Octylcyanoacrylate tissue adhesive as an alternative to mechanical fixation of expanded polytetrafluoroethylene prosthesis

In minimally invasive incisional hernia repair positioning and fixation of the expanded polytetrafluoroethylene (ePTFE) mesh prosthesis on the deep su rface of the abdominal wall may be facilitated using tissue adhesives. Octy lcyanoacrylate (OCTYL), a new adhesive, forms a strong flexible bond with a ntimicrobial properties. In a rabbit model for incisional hernia we investi gated characteristics of the bond created by OCTYL between ePTFE and abdomi nal wall musculature. We studied initial bond strength and the postoperativ e host response to the adhesive over a 6-week period. We compared sutured, stapled, and glued mesh prostheses and examined the tissue-prosthesis inter face. The ePTFE mesh was fixed successfully to the abdominal wall with OCTY L and remained tightly attached at 6 weeks. Prostheses fixed with OCTYL and spiral tacks induced few intra-abdominal adhesions compared with sutured m esh. All prostheses were completely reperitonealized at 2 weeks. The force required to displace mesh fixed with sutures and staples was greater than m esh fixed with OCTYL. Analysis of the ePTFE/tissue interface by light and s canning electron microscopy showed host cellular migration into the interst ices of the mesh with fixation by tacks and suture, whereas an inflammatory infiltrate was seen on the muscular surface with OCTYL fixation of the mes h.