Tissue Adhesives in Cutaneous Surgery

Clinical applications of alkyl alpha cyanoacrylates are presented in relation to cutaneous surgery in hemostasis and closure of wounds. The most likely adhesive for clinical application is isobutyl-2-cyanoacrylate. Polymerization speed, histotoxicity, polymerization temperature, wetting, and spreading are discussed. Isobutyl cyanoacrylate was used in hemostasis, wound closure, and hair transplantation. Bleeding has been controlled effectively in skin graft and in hair transplant donor-sites. Excellent cosmetic skin closures can be obtained, avoiding tissue damage from suture placement. This is important in moist body areas (face, axilla, or perineum) where skin tapes are unsatisfactory. Hair transplant plugs and strips are quickly and bloodlessly secured by topical cyanoacrylates. Advantages of adhesives in cutaneous surgery, reduction of time requirements and pain-free tissue immobilization, are described.