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首页> 外文期刊>Surgical Endoscopy >A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats.
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A comparison of a bovine albumin/glutaraldehyde glue versus fibrin sealant for hernia mesh fixation in experimental onlay and IPOM repair in rats.

机译：牛白蛋白/戊二醛胶与纤维蛋白封闭剂在大鼠实验网架和IPOM修复中用于疝气网固定的比较。

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BACKGROUND: Research in hernia repair has targeted new atraumatic mesh fixation to reduce major complications such as chronic pain and adhesion formation. The efficacy and safety of two surgical adhesives, viz. Artiss(R) (FS, fibrin sealant containing 4 IU thrombin) and Bioglue(R) (AGG, bovine serum albumin/glutaraldehyde glue), were evaluated in this study. Primary study endpoints were tissue integration, dislocation, and adhesion formation. Foreign-body reaction formed the secondary study endpoint. METHODS: Twenty-four polypropylene meshes (VM, Vitamesh(R)) were randomized to four groups (n = 6): two groups of onlay hernia repair (two meshes per animal) with mesh fixation by FS (O-FS) or by AGG (O-AGG), and two groups of IPOM repair (one mesh per animal) with mesh fixation by four sutures and FS (I-FS) or AGG (I-AGG). Eighteen rats underwent surgery. Follow-up was 30 days. Tissue integration, dislocation, seroma formation, inflammation, adhesion formation, and foreign-body reaction were assessed. RESULTS: Meshes fixed with FS (O-FS, I-FS) showed good tissue integration. No dislocation, seroma formation, or macroscopic signs of inflammation were detectable. Adhesion formation of I-FS was significantly milder compared with I-AGG (P = 0.024). A moderate foreign-body reaction without active inflammation was seen histologically in O-FS and I-FS groups. Samples fixed with AGG (O-AGG, I-AGG) showed extensive scar formation. No dislocation and no seroma formation were observed. All of these samples showed moderate to severe signs of inflammation with abscess formation in the six meshes of O-AGG. Histology underlined these findings. CONCLUSIONS: The fibrin sealant adhesive showed very good overall results of the primary and secondary outcome parameters. FS is a recommendable atraumatic fixation tool for the surgical onlay technique. AGG provides high adhesive strength, but shows low biocompatibility. Persisting active inflammation was seen in both the O-AGG and I-AGG groups, not favoring its use for these indications.
机译：背景：疝气修补的研究已针对新型无创伤网状固定，以减少主要并发症，例如慢性疼痛和粘连形成。两种手术粘合剂的功效和安全性。在这项研究中评估了Artiss（FS，含有4 IU凝血酶的纤维蛋白密封剂）和Bioglue（AGG，牛血清白蛋白/戊二醛胶）。主要研究终点为组织整合，脱位和粘附形成。异物反应形成了次要研究终点。方法：将二十四个聚丙烯网片（VM，Vitamesh（R））随机分为四组（n = 6）：两组用疝气修补术（O-FS）或通过网眼固定的疝修补术（每只动物两个网片）。 AGG（O-AGG）和两组IPOM修复（每只动物一个网眼），通过四根缝合线和FS（I-FS）或AGG（I-AGG）进行网眼固定。十八只大鼠接受了手术。随访30天。评估组织整合，脱位，血清肿形成，炎症，粘连形成和异物反应。结果：用FS固定的网片（O-FS，I-FS）显示出良好的组织整合。未检测到脱位，血清肿形成或炎症的宏观体征。与I-AGG相比，I-FS的粘附形成要轻得多（P = 0.024）。在组织学上，在O-FS和I-FS组中观察到中等程度的异物反应，没有活动性炎症。用AGG（O-AGG，I-AGG）固定的样品显示出广泛的疤痕形成。没有观察到脱位和血清肿形成。所有这些样品在O-AGG的6个网孔中均显示出中度至严重的炎症迹象，并形成脓肿。组织学强调了这些发现。结论：纤维蛋白密封胶显示出主要和次要结果参数的总体效果非常好。 FS是用于手术覆盖技术的推荐的无创伤固定工具。 AGG具有高粘合强度，但生物相容性低。在O-AGG和I-AGG组中均观察到持续性活动性炎症，因此不赞成将其用于这些适应症。

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