Cyanoacrylate for wound closure in prosthetic vascular graft surgery to prevent infections through contamination.
OBJECTIVE
Prosthetic vascular graft infection (PVGI) still occurs at an unacceptably high rate, despite the many measures that have proven effective against infection. The major cause of PVGI is perioperative contamination, which usually occurs before a histological barrier is completed and may threaten graft viability. We assessed the efficacy of cyanoacrylate as a tissue adhesive and barrier against early contamination through the skin.


METHODS
A 1 x 0.5-cm Dacron graft was placed subcutaneously under sterile conditions in 16 Sprague-Dawley rats. The skin was closed with polypropylene sutures in eight rats (group A) and with N-butyl 2-cyanoacrylate in eight rats (group B). The closed incisions were then contaminated with 75 x 10(6) cfu/ml methicillin-sensitive Staphylococcus aureus. Microbiological and histopathological assessments were done 7 days later, after the rats were killed.


RESULTS
All of the graft cultures from group A (8/8) were positive for S. aureus whereas all of those from group B (0/8) were negative. This difference was significant (p < 0.001). Histological examination revealed denser inflammatory cell infiltration in group A than in group B.


CONCLUSIONS
Maintaining skin integrity after closure is of the utmost importance because contamination during the first hours of the procedure may cause PVGI. Cyanoacrylate seems to be a promising molecule not only because of its bacteriostatic effects, but also because it seals the barrier effectively and immediately.
Aksoy
Murat
M
Department of General Surgery, Medical Faculty of Istanbul, Istanbul University, Genel Cerrahi ABD Sekreterligi, 34093 Capa, Istanbul, Turkey.
Turnadere
Erhan
E
Ayalp
Kemal
K
Kayabali
Murat
M
Ertugrul
Bulent
B
Bilgic
Levent
L
D000818:Animals; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D003487:Cyanoacrylates / Q000494:pharmacology*; D023421:Models, Animal; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014014:Tissue Adhesives / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects*
D003487:Cyanoacrylates; D014014:Tissue Adhesives