The role of biological adhesive and suture material on rabbit hepatic injury

Abstract

Purpose:To evaluate the performance of fibrin adhesive and absorbable suture thread in the repairing of hepatic injures in rabbits. Methods: New Zealand albino rabbits (n=16), males and females, from 5 to 6 months old, average weight of 2500 g, were distributed randomly in Group A (n-8) -biological adhesive and Group B (n=8) -suture thread. After anesthesia with acepromazine (1mg/Kg), ketamine (50mg/Kg) and fentanyl EV (0,5ml/Kg), it was performed a supra-umbilical median laparotomy, the median hepatic lobe was isolated and subjected to severe standardized incision. In the group B the incision edges were sutured with simple 4-0 catgut, in separated stitches. It was evaluated the total time of the procedure, the hemostasis time and hemorrhage volume. In the 21 st post-operative day it was evaluated the presence of adherences and signs of infection in the abdominal cavity, and it was followed by the resection of the median hepatic lobe for the histological evaluation. Results: The calculated mean and standard deviation showed that the procedure time, hemostasis time and bleeding amount were significantly smaller in the group of animals subjected to the use of fibrin adhesive. The surgical abdominal incision was significantly more extensive in the animals of the suture group (average of 6,8 cm) in relation to the adhesive group (average of 3,8), as well as the number of occurrences of abscesses. The adherence of the intestinal ansas to the sutured incision (group B) occurred in five cases and the major omentum adhesion occurred in all animals. In the group A (adhesive) it occurred adherences of the major omentum in three cases. The microscopy of the hepatic incision repaired with the use of fibrin showed that the inflammatory infection is less intense, not associated with the formulation of secretion in the abscesses, and therefore has a more favorable later cicatricial aspect than a conventional suture with surgical thread. Conclusion:In agreement with other biomedical literature works, the fibrin adhesive is a viable option for the performance of hemostasis in a animal model (rabbit) with severe hepatic injury. Key words: Liver. Fibrin Tissue Adhesive. Sutures Techniques. RESUMO Objetivo:Avaliar o desempenho do adesivo de fibrina e do fio de sutura absorvível no reparo de lesões hepáticas provocadas em coelhos. Métodos: Coelhos (n=16),Nova Zelândia, albinos, machos e fêmeas, 5 a 6 meses de idade, peso médio de 2500 gramas, foram distribuídos aleatoriamente em Grupo A(n = 8) -adesivo biológico e Grupo B(n=8) -fio de sutura. Após anestesia com acepromazina (1mg/Kg), quetamina (50mg/Kg) e fentanylEV (0,5ml/Kg), realizou-se laparotomia mediana supra-umbilical, o lobo hepático médio foi isolado e submetido a uma lesão padronizada grave. No grupo A foi aplicado o adesivo de fibrina. No grupo B as bordas da lesão foram suturadas com categute 4-0 simples, em pontos separados. Avaliou-se o tempo total de procedimento, tempo de hemostasia e volume da hemorragia. No 21 o dia de pós-operatório avaliou-se a presença ...

The collagen, fibrinogen and thrombin biological adhesive is effective in treating experimental liver injuries

“…In a study of 1,000 patients suffering from liver trauma led by Feliciano et al between 1979 and, the mortality rate found was 10% 22 , and in another study, The presence of foreign body inflammatory reaction found in the histological analysis of the rats' livers treated with the collagen adhesive associated with fibrinogen and thrombin was similar to changes found in studies using fibrin glue in rats 24 , fibrin glue in rabbits 21 and polyglycolic acid mesh in pigs 25 . We did not observe histological findings suggestive of liver tissue necrosis or vacuolar degeneration, as described with the use of cyanoacrylate 26 , or the presence of abscesses near the adhesive application areas.…”

“…Several experimental studies show the effectiveness of fibrin adhesive in controlling hepatic hemorrhage in dogs 17 , pigs 18,19 , rats 20 and rabbits 21 , with good adhesion to the injured liver, little local inflammatory reaction and few complications. In our study we obtained similar findings to those of the cited works.…”

Collagen, fibrinogen and thrombin biological addesive is effective in treating experimental liver injuries

“…In a study of 1,000 patients suffering from liver trauma led by Feliciano and Mattox between 1979 and 1984, they found that mortality was 10% 22 . In another study conducted by Saaiq Michelino Collagen, fibrinogen and thrombin biological addesive is effective in treating experimental liver injuries with fibrinogen and thrombin was similar to changes found in studies using fibrin glue in rats 24 , fibrin glue in rabbits 21 and polyglycolic acid mesh in pigs 25 . We did not find histological findings suggestive of necrosis of the liver tissue or vacuolar degeneration, as described with the use of cyanoacrylate 26 , or abscesses near the adhesive areas.…”

“…The Several experimental studies show the effectiveness of fibrin adhesive in controlling hepatic hemorrhage in dogs 17 , pigs 18,19 , rats 20 and rabbits 21 , with good adhesion to the injured liver, little local inflammatory reaction and few complications. In our study we obtained findings similar to those.…”

Agentes hemostáticos locais e adesivos teciduais

“…A trombina ativa as plaquetas e os fatores V, VII e XII e promove a conversão de fibrinogênio em fibrina 2 . Fibrina O adesivo de fibrina é um produto que vem sendo usado há várias décadas para uso em operações cardiovasculares 16,17 e, mais recentemente, tem sido usado para tratar lesões hemorrágicas decorrentes do trauma esplênico, e pode ser uma opção para promover a hemostasia casos de lesão hepática grave 18 .…”