Cyanoacrylate Group Research Articles

Suture reinforcement using a modified cyanoacrylate glue to prevent anastomotic leak in colorectal surgery: a prospective multicentre randomized trial

BackgroundAnastomotic leakage (AL) is the most frequent life-threating complication following colorectal surgery. Several attempts have been made to prevent AL. This prospective, randomized, multicentre trial aimed to evaluate the safety and efficacy of nebulised modified cyanoacrylate in preventing AL after rectal surgery.MethodsPatients submitted to colorectal surgery for carcinoma of the high-medium rectum across five high-volume centres between June 2021 and January 2023 entered the study and were randomized into group A (anastomotic reinforcement with cyanoacrylate) and group B (no reinforcement) and followed up for 30 days. Anastomotic reinforcement was performed via nebulisation of 1 mL of a modified cyanoacrylate glue. Preoperative features and intraoperative and postoperative results were recorded and compared. The study was registered at ClinicalTrials.gov (ID number NCT03941938).ResultsOut of 152 patients, 133 (control group, n = 72; cyanoacrylate group, n = 61) completed the follow-up. ALs were detected in nine patients (12.5%) in the control group (four grade B and five grade C) and in four patients (6.6%), in the cyanoacrylate group (three grade B and one grade C); however, despite this trend, the differences were not statistically significant (p = 0.36). However, Clavien–Dindo complications grade > 2 were significantly higher in the control group (12.5% vs. 3.3%, p = 0.04). No adverse effects related to the glue application were reported.ConclusionThe role of modified cyanoacrylate application in AL prevention remains unclear. However its use to seal colorectal anastomoses is safe and could help to reduce severe postoperative complications.

Compared with other methods, cyanoacrylate and lauromacrogol in treating esophagogastric varices did not increase the risk of postoperative infection.

Patients with cirrhosis commonly undergo endoscopic cyanoacrylate injection for gastric and esophageal variceal bleeding. However, postoperative infections can increase the risk of rebleeding and mortality. This study aimed to determine the risk of postoperative infections and its associated factors following cyanoacrylate injection treatment in these patients. A retrospective analysis was conducted on 57 patients treated with ligation (ligation group), 66 patients treated with cyanoacrylate injection (injection group), and 91 patients treated with conservative treatment (control group) at the Nanchong Central Hospital. The rate of postoperative infection was similar among the cyanoacrylate, ligation, and conservative treatment groups, with no significant statistical difference observed ( P = 0.97). Multivariate analysis identified postoperative Child-Pugh score and renal insufficiency as two independent risk factors for postoperative infection. The rebleeding rate in the injection group was significantly lower than in the other groups ( P = 0.01). Mortality was significantly higher in the control group compared with the ligation and injection groups ( P = 0.01). Cyanoacrylate combined with lauromacrogol injection did not significantly increase the risk of infection compared with ligation and conservative treatments, and it was more effective in reducing the risk of rebleeding. This method is safe, effective, and holds clinical value for broader application.

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies.

To compare the intraluminal initial and maximal pressures of enterotomies closed using three different techniques (single-layer appositional continuous closure; closure with cyanoacrylate; a single-layer appositional closure augmented with cyanoacrylate) in a cooled canine cadaveric jejunal model and to report the initial leak location in all samples. Experimental, ex-vivo study. Grossly normal chilled small intestine segments from three canine cadavers. A total of 45 chilled jejunal segments (n = 15 segments/group) were assigned to a handsewn group (HSE), a cyanoacrylate only group (CE) and a handsewn and cyanoacrylate group (HS + CE). A 2 cm antimesenteric enterotomy was performed and closure with one of the above techniques. Initial leakage pressures (ILP), maximal intraluminal pressures (MIP) and initial leakage location were recorded by a single observer. Handsewn enterotomies leaked at higher ILP when augmented with cyanoacrylate (83.3 ± 4.6 mmHg, p < .001) compared to both the HSE group (43.8 ± 5.3 mmHg) and the CE group (18.6 ± 3.5 mmHg). Those sealed with cyanoacrylate only leaked at a lower MIP compared with the other groups (p < .001). Maximal intraluminal pressures did not differ between handsewn enterotomies, whether augmented or not (p = .19). Reinforcement of a sutured enterotomy closure with cyanoacrylate was easy to perform and resulted in significantly increased initial leak pressures in cadaveric jejunum. The increased leakage pressures achieved by reinforcing enterotomies with cyanoacrylate could consequently reduce the incidence of postoperative intestinal leakage following an enterotomy and may result in reduced patient morbidity or mortality.

Monitoring the development of Ctenocephalides felis felis (Siphonaptera, Pulicidae) eggs from a laboratory colony in Brazil subjected to different adhesive substances.

This study aimed to evaluate the use of different adhesive substances in an method to monitor the development of C. felis felis eggs. Three adhesive substances were selected: cyanoacrylate, stick glue, and liquid silicone. The eggs were obtained from a laboratory colony and placed on a thin layer of adhesive substance on the lid of a Petri dish to prevent contact with the larval growth substrate. One hundred eggs were used for each adhesive substance. The development of the eggs was monitored for three consecutive days, during which larval hatching and egg characteristics were observed. Of the 100 eggs incubated for each adhesive substance, 64, 51, and 76 larvae hatched and survived from the stick glue, cyanoacrylate, and liquid silicone plates, respectively. After 30days of incubation, 59, 45, and 68 hatched adults were observed, respectively, in these groups. The mean hatching of larvae and adults between the liquid silicone and cyanoacrylate groups differed statistically (p<0.05). This study demonstrated positive results, and that liquid silicone was the most easily applicable adhesive substance on the plate and interfered less with egg development, therefore having the best larval recovery compared to incubated eggs compared to the other substances.

Comparison of 2-Octyl Cyanoacrylate with Prolene (4-0) Sutures in Extra Oral Wound Closure.

To compare the healing following various maxillofacial incisions using 2-octyl cyanoacrylate (2-OCA) and prolene (4-0) sutures. To evaluate the complications and aesthetic outcome of the incision wounds after closure using 2-OCA and prolene (4-0) sutures. The patient undergoing an extraoral incision was evaluated for pain, inflammation, infection, dehiscence, scar, and surface texture. In Group I, 15 patient incisions were closed with 2-OCA and in Group II, 15 patient incisions were closed with prolene (4-0) suture. A few patients experienced pain with Group I and then Group II, but infection, inflammation, and dehiscence were more in Group I than in Group II. A cosmetic outcome was higher in the cyanoacrylate group, and the surface texture was satisfying in the same group.

Attached Oral Mucosal Wound Closure using Blue Glue - A Prospective Clinical Study.

Traditionally, sutures have been widely used to close intraoral wounds. Various alternatives have been developed amongst which newer tissue adhesives such as N-butyl-2-cyanoacrylate having accepted clinical properties are gaining popularity. The primary purpose of the present study is to evaluate the efficacy of N-butyl-2-cyanoacrylate for intraoral attached mucosal wound closure following alveoloplasty. In this prospective split-mouth study, 25 patients requiring alveoloplasty in either maxillary or mandibular arch bilaterally with a total of 50 sites were divided into two equal groups, namely silk suture (Group 1) and cyanoacrylate (Group 2). Each patient was evaluated on the first, third, seventh, 14th and 21st post-operative days. Parameters evaluated were time taken to close incision and to achieve haemostasis, pain, oedema, post-operative wound healing, patient discomfort and possible complications. Time taken to close incision, time taken to achieve haemostasis, post-operative pain and oedema were found to be less in Group 2. Wound healing too was found to be better in Group 2. There was one case of adhesive peel off on the first post-operative day which was managed by reapplying the tissue adhesive. The incidence of wound dehiscence and wound infection was observed more in Group 1 on the third post-operative day. Suture breakage (16%) and adhesive dislodgement (8%) were reported on the seventh post-operative day. The use of cyanoacrylates' inherent benefits, such as improved wound seal off in attached mucosa, quick polymerisation and bacteriostatic characteristics can be beneficial when performing minor oral surgical procedures on elderly, young and mentally challenged patients.

Prospective comparative study of mesh fixation in laparoscopic TEP hernia repair using tacker versus cyanoacrylate versus fibrin glue tep mesh fixation with cyanoacrylate

Background: Laparoscopic inguinal hernia repairs done by totally extra peritoneal (TEP) or trans abdominal preperitoneal techniques require mesh fixation which is commonly done by either tackers or fibrin glue. In this study, we discuss about using cyanoacrylate glue for mesh fixation as a more cost effective but equally suitable alternate. Aims and Objectives: The aim of the study was to evaluation of suitability of using highly economical cyanoacrylate ($ 0.13) with tackers ($ 318.52) and fibrin glue ($ 11.94) for mesh fixation during TEP hernia repair. Materials and Methods: A comparative study was done in the Department of Surgery over a period of 3 years (2018–2021). This study included 210 patients who underwent laparoscopic TEP hernia repair. Cases were randomized into three groups of 70 subjects each: Group A - mesh was fixed with tacker, Group B - mesh was fixed using cyanoacrylate, and Group C - mesh was fixed with fibrin glue. Subjects were followed up for 3 months. Type of presentation, diagnosis, and type of mesh fixation were compared to post-operative complications that included pain, seroma, hematoma, and urinary retention findings were recorded and data were statistically analyzed using “SPSS” software. Results: Decreased incidence of post-operative pain (P=0.01) and hematoma was observed in Group B as compared to Groups A and C. Average hospital stay was significantly less in fibrin glue group (P=0.02) and cyanoacrylate group (P=0.02) as compared to tacker group. There was same incidence of postoperative urinary retention (P=0.520) and seroma (P=0.354) formation between all groups. Patients of Group B started daily activities earlier at 15 days follow-up (P=0.032) as compared to Groups A and C. Conclusion: Cyanoacrylate and fibrin glue fixation of mesh in laparoscopic TEP have better outcomes when compared to tackers. Furthermore, as cyanoacrylate is 300 times cheaper than tacker and 10 times cheaper than fibrin glue, this imparts a huge cost advantage to this technique in developing countries. Therefore, use of cyanoacrylate for mesh fixation in laparoscopic TEP can be safely advocated over tackers and fibrin glue.

P-007 CYANOACRYLATE IS A USEFUL TOOL TO PREVENT SEROMAS IN INCISIONAL HERNIA SURGERY

Abstract Aim To demonstrate that the use of cyanoacrylate (Glubran®) can decrease the incidence of postoperative surgical site occurrences (SSO) in incisional hernia (IH) surgery. Methods Retrospective cohort analysis of SSO after elective IH repairs (November 2018 to October 2020). Group 1: mesh fixation by interrupted stitches associating cyanoacrylate (as well as spreading it in subcutaneous tissue). Group 2: without cyanoacrylate. Results 113 patients were analyzed included (females: 50.4%, age: 70 (IQR: 59–75years)). Length of stay: 3 (IQR: 2–6days). Comorbidities: diabetes (7.1%), hypertension(29.2%), dyslipidemia(41%), smoking(38.1%), alcohol consumption(22.1%), cardiovascular disease(15.9%). ASA: I(5.3%), II(62.8%), III(31.9%). BMI: 29.14±3.63kg/m2. Hernia location: midline (89.4%), others (10.6%). Cyanoacrylate group:54.9%. Surgical technique: onlay (61.1%), sublay (38.9%). Postoperative complications: global (29.2%), clinical seroma (25.7%), ultrasound seroma (32.7%). Surgical site infection-SSI (8.8%). Recurrence: 3.5%. Patients with cyanoacrylate had lower overall complications, clinical and ultrasound seroma and SSI rates (17.7% vs 43.1% p=0.003; 16.1% vs 37.3% p=0.011; 27.4% vs 39.2% p=0.1; 3.2% vs 15.7% p=0.02 respectively). These findings are even more statistically significant after selecting onlay procedures (23.3% vs 51.3% p=0.018; 16.7% vs 46.2% p=0.01; 30% vs 46.2% p=0.1; 6.7% vs 20.5% p=0.04 respectively). These differences were maintained in the multivariate analysis (p &amp;lt;0.05). Conclusion The cyanoacrylate (Glubran®) is a good tool in preventing postoperative seromas in patients with IH (particularly in onlay procedures), without increasing the incidence of other complications.

The Effects of Cyanoacrylate on Clinical Healing and Self-Reported Outcomes Following Free Gingival Graft Surgery: A Randomized Clinical Study

Objective: This study aims to reveal the effects of cyanoacrylate application at the recipient bed and the donor site in free gingival graft surgery on graft dimensions, clinical healing parameters and patient-based outcomes. &#x0D; Methods: Free gingival graft operations were conducted on individuals who were randomly assigned to control or test groups. In the test group, the graft was stabilized and the donor site was coated with cyanoacrylate. In the control group, 6/0 polyvinylidene fluoride sutures were used for stabilization, while the donor site was left untreated. Variables including re-epithelization, post-operative complications, pain, bleeding and quality of life at recipient site, and color match, graft dimensions at donor site were assessed for up to 6 months. &#x0D; Results: Twenty-three individuals completed the study. No differences were observed in any variable between groups except horizontal dimension loss of the graft, which was more abundant in the cyanoacrylate group at six months (p&gt;0.05, p

Fast Curing Multifunctional Tissue Adhesives of Sericin-Based Polyurethane-Acrylates for Sternal Closure.

The use of wire cerclage after sternal closure is the standard method because of its rigidity and strength. Despite this, they have many disadvantages such as tissue trauma, operator-induced failures, and the risk of infection. To avoid complications during sternotomy and promote tissue regeneration, tissue adhesives should be used in post-surgical treatment. Here, we report a highly biocompatible, biomimetic, biodegradable, antibacterial, and UV-curable polyurethane-acrylate (PU-A) tissue adhesive for sternal closure as a supportive to wire cerclage. In the study, PU-As were synthesized with variable biocompatible monomers, such as silk sericin, polyethylene glycol, dopamine, and an aliphatic isocyanate 4,4′-methylenebis(cyclohexyl isocyanate). The highest adhesion strength was found to be 4322 kPa, and the ex vivo compressive test result was determined as 715 kPa. The adhesive was determined to be highly biocompatible (on L-929 cells), biodegradable, and antibacterial (on Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus bacteria). Finally, after opening the sternum of rats, the adhesive was applied to bond the bones and cured with UV for 5 min. According to the results, there was no visible inflammation in the adhesive groups, while some animals had high inflammation in the cyanoacrylate and wire cerclage groups. These results indicate that the adhesive may be suitable for sternal fixation by preventing the disadvantages of the steel wires and promoting tissue healing.

Self-adhesive hydrogel meshes reduce tissue incorporation and mechanical behavior versus microgrips self-fixation: a preclinical study

PurposeAtraumatic mesh fixation for abdominal hernia repair has been developed to avoid the disadvantages of classical fixation with sutures, which is considered a cause of chronic pain and discomfort. This study was designed to analyze, in the short and medium term, the biological and mechanical behavior of two self-fixing meshes compared to that of a polypropylene (PP) mesh fixed with a cyanoacrylate (CA) tissue adhesive.MethodsPartial abdominal wall defects (6 × 4 cm) were created in New Zealand rabbits (n = 36) and repaired using a self-adhesive hydrogel mesh (Adhesix™), a self-gripping mesh (ProGrip™) or a PP mesh fixed with CA (Surgipro™ CA). After 14 and 90 days, the host tissue incorporation, macrophage response and biomechanical strength were examined.ResultsAt 14 and 90 days, the ProGrip and Surgipro CA meshes showed good host tissue incorporation; however, the Adhesix implants presented poor integration, seroma formation and a higher degree of shrinkage. The Adhesix hydrogel was completely reabsorbed at 14 days, whereas ProGrip microhooks were observed at all study times. The macrophage response was higher in the ProGrip and Surgipro CA groups at 14 and 90 days, respectively, and decreased over time. At 90 days, the ProGrip implants showed the highest tensile strength values and the Adhesix implants showed the highest failure stretch.ConclusionMeshes with mechanical microgrip self-fixation (ProGrip) show better biological and mechanical behavior than those with adhesive hydrogel (Adhesix) in a preclinical model of abdominal hernia repair in rabbits.

Evaluation of the Efficacy of Iso Amyl 2-Cyanoacrylate Glue in Closure of Extraoral Surgical Wound When Compared with Other Non-Absorbable Suture Materials- A Prospective Clinical Study.

Introduction:Appropriate wound closure with appropriate suture material is of prime significance in surgery. Hence, we aim to assess the efficiency of ISO amyl 2-cyanoacrylate glue in closure of extraoral surgical wound when compared with other suture materials like polypropylene (prolene), nylon (ethilon) and silk (mersilk).Materials and Methods:We conducted a prospective clinical observational study in which 60 subjects were divided into two groups: suture group and cyanoacrylate group. They were compared for wound healing complications on days 1, 3, 7, 12, and at 1 month postoperatively with P < 0.05 as significant.Results:We observed that there was no statistically significant difference between the groups for the various parameters of the wound healing for the different time periods except that color acceptability and visibility were significantly superior in the cyanoacrylate group.Conclusion:Iso amyl 2-cyanoacrylate can be used successfully in the suture closure with excellent patient satisfaction and can be considered as an alternative to the routine suture materials.

Comparison between Tissue Adhesive Cyanoacrylate and Suture for Palatal Fibromucosa Healing: A Randomized Controlled Study.

Cyanoacrylate tissue adhesive is proposed to promote soft tissue healing in oral surgery and minimize complications (pain, inflammation, and bleeding) associated with wound healing by secondary intention. The objective was to compare cyanoacrylate tissue adhesive (test group) with suture (control group) in terms of postoperative complications, operative time, and wound healing in the palatal donor area after harvesting a de-epithelialized gingival graft. A randomized controlled clinical trial was performed in 24 patients randomly assigned to one of two study groups. Data were gathered on wound bleeding, operative time, postoperative pain, inflammation, hyperesthesia, necrosis, and donor area healing time. Operative time was almost 50% shorter in the tissue adhesive cyanoacrylate group, a significant between-group difference (p = 0.003). Spontaneous bleeding in the donor area during the first 24 h was observed in 11.1% of the tissue adhesive cyanoacrylate group versus 88.9% of the suture group—a significant difference. No significant between-group difference was observed in postoperative pain, inflammation, or degree of healing over time. There were no cases of hyperesthesia or wound necrosis. Utilization of tissue adhesive cyanoacrylate rather than suture in palatal de-epithelialized gingival graft harvesting reduces postoperative bleeding during the first 24 h, as well as the operative time.

Dehiscence rate in wound closed with cyanoacrylate and black braided silk after surgical removal of impacted third molar: A systematic review and meta‐analysis

AbstractAimTo perform a systematic review and meta‐analysis of dehiscence rate in wound closed with cyanoacrylate and black braided silk after surgical removal of impacted third molar.Materials and MethodsThis review is based on PRISMA guidelines and the review protocol was registered in PROSPERO (CRD42019097294). An electronic search of PubMed (Medline), Google Scholar, Cochrane database, EbSCOhost, cross referencing and hand search of journals was carried out. The studies published in English literature from 1 January 2008 to 31 March 2019, where wound closure was done using black braided silk suture and cyanoacrylate following third molar surgery, and those reporting dehiscence rate after a minimum follow‐up of 7 days, were included. The event of occurrence of dehiscence in the two groups was used to calculate the risk ratio using the random effects model (Mantel–Haenszel model) at 95% CI.ResultsOf the 309 articles, three unique studies were identified for the review. Of these, two were randomized controlled trials. A total of 190 patients were included in these three trials. Total of seven events of dehiscence were observed in the cyanoacrylate group as compared to eight in the suture group. The meta‐analysis results indicate that there was no statistically significant difference in the dehiscence rate, RR 0.74, 95% CI (0.13–4.13), with a heterogeneity of I2 = 56%.ConclusionThere is no difference in the dehiscence rate of wound closed with cyanoacrylate and black braided silk suture.

Cost-effectiveness of endoscopic ultrasound-guided coils plus cyanoacrylate injection compared to endoscopic cyanoacrylate injection in the management of gastric varices.

BACKGROUNDCyanoacrylate (CYA) injection can be performed using a standard upper endoscopy technique or under endoscopic ultrasound (EUS) guidance alone or in combination with coils. There is little information available on the economic impact of these treatment methods.AIMTo compare the cost-effectiveness of treating gastric varices by CYA injection via upper endoscopy vs coils plus CYA guided by EUS.METHODSThis was an observational, descriptive, and retrospective study. Patients were allocated into two groups: A CYA group and coils plus CYA group. The baseline characteristics were compared, and a cost analysis was performed.RESULTSOverall, 36 patients were included (19 in the CYA group and 17 in the coils + CYA group). All patients in the CYA group had acute bleeding. They underwent a higher mean number of procedures (1.47 vs 1, P = 0.025), and the mean volume of glue used was 2.15 vs 1.65 mL, P = 0.133. The coils + CYA group showed a higher technical success rate (100% vs 84.2%), with a complication rate similar to the CYA group. The majority of CYA patients required hospitalization, and although the mean total per procedure cost was lower (United States $ 1350.29 vs United States $ 2978), the mean total treatment cost was significantly different (United States $ 11060.89 for CYA vs United States $ 3007.13 for coils + CYA, P = 0.03).CONCLUSIONThe use of EUS-guided coils plus cyanoacrylate is more cost-effective than cyanoacrylate injection when the total costs are evaluated. Larger, randomized trials are needed to validate the cost-effectiveness of the EUS-guided approach to treat gastric varices.

Umbilical closure using 2-octyl cyanoacrylate in transumbilical laparoscopic adrenalectomy: A randomized controlled trial.

To evaluate postoperative pain and esthetic outcomes in patients undergoing transumbilical laparoscopic adrenalectomy with wound closure using 2-octyl cyanoacrylate. A total of 26 patients who underwent laparoscopic adrenalectomy with the transumbilical approach and agreed to participate in this study were included. Patients were randomly divided into two groups: the 2-octyl cyanoacrylate group (Glue group) or the non-use group (non-Glue group). A single surgeon (AM) carried out all procedures between 2014 and 2017. There were no significant differences in the clinical background of the Glue and non-Glue groups. The number of patients with moderate or high levels of pain in the resting/moving period on postoperative days1, 2 and 3 was 6/10 (46%/77%), 6/9 (46%/69%) and 3/5 (23%/38%) in the non-Glue group, and 5/7 (38%/54%), 2/7 (15%/54%) and 1/3 (8%/23%) in the Glue group. These differences were not significant. In the subgroup analysis of patients aged <50years, the numbers were 4/6 (57%/86%), 5/7 (71%/100%) and 3/5 (43%/71%) in the non-Glue group, and 3/4 (33%/44%), 1/4 (11%/44%) and 0/1 (0%/11%) in the Glue group in the resting/moving period. On postoperative days2 and 3, these differences were significant (P=0.035 and 0.037 in the resting period, and P=0.017 and 0.013 in the moving period). 2-octyl cyanoacrylate can be used safely for laparoscopic adrenalectomy with the transumbilical approach, and might be useful for reducing postoperative pain in patients aged <50years.

Comparison of stripping/ligation and embolization with cyanoacrylate in venous insufficiency treatment

Aim: Stripping/ligation (S/L) is the gold standard method used in the treatment of varicose veins. Saphenous vein ablation with cyanoacrylate (CA) is a new minimally invasive treatment method that forces this throne. Our aim is to compare these two methods in terms of patient satisfaction. Methods: In this cross-sectional study, voluntary patients who had superficial venous insufficiency and varicose vein were divided into two groups as S/L and CA. CEAP (Clinical-Etiologic-Anatomic-Pathophysiologic-clinical score) and VAS (Visual Analogue Scale ) were evaluated on the 1st, 3rd, 7th, 14th, 30th postoperative days and at the outpatient follow-up visits 1 year later. SF-36 (Short Form-36) questionnaire was applied at the first month. VCSS (Venous Clinical Severity Score) of patients were compared at 6 months after surgery. Control, color doppler ultrasonography was performed on patients with recurrent varicose veins or those who were symptomatic. SPSS 22.0 program was used for data analysis. Results: The preoperative and postoperative VCSS scores were lower in the CA group than in the S/L group (P<0.001). In both groups, postoperative VCSS score was lower compared to preoperative conditions (P<0.001). The VAS score of S/L group was higher than the CA group, during anesthesia, on the 1st, and 3rd postoperative days (P<0.001). However, during the procedure, on the 7th (P<0.001) and 14th days (P=0.033), VAS scores were lower in the S/L group than the CA group. In short form -36, viability score was better in the S/L group (P<0.001). CA group scored higher in the other parameters (such as physical functioning, role limitations, bodily pain, general mental health, social functioning, role limitations due to emotional problems and general health perceptions) (P˂0.001 for all). Conclusion: Although the S/L method is the gold standard for varicose vein treatment, saphenous vein ablation with CA scored higher in terms of patient satisfaction.

A randomized clinical trial of mesh fixation with cyanoacrylate glue compared to sutures in inguinal hernia repair

BACKGROUND: The method of mesh fixation in Lichtenstein hernia repair may have an impact on the incidence of chronic groin pain (CGP) after surgery. This study aimed to compare fixation of mesh with N-butyl 2-cyanoacrylate and with sutures in open inguinal hernia repair in terms of CGP, postoperative complications, operation time, and hernia recurrence. PATIENTS AND METHODS: Adult patients with unilateral uncomplicated inguinal hernia were randomly assigned to one of two equal groups. Group I underwent mesh fixation with cyanoacrylate glue and Group II underwent mesh fixation with polypropylene sutures. The main outcome measures were pain scores at 1, 6, and 12 months of follow-up, hernia recurrence, postoperative complications, and operation time. RESULTS: Forty patients (39 male) of an average age of 48.2 years were included in the study. Patients in Group I had significantly lower pain scores at 1 week and 6 and 12 months after surgery than Group II. The operation time in Group I was significantly shorter than Group II (51.7 vs. 58.7 min, P = 0.007). No recurrence of hernia was recorded in either group at 12 months. Four patients in Group I experienced complications as compared to two patients in Group II with no significant difference (P = 0.66). CONCLUSIONS: Fixation of mesh in Lichtenstein repair with cyanoacrylate glue conferred significantly lower pain scores in the early postoperative period and at 6 and 12 months of follow-up than the classical suture fixation. No difference in the hernia recurrence and postoperative complication rates between cyanoacrylate and suture mesh fixation groups was observed.

A comparative study on the effectiveness of Iso-amyl cyanoacrylate tissue adhesive to silk sutures in the closure of periodontal flap: A split-mouth study

Background: Many factors contribute to uneventful and healthy postoperative healing. Hence the primary union between flap margins during the closure of periodontal flap, post-surgery is of utmost importance. Isoamyl cyanoacrylate is a tissue adhesive, which can be used for the closure of elevated flaps to overcome the problems associated with conventional suture material like silk. Aim: This study aims to compare healing after periodontal flap surgery using isoamyl cyanoacrylate tissue adhesive and silk sutures. Materials and Methods: The split-mouth study was carried out on twenty patients who needed flap surgery for pocket therapy. The outcome measures measured were plaque index (PI), colony forming units (CFU), C-reactive protein levels pre and 1 week after flap surgery, wound healing index and VAS score for discomfort, aesthetics and ease of maintenance 1 week post-op. Paired t-test was used for intragroup post procedure improvement in each parameter, and independent sample t-test was used for intergroup comparison. Results: the cyanoacrylate group showed significant improvement in Plaque Index, colony forming units, C-reactive protein levels and VAS score for discomfort, aesthetics and ease of maintenance. Conclusion: Iso-amyl cyanoacrylate tissue adhesive is an effective procedure in periodontal flap surgery. Clinical Significance: Iso-amyl effectively reduces chair side time due to ease of application and shows better patient compliance due to minimal discomfort and better aesthetics when compared to conventional suture materials.

Electrochemical Studies of New Donor‐Acceptor Oligothiophenes

AbstractElectrochemical studies on a series of new conjugated oligothiophene derivatives are reported. The molecular architectures (D−A and A−D−A) of these compounds present different donor cores (thiophene, bithiophene) with different numbers of 3‐octylthiophene units (that act as π‐bridge and solubilizing components). The acceptor end groups adopted were, in all the cases, ethyl cyanoacrylate units. The results from voltammetric experiments confirm the close relationship between the structure of these oligothiophenes and their electrochemical behavior. Furthermore, we carried out quantum mechanical calculations to be able to obtain the HOMO/LUMO characteristics of some of our compounds in order to confirm our hypotheses on their electrochemical behavior. Moreover, the roles of the oligothiophene backbone and the ethyl cyanoacrylate group in cyclic voltammetry were elucidated by carrying out two different electrolyses at anodic and cathodic peak potentials. In particular, we were successful in the anodic dimerization of a tetrathiophene (D−A) to an octithiophene (A−D−A) (in high yield) with a considerable shortening of the chemical synthesis.