A new method to close an intestinal wall defect using fibrin glue and polyglycolic acid felt sealant
Masayuki Kubota1, Naoki Okuyama, Yutaka Hirayama
1Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan. mkubota@med.niigata-u.ac.jp
Purpose:
This study aimed to propose an alternative method of suture closure for an intestinal wall defect using 2 absorbable materials.
Methods:
An oval intestinal wall defect was created in the duodenum, ileum, or colon of rabbits. The defect was first covered by polyglycolic felt, which was then completely covered by fibrin glue to make a fibrin glue and polyglycolic acid felt (FGPAF) sealant without any suture procedures. The rabbits with a simple suture closure for the defect were used as controls. The bursting pressure of the treated intestine was measured, and macro- and microscopic observations were carried out for 6 months.
Results:
Seven rabbits treated with the FGPAF sealant used in each of the 3 operated regions survived without any signs of peritonitis or intestinal obstruction, similar to the controls. The mean bursting pressure of the segment with wall defect closed by single layer sutures and the segment with FGPAF sealant was 69.7 mm Hg (n = 6) and 70.6 mm Hg (n = 7), respectively. A histologic study at 1 week after operation revealed that the FGPAF circumferentially adhered to the edge of the defect with fibrous tissue extension into the sealant; whereas when performing a laparotomy at 1 month after operation, a round mass consisting of the remnant FGPAF mixed with plant residues of daily chows was found loosely attached to the serousal surface.
Conclusion:
These results suggest that the present technique may be useful for the new technique of intestinal wall closure.
