Tissue Sealants & Adhesives
Products used for hemostasis, tissue sealing or skin approximation have different functions and indications.
Composition, persistence, swelling and delivery restrictions are product-specific. None replaces necessary suturing, vascular control or a structurally appropriate reconstruction. The linked drug and device pages distinguish label-supported use from specialized GU applications.
Agent Library
- Fibrin Sealants (Tisseel, Evicel, Artiss)Fibrinogen and thrombin sealants have product-specific hemostatic, sealing or adhesive indications and spray-application safety restrictions.
- TachoSil / Evarrest (Fibrin Sealant Patches)TachoSil uses equine collagen; Evarrest uses oxidized regenerated cellulose and polyglactin. Both contain human fibrin proteins. Label indications and specialized tunical uses differ.
- Cyanoacrylates (Dermabond, Histoacryl)Skin glues for closing dry external skin, and where their use is off-label.
- PEG-Based Sealants (CoSeal)CoSeal is a PEG hydrogel labeled to seal vascular suture-line leakage, with swelling precautions in confined spaces.
Selection Principles
| Clinical question | Practical distinction |
|---|---|
| Skin approximation | Use a suitable skin adhesive only on clean, approximated skin within its moisture, mucosal and tension restrictions |
| Focal hemostasis | Choose a product whose indication and delivery method fit the tissue; sealants do not replace definitive control of major bleeding |
| Urinary anastomosis reinforcement | Complete the tissue repair and use an adjunct only for a defined reason |
| Tunical defect during Peyronie's surgery | Selected patch techniques have observational evidence |
| Graft fixation | — |
| Urinary-tract use | Check whether the selected product's use for the procedure is labeled or off-label in the operative jurisdiction |
| Confined or minimally invasive field | Check hydrogel swelling, feasibility of required fibrin-patch compression, unwanted adhesion, intravascular-injection warnings and gas-delivery (embolism) restrictions before selecting a product |
The companion pages provide product-specific labels, sources and evidence limits.