The Development of Facial Prosthetics and Adhesives in Plastic and Reconstructive Surgery: A Study in the Application of Prosthetic Materials and Devices Used in Plastic and Reconstructive Surgery Together with Tissue Adhesives as an Alternative to Conventional Ligation

Various silicone elastomers have been evaluated for use in the prostheticreconstruction of facial defects. Their strength, texture, flexibility, hardness, ease of preparation, pigment receptivity and retention, andtheir resistance to cleaning were compared and the data consulted when anelastomer was chosen to restore defects, improve aesthetics and reestablishthe confidence of a selection of patients. Detailed casereports are provided, together with information on the adhesives ormechanical methods available for retaining the facial prosetheses. Cyanoacrylateadhesives for use on skin surfaces and as tissue adhesiveshave been studied in detail. A novel n-butyl 413 cyanoacrylate has beendeveloped with a viscosity, haemostatic property and stability to make itparticularly suitable for use in skin grafting and tissue repair. It hasalready been used with good results on patients with severe burns. Animproved formulation, containing a fluorescent dye, can be preciselyapplied through a specially constructed foot-controlled dispenserilluminated by a fibre-optic supplying UV-light. Cyanoacrylates are already being used as tissue adhesives in place of theconventional but potentially disfiguring suture. The availability ofimproved, imperceptible adhesives and a precision applicator, which canbe used in a modern operating theatre, will extend their effectivenessand satisfy some of the needs of Plastic, and Oral and Maxillo-FacialSurgeons. Portable applicators have potential use in battlefield and inveterinary surgery and overcome the imprecision characteristic ofearlier methods.