Comparison of 2-octyl cyanoacrylate adhesive, fibrin glue, and suturing for wound closure in the porcine urinary tract.
OBJECTIVE
To evaluate 2-octyl cyanoacrylate glue (OCG) for wound closure in the urinary tract and compare the ability of OCG, fibrin glue (FG), and suture to withstand physiologic and supraphysiologic stress, because the use of tissue adhesives such as OCG or FG might simplify laparoscopic surgery.


METHODS
Female domestic pigs (n = 22) underwent a 7.5-cm cystotomy. Of these, 8 had closure with OCG and 8 with FG (6 open and 2 laparoscopic in each group). The controls were closed with suture (n = 4) or not at all (n = 2). Postoperative catheter drainage was not used. At 2 days or 4 weeks postoperatively, the bladders were filled with saline to 200 mm Hg pressure and the cystotomy scars inspected for leakage. The excised scars were also examined histologically.


RESULTS
The 2 OCG and 2 FG pigs tested on postoperative day 2 leaked at less than 200 mm Hg. None of the 6 OCG pigs tested at 4 weeks leaked at less than 200 mm Hg, including the 2 closed laparoscopically. Of the 6 FG pigs intended for study at 4 weeks, 3 (including the 2 closed laparoscopically) died from a massive urine leak, 1 tested at 4 weeks leaked, and 2 did not leak. Thus, 4 of 6 FG pigs leaked by 4 weeks compared with none in the OCG group (P = 0.06). The histologic examination was similar in the two groups.


CONCLUSIONS
Preliminary results suggest that OCG provides enough strength to hold together a large bladder wound. In the same model, FG did not consistently provide adequate closure.
Marcovich
R
R
Department of Surgery, Section of Urology, University of Michigan and Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.
Williams
A L
AL
Rubin
M A
MA
Wolf
J S
JS
D000818:Animals; D003487:Cyanoacrylates; D003559:Cystostomy / Q000379:methods*; D005260:Female; D015718:Fibrin Tissue Adhesive; D013314:Stress, Mechanical; D013536:Suture Techniques; D013552:Swine; D014014:Tissue Adhesives
D003487:Cyanoacrylates; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate