Biomechanical evaluation of fixation properties of fibrin glue for ventral incisional hernia repair

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• 作者：N. Stoikes (1) (2) (3)
  J. Sharpe (1) (2) (3)
  H. Tasneem (1) (2) (3)
  E. Roan (1) (2) (3)
  E. Paulus (1) (2) (3)
  B. Powell (1) (2) (3)
  D. Webb (1) (2) (3)
  C. Handorf (1) (2) (3)
  E. Eckstein (1) (2) (3)
  T. Fabian (1) (2) (3)
  G. Voeller (1) (2) (3)
  
  1. Department of Surgery ; University of Tennessee Health Science Center ; Memphis ; USA
  2. Department of Pathology ; University of Tennessee Health Science Center ; Memphis ; USA
  3. Department of Biomechanical Engineering ; University of Memphis ; Memphis ; USA
  
• 关键词：Fibrin glue ; Mesh fixation ; Hernia
• 刊名：Hernia
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：19
• 期：1
• 页码：161-166
• 全文大小：2,022 KB
• 参考文献：1. Campanelli G, Pascual M, Hoeferlin A et al (2012) Randomized, controlled, blinded trial of Tisseel/Tissucol for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: results of the TIMELI trial. Ann Surg 255:650鈥?57 CrossRef
  2. Clarke T, Katkhouda N, Mason J et al (2011) Fibrin glue for intraperitoneal laparoscopic mesh fixation: a comparative study in a swine model. Surg Endosc 25:737鈥?48 CrossRef
  3. Schug-Pass C, Lippert H, Kockerling F (2009) Fixation of mesh to the peritoneum using a fibrin glue: investigations with a biomechanical model and an experimental laparoscopic porcine model. Surg Endosc 23:2809鈥?815 CrossRef
  4. Chevrel JP, Rath AM (1997) The use of fibrin glues in the surgical treatment of incisional hernias. Hernia 1:9鈥?4 CrossRef
  5. Kingsnorth A, Shahid M, Valliatu A et al (2008) Open on lay mesh repair for major abdominal wall hernias with selective use of components separation and fibrin sealant. World J Surg 32:26鈥?0 CrossRef
  6. Canziani M, Frattini F, Cavalli M, Agrusti S et al (2009) Sutureless mesh fibrin glue incisional hernia repair. Hernia 13(6):625鈥?29 CrossRef
  7. Licheri S, Erdas E, Pisano G et al (2008) Chevrel technique for midline incisional hernia: still an effective procedure. Hernia 12:121鈥?26 CrossRef
  8. Schwab R, Schumacher O, Junge K et al (2006) Fibrin sealant for mesh fixation in lichenstein repair: biomechanical analysis of different techniques. Hernia 11:139鈥?45 CrossRef
  9. Schug-Pass C, Dietmar A, Lippert H (2012) Differences in biomechanical stability using various fibrin glue compositions for mesh fixation in endoscopic inguinal hernia repair. Surg Endosc (epub ahead of print)
  10. Jenkins E, Melman L, Deeken C et al (2010) Evaluation of fenestrated and non fenestrated biologic grafts in a porcine model of mature ventral incisional hernia repair. Hernia 14:599鈥?10 CrossRef
  11. Valentin JE, Badylak JS, McCabe GP, Badylak SF (2006) Extracellular matrix bioscaffolds for orthopaedic applications. A comparative histologic study. J Bone Jt Surg Am 88:2673鈥?686 CrossRef
  12. Gruber-Blum S, Petter-Puchner A, Mika K et al (2010) A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats. Surg Endosc 24:3086鈥?094 CrossRef
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Abdominal Surgery
  
• 出版者：Springer Paris
• ISSN：1248-9204

文摘

Introduction Use of adhesives for mesh fixation in hernia is increasing. There has been minimal study of mesh incorporation and interface strength with adhesive fixation for ventral hernia repair. The purpose of this study was to evaluate the fixation properties of fibrin glue as it compared to suture fixation of mesh in an onlay position. Methods Twenty-four mongrel pigs were divided into three study arms based on time points for biomechanical evaluation: 24聽h (n聽=聽8), 7聽days (n聽=聽8), and 14聽days (n聽=聽8). Initial procedures included placement of two 4聽脳聽6聽cm pieces of wide-pore polypropylene mesh in an onlay position. One was fixated with 4聽ml of fibrin glue and the other with four interrupted 2-0 polypropylene sutures. The shear strength of fixation was evaluated using a uniaxial testing device along with histological evaluation. Maximum force was normalized by the width of the mesh. Results Mesh鈥搕issue interface of glued and sutured specimens at 7 and 14聽days did not fail in our testing configuration. Only at the 24-h time point the mesh detached from the tissue, and the sutured interface (10.4聽N/cm) was significantly stronger than glued interface (4.9聽N/cm, p聽=聽0.004). Histopathologic and gross evaluations of the specimens revealed similar histologic features at all time points for both glued and sutured specimens. Conclusions With mesh in the onlay position, fixation to the abdominal wall occurs quickly. Though sutures were stronger at 24聽h, as early as 1聽week, the strength of the fixation exceeded the tissue or the mesh strength in our testing configuration for both glue and suture groups. Fixation strength is independent of technique at the latter time points. There are potential clinical advantages to the exclusive use of fibrin glue for fixation including acute post-operative pain, chronic post-operative pain, and recurrence for ventral incisional hernia repair.