title: Polypropylene meshes coated with a polysaccharide based bioadhesive for intra-abdominal mesh fixation in a rabbit model.
abstract: BACKGROUND
  In this study, we evaluate a new bioadhesive for intra-abdominal onlay mesh fixation of a polypropylene-polyvinylchloride graft.
  
  
  METHODS
  Three pieces of a commercially available polypropylene/polyvinylfluoride mesh, each 3 × 3 cm in size, and three pieces of the same mesh coated with a polysaccharide bioadhesive were fixated to the surface of the anterior abdominal wall of 30 New Zealand white rabbits. The fixation was performed either by using four transabdominal Prolene(®) 4/0 sutures, four spiral tacks (Protack 5 mm Tyco), or cyanoacrylate glue (Glubran(®) GEM, Viareggio, Italy). Each mesh position and the according kind of fixation were randomized before implantation. The animals were sacrificed 12 weeks postoperatively. After determining the extent of intra-abdominal adhesions, the meshes were excised en bloc with the anterior abdominal wall for tensile strength measurements and histological analysis.
  
  
  RESULTS
  All meshes coated with the bioadhesive adhered to the intact peritoneum without extra fixation. Irrespective of the fixation technique coated meshes led to more and stronger adhesions. Mesh shrinkage by scarring was increased in coated meshes fixed with glue and low in uncoated meshes fixed with tacks. Testing the tensile strength, coated meshes fixed with transfascial sutures achieved the best results (16.14 ± 6.1 N), whereas coated meshes fixed with glue showed the lowest strength (10.39 ± 4.81 N). The foreign body reaction was considerably more distinctive using coated mesh. The mesh ingrowth was not influenced by this reaction.
  
  
  CONCLUSIONS
  All meshes coated with the new bioadhesive were self-adhesive in that way; they stayed in position when attached to the peritoneum. Although this may facilitate intra-operative mesh fixation, the bioadhesive displayed several disadvantages, such as stronger adhesions and an increased shrinkage of the implant. The tensile strength was not influenced by the use of the bioadhesive. At present, we see no major advantage for polysaccharide bioadhesive applied in this study.
authors.affiliation: Department of Surgery Innenstadt, Klinikum der Universität München, Nussbaumstrasse 20, 80336, Munich, Germany. Roland.Ladurner@med.uni-muenchen.de
authors.forename: Roland
authors.initials: R
authors.lastname: Ladurner
authors.forename: Inga
authors.initials: I
authors.lastname: Drosse
authors.forename: Costanza
authors.initials: C
authors.lastname: Chiapponi
authors.forename: Dominik
authors.initials: D
authors.lastname: Bürklein
authors.forename: Volkmar
authors.initials: V
authors.lastname: Jansson
authors.forename: Andreas
authors.initials: A
authors.lastname: Kokott
authors.forename: Bettina
authors.initials: B
authors.lastname: Hoffmann
authors.forename: Günter
authors.initials: G
authors.lastname: Ziegler
authors.forename: Wolf
authors.initials: W
authors.lastname: Mustchler
authors.forename: Thomas
authors.initials: T
authors.lastname: Mussack
authors.forename: Matthias
authors.initials: M
authors.lastname: Schieker
mesh_terms: D000818:Animals; D006555:Hernia, Ventral / Q000601:surgery; D006801:Humans; D011126:Polypropylenes; D011134:Polysaccharides / Q000494:pharmacology*; D011817:Rabbits; D013526:Surgical Mesh; D013537:Sutures; D013718:Tensile Strength; D000267:Tissue Adhesions / Q000209:etiology; D014014:Tissue Adhesives / Q000494:pharmacology*
chemical_list: D011126:Polypropylenes; D011134:Polysaccharides; D014014:Tissue Adhesives