The Experts below are selected from a list of 4158 Experts worldwide ranked by ideXlab platform
Karen M Mcnallyheintzelman - One of the best experts on this subject based on the ideXlab platform.
-
a light activated Surgical Adhesive technique for sutureless ophthalmic surgery
Archives of Ophthalmology, 2003Co-Authors: Jeffrey N Bloom, Mark T Duffy, Jason B Davis, Karen M McnallyheintzelmanAbstract:Objective To investigate a scaffold-enhanced, light-activated bioAdhesive technique as a substitute for sutures in ophthalmic surgery. Clinical Relevance Suture use in ophthalmic surgery is technically demanding and time consuming and may be associated with serious complications such as inadvertent ocular penetration, which can result in retinal detachment and endophthalmitis. BioAdhesive surgery could eliminate many complications and limitations associated with the use of sutures. Methods The bioAdhesive was composed of a poly(L-lactic-co-glycolic acid) (PLGA) porous scaffold doped with a protein solder mix composed of serum albumin and indocyanine green, which was activated with a diode laser. Extraocular rectus muscle–to–extraocular rectus muscle, sclera-to-sclera, and extraocular rectus muscle–to-sclera adhesions were created in freshly harvested tissue followed by tensile-strength testing of these Surgical adhesions. Results Optimum tensile strength for muscle-to-muscle repair was achieved with 50% wt/vol bovine serum albumin and 0.5 mg/mL of indocyanine green saturated into a PLGA porous scaffold and activated with an 808-nm diode laser. The tensile strength was 81% of the native muscle's tensile strength (mean ± SD, 433 ± 70 g vs 494 ± 73 g). Sclera-to-sclera adhesions achieved a mean ± SD tensile strength of 295 ± 38 g, whereas that for extraocular rectus muscle–to-sclera adhesions was 309 ± 37 g. Conclusion Sutureless surgery using this bioAdhesive technique for various ophthalmic procedures appears feasible and may result in reduced Surgical complications and cost.
-
comparison of light activated Surgical Adhesive and suture techniques for vascular repair an in vivo study
Lasers in Surgery: Advanced Characterization Therapeutics and Systems XII, 2002Co-Authors: Eric C Soller, Grant T Hoffman, Jill N Riley, Tonya J Dickson, Pamela Rogers, Larry Solomon, Keith L March, Karen M McnallyheintzelmanAbstract:An in vivo study was conducted to investigate the feasibility, mechanical function, and chronic biocompatibility of a new range of light-activated Surgical Adhesives for vascular anastomosis. Porcine carotid arteries (n=12) and femoral arteries (n=12) were exposed, and a 0.3 -0.6cm longitudinal incision was made in the arterial walls. The vessels were divided equally into two groups. Vessels belonging to the first group were repaired using a Surgical Adhesive, composed of a poly(L-lactic-co-glycolic acid) scaffold doped with the traditional protein solder mix of serum albumin and indocyanine green dye mixed in deionized water. The Adhesive was applied across the incision and denatured using an 805-nm diode laser. Vessels belonging to the second group formed part of a control study, and were repaired using conventional suturing techniques. Blood flow was restored to the vessels immediately after the procedure and the incision sites were checked for patency. The strength and hemostatic abilities of the new Surgical Adhesives were evaluated in the context of arterial pressure, persistence of hemostasis and presence of any inflammatory reaction after 3 days. The Adhesive technique compared favorably with the suture technique. Repairs formed with the Adhesive technique were achieved more rapidly than suturing, and acute leakage was observed less frequently. Repairs closed by suture did not burst, but leaked at pressures significantly below those of vessels closed with the Adhesive material. Finally, the Adhesive technique produced better histology than the suture technique, suggesting that it holds great promise as an alternative to suturing.
Athipettah Jayakrishnan - One of the best experts on this subject based on the ideXlab platform.
-
A novel injectable tissue Adhesive based on oxidized dextran and chitosan
Acta Biomaterialia, 2017Co-Authors: Biji Balakrishnan, Dawlee Soman, Umashanker Payanam, Alexandre Laurent, Denis Labarre, Athipettah JayakrishnanAbstract:A Surgical Adhesive that can be used in different Surgical situations with or without sutures is a surgeons' dream and yet none has been able to fulfill many such demanding requirements. It was therefore a major challenge to develop an Adhesive biomaterial that stops bleeding and bond tissues well, which at the same time is non-toxic, biocompatible and yet biodegradable, economically viable and appealing to the surgeon in terms of the simplicity of application in complex Surgical situations. With this aim, we developed an in situ setting Adhesive based on biopolymers such as chitosan and dextran. Dextran was oxidized using periodate to generate aldehyde functions on the biopolymer and then reacted with chitosan hydrochloride. Gelation occurred instantaneously upon mixing these components and the resulting gel showed good tissue Adhesive properties with negligible cytotoxicity and minimal swelling in phosphate buffered saline (PBS). Rheology analysis confirmed the gelation process by demonstrating storage modulus having value higher than loss modulus. Adhesive strength was in the range 200-400 gf/cm(2) which is about 4-5 times more than that of fibrin glue at comparable setting times. The Adhesive showed burst strength in the range of 400-410 mm of Hg which should make the same suitable as a sealant for controlling bleeding in many Surgical situations even at high blood pressure. Efficacy of the Adhesive as a hemostat was demonstrated in a rabbit liver injury model. Histological features after two weeks were comparable to that of commercially available BioGlue (R). The Adhesive also demonstrated its efficacy as a drug delivery vehicle. The present Adhesive could function without the many toxicity and biocompatibility issues associated with such products. Statement of Significance Though there are many tissue Adhesives available in market, none are free of shortcomings. The newly developed Surgical Adhesive is a 2-component Adhesive system based on time-tested, naturally occurring polysaccharides such as chitosan and dextran which are both biocompatible and biodegradable. Simple polymer modification has been carried out on both polysaccharides so that when aqueous solutions of both are mixed, the solutions gel in less than 10 s and forms an Adhesive that seals a variety of incisions. The strength of the Adhesive is over 5-times the strength of commercially available Fibrin glue and is more tissue compliant than BioGlue. This Adhesive biomaterial showed excellent tissue bonding, was hemostatic, biocompatible and biodegradable. The significance of this work lies on the features of the developed tissue Adhesive that it stops bleeding, bond the tissues well, can act as a drug delivery vehicle and would appeal to the surgeon in terms of the simplicity of application in complex Surgical situations. There is no need for special delivery systems for application of this Adhesive. The two-component Adhesive can be applied one over the other using syringes. There is also no need for light curing with UV or visible light and the gelation between the two components spontaneously takes place on application leading to excellent tissue bonding.
Yoshito Ikada - One of the best experts on this subject based on the ideXlab platform.
-
soft tissue Adhesive composed of modified gelatin and polysaccharides
Journal of Biomaterials Science-polymer Edition, 2000Co-Authors: Hiroo Iwata, Shojiro Matsuda, Yoshito IkadaAbstract:Although fibrin glue has been clinically used as a Surgical Adhesive, hemostatic agent, and sealant, it has the risk of virus infection because its components, fibrinogen and thrombin, are obtained from human blood. To circumvent this problem, we employed bioabsorbable gelatin and polysaccharides to prepare a safer hemostatic glue. Gelatin was modified with ethylenediamine using water-soluble carbodiimide to introduce additional amino groups into the original gelatin, while dextran and hydroxyethyl-starch were oxidized by sodium periodate to convert 1,2-hydroxyl groups into dialdehyde groups. Upon mixing of the two polymer components in aqueous solution, Schiff base was formed between the amino groups in the modified gelatin and the aldehyde groups in the modified polysaccharides, which thus resulted in intermolecular cross-linking and gel formation. The fastest gel formation took place within 2 s, and its bonding strength to porcine skin was about 225 gfcm-2 when 20 wt% of an amino-gelatin (55% amino) an...
-
a novel Surgical glue composed of gelatin and n hydroxysuccinimide activated poly l glutamic acid part 1 synthesis of activated poly l glutamic acid and its gelation with gelatin
Biomaterials, 1998Co-Authors: Hiroo Iwata, Shojiro Matsuda, Kenji Mitsuhashi, Eiji Itoh, Yoshito IkadaAbstract:Although fibrin glue has been widely used as a Surgical Adhesive, its components, fibrinogen and thrombin, obtained from human blood are not completely free from the risk of virus infection due to acquired immune deficiency and hepatitis. Recently, we have reported that a polymer pair composed of gelatin and poly(l-glutamic acid) (PLGA) promptly forms a gel and can firmly bond to soft tissues when crosslinked with the aid of water-soluble carbodiimide (WSC). The present study was undertaken to design a new PLGA-gelatin glue without using WSC. Two kinds of PLGA with molecular weights of 71 and 22 kDa were employed to prepare N-hydroxysuccinimide (NHS) activated derivatives. The NHS-activated PLGA could be synthesized at high yields and was found to be stable for an extended time without losing the ability to crosslink with gelatin when stored under a dry-cold condition. This NHS-activated PLGA could spontaneously form a gel with gelatin in an aqueous solution within a short time, comparable to a commercial fibrin glue, when gelation was allowed to proceed at pH 8.3. The NHS-activated PLGA prepared from PLGA with the molecular weight of 22 kDa could be readily dissolved at high concentrations and its ability to form a gel was maintained for more than 10 min when an acidic 8% NHS-activated PLGA solution was used. The bonding strength of PLGA–gelatin glues with natural tissue was higher than that of fibrin glue. These findings strongly suggest that this combination of gelatin and NHS–PLGA is very promising as a Surgical Adhesive and may possibly replace fibrin glues prepared from human blood components.
Peter J. Rubin - One of the best experts on this subject based on the ideXlab platform.
-
prevention of seroma formation with tissuglu Surgical Adhesive in a canine abdominoplasty model long term clinical and histologic studies
Journal of Plastic Reconstructive and Aesthetic Surgery, 2013Co-Authors: Thomas W Gilbert, Stephen F Badylak, Eric J Beckman, Dottie M Clower, Peter J. RubinAbstract:Summary Background Seroma formation is a common postoperative complication following many Surgical procedures including abdominoplasty. Recently, a lysine-derived urethane (LDU) Surgical Adhesive was shown to prevent seroma formation in short term studies in a canine model of abdominoplasty. This current study evaluates efficacy of the Adhesive (TissuGlu ® , Cohera Medical, Inc.) in the same model at longer time points, and examines the histological tissue response to extended exposure to the Adhesive. Materials and methods Bilateral subcutaneous pockets were created in the ventrolateral abdominal wall and additional tissue damage was inflicted using electrocautery. On one side, the tissue layers were treated with the Adhesive prior to closure, whereas the control side received no treatment prior to standard closure of the incision. Seroma fluid accumulation was measured and histologic analysis was performed at 3 and 12 weeks. Results Seroma formation (mean ± SD, 690 ± 870 ml; median volume of 348.5 ml) was observed on the control side, whereas the treated side had adherence between the tissue layers, and minimal if any fluid accumulation (mean ± SD, 44 ± 53 ml; median volume of 15 ml) ( p n = 8) at 3 week necropsy. In animals survived to 12 weeks, two of the four control sides required aspiration of serous fluid, and dead space persisted for the entirety of the study in one animal. For the Adhesive treated sites, none of the four animals showed signs of seroma at euthanasia, although serial aspiration was performed in one treatment site within the first month and resulted in resolution of the process. The Adhesive was detected in the Surgical site at 3 and 12 weeks, and independent histological analysis found it to be a non-irritant compared to control (no treatment). Conclusions Long term evaluation of TissuGlu ® Surgical Adhesive showed that it is capable of preventing the formation of seroma in this canine abdominoplasty model, indicating that it may be of clinical benefit in the prevention of seroma formation in patients undergoing abdominoplasty.
-
prevention of seroma formation with tissuglu Surgical Adhesive in a canine abdominoplasty model long term clinical and histologic studies
Journal of Plastic Reconstructive and Aesthetic Surgery, 2013Co-Authors: Thomas W Gilbert, Stephen F Badylak, Eric J Beckman, Dottie M Clower, Peter J. RubinAbstract:Summary Background Seroma formation is a common postoperative complication following many Surgical procedures including abdominoplasty. Recently, a lysine-derived urethane (LDU) Surgical Adhesive was shown to prevent seroma formation in short term studies in a canine model of abdominoplasty. This current study evaluates efficacy of the Adhesive (TissuGlu®, Cohera Medical, Inc.) in the same model at longer time points, and examines the histological tissue response to extended exposure to the Adhesive. Materials and methods Bilateral subcutaneous pockets were created in the ventrolateral abdominal wall and additional tissue damage was inflicted using electrocautery. On one side, the tissue layers were treated with the Adhesive prior to closure, whereas the control side received no treatment prior to standard closure of the incision. Seroma fluid accumulation was measured and histologic analysis was performed at 3 and 12 weeks. Results Seroma formation (mean ± SD, 690 ± 870 ml; median volume of 348.5 ml) was observed on the control side, whereas the treated side had adherence between the tissue layers, and minimal if any fluid accumulation (mean ± SD, 44 ± 53 ml; median volume of 15 ml) (p Conclusions Long term evaluation of TissuGlu® Surgical Adhesive showed that it is capable of preventing the formation of seroma in this canine abdominoplasty model, indicating that it may be of clinical benefit in the prevention of seroma formation in patients undergoing abdominoplasty.
-
randomized prospective study of tissuglu Surgical Adhesive in the management of wound drainage following abdominoplasty
Aesthetic Plastic Surgery, 2012Co-Authors: Klaus J Walgenbach, Holger Bannasch, Stefan Kalthoff, Peter J. RubinAbstract:Background Wound drainage and seroma formation following abdominoplasty remain significant concerns to both surgeons and patients due to the resulting increased need for patient follow-up and delays in returning to normal function. While a number of approaches are used to reduce wound drainage and seroma formation, there is still no definitive solution. A promising strategy to reduce these complications is the development of an effective method for closing dead space between tissue layers in order to achieve improved patient outcomes.
Biji Balakrishnan - One of the best experts on this subject based on the ideXlab platform.
-
A novel injectable tissue Adhesive based on oxidized dextran and chitosan
Acta Biomaterialia, 2017Co-Authors: Biji Balakrishnan, Dawlee Soman, Umashanker Payanam, Alexandre Laurent, Denis Labarre, Athipettah JayakrishnanAbstract:A Surgical Adhesive that can be used in different Surgical situations with or without sutures is a surgeons' dream and yet none has been able to fulfill many such demanding requirements. It was therefore a major challenge to develop an Adhesive biomaterial that stops bleeding and bond tissues well, which at the same time is non-toxic, biocompatible and yet biodegradable, economically viable and appealing to the surgeon in terms of the simplicity of application in complex Surgical situations. With this aim, we developed an in situ setting Adhesive based on biopolymers such as chitosan and dextran. Dextran was oxidized using periodate to generate aldehyde functions on the biopolymer and then reacted with chitosan hydrochloride. Gelation occurred instantaneously upon mixing these components and the resulting gel showed good tissue Adhesive properties with negligible cytotoxicity and minimal swelling in phosphate buffered saline (PBS). Rheology analysis confirmed the gelation process by demonstrating storage modulus having value higher than loss modulus. Adhesive strength was in the range 200-400 gf/cm(2) which is about 4-5 times more than that of fibrin glue at comparable setting times. The Adhesive showed burst strength in the range of 400-410 mm of Hg which should make the same suitable as a sealant for controlling bleeding in many Surgical situations even at high blood pressure. Efficacy of the Adhesive as a hemostat was demonstrated in a rabbit liver injury model. Histological features after two weeks were comparable to that of commercially available BioGlue (R). The Adhesive also demonstrated its efficacy as a drug delivery vehicle. The present Adhesive could function without the many toxicity and biocompatibility issues associated with such products. Statement of Significance Though there are many tissue Adhesives available in market, none are free of shortcomings. The newly developed Surgical Adhesive is a 2-component Adhesive system based on time-tested, naturally occurring polysaccharides such as chitosan and dextran which are both biocompatible and biodegradable. Simple polymer modification has been carried out on both polysaccharides so that when aqueous solutions of both are mixed, the solutions gel in less than 10 s and forms an Adhesive that seals a variety of incisions. The strength of the Adhesive is over 5-times the strength of commercially available Fibrin glue and is more tissue compliant than BioGlue. This Adhesive biomaterial showed excellent tissue bonding, was hemostatic, biocompatible and biodegradable. The significance of this work lies on the features of the developed tissue Adhesive that it stops bleeding, bond the tissues well, can act as a drug delivery vehicle and would appeal to the surgeon in terms of the simplicity of application in complex Surgical situations. There is no need for special delivery systems for application of this Adhesive. The two-component Adhesive can be applied one over the other using syringes. There is also no need for light curing with UV or visible light and the gelation between the two components spontaneously takes place on application leading to excellent tissue bonding.