Advertisement

Hernia

, Volume 4, Issue 2, pp 99–103 | Cite as

Use of histoacryl® for incisional hernia repair

  • R. Fernández Lobato
  • D. Fernández Luengas
  • A. Serantes
  • C. Cerquella
  • J. M. Fradejas
  • M. Moreno Azcoita
Papers

Summary

The use of fibrin glues for the closure of wounds in mesh repair of abdominal wall incisional hernias has been found to reduce the morbidity rate. However, the substances of this type derived from blood have the potential risk of virus transmission. The application of a nonbiologic adhesive would eliminate this risk, while offering the same advantages. We have performed a prospective study with the aim of analyzing results of the application of enbucrylate (Histoacryl ®, B. Braun Melsungen AG, Germany) between the muscle layers and subcutaneous tissue after incisional hernia repair with associated dermolipectomy, assessing local morbidity, mean hospital stay and need of wound care. The study included 42 patients divided into two groups, with and without enbucrylate, and results were compared between the groups. The two groups of patients were homogeneous with respect to their clinical data. The incisional hernia was at the midline in all cases, and was repaired using retromuscular prefascial polypropylene mesh in combination with dermolipectomy. Patients in the Histoacryl ® group developed less local morbidity (seromas, hematomas or abscesses) (p < 0.05), had a shorter mean hospital stay (p < o.o1) and required less wound care. We found that this approach improved the results of surgery for large eventrations when repaired by mesh placement and dermolipectomy and decreased global cost because morbidity and hospital stay were reduced.

Key words

Enbucrilate Tissue adhesive Incisional hernia Mesh repair Prosthesis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1: 15–21Google Scholar
  2. Bruns TB, Simon HK, McLario DJ, Sullivan KM, Wood RJ, Anand KJ (1996) Laceration repair using a tissue adhesive in a children's emergency department. Pediatrics 98 (4 Pt I): 673–675PubMedGoogle Scholar
  3. Chevrel JP, Flament JB (1990) Methodes thérapeutiques. In: Les éventrations de la paroi abdominale. Masson, Paris, pp. 124–126Google Scholar
  4. Chevrel JP, Flament JB (1995) Traitement des éventrations de la paroi abdominale. Techniques chirurgicales. Appareil digestif. Encycl Med Chir Paris, pp. 40–165Google Scholar
  5. Chevrel JP, Rath AM (1997) The use of fibrin glues in the surgical treatment of incisional hernias. Hernia 1: 9–14CrossRefGoogle Scholar
  6. Deysine M (1998) Ventral herniorrhaphy: treatment evolution in a hernia service. Hernia 2: 15–18Google Scholar
  7. Gilbert AI, Graham MF (1997) Infected grafts in incisional hernioplasties. Hernia 1: 77–81Google Scholar
  8. Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J (1993) An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 176 (3): 228–234PubMedGoogle Scholar
  9. Jourdan IC, Bailey ME (1998) Initial experience with the use of N-butyl 2-cyanoacrylate glue for the fixation of polypropylene mesh in laparoscopic hernia repair. Surg Laparosc Endosc 8 (84): 291–293PubMedGoogle Scholar
  10. Kram HB, Clark SR, Ocampo HP, Yamaguchi MA, Shoemaker WC (1991) Fibrin glue sealing of pancreatic injuries, resections and anastomoses. Am J Surg 161: 479–481CrossRefPubMedGoogle Scholar
  11. Leaney AB, Gottsch JD, Stark WJ (1993) Clinical experience with N-butyl cyanocrylate (nexacryl) tissue adhesive. Ophthalmology 100: 173–180Google Scholar
  12. Linden CL Jr, Shalby SW (1997) Performance of modified cyanoacrylate composition as tissue adhesives for soft and hard tissues. J Biomed Mater Res 38 (4): 348–355CrossRefPubMedGoogle Scholar
  13. McLanahan D, King LT, Weems C, Novothey M, Gibson K (1997) Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg 173: 445–449CrossRefPubMedGoogle Scholar
  14. Middleton WG, Mattehews W, Chiasson DA (1991) Histoacryl glue in microvascular surgery. J Otolaryngol 20: 363–366PubMedGoogle Scholar
  15. Müller M, Klinge U, Conze J, Schumperlick V (1998) Abdominal wall compliance after Marlex mesh implantation for incisional hernia repair. Hernia 2: 113–117CrossRefGoogle Scholar
  16. Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH (1993) Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg 128 (1): 70–88Google Scholar
  17. Qureshi A, Drew PJ, Duthie GS, Roberts AC; Monson JR (1997) N-butyl-cyanoacrylate adhesive for skin closure of abdominal wounds: preliminary results. Ann R Coll Surg Engl79 (6): 414–415PubMedGoogle Scholar
  18. Rives J, Pire JC, Flament JB, Convers G (1977) Traitement des éventrations. Encycl Med Chir. Paris. Techniques Chirurgicales 4.2.07, 40165Google Scholar
  19. Schumpelick V, Conze J, Klinge V (1996) Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias. Chirurg 67: 1027–1035Google Scholar
  20. Vestweber KH, Lepique F, Haaf F, Lloratz M, Reink A (1997) Results of recurrent abdominal wall hernia repair using polypropylenemesh. Zentralbl Chir 122: 885–888PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • R. Fernández Lobato
    • 1
  • D. Fernández Luengas
    • 1
  • A. Serantes
    • 1
  • C. Cerquella
    • 1
  • J. M. Fradejas
    • 1
  • M. Moreno Azcoita
    • 1
  1. 1.Servicio de Cirugía General y DigestivoHospital de GetafeMadridSpain

Personalised recommendations