Table 2.
Summary of FDA Approved Tissue Adhesives and Sealants in the US.
| Tissue Adhesive Type |
Product name | Manufacturer | Application | Advantages | Limitations |
|---|---|---|---|---|---|
| Cyanoacrylates | Histoacryl/Histoacryl Blue (n-Butyl-2-cyanoacrylate)47 | B. Braun | Topical skin incisions and skin lacerations closure. | Fast curing. Strong dry adhesion. Barrier to microbial penetrations. Haemostatic and bacteriostatic properties. | Rapid degradation in moist conditions. Formaldehyde mediated cytotoxicity. |
| Indermil (n-Butyl-2-cyanoacrylate)51 | Henkel | ||||
| Dermabond (2-Octyl-2-cyanoacrylate)51, 52 | Ethicon | ||||
| Omnex (n-Octyl-2-cyanoacrylate/butyl lactoyl-2-cyano acrylate)47 | Ethicon | Blocking blood loss, bodily fluids, air leaks. | |||
| Fibrin glue | Tisseel (Human pooled plasma fibrinogen and thrombin)53 | Baxter Inc. | Adjunct to hemostasis, used when control of bleeding by conventional techniques is ineffective or impractical. Adjunct for colostomy closure. | Fast curing. Good biocompatibility and biodegradability. | Risk of infection and allergic reaction. Ancillary equipment required. Poor tissue adhesion. Expensive. |
| Evicel (Human pooled plasma fibrinogen and thrombin)53 | Ethicon | ||||
| Vitagel (Autologous plasma fibrinogen and thrombin)44 | Orthovita Inc. | ||||
| Cryoseal system (Autologous plasma fibrinogen and thrombin)54 | ThermoGenesis Corp. | ||||
| Poly (ethylene glycol) (PEG) based sealants | Coseal (2 four-armed PEGsped with glutaryl-succinimidyl ester and thiol)48 | Baxter Inc. | Sealing suture lines and vascular graft. | Rapid gel formation. Fast hemostasis. Biocompatibility. Adhesion to tissue. | Risk of swelling. Possible allergic reaction. Expensive. |
| Duraseal (PEG ester powder and trilysine amine solution with FD&C blue No.1 dye)49 | Covidien Inc. | Sealing of cerebrospinal fluid (CSF). | |||
| SprayGel44 | Covidien | Adhesion barrier in gynecological and colorectal procedures. | |||
| TissuGlu®50 | Cohera Medical, Inc | Prevention of seroma formation under skin flaps. | |||
| OcuSeal44 | Hyperbranch Medical Technology | Dressing for corneal lacerations and bandage for corneal transplants. | |||
| Adherus44 | Sealant for hernia, spinal and cardiovascular applications. | ||||
| Albumin and Glutaraldehyde | BioGlue (Bovine serum albumin and 10% glutaraldehyde)44 | Cryolife Inc. | As adjunct to standard methods of achieving hemostasis in open surgical repair of large vessels. | Fast polymerization (20-30 sec). Full strength in 2 min. Good tissue adhesion. | Risk of glutaraldehyde toxicity. |
| ProGel®44 | NeoMend | Sealing air leaks on lung tissue after surgery. |