FIBRIN ADHESIVES IN PROTECTION OF DIGESTIVE TRACT ANASTOMOSES (REVIEW OF FOREIGN LITERATURE)

Data of experimental and clinical studies concerning fibrin adhesives’ use for theprotection of anastomoses of the gastrointestinal tract are submitted in the article.Definite data have not been obtained.Objective. The purpose of this study was to review literature on the protection ofanastomoses of the digestive system by fibrin adhesives. The study was conductedaccording to the Internet data.Conclusion. The given data testify that anastomoses strengthening with fibrin adhesivescan be effective in bariatric surgery. The majority investigations, preferably on rats,are an experimental research. It is premature to give recommendations concerningapplication of fibrin adhesives to strengthen other types of anastomoses. Fibrin adhesives’investigations in strengthening gastrointestinal tract anastomoses represent a perspectivedirection of up-to-date surgery. Significant achievements should to be expected.

Cerebrovascular complications and granuloma formation after wrapping or coating of intracranial aneurysms with cotton gauze and human fibrin adhesives: results from a single-center patient series over a 5-year period

Object Reinforcement of intracranial aneurysms (IAs) by wrapping or coating is a well-established therapeutic approach to those IAs not amenable to any other definitive treatment, but has been associated with complications such as parent artery narrowing, granuloma formation, and ischemic stroke. The goal of this study was to systematically investigate cerebrovascular complications following this procedure. Methods The authors' hospital database was searched for all patients who underwent wrapping or coating of IAs with cotton gauze and human fibrin adhesives between October 2006 and October 2011. The follow-up records of these patients were extracted, including regular clinical visits and vascular imaging. Results Five hundred sixty-seven patients were treated for IAs over the 5-year period: 303 patients underwent endovascular strategies and 264 underwent craniotomies. Wrapping or coating of IAs was performed in 20 patients (3.5%). Parent artery narrowing occurred in 5 (25%) of the 20 patients and was associated with major ischemic strokes in 4 patients and severe headache in another. Ischemic strokes were associated with parent artery narrowing, which occurred early postoperatively in 2 patients or was a consequence of granuloma formation in 2 patients 1 and 2 months after the procedure, respectively. Conclusions These data should add to the awareness of significant cerebrovascular complications following wrapping or coating of IAs with cotton gauze and human fibrin adhesives and indicate that major ischemic strokes need to be included in the risk/benefit considerations during decision making for such treatment strategies. Patients who receive IA wrapping should be monitored and followed up closely for arterial narrowing and granuloma formation.

Simple, painless, cosmetic closure of endaural incisions

Endaural incisions provide a cosmetic approach to the middle-ear cleft, tympanic membrane for myringoplasty, and attic and antrum for small cavity mastoidectomy. These wounds have traditionally been closed with sutures, but platelet or fibrin adhesives provide an alternative. However, discomfort at the time of suture removal, particularly in children, and the risk of transmission of blood-borne infections in gels are limitations to these wound closure techniques. This paper describes our experience with Histoacryl® glue (butyl-2-cyanoacrylate) in closing endaural incisions.