A look at the glues used in modern medicine

Lisa Salmon on the adhesives at the heart of medicine

ONCE only found in pencil cases, toolboxes, and cluttered kitchen drawers, modern glue has come a long way and its uses go way beyond sealing small wounds.

Every day, special variations of glue — often a type of acrylic resin called cyanoacrylate — are used to stick and seal in a wide variety of surgeries and treatments, ranging from open heart surgery to infertility.

Here are just a few examples of the modern medical advantages of adhesive...

HEART SURGERY: If you thought Kryptonite was only found in Superman films, think again. It’s the name of a state-of-the-art glue that sticks the breastbone together after open heart surgery.

The breastbone is intentionally broken to allow surgeons to get to the heart, and usually rejoined using metal wires. However, the Kryptonite has natural properties which promote bone healing, and using it means patients have fewer complications with bone stability and infections, says the Canadian cardiac surgeon Dr Paul Fedak who pioneered it.

Though not routinely used, glue is particularly useful in heart surgery when a patient is bleeding heavily and it’s difficult to close a wound with staples or stitches.

VARICOSE VEINS: Usually endothermal ablation is used to treat problematic varicose veins, where heat’s used to seal them off. But now a special type of superglue, VenaSeal, can also be used to stick together the veins that feed the blue, bulgy varicose veins, eventually making them disappear.

Vascular surgeon Professor Mark Whiteley, of The Whiteley Clinic in London, says: “The glue helps to close the main vein in the leg that causes varicose veins. The amount of glue used is absolutely minuscule. Basically it’s superglue, but not quite as rigid, otherwise you’d feel it in your leg. It’s completely set within a couple of minutes.”

OPEN WOUNDS: During the Vietnam War, glue was used successfully to seal wounds in field surgery, although it wasn’t officially approved, partly due to unknown toxicity.

Since then, however, skin glue is utilised regularly in A&E departments to heal minor cuts or wounds with a straight edge, in place of adhesive tape, staples or stitches. A layer of skin glue takes a few minutes to set, and will remain there for five to 10 days while the skin heals underneath. But this procedure needs to be performed by a doctor.

FERTILITY TREATMENTS: If you’re having trouble conceiving and trying IVF, there’s a certain logic to giving the embryo a helping hand to implant itself in the womb by making it sticky.

And that’s where EmbryoGlue comes in.

The adhesive contains a substance called hyaluronan, which occurs naturally in the womb and ovaries, aiding the implantation of an embryo by making the area stickier.

Consultant gynaecologist Yacoub Khalaf explains that a developing embryo can be cultured in an EmbryoGlue solution before being transferred to the uterus.

“The theory is that this medium could enhance the embryo’s ability to attach itself to the lining of the uterus. Also, it’s been speculated that the high viscosity of the medium would reduce the risk of embryos failing out of the uterus after transfer,” he says. “The theory may or may not be true.”

As to whether the use of EmbryoGlue helps women struggling with fertility issues to get pregnant, Khalaf says evidence is conflicting, “and far from robust enough to support routine use”.


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