ABSTRACT
This chapter focuses on the development of tissue adhesives used for wound closure. It describes the three types of tissue adhesives: fibrin glue, poly-2-cyanoacrylates, and gelatin-resoreinol-formaldehyde. Fibrin glue is nontoxic when pure human fibrinogen and thrombin are used. Naturally produced clot is an excellent adhesive for tissues, but the clot formation is insufficient in amount for urgent wound closure, unless the tissue incision is tiny. The polyurethane tissue adhesive was concluded to facilitate epithelialization and regeneration of cilia from the regenerated cells in tracheal anastomosis, due to a reduction in both foreign body reaction and mechanical damage. Synthetic cyanoacrylates have been used in surgery, although the cured polymers with short side chains release formaldehyde upon nonenzymatic hydrolysis in tissues, inciting acute inflammation. Poly(alkyl-α-cyanoacrylate)-based tissue adhesives biodegrade inside the body. In the presence of an aqueous environment, the polymer gives rise to its degradation products, notably formaldehyde and other breakdown products.
