Evaluation of acute fixation strength of absorbable and nonabsorbable barrier coated mesh secured with fibrin sealant

Introduction The purpose of this study was to evaluate the acute fixation strength of fibrin sealant as an alternative fixation method for laparoscopic ventral hernia repair (LVHR) when utilized with absorbable and nonabsorbable barrier meshes. Methods Representative mesh types for LVHR included one nonabsorbable barrier mesh (Bard ® Composix™) and three absorbable barrier meshes (Sepramesh™, Proceed™, and Parietex™ Composite Mesh). Macroporous polypropylene mesh (Prolite Ultra™) served as a control. An associated pilot study demonstrated that acute fixation was not achieved with C-Qur™ or Dualmesh ® , thus these meshes were not subjected to further analysis. Two fibrin sealants varying in thrombin concentration (TISSEEL™ 500 IU/ml or ARTISS™ 4 IU/ml) were each utilized to secure a 3 × 4 cm piece of mesh to the peritoneal surface of harvested abdominal wall from New Zealand white rabbits. Ten samples were prepared for each mesh and fibrin sealant combination. The resulting mesh-tissue interface (3 × 3 cm) underwent lap shear testing at a rate of 0.42 mm/s using a tensiometer (Instron 5542, Norwood, MA). The maximum load sustained by the construct was recorded as the acute fixation strength in units of Newtons (N). Data are given as means ± SEM. Statistical significance ( P 0.05) in the acute fixation strength achieved by ARTISS™ versus TISSEEL™ with Composix™, Sepramesh™, Proceed™, and Parietex™ Composite Mesh. However, Prolite Ultra™ fixed with ARTISS™ (7.099 ± 1.01 N) had a significantly higher tensile strength ( P