Tissue Sealants, Adhesives, hemostats and Adhesion Prevention devices for improved Surgical Outcomes

摘要

A field of medical therapy is emerging in which conventional means of tissue securement (sutures, staples, clips, tapes) are being supplanted by sealants which stop fluid (air or liquid) leaks, adhesives which hold tissues together, hemostats which stop bleeding and adhesion prevention treatments which keep tissue structures separated. These advanced products improve clinical outcomes by reducing surgery times, facilitating natural healing, mitigating adverse sequelae post-surgery and enabling procedures not previously feasible (e.g., sealing weeping internal wounds). Some products serve dual or multiple purposes such as sealing and hemostasis, sealing and approximating tissue, adhesion prevention and drug delivery, etc. Most of the advanced surgical adjuncts require the application of sophisticated design and engineering principles as they need to adhere to tissue, function for specified periods and resorb if implanted. They range from completely synthetic structures to reactive biological components. They may be applied as preformed structures or as in situ reactive, tissue binding compositions. Markets for both conventional and advanced tissue treatments stated above are growing rapidly. Globally, revenues exceed $10 billion, with annual sales growth of the constituent segments ranging from 3% to >14%.* All of the techniques referred to comprise forms of tissue engineering, or exerting systematic control of the body's cells, matrices and fluids. Documented histological examples of guided tissue regeneration, enhanced healing rates, void filling, adhesion prevention, etc. provide supporting evidence for this tissue engineering contention. The potential for improved therapeutic outcomes through more sophisticated tissue engineering bodes well for the continuing growth of the advanced surgical products.