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A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats

A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats,10.1

A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats   (Citations: 4)
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Background  Research in hernia repair has targeted new atraumatic mesh fixation to reduce major complications such as chronic pain and adhesion formation. The efficacy and safety of two surgical adhesives, viz. Artiss® (FS, fibrin sealant containing 4 IU thrombin) and Bioglue® (AGG, bovine serum albumin/glutaraldehyde glue), were evaluated in this study. Primary study endpoints were tissue integration, dislocation, and adhesion formation. Foreign-body reaction formed the secondary study endpoint. Methods  Twenty-four polypropylene meshes (VM, Vitamesh®) were randomized to four groups (n = 6): two groups of onlay hernia repair (two meshes per animal) with mesh fixation by FS (O-FS) or by AGG (O-AGG), and two groups of IPOM repair (one mesh per animal) with mesh fixation by four sutures and FS (I-FS) or AGG (I-AGG). Eighteen rats underwent surgery. Follow-up was 30 days. Tissue integration, dislocation, seroma formation, inflammation, adhesion formation, and foreign-body reaction were assessed. Results  Meshes fixed with FS (O-FS, I-FS) showed good tissue integration. No dislocation, seroma formation, or macroscopic signs of inflammation were detectable. Adhesion formation of I-FS was significantly milder compared with I-AGG (P = 0.024). A moderate foreign-body reaction without active inflammation was seen histologically in O-FS and I-FS groups. Samples fixed with AGG (O-AGG, I-AGG) showed extensive scar formation. No dislocation and no seroma formation were observed. All of these samples showed moderate to severe signs of inflammation with abscess formation in the six meshes of O-AGG. Histology underlined these findings. Conclusions  The fibrin sealant adhesive showed very good overall results of the primary and secondary outcome parameters. FS is a recommendable atraumatic fixation tool for the surgical onlay technique. AGG provides high adhesive strength, but shows low biocompatibility. Persisting active inflammation was seen in both the O-AGG and I-AGG groups, not favoring its use for these indications.
Journal: Surgical Endoscopy and Other Interventional Techniques - SURG ENDOSC , vol. 24, no. 12, pp. 3086-3094, 2010
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    • ...Since June 2007, we decided to use Tissucol® (Baxter BioSurgery, Vienna, Austria), a fibrin sealant containing human thrombin which demonstrated appropriate adhesive properties combined with excellent tissue integration and low inflammation response [8]...
    • ...It is also important to notice that such inflammatory response appears to be specific of BioGlue® compared with other biologic glue: on rat models, for the same adhesive properties, BioGlue® provides active inflammation that is absent with fibrin sealant [8]...

    Thomas Gaberelet al. Surgical site infection associated with the use of bovine serum albumi...

    • ...However, their material components or biologic interaction also may induce inflammatory tissue responses that cause postoperative adhesion [2, 4, 5]...
    • ...According to previous studies on the adhesive property of meshes, the mesh must be fixed to the abdominal wall at its corners with four more sutures because fixation of the mesh margin (edge) is important for implantation of the mesh [5, 8, 16]...

    Keiichi FujinoManabuet al. Novel technique of overlaying a poly- l -lactic acid nanosheet for adh...

    • ...This limited adhesive effect is, however, compensated by high elasticity (Redl and Schlag, 1986b), which makes the material especially useful for tissue that must remain fl exible as in skin grafts, lung injuries and e.g superior for fi xation of hernia meshes (Gruber-Blum et al., 2010)...

    James Fergusonet al. Fibrin: The Very First Biomimetic Glue — Still a Great Tool

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