Análise das aderências resultantes da fixação de telas cirúrgicas com selantes de fibrina e sutura: modelo experimental intraperitoneal

Abstract

Comparison of fixation was statistically different only with PP mesh, with lesser degrees of adherence when using the glue. Adhesions were predominantly located at the extremities of the meshes studied.

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

“…There were significant benefits favoring the fibrin sealant group for the incidence of seroma at week 1 (64% versus 92%, P = 0.017) and at month 1 (28% versus 72%, P = 0.002); seroma volume at week 1 ( P = 0.002) and month 1 ( P = 0.001); and abdominal wall normalization as determined by patients input at week 1 (52% versus 24%, P = 0.041) and at month 1 (88% versus 64%, P = 0.047). An in-vivo study in Wistar rats [155] performed by placing pieces of mesh to the abdominal wall found that no adhesions occurred to coated or uncoated polypropylene mesh and that fixation strength was stronger when uncoated mesh was used with sutures than with fibrin sealant ( P < 0.01). The methodology, however, included the placement of only one drop of fibrin sealant placed at the middle of the patches as opposed to the sutures that were placed at the 4 corners of the patches.…”

Critical Analysis of Experimental Model for Study of Adhesions After Incisional Hernias Induced in Rats’ and Repair of Abdominal Wall With Different Biomaterials

“…Another option would be to resect fragments of the abdominal wall in various shapes: rectangular 1 6 23 , triangular 9 , squares 16 , ellipsoids 24 30 , or even defects made laterally to the midline 9 22 28 . Regarding the repair of the defect, it can be made with all the fragments of the prosthesis within the cavity 3 9 6 11 19 21 30 or just suturing the edges in a "bridge" shape 1 6 16 22 23 24 , tactic used in this research.…”

“…Montes et al 21 employed in the same study two opening options of the abdominal cavity of the rat: by a median incision, polypropylene prostheses measuring 2x2 cm sutured with four stitches applied to the angles were implanted. In another group of animals, an incision in the form of "u" on the wall was performed, in order to deploy prostheses of the same material and size, but attached to the peritoneum with a fibrin sealant drop applied in its center, with no use of stitches.…”

“…Biomaterial implants in the abdominal wall allowed the development of classical experimental models for the study of its biocompatibility. They can be basically divided on: 1) those which an incision is made with standard size on the linea alba and its repair is made with different prostheses in the first operation 11 19 21 ; 2) on those that resect fragments with various formats of the wall 9 22 23 30 and also perform primary repair 1 10 29 ; and on 3) those whose model is similar to the usual clinical condition, initially producing an incisional hernia, with its subsequent correction 4 . The focus of these studies is the consequence of the synthetic implants directly in contact with the abdominal viscera, a topic that has gained importance with the development of laparoscopy as an option for treating ventral hernias 5 16 18 25 .…”