Embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate in patients with hemoptysis: A retrospective single-center study.

OBJECTIVES: To evaluate the safety and efficacy of the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate (NBCA) in patients with hemoptysis. METHODS: We analyzed a total of 55 consecutive patients with hemoptysis (14 mild, 31 moderate, and 10 massive) treated with the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate between November 2013 and January 2020. The main variables analyzed were the rates of technical success, of clinical success, of recurrence, and of complications. Statistics included a descriptive analysis and Kaplan-Meier survival curves. RESULTS: Embolization was a technical success in 55 (100%) and a clinical success in 54 (98.2%). During follow-up (mean, 23.8 months; interquartile range, 9.7-38.2 months), hemoptysis recurred in 5 (9.3%) patients. The nonrecurrence rate was 91.9% one year after the initial procedure and 88.7% two years and four years after the initial procedure. Minor complications related with the procedure occurred in 6 (10.9%); no major complications occurred. CONCLUSIONS: The embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate is safe and efficacious for controlling hemoptysis, resulting in low recurrence rates.

Embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato en pacientes con hemoptisis: un estudio monocéntrico y retrospectivo / Embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate in patients with hemoptysis: a retrospective single-center study

Objetivos Evaluar la seguridad y la eficacia de la embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato en pacientes con hemoptisis. Métodos Se han analizado un total de 55 pacientes consecutivos con hemoptisis (14 leves, 31 moderadas y 10 masivas) tratados mediante embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil- cianoacrilato entre noviembre de 2013 y enero de 2020. Las variables principales estudiadas son tasa de éxito técnico, tasa de éxito clínico, tasas de recurrencia y complicaciones. Se ha realizado un análisis estadístico descriptivo y un análisis de supervivencia mediante el método de Kaplan-Meier. Resultados En 55 (100%) pacientes se ha realizado la embolización con éxito técnico y en 54 (98,2%), con éxito clínico. Durante el seguimiento (media, 23,8 meses; rango intercuartílico, 9,7-38,2) ha recurrido en 5 de los 54 (9,3%) pacientes. La tasa de no recurrencia al año ha sido del 91,9%, y a los 2 y 4 años, del 88,7% después del procedimiento inicial. Ha habido 6 (10,9%) complicaciones menores relacionadas con el procedimiento y ninguna mayor. Conclusiones La embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato es segura y eficaz para controlar la hemoptisis con tasas de recurrencia bajas (AU)

Objectives To evaluate the safety and efficacy of the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate (NBCA) in patients with hemoptysis. Methods We analyzed a total of 55 consecutive patients with hemoptysis (14 mild, 31 moderate, and 10 massive) treated with the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate between November 2013 and January 2020. The main variables analyzed were the rates of technical success, of clinical success, of recurrence, and of complications. Statistics included a descriptive analysis and Kaplan-Meier survival curves. Result Embolization was a technical success in 55 (100%) and a clinical success in 54 (98.2%). During follow-up (mean, 23.8 months; interquartile range, 9.7 – 38.2 months), hemoptysis recurred in 5 (9.3%) patients. The nonrecurrence rate was 91.9% one year after the initial procedure and 88.7% two years and four years after the initial procedure. Minor complications related with the procedure occurred in 6 (10.9%); no major complications occurred. Conclusions The embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate is safe and efficacious for controlling hemoptysis, resulting in low recurrence rates (AU)

Un cuerpo extraño inusual de cianoacrilato en el oído. Presentación de un caso clínico y revisión de la literatura / An unusual cyanoacrylate foreign body in the ear. Presentation of a clinical case and literature review

El pegamento basado en cianoacrilato posee una gran capacidad de adherencia a los tejidos, representando un problema cuando se encuentra en el oído externo debido a sus características anatómicas particulares. Se presenta un caso clínico de cuerpo extraño de cianoacrilato que ocluye el conducto auditivo externo y el tímpano, alterando la audición. Se describen los hallazgos y los intentos de extracción utilizando las alternativas terapéuticas descritas en la literatura, sin obtener resultados positivos, debiendo recurrir a la extracción quirúrgica. Además, se presentan detalles del procedimiento y los resultados. El paciente recupera la audición y la normalidad anatómica.

Cyanoacrylate-based glue has a great capacity for adhering to tissue, which is a problem when it is placed in the ear canal due to the anatomy of this structure. A clinical case of a cyanoacrylate foreign body occluding the external auditory canal and the tympanic membrane is presented. The therapeutics alternatives described in the literature used in the case failed, so, it was surgically removed by drilling the glue. Details of the procedure and results are presented. The patient recovers the hearing and anatomical normality.

Opciones terapéuticas para la retirada de “superpegamentos” de la piel / Therapeutic options for removing superglues from the skin

El cianocrilato es un compuesto adhesivo que se utiliza en la fabricación de “superpegamentos”. En contacto con tejidos de algodón o lana puede producir quemaduras térmicas. Por el contrario, en contacto sobre piel sana se han descrito dermatitis de contacto o alérgica pero no quemaduras. Caso clínico. Niña de 8 años que acude a urgencias tras haber derramado de manera accidental un “superpegamento” directamente sobre una mano y ambas extremidades inferiores, permaneciendo con el pegamento en contacto con la piel durante 3 horas sin poder retirarlo en domicilio. En la exploración destacaba gran eritema en varias regiones subyacentes al pegamento, sin ampollas, heridas ni sangrado. El pegamento se retiró bajo sedoanalgesia con lavavajillas líquido diluido en agua tibia, sin apreciarse solución de continuidad ni quemadura. Conclusiones. Existen numerosas medidas para la retirada de adhesivos de la piel. Escoger la opción terapéutica viene determinado, entre otros factores, por la presencia de lesiones cutáneas bajo el adhesivo. La aplicación de acetona está contraindicada en pieles con lesiones debido a que puede empeorar la irritación de las mismas. La demora hasta la retirada del adhesivo puede influir en el éxito del tratamiento; así como en la aparición de posibles secuelas (AU)

Cyanoacrylate is an adhesive used as a component in most of “super glues”. It can cause thermal burns if in contact with wool or cotton fabric. Nevertheless, in contact with intact skin it can cause contact or allergic dermatitis, but no thermal burns have been described.Clinical case: 8-year-old girl who had suffered an accidental fall of one of these glues directly on one of her hands and both lower extremities, and who had remained with the glue in contact with the skin for 3 hours. On examination we observed erythema on several regions underlying the glue, without blisters, wounds or bleeding. The glue was removed with warm water and detergent. No open wounds or burns were noticed.Conclusions: There are different ways to remove adhesives from the skin. Choosing the correct therapeutic option is determined, among other factors, by the presence of skin lesions under the adhesive. The use of acetone is contraindicated in injured skin because it can worsen the irritation. The delay in the removal of the adhesive can influence the success of the treatment and the type of treatment to be applied. (AU)

Cola de cianoacrilato para varizes gastroesofágicas: uma única experiência central no norte da Índia / Cyanoacrylate glue for gastroesophageal varices: a single centre experience from north india

ABSTRACT Background: In natural history of cirrhosis, variceal bleeding is one of the earliest decompensations to happen, and, if adequately managed, survival is improved. Gastric varices have challenges in management due to their location, size and propensity to bleed. The N-butyl 2-cyanoacrylate (NBC) glue application has emerged as definitive therapy in bleeding gastric varices. Here we present our experience with use of NBC in management of gastric and difficult cases of esophageal varices. Methods: A total of 75 patients underwent NBC glue application for varices which included 69 patients with gastric varices and six patients with esophageal varices. All the procedures were done with flexible endoscope and sclerotherapy needle after due precautionary measures. Results: Hemostasis was varices in all patients after endotherapy. The average quantity of glue used was 2.75±0.95 mL. Complete obliteration with single session of NBC application was achieved in 55 patients. Re-bleeding occurred in five patients within 5 days of index event. 20 patients had in-hospital mortality but none was related to gastrointestinal bleeding. 6-week all-cause mortality was 26 (35%). Conclusion: Glue therapy with NBC is a life saving therapy in patients with bleeding gastric varices and esophageal varices not amenable to endoscopic variceal ligation or sclerotherapy.

RESUMO Contexto: Na história natural da cirrose, o sangramento de varizes é uma das primeiras descompensações a acontecer e, se adequadamente controlada, a sobrevivência é melhorada. Varizes gástricas têm desafios na sua gestão devido à sua localização, tamanho e propensão a sangrar. A aplicação de cola N butil 2-cianoacrilato (NBC) surgiu como terapia definitiva em varizes gástricas sangrantes. Apresentamos nossa experiência com o uso da NBC na gestão de casos gástricos e difíceis de varizes esofágicas. Métodos: Um total de 75 pacientes foram submetidos à aplicação de cola NBC para varizes que incluiu 69 pacientes com varizes gástricas e seis pacientes com varizes de esôfago. Todos os procedimentos foram feitos com endoscópio flexível e agulha de escleroterapia após as devidas medidas de precaução. Resultados: A hemostasia foi alcançada em todos os pacientes após a endoterapia. A quantidade média de cola utilizada foi de 2,75+0,95 mL. A obliteração completa com sessão única de aplicação da NBC foi alcançada em 55 pacientes. O reexame ocorreu em cinco pacientes dentro de 5 dias após o evento de índice. 20 pacientes tiveram mortalidade hospitalar, mas nenhum foi relacionado com o sangramento gastrointestinal. A mortalidade após 6 semanas foi de 26 (35%). Conclusão: A terapia de cola com a NBC é uma terapia que salva vidas em pacientes com varizes gástricas hemorrágicas e varizes esofágicas não condizíveis à ligadura endoscópica ou escleroterapia.

Efectividad del Tysuacril en la estomatitis aftosa / Effectiveness of Tysuacril in aphthous stomatitis

RESUMEN Introducción: el Tisuacryl es un biomaterial empleado en la cirugía general y bucal, así como en el tratamiento de la estomatitis aftosa, considerada un proceso multifactorial y actualmente la enfermedad ulcerosa más común de la cavidad oral. Objetivo: determinar la efectividad del Tisuacryl con respecto a la terapia convencional en el tratamiento de la estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. Métodos: se realizó un estudio observacional analítico de casos y controles a 90 pacientes con estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. La información se obtuvo de las historias clínicas individuales de Periodoncia al obtener el consentimiento oral y escrito de los pacientes o sus tutores. Los resultados se obtuvieron por análisis estadístico que incluyó el porciento y la prueba no paramétrica de Cochran Q. Resultados: predominó el sexo femenino y el grupo etario de 10 a 19 años para el 46,7 % en grupo estudio y el 42,2 % en grupo control; la disminución del dolor y la cicatrización iniciaron en el mayor número de pacientes a las 72 horas de tratamiento con Tisuacryl para el 91,1 % y el 55,6 % respectivamente; a los cinco días de aplicación del medicamento la totalidad de ellos estaban asintomáticos y casi todas las aftas bucales cicatrizadas. Conclusiones: las lesiones aftosas en la cavidad bucal evolucionaron satisfactoriamente con la aplicación del Tisuacryl al ser esta una alternativa efectiva de tratamiento en comparación con la terapia convencional.

ABSTRACT Introduction: Tisuacryl is a biomaterial used in general and oral surgery, as well as in the treatment of aphthous stomatitis, considered a multifactorial process and currently the most common ulcerative disease of the oral cavity. Objective: to determine the effectiveness of Tisuacryl with respect to conventional therapy in the treatment of aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Methods: an analytical observational case-control study was conducted on 90 patients with aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Information was obtained from individual Periodontics medical records by obtaining oral and written consent from patients or their guardians. Results were obtained by statistical analysis including percent and Cochran Q nonparametric test. Results: female sex and age group from 10 to 19 years old predominated for 46,7 % in the study group and 42,2 % in the control group; the decrease of pain and healing started in most patients 72 hours after treatment with Tisuacryl for 91,1 % and 55,6 % respectively; being five days after application of the drug all of them asymptomatic and almost all the oral aphthae healed. Conclusions: aphthous lesions in the oral cavity evolved satisfactorily with the application of Tisuacryl being an effective treatment alternative in comparison with conventional therapy.

Longitudinal Evaluation of Ethyl Cyanoacrylate Adhesives on Candida albicans Biofilm

ABSTRACT: The aim of this study is to evaluate the effect of two ethyl cyanoacrylate-based adhesives on the growth of Candida albicans biofilms on a heat-polymerized resin, after 7, 14, and 30 days of exposure. Ninety circular (10 x 2 mm) heat-polymerized resin specimens were equally divided into three groups: control, conventional ethyl cyanoacrylate (ECAc), and ethyl cyanoacrylate gel (ECAg). Two layers of 50 µL of each material were applied to the respective groups. C. albicans SC5314 strain was activated and standardized to 107 cells/mL-1. Specimens were immersed in 1 mL of artificial saliva and deposited in 1 mL fungal suspension, washed, and immersed in 1 mL of RPMI for 7, 14, and 30 days. The medium was changed at 48-hour intervals. The final suspension was diluted (10 -1 to 10-4) and deposited on Sabouraud dextrose agar for 48 h at 37 °C. After this period, the colonies were quantified using the CFU/mL calculation. Data were evaluated using one- way ANOVA and Tukey's test for post-hoc analysis (P=0.05). It was observed that both adhesives significantly reduced (P<0.05) biofilm formation compared to the control at all evaluated periods. In conclusion, an immediate and long-term inhibitory effect on C. albicans biofilm formation was observed.

RESUMEN: El objetivo del estudio fue evaluar el desarrollo microbiano en superficies de resina acrílica de termopolimerización, acondicionadas previamente, con adhesivos a base de etil cianoacrilato después de 7, 14 y 30 días de exposición en biofilm de Candida albicans. Noventa muestras circulares (10 x 2 mm) de resina acrílica de termopolimerización se dividieron por igual en tres grupos: control, etil cianoacrilato convencional (ECAc) y etil cianoacrilato en gel (ECAg). Se aplicaron dos capas de 50 µl de cada adhesivo en cada muestra. Simultáneamente, se activó la cepa C. albicans SC5314 y se estandarizó a 107 células/ml-1. Las muestras fueron sumergidas en 1 mL de saliva artificial por dos horas y luego se depositó 1 mL de suspensión fúngica por una hora. En seguida cada muestra se lavó y se sumergió en 1 mL de RPMI durante 7, 14 y 30 días, con cambios del medio a cada 48 horas. La suspensión final se diluyó (10-1 a 10-4) y se depositó en agar dextrose Sabouraud durante 48 h a 37° C. Después de este período, las colonias se cuantificaron mediante el cálculo de UFC / mL. Los datos obtenidos se evaluaron por medio del test ANOVA-one way y la prueba de Tukey para el análisis post- hoc (p = 0,05). Se observó que ambos adhesivos redujeron significativamente (P<0,05) la formación del biofilm de Candida albicans al ser comparados con el grupo control en todos los períodos evaluados. Los adhesivos a base de etil cianoacrilato poseen un efecto inhibidor de biofilm de Candida albicans de hasta 30 días, al ser aplicados dos veces en resinas acrílicas de termopolimerización.

Embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate in patients with hemoptysis: a retrospective single-center study. / Embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato en pacientes con hemoptisis: un estudio monocéntrico y retrospectivo.

OBJECTIVES: To evaluate the safety and efficacy of the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate (NBCA) in patients with hemoptysis. METHODS: We analyzed a total of 55 consecutive patients with hemoptysis (14 mild, 31 moderate, and 10 massive) treated with the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate between November 2013 and January 2020. The main variables analyzed were the rates of technical success, of clinical success, of recurrence, and of complications. Statistics included a descriptive analysis and Kaplan-Meier survival curves. RESULTS: Embolization was a technical success in 55 (100%) and a clinical success in 54 (98.2%). During follow-up (mean, 23.8 months; interquartile range, 9.7 - 38.2 months), hemoptysis recurred in 5 (9.3%) patients. The nonrecurrence rate was 91.9% one year after the initial procedure and 88.7% two years and four years after the initial procedure. Minor complications related with the procedure occurred in 6 (10.9%); no major complications occurred. CONCLUSIONS: The embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate is safe and efficacious for controlling hemoptysis, resulting in low recurrence rates.

Comparación del tiempo de cicatrización entre N-butil cianoacrilato y ácido poliglicólico en caninos sometidos a esterilización / Comparison of healing times between N-butyl cyanoacrylate and polyglycolic acid in canines subjected to sterilization

RESUMEN El objetivo de este estudio fue comparar el tiempo de cicatrización entre N-butil cianocrilato (NBC) y ácido poliglicólico (AC) sobre el cierre tisular en caninos sometidos a operaciones de esterilización. Se realizó un estudio observacional, comparativo y descriptivo sobre una población de 80 perros (Canis familiaris) vivos. Los animales se dividieron en cuatro grupos de 20 perros cada uno según sexo y material de sutura, así: primero grupo, hembras que recibieron NBC; segundo grupo, machos y NBC; tercero grupo, hembras y AC como medio de sutura en piel y cuarto grupo, machos y AC. La técnica quirúrgica en hembras fue oforosalpingohisterectomia y en machos orquiectomia. El tiempo de cierre fue estadísticamente (p < 0,05) menor en los grupos de machos y hembras con el adhesivo NBC comparado con los dos grupos tratados con AC. Se concluye que el NBC es un material seguro y eficaz como medio de fijación tisular en ambas técnicas quirúrgicas que disminuye los días de cierre y recuperación.

ABSTRACT The aim of this study was to compare N-butyl cyanoacrylate (NBC) and polyglycolic acid (AC) in tissue closure in canines subjected to sterilization operations. An observational, comparative and descriptive study was conducted in a population of 80 living dogs (Canis familiaris). The animals were divided into 4 groups of 20 dogs each, according to gender and suture material: the first group consisted of females that received NBC; the second group consisted of males that received NBC; the third group consisted of females that received AC as skin suture; and the fourth group was formed by males that received AC. The surgical technique in females was salpingo-oophorectomy, and in males it was orchiectomy. The closure time was statistically (p < 0.05) lower in the male and female groups with the NBC adhesive in comparison to the two groups treated with AC. It was concluded that NBC is a safe and effective material for tissue fixation in both surgical techniques, decreasing times of closure and recovery.

Eficacia del cianoacrilato en el cierre de heridas de pacientes intervenidas mediante cesarea segmentaria, en el Hospital Municipal Boliviano Holandés durante el periódo de Septiembre a Diciembre del 2015 / EFFICACY OF THE CYANOACRYLATE IN THE CLOSING OF INJURIES OF PATIENTS INTERVENED BY MEANS OF SEGMENTARY CAESAREAN SECTION, IN THE HOSPITAL MUNICIPAL BOLIVIANO HOLANDES OVER THE COURSE OF SEPTEMBER TO DECEMBER OF 2015

Introducción: Para la sintesis de tejidos existe diversidad de materiales, los más conocidos son los hilos de sutura (absorbible y no absorbible); sin embargo exisen otras alternativas de sutura, como son los adhesivos tisulares en base a cianoacrilato. Objetivo: Determinar la eficacia del cianoacrilato en el cierre de heridas de pacientes intervenidas mediante cesárea segmentaria en el servicio de Ginecología y Obstetricia del Hospital Municipal Bolivano Holandés durante la gesión 2015. Material y métodos: Ensayo clinico ciego simple, longitudinal, prospectivo . Se estudiaron 82 pacientes de 16 a 45 años de edad, internadas en el servicio de Ginecología y Obstetricia del Hospital Municipal Boliviano Holandés, durante el periodo del 1° de Septiembre hasta el 31 de Diciembre del año 2015. Se congregaron en 2 grupos: 34 pacientes en las que se empleo el cianoacrilato (caso) y 48 pacientes en las que se realizó la técnica de sutura intradérminac on nylon 3-0 (control), para posteriormente valorar el tiempo de cierre de la herida quirúrgica, reacción de la epidermis y complicaciones postoperatorias en cada grupo. Resultados: En cuanto al tiempo de cierre de la herida quirúrgica: 7 días con cianoacrilato(61.77%) y 7 días con nylon (77.08%); presencia de cicatriz hipertrofica: 0.00% con cianoacrilato y 4.17 % con nylon: y complicaciones 26.47% con cianoacrilato y 0.00 % con nylon. Conclusión: El cianoacrilato no es más eficaz que la sutura convencional en el cierre de heridas de pacientes intervenidas mediante cesárea segmentaria

Aplicaciones del cianoacrilato en periodoncia: serie de casos / Applications of cyanoacrylate in periodontics: a series of cases

Introducción: Actualmente el uso de adhesivos tisulares como el cianoacrilato ha sido beneficioso en el área odontológica, reduciendo el tiempo del acto quirúrgico, disminuyendo el tiempo de cicatrización y la cicatriz postoperatoria, así también el dolor postoperatorio. Objetivo: El objetivo de este artículo es reportar diversas aplicaciones del cianoacrilato en tratamientos quirúrgicos periodontales, como recontorneo estético, gingivectomía, colgajo posicionado apical y preservación alveolar. Materiales y métodos/Presentación de casos: Los protocolos de tratamiento utilizados fueron los tradicionales para cada caso en particular más la adición de tres capas de cianoacrilato, con lapso de aplicación de 30 segundos entre cada capa. Conclusión: Los resultados clínicos de los casos presentados muestran una eficacia en la cicatrización al utilizar cianoacrilato, sin embargo, no sustituye los métodos tradicionales de los protocolos de cada tratamiento (AU)

Introduction: Currently, the use of tissue adhesives such as cyanoacrylate has been beneficial in the dental area, reducing the time of the surgical act, decreasing the time of healing and the postoperative scar, as well as the postoperative pain. Objective: The objective of this article is to report various applications of cyanoacrylate in periodontal surgical treatments, such as aesthetic crown lengthening, gingivectomy, apically positioned flap, and alveolar preservation. Materials and methods/Case presentation: The treatment protocols were the traditional ones for each particular case plus the addition of three layers of cyanoacrylate, with application time of 30 seconds between each layer. Conclusion: The clinical results of the presented cases show an efficacy in the cicatrization when using cyanoacrylate adhesives, nevertheless it does not substitute the traditional methods of the protocols of each treatment (AU)

Incisional hernia prevention using a cyanoacrilate-fixed retrofascial mesh. / Prevención de la hernia incisional mediante malla retrofascial fijada con cianoacrilato.

INTRODUCTION: The rate of incisional hernia in high-risk patients (obesity, cancer, etc.) is high, even in laparoscopic surgery. The aim of this study is to evaluate the safety of the use of cyanoacrylate fixed prophylactic meshes in the assistance incision in overweight or obese patients undergoing laparoscopic colorectal surgery. METHODS: A prospective, non-randomized cohort study of patients undergoing elective laparoscopic resection for colorectal cancer between January 2013 and March 2016 was performed. Those with a body mass index greater than 25kg / m2 were evaluated to implant a prophylactic meshes fixed with cyanoacrylate (Histoacryl®) as reinforcement of the assistance incision. RESULTS: 52 patients were analyzed (mean body mass index: 28.4±2kg / m 2). Prophylactic meshes was implanted in 15 patients. The time to put the mesh in place was always less than 5minutes. There was no significant difference in wound infection rate (12% vs. 10%). No mesh had to be explanted. Although the mean follow-up was shorter (14.1±4 vs. 22.3±9 months), there were no incisional hernia in the mesh group. On the other hand, in the non-mesh group, 1 acute evisceration (2.7%) and 4 incisional hernia of the assistance incision were observed (10.8%). There were no significant differences between groups regarding trocar incisional hernia (6.6 vs. 5.4%). CONCLUSIONS: The implantation of a reinforcement prophylactic mesh in overweight or obese patients undergoing laparoscopic colorectal surgery is safe and seems to reduce the short-term rate of incisional hernia. Fixation with cyanoacrylate is a rapid method that facilitates the procedure without additional complications.

Diagnosis of gynecological pseudoaneurysms and embolization with cyanoacrylate. / Diagnóstico y embolización con cianoacrilato de pseudoaneurismas de origen ginecológico.

Pseudoaneurysms of the uterine artery are an uncommon cause of severe gynecological bleeding secondary to surgical manipulation of the pelvis or to instrumental delivery. The different imaging techniques are of vital importance in the diagnosis. Angiography is the technique used for confirmation and also for treatment in many cases. Endovascular treatment by embolizing the pseudoaneurysm has become established as the treatment of choice, making it possible to avoid hysterectomy in women of childbearing age. This article presents two cases of gynecological bleeding due to pseudoaneurysms (one secondary to surgery and one secondary to childbirth) that were embolized in a novel way using cyanoacrylate.

Embolismo pulmonar después de obturación de várices gástricas con N-butil-2-cianoacrilato / Pulmonary embolism after endoscopic injection with N-butyl-2-cyanoacrylate for gastric varices

Las várices gástricas están presentes en cerca de un tercio de los pacientes con hipertensión portal y el sangrado de las mismas representa una causa significativa de mortalidad. El tratamiento de primera línea es la obturación con N-butil-2-cianoacrilato, que si bien es seguro no está libre de complicaciones. Presentamos el caso de un paciente de 61 años de edad con antecedente de cirrosis criptogénica que se presentó a la consulta febril, taquicárdico e hipoxémico después de la obturación endoscópica con N-butil-2-cianoacrilato. Las imágenes mostraron embolia pulmonar bilateral del material obturante. El objetivo de este trabajo es destacar las manifestaciones clínicas y las imágenes de esta situación para ayudar a su diagnóstico precoz y diferenciarla de otras entidades que requieren un tratamiento específico.

Gastric varices occur in one-third of patients with portal hypertension. Bleeding from gastric varices remains a significant cause of death. Currently the first-line of treatment for gastric varices is endoscopic obliteration with N-butyl-2-cyanoacrylate. Though relatively safe, this option has several well-known complications. We report the case of a 61-year-old male patient with cryptogenic cirrhosis, who presented with fever, tachycardia and hypoxemia after endoscopic obliteration with N-butyl-2-cyanoacrylate. Radiographic findings were consistent with pulmonary embolism of the sclerosing substance. The aim of this case report is to emphasize the clinical and radiological findings of this complication in order to distinguish it from other similar medical conditions and prevent a delay in diagnosis.

Tratamiento de las várices gástricas con cianoacrilato, experiencia institucional / Institutional Experience with Cyanoacrylate Treatment of Gastric Varices

La principal causa de hemorragia de vías digestivas altas es la enfermedad ulcerosa del estómago y/o duodeno (Enfermedad ulceropéptica). Cada vez y con mayor frecuencia se presentan pacientes con sangrado originado en várices gástricas, quizás debido al número creciente de pacientes que las presentan como una secuela de la hipertensión portal causada a su vez por problemas hepáticos, especialmente por la cirrosis. Las opciones actuales de tratamiento de las várices gástricas incluyen desde métodos preventivos o profilácticos, hasta los propiamente terapéuticos mediante el uso de medicamentos (vasopresina, somatostatina y sus análogos), las derivaciones portosistémicas transyugulares (TIPS, por sus siglas en inglés) los métodos endoscópicos y la cirugía. Los métodos endoscópicos incluyen el uso de bandas y de inyección de sustancias esclerosantes, o de sustancias obturativas como el N-Butyl-2-cianoacrilato (Histoacryl®). Desde hace poco tiempo, y basados en la literatura cada vez con mejores niveles de evidencia y grados de recomendación, hemos empezado a usar el cianoacrilato en la Clínica Universitaria Colombia. Presentamos nuestra casuística y realizamos una revisión del tema

The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (peptic ulcer disease). With increasing frequency, patients are being seen who have bleeding gastric varices. This may be due to the increasing number of patients who have portal hypertension caused in turn by liver problems, especially cirrhosis. Current options for treatment of gastric varices range include preventive and prophylactic methods. These include therapy using drugs including vasopressin, somatostatin and their analogs, transjugular intrahepatic portosystemic shunts (TIPS) endoscopic methods and surgery. Endoscopic methods include the use of bands and injection sclerotherapy and sealants such as N-Butyl-2-cyanoacrylate (Histoacryl ®). Recently, on the basis of literature with increasingly higher levels of evidence and recommendations, we have started using cyanoacrylate at the Clínica Universitaria Colombia. We present our cases and we review the issue.

Análise de custo-efetividade do n-butil-cianoacrilato para fixação de telas em hernioplastias inguinais sob a perspectiva da saúde suplementar brasileira / Cost-effectiveness of n-buthyl-cyanoacrylate for mesh fixation in inguinal hernioplasty under the perspective of Supplementary Healthcare in Brazil

Objetivo: Estimar a custo-efetividade do n-butil-cianoacrilato (NBCA) para fixação de telas em pacientes submetidos a hernioplastias inguinais por reparo aberto ou laparoscópico, sob a perspectiva da Saúde Suplementar do Brasil. Métodos: Foi elaborado modelo analítico de decisão para estimar a razão de custo efetividade incremental (RCEI) em horizonte de tempo de um ano após procedimento cirúrgico com o uso do adesivo sintético versus técnicas tradicionais de fixação (sutura e grampos). Alternativamente, o uso de NBCA foi comparado à cola de fibrina. Os desfechos clínicos avaliados foram incidência de dor aguda e crônica. A estimativa de custos médicos diretos totais para as diferentes abordagens cirúrgicas e terapia da dor foi elaborada a partir da opinião de especialistas e coletadas em bases de dados secundárias. Resultados: A RCEI obtida através do modelo evidenciou economia substancial de recursos financeiros relacionada ao uso de NBCA de aproximadamente R$ 2.800 por procedimento após reparo laparoscópico e R$ 60 reais por procedimento para reparo aberto, resultados direcionados majoritariamente pela menor tendência de dor (efetividade incremental de 21,74% em termos de dor evitada) versus métodos de fixação tradicional. No cenário alternativo, no qual comparou-se NBCA com a cola biológica (adesivo de fibrina), atingiu-se economia financeira com nível de efetividade equivalente do ponto de vista estatístico entre os comparadores. Conclusão: Pode-se atribuir que o uso de NBCA para fixação de telas em cirurgias de reparo de hérnia inguinal constitui alternativa segura, efetiva e viável economicamente, quando comparado tanto a técnicas de fixação tradicionais como à cola biológica.

Objective: To estimate the cost-effectiveness of n-butyl-cyanoacrylate (NBCA) for mesh fixation in patients undergoing inguinal hernia repair by open or laparoscopic methods, from the perspective of the Brazilian supplementary health sector. Methods: A decision model was developed to estimate the incremental cost-effectiveness ratio (ICER) in time horizon of one year after surgery with the use of synthetic adhesive versus traditional fixation techniques (suture and staples). Alternatively, the use of NBCA was compared to the fibrin glue. Clinical outcomes applied to the model were incidence of acute and chronic pain. The estimation of total direct medical costs for surgical approach and pain therapy was developed based on experts' opinions and collected from secondary databases. Results: The ICER obtained through the model indicated substantial savings of financial resources related to the use of NBCA of approximately 2,800 BRL per procedure after laparoscopic repair and 60 BRL per procedure for open repair, results primarily due to the lower tendency of pain (incremental effectiveness of 21.74% in terms of avoided pain) versus traditional fixation methods. In the alternative scenario, which compared NBCA with biological glue (fibrin glue), it was achieved financial savings, with statistically equivalent level of effectiveness among the comparators. Conclusion: The use of NBCA for mesh fixation in inguinal hernia repair surgery is a safe, effective and feasible alternative from an economic point of view, when compared to both traditional fixation techniques as the biological glue.

Tissue adhesive in free gingival graft / Adesivo tecidual no enxerto gengival livre

The aim of the present study was to review the literature regarding the utilization of 2-octyl cyanoacrylate's (Dermabond®, Ethicon US, USA) as a tissue adhesive in dentistry; also, to report its use in the stabilization and fixation of a free gingival graft, indicated to increase the width of the keratinized attached mucosa at the lower incisive region. Literature analysis revealed numerous indications for this tissue adhesive in the medical field related to maxillofacial injuries. In dentistry, clinical reports, as well as controlled clinical studies conducted in humans and in animal models, using histological analysis described positive results for the use of different cyanoacrylate-based tissue adhesives. These studies reported that the use of tissue adhesives reduced the surgical procedure time period, eliminated postoperative visits as well as the discomfort of suture removal and, in addition, did not interfere with the clinical repair process. Favorable results, like the ones described in the literature, were obtained in the present case report using Dermabond®.

O objetivo do presente estudo foi revisar a literatura pertinente sobre a utilização do 2-octil cianoacrilato (Dermabond®, Ethicon US, USA) como adesivo tecidual na Odontologia, assim como relatar seu uso na estabilização e fixação de um enxerto gengival livre indicado para aumento da mucosa ceratinizada inserida na região dos incisivos inferiores. A análise da literatura revelou ampla aplicabilidade deste adesivo tecidual na área médica relacionada aos ferimentos maxilofaciais. Na Odontologia existem relatos clínicos e estudos controlados em humanos e em modelos animais, descrevendo resultados positivos, inclusive por meio da análise histológica, sobre a utilização de diferentes adesivos teciduais, à base do cianocrilato. Estes estudos relataram que o uso dos adesivos teciduais, reduz o tempo operatório, elimina visitas pós-operatórias, não apresenta o desconforto da remoção de suturas, além de não interferir no processo de reparo clínico. Resultados favoráveis como os descritos na literatura, foram obtidos no presente relato de caso com a utilização do Dermabond®.

A new surgical technique to treat corneal perforations using amniotic membrane and surgical adhesive / Nova técnica cirúrgica para tratamento de perfuração de córnea utilizando membrana amniótica e adesivo cirúrgico

The objectives of this study were to compare surgical techniques and the effects of using n-butyl 2-cyanoacrylate and bovine amniotic membrane to repair perforated lesions in corneas. Penetrating keratoplasty was performed in sixty New Zealand White rabbits under general anesthesia. Group 1 (G1) was treated with n-butyl 2-cyanoacrylate, group 2 (G2) received a fragment of amniotic membrane through the anterior chamber and application of n-butyl 2-cyanoacrylate over the lesion, group 3 (G3) was treated with the same technique as G2 with the addition of an amniotic membrane bandage covering the cornea and sutured in the limbus region, and group 4 (G4) was treated with an amniotic membrane sutured to the lesion and an amniotic membrane bandage sutured in the limbus region. Clinical, histological and histomorphometric examinations of the corneas were performed. The membrane acted as a barrier for aqueous humor in G2 and G3, thereby keeping the surface dry for adhesive application; it also prevented the adhesive from contacting intraocular structures. The groups treated with amniotic membrane and surgical adhesive showed better results than the groups treated with either material alone. Thus, the combination of the membrane with the adhesive is recommended for this type of lesion...

Os objetivos deste estudo foram comparar técnicas cirúrgicas e efeitos do n-butil 2-cianoacrilato e da membrana amniótica bovina na reparação de lesões perfuradas em córneas. Sessenta coelhos da raça Nova Zelândia Branca foram submetidos à ceratoplastia penetrante sob anestesia geral. O grupo 1 (G1) foi tratado com n-butil 2-cianoacrilato; o grupo 2 (G2) recebeu um fragmento de membrana amniótica pela câmara anterior e aplicação de n-butil 2-cianoacrilato sobre a lesão; o grupo 3 (G3) foi tratado com a mesma técnica aplicada ao G2, adicionando-se uma bandagem de membrana amniótica cobrindo a córnea e suturada à região do limbo; e o grupo 4 (G4) foi tratado com membrana amniótica suturada nas bordas da lesão e bandagem de membrana amniótica suturada na região do limbo. Foram realizados exames clínico, histológico e histomorfométrico. A membrana atuou como barreira contra o extravasamento do humor aquoso nos grupos 2 e 3, manteve a superfície seca para posterior aplicação do adesivo e impediu o contato do adesivo com as estruturas intraoculares. Os grupos tratados com o adesivo associado à membrana amniótica demonstraram melhores resultados do que aqueles tratados com cada material isoladamente. Assim, a combinação da membrana com o adesivo é indicada neste tipo de lesão...

Alterações dimensionais em modelos de gessos com fraturas e colagem com cianocrilato / Dimensional change in gypsum models with fractures and collage with cyanocrylate

Objetivo: avaliar a precisão dimensional de modelos de gesso tipos III e IV submetidos a diversos tipos de fraturas, seguidas de colagem com cianoacrilato. Materiais e mé-todo: a amostra foi constituída por 80 modelos de gesso obtidos a partir de moldes de silicone de adição Zetala-bor Platinum®, provenientes de um modelo mestre em aço inox, com dois pilares. Foram formados 2 grupos (n = 40): Grupo 1-Modelos de gesso tipo III e Grupo 2-Mo-delos de gesso tipo IV. Cada grupo foi subdividido em: Controle (n = 10) Modelos de gesso sem fratura; Experi-mental 1 (n = 10) Modelos de gesso colados com adesi-vo a base de cianoacrilato SuperBonder® após fratura no espaço protético, entre os dois pilares; Experimental 2 (n = 10) Modelos de gesso colados após fratura horizontal nos pilares, simulando fratura, ocorrida durante a remo-ção do modelo do molde; Experimental 3 (n = 10) Mo-delos de gesso colados após fratura simulando acidente de queda de uma bancada de laboratório. As unidades amostrais foram mensuradas com paquímetro digital. Os dados foram processados e submetidos à análise estatís-tica (teste de Shapiro-Wilk e teste t student). Resultados: os modelos de gesso fraturados e colados com cianoacri-lato exibiram alterações dimensionais lineares quando comparados aos respectivos controles. Os modelos de gesso tipo III do Grupo 1, se comportaram de forma di-ferente, quando comparados aos modelos de gesso tipo IV do mesmo grupo. Conclusão: a colagem de pilares em modelos de gesso de prótese fixa, sem padronização, põe em risco a precisão dimensional desses.

Biocompatibilidad del cianoacrilato de butilo en suturas en piel en comparación con las suturas convencionales / Biocompatibility of n-butyl-cyanoacrylate compared to conventional skin sutures in skin wounds

Introducción: El cianoacrilato de butilo es un material de síntesis de tejidos, presenta innumerables ventajas como un tiempo de aplicación corto, fácil ejecución, carácter hemostático, bacteriostático, biodegradable y una adecuada fuerza tensil. Objetivo: Evaluar histológicamente la biocompatibilidad del cianoacrilato de butilo en el lomo de rata en comparación con la seda negra trenzada y la poliglactina 910. Materiales y métodos: Se emplearon 36 ratas albinas de raza Wixtar. Se dividieron aleatoriamente en 4 grupos (A, B, C y D) correlacionados con los periodos de sacrificio (3°, 7°, 14° y 21° día) respectivamente. Se realizaron 3 incisiones de 2 cm de longitud en el lomo de rata. Los parámetros histológicos fueron: infiltrado inflamatorio de células polimorfonucleares, fibroblastos jóvenes y engrosamiento de la epidermis. Resultados: El cianoacrilato de butilo ocasionó menor infiltrado polimorfonuclear en comparación con los otros materiales utilizados. Los picos de proliferación fibroblástica en los grupos tratados con cianoacrilato de butilo fueron superiores al resto. El engrosamiento de la epidermis mostró la alta capacidad mitótica de los queratinocitos para remodelar el epitelio. Al 14° y 21° día, la mayoría de los tejidos tratados con cianoacrilato de butilo ya se encontraban totalmente remodelados en comparación con el resto. Conclusiones: El cianoacrilato de butilo es un material biocompatible con los tejidos, permitiendo disminuir el tiempo de cicatrización de los mismos.

Introduction: N-Butyl-cyanoacrylate is a tissue-synthesis material. It offers countless advantages: short application time, easy execution, as well as possessing hemostatic character. This material is bacteriostatic, biodegradable, and exhibits suitable tensile strength. Objective: The objective of the present paper was the histological evaluation of n-butyl-cyanoacrylate biocompatibility on rats dorsum (spine), compared to braided black silk and Polyglactin 910. Materials and Methods: Thirty six Wixtar albino rats were used for the procedure. They were randomly divided into four groups (A, B, C, D) related to the time of sacrifice (3rd, 7th, 14th and 21st day) respectively. On the rats' spine, three 2 cm long incisions were performed. Histological parameters were as follows: polymorphonuclear cell inflammatory infiltrate, young fibroblasts and epidermis thickening. Results: N-butyl-cyanoacrylate caused lesser polymorphonuclear infiltrate when compared to other used materials. Fibroblast proliferation peaked in groups treated with n-butyl-cyanoacrylate when compared to the rest. Epidermis thickening showed high mitotic ability of keratocytes to remodel epithelium. At the 14th and 21st days most tissues treated with N-Butyl-cyanoacrylate were found to be completely remodeled when compared to the rest. Conclusion: N-butyl-cyanoacrylate was shown to be the most biocompatible material, since it elicited shortest healing time.