Cyanoacrylate Tissue Adhesives Research Articles

Performance of multiple therapeutic approaches for palatal wound healing after soft tissue graft removal - an overview of systematic reviews.

To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. PROSPERO registration number: CRD42022301257.

Outcomes of N-butyl-2-Cyanoacrylate Tissue Adhesive Application in Corneal Perforation Disorders: Consecutive Case Series.

The purpose of this study was to report the success and long-term outcomes of cyanoacrylate tissue adhesive (CTA) application in the management of corneal perforation disorders. This retrospective case series describes the profile and outcomes of eyes that underwent CTA for corneal perforation over an 11-year period from January 2009 until January 2020 at a tertiary eye centre in the United Kingdom. In total, 25 eyes underwent CTA application during the study period. Non-traumatic sterile corneal melt was responsible in more than half of the cases (56.0%; n = 14) followed by infection (32.0%; n = 8) and trauma (12.0%; n = 3). Median size of perforation was 2.0mm (interquartile range, IQR 1.0-3.0). The most common anatomical location of corneal perforation was central (56.0%; n = 14). Ocular surface disease was seen in almost all eyes except two (92.0%; n = 23) with dry eye disease being the most common (48.0%; n = 12). Amongst 23 eyes that completed follow-up (median 27months; IQR 9.5-46.5), single CTA application was successful in achieving intact globe in 13 (56.5%) eyes and repeat gluing sealed total of 20 (86.9%) eyes. Survival analysis showed cumulative success of 71.0% and 51.2% at 90 and 250days, respectively. The CTA was retained in the eyes for median of 94.0days (IQR 30.0-140.5). A total of five patients developed adverse events, including endophthalmitis (n = 2), following CTA application. CTA was highly effective in sealing corneal perforations in acute setting and showed moderate long-term success. However, multiple applications are often required.

Cyanoacrylate Tissue Adhesives Compared With Sutures on Facial and Neck Wounds: A Meta-analysis.

To compare the effectiveness between cyanoacrylate tissue adhesives (CTAs) and sutures for skin closure on the face and neck. Embase, Medline, Scopus, Central, Web of Science. Randomized controlled trials comparing CTAs versus sutures for skin closure on the face and neck were included. Primary outcomes were cosmetic outcomes. Secondary outcomes were scar depth, scar width, pain, closure time, cost, and adverse events. Subgroup analyses were performed by wound locations, type of CTAs, type of sutures, age groups, and type of wounds. Physicians and patients evaluated the cosmetic outcomes. Eighteen studies (1020 patients) were included. CTAs offered better cosmetic outcomes by Wound Registry Scale at ≤1 month (physician: mean difference [MD]: -1.50, 95% confidence interval, CI: -2.42 to -0.58). The cosmetic outcomes assessed by Visual Analog Scale were comparable at >1 to ≤3 months (physicians: standard mean difference [SMD], -0.01, 95% CI, -0.25 to 0.23, patients: SMD, -0.02, 95% CI, -0.84 to 0.79). The cosmetic outcomes by the Patient and Observer Scar Assessment Scale favored sutures at >3 to 12 months (physician: MD 4.26, 95% CI, 2.02-6.50). Subgroup analyses revealed no differences. CTAs offered less scar depth, scar width, pain, closure time, and total cost of closure. Adverse events were similar. Based on the wound healing process, the cosmetic outcomes exhibited a favorable inclination toward CTAs at <1 month while demonstrating comparable results between CTAs and sutures at >1 to ≤3 months. Subsequently, sutures exhibited superior cosmetic outcomes compared to CTAs at >3 to 12 months.

Evaluation of fibrin, cyanoacrylate, and polyurethane-based tissue adhesives in sutureless vascular anastomosis: a comparative mechanical ex vivo study

The stability of a microvascular anastomosis is an important prerequisite for successful tissue transfer. Advances in tissue adhesives are potentially opening new avenues for their use in sutureless microsurgical anastomosis, however they have not yet gained clinical acceptance. In this ex vivo study, a novel polyurethane-based adhesive (PA) was used in sutureless anastomoses and its stability compared with that of sutureless anastomoses performed with fibrin glue (FG) and a cyanoacrylate (CA). Stability was assessed using hydrostatic (15 per group) and mechanical tests (13 per group). A total of 84 chicken femoral arteries were used in this study. The time taken to create the PA and CA anastomoses was significantly faster when compared to the FG anastomoses (P < 0.001): 1.55 ± 0.14 min and 1.39 ± 0.06 min, respectively, compared to 2.03 ± 0.35 min. Both sustained significantly higher pressures (289.3 mmHg and 292.7 mmHg, respectively) than anastomoses using FG (137.3 mmHg) (P < 0.001). CA anastomoses (0.99 N; P < 0.001) and PA anastomoses (0.38 N; P = 0.009) could both withstand significantly higher longitudinal tensile forces compared to FG anastomoses (0.10 N). Considering the background of an in vitro study, the PA and CA anastomosis techniques were shown to be similar to each other and superior to FG, due to their stability and faster handling. These findings need to be validated and confirmed in further in vivo studies.

Efficacy of Cyanoacrylate in Intraoral Surgical Wound Closure

Objective: To evaluate the efficacy of cyanoacrylate tissue adhesives in the management of intraoral surgical wounds in term of wound healing. Material &amp; Methods: Descriptive case series study. Department of oral and maxillofacial surgery. Punjab Dental Hospital, Lahore. 6 months i.e. from: 10-08-2017 to 10-02-2018. After meeting the inclusion criteria 140 patients were enrolled. Strict aseptic measures were taken. Tissue glue applied on the incision line in form of drops at equidistant intervals and then allowed to flow and set for 1-2 minutes. The researcher evaluated the efficacy of wound healing clinically on 15‘, 2"d and 7th postoperative day. All the collected data was entered and analyzed on SPSS version 21. Results: The mean age of patients was 34.16±9.57 years. Male to female ratio was 0.79:1. The wound healing was found in 128(91.4%) patients and the efficacy achieved in 128(91.43%) patients. Conclusion: The cyanoacrylate tissue adhesives is efficacious for the management of intraoral surgical wounds in term of wound healing Keywords: Wound Healing, Efficacy, Cyanoacrylate, Surgery

Electrospinning of cyanoacrylate tissue adhesives for human dural repair in endonasal surgery.

Cerebral spinal fluid (CSF) leakage is a major postoperative complication requiring surgical intervention, resulting in prolonged healing and higher costs. Biocompatible polymers, such as cyanoacrylates, are currently used as tissue adhesives for closing surgical defects and incisions. Coupling these polymers with nanofiber technology shows promising results for generating nanofibers used in wound care, tissue engineering, and drug delivery. Fiber membranes formed by electrospinning of n-octyl-2-cyanoacrylate (NOCA) are investigated for in situ dural closures after neurosurgery to improve the quality of the closure and prevent post-surgical CSF leaks. Electrospun NOCA fiber membranes showed significantly higher sealing capabilities of defects in human dura, with an average burst pressure of 149 mmHg, compared with that of an FDA-approved common dural sealant that had an average burst pressure of 37 mmHg. In this study, microfabrication of NOCA fibers demonstrates a promising technique for dural repairs.

Tissue adhesives for bacterial inhibition in extracorporeal membrane oxygenation cannulae

BackgroundOne of the most serious complications of extracorporeal membrane oxygenation (ECMO) therapy is ECMO cannulae infection, which can occur at quadruple the rate of central venous catheter infections, and significantly impact morbidity and paediatric mortality. The objective of this in vitro observational study was to assess antimicrobial properties of two n-butyl-2-octyl cyanoacrylate tissue adhesive (TA) formulations for bacterial inhibition at peripheral ECMO cannulae insertion sites.MethodsAntimicrobial properties were assessed using modified agar disk-diffusion (n = 3) and simulated agar cannulation insertion site (n = 20) models. Both assays used Staphylococcus epidermidis which was seeded at the edge of the TA or dressing. Microorganism inhibition was visually inspected and evidenced by the presence or absence of a TA bacterial inhibition zone at 24 and 72 h.ResultsBoth TAs provided effective barriers to bacterial migration under cannula dressings, to cannula insertion sites and down cannula tunnels. Additionally, both TAs demonstrated distinct zones of inhibition produced when left to polymerise onto agar plates seeded with S. epidermidis.ConclusionsN-Butyl-2-octyl cyanoacrylate TA appears to inhibit bacterial growth and migration of S. epidermidis. Application of TA to cannulae insertion sites may therefore be a potential bedside strategy for infection prevention in ECMO cannulae, but requires further testing before being used clinically for this purpose.

In vitro testing of cyanoacrylate tissue adhesives and sutures for extracorporeal membrane oxygenation cannula securement

BackgroundExtracorporeal membrane oxygenation (ECMO), an invasive mechanical therapy, provides cardio-respiratory support to critically ill patients when maximal conventional support has failed. ECMO is delivered via large-bore cannulae which must be effectively secured to avoid complications including cannula migration, dislodgement and accidental decannulation. Growing evidence suggests tissue adhesive (TA) may be a practical and safe method to secure vascular access devices, but little evidence exists pertaining to securement of ECMO cannulae. The aim of this study was to determine the safety and efficacy of two TA formulations (2-octyl cyanoacrylate and n-butyl-2-octyl cyanoacrylate) for use in peripherally inserted ECMO cannula securement, and compare TA securement to ‘standard’ securement methods.MethodsThis in vitro project assessed: (1) the tensile strength and flexibility of TA formulations compared to ‘standard’ ECMO cannula securement using a porcine skin model, and (2) the chemical resistance of the polyurethane ECMO cannulae to TA. An Instron 5567 Universal Testing System was used for strength testing in both experiments.ResultsSecurement with sutures and n-butyl-2-octyl cyanoacrylate both significantly increased the force required to dislodge the cannula compared to a transparent polyurethane dressing (p = 0.006 and p = 0.003, respectively) and 2-octyl cyanoacrylate (p = 0.023 and p = 0.013, respectively). Suture securement provided increased flexibility compared to TA securement (p < 0.0001), and there was no statistically significant difference in flexibility between 2-octyl cyanoacrylate and n-butyl-2-octyl cyanoacrylate (p = 0.774). The resistance strength of cannula polyurethane was not weakened after exposure to either TA formulation after 60 min compared to control.ConclusionsTissue adhesive appears to be a promising adjunct method of ECMO cannula insertion site securement. Tissue adhesive securement with n-butyl-2-octyl cyanoacrylate may provide comparable securement strength to a single polypropylene drain stitch, and, when used as an adjunct securement method, may minimise the risks associated with suture securement. However, further clinical research is still needed in this area.

Intracorneal scleral patch supported cyanoacrylate application for corneal perforations secondary to rheumatoid arthritis.

Purpose:To describe a new technique of intracorneal scleral patch (ICSP) supported cyanoacrylate tissue adhesive (CTA) application in corneal perforations, greater than 3.0 mm secondary to rheumatoid arthritis (RA).Methods:This Prospective, non-randomized, non-comparative, interventional series included 14 eyes (14 patients). All patients had corneal perforations sized 3.5 to 4.5 mm due to RA, which were treated with ICSP supported CTA application. A partial thickness scleral patch 1.0 mm larger than diameter of corneal perforation was prepared. A lamellar corneal pocket 0.5 mm all around the corneal perforation was created. The partial thickness scleral patch was placed in the corneal perforation site and the edge was fitted into the lamellar intracorneal pocket. A minimum quantity of CTA was applied on the scleral patch to seal the perforation.Results:The corneal perforations healed in 14 eyes (100%) in a mean 7.71 ± 1.14 (range, 6–9) weeks. One eye (7.14%) had inadvertent extrusion of ICSP due to premature removal of CTA but, Seidel's test was negative, and the corneal epithelial defect healed with BCL alone. One eye each (7.14%) developed steroid induced cataract and glaucoma. None of eyes developed infective keratitis, re-opening of corneal perforation (necessitating repeat procedure) or enlargement of corneal perforation requiring penetrating keratoplasty (PKP).Conclusion:ICSP supported CTA application is a successful alternative option to emergency PKP in treating corneal perforations sized 3.5 to 4.5 mm with associated RA.

Effect of cyanoacrylate tissue adhesive in postoperative palatal pain management: a systematic review.

To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management. Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed. Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment. Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG. The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.

Efficacy of cyanoacrylate tissue adhesive in the management of corneal thinning and perforation due to microbial keratitis

PurposeReport the efficacy of cyanoacrylate tissue adhesive (CTA) application in the management of corneal thinning and perforations associated with microbial keratitis. MethodsA retrospective review of consecutive patients who underwent CTA application for corneal thinning and perforation secondary to microbiologically proven infectious keratitis between 2001 and 2018 at a single center. We defined successful CTA application as an intact globe without tectonic surgical intervention. ResultsThe cohort included 67 patients, and 37 presented with corneal perforation while 30 had corneal thinning. The perforation/thinning was central/paracentral in 43 eyes and peripheral in 23 eyes. The underlying infectious etiologies were monomicrobial in 42 cases (35 bacterial, 3 fungal, 2 viral, and 2 acanthamoeba cases) and polymicrobial in 25 cases (22 polybacterial cases and 3 cases with a combination of Gram positive bacteria and fungus). The median duration of glue retention was 29 days. The CTA success rate was 73%, 64%, and 44% at 10, 30, and 180 days, respectively. CTA application appears more successful in monomicrobial (vs. polymicrobial) and Gram positive bacterial (vs. Gram negative) keratitis but the differences are statistically non-significant. The location of perforation/thinning and the use of topical corticosteroid were not associated with CTA failure. ConclusionCTA was moderately effective in restoring globe integrity in severe corneal thinning and perforation secondary to microbial keratitis in the short term. However the majority of patients require tectonic surgical intervention within 6 months. CTA application success is not significantly associated with the location of thinning/perforation or the use of topical corticosteroid.

Cyanoacrylate Tissue Adhesive for the Treatment of Corneal Thinning and Perforations: A Multicenter Study.

To examine the outcomes of cyanoacrylate tissue adhesive (CTA) application for impending or frank corneal perforations and assess for predictors of treatment response. A multicenter cohort study was conducted to assess the clinical outcomes of adult patients who underwent CTA gluing for impending or frank corneal perforations between 2013 and 2018. The primary outcome was the proportion of successful CTA applications, defined as tectonic stability of the globe without subsequent keratoplasty (KP). Secondary outcomes included visual acuity and success of subsequent surgical interventions, if performed. Fifty-three eyes of 52 patients were included in this study [56% women; mean age at presentation 70 ± 13 years; median length of follow-up of 387 days (interquartile range: 191-704)]. Medical comorbidities were present in 62% of patients. The most common etiologies for perforations included infections (43%) and Sjogren disease (9%). Of the CTA-treated eyes, 22% had a complete resolution of the corneal lesion. Fifty-four percent of patients underwent KP. Longer duration of CTA treatment was associated with CTA success (P = 0.04). For patients requiring KP, 71% were successful and 29% failed. There is no significant difference in the median time delay between patients with successful and failed KPs (P = 0.4). CTA may be considered a stand-alone treatment for corneal perforations. It yielded a success rate of 22%. Failed CTA treatment occurred quickly, largely because of the severity of presentation. In cases requiring KP, the delay between glue application and surgery did not influence the PK success.

Cyanoacrylate tissue adhesive for the management of corneal perforation in dogs:a report of three cases

Corneal perforation can cause profound vision loss and requires immediate treatment. Bandage contact lens insertion and gluing are temporary treatment methods. However, if the patient cannot undergo surgery for a variety of reasons, these methods are inevitably used as permanent treatment methods. The use of cyanoacrylate tissue adhesive (CTA) for the management of corneal perforation in humans has been reported for several decades. Here we describe, for the first time as per our knowledge, the use of CTA (Vetbond) for the management of corneal perforation with a diameter of

Evaluation of antibacterial efficacy and healing with cyanoacrylate tissue adhesive after periodontal flap surgery

Surgical pocket therapy entails raising a mucoperiosteal flap in order to carry out effective debridement so as to eliminate periodontal pockets and result in a healthy periodontium. Braided silk is the most commonly used suture material following periodontal flap surgery. Cyanoacrylate tissue adhesives are slowly gaining popularity as wound closure agents. OBJECTIVES: To evaluate the antibacterial and healing properties of cyanoacrylate tissue adhesives following periodontal flap surgery. METHODS: Patients undergoing full mouth periodontal flap surgery were randomly selected for placement of cyanoacrylates or silk sutures using split mouth study design. Wound healing was evaluated at 1 week using Early Wound Healing Index. Supragingival pooled plaque samples were collected for analysis of total bacterial count at 1week follow up using lawn cultures in blood agar. Pain and burning sensation with cyanoacrylates during and post surgery was recorded using a questionnaire. RESULTS: Silk sutures showed improved wound healing when compared with cyanoacrylates. However, use of cyanoacrylates resulted in reduced bacterial colony counts thereby exhibiting antibacterial properties. Enhanced patient compliance was noted with cyanoacrylate tissue adhesives. SIGNIFICANCE: Cyanoacrylates can be used as an alternative to silk sutures for periodontal wound closure. KEY WORDS: Cyanoacrylate tissue adhesive, silk sutures, antibacterial efficacy, wound healing

In Vitro Assessment of Microbial Barrier Properties of Cyanoacrylate Tissue Adhesives and Pressure-Sensitive Adhesives.

Background: Despite advances in incision care and surgical dressings, surgical site infections remain a common complication. Post-operative contamination of a surgical site is believed to play a role in many of these infections. Most surgical dressings adhere to the skin with pressure-sensitive adhesives. Cyanoacrylate tissue adhesives bond to skin with much greater strength and have inherent antimicrobial properties. This study was designed to compare the microbial barrier properties of common pressure-sensitive adhesives to medical-grade cyanoacrylate tissue adhesives (2-octyl cyanoacrylate and N-butyl cyanoacrylate). Methods: Samples of cyanoacrylate tissue adhesives and pressure-sensitive adhesives were placed on solid culture media. Five common bacterial pathogens were used to contaminate 50 cyanoacrylate samples and 150 pressure-sensitive adhesive samples. Each plate was evaluated for bacterial growth underneath the adhesive sample daily for a total of 72 hours. Results: No penetration was seen through any of the cyanoacrylate adhesive samples at 72 hours. In sharp contrast, bacteria penetrated 99.3% of the pressure-sensitive adhesive samples at 72 hours. Conclusions: Medical grade cyanoacrylate tissue adhesives provide a superior microbial barrier compared with common pressure-sensitive adhesives. Consideration could be given to the use of these adhesives for the securement of surgical dressings.

Outcomes of Cyanoacrylate Tissue Adhesive Application in Corneal Thinning and Perforation.

To report the outcomes of cyanoacrylate tissue adhesive (CTA) application in corneal thinning and perforation. A retrospective interventional case series of 137 patients receiving CTA for corneal thinning and perforation in 140 eyes between 2001 and 2018 at a single center was reviewed. Success rate and factors associated with glue failure were analyzed. Median age of the cohort was 63 years and 69 (50%) were women. One hundred fifteen patients (84%) had at least 1 systemic condition, 46 (34%) had autoimmune diseases. Eighty-nine eyes (64%) presented with perforation and 51 (36%) with thinning. The perforation/thinning was central/paracentral in 82 eyes (59%) and peripheral in 57 eyes (41%). Median size of perforation was 3.1 mm. Causes of perforation and thinning were microbial infection in 75 (55%), sterile melt in 49 (35%), laceration in 10, and keratoprosthesis melt in 8 eyes. Median glue retention was 58 days. Success rate of glue application (defined as intact globe without surgical intervention) was 72%, 61%, and 46% at 10, 30, and 90 days after glue application, respectively. Larger size of perforation/thinning, perforation (vs. thinning), and single glue application (vs. multiple) were correlated with higher failure rate. Systemic conditions, use of topical corticosteroid, etiologies, and location of perforation/thinning were not significantly correlated with glue failure. CTA application was moderately effective in stabilizing corneal perforation and thinning in the very short-term. Multiple applications are often required. Maintenance of globe integrity after glue application decreases with time and the need for surgical intervention remains high.

In Vitro Testing of Cyanoacrylate Tissue Adhesives and Sutures for Extracorporeal Membrane Oxygenation Cannula Securement

In Vitro Testing of Cyanoacrylate Tissue Adhesives and Sutures for Extracorporeal Membrane Oxygenation Cannula Securement

The Antimicrobial effect of Iso-amyl Cyanoacrylate: An In-vitro study

Introduction: Conventional suture materials tend to accumulate microorganisms which will be the possible cause of surgical wound infection. This led to the use of tissue adhesives like cyanoacrylate. The aim of this study is to assess if iso-amyl cyanoacrylate tissue adhesive had an inherent antimicrobial effect. Material and Methods: Pure cultures Staphylococcus aureus, Streptococcus mutans, Pseudomonas aeruginosa and Candida albicans were seeded on agar plates containing Brain Heart infusion agar. Wells filled with different volumes of iso-amyl cyanoacrylate were prepared. Ampicillin and amphotericin B were used as positive controls. The plates were incubated overnight at 37oC and the zone of inhibition was measured. Results: Iso-amyl cyanoacrylate exhibited an inhibitory activity against the gram positive organisms and candida but did not show any effect on the gram negative organism. Conclusion: Iso-amyl cyanoacrylate tissue adhesives have an antimicrobial effect on gram positive organisms and fungi commonly associated with surgical wound infections. This would be an added benefit these tissue adhesives have over conventional suture materials.

A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts.

The purpose was to compare patient-centered outcomes, early wound healing, and postoperative complications at palatal donor area of subepithelial connective tissue grafts (CTG) between cyanoacrylates tissue adhesives and polytetrafluoroethylene (PTFE) sutures. Thirty-six patients who required harvesting of CTG were enrolled in this randomized clinical trial and assigned to one of two groups. In the "suture" group, wound closure was achieved with standardized continuous interlocking 6-0 PTFE sutures, while in the "cyanoacrylate" group, a high viscosity blend of n-butyl and 2-octyl cyanoacrylate was applied until hemostasis was achieved. The primary outcome was the discomfort (eating, speaking, etc.) from the donor site during the first postoperative week; this was self-reported on a visual analog scale questionnaire. Secondary outcomes were the time required for suture placement or cyanoacrylate application, patient self-reported pain on the first day and the first week after surgery, the analgesic intake and the modified early-wound healing index (MEHI). The median value of discomfort was 1.49 in the "suture" group and 1.86 in the "cyanoacrylate" (P=0.56). The mean time required for suture placement was 7.31 minutes and for cyanoacrylate application 2.16 minutes (P<0.0001). No statistically significant differences were found between the two methods in reported pain level, analgesic intake, and MEHI. Cyanoacrylate performs similarly to sutures and can be used for wound closure of the donor site of CTG. The application was about 5 minutes faster than conventional suture placement, reducing the total time of the surgical procedure.

In-vitro evaluation of antibacterial potential of cyanoacrylate tissue adhesives for intraoral wound closure

Background: Cyanoacrylate tissue adhesives have been used as a substitute to silk for intraoral wound closure. Placement of sutures provides a corridor for accumulation of microorganisms into tissue which leads to infection. Cyanoacrylate-based adhesives exhibit many properties of an ideal wound closure agent, minimizing the problems generated by suturing thread. The antimicrobial properties of cyanoacrylates have been extensively assessed in other fields of medicine. However, there is a dearth in the literature on the antibacterial effect of cyanoacrylates in oral environment against oral microflora. Aim: To assess the antibacterial properties of two commonly used formulations of cyanoacrylate tissue adhesives against oral pathogens. Materials and Methods: Iso-amyl cyanoacrylate and a blend of n-butyl and 2-Octyl cyanoacrylates were applied on sterile filter paper discs and placed on culture plates. Plates for aerobic & anaerobic bacterial cultures were incubated in blood agar & Brain-Heart infusion agar respectively.Following incubation period, the bacterial inhibitory halos were measured in millimeters. In order to evaluate the bactericidal efficacy, samples were collected from the inhibitory halos and re-cultured on new bacterial culture plates. Antibacterial activity was assessed against five bacteria: A.actinomycetemcomitans, P.gingivalis, T.forsythia, L.amylovorus and S.aureus. Statistical analysis used: The data collected was analysed using Mann Whitney u test. Results: Cyanoacrylates demonstrated potent inhibitory effects against all test organisms. The zones of inhibition against gram positive bacteria were found to be larger than gram negative bacteria. The bactericidal activity of Iso amyl cyanoacrylate was found to be more potent than n-butyl + 2 octyl cyanoacrylate. Conclusions: Due to its potent antibacterial properties, cyanoacrylate tissue adhesives can be considered as appealing alternatives to silk sutures for intraoral wound closure and help prevent postoperative.