Use Of Absorbable Cyanoacrylate Glue To Repair An Open Cystotomy

Abstract

A biodegradable cyanoacrylate glue was tested for its ability to close bladder injuries in an established porcine model. Inflammation and encrustation associated with this glue were examined in a rabbit model. Four domestic pigs underwent transverse cystotomy, which was closed with absorbable cyanoacrylate glue. Four weeks later the bladder was distended with normal saline to evaluate the repair. A total of 45 rabbits underwent cystotomy, which was closed with polyglactin suture, absorbable cyanoacrylate glue or nonabsorbable 2-octyl cyanoacrylate glue. The bladder was harvested at 4 or 12 weeks to evaluate inflammation, microcalcification and encrustation. All 4 pig bladders tolerated a pressure of 200 mm. Hg 4 weeks after closure. In the rabbit bladders there was no difference in inflammation in the groups at 4 and 12 weeks. The absorbable glue and suture groups had less microcalcification than the 2-octyl cyanoacrylate glue group at 4 and 12 weeks (p = 0.01 and 0.02, respectively). Encrustation was less in the suture and absorbable glue groups than in the 2-octyl cyanoacrylate glue group at 4 and 12 weeks (p = 0.004 and 0.02, respectively). An experimental absorbable cyanoacrylate glue has the strength to seal a large cystotomy. The inflammatory response to absorbable glue is similar to that to suture at 12 weeks. Absorbable glue does not promote calcification. These properties may make it a suitable material for replacing or augmenting suture in the urinary tract.