Department of Surgery Innenstadt, University of Munich (LMU), Munich, Germany.
J Surg Res. 2011 May 15;167(2):e157-62. doi: 10.1016/j.jss.2009.11.710. Epub 2009 Dec 9.
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.
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.
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.
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.
氰基丙烯酸酯胶是一种具有高黏附性和止血性能的组织粘合剂。本研究旨在评估氰基丙烯酸酯胶在兔模型中用于聚丙烯-聚偏二氟乙烯(PP-PVDF)腹腔内补片(IPOM)固定的效果。
在 40 只新西兰白兔中,使用 IPOM 技术将三块(3×3cm)PP-PVDF 补片(n=120)固定在中线剖腹术的两侧。补片固定采用螺旋钉、不可吸收缝线或氰基丙烯酸酯胶,随机分组。所有动物在 12 周后处死。切除与前腹壁整块的假体材料进行拉伸强度和组织学分析。结果以平均值和标准差表示。
与钉和缝线组相比,用胶固定的补片显示出明显更高的黏附强度(2.75±0.97)。胶组的黏附百分比与缝线组相当(36.50%±27.60%胶,37.62%±27.36%缝线)。钉和缝线固定的补片的拉伸强度明显高于胶固定的补片(14.15±0.97N 缝线对 14.84±0.74 钉对 9.64±0.78N 胶)。补片收缩与固定技术无关。在胶组中炎症反应更为明显。
尽管氰基丙烯酸酯胶在这种兔模型中显示出相当大的细胞内生长,但在拉伸强度方面,缝线和钉对于 PP-PVDF 补片的 IPOM 固定效果优于胶。