An adhesive for repair of tissues

Nassif, Anthony C.

doi:10.1016/s0022-4804(65)80003-8

Cited by 13 publications

(1 citation statement)

References 12 publications

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“…Although adhesives, especially cyanoacrylates [58], have been used for decades in surgical repairs to replace or augment suture for closing the skin and other tissues [59, 60], their application has been almost entirely limited to the interface between the aligned tissues. The application of adhesive to the lateral faces of sutures has never been reported for a tissue that works in tension.…”

Section: Discussionmentioning

confidence: 99%

Shear lag sutures: Improved suture repair through the use of adhesives

et al. 2015

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Suture materials and surgical knot tying techniques have improved dramatically since their first use over five millennia ago. However, the approach remains limited by the ability of the suture to transfer load to tissue at suture anchor points. Here, we predict that adhesive-coated sutures can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize the strength of the adhesive-coated suture repair construct. To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine). As a clinically relevant proof-of-concept, cyanoacrylate-coated sutures were then used to perform a clinically relevant flexor digitorum tendon repair in cadaver tissue. The repair performed with adhesive-coated suture had significantly higher strength compared to the standard repair without adhesive. Notably, cyanoacrylate provides strong adhesion with high stiffness and brittle behavior, and is therefore not an ideal adhesive for enhancing suture repair. Nevertheless, the improvement in repair properties in a clinically relevant setting, even using a non-ideal adhesive, demonstrates the potential for the proposed approach to improve outcomes for treatments requiring suture fixation. Further study is necessary to develop a strongly adherent, compliant adhesive within the optimal design space described by the model.

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Section: Discussionmentioning

confidence: 99%

Shear lag sutures: Improved suture repair through the use of adhesives

et al. 2015

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Cytotoxicity of alkyl‐2‐cyanoacrylate adhesives

Papatheofanis

1989

J. Biomed. Mater. Res.

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The cytotoxicity of methyl- and isobutyl-2-cyanoacrylate adhesives was determined using a rat polymorphonuclear leukocyte suspension. Cell degranulation increased and migration decreased on addition of the alkyl-2-cyanoacrylates to the suspension in a concentration-dependent manner. When acetylsalicylic acid or indomethacin, inhibitors of prostaglandin H synthase, were present, the cytotoxicity observed on addition of the adhesives to the leukocytes decreased up to eightfold in a dose-dependent manner as detected by trypan blue exclusion. Likewise, glutathione peroxidase and superoxide dismutase lowered such cytotoxicity resulting from the cyanoacrylates up to eight- and sevenfold, respectively. The data suggested that the adhesives may have generated lipid hydroperoxides that activated prostaglandin and thromboxane biosynthesis, and participated in membranal oxidation and lysis. Such a mechanism may contribute to understanding the thrombotic events associated with the necrosis observed on application of these adhesives to tissues in vivo.

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