Scientific exploitation of nature's potential has ushered in an era of tissue adhesives. These are poised to revolutionise surgery, and this review focuses on their significance.
Why is there a search for tissue adhesives and sealants? A patient with traumatic injury to the abdomen, which results in the rupture of the liver/spleen, is in a state of shock. In this situation, speedy intervention is the key to survival. On exposure of the traumatised segment of viscera involved, a tissue adhesive can act as a balm to soothe the ailing organ and, therefore, further bleeding can be avoided. Previous time is saved in the process. Sutures have several drawbacks in the sense that many pricks may be required and may cause further bleeding points; they may take time to act as a noose on the right culprit vessels, and they may act as foreign bodies causing reaction. Similarly, diathermy has several drawbacks in the form of inadvertent burning of the structure involved causing a mini funeral pyre and giving the familiar stench of a burning corpse, and the resultant infection and weakness from it. At least, on these fronts, the tissue adhesives have an upper hand as they cause minimal reaction, are less tedious to prepare, can be applied speedily with efficacy, and are systemically absorbed or degraded by body leaving no major damage. Use of tissue adhesives also helps to avoid the constant nudging by a step-motherly body and provides the magical healing touch.
Today, the chief agents for sutureless surgery are the wonder glues that join tissues and seal leaking blood vessels. These include the plastic adhesives called Cyanoacrylate gel or Eastman 910 monomer, the fibrin glue, and the G/R/F glue.
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