Koukoubis T D, Glisson R R, Feagin J A, Seaber A V, Vail T P
Orthopaedic Research Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Biomed Mater Res. 1995 Jun;29(6):715-20. doi: 10.1002/jbm.820290607.
Cyanoacrylate glues are biodegradable, bacteriostatic, hemostatic adhesives which have been used experimentally in surgical procedures on many tissues. This study evaluates the efficacy of cyanoacrylate glues used for in vitro bovine meniscus repair. Our hypothesis was that a local adhesive might improve fixation of meniscus tears reapproximated with suture, or obviate the need for suture. Three high-viscosity flexible cyanoacrylate glues were tested and their tensile strengths compared to those of suture alone and suture augmented with glue. The flexible formulation enables the glue to deform with the meniscus during movement of the knee joint. Bovine meniscus tissue was used as the model to compare the tensile strength at the meniscus repair site using the 300 cps glue in combination with 3-0 prolene suture, 300 cps cyanoacrylate glue alone, and suture alone. Twenty specimens were included in each repair group, and the peak load to failure was normalized for surface area and subjected to analysis of variance. Results of the analysis showed that the peak load to failure of the combination of cyanoacrylate glue plus suture was significantly higher than that of glue alone (P < .0001), but not significantly higher than that of suture alone (P = .18). However, in tissues repaired with suture, tissue separation at the tear site was noted almost immediately after distraction started, as a result of the elasticity of the suture. The combination of cyanoacrylate glue plus suture provided the maximum tensile strength before tissue separation. Because tissue separation may interfere with the meniscal healing process, glue used in combination with suture appears to offer some advantage mechanically.(ABSTRACT TRUNCATED AT 250 WORDS)
氰基丙烯酸酯胶水是可生物降解、具有抑菌和止血作用的粘合剂，已在许多组织的外科手术中进行了实验性应用。本研究评估了氰基丙烯酸酯胶水用于体外牛半月板修复的效果。我们的假设是，局部粘合剂可能会改善用缝线重新对合的半月板撕裂的固定效果，或者无需缝线。测试了三种高粘度柔性氰基丙烯酸酯胶水，并将它们的拉伸强度与单独使用缝线以及用胶水增强的缝线的拉伸强度进行比较。这种柔性配方使胶水能够在膝关节运动期间随半月板一起变形。使用牛半月板组织作为模型，比较使用300厘泊胶水与3-0普理灵缝线组合、单独使用300厘泊氰基丙烯酸酯胶水以及单独使用缝线时半月板修复部位的拉伸强度。每个修复组纳入20个标本，将破坏峰值载荷按表面积进行标准化，并进行方差分析。分析结果表明，氰基丙烯酸酯胶水加缝线组合的破坏峰值载荷显著高于单独使用胶水的情况（P <.0001），但并不显著高于单独使用缝线的情况（P =.18）。然而，在用缝线修复的组织中，由于缝线的弹性，在开始牵张后几乎立即在撕裂部位出现组织分离。氰基丙烯酸酯胶水加缝线的组合在组织分离前提供了最大拉伸强度。由于组织分离可能会干扰半月板愈合过程，胶水与缝线联合使用在机械性能上似乎具有一些优势。（摘要截断于250字）
