Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study.
Abstract: Resection and anastomosis of small intestine during colic can lead to adhesions and recurrent colic. Several methods are available to reduce the rate of adhesions in the postoperative period, such as the use of serosal barriers. Surgical glues form a smooth surface, are fast to apply, and could reduce surgery time when performing anastomosis. A recently developed UV-polymerizable methacrylate adhesive (UV-PMA) is designed to anchor into the biological tissues' top surface offering sealant and a smooth cover over the anastomosis site. This adhesive was used ex vivo on fifteen samples of equine jejunum as the second layer of a two-layer anastomosis (1L-UV-PMA group) and compared to a two-layer anastomosis (simple continuous pattern covered with a Cushing pattern; 2L-CT group), in terms of feasibility, bursting strength pressure (BSP), luminal diameter reduction (LDR), and time of construction. Data were analysed using a paired -test or a chi-test ( < 0.05). The results showed no statistical difference in BSP, LDR, or any mode of failure between the two anastomosis types. However, the glue anastomosis formed a tunnel-like anastomosis and shredded under pressure, before apparition of leakage, preventing its usage in clinical cases with this methodology. It was concluded that modification of the technique is warranted before testing in clinical cases. A preprint of a former version of the manuscript is available on researchsquare.com, which was not conducted to print and publication after peer reviewing. Since then, the manuscript has been modified to this current version.
Copyright © 2021 Augustin Lenoir et al.
Publication Date: 2021-04-04 PubMed ID: 33884160PubMed Central: PMC8041519DOI: 10.1155/2021/5545758Google Scholar: Lookup
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- Journal Article
Summary
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This research investigates the efficiency of a newly-developed UV-polymerizable methacrylate adhesive (UV-PMA) on equine jejunal anastomosis. The study compares the adhesive’s performance with a traditional two-layer suturing method called a Cushing pattern. Although the adhesive didn’t present statistical differences in several parameters, it exhibited shredding under pressure, indicating a need for technique modification before clinical applications.
Overview of the Research
- The central objective of this research study is to compare the practicality and efficacy of a new ultraviolet light curing methacrylate adhesive (UV-PMA) and a conventional two-layer suturing technique in intestinal anastomosis, which is a surgical procedure to connect two parts of the intestine together, in horses.
- Equine jejunal samples were used in an ex vivo setup to assess these two methods based on feasibility, bursting strength pressure (BSP), luminal diameter reduction (LDR), and construction time. These are critical factors to determine the efficiency and reliability of a surgical anastomosis.
Method and Results of the Research
- Two groups were created for comparison: one where the UV-PMA adhesive was used as the second layer of a two-layer anastomosis, referred to as the 1L-UV-PMA group, and another where the anastomosis was done using a conventional suturing approach involving a simple continuous pattern covered with a Cushing pattern. This group is referred to as the 2L-CT group.
- Data from these tests were then analysed statistically. However, no significant differences were found between the two groups regarding BSP, LDR, or any other mode of failure.
- One notable phenomenon was that the adhesive formed a tunnel-like anastomosis, which shredded under pressure prior to the occurrence of leakage. This prevented the potential use of the UV-PMA method in live clinical cases without further modification to the technique.
Conclusions of the Study
- The findings suggest that the UV-PMA adhesive, in its current form, may not be ready for live clinical use in horses due to the risk of shredding under pressure.
- However, it also implies that with necessary modifications, the adhesive could potentially be efficient as it shows no statistical difference in bursting strength and luminal diameter reduction compared to the traditional suturing technique.
Cite This Article
APA
Lenoir A, Perrin BRM, Lepage OM.
(2021).
Ex Vivo Comparison of a UV-Polymerizable Methacrylate Adhesive versus an Inverting Pattern as the Second Layer of a Two-Layer Hand-Sewn Jejunal Anastomosis in Horses: A Pilot Study.
Vet Med Int, 2021, 5545758.
https://doi.org/10.1155/2021/5545758 Publication
Researcher Affiliations
- Groupe de Recherche en Médecine et Rééducation des Equidés de Sport, Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, Université de Lyon, Marcy-l'Etoile 69280, France.
- Cohesives, Laboratoire de Recherche et Développement, Université de Bourgogne, Dijon 21000, France.
- Groupe de Recherche en Médecine et Rééducation des Equidés de Sport, Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, Université de Lyon, Marcy-l'Etoile 69280, France.
Conflict of Interest Statement
B. R. M. Perrin is the CEO of Cohesives, the company providing the glue. He had a part in reviewing the report but did not participate in the experimental part and the initial writing.
References
This article includes 37 references
- Freeman D. E. Equine Surgery. 5th. St. Louis, MO, USA: Elsevier; 2018. Chapter 35—jejunum and ileum.
- Baxter GM, Hunt RJ, Tyler DE, Parks AH, Jackman BR. Sutured end-to-end and stapled side-to-side jejunal anastomoses in the horse.. Vet Surg 1992 Jan-Feb;21(1):47-55.
- Bickers RJ, Blackford JT, Eiler H, Rohrbach B. A comparison of the mechanical strength of two stapled anastomosis techniques for equine small intestine.. Vet Surg 2002 Mar-Apr;31(2):104-10.
- Bleyaert HF, Madison JB, Bailey JE, Johnson CM. Evaluation of a biofragmentable anastomosis ring for small intestinal anastomosis in ponies.. Vet Surg 1996 Jul-Aug;25(4):327-35.
- Bracamonte JL, Anderson SL, Hendrick S, Barber SM, Deutscher D, Sumner D. Ex vivo comparison of the biomechanical properties of hand-sewn and stapled jejunoileal anastomoses in horses.. Vet Surg 2014 May;43(4):451-8.
- Nelson BB, Hassel DM. In vitro comparison of V-Loc™ versus Biosyn™ in a one-layer end-to-end anastomosis of equine jejunum.. Vet Surg 2014 Jan;43(1):80-4.
- Troy JR, Holcombe SJ, Fogle CA, Epstein KL, Woodie JB. Effects of hyaluronate-carboxymethylcellulose membranes on the clinical outcome of horses undergoing emergency exploratory celiotomy.. Vet Surg 2018 Apr;47(3):385-391.
- Alonso Jde M, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA. Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies.. Vet Med Int 2014;2014:279730.
- Parker JE, Fubini SL, Todhunter RJ. Retrospective evaluation of repeat celiotomy in 53 horses with acute gastrointestinal disease.. Vet Surg 1989 Nov-Dec;18(6):424-31.
- Gorvy DA, Barrie Edwards G, Proudman CJ. Intra-abdominal adhesions in horses: a retrospective evaluation of repeat laparotomy in 99 horses with acute gastrointestinal disease.. Vet J 2008 Feb;175(2):194-201.
- Baxter GM, Broome TE, Moore JN. Abdominal adhesions after small intestinal surgery in the horse.. Vet Surg 1989 Nov-Dec;18(6):409-14.
- Jackson MR. Fibrin sealants in surgical practice: An overview.. Am J Surg 2001 Aug;182(2 Suppl):1S-7S.
- 2020. Hémostatiques chirurgicaux: un traitement de dernière intention, Haute Aut. Santé, https://www.has-sante.fr/jcms/c_1074169/fr/hemostatiques-chirurgicaux-un-traitement-de-derniere-intention.
- Perrin B, Brichon P-Y, Bracini M. Une revue des colles utilisées en chirurgies cardiaque, thoracique et vasculaire. 2012;10.
- Perrin BR, Dupeux M, Tozzi P, Delay D, Gersbach P, von Segesser LK. Surgical glues: are they really adhesive?. Eur J Cardiothorac Surg 2009 Dec;36(6):967-72.
- Dragu A, Unglaub F, Kneser U, Horch RE. Clinical impact of surgical glues: interdisciplinary indications for its use.. Eur J Cardiothorac Surg 2010 Apr;37(4):985; author reply 985-6.
- Perrin B R M, Braccini M, Bidan C M. Adhesion of surgical sealants used in cardiothoracic and vascular surgery. International Journal of Adhesion and Adhesives 2016;70:81–89.
- Kayaoglu HA, Ersoy OF, Ozkan N, Celik A, Filiz NO. Effect of n-butyl-2-cyanoacrylate on high-risk colonic anastomoses.. Kaohsiung J Med Sci 2009 Apr;25(4):177-83.
- Vakalopoulos KA, Wu Z, Kroese L, Kleinrensink GJ, Jeekel J, Vendamme R, Dodou D, Lange JF. Mechanical strength and rheological properties of tissue adhesives with regard to colorectal anastomosis: an ex vivo study.. Ann Surg 2015 Feb;261(2):323-31.
- Wu Z, Boersema GS, Vakalopoulos KA, Daams F, Sparreboom CL, Kleinrensink GJ, Jeekel J, Lange JF. Critical analysis of cyanoacrylate in intestinal and colorectal anastomosis.. J Biomed Mater Res B Appl Biomater 2014 Apr;102(3):635-42.
- Rossignol F, Mespoulhes-Rivière C, Vitte A, Lechartier A, Boening KJ. Standing laparoscopic inguinal hernioplasty using cyanoacrylate for preventing recurrence of acquired strangulated inguinal herniation in 10 stallions.. Vet Surg 2014 Jan;43(1):6-11.
- Meddahi-Pellé A, Legrand A, Marcellan A, Lo L, Letourneur D, Leibler L. Organ repair, hemostasis, and in vivo bonding of medical devices by aqueous solutions of nanoparticles.. Angew Chem Int Ed Engl 2014 Jun 16;53(25):6369-73.
- Mahdavi A, Ferreira L, Sundback C, Nichol JW, Chan EP, Carter DJ, Bettinger CJ, Patanavanich S, Chignozha L, Ben-Joseph E, Galakatos A, Pryor H, Pomerantseva I, Masiakos PT, Faquin W, Zumbuehl A, Hong S, Borenstein J, Vacanti J, Langer R, Karp JM. A biodegradable and biocompatible gecko-inspired tissue adhesive.. Proc Natl Acad Sci U S A 2008 Feb 19;105(7):2307-12.
- Narayanan A, Kaur S, Peng C, Debnath D, Mishra K, Liu Q, Dhinojwala A, Joy A. Viscosity Attunes the Adhesion of Bioinspired Low Modulus Polyester Adhesive Sealants to Wet Tissues.. Biomacromolecules 2019 Jul 8;20(7):2577-2586.
- Chandrasekharan A, Seong K-Y, Yim S-G. In situ photocross linkable hyaluronic acid-based surgical glue with tunable mechanical properties and high adhesive strength. Journal of Polymer Science Part A: Polymer Chemistry 2019;57(4):522–530.
- Annabi N, Zhang YN, Assmann A, Sani ES, Cheng G, Lassaletta AD, Vegh A, Dehghani B, Ruiz-Esparza GU, Wang X, Gangadharan S, Weiss AS, Khademhosseini A. Engineering a highly elastic human protein-based sealant for surgical applications.. Sci Transl Med 2017 Oct 4;9(410).
- Djordjevic I, Pokholenko O, Shah AH, Wicaksono G, Blancafort L, Hanna JV, Page SJ, Nanda HS, Ong CB, Chung SR, Chin AYH, McGrouther D, Choudhury MM, Li F, Teo JS, Lee LS, Steele TWJ. CaproGlu: Multifunctional tissue adhesive platform.. Biomaterials 2020 Nov;260:120215.
- Auletta L, Lamagna F, Uccello V, Lamagna B, Pasolini MP. In vitro comparison of three suture techniques for anastomosis of the equine small intestine.. Equine Vet J Suppl 2011 Nov;(40):46-50.
- Eggleston RB, Mueller PO, Parviainen AK, Groover ES. Effect of carboxymethylcellulose and hyaluronate solutions on jejunal healing in horses.. Am J Vet Res 2004 May;65(5):637-43.
- Lee WL, Epstein KL, Sherlock CE, Mueller PO, Eggleston RB. In vitro comparison of a single-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end jejunoileal anastomosis in normal equine small intestine.. Vet Surg 2012 Jul;41(5):589-93.
- Nieto JE, Dechant JE, Snyder JR. Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum.. Vet Surg 2006 Oct;35(7):669-73.
- Sherlock C, Lee W, Mueller PO, Eggleston R, Epstein K. Ex vivo comparison of three hand sewn end-to-end anastomoses in normal equine jejunum.. Equine Vet J Suppl 2011 Aug;(39):76-80.
- Allen D Jr, White NA, Tyler DE. Factors for prognostic use in equine obstructive small intestinal disease.. J Am Vet Med Assoc 1986 Oct 1;189(7):777-80.
- Marinis A, Yiallourou A, Samanides L, Dafnios N, Anastasopoulos G, Vassiliou I, Theodosopoulos T. Intussusception of the bowel in adults: a review.. World J Gastroenterol 2009 Jan 28;15(4):407-11.
- Edwards GB. Resection and anastomosis of small intestine: current methods applicable to the horse.. Equine Vet J 1986 Jul;18(4):322-30.
- Hendriks T, Mastboom WJ. Healing of experimental intestinal anastomoses. Parameters for repair.. Dis Colon Rectum 1990 Oct;33(10):891-901.
- Pascoe JR, Peterson PR. Intestinal healing and methods of anastomosis.. Vet Clin North Am Equine Pract 1989 Aug;5(2):309-33.
Citations
This article has been cited 1 times.- Baldwin CM, Gillen A. An ex vivo comparison of jejunal transection angles and the effect on lumen diameter following end-to-end jejunojejunal anastomoses. Vet Surg 2026 Feb;55(2):484-490.
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