High-strength glue products were approved for topical closure applications in the United States in the late 1990s. Outside the United States, high-strength glues and adhesives have been approved in some countries for a number of years and have built up a track record of use in internal surgery. With time, high-strength glues will come to be used in a wider range of procedures and enable new procedures to be performed more economically with better outcomes and reduced morbidity and mortality.
We have reviewed applications and indications of commercial products and include below a list of approved and indicated neurosurgery procedures in the European Union, as it 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 that will lead to their increasing adoption by clinical practitioners, starting with surgical closure and specific internal procedures for which there is no alternative. We expect that this will be followed, in the next five years, by increasing usage for gluing of tissues in vascular, neurological, spinal, orthopedic, and other procedures. We also envisage the introduction of new products and technologies that are under development to address the failings of existing first-generation high-strength glue products, to make them less toxic, more resorbable, and with higher strength.
- As a sealant in cranial and spinal dural plastic surgery to prevent CSF fistulas.
- As a sealant in dural plastic surgery in residual cavities following tumor removal.
- As sealant in dural lacerations in hemilaminectomy operations.
- Closure and filling of cranial fossae and cavities.
- Closure of the sella turcica by the sphenoidal route.
- Gluing of bone and osteocartilaginous fragments.
(See the complete list of procedures in Europe for high strength glues, encompassing the specific procedures in cardiac surgery, digestive tract endoscopy, general surgery, gynecological surgery, urological surgery, interventional radiology and vascular neuroradiology, pediatric surgery, and ENT surgery in Report #S175.)
From "Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Market, 2009-2013". Report #S175.