Glue Group Research Articles

Is Popularity of Fibrin Glue a Misrepresentation? A Comparative Study with Fibrin Glue and Suture Anastomosis in Rat Sciatic Nerve Injury Analysing Functional, Histological, Electrophysiological Parameters.

Fibrin glue as an adjunct in peripheral nerve injuries has gained recent popularity. Whether fibrosis and inflammatory processes which are the major hindrances in repair reduce with fibrin glue has more of theoretical support than experimental. A prospective nerve repair study was conducted between two different species of rats as donor and recipient. Four comparison groups with 40 rats were outlined with or without fibrin glue in immediate post-injury period with fresh or cold preserved grafts were examined based on histological, macroscopic, functional, and electrophysiological criteria. There was suture site granuloma along with neuroma formation and inflammatory reaction and severe epineural inflammation in allografts with immediate suturing (Group A), whereas suture site inflammation and epineural inflammation were negligible in cold preserved allografts with immediate suturing (Group B). Allografts with minimal suturing and glue (Group C) had less severe epineural inflammation with less severe suture site granuloma and neuroma formation as compared to first two groups. Continuity of nerve was partial in later group as compared to other two. In fibrin glue only group (Group D), suture site granuloma and neuroma were absent, with negligible epineural inflammation, but continuity nerve was partial to absent in most of the rats with some showing partial continuity. Functionally, microsuturing with or without glue demonstrated significant difference with better SLR and toe spread (p = 0.042) as compared with only glue. Electrophysiologically, NCV was maximum in Group A and least in Group D at 12 weeks. We report significant difference in CMAP and NCV between microsuturing group vs. only glue group (p < 0.05) and also between microsuturing with glue group vs. only glue group (p < 0.05). There may be more data required with proper standardization for adept usage of fibrin glue. Though our results have shown partial success, it nonetheless highlights the lack of sufficient data for widespread glue usage.

The use of fibrin glue in pterygium surgery with amniotic membrane transplantation: Systematic review and meta-analysis.

To compare the outcomes of fibrin glue versus sutures in pterygium surgery with amniotic membrane transplantation. A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guidelines. An electronic search identified all studies comparing the outcomes of using fibrin glue versus sutures in pterygium surgery with amniotic membrane transplantation. Conjunctival inflammation, postoperative pain and discomfort, pterygium recurrence, pyogenic granuloma, and surgical time were primary outcome measures. Secondary outcome measures included amniotic membrane transplant outcomes, time to recurrence, graft loss, and subconjunctival hemorrhage. Fixed and random-effects models were used for the analysis. Four studies enrolling 180 patients were identified. Conjunctival inflammation (odds ratio [OR] 0.21, P = 0.0005) demonstrated a significant difference favoring the fibrin glue group. Despite the trend favoring the use of fibrin glue, there were no significant differences in terms of postoperative pain and discomfort (OR = 0.46, P = 0.25), pterygium recurrence (OR = 0.74, P = 0.48), pyogenic granuloma (OR = 0.47, P = 0.38), and surgical time (mean difference = -17.52, P = 0.13). For secondary outcomes, fibrin glue had significantly fewer cases of graft loss compared with sutures. No statistically significant difference was found in amniotic membrane graft outcomes, time to recurrence, and subconjunctival hemorrhage. Fibrin glue is comparable to the sutures used in pterygium surgery with amniotic membrane transplantation as it significantly improves conjunctival inflammation and does not increase postoperative pain and discomfort, pterygium recurrence, pyogenic granuloma, and surgical time.

Prospective comparative study of mesh fixation in laparoscopic TEP hernia repair using tacker versus cyanoacrylate versus fibrin glue tep mesh fixation with cyanoacrylate

Background: Laparoscopic inguinal hernia repairs done by totally extra peritoneal (TEP) or trans abdominal preperitoneal techniques require mesh fixation which is commonly done by either tackers or fibrin glue. In this study, we discuss about using cyanoacrylate glue for mesh fixation as a more cost effective but equally suitable alternate. Aims and Objectives: The aim of the study was to evaluation of suitability of using highly economical cyanoacrylate ($ 0.13) with tackers ($ 318.52) and fibrin glue ($ 11.94) for mesh fixation during TEP hernia repair. Materials and Methods: A comparative study was done in the Department of Surgery over a period of 3 years (2018–2021). This study included 210 patients who underwent laparoscopic TEP hernia repair. Cases were randomized into three groups of 70 subjects each: Group A - mesh was fixed with tacker, Group B - mesh was fixed using cyanoacrylate, and Group C - mesh was fixed with fibrin glue. Subjects were followed up for 3 months. Type of presentation, diagnosis, and type of mesh fixation were compared to post-operative complications that included pain, seroma, hematoma, and urinary retention findings were recorded and data were statistically analyzed using “SPSS” software. Results: Decreased incidence of post-operative pain (P=0.01) and hematoma was observed in Group B as compared to Groups A and C. Average hospital stay was significantly less in fibrin glue group (P=0.02) and cyanoacrylate group (P=0.02) as compared to tacker group. There was same incidence of postoperative urinary retention (P=0.520) and seroma (P=0.354) formation between all groups. Patients of Group B started daily activities earlier at 15 days follow-up (P=0.032) as compared to Groups A and C. Conclusion: Cyanoacrylate and fibrin glue fixation of mesh in laparoscopic TEP have better outcomes when compared to tackers. Furthermore, as cyanoacrylate is 300 times cheaper than tacker and 10 times cheaper than fibrin glue, this imparts a huge cost advantage to this technique in developing countries. Therefore, use of cyanoacrylate for mesh fixation in laparoscopic TEP can be safely advocated over tackers and fibrin glue.

Fibrin glue: an anti-fibrotic agent for contracted socket

Background: The contracted socket is caused by fibrosis leading to the shortening of the orbital tissue. Vascular endothelial growth factor (VEGF) is a profibrotic factor in postoperative wound healing. The novel option to prevent fibrosis is the use of fibrin glue. This study aims to evaluate the role of fibrin glue in reducing the VEGF expression in cells that cause post-socket surgery scar. Methods: An in vivo experimental study using an animal model was conducted. We used twenty eyes of white rabbit species as the study sample. The evisceration was carried out and distributed to the animals in four experimental groups consisting of the control group, the MMC group (0.1 ml of mitomycin-C (MMC) 0.4 mg/ml), the triamcinolone acetonide (TCA) group (0.1 ml of TCA 40 mg/ml), and the fibrin glue group (0,1 ml of fibrin glue). The treatment was performed through injection of the subconjunctival. After 14 days, rabbits were euthanized, and conjunctiva samples were cut. Immunoreactivity scores (IRS) were used to analyze the expression of VEGF in epithelia conjunctiva with a significant level of p &lt;0.05. Data were analyzed using SPSS version 26 for Windows. Results: All groups showed a statistically significant difference in VEGF expression with a p-value 0,000 (p&lt;0,05). The VEGF level was significantly lower in the three treatment groups compared with the control group. The VEGF expression was highest for the control group, followed by fibrin glue, TCA and MMC group. We found significant differences between the control group and the three treatment groups; the MMC group (p=0.001), the TCA group (p=0.002), and the fibrin glue group (p=0.005). While differences in VEGF expression between the three treatment groups could not be proven statistically. Conclusion: Fibrin glue is proven to reduce VEGF expression as a marker of fibrosis; thus, fibrin glue can be an alternative anti-fibrotic agent.

The effect of fibrin glue on suppressing Transforming Growth Factor-β (TGF-β) expression compared to Mitomycin-C (MMC) and Triamcinolone Acetonide (TCA) as antifibrotic agents in contracted socket prevention

Background: Post-evisceration fibrosis remains the leading cause of contracted socket. The application of fibrin glue is considered an alternative adjuvant therapy in suppressing profibrotic factor (TGF-β) expression following evisceration surgery to prevent contracted socket. This study aimed to know the role of fibrin glue in suppressing the TGF-β expression following evisceration surgery. Methods: An in vivo experimental study with a randomized post-test-only control group using twenty New Zealand rabbits were conducted. The sample was divided into four groups, each consisting of five rabbits, and one healthy eye was selected randomly for evisceration. Each rabbit in the study group was given a subconjunctival injection of agents corresponding to each study group, namely: Group I (control [no injection]), Group II (0.1 ml MMC 0.4 mg/ml), Group III (0.1 ml TCA 40 mg/ml), and Group 4 (0.1 ml fibrin glue) at the inferior fornix. Following a 14-day observation period, the animals were euthanized, and tenon conjunctiva in inferior fornix samples was collected for immunohistochemistry (IHC) staining examination. The pathologist calculates the immunoreactive scores (IRS) for each specimen. The differences in TGF-β expression were statistically analyzed with a significant p&lt;0.05. Data were analyzed using SPSS version 26 for Windows. Result: The highest TGF-β expression was found in the control group (I), and the lowest was in the mitomycin-C group (III), followed by the triamcinolone group (IV) and fibrin glue group (II). There were significant differences in TGF-β expression among the four groups (p=0.004). The difference between fibrin glue, MMC, and triamcinolone acetonide groups was insignificant (p&gt;0.05). Conclusion: As an alternative to mitomycin-C and triamcinolone acetonide, fibrin glue can be used as adjuvant therapy to prevent constricted sockets after evisceration.

P-008 PRELIMINARY RESULTS OF A RANDOMIZED CLINICAL TRIAL COMPARING TWO DIFFERENT MESH FIXATION TECHNIQUES IN OPEN RETROMUSCULAR VENTRAL HERNIA REPAIR

Abstract Aim Retromuscular ventral hernia repair has become very popular recently due to its very promising results concerning recurrence and other complications. However, controversy exists regarding the optimal mesh fixation method. The aim of this study is to compare the safety and effectiveness of two mesh fixation techniques. Material &amp; Methods This is an ongoing randomized, prospective, single-blind study. According to study protocol, patients with midline ventral hernias who meet the inclusion criteria, undergo open retromuscular hernia repair and the mesh is fixed either with transfascial sutures or with n-butyl-2-cyanoacrylate glue. In the three-month follow-up patients answer the EuraHS QoL score to assess postoperative pain and other QoL features and are examined for the identification of postoperative complications. The results of the first 20 patients who have completed the three-month follow-up are presented. Results Glue group had an average VAS pain at the site of the hernia of 0.3/10, 0.9/10 and 0.3/10, in rest, during activities, and during last week, respectively, while suture group had 0.3/10, 1.1/10 and 0.6/10, respectively. Concerning the restrictions of daily activities: inside, outside the house, during sports and during heavy labor, glue group had 0.2/10, 0.3/10, 0.6/10 and 1/10 and suture group 0.2/10, 0.4/10, 0.9/10 and 1.1/10, respectively. All differences between groups were not statistically significant. Regarding postoperative complications, only one patient from the suture group presented with seroma. Conclusions The preliminary results slightly favor the glue group, without reaching statistical significance. Retromuscular hernia repair leads to very good early results concerning pain and other complications.

Comparative study between temporalis fascia graft with and without addittion of cyanoacrylate glue in myringoplasty

Background: Tissue adhesives are often used in myringoplasty because they can hold the graft in place and help the graft absorb by acting as a framework. Aim of the study: The goal is to look at the temporalis fascia graft used in myringoplasty with and without cyanoacrylate glue and compare the two. Patients, and methods: Fifty patients with dry central tympanic membrane perforation were treated with type I tympanoplasty over the course of 1.5 years. In each instance, the autogenous temporalis fascia graft was spot welded and fixed to flaps and the surrounding tissue using glue. Myringoplasty was done on 50 people, and they were randomly put into two groups: those who had cyanoacrylate glue put on the temporalis fascia graft and those who didn't. Results: Each group had 25 cases, and there were no big differences between the groups in terms of age, direction, or size of the tympanic membrane hole. After 6 weeks, there wasn't much difference between the glue group and the control group. In the glue group, 72% had healed and 28% had perforated, while in the control group, 64% had healed and 36% had perforated (p-value 0.544).

Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules.

BackgroundPreoperative localization is challenging due to the small diameter of pulmonary nodules or their deep location in the lung parenchyma during VATS surgery. The purpose of this study was to compare the efficacy and safety of both hook-wire and medical glue for pre-operative localization of pulmonary nodules.MethodsIn the current study, 158 patients were retrospectively analyzed (January 2019 and January 2020). The patients underwent hook-wire or medical glue for pre-operative localization of pulmonary nodules. Among them, 74 patients in the hook-wire group and 84 patients in the medical glue group underwent VATS anatomic segmentectomy or wedge resection after localization of pulmonary nodules. Pre-operative localization data from all patients were compiled. Moreover, the efficacy and safety of the two methods were evaluated according to localization success rates and localization-related complications.ResultsThe success rate of localization in the medical glue group was 100% while 97.3% in the hook-wire group. After localization of the pulmonary nodules, the incidence of minor pneumothorax in the medical glue group (11.9%) was lower than that in the hook-wire group (37.8%) (p=0.01). The incidence of mild pulmonary parenchymal hemorrhage in the medical glue group (13.1%) was also lower than that in the hook-wire group (24.3%) (p=0.000). The mean time from the completion of localization to the start of surgery was also longer in the medical glue group than in the hook-wire group (p=0.000). The mean visual analog scale (VAS) scores after localization were higher in the hook-wire group than in the medical glue group (p=0.02). In both groups, parenchymal hemorrhage was significantly associated with the needle length in hook-wire localization and the depth of the medical glue in the lung parenchyma (p = 0.009 and 0.001, respectively).ConclusionThese two localization methods are safe and effective in pre-operative pulmonary nodule localization. The medical glue localization method had a lower risk of complications, a higher localization success rate, less pain after localization and more flexibility in the arrangement of operation time.

Effect of Ejiao (Asini Corii Colla) and Turtle Carapace Glue on Gut Microbiota in Nude Mice with Uterine Fibroids Based on High-Throughput Sequencing of 16SrRNA Gene.

Objective To observe the effects of Asini Corii Colla, turtle carapace glue, and other drugs on the intestinal flora of nude mice with uterine fibroids model, so as to provide evidence for the clinical application of drugs. Methods Set up five groups: blank control group, turtle carapace glue group, turtle carapace glue and ejiao 4 : 1 mixed group, turtle carapace glue and ejiao 1 : 1 mixed group, and turtle shell glue and Salvia miltiorrhiza (danshen) 1 : 1 mixed group. Then, the model nude mice were fed ejiao, turtle carapace glue, and other corresponding drugs. Before administration, 2 weeks after administration, and 4 weeks after administration, the feces of the model nude mice were taken respectively, subpacked into labeled cryotubes, and stored at −80°C. All samples were sent for gene sequencing after completion. The differences in gut microbiota and abundance in different groups were compared by 16SrRNA segment sequencing. Results ① There were differences in flora composition and a relative abundance among the groups, but the strains with a high relative abundance were Bacteroides, Firmicutes, and Proteobacteria; ② there were significant differences in the community structure and composition of intestinal flora between nude mice treated for 4 weeks and those not treated (p < 0.05); ③ after 4 weeks of administration, the relative abundance of Bacteroidetes in each group was higher than that before administration, and the relative abundance of Firmicutes decreased. Conclusion Asini Corii Colla, turtle carapace glue, and other drugs with different compatibility ratios can change the composition of intestinal flora in nude mice with uterine fibroids to a certain extent; the decrease in the relative abundance of Firmicutes and the increase in the relative abundance of Bacteroidetes were important structural changes of intestinal flora in nude mice at 4 weeks after administration.

Preliminary study of rabbits as an animal model of mammalian eye transplantation and literature review

Purpose: To describe an innovative animal model of eye transplantation used in rabbits. Methods: six Dutch-belted male rabbits were submitted to lateral orbitotomy in the right eye, wide retrobulbar anatomy exposure, dissection of the structures, identification and distal section of the optic nerve followed by anastomosis either by vicryl (group 1) or fibrin glue (group 2). Electroretinography recording was performed before the section of the optic nerve and every 30 seconds after, to monitor the function of retina. Left [...]

CORNEAL TOPOGRAPHIC CHANGES AFTER PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTING USING SUTURES VERSUS FIBRIN GLUE: A COMPARATIVE STUDY

Aim: To compare the corneal topographic changes after pterygium excision with conjunctivalautografting using sutures versus fibrin glue. Materials and Methods:A prospective study was conducted on 100 eyes of 100 patients visiting the outpatient Department of Ophthalmology,Government Medical College Srinagar over a period of two years. Patients were randomly allocated in two groups (Group S and Group FG) and underwent complete eye examination along with preoperative corneal topography where corneal astigmatism at central 3mm and total mean refractive power of cornea were noted.50 patients underwent pterygium excision with conjunctivalautografting using 10-0 nylon sutures (Group S) and other 50 underwent same procedure using fibrin glue (Group FG). Corneal topography was again repeated postoperatively in both groups at 2nd week, 1st month, 3rd month and 6th month of follow up and results were noted. Results:The mean age of study patients in suture group was41.7±8.64 years and in fibrin glue group was39.5±9.58 years. The mean corneal astigmatism at central 3mm significantly decreased from 1.95D preoperatively to 0.61D at postoperative 6thmonth following pterygium excision (p-value 0.003) in suture group. The mean preoperative corneal astigmatism in patients in fibrin glue group also decreased from 2.03D preoperatively to 0.62D at 6thmonth postoperative follow up(p value&lt;0.001).The total mean refractive power of cornea increased significantly from 43.17D preoperatively to 44.59 D postoperatively at 6th month of follow up (p value &lt;0.001) in suture group and in fibrin glue group it significantly increased from 43.23D preoperatively to 44.69D at 6thmonth of postoperative follow up (p value &lt; 0.001).However no significant difference was seen in the postoperative corneal astigmatism at central 3mm or total mean refractive power of cornea between the two groups at any follow up. Conclusion:Pterygiumexcision with conjunctiva autografting causes reversal of corneal topographic changes induced by pterygium irrespective of whether fibrin glue or sutures are used for autografting.

Adhesive Glue vs Subcuticular Sutures for Cesarean Section Skin Closure: A Double Blind Randomized Controlled Trial

Objectives: The objectives of the study were to compare the wound complication rate, postoperative pain and overall patient satisfaction between adhesive glue and subcuticular suture in women undergoing elective Caesarean Section (CS). Methods: A double blind Randomized Controlled trial was conducted among pregnant women undergoing an elective CS, who were randomly assigned to skin closure with adhesive glue or with a Polyglactin 3-0 subcuticular suture. In both groups after closure of the rectus fascia, the subcutaneous fat layer was closed with 3-4 interrupted catgut or Vicryl 1-0. In the adhesive glue group, 2 layers of adhesive glue were used to close the outer skin layer. In the suture group, the skin was closed with Polyglactin 3-0 suture under the skin using a continuous suture technique. A sample of 52 in each group was needed to achieve any significant finding with a power of 80%. Primary outcome assessed were parenteral analgesic use, daily subjective pain scores while in hospital, 6 week postoperative subjective pain score and scar cosmetic score 6 weeks post-operatively. Secondary outcome assessed were surgeons satisfaction, duration of surgery, duration of hospitalization after the caesarean, and wound complications. Results: Two hundred pregnant women at term for elective caesarean were assessed for eligibility of which 132 fulfilled the criteria and were randomized into two groups. Sixty women in each group completed the required follow up. Patients’ baseline demographic and clinical backgrounds were similar in both the groups. Postoperative day 3 subjective pain score was significantly lower in adhesive glue group (p=0.023) compared to suture group. Skin closure time with glue required less time compared to suture (glue 2.57±.67 minute vs suture 3.2±1.18 minute, p=0.001). Total operative time was also less in adhesive glue group though the difference was not significant (39.52±8.24 minute vs 42.1±6.10, p=0.054). Scar assessment by the modified patient and observer scar assessment scale (POSAS) at 6 weeks postpartum showed similar cosmetic outcome between the two groups. Patient Scar cosmetic score was 11.8 for glue group and 12.7 for suture group (p=0.330) while the Observer Scar cosmetic score was 10.8 for glue group and 11.7 for suture (p=0.252). No significant differences were observed between the groups in blood loss, surgical site infection, length of hospitalization, or wound breakdown. Conclusion: Adhesive glue may be a useful option for skin closure of Pfannenstiel skin incisions after caesarean delivery. It has the advantages like shorter skin closure and operating time, less postoperative pain and similar cosmesis and satisfaction among surgeons with no increases in wound complication rates. Keywords: Adhesive glue, suture, caesarean section, skin closure

Role of Autologous Fibrin Glue (AFG) to Reduce Drainage Volume After Modified Radical Mastectomy for Breast Cancer

Background: Seroma is arguably the most significant complication that can happen after mastectomy. Although seroma is not a life-threatening complication, this condition can lead to severe morbidities. This situation can cause prolonged hospital stays and delayed adjuvant therapy. In this regard, autologous fibrin glue is a hemostatic agent that can accelerate fibrin formation, stop vascular oozing, and decrease dead space. Therefore, this research was performed to evaluate autologous fibrin glue function in lowering seroma volume after mastectomy and shortening the length of hospital stay.Methods: This randomized control trial research was designed to compare the effect of autologous fibrin glue to a control group that did not receive autologous fibrin glue. Seroma volume was calculated every 24 hours. The drains were then removed after the production of seroma less than 30 mL/24 hours.Results: We recruited 20 patients for each of the two groups who met the inclusion criteria. Age, histopathology type, breast cancer stage, number of lymph nodes, and tumor size did not significantly differ. However, patients in the fibrin glue group had significantly lower cumulative drain production. The median seroma volume in the treatment group was 9.30 mL, while the median in the control group was 20.90 mL (p &lt; 0.05).Conclusions: Autologous fibrin glue significantly decreased seroma formation and length of hospital stay.

Effects of Esterified Hyaluronic Acid, Adipose Tissue, and Blood Glue on Survival of Diced Cartilage Grafts.

Diced cartilage grafts are used for correcting nasal dorsal deformities and irregularities. However, cartilage resorption is among most common problems after rhinoplasty. The purpose of this experimental study was to investigate the effects of esterified hyaluronic acid, adipose tissue, and blood glue on the viability of diced cartilage grafts. A total of 24 Wistar albino rats were used for the study. Cartilage grafts were obtained from 1 side ear and diced. The rats were divided into 4 groups (6 in each group): bare diced cartilage (group 1), diced cartilage wrapped with adipose tissue (group 2), diced cartilage blended with blood glue (group 3), and diced cartilage wrapped with esterified hyaluronic acid (group 4). The grafts were inserted into the subcutaneous pockets of the back of same rat. After 2 months follow-up specimens were harvested for histopathological and dimensional examination. The sections were stained with Hematoxylin and Eosin, Masson-Trichrome, and Elastic Van-Gieson. Chronic inflammation, loss of chondrocyte nucleus, vascularization, foreign body reaction, collagen content of matrix, and extent of elastic fiber were assessed under light microscopy. Foreign body reaction in adipose tissue and blood group was significantly higher than bare cartilage and esterified hyaluronic acid group ( P = 0.001). With respect to loss of chondrocyte nucleus esterified hyaluronic acid group had significant higher rate of nucleus loss than other groups ( P = 0.002). This study suggests that blood glue, esterified hyaluronic acid and autologous adipose tissue have not beneficial effects in improving viability of diced cartilage grafts.

Subcuticular Barbed Suture and Skin Glue Wound Closure Decreases Reoperation and Length of Stay in Geriatric Hip Fractures When Compared With Staples.

Introduction:Patients with geriatric hip fracture are notoriously frail and at risk for complications. Persistent postoperative wound drainage can lead to prolonged hospital stay, increased risk for infection, and need for revision surgery. The purpose of this study was to determine the effect of wound closure technique, barbed monofilament subcuticular suture and skin glue versus staples on rates of intervention for wound drainage and length of hospital stay after geriatric hip fracture fixation.Methods:A retrospective review of isolated hip fractures in patients older than 60 years at a single institution over a 3-year period was done. Hip fractures included femoral neck, intertrochanteric, and subtrochanteric femur fractures treated with internal fixation or arthroplasty. Skin closure technique, at the discretion of the operating surgeon, included either barbed subcuticular monofilament suture and skin glue or staples. Charts and radiographs were reviewed to determine patient characteristics, Charlson Comorbidity Index, type of wound closure, length of stay, and interventions for persistent wound drainage.Results:There were 175 patients in the barbed suture and skin glue group and 211 patients in the staples group. The barbed suture group had an average postsurgical length of stay of 5.0 days which was significantly lower than the staples group (7.0 days, P < 0.00001). In the staples group, 17 patients (8%) required incisional negative pressure wound therapy due to wound drainage with five patients (2.4%) returning to the operating room secondary to persistent wound drainage. No patients were observed in the barbed suture group that required intervention for wound drainage.Discussion:Barbed suture and skin glue closure is associated with markedly shorter hospital stay and fewer interventions for wound drainage when compared with staples after surgical treatment of geriatric hip fractures.

P13.10 Chemoattraction of glioma cells in a local hydrogel trap and immune control associated with improved survival and cognitive functions in a mouse model of glioblastoma resection

Abstract BACKGROUND Glioblastoma (GB) is the most aggressive brain primary tumor. The prognosis remains poor mainly due to the invasiveness of glioma cells, radio and/or chemoresistance and GB-induced immunosuppressive environment. Here, we propose to use a local delivery system based on a biocompatible hydrogel containing the chemopeptide urotensin II (hUII) or a biased synthetic analog DAB8-hUII, to “trap” GB cells, and/or to control immune cells expressing its G protein-coupled receptor UT, leading to tumor regression and neurological benefit, in a mouse model of GB resection. MATERIAL AND METHODS In vitro, invasion towards UII/analog across different hydrogels or glue of human or murine GB-GFP cell lines was evaluated in Boyden chamber and cloning ring assays. In vivo GB cells were intrastriatally xenografted, then resected while hydrogel- or glue-containing UII/analog was injected in the cavity resection. Behavioral tests, brain immunohistochemical analyses and mouse survival were then investigated. RESULTS In vitro, invasive capacity of human U87 and 42MG or murine GL261 and CT2A GB cells was stimulated by UII loaded into hydrogel-based hyaluronic acid supplemented with collagen or other chemicals, PNIPAAm-PEG, or thrombin-fibrin glue. In vivo, injection of UII- or DAB8-hUII-loaded glue into the cavity resection of GL261 and CT2A GB in C57BL/6 mice significantly improved survival compared with tumor and resected experimental conditions. Neurological status was also tested before and after GB resection. We found that GL261 and CT2A cell-bearing mice expressed altered spontaneous activity, emotion and cognitive functions. Intracavity injection of the glue improved resignation and anxiety and increased motor activity and cognition with a best cognitive recovery with hUII and DAB-8-hUII-loaded glue groups. Ex vivo brain analyses revealed high expression of UT and UII in some GB GFP-positive cells and macrophages within GB core and at the interface with the normal brain, GB cells expressing UT migrating along tortuous podocalyxin+ vascular components. In brains bearing hydrogel/hUII glue, vascularization appears modified and GFAP+ astrocytes and F4/80+ macrophages were highly recruited in the border of the cavity, compared with the other conditions. CONCLUSION A local glue containing UII may trap GB cells and remodel the tumor microenvironment responsible for survival and cognitive improvements, providing new option in the therapeutic arsenal of GB.

Mesh fixation with fibrin glue versus tacker in laparoscopic totally extraperitoneal inguinal hernia repair.

The advent of mesh was a breakthrough in the field of hernia surgery. Mechanical methods of mesh fixation are hypothesized to cause more tissue trauma than nonmechanical methods. The present study was conducted to study the outcomes of mesh fixation using fibrin glue, a nonmechanical method versus tackers in totally extraperitoneal repair (TEP) of unilateral inguinal hernia. A randomized controlled single blinded study was conducted in India from June 2017 to March 2019. Patients diagnosed with unilateral uncomplicated inguinal hernia with a hernial sac of size not more than 5cm were invited to participate in the study. Sample size was 60 patients randomized into groups just before mesh fixation. In group A mesh was fixed using tackers while in group B mesh was fixed using fibrin glue. Patients were followed-up prospectively for 3 months. There was no statistical difference between the two groups with respect to operating time. Average hospital stay and pain scores at all follow-ups were better for fibrin glue group. There was no difference in the incidence of postoperative urinary retention, seroma formation and hematoma formation between the two groups. Patients of fibrin glue group had early restart of daily activities at 15 days follow-up when compared to tacker group. Fibrin glue fixation technique should be advocated over tackers for mesh fixation in TEP considering the better outcomes and cost-effectiveness of the technique.

Comparison of efficacy of conjunctival autografts using sutures and fibrin glue in patients undergoing pterygium excision surgery

Background: Pterygium is a wing-shaped ocular surface lesion traditionally described as an encroachment of bulbar conjunctiva onto the cornea. Hence; the present study was undertaken for comparing the efficacy of conjunctival autografts using sutures and fibrin glue in patients undergoing pterygium excision surgery. Materials & Methods: 40 patients presenting with the pterygia of various types were enrolled. Patients were divided into 2 groups with 20 patients in each group, for applying sutures and fibrin glue to one group each. Each eye of the patient was considered as one case. Screening of the patient by brief history and general physical examination was done. Diffuse torch light examination for details of the pterygium and to rule out any other gross ocular pathology. Follow-up was done and postoperative findings were compared. Results: Mean duration of surgery of the suture group and the glue group were 31.5 minutes and 18.4 minutes respectively. Significant results were obtained while comparing the mean duration of surgery. Patient discomfort was significantly less in the glue group in comparison to the suture group. Conclusion: From the above results, the authors concluded that the use of fibrin glue to attach the free conjunctival autograft in pterygium surgery produces shorter operating time and less post-operative discomfort as compared to sutures.

English

BACKGROUND Pterygium removal is prone for recurrence. Use of conjunctival autografting is considered the most suitable approach that can lower the recurrence. Traditionally, the conjunctival autograft (CAG) is attached to the sclera by suturing. Recently fibrin glue has been used as an alternative to suturing. Advantages being shortened operating time, improved postoperative comfort and absence of suture related complications. Fibrin glue (Baxter TISSEEL kit) is a biological tissue which has a fibrinogen component and a thrombin component prepared by processing plasma. On activation of human fibrinogen by thrombin it imitates the final stage of the coagulation cascade and acts as a tissue adhesive. Fibrin glue is absorbable, relatively easy to use and can be kept at room temperature or in a refrigerator. We wanted to compare the postoperative outcomes in patients undergoing pterygium surgery with conjunctival autografting using fibrin glue (fibrin glue group) in comparison to suturing with 10 - 0 nylon (suture group). METHODS This was a prospective study carried out at M.R. Medical College, Kalaburgi, in the Department of Ophthalmology. Patients with pterygium were enrolled into the study after taking informed and written consent. Clinical grading of pterygium was done as Grade 1 - &lt; 2 mm onto cornea, Grade 2 – 2 to 4 mm onto the cornea, Grade 3 - &gt; 4 mm onto the cornea. 100 subjects were randomly divided into 2 groups of 50 patients each undergoing pterygium surgery between Nov 2018 and Oct 2019. Group 1: Conjunctival autograft with 10 0 nylon suture. Group 2: Conjunctival autograft with fibrin glue. A post-operative comfort scale was used to assess pain, foreign body sensation and lacrimation. These patients were followed up on postoperative day 1, one week, 1 month for postoperative signs and symptoms and 6 months for any recurrence of pterygium. RESULTS Patients in the fibrin glue group experienced significantly less pain, foreign body sensation and lacrimation on day-one, 1 week and at 1 month after surgery, compared to those in the suture group. Other complications like graft oedema, graft retraction, corneal scarring, sub graft haemorrhage were noted in both the groups. At the end of 6 months follow up, no recurrence was noticed in both the groups. CONCLUSIONS The use of fibrin glue for attaching autografts in pterygium surgery is an effective method with global autograft success, less post-operative discomfort like pain, foreign body sensation, lacrimation and less chance of recurrence. KEYWORDS Pterygium, Conjunctival Autograft, Suture, Fibrin Glue

Decreasing leakage during continuous femoral nerve catheter fixation using 2-octyl cyanoacrylate glue (Dermabond\xae): a randomized controlled trial

BackgroundContinuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. A common problem encountered with CPNCs is pericatheter leakage, which can lead to dressing adhesive failure. Frequent dressing changes increase the risk of catheter dislodgement and infections. Adhesive glue is effective in securing the peripheral nerve catheter and decreasing leakage around the catheter insertion site. This study aimed to evaluate the incidence of pericatheter leakage with fixation using 2-octyl cyanoacrylate glue (Dermabond®) as compared to sterile strips.MethodsThirty patients undergoing unilateral total knee arthroplasty (TKA) with continuous femoral nerve catheter for postoperative analgesia were randomized into the catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) group or the sterile strip group. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included the frequent of catheter displacement, the difficulty of catheter removal, pain score and patient satisfaction.ResultsThe incidence of pericatheter leakage at 24 and 48 h was 0% versus 93 and 0% versus 100% in the Dermabond® and sterile strip groups, respectively (P < 0.001). The incidence of displacement at 24 and 48 h was 6.7% versus 93.3 and 6.7% versus 100% in the Dermabond® and sterile strip, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal, or satisfaction scores between groups.ConclusionsCatheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) decreased the incidence of pericatheter leakage, as well as catheter displacement, over 48 h as compared to sterile strip fixation.Trial registrationThis trial was registered on Thai clinical trial registry: TCTR20200228002, registered 24 February 2020- Retrospectively registered.