Mesh fixation with sutures versus fibrin sealant in hernioplasty with reabsorbable prosthesis (polyglycolic acid and trimethylene carbonate). Experimental study in animals

Abstract Introduction Current studies have shown the validity of the atraumatic fixation with fibrin glue (Tissucol ® ) compared to conventional sutures in polypropylene mesh fixation. We propose to study the behaviour of absorbable mesh. Material and methods We used 20 Wistar white rats. Two hernia defects were made in the abdominal wall, which were repaired using absorbable PGA-TMC preperitoneal mesh. The right side of the mesh was fixed with Tissucol ® and left side with conventional suture attached to the muscle fascia. One group of 10 rats were sacrificed at day 14 (series A) and the other 10 rats at 28 days (series B). We used 2 tests to assess the contingency of the abdominal wall; pressure test: pneumoperitoneum more than 40 mm Hg maintained for 1 min, traction test: dynamometry of the affected area more than 300 mg per cm 2 of traction. Abdominal wall was analysed to determine the integration of the new generation mesh. Results The fixation of the mesh after the pressure and traction tests showed no statistically significant changes in either group. The integration of the mesh and vessel neoformation was higher in the cases of fixation with fibrin glue. Conclusions Biological fixation with fibrin glue is similar to the conventional. Absorbable mesh was suitably integrated and vascular neoformation and integration of the mesh was also found to be better than conventional sutures when fibrin sealant was applied.