Abstract
Rapid hemostasis and formation of stable blood clots are very important to prevent massive blood loss from the excessive bleeding for living body, but their own clotting process cannot be completed in time for effective hemostasis without the help of hemostatic materials. In general, traditionally suturing and stapling techniques for wound closure are prone to cause the additional damages to the tissues, activated inflammatory responses, short usage periods and inevitable second operations in clinical applications. Especially for the large wounds that require the urgent closure of fluids or gases, these conventional closure methods are far from enough. To address these problems, various tissue adhesives, sealants and hemostatic materials are placed great expectation. In this review, we focused on the development of two main categories of tissue adhesive materials: synthetic polymeric adhesives and naturally derived polysaccharide adhesives. Research of the high performance of hemostatic adhesives with strong adhesion, better biocompatibility, easy usability and cheap price is highly demanded for both scientists and clinicians, and this review is also intended to provide a comprehensive summarization and inspiration for pursuit of more advanced hemostatic adhesives for biological fields.
Highlights
Traumatic closure, wound repair and regeneration of surgical damaged soft tissues often occur medically
One of the key issues is that the existed adhesives are lack of sufficient adhesion strength to replace the sutures, especially for the fragile tissues that need to close the leakage of liquids or gases
For synthetic polymersbased hemostatic adhesives, the cyanoacrylate-based adhesive exhibited the incomparable hemostatic property than any other hemostatic agents, the biocompatibility profile of this cyanoacrylate did not meet the standardized guidelines to speed up regulatory approval process
Summary
Wound repair and regeneration of surgical damaged soft tissues often occur medically. Body’s own coagulation process played important roles in preventing the excessive bleeding from the death, formation of stable blood clots or insoluble fibrin including primary hemostasis and clotting cascades process are always required a long time to accomplish. Cyanoacrylate-derived tissue adhesives are a series of synthetic sealants with instantaneously strong adhesion force and rapid adhesive time, which are polymerized at room temperature without any harsh conditions of solvent, heating, light, catalyst, pressure, etc. In this process, cyanoacrylates can be generated within seconds by exposure to a small amount of water to initiate the polymerization and form strong bond interactions to yield polycyanoacrylate adhesives in a single-component system. The degradation rate decreases with steric hindrance of long alkyl chains of cyanoacrylate polymers (Figure 1), and shorter chains of polycyanoacrylate derivatives can cause higher concentrations of toxic products for endanger
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