Use of cyanoacrylate adhesives in general surgery.

This paper presents a review of the use of cyanoacrylate adhesives (CA) in general surgery and digestive surgery, studies the mechanisms of action and interactions of CAs in adherent tissues, and compiles data on the latest experimental and clinical applications. More than seven million traumatic injuries are estimated to occur every year, and between 26 and 90 million surgical procedures using different techniques are performed to close the resulting wounds. Traditional methods not only are both useful and effective, but also have some drawbacks. This review covers a considerable number of surgical procedures for which CAs had satisfactory results. The adhesive facilitated the healing of very diverse tissues, such as solid organs, vascular tissue or the abdominal wall. In other cases, no significant differences were found when CA was compared to traditional methods, with the adhesive standing out as a simple and reliable solution. The number of procedures in which CA was detrimental was very low. This review also collects and describes these. In conclusion, the surgical fields and procedures in which CA was successfully used are highly diverse. This review will allow physicians to determine which techniques were first used experimentally, but finally settled in clinical practice as feasible alternatives to standard treatments.

Allopurinol in renal ischemia.

Allopurinol is a xanthine oxidase inhibitor and antioxidant free radical scavenger which facilitates the protection of ischemic organs in part via this mechanism of action. The accumulation of free radicals during ischemia and reperfusion is in great manner overcome by inhibitors of xanthine oxidase and by the development of endogenous antioxidants. The ischemic lesion generates a well-established inflammatory response with the subsequent production of inflammatory molecules characteristically present at the first stages of the injury. Inflammatory cytokines, chemokines, adhesion molecules, and other cellular and molecular compounds are consequently produced as the lesion sets in. Under these conditions, allopurinol diminishes the effect of inflammatory mediators during the ischemic inflammatory response. This study reviews the literature associated with allopurinol and renal ischemia making special emphasis on the best dose and time of administration of allopurinol regarding its protective effect. It also defines the most accepted mechanism of protection on ischemichally damaged kidneys.