Comparison of 2-octyl cyanoacrylate adhesive, fibrin glue, and suturing for wound closure in the porcine urinary tract

Objectives. To evaluate 2-octyl cyanoacrylate glue (OCG) for wound closure in the urinary tract and compare the ability of OCG, fibrin glue (FC), and suture to withstand physiologic and supraphysiologic stress, because the us e of tissue adhesives such as OCG or FG might simplify laparoscopic surgery . Methods. Female domestic pigs (n = 22) underwent a 7.5-cm cystotomy. Of the se, 8 had closure with OCG and 8 with FG (6 open and 2 laparoscopic in each group). The controls were closed with suture (n = 4) or not at all (n = 2) . Postoperative catheter drainage was not used. At 2 days or 4 weeks postop eratively, the bladders were filled with saline to 200 mm Hg pressure and t he cystotomy scars inspected for leakage. The excised scars were also exami ned histologically. Results. The 2 OCG and 2 FG pigs tested on postoperative day 2 leaked at le ss than 200 mm Hg. None of the 6 OCG pigs tested at 4 weeks leaked at less than 200 mm Hg, including the 2 closed laparoscopically. Of the 6 FC pigs i ntended for study at 4 weeks, 3 (including the 2 closed laparoscopically) d ied from a massive urine leak, 1 tested at 4 weeks leaked, and 2 did not le ak. Thus, 4 of 6 FG pigs leaked by 4 weeks compared with none in the OCG gr oup (P = 0.06). The histologic examination was similar in the two groups. Conclusions. Preliminary results suggest that OCG provides enough strength to hold together a large bladder wound. In the same model, FG did not consi stently provide adequate closure. UROLOGY 57: 806-810, 2001. (C) 2001, Else vier Science Inc.