In 1959, a variety of cyanoacrylate adhesives were developed, some types of which are now used for surgical purposes in Canada and Europe. These glues polymerize on contact with basic substances such as water or blood to form a strong bond. The first glue developed was methyl cyanoacrylate, which was studied extensively for its potential medical applications and was rejected due to its potential tissue toxicity such as inflammation or local foreign body reactions.
Further research revealed that by changing the type of alcohol in the compound to one with a longer molecular chain, the tissue toxicity was much reduced. All the medical grade tissue adhesives currently available for human use contain butyl-esters.
In 1964, the Tennessee Eastman lab submitted its first application for new drug approval to the FDA. The military learned of this new glue and became extremely interested in its potential for use in field hospitals.
N-butyl cyanoacrylate has been used extensively in Europe since the 1970s for a variety of surgical applications including middle ear surgery, bone and cartilage grafts, repair of cerebrospinal fluid leaks, and skin closure.
Medical grade products currently available contain either butyl, isobutyl or octyl esters. They are bacteriostatic and painless to apply when used as directed, produce minimal thermal reaction when applied to dry skin and break down harmlessly in tissue.
The only currently FDA approved adhesives suitable for use as suture alternatives are n-butyl- cyanoacrylate tissue adhesives.