Use of Tissue Glue: Current Status

ABSTRACT

Tissue adhesives are among the oldest form of tissue apposition and are enjoying a resurgence in popularity as biomaterials are being engineered to better suit our advanced understanding of wound biology. This article reviews tissue adhesives used for both bone and soft tissues. For bone fixation, the cyanoacrylate family of adhesives is most commonly used and has been used both for direct fixation of bone segments and for fixation of resorbable plates used to stabilized bone segments. Butyl-2-cyanoacrylate is the most widespread adhesive for bone fixation. Composite mixtures, including fibrin adhesives and platelet gel, have also been used to promote bone ingrowth in osseous defects. Numerous adhesives have been used to approximate soft tissues. 2-Octyl-cyanoacrylate is the most common adhesive used in soft tissues for closure of cutaneous wounds. Although butyl-cyanoacrylate can be placed between healing bone fragments, octyl-cyanoacrylate must be placed superficial to, and not within, the healing wound to prevent wound toxicity. Fibrin glues have been used successfully in a wide variety of surgical fields. These glues can either be prepared on site or be obtained in premanufactured form. Alternatives to fibrin include platelet gel, photo-induced tissue adhesion, and glass ionomer cements. Fibrin glues remain the most versatile of the tissue glues and hold great potential in future application of soft tissue adhesives.

Keywords

Bone fixation - tissue glue - fibrin glues - apposition