Health and Development in the Midwest Region, UFMS, Campo Grande-MS, Brazil. Technical procedures
| | - Cynthia Alexia Cunha Silva
- Fellow Biologist undergraduate, Biosciences Institute, UFMS, Campo Grande-MS, Brazil. Technical procedures
| | - Karina Bossi Faleiros
- Fellow medical undergraduate, Faculty of Medicine, UFMS, Campo Grande-MS, Brazil. Technical procedures
| | | | - Rondon Tosta Ramalho
- Full Professor, Postgraduate Program in Health and Development in the Midwest Region, UFMS, Campo Grande-MS, Brazil. Technical procedures, macroscopic and histopathologic analysis, manuscript writing
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Lv FY, Dong RH, Li ZJ, Qin CC, Yan X, He XX, Zhou Y, Yan SY, Long YZ. In situ precise electrospinning of medical glue fibers as nonsuture dural repair with high sealing capability and flexibility. Int J Nanomedicine 2016; 11:4213-20. [PMID: 27621616 PMCID: PMC5010156 DOI: 10.2147/ijn.s113560] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose In this work, we propose an in situ precise electrospinning of medical glue fibers onto dural wound for improving sealing capability, avoiding tissue adhesion, and saving time in dural repair. Methods N-octyl-2-cyanoacrylate, a commercial tissue adhesive (medical glue), can be electrospun into ultrathin fibrous film with precise and homogeneous deposition by a gas-assisted electrospinning device. Results The self-assembled N-octyl-2-cyanoacrylate film shows high compactness and flexibility owing to its fibrous structure. Simulation experiments on egg membranes and goat meninges demonstrated that this technology can repair small membrane defects quickly and efficiently. Conclusion This method may have potential application in dural repair, for example, working as an effective supplementary technique for conventional dura suture.
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Affiliation(s)
- Fu-Yan Lv
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University
| | - Rui-Hua Dong
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University
| | - Zhao-Jian Li
- Department of Neurosurgery, Affiliated Hospital of Qingdao University
| | - Chong-Chong Qin
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University
| | - Xu Yan
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University; Industrial Research Institute of Nonwovens & Technical Textiles, College of Textiles & Clothing
| | - Xiao-Xiao He
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University
| | - Yu Zhou
- Medical College, Qingdao University, Qingdao, People's Republic of China
| | - Shi-Ying Yan
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University
| | - Yun-Ze Long
- Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University; Industrial Research Institute of Nonwovens & Technical Textiles, College of Textiles & Clothing
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Abstract
BACKGROUND Surgical site infections (i.e. incisions that become infected) are a continuing concern in health care. Microbial sealant is a liquid that can be applied to the skin immediately before surgery and is thought to help reduce the incidence of surgical site infections (SSIs) by sealing in the skin flora, thus preventing contamination and infection of the surgical site. OBJECTIVES To assess the effects of the preoperative application of microbial sealants (compared with no microbial sealant) on rates of SSI in people undergoing clean surgery. SEARCH METHODS For this second update we searched the following electronic databases in May 2015: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. There were no restrictions based on language or date of publication or study setting. SELECTION CRITERIA Randomised controlled trials (RCTs) were eligible for inclusion if they involved people undergoing clean surgery (i.e. surgery that does not involve the breathing system, gut, genital or urinary tract, or any part of the body with an existing infection) in an operating theatre and compared the use of preoperative microbial sealants with no microbial sealant. DATA COLLECTION AND ANALYSIS All review authors independently extracted data on the characteristics, risk of bias and outcomes of the eligible trials. MAIN RESULTS Seven trials (859 participants undergoing clean surgery) met the inclusion criteria. The trials all compared cyanoacrylate microbial sealant with no sealant. We found there were fewer SSIs with the use of microbial sealant (23/443 participants) than with the control comparison (46/416 participants). There was no evidence of a difference between the two groups in surgical site infection rates following the use of microbial sealants when the results were pooled (risk ratio (RR) 0.53, 95% CI 0.24 to 1.18). There were adverse events in three studies, but these were not judged to be a result of the use of microbial sealant. AUTHORS' CONCLUSIONS In this second update there is still insufficient evidence available to determine whether the use of microbial sealants reduces the risk of surgical site infection or not. Further rigorous, adequately-powered RCTs are required to investigate this properly.
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Affiliation(s)
- Callum Wood
- University of YorkDepartment of Health SciencesSeebohm Rowntree BuildingYorkUKYO10 5DD
| | - Cheryl Phillips
- Department of Care Sciences, University of GlamorganFaculty of Health, Sport and ScienceRoom 7012, Glyn Taff CampusPontypriddRhondda Cynon TaffUKCF37 1DL
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López J, Rodriguez K, Targarona EM, Guzman H, Corral I, Gameros R, Reyes A. Systematic review of cyanoacrylate embolization for refractory gastrointestinal fistulae: a promising therapy. Surg Innov 2014; 22:88-96. [PMID: 24902686 DOI: 10.1177/1553350614535860] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Surgical management of gastrointestinal fistulae has been reported to carry a 30-day morbidity rate up to 82% and a mortality rate ranging from 2% to 4.8%; thus nonoperative alternatives are required. The aim of the present study was to assess the current experience on the use of cyanoacrylates in the management of these fistulae. METHODS A systematic review was carried out on Medline, Embase, The Cochrane database, Academic Search Complete, MedicLatina, and SciELO for English, Spanish, and Portuguese articles dealing with refractory fistulae by means of cyanoacrylate embolization therapy. Publication dates were restricted from 1969 to present. Outcome parameters were study design, number of participants, etiology of the fistula, approach, material used, success rate, complications, and mortality. RESULTS Electronic search yielded a total of 377 articles. After a meticulous screening, only 14 studies dealing with foregut/midgut fistulae and 6 addressing hindgut fistulae were included. All the included articles were prospective and retrospective case series. Cumulative success rate was 81% (range 0% to 100%) and 3 out of 203 patients (1%) developed minor complications. CONCLUSION Cyanoacrylate embolization of nearly all types of refractory gastrointestinal fistulae is a feasible and harmless technique. Prospective controlled studies are required to support the available evidence.
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Affiliation(s)
- Julio López
- Mexican Institute for Social Security, HGZ 11, Delicias, Mexico
| | | | | | - Heber Guzman
- Mexican Institute for Social Security, UMAE 25, Monterrey, Mexico
| | - Iván Corral
- Mexican Institute for Social Security, HGZ 6, Juarez, Mexico
| | - Rene Gameros
- Mexican Institute for Social Security, Chihuahua, Mexico
| | - Arturo Reyes
- Mexican Institute for Social Security, Chihuahua, Mexico
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Winkler CK, Clay D, Turrini NG, Lechner H, Kroutil W, Davies S, Debarge S, O'Neill P, Steflik J, Karmilowicz M, Wong JW, Faber K. Nitrile as Activating Group in the Asymmetric Bioreduction of β-Cyanoacrylic Acids Catalyzed by Ene-Reductases. Adv Synth Catal 2014; 356:1878-1882. [PMID: 26190962 PMCID: PMC4498475 DOI: 10.1002/adsc.201301055] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 02/13/2014] [Indexed: 11/13/2022]
Abstract
Asymmetric bioreduction of an (E)-β-cyano-2,4-dienoic acid derivative by ene-reductases allowed a shortened access to a precursor of pregabalin [(S)-3-(aminomethyl)-5-methylhexanoic acid] possessing the desired configuration in up to 94% conversion and >99% ee. Deuterium labelling studies showed that the nitrile moiety was the preferred activating/anchor group in the active site of the enzyme over the carboxylic acid or the corresponding methyl ester.
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Affiliation(s)
- Christoph K Winkler
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
| | - Dorina Clay
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
| | - Nikolaus G Turrini
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
| | - Horst Lechner
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
| | - Wolfgang Kroutil
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
| | - Simon Davies
- Pfizer Global Supply, Process Development Centre Loughbeg, County Cork, Ireland
| | - Sebastien Debarge
- Pfizer Global Supply, Process Development Centre Loughbeg, County Cork, Ireland
| | - Pat O'Neill
- Pfizer Global Supply, Process Development Centre Loughbeg, County Cork, Ireland
| | - Jeremy Steflik
- Pfizer Worldwide R&D, Chemical R&D Eastern Point Rd, Groton, CT 06340, USA
| | - Mike Karmilowicz
- Pfizer Worldwide R&D, Chemical R&D Eastern Point Rd, Groton, CT 06340, USA
| | - John W Wong
- Pfizer Worldwide R&D, Chemical R&D Eastern Point Rd, Groton, CT 06340, USA
| | - Kurt Faber
- Department of Chemistry, Organic & Bioorganic Chemistry, University of Graz Heinrichstrasse 28, A-8010 Graz, Austria, ; phone: (+43)-316-380-5332 ; e-mail:
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Abstract
PURPOSE To assess the effect of cyanoacrylate glue on knot slippage and strength in vitro. METHODS Ethibond 3/0 was tested using a tensile tester. A single drop of cyanoacrylate glue was applied to the knots. Seven knot configurations (10 samples each) were tested: (1) a surgeon's knot (S) plus 4 square throws (+4) without glue (control group), (2) S plus one square throw (+1) without glue, (3) S+1 with glue, (4) S with glue, (5) S+1 wet posttie without glue, (6) S+1 wet pre-tie without glue, and (7) S+1 wet pre-tie with glue. Wet sutures were immersed in normal saline for 24 hours prior to knot tying. Wet pre- and post-tie sutures were immersed for one minute prior to knot tying and tensile testing, respectively. Outcome measures were the mode of failure (knot slippage or suture snapping) and the ultimate tensile strength. RESULTS All knots without glue failed owing to knot slippage, except for the controls, whereas all knots with glue failed owing to suture snapping. The ultimate tensile strength was significantly higher in knots with glue and controls than in knots without glue. The ultimate tensile strength did not differ significantly between S+4 without glue and S with glue (p=0.48), indicating that glue could reinforce knots and reduce the number of throws needed. Wet suture is protective against failure (p<0.01). CONCLUSION Cyanocrylate glue may have clinical applications for flexor tendon repairs for which a reduced knot size is advantageous.
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Affiliation(s)
- George H Smith
- South East Scotland Rotation, Royal Infirmary, Edinburgh, United Kingdom.
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Schneider G. Tissue adhesives in otorhinolaryngology. GMS Curr Top Otorhinolaryngol Head Neck Surg 2011; 8:Doc01. [PMID: 22073094 PMCID: PMC3199812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The development of medical tissue adhesives has a long history without finding an all-purpose tissue adhesive for clinical daily routine. This is caused by the specific demands which are made on a tissue adhesive, and the different areas of application. In otorhinolaryngology, on the one hand, this is the mucosal environment as well as the application on bones, cartilage and periphery nerves. On the other hand, there are stressed regions (skin, oral cavity, pharynx, oesophagus, trachea) and unstressed regions (middle ear, nose and paranasal sinuses, cranial bones). But due to the facts that adhesives can have considerable advantages in assuring surgery results, prevention of complications and so reduction of medical costs/treatment expenses, the search for new adhesives for use in otorhinolaryngology will be continued intensively. In parallel, appropriate application systems have to be developed for microscopic and endoscopic use.
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Affiliation(s)
- Gerlind Schneider
- Department of Otorhinolaryngology, Friedrich Schiller University Jena, Germany,*To whom correspondence should be addressed: Gerlind Schneider, Department of Otorhinolaryngology, Friedrich Schiller University Jena, Lessingstrasse 2, 07743 Jena, Germany, Telephone 03641/935015, Fax 03641/935129, E-mail:
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