title: Cyanoacrylate surgical glue as an alternative to suture threads for mesh fixation in hernia repair.
abstract: BACKGROUND
  In recent years, the use of synthetic glues has become an established practice in several areas of surgical treatment. For example, they are used in open and laparoscopic surgery and in digestive tract endoscopy, interventional radiology, and vascular neuroradiology. The experiments in this study were aimed at elucidating that suture-based permanent mesh fixation can be replaced by fixation with N-butyl 2-cyanoacrylate glue (Glubran2) for surgical repair of abdominal wall hernias.
  
  
  METHODS
  In 25 Wistar rats, two hernia defects (1.5 cm in diameter) per animal were created bilaterally in the midline of the abdominal wall. The peritoneum was spared. The lesions were left untreated for 10 d to achieve a chronic condition. Then the defects were covered with TiMESH extralight (2 × 2 cm) and fixed by 30 μL of Glubran2 or traditional suture. The time points of sacrifice were 17 and 28 d, 3, 4, and 5 mo. At autopsy, histology and immunohistochemistry were performed to evaluate the inflammatory response and the presence of apoptotic cells respectively.
  
  
  RESULTS
  Mesh fixation was excellent in all samples at each time point. At application sites, the inflammatory reaction was mild with a small number of macrophages and vascularized connective tissue presence around glue and mesh threads. Glue residues were observed in histologic sections at each time point. No presence of apoptotic cells was found.
  
  
  CONCLUSIONS
  This study demonstrated that Glubran2 can effectively replace traditional suture in mesh fixation without affecting tissue healing and determining a physiological inflammatory reaction at the abdominal wall site.
authors.affiliation: Laboratory for Biomaterials & Graft Technology, Institute of Clinical Physiology CNR, Massa, Italy. losi@ifc.cnr.it
authors.forename: Paola
authors.initials: P
authors.lastname: Losi
authors.forename: Silvia
authors.initials: S
authors.lastname: Burchielli
authors.forename: Dario
authors.initials: D
authors.lastname: Spiller
authors.forename: Valentina
authors.initials: V
authors.lastname: Finotti
authors.forename: Silvia
authors.initials: S
authors.lastname: Kull
authors.forename: Enrica
authors.initials: E
authors.lastname: Briganti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Soldani
mesh_terms: D000818:Animals; D003487:Cyanoacrylates; D046449:Hernia, Abdominal / Q000473:pathology / Q000601:surgery*; D007150:Immunohistochemistry; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D013537:Sutures; D014014:Tissue Adhesives; D014945:Wound Healing
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives