[HSF] Bioglue

[Nasser F. Abou'Seada]

Thank you Ben 
that was really comprehensive .... 
would you post the original lecture please ? 

NFA

> From: Ben Bidstrup
> One needs to look at such things as glues or adhesives and hemostatic
agents.
> 
> GRF and BioGlue are adhesives.
> They form a firm layer that allows 2 surfaces to adhere - ie layers of a
dissection.
> 
> The 'curing' that happens with the glutaraldehyde or formalin cures the
other
> components which glue the surfaces together.
> They are hemostatic in that they provide a firm layer, not that they
encourage
> hemostasis
> (rather they probably discourage it with their toxic nature).
> 
> We have then the biological sealants.
> These are the various fibrin glues Tisseel for one.
> These rely on naturally occurring fibrinogen being converted to fibrin in
an area of
> bleeding.
> If you can keep the layer from floating away it can help.
> They are naturally absorbed.
> 
> There are the substances that provide a substrate for clotting  e.g.
Surgicel (oxidised
> cellulose).
> Topical thrombin is often used with this.
> 
> There are a series of similar products such as Tachosil, Tachocomb etc.
> These are not so much as adhesives but sealants.
> 
> There are now a wealth of other synthetic substances.
> These include Hemaderm or Medafor
> (a starch based compound that absorbs blood and promotes clotting as well
as
> providing a degree of tamponade).
> 
> CoSeal and related substances act as sealants with no mechanical strength.
> 
> There are also the devices Tomas mentioned a couple of weeks ago.
> 
> These all are topical. I have not mentioned any of the drugs that can be
given
> internally
> (lysine analogues and aprotinin etc.)
> 
> So, as far as Bioglue goes, not good for stopping bleeding, but useful in
VSD and LV
> rupture etc.
> It has a drawback - it solidifies and thus can embolise.
> 
> So, there are horses for courses.
> (Sorry for the lecture it is part of a talk on such things)
> --
> 
> Ben Bidstrup FRACS FRCSEd FEBCTS
> Consultant Cardiothoracic Surgeon
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