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Ann Thorac Surg 2000;70:1762-1763
© 2000 The Society of Thoracic Surgeons

Correspondence

Reply

M. Murat Demirtas, MDa

a Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey

To the Editor

I appreciate Dr Ogus and associates’ article [1] and respect their opinion on the usage of cyanoacrylate in the treatment of postoperative mediastinitis and sternal infections.

I would like to mention here that we used two different commercial brands of cyanoacrylate adhesive (Lely Turbo-Lely Colle Technique, S.A.R.L., Wolfenbüttel, Germany, and Pattex Superglue-Türk, Henkel AS, Istanbul, Turkey) in 28 sporadic patients for the management of sternal dehiscence, anastomotic line reinforcement, and bleeding control in aortic surgery, control of air leakage after lung operation, right ventricular free-wall perforation, superior vena caval laceration, and left ventricular apical bleeding after aneurysmectomy.

We used ethylene dioxide for external sterilization of the packages and in all patients, a sample of cyanoacrylate glue was inoculated into a soybean–casein digest broth, endo-agar and Sabouraud dextrose agar for bacteriologic control. These studies showed no growth in any of the cultured samples.

Our current indications for using cyanoacrylate glue are aortic, ventricular, or vascular bleeding that cannot be controlled by standard techniques, sternal detachment where it is considered that rewiring will not be sufficient to stabilize the sternum. We have already published our results concerning the first 20 patients at the end of 1999 [2].

Commercially available cyanoacrylate glue is the cheapest of today’s available biological or biocompatible synthetic adhesives. It is a new adjunct in cardiac surgery but all cyanoacrylate derivates and polymer solutions have not the same gluing properties. Thus, the appropriate type of polymer for best results needs to be precisely defined by biochemical and in vitro studies.

References

  1. Ogus N.T., Emir M., Yegin A. Prevention of recurrent osteomyelitis using cyanoacrylate gluing in mediastinitis [Letter]. Ann Thorac Surg 2000;70:1761-1762.[Free Full Text]
  2. Demirtas M.M., Çimen S., Ketenci B., Günay R., Akçar M., Özler A. Late follow-up of cyanoacrylate usage in cardiothoracic surgery. Asian Cardiovasc Thorac Ann 1999;7:195-199.[Abstract/Free Full Text]




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