A sutureless technique using cyanoacrylate adhesives when creating a stoma for extremely low birth weight infants

Abstract

PurposeIntestinal perforation and necrotizing enterocolitis (NEC) are neonatal intestinal emergencies that are especially common in premature infants. While prompt surgical intervention, including stoma creation, is often required, the optimal surgical treatment has been controversial because of the substantial risks related to the stoma creation and management. The use of a tissue adhesive may have some advantages over the use of sutures when creating an intestinal stoma in extremely low birth weight (ELBW) infants. The purpose of this report was to present a novel approach for creating a stoma using a tissue adhesive in ELBW infants.MethodsA total of eight ELBW infants that underwent laparotomy with the creation of intestinal stomas using cyanoacrylate adhesive at our institution between 2009 and 2014 were enrolled. The clinical parameters, including the length of the operation, intra- and postoperative complications and the outcomes were evaluated.ResultsThe median body weight and gestational age at birth were 630 g and 24.3 weeks, respectively. The median age at referral was 11.5 days. The median length of the procedure was 58.5 min, including the inspection and resection of the intestine. All procedures were completed without any intraoperative complications. There were no postoperative complications associated with the stoma. Two patients died of the associated septic status.ConclusionsSutureless enterostomy using cyanoacrylate adhesive is a simple technique which has the potential to reduce the incidence of complications related to the intestinal stoma in ELBW infants.

The aplication of cyanoacrilate surgical glue on skin suture in rats

“…compounds have been used as complement to conventional sutures. There are studies that show that they are able to create syntheses with no suture in intestines since they do not cause tissue ischemia 6,7 .…”

Distribution and Determinants of Low Birth Weight in Developing Countries

“…This adverse pregnancy outcome may be influenced by several conditions, such as heart disease, diabetes, hypertension, behavioral disorders, impaired cognitive function, psychological disorders, and a substantial risk of complications related to the stoma includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, urinary bladder, and kidney pelvis etc. [ 8 ], and usually incurs long-term financial burdens for households [ 9 , 10 ]. Furthermore, with the demographic change of increased life expectancy at birth in developing countries, children born with LBW can cause an increased economic burden and an increased disease burden [ 10 , 11 ].…”

Evaluation of Tissue Response in Sites Sutured with Cyanoacrylate and Submitted to Low Power Laser Therapy: A Randomized Clinical Trial

“…Another study compared the reaction to the absorbable suture thread with laser application. This demonstrated that photodynamic therapy was not appropriate forreabsorbable materials, since it promoted slower absorption of the material, which, in turn, triggered foreign body reactions during the observation period [14]. In this study, no differences were observed regarding the use of nylon or cyanoacrylate in the inflammatory response, with recruitment of lymphocytes, neutrophils, presence of edema and hyperemia.…”

“…The study of tissue reaction has a direct contribution on the prediction of results. Planning, execution and adoption of precautionary measures are of great importance in surgical practice, in order to reduce inflammatory response, as is as the use of photodynamic therapy to modulate inflammation, promote analgesic effects and induce tissue repair [14].…”