Introduction of Flexible Cyanoacrylates in Sutureless Gastric Closure

Introduction of Flexible Cyanoacrylates in Sutureless Gastric Closure

Background. Clinical effectiveness and safety of biological and synthetic adhesives in digestive closures have been evaluated. Their use is becoming more prevalent, as rigidity and inflexibility are its more remarkable weaknesses. However, little is known about their role in gastric and anastomotic...

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Published in:Surgical innovation Vol. 23; no. 5; pp. 490 - 497
Main Authors: Julián Ibáñez, Joan F., Tarascó Palomares, Jordi, Navinés López, Jordi, Balibrea del Castillo, José M., Odermatt, Erich K., Pacha González, Miguel A., del Castillo Riestra, Luis F., Guardia Torner, Natàlia, Turon Dols, Pau, Fernández-Llamazares Rodríguez, Jaime
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01-10-2016
Subjects:
Abdominal Wound Closure Techniques
Animals
Confidence Intervals
Cyanoacrylates - pharmacology
Male
Models, Animal
Random Allocation
Rats
Rats, Wistar
Statistics, Nonparametric
Stomach - surgery
Suture Techniques
Sutureless Surgical Procedures - methods
Tissue Adhesives - pharmacology
Wound Healing - physiology
NOTES
tissue engineering
biomedical engineering
gastric surgery
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Summary:Background. Clinical effectiveness and safety of biological and synthetic adhesives in digestive closures have been evaluated. Their use is becoming more prevalent, as rigidity and inflexibility are its more remarkable weaknesses. However, little is known about their role in gastric and anastomotic closures. Moreover, usefulness of novel flexible types of synthetic adhesives as n-butyl-cyanoacrylate has not been assessed yet. Materials and Methods. One centimeter long gastrotomy was performed in 24 male Wistar rats, which were divided depending on the type of closure method employed: manual USP 5/0 silk interrupted suture versus sutureless closure with Histoacryl Flexible (n-butyl-cyanoacrylate with softener) or Histoacryl Double Component (n-butyl-cyanoacrylate with softener and hardener). Microscopic evaluation of the suture viability and integrity was performed, and adhesion formation during the cicatrization process were assessed. During an 8-week follow-up clinical and histopathological aspects as well as hematologic and inflammatory biomarkers were studied. Results. No differences among groups where found in any of the clinical, analytical, or histopathological issues assessed except for a higher incidence rate of adhesions in the Histoacryl Double Component group when compared with hand-sewn suture group (P = .04). Our results support experimental studies in large mammals (pigs) for further study of sutureless hollow viscera closure.
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ISSN:1553-3506
1553-3514
DOI:10.1177/1553350616639142