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Introduction: The popular wound closure methods for carpal tunnel decompression (CTD) include non-absorbable and absorbable sutures which have comparable results in clinical outcomes. However, these wound closure methods are recommended to keep a wound dry which may limit some ADLs. We conducted a prospective randomized controlled trial that compares clinical outcomes and cost-effectiveness in a skin closure following CTD between absorbable sutures plus a 2-octyl cyanoacrylate tissue adhesive (2OCA) versus non-absorbable skin sutures plus a waterproof dressing (NSPWD). Materials and Methods: We enrolled 120 patients undergoing CTD into two groups: 2OCA and NSPWD, with 60 patients in each group. Number of dressing changes, Quick DASH, pain VAS, cosmetic VAS, patient satisfaction VAS, and Hollander wound evaluation score, cost-effectiveness, and post-operative complications were collected at pre-operative period and two and six weeks post-operatively. Results: Slightly better patient satisfaction VAS (7.9 vs 7.2, p=0.018) and cosmetic VAS (8.0 vs 7.2, p=0.025) were observed in 2OCA at 2 weeks. Meanwhile, NSPWD revealed lesser times of dressing change (Median, mode, IQR: 0/0/0 vs 2/3/2, p<0.001). The total wound-related costs include dressing change and suture removal cost ($15.9 for 2OCA vs $19.2 for NSPWD, p=0.002) although an initial wound-related cost in 2OCA was higher ($15.7/case vs $7.9/case, p<0.001). Conclusion: Our study revealed that the supplementary tissue adhesive to absorbable sutures following CTD could reduce total wound-related costs while clinical outcomes might not be considered clinically significant.

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microRNAs (miRNAs) regulate gene expression post-transcriptionally and have been extensively tested as therapeutic molecules against several human diseases. In vivo delivery of miRNAs needs to satisfy the following conditions: safety, efficiency, and long-term therapeutic effectiveness. To satisfy these conditions, we developed a tissue-adhesive nucleotide-polymer complex (NPX-glue) for in vivo delivery of miRNAs to treat hepatocellular carcinoma (HCC). Methods: Polyallylamine (PAA), a cationic polymer, was mixed with tumor-suppressing miR-141 to form NPX and then mixed with partially oxidized alginate (OA) to form NPX-glue. Delivery efficiency of miR-141:NPX-glue was determined in cultured HCC cells and in an implanted HCC tumor model. In vivo tumor-suppressive effects of miR-141 on HCC were examined in mice upon intratumoral injection of miR-141:NPX-glue. Result: NPX-glue was generated by mixing of NPX with OA, which eliminated the inherent cytotoxic effect of NPX. NPX-glue led to the efficient delivery of miR-141 and plasmid to cultured cells and solid tumors in mice, where their expression was maintained for up to 30 days. Upon intratumoral injection of miR-141:NPX-glue, the growth of the tumors was dramatically retarded in comparison with the negative control, NCmiR:NPX-glue, (p < 0.05). Molecular examination proved miR-141:NPX-glue efficiently regulated the target genes including MAP4K4, TM4SF1, KEAP1, HDGF, and TIAM1 and finally induced apoptosis of cancer tissues. Conclusion: Here, we show that NPX-glue delivers therapeutic miR-141 to solid tumors in a safe, stable, and long-term manner and prove that locoregional treatment of HCC is possible using the NPX-glue system.

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Objective To investigate the effect of tissue adhesive glue in the repairment of eyelid lacerations and surgical incisions in children.Methods Retrospective comparison trial in paediatric ophthalmology department.Children who presented for laceration and surgical incision repair between November 2015 and October 2016 were evaluated.Patients from 11 months old to 12 years old with a total of 458 patients were randomly allocated to either glue (258 cases) or sutures (200 controls) to repair their wound.Cases and controls were similar in age,wound length and width involved.Those with wound seriously infected and longer than 5 cm were excluded.Length of time to perform procedure,pain assessment of procedure by doctor,parent and child and cosmetic outcome in 3 months and 1 year were measured.Results Time taken to repair the wound was faster in the glue group (P0.05).Cosmetic outcome was better in the glue group in 3 months and 1 year (P<0.05).Conclusion Tissue adhesive glue is faster and easier and less painful than suturing.Tissue adhesive glue has better cosmetic outcomes than suturing when used for the repair of eyelid lacerations and surgical incisions in children.

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PURPOSE: Intestinal perforation and necrotizing enterocolitis (NEC) are neonatal intestinal emergencies that are especially common in premature infants. While prompt surgical intervention, including stoma creation, is often required, the optimal surgical treatment has been controversial because of the substantial risks related to the stoma creation and management. The use of a tissue adhesive may have some advantages over the use of sutures when creating an intestinal stoma in extremely low birth weight (ELBW) infants. The purpose of this report was to present a novel approach for creating a stoma using a tissue adhesive in ELBW infants. METHODS: A total of eight ELBW infants that underwent laparotomy with the creation of intestinal stomas using cyanoacrylate adhesive at our institution between 2009 and 2014 were enrolled. The clinical parameters, including the length of the operation, intra- and postoperative complications and the outcomes were evaluated. RESULTS: The median body weight and gestational age at birth were 630 g and 24.3 weeks, respectively. The median age at referral was 11.5 days. The median length of the procedure was 58.5 min, including the inspection and resection of the intestine. All procedures were completed without any intraoperative complications. There were no postoperative complications associated with the stoma. Two patients died of the associated septic status. CONCLUSIONS: Sutureless enterostomy using cyanoacrylate adhesive is a simple technique which has the potential to reduce the incidence of complications related to the intestinal stoma in ELBW infants.

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BACKGROUND: Distal fingertip pad dermal avulsion injuries can be challenging for emergency physicians. A common occurrence with these injuries is difficult-to-control bleeding. The nature of these wounds is such that conventional primary closure to achieve hemostasis is not feasible. Often, direct pressure, even for prolonged periods, will not adequately control the bleeding. Currently recommended techniques are inadequate to control bleeding, and commercially available hemostatic products may be more costly and not widely available. OBJECTIVE: To present a simple method to achieve permanent hemostasis of these injuries using a tourniquet and tissue adhesive glue. PROCEDURE: A tourniquet is placed around the proximal digit, and the digit is exsanguinated and elevated to achieve short-term hemostasis. Several layers of commercially available tissue adhesive glue are applied sequentially over the avulsed region of the digit and allowed to dry. The tourniquet is then removed. A clean, bloodless dressing is created over the avulsed fingertip. CONCLUSION: This technique provides a rapid, simple, and likely safe means to control bleeding from a fingertip dermal avulsion injury.

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