Cyanoacrylate Tissue Research Articles

A turning point in the invasive treatment of lower limb varicosity

During the 20th century, continuous development of classic varicose vein surgery was carried out. From the beginning of the 21st century, however, new endovascular interventions were introduced. Compared to classic surgery, their main benefit is that no incision and dissection is necessary. Only catheters are used to scar the saphenous stems, which are introduced via punctures. Before and during the intervention, ultrasound is used. Laser surgery is the most popular option, and its outcomes have improved a lot with the introduction of laser crossectomy. Radiofrequency surgery is another intervention which is widely performed. A further heat ablation method is the steam operation. One newer technique is the cyanoacrylate tissue adhesive operation. The well-known practice of sclerotherapy has developed by turning the liquid sclerosant into foam, and by causing mechanical damage to the intimal layer of the vein. The new methods have fewer complications because these avoid incisions and dissections during the interventions. Orv Hetil. 2018; 159(52): 2195-2201.

Cyanoacrylate tissue adhesive or silk suture for closure of surgical wound following removal of an impacted mandibular third molar: A randomized controlled study

AimThe aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture. MethodsSubjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated. ResultsSixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group. ConclusionsThis study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding.

Cytotoxicity of three-dimensional paper-based models from a three-dimensional paper-based printer

Objective: Our study aimed to determine the possibility of using models created with a low-cost, paper based 3D printer in an operating room. Therefore influence of different methods of sterilization on models was tested and cytotoxicity of generated models was determined. Material and methods: 30 cuboids divided into three groups were used for verification of shape stability after sterilization. Each group was sterilized either with: Ethylene oxide in temperature 55˚C, Hydrogen peroxide gas plasma in temperature 60˚C or Gamma irradiation at 21˚C, 25kGy. Each cuboid was measured using calliper three times before and three times after sterilization. Results were analysed statistically in Statgraphics Plus. Statistical significance was determined as p< 0.05. Sixty cylinders divided into six groups were used for cytotoxicity tests. Three of those groups were covered before sterilization with 2-octyl-cyanoacrylate. Each group was sterilized with one of the previously described methods. Cytotoxicity was tested by Nanostructural and Molecular Biophysics Laboratory in Technopark Lodz using normal adult human dermal fibroblasts. Survival of cells was tested using spectrophotometry with XTT and was defined as ratio of absorbency of tested probe to absorbency of control probe. Calcein/Ethidium dyeing test was performed according to LIVE/DEAD Viability/Cytotoxicity Kit protocol. Observation was done under Olympus GX71 fluorescence microscope. Results: There was no statistically significant difference for established statistical significance p=0.05 in cuboids dimensions before and after sterilization regardless of sterilization method. In XTT analysis all samples showed higher cytotoxicity against normal, human, adult dermal fibroblast culture when compared to positive control. ANOVA statistical analysis confirmed that 2-octyl cyanoacrylate coating of paper model improved biological behaviour of the material. It decreased cytotoxicity of the model independently of sterilization method. In calcein/ethidium dyeing test due to the high fluorescence of the background caused by cylinders of analysed substance it was impossible to perform the exact analysis of the number of marked cells. Conclusions: Acquired results allow to conclude that Mcor Technology Matrix 300 3D paper-based models can be used in operating room only if covered with cyanoacrylate tissue adhesive. Nemesis relevance: We found no statistically significant difference in cuboids dimensions before and after sterilization regardless of sterilization method. Three-dimensional paper-based models present with high cytotoxicity without coating.

Surgical glue- a promising technology for wound healing

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred.

Comparative study between cyanoacrylate tissue adhesive versus skin sutures in closure of wound in 60 operated cases of open inguinal hernia

Background: Today there are numerous methods available for closure of wounds like tissue adhesives, staplers, adhesive tapes and obviously the age old conventional suturing, all of which have their own pros and cons. The aim was to study the complications and results of use of 2-octyl cyanoacrylate on wound healing and compare them without those of conventional suturing.Methods: Study included 60 operated cases of open inguinal hernia. And comparison was made between cyanoacrylate tissue adhesive and conventional skin suturing in open inguinal hernia.Results: 1 out of 30 (3.3%) from tissue adhesive group and 2 out of 30(6.7%) develop fever ( P value=1.000). 4 (13.3%) of tissue adhesive and 4 (13.3%)from suturing developed redness (P value=1.000). 4 (13.3%) tissue adhesive and 5 (16.7%) from suturing had discharge (P value=0.718). 2 (6.7%) and 1 (3.3%) developed wound dehiscence from tissue adhesive and suturing respectively (P value=0.554). 1 (3.3%) from tissue adhesive developed edge eversion (P value=0.313). 24 (80%) wounds are cosmetically good in which tissue adhesive was applied and 2(6.7%) in which suturing was done (P value=0.001) which is statistically significant.Conclusions: Time required for the intraoperative application of cyanoacrylate glue is less than suturing of incision.Incidence of wound infection was found to be less when wound closure done by cyanoacrylate glue in comparison to suturing. A single linear scar was obtained using cyanoacrylate glue which is cosmetically better than suture scar. Incidence of wound dehiscence is more in cases of application of cyanoacrylate glue than suturing.

Extracorporeal membrane oxygenation line-associated complications: in vitro testing of cyanoacrylate tissue adhesive and securement devices to prevent infection and dislodgement

BackgroundExtracorporeal membrane oxygenation (ECMO) delivers cardiac and/or respiratory support to critically ill patients who have failed conventional medical therapies. If the large-bore cannulas used to deliver ECMO become infected or dislodged, the patient consequences can be catastrophic. ECMO cannula-related infection has been reported to be double the rate of other vascular devices (7.1 vs 3.4 episodes/1000 ECMO days respectively). The aim of this study was to assess the ability of cyanoacrylate tissue adhesive (TA) to inhibit bacterial growth at the ECMO cannulation site, and the effectiveness of TA and securement devices in securing ECMO cannulas and tubing.MethodsThis in vitro study tested the (1) antimicrobial qualities of TA against standard transparent dressing with ECMO cannula; (2) chemical compatibility between cannula, TA and removal agent; (3) pull-out strength of transparent dressing and TA at the cannula insertion site; and (4) pull-out strength of adhesive bandage and commercial sutureless securement devices (SSDs) on circuit tubing. Fisher’s exact test was used to evaluate differences in bacterial growth observed between the transparent dressing and TA groups. Data from mechanical testing were analysed using one-way ANOVA, followed by Tukey’s multiple comparison test or t test as appropriate. Statistical significance was defined as p < 0.05.ResultsNo bacterial growth occurred under TA-covered cannulas compared with transparent dressing-covered cannulas (p = 0.002). Compared to plates lacking TA or transparent dressing, growth was observed at the insertion point and under the dressing in the transparent dressing group; however, no growth was observed in the TA group (p = 0.019). TA did not weaken the cannulas; however, the TA removal agent did after 60 min of exposure, compared with control (p < 0.01). Compared with transparent dressing, TA increased the pull-out force required for cannula dislodgement from the insertion point (p < 0.0001). SSDs significantly increased the force required to remove the tubing from the fixation points compared with adhesive bandage (p < 0.01).ConclusionsOur findings suggest that the combined use of TA at the cannula insertion site with a commercial device for tubing securement could provide an effective bedside strategy to prevent or minimise infection and line dislodgement.

The Biocompatibility of Cyanoacrylate Tissue Adhesive in Conjunction with a Collagen Membrane for Providing Soft and Hard Tissue Regeneration in Extraction Socket Preservation Procedures.

This clinical investigation was performed to determine the efficacy of cyanoacrylate tissue adhesive to enhance soft and hard tissue healing of extraction wounds requiring a regenerative effort. Fourteen patients requiring a total of 25 tooth extractions were selected. Twenty sockets were treated with cyanoacrylate tissue adhesive over an exposed collagen barrier membrane without altering the mucogingival junction, while five extraction sockets were allowed to heal by the secondary healing intention as well but without tissue adhesive application. The results were evaluated with emphasis on soft tissue color and form as well as bone surface morphology. All sites received dental implants. There was a clear advantage to using cyanoacrylate tissue adhesive as a protective mechanism over an exposed collagen barrier membrane.

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.

Diamond Burr for the Treatment of an Indolent Corneal Ulcer in a Foal

Background: Indolent corneal ulcers have been described as superficial ulcers with an associated rim of loose peripheral epithelium Treatment for indolent ulcers include debridement, grid keratotomy, multiple punctate keratotomy, third eyelid flaps, application of cyanoacrylate tissue adhesives, superficial keratectomy, and a debridement with a diamond burr.Case: A 2-month-old female American Quarter Horse was referred to the Ophthalmology Veterinary Section of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, presenting epiphora and blepharospasm. A local veterinarian doctor had prescribed broad spectrum topical antibiotic and anti-inflammatory drops, although there was no positive response to the treatment for the past two weeks. Ophthalmic examination reveals and moderate discomfort in the left eye, epiphora, and mild corneal edema in the area of the defect. Slit lamp biomicroscopy revealed a superficial corneal ulcer with about 6 mm. Corneal epithelium did not adhere to underlying corneal stroma. The remainder of the ophthalmic examination of the left eye was unremarkable. The diagnosis of a corneal ulcer was made based on these clinical signs and fluorescein staining of the cornea where the stain dissects under the unattached epithelial lip. A handheld battery-operated motorized diamond burr, with a 3.5 mm medium grit tip, was utilized to remove the epithelium. The medical treatment included tobramycin eye drops, and flurbiprofen sodium ophthalmic solution, being applied six times daily, after the procedure, during two weeks, and atropine sulphate 1% was applied once a day, during three days. The foal was hospitalized until healing the corneal ulcer. For two weeks, the foal was assessed daily, and, after that, follow-up visits were scheduled weekly for four months. Healing was defined as the point at which the cornea no longer retained fluorescein.Discussion: Ulcers localized to the corneal epithelium, do not heal within the expected time frame, and have been characterized by epithelial border poorly adherent corneal and being commonly referred as indolent corneal ulcers. In this case, corneal ulcers are chronic and have not responded to an appropriate therapy for 14 days. The corneal ulcer was diagnosed based on history, clinical signs and fluorescein staining of the cornea. Usually, medical treatments provide disappointing results. Surgical treatment aims to remove the loosened epithelium in order to facilitate the growth of new epithelial cells, with stronger adhesion complexes. The utilization of a diamond burr, for the treatment of an indolent corneal ulcer, has been previously reported in humans, and dogs. In the present case, the debridement with a diamond burr was chosen on account of excellent results obtained in previous studies in humans and dogs, when treating indolent corneal ulcers. In the current case, the corneal ulcer healed in ten days, while in a study comparing the outcome in 23 horses treated by debridement, grid keratotomy, or superficial keratectomy, the mean times until complete healing were 15, 16 and 23 days, respectively. In the present case, debridement with diamond burr was effective in the treatment of a recurrent corneal ulcer in a foal.

Septal Deviation Treatment Using Bone or Cartilage Grafts Fixed with Cyanoacrylate Tissue Adhesive.

This paper presents a method in which bone or cartilage grafts are fixed to the septal cartilage with cyanoacrylate-based tissue adhesive for the treatment of septal deviation. A prospective study was designed to show the effectiveness of the technique. Cyanoacrylate-based tissue adhesive was used to fix the cartilage or bone grafts onto the septal cartilage to straighten deviated septal cartilage in 77 patients. Regarding the patients' preoperative and postoperative nasal respiration, the following were assessed: (1) Nasal Obstruction Symptom Evaluation (NOSE) scales, (2) patient satisfaction with postoperative nasal respiration using visual analog scoring, and (3) computerized tomographic images. The patients were followed up for 29months on average. Patients' respiration-related problems resulting from septal deviation were relieved in all but four patients. Clinically and radiologically, the straightened septums preserved their new forms, and it was detected with computerized tomography that the bone grafts had acquired permanency. In addition, the NOSE scores improved significantly compared to their preoperative levels. In cases in which the use of bone or cartilage grafts is chosen to straighten the deviated septal cartilage, fixation of grafts with cyanoacrylate (CA) tissue adhesive is a quick, instantly effective, and reliable method. CA, which enables the subsurface of the graft to have complete contact with the septal cartilage, provides extra benefit by transferring all of the reformative forces of the grafts to the septal cartilage. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

To compare Post-frenectomy Healing using Conventional Silk Sutures with N-butyl Cyanoacrylate Tissue Adhesive

To compare Post-frenectomy Healing using Conventional Silk Sutures with N-butyl Cyanoacrylate Tissue Adhesive

Local and systemic effects of fibrin and cyanoacrylate adhesives on lung lesions in rabbits

OBJECTIVES:Tissue adhesives can be used to prevent pulmonary air leaks, which frequently occur after lung interventions. The objective of this study is to evaluate local and systemic effects of fibrin and cyanoacrylate tissue adhesives on lung lesions in rabbits.METHODS:Eighteen rabbits were submitted to videothoracoscopy + lung incision alone (control) or videothoracoscopy + lung incision + local application of fibrin or cyanoacrylate adhesive. Blood samples were collected and assessed for leukocyte, neutrophil and lymphocyte counts and interleukin-8 levels preoperatively and at 48 hours and 28 days post-operatively. After 28 days, the animals were euthanized for gross examination of the lung surface, and lung fragments were excised for histopathological analysis.RESULTS:Fibrin and cyanoacrylate produced similar adhesion scores of the lung to the parietal pleura. Microscopic analysis revealed uniform low-cellular tissue infiltration in the fibrin group and an intense tissue reaction characterized by dense inflammatory infiltration of granulocytes, giant cells and necrosis in the cyanoacrylate group. No changes were detected in the leukocyte, neutrophil or lymphocyte count at any time-point, while the interleukin-8 levels were increased in the fibrin and cyanoacrylate groups after 48 hours compared with the pre-operative control levels (p<0.01).CONCLUSION:Both adhesive agents promoted normal tissue healing, with a more pronounced local inflammatory reaction observed for cyanoacrylate. Among the serum markers of inflammation, only the interleukin-8 levels changed post-operatively, increasing after 48 hours and decreasing after 28 days to levels similar to those of the control group in both the fibrin and cyanoacrylate groups.

Compression properties and dissolution of bioactive glass S53P4 and n-butyl-2 cyanoacrylate tissue adhesive-composite.

Bioactive glass (BG)-containing fiber-reinforced composite implants, typically screw-retained, have started to be used clinically. In this study, we tested the mechanical strength of composites formed by a potential implant adhesive of n-butyl-2-cyanoacrylate glue and BG S53P4 particles. Water immersion for 3, 10 or 30 days had no adverse effect on the compression strength. When cyanoacrylate glue-BG-composites were subjected to simulated body fluid immersion, the average pH rose to 7.52 (SD 0.066) from the original value of 7.35 after 7 days, and this pH increment was smaller compared to BG particle-group or fibrin glue-BG-composite group. Based on these results n-butyl-2 cyanoacrylate glue, by potentially producing a strong adhesion, might be considered a possible alternative for fixation of BG S53P4 containing composite implants. However, the mechanical and solubility properties of the cyanoacrylate glue may not encourage the use of this tissue adhesive with BG particles.

Behavior of a new long-chain cyanoacrylate tissue adhesive used for mesh fixation in hernia repair

BackgroundSynthetic tissue adhesives (TA) are sometimes used in hernia repair surgery. This study compares the use of a new, noncommercial, long-chain cyanoacrylate (n-octyl) TA and Ifabond for mesh fixation. Materials and methodsIn two implant models in the rabbit, expanded polytetrafluorethylene meshes were fixed to the parietal peritoneum using a TA or tacks (intraperitoneal model), or polypropylene meshes used to repair partial abdominal wall defects were fixed with a TA or sutures (extraperitoneal model). Animals were euthanized 14 or 90 d postsurgery and implant specimens were processed for microscopy (labeling of macrophages and apoptotic cells), peritoneal fluid and biomechanical strength testing.Interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were determinated in peritoneal fluid. ResultsMesothelial cell deposition on the intraperitoneal implants fixed using the new TA and Ifabond was adequate and similar IL-6 and TNF-α levels were detected in these implants. Intraperitoneal meshes fixed with tacks showed IL-6 overexpression. Three months after surgery, macrophage and apoptotic cell rates were higher for the intraperitoneal implants fixed with Ifabond versus the new TA or tacks. In the extraperitoneal model, reduced macrophage and cell damage responses were observed in the meshes fixed with sutures versus both TA. Tensile strengths were greater for the tacks versus TA in the intraperitoneal implants and similar for the sutures and TA in the extraperitoneal implants (90 d). ConclusionsBoth TA showed a good cell response in both models. Their use in an intraperitoneal location resulted in reduced tensile strength compared with the tacks. However, strengths were comparable when extraperitoneal implants were fixed with these adhesives or sutures.

Use of cyanoacrylate tissue adhesive to prevent a saliva leak post neck dissection

Use of cyanoacrylate tissue adhesive to prevent a saliva leak post neck dissection

Nonthermal, Nontumescent Endovenous Treatment of Varicose Veins

Endothermal treatment of the great saphenous vein has become the first line of treatment for superficial venous reflux. A new technique for venous insufficiency is non-thermal ablation with vein sealing system which comprises the endovenous delivery of cyanoacrylate tissue adhesive to the vein causing fibrosis. This is a single-center prospective study of treatment of great saphenous vein incompetence in 62 patients with vein sealing system (Biolas VariClose® FG Group, Turkey). All cases were implemented under local anesthesia. Tumescent anesthesia was not required. Patients were not given any nonsteroidal anti-inflammatory drug postoperatively; advised to wear elastic bandages for 1 day; and compression stockings were not offered. Treatment success was defined as complete occlusion of treated vein or recanalized segment shorter than 5cm. Subtotal recanalization was defined as great saphenous vein flow containing 5-10cm segment of treated vein. A recanalized great saphenous vein or treatment failure was defined as an open part of the treated vein segment more than 10cm in length. At 1 week and 1 month control, duplex scans showed total occlusion for all patients (100%), total occlusion for 58 patients (93.5%), and subtotal occlusion for 4 patients (6.5%) at third month. At the end of 6months, total occlusion 56 patients (90.3%) and subtotal occlusion for 2 patients (3.2%). For 4 (6.5%) patients, no occlusion was observed, and the diameter was >11mm. Embolization of great saphenous vein with cyanoacrylate has been performed since the beginning of this decade. Combined chemical and physical mechanism of action results in permanent vein closure. In a recently published study, a 24-month occlusion rate of 92% was demonstrated. The most commonly reported complications of cyanoacrylate use for the treatment of varicose vein disease, so far, include ecchymosis and phlebitis. Almeida et al. reported that phlebitis is the most frequent side effect at a rate of 16%. In our study, phlebitis rate was not as high as reported. It may be caused due to shorter time of follow-up in the hospital. Endovenous ablation of incompetent great saphenous vein with cyanoacrylate-based glue is feasible. Operation time is short, and tumescent anesthesia is unnecessary as postprocedure compression stockings. Lack of significant side effects and an yearly success rate of 100% are benefits of the system.

Sutureless Adult Voluntary Male Circumcision with Topical Anesthetic: A Randomized Field Trial of Unicirc, a Single-Use Surgical Instrument.

IntroductionThe World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC).Study designNon-blinded randomized controlled field trial with 2:1 allocation ratio.Participants75 adult male volunteers.SettingOutpatient primary care clinic.InterventionOpen surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive.Primary OutcomeIntraoperative duration.Secondary OutcomesIntraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result.ResultsThe intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p < 0.001). Wound healing and cosmetic results were superior in the Unicirc group. Adverse events were similar in both groups.ConclusionsVMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC.Trial RegistrationClinicaltrials.gov NCT02443792

THE FEASIBILITY OF CRANIOFACIAL SKELETAL FIXATION USING CYANOACRYLATE GLUE BASED ON CLINICAL EXPERIENCE, AT A GOVERNMENTAL HOSPITAL, ALEXANDRIA, EGYPT

objective: The purpose of this study was to present experience using cyanoacrylate tissue glue in fixation of onlay bone grafts used in different craniofacial reconstruction situations design: Prospective analysis of patients with craniofacial defects including nasofrontal encephalocele and post traumatic craniofacial fractures repaired by onlay bone grafts. setting: Institutional center patients/participants: A total of 27 patients presented with nasofrontal encephalocele (5) and post traumatic craniofacial fractures (22). interventions: Reconstruction of nasofrontal defects using onlay bone grafts fixed by cyanoacrylate tissue glue outcome measures: Patients had repair using bone grafts fixed by cyanoacrylate tissue glue between 2010 and 2013. Patients’ photographs, and clinical records, were collected. The technique of defect reconstruction and method of bone grafts securing it in its position is described in this study. results: Patients were followed up over a mean period of 12.6 months to clinically check the stability of the reconstruction, and the contour of the cranium. All patients showed uneventful healing without complications. Conclusions: This technique offered a secure method of onlay bone fixation during reconstruction. Further researches are needed to show this technique advantages and drawbacks.

THE APPLICATION OF SKIN ADHESIVE TO MAINTAIN SEAL IN NEGATIVE PRESSURE WOUND THERAPY

Optimal wound healing in negative pressure wound therapy (NPWT) depends on a properly sealed vacuum system. Anatomically difficult wounds disrupt the adhesive dressing, resulting in air leaks that impair the integrity of this system. Several techniques have been used in previous reports to prevent air leaks, including the addition of skin adhesives (eg, Skin-Prep [Smith and Nephew, St. Petersburg, FL] or compound tincture of benzoin), hydrocolloid dressings, silicone, and stoma paste. The purpose of this case report is to demonstrate the effectiveness of using a cyanoacrylate tissue adhesive, dermaFLEX (FLEXCon, Spencer, MA), in maintaining an airtight, durable seal in NPWT.The authors present a patient with a difficult to manage anogenital wound where efforts to maintain an airtight seal in NPWT proved difficult. It was decided during the course of treatment to use the cyanoacrylate tissue adhesive to create an airtight, durable seal. The tissue adhesive was applied circumferentially to the skin surrounding the wound edge. After placement of vacuum-assisted closure foam over the wound, the adhesive dressing was applied with its edges overlapping the skin area where the tissue adhesive was applied.The size of the wound was visibly reduced at each dressing change. An airtight seal was consistently maintained for 3 days at a time, surviving the difficult environment of the wound and maximizing the life of each adhesive dressing.For wounds in anatomically challenging locations, the use of the tissue adhesive appears to be a safe and viable option in creating a durable seal in NPWT.

Effect of Allogeneic Platelet Lysate and Cyanoacrylate Tissue Glue on the Fibrovascularization of the Porous Polyethylene Implant.

Because of limited autogenous tissue sources, donor site morbidity, and difficulty of shaping the autologous tissue, surgeons often need to use alloplastic frameworks in reconstruction of 3-dimensional tissue defects. Synthetic porous polyethylene (PP) implant is widely used in plastic surgery for 3-dimensional reconstruction of the lost or highly deformed tissues. One of the main factors of PP implant exposure is delayed fibrovascular ingrowth. In the present study, the authors investigated the effect allogeneic plateletlysate (PL) and cyanoacrylate tissue glue (CTG) (2-octyl cyanoacrylate) on the fibrovascularization of the PP implant.Twenty adult female Wistar rats were divided into 4 groups equally, according to the different surgical techniques and implanted materials used. Only PP implant was implanted subcutaneously through a skin incision on the chest wall skin of the rats in the control group; however, CTG was applied with PP implant in the cyanoacrylate group, PL was applied with PP implant in the platelet group, CTG and platelet was applied together with PP implant in the combination group. All of the implants in each group were histologically assessed at postoperative second week. Determination of the collagen density in the tissues, inflammation, and necrosis and vascularization status was assessed semiquantitatively.A denser collagen structure, low inflammation, and necrosis were found in PL groups. There was, however, a significant decrease in vascular density with PL-treated groups. PL treatment may have a potential to reduce complications related to PP implants.