OBJECTIVES: The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty.MATERIALS AND METHODS: A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first.RESULTS: Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing.CONCLUSION: These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.
Adhesives ; Alveoloplasty ; Cyanoacrylates ; Enbucrilate ; Hemostasis ; Humans ; Incidence ; Operative Time ; Pain, Postoperative ; Pathology ; Silk ; Sutures ; Tissue Adhesives ; Wound Closure Techniques ; Wound Healing ; Wounds and Injuries

BACKGROUND/AIMS: Endoscopic variceal ligation(EVL) is a method to manage esophageal varices bleeding and induces mechanical ligation and strangulation of varices by using elastic O-rings. The lower complication rate seen with EVL compared to sclerotherapy can be explained by the more limited degree of local tissue injury induced by EVL. Only the mucosal and submucosal layers are aspirated into cylinder attachment of the ligating devices, thus limiting injury to these layers. But, sometimes band induced ulcer shows massive bleeding. In these cases, endoscopic therapy is very difficult. This study was performed in order to find out the effectiveness of Histoacryl ingection for band-induced esophageal ulcer bleeding, METHODS: We tried to control band-induced bleeding by injecting Histoacryl in 8 cases of band-induced ulcer bleeding. RESULTS: This therapeutic trials show exellent control of bleeding in all cases without rebleeding. CONCLUSIONS: The cyanoacrylate tissue adhesive Histoacryl(N-butyl-2-cyanoacrylate) is a remarkable substance that transforms from its original liquid state into a solid state when mixed with a physiologic medium such as blood. Histoacryl undergoes an instantaneous polymerization reaction and hardens, thereby plugging the varix or bleeding vessel lumen. Rapid hemostasis of an active bleeding occurs and rebleeding of the treated lesion is prevented. We found out that Histoacryl injection is a safe and effective treatment for band-induced ulcer bleeding.
Cyanoacrylates ; Enbucrilate* ; Esophageal and Gastric Varices ; Esophagus* ; Hemorrhage* ; Hemostasis ; Intestines* ; Ligation ; Polymerization ; Polymers ; Sclerotherapy ; Stomach* ; Tissue Adhesives ; Ulcer* ; Varicose Veins

Gastrointestinal fistula is a disease of varying etiologies. It may occur spontaneously or as a result of an iatrogenic cause. Spontaneous fistula occurs as a result of an inflammatory process, malignancy or radiotherapy. The majority of fistula are caused by iatrogenic causes, most frequently as a complication of surgical intervention. Treatment of gastrointestinal fistulae usually consists of surgery and conservative management such as nutritional support and control of inflammation. Recently, it has been reported that gastrointestinal fistulae can be treated endoscopically using tissue adhesive agents such as Histoacryl and fibrin glue. We report two cases of gastrointestinal fistulae that were successfully treated by endoscopic local injection therapy with a review of literature.
Enbucrilate ; Fibrin Tissue Adhesive ; Fistula* ; Inflammation ; Nutritional Support ; Radiotherapy ; Tissue Adhesives

In determining the effects of strabismus surgery, it is very important to know where the reattachment site of an extraocular muscle following recession procedure is located. Undercorrections or overcorrections after muscle surgery have been thought to be due to a postoperative positional changes of reattachment site along the surface of the globe. The author performed this experimental study to evaluate the amounts of changes of reattachment site after recession procedure in rabbit with 4 different methods of scleral fixation;direct suture with 6-0 vicryl, hang-back suture, application with Tisseel and Histoacryl. Superior rectus recession was performed in all 40 rabbit eyes, 10 eyes in each group. The distance from limbus to proximal end of recessed superior rectus muscle was measured on day 1, 2, 3, 5 and 7 postoperatively. Further measurements were followed at 2, 3, 4 and 8 weeks after recession procedure. The muscles were found an average of 0.4mm posterior to the intended position in direct suture group and 0.5 mmin hang-back suture group at one week postoperatively. But in the other two groups in which tissue adhesive agents, Tisseel and Histoacryl were used, the amount of displacement of the reattachment site were minimal of within 0.1 mm. From this experimental study, it is suggested that the positional changes of the reattachment site after recession procedure may influence the surgical corrective effects for strabismus.
Enbucrilate ; Fibrin Tissue Adhesive ; Muscles ; Polyglactin 910 ; Strabismus ; Sutures ; Tissue Adhesives

Tissue adhesives have gained popularity for quicker and painless closure of lacerations. The use of tissue glue is currently popular for the closure of superficial lacerations, especially in children. Histoacryl Blue(R)(2-N-butylcyanoacrylate) is a topical wound closure that precludes the need for foreign bodies to close wounds. The purpose of this study was to compare the applications of Histoacryl Blue(R)(HAB) and conventional suture, regarding cosmetic outcome. To compare the short term and long term results of various repair methods, we designed the prospective, randomized, blind study. Patients with laceration undergoing repair were randomly allocated to conventional suture, subcutaneous suture plus HAB, and HAB only groups. The exclusion criterions were large wound that require large tension for repair or avulsion wound. An independent, blinded observer assessed cosmetic result at 7-10 days after repair and 3-9 months postoperatively. Physician's satisfaction with wound appearance was recorded on 100 mm Visual Analogue Scale(VAS)(0=worst, 100=best). The difference in VAS score between conventional suture method and subcutaneous suture plus HAB methods were not significant. Tissue glue being easy to use with no complications and still resulting in equivalent cosmetic outcomes has several benefits. Especially in the case of children, the wound closure with Histoacryl Blue(R) could be a good alternative for repair of laceration in emergency room.
Adhesives ; Child ; Emergency Service, Hospital ; Enbucrilate ; Foreign Bodies ; Humans ; Lacerations ; Prospective Studies* ; Sutures* ; Tissue Adhesives ; Wounds and Injuries*

PURPOSE: In treatment of facial bone fracture, occurred in children, we generally use wires, miniplate, absorbable plate or their combination. These foreign bodies can be palpable, and sometimes may cause infections, and need reoperation for removing. When bone fragments are multiple, small or thin, they are hard to handle and make accurate reduction of all fragments. In these cases, a biodegradable tissue adhesive, Histoacryl(R) (n-butyl-2-cyanoacrylate), can be used as fixation technique for small, multiple, and thin fracture fragments. METHODS: 3 years old and 6 years old children, who has comminuted fracture on frontal sinus, we used Histoacryl(R) for fixation of multiple bone fragments. After approaching by coronal incision, we pulled out all bone fragments and reconstructed bone fragments by Histoacryl(R) and fixed those on frontal sinus by absorbable plates. RESULTS: Photographs and 3-dimensional CT obtained preoperatively and postoperatively. And we compared them each other in terms of accuracy of reconstructed bony contour. We could reconstruct almost all bone fragments easily along 3-dimensional structure and get excellent aesthetic results. There was no complication such as infection. CONCLUSION: In treatment of comminuted facial bone fracture, occurred in children, Histoacryl(R) is an excellent method for accurate reconstruction in small and thin bone fragments which cannot be fixed by wire, miniplate or absorbable plate without complication.
Child ; Enbucrilate ; Facial Bones ; Foreign Bodies ; Fractures, Comminuted ; Frontal Sinus ; Humans ; Reoperation ; Tissue Adhesives

Injection of the tissue adhesive Histoacryl (N-butyl-2-cyanoacrylate, enbucrilate) has been more effective than conventional sclerosants in the treatment of active upper G-I bleeding. Histoacryl is an effective sclerosant that is polymerized immediately after contact with blood, and has been used for the treatment of bleeding gastric and esophageal varices. We present here a case of infarction of the caudate lobe that developed after an injection of a Histoacryl -Lipiodol mixture for the hemostasis of duodenal ulcer bleeding.
Duodenal Ulcer* ; Enbucrilate* ; Esophageal and Gastric Varices ; Hemorrhage* ; Hemostasis ; Infarction* ; Liver* ; Polymers ; Sclerosing Solutions ; Tissue Adhesives

In this experiment using 30 rabbits(40 normal eyes), the applicability of ocular adhesive, HISTOACRYL blue, as an implant beneath the scleral and conjunctival flap. Group 1 consisted of 10 left eyes. These eyes had undergone a fornix-based conjunctival flap and a triangular lamellar scleral flap without sclerectomy and served as a control on histologic examination. Group 2 consisted of 10 right eyes of the rabbits used in group 1. The Histoacryl was pasted on the sclera under the lamellar scleral flap and the conjunctiva. The pasted Histoacryl turned into a thin membrane. Group 3 consisted of 10 right eyes which had undergone a conventional trabeculectomy. Group 4 consisted of 10 right eyes. These eyes had undergone a trabeculectomy and placement of a Histoacryl membrane. The adhesive was applied closely to the limbus in 5 eyes and posteriorly away from the limbus in the remaining 5 eyes of group 4. At the eighth week after operation a filtering bleb was observed in all of the eyes in group In contrast to this, only two eyes showed filtering blebs in group 3. Filtering blebs were so confined over the Histoacryl membrane that their size and location was in accordance with the membrane. The vessels of the conjunctiva overlying the Histoacryl membrane were dilated and congested. This vascular congestion lasted long. The light microscopic examinations of the operation site showed a thick layer composed of macrophages, eosinophils, neutrophils, foreign body giant cells, and fibroblasts surrounding the Histoacryl membrane with cystic space between them. At the eight postoperative week, this wall remained thick measuring about 50-70 micro thick. From the result, Histoacryl appeared to be effective in preventing the fibrotic scarring down of the filtering bleb, but postoperative inflammatory changes indicated that the Histoacryl seemed to be rather unsuitable for clinical application.
Adhesives ; Blister* ; Cicatrix ; Conjunctiva ; Enbucrilate ; Eosinophils ; Estrogens, Conjugated (USP) ; Fibroblasts ; Filtration* ; Giant Cells, Foreign-Body ; Macrophages ; Membranes ; Neutrophils ; Rabbits ; Sclera ; Tissue Adhesives* ; Trabeculectomy

Suture threads have been the mainstay material for bonding biologic tissues in the medical field, and are still used as the basic method for wound closure; on the other hand, various types of medical glue have also been continuously developed as an alternative approach. Cyanoacrylate, fibrin glue, protein glue, polyethylene glycol polymer hydrogel glue, and mussel protein are currently marketed as clinical products; among these, cyanoacrylate and fibrin glue are the most widely used bonding materials. Cyanoacrylate hardens rapidly with a high bonding strength, but is vulnerable to external stress and has tissue toxicity; fibrin glue may be easily applied on wide tissue surfaces and has an excellent hemostatic effect, but has a weak bonding strength and may provide a spreading source for infectious disease through its blood components. A perfect bonding material without such disadvantages is yet to be developed, and it is important to use each product judiciously with regard to its merits and drawbacks. Many types of medical glue are being developed and marketed in more medically advanced countries, and their usage in the medical field is constantly increasing. Global markets for such medical bonding products are undergoing rapid expansion; therefore, active research and development in the relevant fields is imperative.
Adhesives* ; Bivalvia ; Communicable Diseases ; Cyanoacrylates ; Fibrin Tissue Adhesive ; Hand ; Hydrogel ; Polyethylene Glycols ; Polymers ; Sutures ; Tissue Adhesives ; Wounds and Injuries

PURPOSE: Comparing with suture and staple, skin graft fixation with Histoacryl (N-butyl-cyanoacrylate, B.Braun, Germany) has two advantages. Fixation is simple, painless and removal process is unnecessary. There are few reports that compare histoacryl with conventional methods for skin graft fixation in FTSG. However, there are no comparative studies in STSG. The purpose of this study is to show our experience of skin graft fixation with histoacryl in STSG of burn patients. METHODS: This study included those who was burned less than 10% of TBSA and needed STSG. The patients who had underlying disease (DM, hypertension, liver disease, lung disease) were excluded. 29 patients who visited Bestian burn center from January to July 2009 was enrolled in the study. In STSG, skin graft was fixed with histoacryl and authors marked the fixed points with pen. Fixation rate was checked in 7 days after STSG and take rate was checked in 14 days after STSG. RESULTS: The patient group consisted of 7 males and 22 females. The mean extent of burn area was 2.3%. The type of injury consisted of 18 contact, 8 scald, 1 flame, 2 friction. 31 STSG of 29 patients was done. STSG was done at 24th day after burn, the mean area of wound for STSG was 51 cm2. Mean numbers of fixation point with histoacryl per patients were 14.1. 430 of 436 fixation were stable and fixation rate was 98.6%. There was no infection case. Take rate was 99.1% in 14 days after STSG and it took 21 days for wound opening. CONCLUSION: Until now, suture and staple are common methods in skin graft fixation. However, it is disadvantageous that suture and staples should be removed. Histoacryl does not need those process. This study showed that take rate was 99.1% and fixation rate was 98.6% in fixation with histoacryl. In STSG, Skin graft fixation with histoacryl could be alternative methods for suture and staple.
Burn Units ; Burns ; Enbucrilate ; Female ; Friction ; Humans ; Hypertension ; Liver Diseases ; Lung ; Male ; Skin ; Sutures ; Tissue Adhesives ; Transplants