High-strength glue products were approved for topical closure applications in the United States in the late 1990s, but have been used considerably more outside the USA. In other countries, such as the major markets of the EU, high-strength glues and adhesives were approved several years ago and have built up a track record of use in internal surgery. Today, high-strength glues are being used in a wider range of procedures both in the US and outside the US. Physicians and researchers are exploring how these glues may be utilized in current or new procedures to produce more cost-effective, better outcomes with reduced morbidity and mortality.
The unmet need for non-toxic, high-strength, resorbable glues is clearly demonstrated by adoption of existing glue products outside of the United States. The table below displays selected applications (seereport #S190 for the comprehensive list) for commercially approved products and illustrates the growing potential for these high-strength glues once they gain universal approval and adoption within the surgical community worldwide. These products have high-strength sealant and adhesive properties is leading to their increasing adoption by clinical practitioners, starting with surgical closure and specific internal procedures for which there is no good alternative. Recent data shows increasing usage for tissue adhesives in vascular, neurological, spinal, orthopedic, and other procedures.
Selected* Surgical Indications for High-Strength Glues
|Surgical Field||Selected Applications|
|Cardiac surgery||Augmentation of aortic and vascular sutures.|
Repair of minor epicardial lacerations without the use of sutures.
In re-operations, as a hemostatic adhesive on lacerations of the ventricle caused by re-sternotomy or the presence of adhesions.
|Digestive tract endoscopy||Endoscopic treatment of esophageal and esophagotracheal, gastric, gastrointestinal, duodenal, and pancreatic fistulas.|
|Neurosurgery||As a sealant in cranial and spinal dural plastic surgery to prevent CSF fistulas.|
Closure and filling of cranial fossae and cavities.
|General surgery||As an adhesive in both traditional and laparoscopic inguinal hernia plastic surgery with patches.|
Hemostasis of liver section slices.
|Gynecological surgery||As an adhesive and hemostatic agent in cervical trauma.|
As an adhesive and hemostatic agent in vaginal and perineal plastic surgery.
|Urological surgery||Sealing of surgical sutures to avoid urinary extravasation.|
Hemostasis in the course of kidney transplants.
|Interventional radiology and vascular neuroradiology||Arterial and venous embolizations.|
|Pediatric surgery||Hemostasis of liver section slices.|
Gluing, repair and hemostasis of parenchymal tissue on lacerations or hemorrhagic lesions of the liver, kidney, pancreas, or spleen.
|Pediatric cardiac surgery||Consolidation of aortic and vascular sutures in general.|
As a hemostatic agent on suture lines between biological and/or synthetic tissues in the reconstruction of cardiac and vascular walls.
|ENT surgery||Hemostasis and salivary sealing in oral and rhino-pharyngeal cavity surgery. Hemostasis and salivary sealing of damaged portions of the pharynx, tongue, soft and hard palates in extirpative oncological procedures.|
*See Report #S190 for the comprehensive list.
Source: MedMarket Diligence, LLC; Report #S190.