Use of histoacryl® for incisional hernia repair
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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 wordsEnbucrilate Tissue adhesive Incisional hernia Mesh repair Prosthesis
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- Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1: 15–21Google Scholar
- Chevrel JP, Flament JB (1990) Methodes thérapeutiques. In: Les éventrations de la paroi abdominale. Masson, Paris, pp. 124–126Google Scholar
- Chevrel JP, Flament JB (1995) Traitement des éventrations de la paroi abdominale. Techniques chirurgicales. Appareil digestif. Encycl Med Chir Paris, pp. 40–165Google Scholar
- Deysine M (1998) Ventral herniorrhaphy: treatment evolution in a hernia service. Hernia 2: 15–18Google Scholar
- Gilbert AI, Graham MF (1997) Infected grafts in incisional hernioplasties. Hernia 1: 77–81Google Scholar
- Leaney AB, Gottsch JD, Stark WJ (1993) Clinical experience with N-butyl cyanocrylate (nexacryl) tissue adhesive. Ophthalmology 100: 173–180Google Scholar
- 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
- Rives J, Pire JC, Flament JB, Convers G (1977) Traitement des éventrations. Encycl Med Chir. Paris. Techniques Chirurgicales 4.2.07, 40165Google Scholar
- 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