Effects of sildenafil citrate on ischemic colonic anastomotic healing in rats: Its relationship between nitric oxide and oxidative stress

[No abstract available

Glyceryl trinitrate: The management of chronic anal fissure in patients who are unfit for surgery

[No abstract available

A preliminary study on the use of cyanoacrylate glue for the closure of fetal membranes

Amnion leakage, infection and inflammation are the most important problems of intrauterine fetal surgery. This study aimed to determine the shear strength characteristics of fetal membranes attached with cyanoacrylate glue. Fresh amniochorionic membrane stripes (40×30 mm) were prepared after ten term elective cesarean section patients. Two stripes were attached with 5 mm overlapping and an increasing weight was applied until separation. Shear strength of the attached segment and resultant normal stresses developed in the membrane were calculated. Finally, corresponding intraluminal pressure that shear strength could resist without rupture was estimated by assuming two perfect semi-spherical membranes that are glued together with 5 mm overlapping to form a perfect sphere with a diameter of 200 mm. Mean total weight until rupture was 156 ± 72 gr. Shear strength of the glued 5 mm segment was calculated as 10199 ± 4696 Pa (104 ± 48 cmH20) that resulted in 101989 ± 46963 Pa (1040 ± 479 cmH20) mean tensile normal stress within the membrane. Assuming a perfect sphere with a diameter of 200 mm, the maximum intraluminal pressure that attached membrane stripes could resist without rupture was calculated as 1020 ± 470 Pa (10.4 ± 4.79 cmH2O). This preliminary basic study showed that the shear strength of cyanoacrylate was strong even in small tissue segments. Considering antibacterial properties, immediate action in the presence of tissue fluids, and water impermeability of the attachment sites, this agent should be considered for closure of amniochorionic membranes after fetal surgery. © 2009 Informa UK Ltd

Use of cyanoacrylate glue for the closure of uterine incisions

Closure of uterine incisions in a variety of gynecological procedures, specifically in myomectomy operations, is associated with significant hemorrhage. Excessive suturing to control bleeding may have negative effects on wound healing and might increase peritoneal adhesions. Moreover, difficulty of handling uterine tissue in laparoscopic procedures is not only a factor for suboptimal closure and inadequate control of bleeding but also a significant factor for surgeons for choosing laparotomy over laparoscopic approach. Cyanoacrylates are a group of molecules used as industrial adhesives. Newer cyanoacrylates are widely used in medicine. These agents are excellent biological adhesives due to strong adhesive action, hemostatic action, and antibacterial properties. Moreover, the presence of blood and tissue fluids enhances the activity of cyanoacrylates. In this study, 2-octyl cyanoacrylate, polypropylene, and polyglactin 910 sutures were compared in terms of adhesive strength, control of hemorrhage and postoperative intraabdominal adhesions in a rat model. Wound healing was excellent in all groups. Cyanoacrylates were associated with significantly lower total adhesion scores. This is the first report proposing the use of cyanoacrylates in gynecologic surgeries with supporting evidence for clinical use. Cyanoacrylates might be the first choice for the closure of uterine incisions and for the control of hemorrhage especially in laparoscopic procedures. © 2009 Informa UK Ltd