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Background: Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples. Methods: From February 2017, in a cohort of 1000 consecutive patients receiving primary total hip, total knee (TKA) or unicondylar knee arthroplasty, tissue adhesive was administered after skin closure with staples. Patients were prospectively analyzed for increased duration of hospital admission due to wound drainage. This cohort was compared to a consecutive cohort of 1000 patients before February 2017, treated with the same perioperative protocol, except for administration of tissue adhesive for skin closure. Difference in number of patients requiring prolonged hospital stay due to wound drainage was assessed between the two cohorts. Besides, costs of tissue adhesive were compared to change in hospital admission costs to assess the cost-effectiveness. Results: The number of patients requiring prolonged hospital admission due to wound drainage was significantly reduced in the study group compared to the group not treated with tissue adhesive (39/990 patients vs. 68/961 patients, p = 0.002). The mean number of extra days of hospital admission due to wound drainage was also significantly lower in the tissue adhesive cohort (0.06 vs. 0.13 days). The mean number of extra days in hospital only proved to be significant in the TKA cohort. Total money saved by preventing prolonged hospital admission in general cohort amounted €19,610. Conclusion: This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended. [ABSTRACT FROM AUTHOR]

Uncontrolled traumatic hemorrhage is a leading cause of preventable death. As two main forms of hemostatic materials, however, both sponges and hydrogel adhesives usually fail to control massive hemorrhage due to their respective shortcomings. Hemostatic sponge shows weak tissue adhesion, while the gelation process of hydrogel makes it difficult to seal high‐pressure bleeding wounds. There is an urgent need to develop next‐generation hemostats combining the advantages of sponges and hydrogel adhesives. Herein, a general methodology to prepare novel Fe3+‐laden porous material (Fe3+@GCS) for rapid hemostasis of the high‐pressure and ‌severe hemorrhages is proposed, which is fabricated by loading ferric chloride with ethanol into the catechol‐modified carboxylated gelatin sponge (GCS). Notably, porous Fe3+@GCS can undergo water‐triggered rapid transformation‌ to robust‐adhesive hydrogels. The sealing strength of Fe3+@GCS on wet tissues reaches an astonishing ≈600 mm Hg. Rapid water uptake of Fe3+@GCS around wound not only concentrates blood components but also excludes interfacial water, facilitating blood clotting and wound sealing with the in situ formed sticky hydrogel. Fe3+@GCS can efficiently stop the high‐pressure hemorrhaging from traumatic injuries of arteries and hearts in rats and pigs, respectively, via a simple and short‐time pressing. Furthermore, the wound sealing by Fe3+@GCS promotes wound repair and healing. [ABSTRACT FROM AUTHOR]

Neonates often require vascular access devices for medication or fluid therapy, but a third of devices fail before treatment completion or end with a complication. For adults and children, securing these devices with tissue adhesive (TA) increases the dwell and reduces complications. However, there is a lack of evidence for the neonatal population. This scoping review aimed to assess the evidence of TA for vascular access devices in neonates. The Arksey and O'Malley's (2005) framework was used. The inclusion criteria covered studies published from 2007 (when TA was first reported for use in vascular access devices) to June 2024, available in English, Portuguese, and Spanish, across six databases. Two independent reviewers assessed the studies using Covidence software, with a third reviewer resolving conflicts. Quality assessment was performed using the Mixed Methods Appraisal Tool. From 981 identified studies, 12 were included. Most studies (n = 5, 41.7%) enrolled between 100 and 500 neonates with vascular access devices. Publications originated from four regions and were observational studies (n = 6, 50%), quasi-experimental (n = 3, 25%), and case series (n = 2, 16.7%) with one randomized controlled trial (8.3%) focusing on umbilical venous catheters (UVC). The most common TA composition used was a combination of n-butyl- and 2-octyl- cyanoacrylate (n = 4, 33.3%). The amount of TA applied varied across studies, and often TA was part of a bundle (n = 7, 58.3%). Most studies applied TA to central venous access devices (n = 10, 83.3%) and 2 (16.7%) in peripheral devices. Although there was variation in device failure, the studies generally indicated a reduction in complications such as dislodgment (central catheter: 11.3% [peripherally inserted central catheter {PICC}] to 24.6% [UVC] in non-TA group vs 0.7% [PICC] to 7.7% [UVC] in TA group), device-associated bloodstream infections (central: 7.7% [UVC] and incidence of 2.76/1000 catheter days [PICC] in non-TA group vs 3.1% [UVC] and incidence of 0.99/1000 catheter day [PICC] in TA group), and phlebitis (13% in non-TA group vs 3% in TA-group), as well as increased dwell time in peripheral catheters. Most studies included both term and preterm neonates but did not differentiate between them in their analyses. Skin assessment, life of first dressing, and follow-up of catheters and patients were not reported in most studies. Conclusion: TA may reduce complications in vascular access devices, but the evidence in neonates is limited and varied. Many studies include TA as part of bundle, making it difficult to isolate its effects. Additionally, the current evidence lacks robustness due to the design limitations of the studies. Future research should focus on randomized controlled trials to evaluate TA's effectiveness and safety in preventing device failures and complications in neonates, considering different subgroups, to ensure the safety of TA in these nuanced populations. What is Known: • Research in adults and pediatrics provides evidence supporting the use of tissue adhesive (TA) for vascular access devices, showing a positive impact in reducing failures and complications. • The use of TA in neonates needs to be carefully considered due to their unique characteristics. What is New: • There is a gap in the literature on the use of TA for securing vascular access devices in neonates, particularly regarding its safety and effectiveness in preventing failures and complications. • Further studies are needed to provide robust evidence verifying the effectiveness and safety of TA in this population. [ABSTRACT FROM AUTHOR]

Over the past few decades, there have been advancements in the development of high‐performance tissue adhesives as alternatives to traditional sutures and staples for rapid and effective wound closure post‐surgery. While tissue adhesives offer advantages such as ease of use, short application time, and minimal tissue damage, they also face challenges related to biocompatibility, biodegradability, and adhesive strength. In this study, L‐lysine diisocyanate (LDI) and trimethylolpropane (TMP) were utilized as the primary raw materials to produce a prepolymer terminated with NCO, resulting in the development of a new biocompatible polyurethane tissue adhesive (TMP‐LDI). Additionally, SiO2 nanoparticles were incorporated into the prepolymer, significantly enhancing the adhesive strength of the TMP‐LDI tissue adhesive through the "nanobridging effect," achieving a strength of 170.4 kPa. Furthermore, the SiO2/TMP‐LDI tissue adhesive exhibited satisfactory temperature change during curing and degradation performance. In vitro and in vivo studies demonstrated that SiO2/TMP‐LDI exhibited good biocompatibility, efficient hemostasis, antimicrobial properties, and the ability to promote wound healing. This research presents a novel approach for the development of tissue adhesives with superior adhesive performance. [ABSTRACT FROM AUTHOR]

Controlled branched structures remain a key synthetic limitation for monomeric tissue adhesives because their on‐site polymerization that enables adhesion formation requires rapid kinetics, high conversion, and straightforward setup. In this context, site‐specific branching initiation by using evolmers is potentially effective for structural control; however, the efficiency and kinetics in current reaction setups persists to be a major challenge. In this paper, an evolmer induces a controlled branching polymerization of cyanoacrylate amid the high monomer reactivity useful in rapid adhesion. The contrasting reactivities between the vinyl and the initiating groups in the evolmer molecule generate a kinetic pathway that favors a control‐enabling branching mechanism. Through density functional theory calculations, the reaction pathway toward branching is shown to kinetically favor site‐specific initiation by six orders of magnitude than the route toward non‐specificity. Reaction monitoring confirms the branching polymerization after the polymerization with the evolmer forms a more compact structure than the linear counterpart. Control of branching density is demonstrated in rapid polymerizations within minutes and in polymerizations completed in an instant. These results provide a template for achieving site‐specific branching initiation during adhesion formation and, broadly, where conditions for kinetic control are necessary. [ABSTRACT FROM AUTHOR]

Implantable flexible electronic has attracted significant research interest in various fields. However, it still faces the challenge of simultaneously achieving tight adhesion to tissues in a mildly wet environment and possessing excellent biocompatibility to reduce immune rejection reactions after implantation. Here, a degradable wet‐adhesive flexible electronic device based on liquid metal and ultrathin gelatin film is developed. The ultrathin gelatin film forms numerous hydrogen bonds with tissue in a slightly humid environment, rapidly constructing a wet‐adhesive interface without damaging tissue structure. Inkjet printing is utilized to pattern the mixture of liquid metal and PVP on the surface of the ultrathin gelatin to create flexible patch. With the excellent conductivity of liquid metal, low toxicity, and similarity to natural tissue components of gelatin, flexible patch exhibits outstanding biocompatibility and fatigue resistance. It can be implanted in the body for up to 6 weeks, retaining monitoring capabilities and resisting 1 000 000 cycles of bending fatigue. This study provides a novel strategy for the future development of implantable flexible electronics. [ABSTRACT FROM AUTHOR]

The medicated tissue adhesive on a stretching surface through Prandtl–Eyring nanofluid flow is emphasized in the current article to estimate the heat transfer rate and optimize the adhesion process. The effects of Brownian motion and thermophoresis on electrically conducting viscoinelastic nanofluid are taken into consideration with the sight of convective states. The modeled governing equations are nondimensionalized by operating similarity variables to stimulate the optimization process. The result of an executed model is solved scientifically by employing the NDSolve technique. The influence of various parameters on the fluid momentum, thermal, and concentration distributions is accentuated through graphs. Furthermore, the machine learning approach is enhanced to analyze the physical quantities of interest in the entire region. The outcomes are validated to those that have already been published in the pertinent area literature to determine the effectiveness of viscoinelastic nanofluid. The findings revealed that the Prandtl–Eyring fluid parameter enhances the momentum, while the Hartmann number indicates the reverse trend. In addition, it delivers that the proposed machine learning model is capable of forecasting the physical quantities with lower error (${10^{ - 3}}$10−3) and is a powerful engineering tool that can be effectively employed in a viscoinelastic nanofluid. [ABSTRACT FROM AUTHOR]

Natural-based and synthetic tissue adhesives have attracted extensive attention in the last two decades for their ability to stabilize uncontrolled bleeding instances. However; these materials present several drawbacks during use that scientists have tried to minimize in order to optimize their usage. This study comprises the development of a novel wound dressing, combining the excellent properties of polylactic acid (PLA) non-woven textile, as substrate, obtained through electrospinning, and a cyanoacrylate-based (CA) tissue adhesive, for rapid hemostatic action. Thus, the fabrication of electrospun PLA membranes at three different PLA concentrations, the design and manufacturing of the support system and the production of surgical patches were carried out. SEM and FT-IR methods were employed for analyzing the morphology as well as the indicative markers for the shelf life evolution of the obtained patches. PLA fibers with well-defined structures and a mean diameter varying between 4.6 and 7.24 μm were obtained with the increase of the concentration of the PLA solutions. In vivo tests on a rat model as well as peeling tests for good patch adhesion on liver fragments harvested from the test animals, with a limit for the strength of the liver tissue of 1.5 N, were carried out. The devices exhibited excellent adhesion to the parenchymal tissue and a long enough shelf life to be used with success in surgical procedures, also facilitating prompt hemostatic action. [ABSTRACT FROM AUTHOR]

Background: Skin closure techniques in otolaryngology vary based on surgeon preference and wound site. Octyl‐2‐Cyanoacrylate may be a safe, rapid, and cost‐effective option for post‐site closure. Aim: This randomized controlled trial study aimed to compare Octyl‐2‐Cyanoacrylate and conventional subcuticular sutures in ear surgeries, assessing wound closure results in both case and control groups. Methods: This prospective, randomized, controlled, single‐blind study was conducted at Ohud Hospital from May 2021 to May 2022. Ear surgery and cochlear implantation in patients were examined, and each group was randomly assigned to receive Dermabond TM and deep layer subcuticular sutures closure. Incisions were assessed at various time points, including 3 weeks, 6 weeks, 6 months, and 1 year post‐surgery. The patient and observer Scar Assessment Scale was used, and two independent ear surgeons used the Stony Brook Scar Evaluation Scale for initial scar assessment. Results: This study involved 126 ear surgery and cochlear implantation patients randomized to use cyanoacrylate tissue adhesive or subcuticular suture for port site closure. The study found that tissue adhesive (OCA) was faster and more efficient than standard sutures, saving an average of 12 min per incision in each ear. Incision cosmesis showed immediate results and significant differences, and patient satisfaction with OCA wound closure was higher than standard sutures. Conclusion: The findings confirmed that cyanoacrylate tissue adhesive significantly reduced the time needed for skin closure during ear surgery and showed immediate cosmetic improvements without any documented instances of bleeding, hematoma, infection, or wound separation. Level of Evidence: This is a randomized controlled trial, it follows Level 2 of evidence. Randomized trial or observational study with dramatic effects Laryngoscope, 134:4036–4041, 2024 [ABSTRACT FROM AUTHOR]

Sutureless anastomotic devices present several advantages over traditional suture anastomosis, including expanded global access to microvascular surgery, shorter operation and ischemic times, and reduced costs. However, their adaptation for arterial use remains a challenge. This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation. These approaches include extraluminal couplers, intraluminal devices, and methods assisted by lasers or vacuums, with a particular emphasis on tissue adhesives. We analyze these devices for artery compatibility, material composition, potential for intimal damage, risks of thrombosis and restenosis, and complications arising from their deployment and maintenance. Additionally, we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques. Ideally, a sutureless anastomotic device or technique should eliminate the need for vessel eversion, mitigate thrombosis through either biodegradation or the release of antithrombotic drugs, and be easily deployable for broad use. The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.

Objectives: The aim of this study was to evaluate, through qualitative and semi‐quantitative histological analysis, onlay autologous bone grafts fixed with ethyl‐cyanoacrylate adhesive and titanium screw, in order to verify whether the method of applying the adhesive would interfere with the graft incorporation. Materials and Methods: Fourteen rats underwent bone graft surgery: seven grafts were fixed with ethyl‐cyanoacrylate (SB group, n = 7) and seven grafts were fixed with titanium screws (TS group, n = 7). After 30 days, the grafts were histologically analysed for vitality, adhesive presence, tissue reaction with formation of osteoid matrix, bone resorption presence, capillaries formation, inflammatory infiltrate, fibroblastic proliferation, presence of osteoblasts, osteocytes and osteoclasts. The data were submitted to non‐parametric tests, Mann–Whitney, Fisher's Test, Wilcoxon and McNemar and to statistical analysis (p < 0.05). Results: No significant differences were found in the qualitative evaluations. While findings of more osteocytes (p = 0.035) in the TS group in greater inflammation (p = 0.030) and more osteoclasts (p = 0.048) in the SB. Despite the fact that the titanium screw has presented bone neoformation with welding points, there was no complete incorporation and the adhesive affected the bone repair in a way that not even neoformation points could be seen in 30 days. Conclusion: The method of applying the adhesive did not show an advantage according to the histological aspects studied, as there was the formation of a dead space at the interface of the SB group and the adhesive acted as a barrier. [ABSTRACT FROM AUTHOR]

Background: Surgeons have always aimed to produce less visible scars, with techniques evolving from simple sutures to advanced materials like absorbable sutures, tapes, and adhesives. Cosmetic outcomes are particularly important in thyroid surgeries, common in women aged 30-40, as these surgeries often involve anterior neck incisions. While suturing is reliable, it requires skill and time, prompting the search for easier alternatives. Octyl-cyanoacrylate adhesives have gained popularity for their diverse applications, including wound closure. This study aims to compare the efficacy of octyl-cyanoacrylate to sub-cuticular sutures in thyroidectomy skin closure to meet patients' cosmetic expectations. Materials and Methods: 60 patients scheduled to undergo thyroidectomy were included in the study after taking a written informed consent. This prospective observational study was conducted in the Department of Surgery, over a period of 1 year. Results: Tissue adhesive (octyl-cyanoacrylate) was found to be better in terms of time required to close the wound, cosmetic appearance of wound and less number of wound related complications. Conclusion: The study concludes that tissue adhesives are better in wound closure during initial 1 month of post-operative period in comparison to suturing. However, over period of time, the cosmetic appearance of suturing is almost on par with tissue adhesives. [ABSTRACT FROM AUTHOR]

Background: Tissue adhesive has been widely used in ophthalmic surgery for various procedures, proving both effective and safe. However, no studies have compared the surgical efficacy of the tissue adhesive 2-octyl cyanoacrylate (SurgiSeal®) to that of traditional suture closure in Asian children undergoing surgery for lower lid epiblepharon. Methods: This is a single-center retrospective case-control study. Surgical correction for epiblepharon was performed on 22 patients from November 2019 to May 2023. A total of 20 patients who were followed up for at least 1 month were included for analysis. After standardized epiblepharon surgery, group A underwent wound closure with a subcuticular suture and 2-octyl cyanoacrylate, and group B underwent closure with a 6-O fast-absorbing surgical gut suture. Patients were followed up at 1, 4, and 12 weeks post-surgery. Results: A total of 10 patients (20 eyes) underwent skin closure with tissue adhesives (group A), and 10 patients (18 eyes) underwent wound closure using conventional suture material (group B). No significant differences in the sex ratio, mean age at operation, pre- and postoperative best-corrected visual acuity (BCVA), or average surgical time were observed between groups. Both groups exhibited improved postoperative BCVA, with symptom relief and a significant decrease in the severity of keratopathy after surgery. Neither recurrence nor complications were reported during follow-up. The aesthetic results were similar between groups, while caregivers of children in the tissue adhesive group expressed high satisfaction regarding the ease of postoperative care. Conclusions: Successful closure of lower lid epiblepharon surgery wounds in children can be performed using 2-octyl cyanoacrylate (SurgiSeal®). This method is simple, safe, and effective when compared to conventional sutures. [ABSTRACT FROM AUTHOR]

* This report details a rare case of corneal infection caused by Medicopsis romeroi, highlighting clinical presentation, diagnostic methods, treatment, and outcome. An early adolescence male, after recent corneal tear repair, presented acute eye pain, redness, and decreased vision for 1 day. He underwent corneal tear repair elsewhere post vegetative matter-related swimming injury. Ophthalmic examination revealed a 2.5*3.3mm ulcer around sutures. Corneal scrapings enabled microscopy and culture. With lesion worsening, tissue adhesive (TA) and bandage contact lens (BCL) were applied. Fungal culture identified Medicopsis romeroi. Patient's history, clinical course, and treatment were documented. Microscopy unveiled fungal hyphae, later confirmed as Medicopsis romeroi. Treatment included topical/systemic antifungals. Post-TA + BCL, significant improvement followed, with re-epithelialization, scarring. This report underscores the importance of considering rare fungal pathogens like Medicopsis romeroi in cases of corneal ulcers, especially in individuals with unusual risk factors. Timely diagnosis through microscopy and fungal culture, coupled with tailored antifungal treatment led to successful management and favorable patient outcomes. This case also emphasizes the significance of vigilant clinical observation, precise laboratory analysis, and multidisciplinary collaboration between ophthalmologists and microbiologists in managing atypical ocular infections.

Introduction: Cosmesis is the primary concern for the patient undergoing facial surgery and there are numbers of well proven materials that are available such as adhesive tapes, subcuticular suture, skin adhesive or glue to achieve better cosmesis. The objective of our study was to assess the surgical outcome of sutureless skin closures using Octyl-2-cyanoacrylate (Dermabond™) versus Steri-Strip™. Method: The present prospective study was conducted in 20 patients. Patients were divided into two groups. After subcutaneous closure of wounds, either Dermabond™ or Steri-Strip™ was placed. The patients were assessed for wound complication (erythema, tenderness, dehiscence or any discharge), scar hypertrophy and cosmetic appearance also time consumed in surgical skin closure was evaluated. Wound assessment, scar hypertrophy and cosmetic appearance were assessed by using Chi-square test. Time closure was assessed by using Mann-whitney U test. Result: Twenty patients belonging to all age group were included in study. Ten patients undergone closure with Dermabond™ and ten with Steri-Strips™. Assessment of wound complications, cosmetic appearance and scar hypertrophy was done. There was no significant difference found between both the groups, but 2 patients had fair cosmetic outcomes at one month and 1 patient had fair scar hypertrophy at 6 month. However, excellent cosmetic outcome in terms of scar hypertrophy at 6 month was significantly more among group II. Conclusion: Octyl-2-cyanoacrylate (Dermabond™) and Steri-Strip™ provide similar outcomes in terms of wound complications. Cosmetic outcomes in terms of scar hypertrophy with steri-strip wound closure seem to be better and more economical. [ABSTRACT FROM AUTHOR]

Cold water fish skin gelatin (FSGltn) was chosen as the main material, wherein catechol groups (CAT) were linked through quantitative modification to prepare a catechol-modified gelatin (CAT-FSGltn). Then CAT-FSGltn and dextran dialdehyde (DDA) were mixed in situ to prepare a tissue adhesive (CAT-FSGltn/DDA) with good adhesion in a wet environment. It was found that the gelation time of CAT-FSGItn/DDA was within 60 s. The fully crosslinked CAT-FSGltn/DDA hydrogel showed minimal mass loss after being immersed in PBS solution for over 80 h. When adhered to a rubber film resembling the tissue membrane, the hydrogel CAT-FSGltn/DDA demonstrated an ability to withstand stretching up to twice its initial length without fracturing. An in vitro model was used to evaluate the compressive strength of the tissue adhesive. The compressive strength of CAT-FSGltn/DDA was observed to reach 105.7 mmHg, surpassing the human diastolic pressure. The results indicated that CAT-FSGltn/DDA possessed both strong cohesion and adhesion. Tissue sections showed that CAT-FSGltn/DDA cured for 30 min was closely attached to the casing surface, and the hydrogel/casing interface remained intact after the water flow impact. Cell experiments showed that the survival rate of L929 cells was more than 80%, CAT-FSGltn/DDA hydrogel had good biocompatibility. [ABSTRACT FROM AUTHOR]

Rapid haemostasis during surgery is essential when one wants to reduce the duration of operations, reduce the need for transfusions, and above all when one wants to achieve better patient management. The use of haemostatic agents, sealants, and adhesives improves the haemostatic process by offering several advantages, especially in vascular surgery. These agents vary widely in their mechanism of action, composition, ease of application, adhesion to wet or dry tissue, immunogenicity, and cost. The most used are cyanoacrylate-based glues (Glubran 2) or polysaccharide hydrogel-microsphere powder (AristaTMAH). This work is based on a retrospective study carried out on a sample of patients with different vascular diseases (FAV, pseudoaneurysm, and PICC application) in which two different haemostatic sealants were used. The aim was to assess the safety, the advantages, and the ability of both sealants to activate the haemostatic process at the affected site, also in relation to their chemical-physical characteristics. The obtained results showed that the application of Glubran 2 and AristaTMAH as surgical wound closure systems is effective and safe, as the success achieved was ≥94% on anastomoses of FAV, 100% on stabilization of PICC catheters, and ≤95% on pseudoaneurysms. [ABSTRACT FROM AUTHOR]

In recent years, the development of biodegradable hydrogels as an alternative over the traditional wound dressing has become increasingly significant. These specific hydrogels are able to offer suitable microenvironments to further aid the process of tissue or organ regeneration. However, application of biodegradable hydrogels in clinical medicine remains uncommon due to most biodegradable hydrogels struggle with achieving satisfactory adhesiveness property, high mechanical support and cell compatibility simultaneously. In order to overcome these constraints and enhance the applicability of biodegradable hydrogels, methods have been employed in this study.By reacting gellan gum with methacrylic anhydride and incorporating a biodegradable protein, keratin, we endowed the hydrogels with high pliability via photo-polymerization chain extension, thereby obtaining a biodegradable hydrogel with exceptional properties. Through a series of in vitro tests, GGMA/keratin hydrogels exhibited great cell compatibility via providing an appropriate environment for cell proliferation. Furthermore, this hydrogel not only exhibits extraordinary adhesive ability on visceral tissues but also extends to scenarios involving skin or organ damage, offering valuable assistance in wound healing. Our design provides a suitable platform for cell proliferation and tissue regeneration, which shows prospects for future medical research and clinical applications.

Bacterial wound infections are prevalent in daily life. However, conventional tissue adhesives lack antimicrobial properties. In this study, a redox method was employed to prepare a nano-silver solution with tannic acid as a dispersant. Subsequently, the nano-silver solution was combined with the precursor solution of the hydroxyethyl methacrylate/vinylpyrrolidone (HEMA/NVP) hydrogel. Finally, it was put under ultraviolet light to produce the hydrogel. The hydrogel exhibits remarkable extendibility (1223 %), an elastic modulus compatible with human skin tissue (3.7 ± 0.5 kPa), the strong adhesion to porcine skin tissue (24.67 ± 1.15 kPa) markedly exceeds that achieved by clinically utilized fibrin glue, low swelling ratio (75 ± 1.55 %), and demonstrates good in vitro antimicrobial properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Furthermore, it displays excellent biocompatibility with fibroblast cells (NIH/3T3) with cell viability above 80 %, favorable blood compatibility with goat blood, and moderate coagulation ability. It provides more possibilities for clinical wound repair.

Adhesives have emerged as an effective method for wound closure, hemostasis and tissue engineering in recent years, which not only are suitable for the adhesion of wet tissues, but also can adapt to the peristalsis and mechanical stretching of tissues and organs, especially for arteries and organize bleeding. With the further development of technology, existing adhesives can be modified through different strategies, and new materials are explored, giving new properties and uses to adhesives, such as drug delivery, temperature sensitivity, light sensitivity and so on. Nevertheless, there are many questions about the design and practical clinical application of adhesives in the future. The recent research progress of traditional adhesives and their application in hemostasis is reviewed, and the design and development ideas of future adhesives are discussed in the study.

Background and Aim: Tissue adhesives are increasingly used instead of sutures or staples to close wounds in modern medicine. It seems that use of tissue adhesives can lead to faster and easier closure of the surgical wounds in comparison to sutures. Moreover, tissue glues have a wide application in the fields of tissue engineering and drug delivery systems. Bio-glue which is a widely used bioadhesive in surgery contains bovine serum albumin and glutaraldehyde, but it has significant tissue toxicity due to the high percentage of glutaraldehyde. Adhesive biocompatibility may improve by using albumin nanoparticles along with less toxic cross-linkers such as polypyrrole. Materials and methods: Albumin nanoparticles were prepared by coacervation method and then, polypyrrole and glutaraldehyde in different proportions were used to prepare the bioadhesive. The properties of nanoparticles were examined by DLS, zeta potential analysis, FT-IR spectrum, and scanning electron microscopy. The effects of pH and concentration of albumin nanoparticles on gelation time were analyzed and the cytotoxicity of the adhesive was investigated by the MTT technique. Results: Among the prepared composites, the shortest gelation time was 20 seconds which belonged to the composite containing both crosslinking agents (pyrrole and glutaraldehyde 3%). The results of MTT assay showed that by reducing the percentage of glutaraldehyde, the toxicity of the adhesive significantly decreased (P

Purpose: This study aimed to formulate evidence‐based recommendations for optimising wound management in hip and knee arthroplasty by exploring alternative methods such as barbed sutures and skin adhesives. Methods: A Delphi panel, comprising seven orthopaedic surgeons, one musculoskeletal infectious disease specialist, and one health economics expert, was convened to evaluate the use of barbed sutures and skin adhesives for wound closure in hip and knee arthroplasty. Two systematic reviews informed the development of questionnaires, with panelists ranking their agreement on statements using a 5‐point Likert scale. Consensus was achieved if ≥75% agreement. Unresolved statements were revisited in a second round. Results: Consensus was reached on 11 statements, providing evidence‐based recommendations. The expert panel advocates for a multilayer watertight technique using barbed sutures to prevent surgical site infections (SSI), reduce complications, shorten surgical times, optimise resources and improve cosmetic appearance. For skin closure, the panel recommends topical adhesives to decrease wound dehiscence, enhance cosmetic appearance, promote patient compliance, prevent SSIs, and optimise resources. Conclusion: The Delphi consensus by Italian total joint arthroplasty experts underscores the pivotal role of barbed sutures and skin adhesives in optimising outcomes. While guiding clinical decision‐making, these recommendations are not prescriptive and should be adapted to local practices. The study encourages further research to enhance current evidence. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Introduction: The present study evaluated the biomechanical characteristics of cyanoacrylate-based tissue adhesive (TA) compared to surgical sutures in coronally advanced flap (CAF) procedures using an ex-vivo model. Material and methods: Thirty-six half-pig mandibles were divided into three groups, n=12 each: (I) CAF fixed with sutures (sling and tag suture technique), (II) CAF fixed with TA, and (III) CAF fixed with sutures and TA. At mandibular premolars, gingival recession defects extending 3 mm apical to the cemento-enamel junction (CEJ) were created. CAF procedures were performed using a split-full-split approach, with coronal advancement of the flap to 1 mm above the marked CEJ and stabilization according to the respective groups I–III. Marginal flap stability against pull-of forces (maximum tensile force) was measured with a universal material testing machine until the CEJ became visible. Results: The comparison between groups I–III demonstrated a significantly increased maximum tensile force for the TA (II) compared to the suture group (I) (p<0.001). A significantly increased maximum tensile force was found for the suture and TA (III) compared to the suture group (I) (p<0.001). There was also a significantly increased maximum tensile force in the suture and TA (III) compared to the TA group (II) (p<0.001). Conclusion: The results suggest that cyanoacrylate-based TA can increase marginal flap stability compared to sutures in CAF procedures. Clinical relevance: Cyanoacrylate-based TA can be considered a useful and valuable adjunct to conventional suturing techniques in periodontal plastic surgery, especially in cases where high flap stability is required. The results of this ex-vivo study can only be transferred to the clinical situation with limitations. Clinical long-term follow-up data must be generated. [ABSTRACT FROM AUTHOR]

As a superior alternative to sutures, tissue adhesives have been developed significantly in recent years. However, existing tissue adhesives struggle to form fast and stable adhesion between tissue interfaces, bond weakly in wet environments and lack bioactivity. In this study, a degradable and bioactive citrate-based polyurethane adhesive is constructed to achieve rapid and strong tissue adhesion. The hydrophobic layer was created with polycaprolactone to overcome the bonding failure between tissue and adhesion layer in wet environments, which can effectively improve the wet bonding strength. This citrate-based polyurethane adhesive provides rapid, non-invasive, liquid-tight and seamless closure of skin incisions, overcoming the limitations of sutures and commercial tissue adhesives. In addition, it exhibits biocompatibility, biodegradability and hemostatic properties. The degradation product citrate could promote the process of angiogenesis and accelerate wound healing. This study provides a novel approach to the development of a fast-adhering wet tissue adhesive and provides a valuable contribution to the development of polyurethane-based tissue adhesives. [ABSTRACT FROM AUTHOR]

Background: Wound healing is a mechanism where body attempts to restore the integrity of injured part, delayed healing results in loss of function / poor cosmetic outcome, so the process of regeneration and tissue repair is sequence of molecular and cellular events occurring to restore the damaged tissue. Over time, researchers have found newer technology for wound closure and one among them are the surgical adhesives. Materials and Methods: Patients admitted in the wards under the department of General Surgery during a period of one year were the source of data collection after considering inclusion and exclusion criteria. A descriptive comparative study design was used for data collection and the total sample size of our study was 100. Simple random sampling technique was used to select patients for wound closure, 50 patients underwent wound closure by isoamyl 2 cyanoacrylate and other 50 by conventional suture closure method. Results: There was no much difference in age distribution, gender distribution and investigations like haemoglobin, bleeding and clotting time, blood urea and s. creatinine between groups. Among conventional suture participants, appearance of secondary infection was higher, the mean time taken for the wound to heal after the procedure was also higher, also they received antibiotic therapy for longer duration and mean RBS was higher when compared to the adhesive glue group and the difference was statistically significant. Conclusion: Use of isoamyl 2-cyanoacrylate was better compared to conventional suture method as it required less time to heal, lesser antibiotic duration, lesser chance of appearance of secondary infection and also cosmetic appearance was better compared to the use of sutures. [ABSTRACT FROM AUTHOR]

Introduction: 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. Methods: 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. Results: 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 2.0 mm (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 27 months; 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 250 days, respectively. The CTA was retained in the eyes for median of 94.0 days (IQR 30.0–140.5). A total of five patients developed adverse events, including endophthalmitis (n = 2), following CTA application. Conclusions: CTA was highly effective in sealing corneal perforations in acute setting and showed moderate long-term success. However, multiple applications are often required. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical tissue adhesives remain some critical drawbacks for managing emergency injuries, such as inadequate adhesive strength and insufficient anti-infection ability. Herein, a novel, self-healing, and antibacterial carboxymethyl chitosan/polyaldehyde dextran (CMCS/PD) hydrogel is designed as the first-aid tissue adhesive for effective trauma emergency management. Methods We examined the gel-forming time, porosity, self-healing, antibacterial properties, cytotoxicity, adhesive strength, and hemocompatibility. Liver hemorrhage, tail severance, and skin wound infection models of rats are constructed in vivo, respectively. Results Results demonstrate that the CMCS/PD hydrogel has the rapid gel-forming (~ 5 s), good self-healing, and effective antibacterial abilities, and could adhere to tissue firmly (adhesive strength of ~ 10 kPa and burst pressure of 327.5 mmHg) with excellent hemocompatibility and cytocompatibility. This suggests the great prospect of CMCS/PD hydrogel in acting as a first-aid tissue adhesive for trauma emergency management. The CMCS/PD hydrogel is observed to not only achieve rapid hemostasis for curing liver hemorrhage and tail severance in comparison to commercial hemostatic gel (Surgiflo ®) but also exhibit superior anti-infection for treating acute skin trauma compared with clinical disinfectant gel (Prontosan ®). Conclusions Overall, the CMCS/PD hydrogel offers a promising candidate for first-aid tissue adhesives to manage the trauma emergency. Because of the rapid gel-forming time, it could also be applied as a liquid first-aid bandage for mini-invasive surgical treatment. Graphical Abstract

Abstract In recent years, polymer-based tissue adhesives (TAs) have been developed as an alternative to sutures to close and seal incisions or wounds owing to their ease of use, rapid application time, low cost, and minimal tissue damage. Although significant research is being conducted to develop new TAs with improved performances using different strategies, the applications of TAs are limited by several factors, such as weak adhesion strength and poor mechanical properties. Therefore, the next-generation advanced TAs with biomimetic and multifunctional properties should be developed. Herein, we review the requirements, adhesive performances, characteristics, adhesive mechanisms, applications, commercial products, and advantages and disadvantages of proteins- and synthetic polymer-based TAs. Furthermore, future perspectives in the field of TA-based research have been discussed.

Resumen: Introducción. El uso en pediatría de adhesivos tisulares como el cianocrilato para el cierre de heridas ofrece ventajas significativas. Es un procedimiento sencillo rápido e indoloro, conformándose como una alternativa en la población pediátrica debido a las características específicas de estos pacientes. Objetivo. Evaluar la efectividad del adhesivo tisular con cianocrilato en el cierre de heridas en zonas pilosas y mentón. Metodología. Se diseñó un estudio observacional prospectivo conformado por pacientes pediátricos que acudieron a urgencias con heridas que requerían sutura en zona mentoniana, ceja y cuero cabelludo. Se valoraron variables demográficas y clínicas, así como la colaboración del menor y grado de satisfacción de padres y profesionales tras la aplicación de cianocrilato. A los 3 meses se valoró la cicatrización. Los datos se analizaron mediante el programa estadístico SSPS. Resultados. Las heridas en zonas pilosas presentaron una correcta epitelización con un índice ≤ 2 según escala de Vancouver. Se establecieron diferencias estadísticamente significativas entre la localización de la herida y su cicatrización (p

Adhesives are commonly assessed by two properties: strength and toughness. Here we study how strength and toughness are affected by adhesive thickness. We sandwich gelatin adhesives of various thicknesses between glass substrates. The transparency of the adhesives and substrates enables us to observe crack nucleation and growth. We measure strength by lap shear of samples without precrack, and measure toughness by lap shear of samples with precrack. Our data show a characteristic adhesive thickness, about 0.5 mm. For adhesives below the characteristic thickness, strength is independent of thickness, but toughness increases with thickness. For adhesives above the characteristic thickness, strength decreases as thickness increases, but toughness is a constant. Strength scatters narrowly for samples of a thin adhesive, but broadly for samples of a thick adhesive. By contrast, toughness scatters narrowly for samples of all thicknesses. This work shows the importance of assessing adhesives of various thicknesses.

A meta‐analysis investigation was executed to measure the outcome of sutured wounds (SWs) compared with tissue adhesive (TA) for paediatric wound closure (PWC). A comprehensive literature inspection till February 2023 was applied and 2018 interrelated investigations were reviewed. The 18 chosen investigations enclosed 1697 children with PWC in the chosen investigations' starting point, 977 of them were utilising SWs, and 906 were utilising TA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of SWs compared with TA for PWC by the dichotomous approaches and a fixed or random model. SWs had significantly higher wound cosmetic (WC) scores (mean deviation [MD], 1.70; 95% CI, 0.57–2.84, P =.003), lower wound dehiscence (WD) (OR 0.60; 95% CI, 0.06–0.43, P <.001), and lower cost (MD, −10.22; 95% CI, −10.94 to −9.50, P <.001) compared with those with TA in PWC. No significant difference was found between children utilising SWs and TA in wound infection (WI) (OR, 0.45; 95% CI, 0.15–1.30, P =.14) with no heterogeneity (I2 = 0%) in PWC. SWs had significantly higher WC scores, lower WD, and lower cost, yet, no significant difference was found in WI compared with those with TA in PWC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations and the low number of selected investigations for the meta‐analysis. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the efficacy of octyl-2-cyanoacrylate as well as sutures as a wound closure material. Whether octyl-2-cyanoacrylate can be used as an alternative to suture in the closure of facial wounds. Out of total of 19 wounds, 11 wounds were closed with sutures and tissue adhesive both, out of rest 8 wounds, 4 wounds were closed using sutures alone and in 4 wounds, closure was done with tissue adhesive alone. Therefore, a total of 15 facial wounds were divided into two groups: Group-I Cases in whom 3-0 Black silk suture was used for closure of the wound and Group-II Cases in whom Dermabond (Octyl-2-Cyanoacrylate) was used for closure of the wound. Results showed that Octyl-2-cyanoacrylate offered the benefit of decreased procedure time with less pain, no need for its removal, and better cosmetic outcome compared to sutures.

Photodynamic therapy (PDT) is a great potential anti-tumor therapy owing to its non-invasiveness and high spatiotemporal selectivity. However, systemically administered photosensitizers diffuse in the skin and the eyes for a long duration, which cause phototoxicity to bright light and sunlight. Therefore, following PDT, patients must avoid exposure of to light and sunlight to avoid this phototoxicity. In this study, we have developed a locally administered PDT using nano-adhesive porphyrin with polycations consisting of quaternary ammonium salt groups (aHP) as a photosensitizer. The aHP, approximately 3.0 nm in diameter, adhered the negatively charged cell membrane via electrostatic interaction. The aHP localized to the endosome via cell adhesion and induced apoptosis upon 635 nm light irradiation. On being administered subcutaneously on the tumor, 30% of the injected aHP remained in the administered sites. However, low-molecular-weight hematoporphyrin dihydrochloride (HP) disappeared due to rapid diffusion. PDT with locally administered aHP showed a higher anti-tumor effect after light irradiation at 635 nm for three days compared to low-molecular-weight HP. Intraperitoneal administration of HP caused severe phototoxicity upon irradiation with ultraviolet A at 10 J cm−2, whereas aHP did not cause phototoxicity because its diffusion into the skin could be suppressed, probably due to the high-molecular weight of aHP. Therefore, locally administered PDT with aHP is a potential PDT having high therapeutic efficacy without phototoxicity. [ABSTRACT FROM AUTHOR]

Background: The labial frenulum may be associated with traction on the marginal gingiva of the incisors with resulting gingival recession, a condition known as "pull syndrome". In this case, performing a frenulectomy at least 6 months before root covering surgery is necessary. Recently, tissue adhesives have been studied as a good alternative to conventional sutures. Methods: A 34-year-old female affected by pull syndrome of the central lower incisors underwent frenulectomy, and an n-hexyl-cyanoacrylate tissue adhesive was used to ensure wound closure. Results: The patient was instructed in hygiene maneuvers and rinsed with 0.12% chlorhexidine-based mouthwash for 15 days. The glue was partially removed at 7 days, and for the remaining, natural disposal time was expected. The wound healing process was complete after 15 days with minimal postoperative discomfort. Conclusion: This n-hexyl-cyanoacrylate surgical glue could be proposed as a viable alternative to conventional sutures during surgical procedures involving wide flaps with the impossibility of first-intention healing. Moreover, it could be indicated to reduce operative time and patients' discomfort, even if these hypotheses should be confirmed by future clinical studies. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the efficacy of octyl-2-cyanoacrylate as well as sutures as a wound closure material. Whether octyl-2-cyanoacrylate can be used as an alternative to suture in the closure of facial wounds. Out of total of 19 wounds, 11 wounds were closed with sutures and tissue adhesive both, out of rest 8 wounds, 4 wounds were closed using sutures alone and in 4 wounds, closure was done with tissue adhesive alone. Therefore, a total of 15 facial wounds were divided into two groups: Group-I Cases in whom 3-0 Black silk suture was used for closure of the wound and Group-II Cases in whom Dermabond (Octyl-2-Cyanoacrylate) was used for closure of the wound. Results showed that Octyl-2-cyanoacrylate offered the benefit of decreased procedure time with less pain, no need for its removal, and better cosmetic outcome compared to sutures. [ABSTRACT FROM AUTHOR]

Materials employed in the treatment of conditions encountered in surgical and clinical practice frequently face barriers in translation to application. Shortcomings can be generalized through their reduced mechanical stability, difficulty in handling, and inability to conform or adhere to complex tissue surfaces. To overcome an amalgam of challenges, research has sought the utilization of polymer‐derived nanomaterials deposited in various fashions and formulations to improve the application and outcomes of surgical and clinical interventions. Clinically prevalent applications include topical wound dressings, tissue adhesives, surgical sealants, hemostats, and adhesion barriers, all of which have displayed the potential to act as superior alternatives to current materials used in surgical procedures. In this review, emphasis will be placed not only on applications, but also on various design strategies employed in fabrication. This review is designed to provide a broad and thought‐provoking understanding of nanomaterials as adjuvant tools for the assisted treatment of pathologies prevalent in surgery. This article is categorized under:Implantable Materials and Surgical Technologies > Nanomaterials and ImplantsImplantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery [ABSTRACT FROM AUTHOR]

Currently, most of the clinically available surgical glues and sealants lack elasticity, good adhesion and biocompatibility properties. Hydrogels as tissue adhesives have received extensive attention for their tissue-mimicking features. Here, a novel surgical glue hydrogel based on a fermentation-derived human albumin (rAlb) and biocompatible crosslinker for tissue-sealant applications has been developed. In order to reduce the risks of viral transmission diseases and an immune response, Animal-Free Recombinant Human Albumin from the saccharomyces yeast strain was used. A more biocompatible crosslinking agent, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC), was used and compared with glutaraldehyde (GA). The design of crosslinked albumin-based adhesive gels was optimized by varying the albumin concentration, the mass ratio between albumin and the crosslinking agent as well as the crosslinker type. Tissue sealants were characterized in terms of mechanical (tensile and shear), adhesive and in vitro biocompatibility properties. The results indicated that the mechanical and adhesive properties improved as the albumin concentration increased and the mass ratio between albumin and crosslinker decreased. Moreover, the EDC-crosslinked albumin gels have better biocompatibility properties than GA-crosslinked glues. [ABSTRACT FROM AUTHOR]

Dental implants constitute the standard of care to replace the missing teeth, which has led to an increase in the number of patients affected by peri-implant diseases (PIDs). Here, we report the development of an antimicrobial bioadhesive, GelAMP, for the treatment of PIDs. The hydrogel is based on a visible light-activated naturally-derived polymer (gelatin) and an antimicrobial peptide (AMP). The optimized formulation of GelAMP could be rapidly crosslinked using commercial dental curing systems. When compared to commercial adhesives, the bioadhesives exhibited significantly higher adhesive strength to physiological tissues and titanium. Moreover, the bioadhesive showed high cytocompatibility and could efficiently promote cell proliferation and migration in vitro. GelAMP also showed remarkable antimicrobial activity against Porphyromonas gingivalis. Furthermore, it could support the growth of autologous bone after sealing calvarial bone defects in mice. Overall, GelAMP could be used as a platform for the development of more effective therapeutics against PIDs.

Effective strategy of hemostasis and promoting angiogenesis are becoming increasingly urgent in modern medicine due to millions of deaths caused by tissue damage and inflammation. The tissue adhesive has been favored as an optimistic and efficient path to stop bleeding, while, current adhesive presents limitations on wound care or potential degradation safety in clinical practice. Therefore, it is of great clinical significance to construct multifunctional wound adhesive to address the issues. Based on pro-angiogenic property of l-Arginine (L-Arg), in this study, the novel tissue adhesive (G-DLPUs) constructed by L-Arg-based degradable polyurethane (DLPU) and GelMA were prepared for wound care. After systematic characterization, we found that the G-DLPUs were endowed with excellent capability in shape-adaptive adhesion. Moreover, the L-Arg released and the generation of NO during degradation were verified which would enhance wound healing. Following the in vivo biocompatibility was verified, the hemostatic effect of the damaged organ was tested using a rat liver hemorrhage model, from which reveals that the G-DLPUs can reduce liver bleeding by nearly 75% and no obvious inflammatory cells observed around the tissue. Moreover, the wound care effect was confirmed in a mouse full-thickness skin defect model, showing that the hydrogel adhesive significantly improves the thickness of newly formed dermis and enhance vascularization (CD31 staining). In summary, the G-DLPUs are promising candidate to act as multifunctional wound care adhesive for both damaged organ and trauma.

Swapnali Sabhapandit,1 Somasheila I Murthy,2 Namrata Sharma,3 Virender S Sangwan4 1Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India; 2Tej Kohli Cornea Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India; 3Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 4Dr Shroff’s Charity Eye Hospital, New Delhi, IndiaCorrespondence: Swapnali Sabhapandit, Institute of Ophthalmic Sciences, Asian Institute of Gastroenterology Hospitals, Mindspace Road, Gachibowli, Hyderabad, 500032, India, Tel +91 8790622699, Email drswapnali@gmail.comAbstract: Peripheral ulcerative keratitis (PUK) is an inflammatory, necrotic condition in the peripheral cornea which may end in corneal perforation and visual morbidity if not treated adequately. PUK can occur due to infectious or non-infectious causes. Early cases need medical therapy, both locally and systemically (for some cases). However, advanced PUK may necessitate surgical removal of inciting cause of the pathology and maintaining tectonic stability. Such surgical treatment, including corneal transplantations, may be used in an emergency setting or for visual rehabilitation following preliminary stabilization of the affected cornea. The outcome of these surgeries need to be analyzed to understand the long-term visual prognosis of such eyes. This is an attempt to analyze surgical modalities in the management of PUK and their outcomes.Keywords: peripheral ulcer, tissue adhesive, amniotic membrane, keratoplasty

This study aimed to develop hydrogels for tissue adhesion that are biocompatible, antioxidant, and antibacterial. We achieved this by using tannic acid (TA) and fungal-derived carboxymethyl chitosan (FCMCS) incorporated in a polyacrylamide (PAM) network using free-radical polymerization. The concentration of TA greatly influenced the physicochemical and biological properties of the hydrogels. Scanning electron microscopy showed that the nanoporous structure of the FCMCS hydrogel was retained with the addition of TA, resulting in a nanoporous surface structure. Equilibrium-swelling experiments revealed that increasing the concentration of TA significantly improved water uptake capacity. Antioxidant radical-scavenging assays and porcine skin adhesion tests confirmed the excellent adhesive properties of the hydrogels, with adhesion strengths of up to 39.8 ± 1.2 kPa for 1.0TA-FCMCS due to the presence of abundant phenolic groups on TA. The hydrogels were also found to be biocompatible with skin fibroblast cells. Furthermore, the presence of TA significantly enhanced the antibacterial properties of the hydrogels against both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria. Therefore, the developed drug-free antibacterial and tissue-adhesive hydrogels can potentially be used as wound dressings for infected wounds. [ABSTRACT FROM AUTHOR]

The non-invasive tissue adhesives with strong tissue adhesion and good biocompatibility are ideal for replacing traditional wound treatment methods such as sutures and needles. The self-healing hydrogels based on dynamic reversible crosslinking can recover their structure and function after damage, which is suitable for the application scenario of tissue adhesives. Herein, inspired by mussel adhesive proteins, we propose a facile strategy to achieve an injectable hydrogel (DACS hydrogel) by grafting dopamine (DOPA) onto hyaluronic acid (HA) and mixing it with carboxymethyl chitosan (CMCS) solution. The gelation time and rheological and swelling properties of the hydrogel can be controlled conveniently by adjusting the substitution degree of the catechol group and the concentration of raw materials. More importantly, the hydrogel exhibited rapid and highly efficient self-healing ability and excellent biodegradation and biocompatibility in vitro. Meanwhile, the hydrogel exhibited ~4-fold enhanced wet tissue adhesion strength (21.41 kPa) over the commercial fibrin glue. This kind of HA-based mussel biomimetic self-healing hydrogel is expected to be used as a multifunctional tissue adhesive material. [ABSTRACT FROM AUTHOR]

More than 260 million surgical procedures are performed worldwide each year. Although sutures and staples are widely used to reconnect tissues, they can cause further damage and increase the risk of infection. Bioadhesives have been proposed as an alternative to reconnect tissues. However, clinical adhesives that combine strong adhesion with cytocompatibility have yet to be developed. In this study, we explored the production of adhesives based on protein-engineered polymers bioinspired by the sequence of elastin (i.e., elastin-like recombinamers, ELRs). We hypothesized that the combination of polyphenols (i.e., tannic acid, TA) and ELRs would produce an adhesive coacervate (ELR+TA), as reported for other protein polymers such as silk fibroin (SF). Notably, the adhesion of ELR alone surpassed that of ELR+TA. Indeed, ELR alone achieved adhesive strengths of 88.8 ± 33.2 kPa and 17.0 ± 2.0 kPa on porcine bone and skin tissues, respectively. This surprising result led us to explore a multicomponent bioadhesive to encompass the complementary roles of elastin (mimicked here by ELR) and silk fibroin (SF), and subsequently mirror more closely the multicomponent nature of the extracellular matrix. Tensile testing showed that ELR+SF achieved an adhesive strength of 123.3 ± 60.2 kPa on porcine bone and excellent cytocompatibility. To express this in a more visual and intuitive way, a small surface of only 2.5 cm2 was able to lift at least 2 kg of weight. This opens the door for further studies focusing on the ability of protein-engineered polymers to adhere to biological tissues without further chemical modification for applications in tissue engineering. [ABSTRACT FROM AUTHOR]

Injuries caused by surgical incisions or traumatic lacerations compromise the structural and functional integrity of skin. Immediate approximation and robust repair of skin are critical to minimize occurrences of dehiscence and infection that can lead to impaired healing and further complication. Light‐activated skin sealing has emerged as an alternative to sutures, staples, and superficial adhesives, which do not integrate with tissues and are prone to scarring and infection. Here, we evaluate both shorter‐ and longer‐term efficacy of tissue repair response following laser‐activated sealing of full‐thickness skin incisions in immunocompetent mice and compare them to the efficacy seen with sutures. Laser‐activated sealants (LASEs) in which, indocyanine green was embedded within silk fibroin films, were used to form viscous pastes and applied over wound edges. A hand‐held, near‐infrared laser was applied over the incision, and conversion of the light energy to heat by the LASE facilitated rapid photothermal sealing of the wound in approximately 1 min. Tissue repair with LASEs was evaluated using functional recovery (transepidermal water loss), biomechanical recovery (tensile strength), tissue visualization (ultrasound [US] and photoacoustic imaging [PAI]), and histology, and compared with that seen in sutures. Our studies indicate that LASEs promoted earlier recovery of barrier and mechanical function of healed skin compared to suture‐closed incisions. Visualization of sealed skin using US and PAI indicated integration of the LASE with the tissue. Histological analyses of LASE‐sealed skin sections showed reduced neutrophil and increased proresolution macrophages on Days 2 and 7 postclosure of incisions, without an increase in scarring or fibrosis. Together, our studies show that simple fabrication and application methods combined with rapid sealing of wound edges with improved histological outcomes make LASE a promising alternative for management of incisional wounds and lacerations. [ABSTRACT FROM AUTHOR]

AimsTissue adhesives (TAs) are a commonly used adjunct to traditional surgical wound closures. However, TAs must be allowed to dry before application of a surgical dressing, increasing operating time and reducing intraoperative efficiency. The goal of this study is to identify a practical method for decreasing the curing time for TAs.MethodsSix techniques were tested to determine which one resulted in the quickest drying time for 2-octyle cyanoacrylate (Dermabond) skin adhesive. These were nothing (control), fanning with a hand (Fanning), covering with a hand (Covering), bringing operating room lights close (OR Lights), ultraviolet lights (UV Light), or prewarming the TA applicator in a hot water bath (Hot Water Bath). Equal amounts of TA were applied to a reproducible plexiglass surface and allowed to dry while undergoing one of the six techniques. The time to complete dryness was recorded for ten specimens for each of the six techniques.ResultsUse of the Covering, OR Lights, and Hot Water Bath techniques were associated with a 25- (p = 0.042), 27- (p = 0.023), and 30-second (p = 0.009) reduction in drying time, respectively, when compared to controls. The UV Light (p = 0.404) and Fanning (p = 1.000) methods had no effect on drying time.ConclusionUse of the Covering, OR Lights, and Hot Water Bath techniques present a means for reducing overall operating time for surgeons using TA for closure augmentation, which can increase intraoperative efficiency. Further studies are needed to validate this in vivo.Cite this article: Bone Jt Open 2022;3(8):607–610.