Tissue Sealants & Adhesives
Products used for hemostasis, tissue sealing or skin approximation have different functions and indications. A skin adhesive, vascular sealant, fibrin glue and absorbable patch should not be selected by class name alone.
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)Dual-component fibrinogen + thrombin delivered as a spray or drip; mimics the final common pathway of coagulation to form fibrin at the application site. Product-specific hemostatic or adhesive indications; GU suture-line and graft uses need their own evidence.
- 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)Liquid monomer adhesives that polymerize on contact with tissue moisture. Skin-closure formulations are applied to appropriate external skin; specialized formulations and uses must be distinguished from Dermabond instructions.
- PEG-Based Sealants (CoSeal)Product-specific PEG-containing sealants. CoSeal mechanically seals vascular leakage; lung and dural products have different compositions and indications.
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 | Routine first-line benefit is not established here; 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; use the operative article rather than treating all patches as interchangeable grafts |
| Graft fixation | A glue layer is not automatically required and does not itself establish better inosculation |
| Confined or minimally invasive field | Check swelling, compression, unwanted adhesion and gas-delivery restrictions before selecting a product |
The companion pages provide product-specific labels, sources and evidence limits. Do not extrapolate cure time, absorption time, composition or approved use from one brand to the whole class.