Alkyl 2-cyanoacrylates have been used as surgical glues and liquid band aids for years. Current cyanoacrylates have been approved by the Food and Drug Administration (FDA) to close incised skin, repair minor abrasions, and are used as a barrier against certain pathogens. Unfortunately, because of their limited tensile and tear strengths these adhesives cannot be used to repair deep dermal cuts or to close wounds that are under tensions unless sutures and/or immobilization are also used. Finally they cannot be used to cover large abrasions, wounds or burns because they would crack during body movement. In this project TDA Research, Inc. (TDA), Golden, CO, will develop novel tissue adhesives that are tear resistant and elastic but will retain the good adhesive properties, fast kinetics of cure, good handling characteristics and low toxicity of current cyanoacrylates. These novel adhesives will allow medical professional to expand the clinical applications of tissues adhesives to more challenging cases.
Each year medical professionals close between 26 and 90 million incisions and lacerations in the USA. Traditionally all these procedures were performed using sutures and staples. In recent years an increasing number of patients are being treated with tissue adhesives, which are quicker and easier to apply than sutures and have a high success rate (the bond strength at 7 days is comparable to that of a 5-0 suture). Current tissue adhesives offer advantages to patients, doctors, and paying parties. Compared to sutures they provide faster wound closure and procedures, they reduce the need for surgical supplies and equipment, give better cosmetic outcomes, reduce patient discomfort and hitching at wound site, and provide a good antibacterial barrier. The use of tissue adhesives in place of sutures also eliminates the need for local anesthesia and follow-up visits to remove the stiches when non-biodegradable sutures are used. Finally avoiding needle handling eliminates the risk of needle stick injuries, which is important in minimizing the risk of transmission of blood diseases. Unfortunately the low tensile strength of current tissue adhesives limits their use to small cuts and abrasions and sutures are still significantly better than tissue adhesives for minimizing dehiscence. In this research TDA will develop tissue adhesives that have the improved tensile strength and tear resistance needed to repair larger wounds or wounds under tension and for covering larger skin abrasions.
