Prevention of seroma formation with TissuGlu^® surgical adhesive in a canine abdominoplasty model: Long term clinical and histologic studies

Background: Seroma formation is a common postoperative complication following many surgical procedures including abdominoplasty. Recently, a lysine-derived urethane (LDU) surgical adhesive was shown to prevent seroma formation in short term studies in a canine model of abdominoplasty. This current study evaluates efficacy of the adhesive (TissuGlu^®, Cohera Medical, Inc.) in the same model at longer time points, and examines the histological tissue response to extended exposure to the adhesive. Materials and methods: Bilateral subcutaneous pockets were created in the ventrolateral abdominal wall and additional tissue damage was inflicted using electrocautery. On one side, the tissue layers were treated with the adhesive prior to closure, whereas the control side received no treatment prior to standard closure of the incision. Seroma fluid accumulation was measured and histologic analysis was performed at 3 and 12 weeks. Results: Seroma formation (mean ± SD, 690 ± 870 ml; median volume of 348.5 ml) was observed on the control side, whereas the treated side had adherence between the tissue layers, and minimal if any fluid accumulation (mean ± SD, 44 ± 53 ml; median volume of 15 ml) (p < 0.01) (n = 8) at 3 week necropsy. In animals survived to 12 weeks, two of the four control sides required aspiration of serous fluid, and dead space persisted for the entirety of the study in one animal. For the adhesive treated sites, none of the four animals showed signs of seroma at euthanasia, although serial aspiration was performed in one treatment site within the first month and resulted in resolution of the process. The adhesive was detected in the surgical site at 3 and 12 weeks, and independent histological analysis found it to be a non-irritant compared to control (no treatment). Conclusions: Long term evaluation of TissuGlu^® Surgical Adhesive showed that it is capable of preventing the formation of seroma in this canine abdominoplasty model, indicating that it may be of clinical benefit in the prevention of seroma formation in patients undergoing abdominoplasty.