Review : photochemical tissue bonding (PTB) methods for sutureless tissue adhesion

Every year more and more medical devices are being implanted in the human body. Sutures are currently the gold standard for attachment of these devices, but they have associated issues such as needle trauma, unsuitability for certain tissues, such as eye or lung, and require skilled surgeons. A variety of sutureless methods have been developed to overcome some of these issues. Sutureless methods developed include fibrin glue, cyanoacrylates, scaffolds and bio-inspired adhesives. A sutureless method that is receiving increasing attention is Photochemical Tissue Bonding (PTB). This method involves using photoactive dyes and light-activation to initiate a chemical reaction that forms cross-links with collagen. In this review, we describe the current status of PTB. A variety of dyes have been identified and the literature analysed to identify the most promising photoactive dyes for PTB. Rose Bengal appears to be the most promising of the dyes identified as it produces the strongest bonding of all the dyes and its use is associated with minimal thermal damage. Development of applications for Rose Bengal is an area of active research with multiple articles published in the last 5 years. The outlook is promising for PTB and Rose Bengal to provide clinically viable solutions for tissue adhesion.