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Published on: September 11, 2021
Reduction of peritoneal adhesion to polypropylene mesh with the application of fibrin glue
E Prieto-Díaz-Chávez1, J Luis Medina-Chávez, E J Ramírez-Barba
1Departamento de Cirugía y Unidad de Investigación en Epidemiología Clínica Hospital General Zona y Medicina Familiar No. 1, Instituto Mexicano del Seguro Social, Colima, México.
Purpose:
The purpose of our study was to evaluate the possibility of the reduction of peritoneal adhesions to a polypropylene mesh with fibrin glue.
Methods:
Forty Wistar rats were assigned to two treatment groups: Group 1) hernioplasty with polypropylene mesh plus fibrin glue sealant, and Group 2) hernioplasty with polypropylene mesh without fibrin glue sealant. The variables evaluated were: presence and density of adhesion, organs or abdominal structures adhered to the polypropylene mesh, inflammatory tissular reaction and cell recount.
Results:
Group 1 presented a statistically lower adhesion percentage than Group 2 (40% versus 100%, P = 0.0003). The mean areas of mesh patch surfaces covered with adhesions were statistically different between Groups 1 and 2 (0.67 +/- 0.65 cm2 versus 1.60 +/- 0.51 cm2; P = 0.00001). Twelve rats presented with adhesions in Group 1; eleven were adhesions to the epiploon and one to the colon. In Group 2 there were 16 adhesions to the epiploon, 2 to the colon, 1 to the small intestine and 1 to the stomach. Tissular reaction comparison showed a significant difference (21 +/- 4.9 versus 17 +/- 4.1; P = 0.006).
Conclusions:
Fibrin glue sealant significantly reduced the frequency and severity of intra-abdominal adhesions.
