In vitro and in vivo studies on the use of Histoacryl(®) as a soft tissue glue.

The skin adhesive Histoacryl(®) consists of n-butyl-2-cyanoacrylate which polymerises in contact with moisture. It is not fully biodegradable, produces heat during polymerisation and releases products which are toxic and inhibit cell growth. Clinical application is exclusively approved to glue skin. However, there are also clinical studies and case reports in the scientific literature, which discuss the application of Histoacryl(®) as a soft tissue adhesive. In parallel to an analysis of the literature which discusses the usage of Histoacryl(®) in head and neck surgery, we performed in vitro and in vivo investigations with this adhesive. In vitro, the vitality of cultured cell lines which where treated with extracts of Histoacryl(®) was determined with a viability assay. In addition, Histoacryl(®) was examined by fixing defined mucous membrane of the nasal septum in an animal study in rabbits. The analysis of the literature shows both positive and negative results for the application of Histoacryl(®) as a soft tissue adhesive depending on the manner and place of the application as well as the applied amount of glue. Our own results confirm a negative influence of Histoacryl(®) on the viability of cultured cells and soft tissue. The histological examination showed that a better biocompatibility is achieved if the glue is used in small amounts. Both the literature study as well as the in vitro and in vivo examinations showed that the usage of Histoacryl(®) as a soft tissue glue may be arguable. Critical factors are the moisture at the application area and the applied amount of glue.