Structural Analysis and Application of n‐Alkyl Cyanoacrylate Surgical Adhesives to the Fixation of Meshes for Hernia Repair

Abstract

The article deals with a comparative analysis of the parameters of the polymerization in physiological conditions of three commercially available alkyl cyanoacrylates, n-butyl cyanoacrylate (GLUBRAN 2), n-hexyl cyanoacrylate (IFABOND), and n-octyl cyanoacrylate (EVOBOND), the cell behavior of the corresponding polymers and the application of these adhesives in the fixation of surgical polypropylene meshes for hernia repair in an animal model of rabbits. The results obtained demonstrate that the curing process depends on the nature of the alkyl residue of the ester group of cyanoacrylate molecules, being the heat of polymerization lower for the octyl derivative in comparison with the hexyl and butyl, and reaching a maximum temperature of 35 °C after a time of mixing with physiological fluids of 60-70 s. The cell behavior demonstrates that the three systems do not present toxicity for fibroblasts and low adhesion of cells, which is a positive result for application as tissue adhesives, especially for the fixation of abdominal polypropylene meshes for hernia repair. The animal experimentation indicates the excellent tolerance of the meshes fixed with the cyanoacrylic adhesives, during at least a period of 90 d, and guarantees a good adhesion for the application of hernia repair meshes.

Pre-clinical assay of the tissue integration and mechanical adhesion of several types of cyanoacrylate adhesives in the fixation of lightweight polypropylene meshes for abdominal hernia repair

“…The suitability of these tissue adhesives in the fixation of high-density PP prostheses has already been tested by different authors and by our group in previous preclinical studies [ 22 , 28 , 44 – 46 ], which showed proper fixation and effective biocompatibility. The main problem of the CAs has turned out to be the general increase in the macrophagic response with respect to the sutures.…”

A novel injectable tissue adhesive based on oxidized dextran and chitosan

“…Having such multipurpose advantages, the tissue adhesives have been explored as hemostats, as drug delivery systems for the delivery of bioactive agents, sealants to prevent fluid or gas loss from the body, and as wound dressings [1,2]. Besides this, tissue adhesives have also been employed for fixation of surgical meshes for hernia repair [3], treatment of meniscus tears [4], abdominoplasty [5], plastic surgery [6] and as bone cements [7]. Though there are numerous tissue adhesives commercially available, none of them is completely devoid of shortcomings.…”