Current Thoracic Surgery 2019 , Vol 4 , Issue 1
The effect of polyglycolic acid mesh application in tracheal anastomoses on pressure and tensile strength: an ex vivo experimental study
Ali Kılıcgün1,Yusuf Özgür Biçer2,Ali Cevat Kutluk3,Sinan Seyhan2,Serap Köybaşı Sanal2
1Department of Thoracic Surgery, Abant İzzet Baysal University, Medical School, Bolu, Turkey
2Department of Head and Neck Surgery, Abant Izzet Baysal University, Medical School, Bolu, Turkey
3Department of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.26663/cts.2019.0002 Viewed : 50 - Downloaded : 49 Background: This study aims to investigate the effect of polyglycolic acid (PGA) mesh application in tracheal anastomosis on the air-leakage and tension resistance.

Materials and Methods: Tracheae were collected from freshly slaughtered healthy sheep weighing 25-30 kg (2-3 years old) that were acquired from the local slaughterhouse. Twenty-eight tracheae were transported to the laboratory within an hour of slaughter and then dissected to remove the esophagus before obtaining 20-cm long tracheae. All tracheae were transected at the midpoint. In Groups 1 and 2, the transected tracheae were anastomosed by using interrupted 3-0 Vicryl sutures. In Groups 3 and 4, after anastomosing the transected tracheae with interrupted 3-0 Vicryl, the sites of anastomosis were reinforced by using Polyglycolic acid mesh. Groups 1 and 3 were tested for tensile strength, while Groups 2 and 4 were tested for pressure resistance.

Results: The median pressure was 49.00 ± 7.47 mmHg in the group anastomosed with only Vicryl, whereas it was measured as 70 ± 13.49 mmHg in the group on which the anastomoses were reinforced with PGA mesh. The median force needed to break anastomoses were 166.40 ± 24.28 Newton in the Vicryl-only group and 136.80 ± 34.93 newton in the PGA- reinforced group. The difference between the pressure resistance values of the Vicryl-only group and the PGA reinforced group was significant (p = 0.006). However, the difference with regard to the tensile strength was insignificant (p = 0.201).

Conclusion: We found that the reinforcement of the anastomosis site with polyglycolic acid mesh significantly increases the pressure resistance but does not significantly affect tensile strength. Keywords : trachea, anastomoses, polyglycolic acid