Progress Towards Seamless Tissue Fusion for Wound Closure

The most basic wound closure techniques, including mechanical (eg, plant thorns, ant jaws) and thermal (eg, hot liquids, burning applicators) methods, date back thousands of years and. Modern devices and materials for connecting or sealing tissues have increased in sophistication. However, most rely on the same fundamental principals as in the past. Mechanical closures have progressed to include natural and synthetic sutures, staples, tapes, and adhesive compounds, whereas modern thermal closure is achieved by relatively controlled cauterization with electronic devices. Despite the use of advanced materials and technology, some fundamental problems remain, including leakage, dehiscence, infection, and iatrogenic related trauma.The ideal closure would restore the original integrity of the tissue. The seal would be physiologically and mechanically seamless, be fluid- and airtight, and have a tensile strength and degree of elasticity suited to the tissue. Additionally, it would be aesthetically acceptable, inexpensive to achieve, and easy to apply even in minimally invasive surgeries. This paper reviews tissue fusion devices and techniques that may one day provide us with such biologically invisible wound closures.