title: Fibrin sealant effects on the ilioinguinal nerve.
abstract: BACKGROUND
  Chronic pain after mesh repair for inguinal hernia may be related to the trauma to the regional nerves by direct compression with sutures, staples, or tacks during mesh fixation. Fibrin sealant (FS) has been recommended to eliminate this risk. In this experimental study, the effects of FS on the ilioinguinal nerve when a mesh was applied was searched.
  
  
  METHODS
  Fifteen New Zealand rabbits were used in three groups. In Group 1, a 2×1 cm, standard monofilament, pure polypropylene mesh was laid over ilioinguinal nerve. In Group 2, 0.5 ml FS was applied on the nerve without using an onlay mesh. In Group 3, a 2×1 cm mesh was laid onlay and secured with 0.5 ml FS with no fixating suture. Three months after surgery bilateral nerve samples were taken from the contiguous nerve segment for microscopic study.
  
  
  RESULTS
  Group 1 showed prominent findings with regard to all parameters. There were significant differences between Group 1 and Group 2 in respect of fibrosis, lymphocyte, and edema scores, and foreignbody reaction. The values of Group 3, where the mesh was secured by the application of FS with no suture, were roughly placed in between Group 1 and Group 2. Prominent fibrosis and increased collagen proliferation in peripheral area of mesh was seen in Group 1 subjects, whereas a mild fibroblastic activity among mesh fibers in Group 3 subjects.
  
  
  CONCLUSIONS
  FS has no negative effect on ilioinguinal nerve. FS application may protect the nerve from the harmful effects of polypropylene mesh in inguinal hernia repair.
authors.affiliation: Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey. drengin@gmail.com
authors.forename: Engin
authors.initials: E
authors.lastname: Olcucuoglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Kulacoglu
authors.forename: Cemal Ozben
authors.initials: CO
authors.lastname: Ensari
authors.forename: Alper
authors.initials: A
authors.lastname: Yavuz
authors.forename: Aynur
authors.initials: A
authors.lastname: Albayrak
authors.forename: Zafer
authors.initials: Z
authors.lastname: Ergul
authors.forename: Oya
authors.initials: O
authors.lastname: Evirgen
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D023421:Models, Animal; D010525:Peripheral Nerves / Q000187:drug effects* / Q000473:pathology* / Q000648:ultrastructure; D011126:Polypropylenes; D011817:Rabbits; D013526:Surgical Mesh
chemical_list: D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive; D011126:Polypropylenes