Adhesive biomaterials for tissue reconstruction

Tissue reconstruction and wound closure rely on sutures, staples and clips in current surgical procedures. These traditional devices are nonetheless unable to prevent leakage of fluids from a variety of tissue including blood vessels and dura mater. Furthermore, sutures are usually difficult to apply during minimal invasive surgery and often induce detrimental scarring that may impair healing. To overcome these disadvantages, biocompatible and biodegradable glues based on fibrin, polyethylene glycol (PEG) and cyanoacrylate have recently been used in patients to seal and repair tissue wounds. Cyanoacrylate glues create typically very strong tissue bonds but have mostly been applied externally for skin wound closure because of their residual cytotoxicity. Other adhesive biomaterials are also emerging; these glues and adhesives are usually based on proteins such as albumin and collagen or polysaccharides like chitosan; these are irradiated with coherent or non-coherent light to trigger their adhesion to tissue. These biomaterial based devices offer significant advantages over sutures, such as their sealing or repairing ability, easy application modality and delivery in situ of compounds for accelerating wound healing. This paper reviews different tissue reconstruction strategies employing adhesive biomaterials currently used in surgical and experimental procedures.