title: Comparison of healing after cystotomy and repair with fibrin glue and sutured closure in the porcine model.
abstract: OBJECTIVE
  We compared healing after laparoscopic cystotomy using fibrin glue, sutures, or a combination to determine whether fibrin glue can obviate the need for sutures and whether there is any detriment when glue is used in the presence of sutures.
  
  
  METHODS
  In 24 Yorkshire pigs, a 3.5 cm vertical cystotomy was created laparoscopically and repaired as follows: Group 1--no closure; group 2--fibrin glue closure; group 3--suture repair; group 4--combined fibrin glue and suture repair. All animals had a Foley catheter for 1 week. In each group, three animals were harvested at 1 week (acute) and three animals were harvested at 6 weeks (chronic).
  
  
  RESULTS
  Acute: Group 1--all pigs had an unhealed defect that leaked when evaluated by cystography. Groups 2, 3, 4--mean leak pressures were 80, 97, and 60 cm H(2)O (P = 0.36), respectively. Mean bladder capacity was not significantly different between groups. Chronic: No leakage seen on a cystogram at 1 week; at 6 weeks, bladders were filled at > or =95 to 100 cm H(2)O without leakage. Histologically, there was more inflammation in the acute group v chronic group pigs. In the acute group pigs repaired with glue or suture + glue, there was more inflammation and less epithelial continuity than in the suture alone group. At 6 weeks, there was no difference between groups.
  
  
  CONCLUSIONS
  Fibrin glue provoked an intense inflammatory response that might have delayed healing acutely, resulting in a lower burst pressure in both scenarios in which it was used (i.e., alone or in combination with sutures). However, by 6 weeks, there did not seem to be any difference between groups either clinically or histopathologically.
authors.affiliation: Department of Urology, University of California-Irvine, 101 The City Drive, Orange, CA 92612, USA. jborin@uci.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Borin
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Deane
authors.forename: Leandro G
authors.initials: LG
authors.lastname: Sala
authors.forename: Corollos S
authors.initials: CS
authors.lastname: Abdelshehid
authors.forename: Shannon M
authors.initials: SM
authors.lastname: White
authors.forename: Alfred Krebs
authors.initials: AK
authors.lastname: Poulson
authors.forename: Farhan
authors.initials: F
authors.lastname: Khan
authors.forename: Robert A
authors.initials: RA
authors.lastname: Edwards
authors.forename: Elspeth M
authors.initials: EM
authors.lastname: McDougall
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000818:Animals; D053715:Cystotomy; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D034421:Sus scrofa; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use*; D001743:Urinary Bladder / Q000601:surgery; D014945:Wound Healing
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives