Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain; Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain; Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
J Surg Res. 2020 Feb;246:26-33. doi: 10.1016/j.jss.2019.08.020. Epub 2019 Sep 23.
Tissue adhesives are a feasible option to fix a hernia repair mesh, avoiding tissue trauma of suture fixation. Classically, they are applied in the form of a drop, although novel applications such as spray are emerging. This study compares the use of a new experimental cyanoacrylate (n-butyl) in the form of a spray or drops.
Three study groups of New Zealand White rabbits were established (n = 6 each) according to the method used to fix a 5 × 3 cm polypropylene mesh in a partial abdominal wall defect model: control group (polypropylene stitches), adhesive drops group, and adhesive spray group. Morphological, immunohistochemical, and biomechanical strength studies were performed at 14 d postimplant. Collagen 1/3 gene ratio was determined by quantitative reverse transcription polymerase chain reaction.
In the drops group, the adhesive obstructed the mesh pores and prevented tissue infiltration at the points of application. When the adhesive was applied as a spray, although more numerous, adhesive deposits were smaller and allowed for better host tissue infiltration into the mesh. The inflammatory response was similar in the adhesive groups and more intense than in the control group. Collagen 1/3 mRNA ratio was significantly higher in the spray than the control group. The mechanical resistance of the meshes was similar in all three groups.
The application of the cyanoacrylate adhesive in the form of spray to fix polypropylene meshes in an animal model had a similar inflammatory response compared with droplet application. Neither application impacted the mechanical strength of the repaired area. An increased in collagen 1/3 ratio was found with cyanoacrylate spray compared with suture, and future studies should focus on this pathway.
组织粘合剂是固定疝修补网片的一种可行选择，可以避免缝线固定造成的组织创伤。传统上，它们以滴状形式使用，尽管新的应用，如喷雾，正在出现。本研究比较了新型实验性氰基丙烯酸酯（正丁基）以喷雾或滴状形式的应用。
根据在部分腹壁缺损模型中固定 5×3cm 聚丙烯网片的方法，建立了三组新西兰白兔（每组 n=6）：对照组（聚丙烯缝线）、粘合剂滴注组和粘合剂喷雾组。在植入后 14 天进行形态学、免疫组织化学和生物力学强度研究。通过定量逆转录聚合酶链反应确定胶原 1/3 基因比值。
在滴注组中，粘合剂阻塞了网孔，并在应用点阻止组织渗透。当粘合剂以喷雾形式使用时，尽管沉积更多，但粘合剂沉积较小，允许更好的宿主组织渗透到网片中。粘合剂组的炎症反应与对照组相似，但比对照组更强烈。与对照组相比，喷雾组的胶原 1/3 mRNA 比值显著升高。三组的网片力学阻力相似。
在动物模型中，将氰基丙烯酸酯粘合剂以喷雾形式应用于固定聚丙烯网片，与滴注应用相比具有相似的炎症反应。两种应用都不会影响修复区域的机械强度。与缝线相比，氰基丙烯酸酯喷雾发现胶原 1/3 比值增加，未来的研究应集中在这一途径上。
