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Histoacryl®

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Histoacryl®

L' adesivo tissutale Histoacryl® è costituito da monomeri di n-butil-2-cianocrilato che polimerizza velocemente a contatto coni liquidi corporei.

Histoacryl® è disponibile in due colori: trasparente, specifico per applicazioni sul viso e blu che permette un facile controllo della quantità applicata per tutte le altre indicazioni approvate.

Vantaggi

Chiusura della cute

  • Chiusura della ferita in un minuto [1, 2, 3, 4]
  • Significativamente meno doloroso rispetto alle suture tradizionali [5]
  • Efficace barriera antimicrobica [6, 7, 8]
  • Conservabile a temperature ambiente < 22° [9]
  • Molto apprezzato da pazienti e operatori sanitari [2, 7, 10, 11, 12]
  • Risparmio di tempo e costi [1, 2, 3, 4, 5, 10, 12]
  • Necessario applicare solo uno strato [4, 8]
  • Histoacryl® può essere usato per la chiusura delle brecce da trocar [8, 13]

 

Scleroterapia

  • Per varici sanguinanti e non sanguinanti [14, 15, 16, 17, 18, 19]
  • E' possibile combinare Histoacryl® con le tradizionali terapie sclerosanti [14, 15, 17, 20]
  • L' emostasi finale è raggiunta in più del 90% dei casi [14, 15, 16, 18, 19]
  • Tasso di re-sanguinamento inferiore rispetto alla legatura [14, 15, 18, 20]

 

Fissaggio delle reti

  • Metodo di fissaggio non invasivo: la letteratura riporta come sia meglio tollerato dai pazienti rispetto ai metodi tradizionali [22, 23, 24, 25, 26]
  • Metodo di fissaggio unico che può essere applicato a diverse tecniche di riaparazione dell'ernia [22, 23, 24, 25, 26]
  • Tasso di recidiva paragonabile a quello rilevato coni metodi di fissaggio tradizionali [23, 24, 25, 26]
  • Bassa morbosità intra e post-operatoria [24, 26]
  • Ridotto rischio di dolore post-operatorio cronico rispetto ai tradizionali metodi di fissaggio [23, 24, 25, 26]
  • Diminuzione dei tempi operatori rispetto ai tradizionali metodi di fissaggio [23, 25]
  • Buona biocompatibilità e tolleranza in vivo [23, 24, 25, 26, 27]

Indicazione

  • Chiusura della cute: Chiusura di ferite della pelle non sotto tensione (comprese incisioni chirurgiche pulite e incisioni derivanti da accessi per chirurgia mini-invasiva) e lacerazioni indotte da trauma semplici e pulite attentamente.
  • Scleroterapia: Scleroterapia di grosse varici esofagee e del fondo gastrico.
  • Fissaggio delle reti: Fissaggio di reti per ernia, in particolare nella chirurgia dell'ernia inguinale.

Skin closure
• [1] Dumville JC, Coulthard P, Worthington HV, Riley P, Patel N, Darcey J, Esposito M, van der Elst M, van Waes OJ. Tissue adhesives for closure of surgical incisions. Cochrane Database Syst Rev. (2014) Nov 28;(11)
• [2] Koonce SL, Eck DL, Shaddix KK, Perdikis G. A prospective randomized controlled trial comparing N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), and subcuticular suture for closure of surgical incisions. Ann Plast Surg. (2015) 74:1 (107-10).
• [3] Lloris-Carsí JM, Ballester-Álvaro J, Barrios C, Zaragozá-Fernández C, Gómez-De la Cruz C, González-Cuartero C, Prieto-Moure B, Cejalvo-Lapeña D. Randomized clinical trial of a new cyanoacrylate flexible tissue adhesive (Adhflex) for repairing surgical wounds. Wound Repair Regen. (2016) 24:3 (568-80).
• [4] Elmasalme FN, Matbouli SA, Zuberi MS. Use of tissue adhesive in the closure of small incisions and lacerations. J Pediatr Surg. (1995) 30:6 (837-8).
• [5] Farion K, Osmond MH, Hartling L, Russell K, Klassen T, Crumley E, Wiebe N. Tissue adhesives for traumatic lacerations in children and adults. Cochrane Database Syst Rev. (2002) 3:CD003326
• [6] mdt medical device testing GmbH report / Project 12m020 / Determination of Microbiological Barrier Properties of Two Topical Skin Adhesives.
• [7] Ranson JM, et al. Haemostatic property of cyanoacrylate in pedicled flaps. Br J Oral Maxillofac Surg (2016), http://dx.doi.org/10.1016/j.bjoms.2016.01.035
• [8] Yulevich A, Cohen Z, Mares AJ. Use of N-Butyl-2-Cyanoacrylate (HistoacrylR) in Closure of Thoracoscopic an Laparoscopic Surgical Wounds in Children. Pediatric Endosurg. (1998) 2:1 (31-4).
• [9] Long Time Stability: RDR/DID/CHM/SLE/17095 Long time stability at room temperature of Histoacryl in aluminum pouches_reissue
• [10] Hovaghimian DG, Sedira KAA, Farag MY. N-butyl-2-cyanoacrylate tissue adhesive versus subcuticular skin closure in external dacryocystorhinostomy. DJO (2015) 16 (97–102).
• [11] Edwards S, Parkinson L. Is Fixing Pediatric Nail Bed Injuries With Medical Adhesives as Effective as Suturing?: A Review of the Literature. Pediatr Emerg Care. (2016) Dec 12. [Epub ahead of print]
• [12] Goktas N, Karcioglu O, Coskun F, Karaduman S, Menderes A. Comparison of tissue adhesive and suturing in the repair of lacerations in the emergency department. Eur J Emerg Med. (2002) 9:2 (155-8).
• [13] 13 Yang J., Yong Jin Na, Yong Jung Song, Ook Hwan Choi, Sun Kyung Lee, Hwi Gon Kim. The effectiveness of laparoendoscopic single-site surgery (LESS) compared with conventional laparoscopic surgery for ectopic pregnancy with hemoperitoneum. Taiwanese Journal of Obstetrics & Gynecology 55 (2016) 35e39
 
Sclerotherapy
• [14] Cho E., Jun C.H., Cho S.B., Park C.H., Kim H.S., Choi S.K., Rew J.S. Endoscopic variceal ligation-induced ulcer bleeding: What are the risk factors and treatment strategies? Medicine (United States) (2017) 96:24 Article Number e7157
• [15] Holster IL, Tjwa ET, Moelker A, Wils A, Hansen BE, Vermeijden JR, Scholten P, van Hoek B, Nicolai JJ, Kuipers EJ, Pattynama PM, van Buuren HR. Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy + β-blocker for prevention of variceal rebleeding. Hepatology. (2016) 63:2 (581-9).
• [16] Kozieł S, Kobryń K, Paluszkiewicz R, Krawczyk M, Wróblewski T. Endoscopic treatment of gastric varices bleeding with the use of n-butyl-2 cyanoacrylate. Prz Gastroenterol (2015) 10:4 (239–243).
• [17] Jang WS, Shin HP, Lee JI, Joo KR, Cha JM, Jeon JW, Lim JU. Proton pump inhibitor administration delays rebleeding after endoscopic gastric variceal obturation. World journal of Gastroenterology (2014) 20:45 (17127-17131).
• [18] Prachayakul V, Aswakul P, Chantarojanasiri T, Leelakusolvong S. Factors influencing clinical outcomes of Histoacrylglue injection-treated gastric variceal hemorrhage. World J Gastroenterol. (2013) 19:15 (2379–2387).
• [19] Lo GH, Lin CW, Perng DS, Chang CY, Lee CT, Hsu CY, Wang HM, Lin HC. A retrospective comparative study of histoacryl injection and banding ligation in the treatment of acute type 1 gastric variceal hemorrhage. Scand J Gastroenterol. (2013) 48:10 (1198-204).
• [20] Feretis C, Dimopoulos C, Benakis P, Kalliakmanis B, Apostolidis N. N-butyl-2-cyanoacrylate (Histoacryl) plus sclerotherapy versus sclerotherapy alone in the treatment of bleeding esophageal varices: a randomized prospective study. Endoscopy. (1995) 27:5 (355-7).
• [21] Tan PC, Hou MC, Lin HC, Liu TT, Lee FY, Chang FY, Lee SD. A randomized trial of endoscopic treatment of acute gastric variceal hemorrhage: N-butyl-2-cyanoacrylate injection versus band ligation. Hepatology. (2006) 43:4 (690-7).

Mesh fixation
• [22] Liew W, Wai YY, Kosai NR, Gendeh HS. Tackers versus glue mesh fixation: an objective assessment of postoperative acute and chronic pain using inflammatory markers. Hernia. (2017) 21:4 (549-554).
• [23] Hoyuela C, Juvany M, Carvajal F, Veres A, Troyano D, Trias M, Martrat A, Ardid J, Obiols J, López-Cano M. Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair. Br J Surg. (2017) 104:6 (688-694).
• [24] Helbling C, Schlumpf R. Sutureless Lichtenstein: first results of a prospective randomized clinical trial. Hernia. (2003) 7:2 (80-4).
• [25] Kim-Fuchs C, Angst E, Vorburger S, Helbling C, Candinas D, Schlumpf R. Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results. Hernia. (2012) 16:1 (21-7).
• [26] Testini M, Lissidini G, Poli E, Gurrado A, Lardo D, Piccinni G. A singlesurgeon randomized trial comparing sutures, N-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair. Can J Surg. (2010) 53:3 (155-60
• [27] Kukleta JF, Freytag C, Weber M. Efficiency and safety of mesh fixation in laparoscopic inguinal hernia repair using n-butyl cyanoacrylate: long-term biocompatibility in over 1,300 mesh fixations. Hernia. (2012) 16:2 (153–62).