The chemistry of tissue adhesive materials

Each year millions of people sustain traumatic or surgical wounds, which require proper closure. Conventional closure techniques, including suturing and stapling, have many disadvantages. They inflict additional damage on the tissue, elicit inflammatory responses and have a relatively long application time. Especially for the more demanding wounds, where fluids or gasses are to be sealed off, these techniques are often insufficient. Therefore, a large variety of tissue adhesives, sealants and hemostatic agents have been developed. This review provides an overview of such tissue adhesive materials from a polymer chemistry perspective. The materials are divided into synthetic polymer, polysaccharide and protein based adhesives. Their specific properties and behavior are discussed and related to their clinical application. Though each type has its specific advantages, yet few have become standard in clinical practice. Biomimetic based adhesives and other novel products have shown promising results but also face specific problems. For now, the search for better adhering, stronger, easier applicable and cheaper adhesives continues and this review is intended as starting point and inspiration for these future research efforts to develop the next generation tissue adhesives.