From the Preface Surgical tissue adhesives are an ancient idea,
going back to the beginnings of recorded history. The concept of
adhering, rather than suturing, packing, or stapling planes of
tissue is attractive, in that it is fast-acting and assures
complete closure. Numerous technologies have been tried; some with
limited success, others outright failures. In short, the perfect
adhesive does not exist. Limitations occur in a number of areas:
strength, toxicity, degradation, and safety. It is also important
to keep in mind that "one size fits all" does not apply to
adhesives in surgical applications any more than it does in
day-to-day application. As one would not use paper glue to seal a
bathtub, one would presumably not apply an adhesive onto tendons,
which is suitable for sealing corneas. The properties required of
an adhesive for each indication are quite different. Over the last
twenty-five years, advances have been made in a wide range of
technologies targeting some embodiment of a practical and safe
adhesive. Foremost and successful among these are cyanoacrylates,
marine adhesive proteins, and fibrin-based sealants. Another
promising adhesive technology is laser solders, a mixture of
polypeptides and proteoglycans, which integrates with the repair
site when laser energy is applied. In light of these advances in
the field, the Symposium for Surgical Tissue Adhesives was
organized and held at the Atlanta Hyatt from October 8-10, 1993.
The goal was to bring together these far-flung technologies in a
comprehensive and cohesive manner. Presentations by investigators
from around the world described the history of adhesives in
medicine, current technologies, laboratorycharacterizations, and
application developments, as well as regulatory aspects and
clinical applications. We felt that as many viewpoints as possible,
however conflicting, were important to present in order to give the
most complete picture of the state of the art of surgical
adhesives.
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