BioGlue is a surgical adhesive, with a wide range of uses, particularly in the field of blood vessel repair in cardiac surgery. It is the chief surgical adhesive utilized in cardiac surgery throughout the world. Manufactured by CryoLife, Inc, BioGlue has been used in 550,000 surgical procedures, since its market introduction in 1998. It is FDA approved for use in adult patents “as an adjunct to sutures and staples in open surgical repair of large vessels.” Its primary indications are to seal tissue anastomoses, adhere tissue layers, and reinforce friable tissue.
*Composition and Delivery
BioGlue consists of glutaraldehyde and purified bovine serum albumin (BSA). Similar to a home epoxy self-mixing delivery syringe, the delivery system for BioGlue is in the form of a double-chambered syringe. This delivery system includes applicator tips and has optional extender applicator tips. When dispensed, the two adhesive components mix within the applicator tip, and the glutaraldehyde molecules bond with the BSA molecules. When this mixture makes contact with the tissue proteins, a flexible seal begins to form, “independent of the body’s clotting mechanism.” Within 20 to 30 seconds, BioGlue begins to polymerize, reaching maximum bonding strength within two to three minutes.
BioGlue is indicated as an adjunct to standard surgical repair techniques, such as sutures, staples, and electrocautery. Because of its strength and ability to be stored at room temperature, BioGlue is readily available for use in the operating room. Its major indications include bonding, sealing, and reinforcing tissue.
BioGlue is effective on many types of soft tissues, such as cardiac, vascular, pulmonary, genitourinary, dural, alimentary, and abdominal. Advertised as the “ideal sealant,” BioGlue reapproximates layers of tissue in repair of blood vessels, including aortic dissections, and reduces the overall surgery time. "Sealing the affected vessels appropriately is key to a successful technical outcome in cardiac and vascular surgery," said T. P. Sarac, M. D., F.A.C.S., of the Cleveland Clinic, Cleveland, Ohio.
For aortic repairs, BioGlue strengthens weakened tissue and improves hemostasis. BioGlue is especially useful in reinforcing friable tissues in aortic valve replacements in the elderly population. It is also useful in the fixation of surgical mesh in hernia repair surgery.
Because BioGlue requires a bloodless field to adhere, it cannot be used to control any active bleeding. BioGlue is not recommended for any cerebrovascular repairs or intraluminal areas. Any patients with sensitivities or allergies to bovine material would not be surgical candidates for the use of BioGlue. In cardiac surgery involving mechanical valves, the recommendation is for BioGlue to be used sparingly, and with caution, due to the possibility of the substance leaking into the valve apparatus.
BioGlue is the leading surgical adhesive, in cardiac surgery, having been used in over 70 countries worldwide, in over 550,000 surgical procedures since 1998. Its main indications are for use in adult surgical patients to repair blood vessels, seal tissue anastomoses, approximate layers of tissue, and reinforce friable tissue. Its strength provides surgeons with the confidence that weakened tissues are well reinforced during complex cardiac and vascular procedures.