Clinical application of tissue adhesives in soft-tissue surgery of the head and neck

Abstract

To evaluate the clinical applications of tissue adhesives in soft-tissue surgery of the head and neck, and to highlight the practical and theoretical differences between the various synthetic and biologic products. Fibrin glues have been used extensively in head and neck procedures. Fibrin glues have been successfully used to reduce wound drainage and to improve other short-term postoperative results. More recently, commercial systems have become available that allow easy and rapid isolation of autologous tissue adhesives from the patient's own blood during or immediately prior to surgery. There is intuitive appeal of autologous over donor-derived products. Platelet-rich adhesives possess the added potential of improving wound healing beyond fibrin glues alone. Strong evidence for its efficacy in the clinical setting is, however, lacking. Future investigations need to evaluate the benefits of autologous products in both complex and high-risk surgical wounds, incorporating both short-term and long-term outcome metrics of wound healing and fibrosis.