The Effect of Tissue Adhesive Coated Onlay Meshes on Wound Healing in Rabbits

zObjective: The aim of our study was to evaluate the histopathological effects of coating different types of meshes with tisseel on wound healing in rabbits operated for incisional hernia (IH). Methods:In this study, we used 35 New Zealand type rabbits.Midline defects were created in order to simulate IH and repaired with two different types of meshes [heavyweight (HW) vs. lightweight (LW)].Each mesh group was further subdivided into two groups depending on the mesh fixation method (suture vs. tisseel).The rabbits were re-operated on and full thickness samples were examined histopathologically 90 days postoperatively.American Society for Testing and Materials scales were used to score the inflammatory response to these meshes.Mean overall response (MOR) scores were calculated and statistically significant differences were examined. Results:In the suture fixation group, histopathological examination of specimens revealed a significantly higher inflammatory response to HW meshes when compared to LW meshes.However, the inflammatory response and MOR values were not significantly higher when HW meshes were fixed with tisseel.Surprisingly; LW meshes covered with tisseel led to a significantly higher inflammatory response and MOR values when compared to tisseel covered HW meshes, sutured LW meshes and sutured HW meshes. Conclusion:In the routine surgical practice HW meshes create an elevated inflammatory response when fixed with suture materials.Tisseel leads to a higher inflammatory response when used alone and when combined with LW meshes this response is even higher than HW meshes.