The use of fibrin glues in the surgical treatment of incisional hernias

Summary

The purpose of this work is to report on the results of a series of 110 operations for incisional hernia treated either by primary suture or by a plasty reinforced with a prosthesis placed anterior to the rectus sheath, and fixed by a new method involving a spray of fibrin glue. The composition and properties of the two fibrin glues presently available commercially in France are analysed, together with the procedures undertaken to prevent viral contamination. Several techniques of suture and hernioplasty have been used in this series, prostheses were all placed anterior to the myo-fascial layer. The arguments in favor of the choice of technique are put forward, as well as details of the surgical procedure. There was no mortality in this series. Minor complications were seen in 10% of cases. There was no significant difference between the two types of glue employed. Analysis of the results favors the routine use of suction drainage and a volume of glue of 2 ml. The use of a prosthesis fixed with fibrin glue reduces the definitive recurrence rate to 0.97%, against 9.02% for techniques using a prosthesis only and 18.3% for techniques without a prosthesis, in an overall series of 389 operations.