Fixation of polyvinylidene fluoride (PVDF) mesh with cyanoacrylate-derived glues in a rat experimental model: histopatho
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ORIGINAL ARTICLE
Fixation of light‑weight polypropylene mesh with cyanoacrylate‑derived glues in a rat experimental model: histopathologic immunohistochemical and morphometric study A. Poli1 · F. Parisi1 · F. Millanta1 · L. Solfanelli2 · P. García‑Pastor3 · C. Magliaro4 · V. Miragliotta1 · S. Burchielli5 Received: 11 July 2019 / Accepted: 3 November 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
Abstract Purpose The use of cyanoacrylate (CA)-based tissue adhesives for mesh fixation in abdominal hernia repair is increasing due to the fast action and bond strength of these glues. The aim of the present study was to assess tissue changes induced by different CA glues used for mesh fixation in an animal model. Methods Parietal defects were induced in the abdominal wall of 60 rats and repaired by polyvinylidene fluoride (PVDF) mesh fixation using different CA glues. At 1, 7, 15, and 30 days post-surgery, macroscopic and histopathological studies were performed to evaluate mesh adhesion, the presence of complications and the tissue response. Results All meshes were successfully fixed without signs of inflammatory reaction, displacement or detachment. In areas where CA adhesives were applied, the acute tissue response was limited and transient. At 7 days post-surgery, collagen fibril production around prosthetic materials was observed, and collagen maturation was achieved at 30 days post-surgery. Good mesh incorporation was detected with all three glues, but the application of Glubran-2 was associated with an early macrophagic response and the early production and maturation of collagen fibrils. Conclusions Our study confirmed that CA tissue adhesives induced the good incorporation of prosthetic mesh within host tissue with a low incidence of complications and reduced acute tissue reaction. At 30 days post-surgery no signs of mesh disinsertion or migration were observed, the prosthetic mesh adhesion was due to the presence of a dense mature connective tissue rich in type I collagen fibres. Keywords Hernia repair · Tissue adhesives · Cyanoacrylate glue · Cellular response · Collagen production
Introduction
* A. Poli [email protected] 1
Dipartimento Di Scienze Veterinarie, Università Di Pisa, Viale delle Piagge, 2, 56124 Pisa, Italy
2
Dipartimento Di Medicina Clinica E Sperimentale, Università Di Pisa, Pisa, Italy
3
Abdominal Wall Surgery Unit, Surgery Department, La Fe University and Politechnic Hospital, Valencia, Spain
4
Centro Di Ricerca “E. Piaggio”, Università Di Pisa, Pisa, Italy
5
Fondazione Toscana “Gabriele Monasterio” E Centro Di Biomedicina Sperimentale del CNR, Pisa, Italy
In the field of abdominal surgery, prosthetic hernia repair is one of the most common procedures. Mesh reinforcement is more effective than suture repair with a low percentage of hernia recurrence [1]. Since the occurrence of chronic pain remains a major complication after this surgical procedure, the use of less traumatic mesh fixation techniques, such as recently introduced tissue adhesi
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