Cyanoacrylate glue for intra-abdominal mesh fixation of polypropylene-polyvinylidene fluoride meshes in a rabbit model.
BACKGROUND
Cyanoacrylate glues are tissue adhesive with high adherent and hemostatic properties. The aim of this study was to evaluate the efficacy of cyanoacrylates glue for polypropylene-polyvinylidene fluoride (PP-PVDF) intraperitoneal onlay mesh (IPOM) fixation in a rabbit model.


METHODS
In 40 New Zealand white rabbits, three pieces (3×3cm) of a PP-PVDF mesh (n=120) were fixed in IPOM technique on both sides of a midline laparotomy. For mesh fixation we used spiral tacks, nonabsorbable sutures, or cyanoacrylate glue in a randomized manner. All animals were killed after 12 wk. The prosthetic materials were excised en bloc with the anterior abdominal wall for evaluation of the tensile strength and histologic analysis. Results are presented as mean and standard deviation.


RESULTS
Meshes fixed with glue showed a significantly higher tenacity of adhesions (2.75±0.97) compared with those with tacks (2.44±0.97 sutures versus 1.91±0.92 tacks). The percentage of adhesions in the glue group was comparable to the suture group (36.50% ± 27.60% glue, 37.62% ± 27.36% suture). The tensile strength of stapled and sutured meshes was significantly higher than the tensile strength glued mesh (14.15±0.97N suture versus 14.84±0.74 stapler versus 9.64±0.78N glue). Mesh shrinkage was irrespective of the fixation technique. The inflammation reaction was more pronounced in the glue group.


CONCLUSIONS
Although cyanoacrylate glue showed a considerable cellular ingrowth in this rabbit model, sutures and tacks proved to be superior for IPOM fixation of PP-PVDF meshes in terms of tensile strength.
Ladurner
Roland
R
Department of Surgery Innenstadt, University of Munich (LMU), Munich, Germany. Roland.Ladurner@med.uni-muenchen.de
Drosse
Inga
I
Bürklein
Dominik
D
Plitz
Wolfgang
W
Barbaryka
Gregor
G
Kirchhoff
Chlodwig
C
Kirchhoff
Sonja
S
Mutschler
Wolf
W
Schieker
Matthias
M
Mussack
Thomas
T
D000005:Abdomen / Q000601:surgery; D000269:Adhesives; D000818:Animals; D003487:Cyanoacrylates; D059685:Herniorrhaphy; D007813:Laparotomy / Q000295:instrumentation / Q000379:methods; D023421:Models, Animal; D011126:Polypropylenes; D011145:Polyvinyls; D011817:Rabbits; D013526:Surgical Mesh; D013537:Sutures; D013718:Tensile Strength; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*; D005465:Fluorocarbon Polymers
D000269:Adhesives; D003487:Cyanoacrylates; D011126:Polypropylenes; D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers