Use of histoacryl® for incisional hernia repair

Abstract

The use of fibrin glues for the closure of wounds in mesh repair of abdominal wall incisional hernias has been found to reduce the morbidity rate. However, the substances of this type derived from blood have the potential risk of virus transmission. The application of a nonbiologic adhesive would eliminate this risk, while offering the same advantages. We have performed a prospective study with the aim of analyzing results of the application of enbucrylate (Histoacryl ®, B. Braun Melsungen AG, Germany) between the muscle layers and subcutaneous tissue after incisional hernia repair with associated dermolipectomy, assessing local morbidity, mean hospital stay and need of wound care. The study included 42 patients divided into two groups, with and without enbucrylate, and results were compared between the groups. The two groups of patients were homogeneous with respect to their clinical data. The incisional hernia was at the midline in all cases, and was repaired using retromuscular prefascial polypropylene mesh in combination with dermolipectomy. Patients in the Histoacryl ® group developed less local morbidity (seromas, hematomas or abscesses) (p < 0.05), had a shorter mean hospital stay (p < o.o1) and required less wound care. We found that this approach improved the results of surgery for large eventrations when repaired by mesh placement and dermolipectomy and decreased global cost because morbidity and hospital stay were reduced.