Histological assessment of titanium and polypropylene fiber mesh implantation with and without fibrin tissue glue

Abstract

Polypropylene (PP) and titanium (Ti) meshes are well-known surgical implants that provoke a relative low foreign body reaction. Firm stabilization of the implant is important to prevent migration and subsequent failure of the operation. Fibrin tissue glues are commercially available adhesives and are widely accepted and applied in the medical field for hemorrhage, surgical bleeding, support of wound healing, wound and tissue gluing, sealing, and closure but also as antiadhesive agent in certain applications. The objective of this study was to evaluate the additional histological effect of fibrin glue application combined with two different types of meshes. Six pieces of mesh of each were subcutaneously implanted for 3, 6, and 12 weeks, with and without fibrin glue. After excision, processing, and staining, light microscopic analysis was performed on the sections, using subjective histological description and histomorphometry. Capsule quality, capsule thickness, interstitial quality, and total score were evaluated. To compare the samples with glue and without glue, analysis of variance (ANOVA) tests were carried out. No complications were observed. In general, the glue remnants remained visible at 3 and 6 weeks of implantation, accompanied by an inflammatory reaction and macrophage activity. At 12 weeks, all samples showed good tissue integration without evidence of glue. Evidently, the samples with glue demonstrated a prolonged inflammatory response and were surrounded by fibrous tissue capsules that were significantly thicker compared with the samples without glue (p < 0.05).

Primary mesh augmentation with fibrin glue for abdominal wall closure—investigations on a biomechanical model

“…Reliable integration of the mesh is assured at a later stage, thanks to the earlier scar formation mediated by the use of fibrin glue [37]. This means that, here too, it can be assumed that less pressure is being exerted on the laparatomy wound as it heals.…”

“…But, once again, the question arises as to how such meshes are to be fixed so that they can assume an effective prophylactic role. By means of other models of hernia repair, it was possible to demonstrate that mesh fixation with fibrin glue could be equated with sutureor staples-based fixation [35][36][37] and that this could even expedite mesh integration into the surrounding tissue.…”

Kasık Fıtığı Onarımında Fibrin Dolgu Maddesi ve Zımba Tabancanın Karşılaştırılması

“…Increased fibroblast activity even resulted in better and faster incorporation of the mesh material 6 . A lower rate of early postoperative pain with earlier reconvalescence is reported, but also, and primarily, a reduction in chronic pain in comparison with mesh fixation using staples 7 .…”

Additive Manufacturing Technology Applications Targeting Practical Surgery

“…Moreover, by having spatially asymmetric (for example elongated) lattice cells one can manufacture the structures with desired anisotropic mechanical properties, for example stiff in one direction and flexible in two others. Though significant success in using lattice and porosity within EBM ® -manufactured structures is already achieved [23,27,[34][35][36][37][38] , further research is under the way in many groups across the world. Here the designer inspiration could be taken from the structural studies of strongly anisotropic natural materials like wood, and crystal lattice cells.…”

“…Implants with surface lattice and porosity are reported to have better bone ingrowths and higher stability in the functioning body [23][24][25][26][27][28][29][30][31][32][33][34] . AM technology easily combines mesh structures with different lattice cells and solid parts in the same technological process.…”