A new method of applying fibrin glue at the microvascular anastomotic site: The “paintbrush” technique

Padubidri, Arvind N.; Browne, Earl Z.

doi:10.1002/(sici)1098-2752(1996)17:8<428::aid-micr2>3.0.co;2-a

Cited by 12 publications

(6 citation statements)

References 9 publications

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“…Although there is controversy as to the safety of fibrin sealant at a microvascular anastomosis, in the human, a fibrin glue-affixed probe could be placed distant from this site. [24][25][26] Future evaluation in this area could include the use of other tissue adhesives. Currently, research is expanding in this field, and new biocompatible glues are under investigation.…”

Section: Discussionmentioning

confidence: 99%

Fibrin Sealant: A Novel Method of Fixation for an Implantable Ultrasonic MicroDoppler Probe

Bill¹,

Foresman²,

Rodeheaver³

et al. 2001

J reconstr Microsurg

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While free tissue transfer affords the reconstructive microvascular surgeon the ability to provide coverage for complex wounds, the postoperative monitoring of these flaps continues to evolve. The most recent advance has been the development of an implantable microDoppler probe to provide an early warning signal for vascular obstruction. The current system relies on the use of a silicone cuff to secure a 1-mm probe to the outflow vein. The release force to remove the probe from the cuff is reported to be 1/10 of a pound (45 g). A disadvantage of this system is the need for a circumferential, relatively inelastic device around the vein. Should the cuff be too tightly secured to the vein, the potential for outflow obstruction exists. Moreover, if the probe is not well-approximated to the vein, no signal is produced. Finally, the fact that a foreign body remains in the wound after completion of the monitoring period remains a concern. The authors have investigated a new method to adhere the probe, using a commercially available fibrin sealant. The use of this biocompatible substance has the potential to obviate the need for the current method of fixation, and the associated concerns.

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Section: Discussionmentioning

confidence: 99%

Fibrin Sealant: A Novel Method of Fixation for an Implantable Ultrasonic MicroDoppler Probe

Bill¹,

Foresman²,

Rodeheaver³

et al. 2001

J reconstr Microsurg

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“…However, 50% of the reduced suture FG anastomoses had thromboses at 3 to 4 weeks secondary to intraluminal FG leakage. To combat intravascular thrombosis and vessel inelasticity, which may cause stenosis, from an excess of FG at the anastomotic site, Padubidri and Browne [92] developed a paintbrush technique employing a suture passed through a 27-gauge needle. The glue is applied in a brush-stroke manner instead of using the doublesyringe Duplojet [56] or spray gun [93].…”

Section: Tensile Strength and Thrombogenicitymentioning

confidence: 99%

“…The glue is applied in a brush-stroke manner instead of using the doublesyringe Duplojet [56] or spray gun [93]. Padubidri and Browne had 100% patency after 2 weeks [92].…”

Section: Tensile Strength and Thrombogenicitymentioning

confidence: 99%

“…The 8 to 12 sutures required for anastomosis of vessels of 1 mm or less result in reduced diameter, focal medial damage, leakage, thrombosis, ischemia, necrosis, and stenosis in vessels of 1 mm or less [51,92,94,95]. Many investigators suggest that reduced suture FG vascular anastomoses reduce the risk of these complications [24,61,85,[95][96][97][98][99][100][101][102][103][104].…”

Section: Reduced Suture Fibrin Glue Anastomosesmentioning

confidence: 99%

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Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Detweiler

Fenton

1999

Journal of Investigative Surgery

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Research in reduced suture fibrin glue (FG) and sutureless FG anastomosis has been lagging behind FG utilization in other surgical fields. A review of the literature for vascular, esophageal, tracheal, gastrointestinal, common bile duct, ureteral, vas deferens, and Fallopian tube FG anastomosis indicates that reduced suture FG and sutureless FG procedures may be performed with less training, reduced operating time, leakage, ischemia, inflammation, and necrosis compared to sutured techniques. Reduced suture FG vascular anastomosis augments early anastomotic strength. Suture number for esophageal, tracheal, and tracheobronchial anastomoses can be reduced with FG. Bursting strength in pig small intestine and rat colon was lower at 4 days postoperatively, but returned to sutured strength at 7 days. Mortality was unaffected, and 18-month follow-up in sutureless FG intestinal anastomosis in pigs showed no stenosis. Preliminary ureteral studies have demonstrated successful sutureless FG and reduced suture FG laparoscopic techniques in pigs. Reduced suture FG and sutureless FG vas deferens anastomosis may reduce sperm granuloma rates, with increased patency and pregnancy rates. Patency and pregnancy rates have been similar for tubal FG, reduced suture FG, autologous fibrin glue (AFG), and sutured anastomosis. Any risk of viral transmission or immune response is eliminated by AFG. While there are few studies in many areas of FG hollow vessel anastomosis, the current literature illustrates many of the advantages of FG over other anastomotic techniques and should provide impetus for continued research in this promising field of surgery.

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“…To circumvent the problem of excess sealant deposition and thus minimize intraluminal complications, different application modes were described. 9,10 Another tool for the achievement of hemostasis in surgical procedures (besides sutures) is the application of autologous muscle pads to the bleeding source. The underlying pathophysiological mechanisms are the initiation of the coagulation cascade due to muscle thromboplastin 11 and the mechanical tamponade due to the muscle pad itself.…”

mentioning

confidence: 99%

Closing microvascular lesions with fibrin sealant-attached muscle pads

et al. 2005

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Fibrin sealants are used in a variety of surgical procedures, mainly for purposes of hemostasis and assisted wound healing. The combined use of fibrin sealant and autologous muscle pads for hemostasis was not reported previously. Arterial incisions in the common carotid artery in rats were closed by the combined application of fibrin sealant and an autologous muscle pad. Postsurgical vessel patency and degree of stenosis were evaluated by color duplex sonography, computed tomography angiography, and postmortem histology. The combined application of muscle pad and fibrin sealant and achievement of hemostasis was feasible in all animals. Seventy-eight percent of animals showed no or only slight postsurgical vessel stenosis. Our method is simple and quick to perform, showing a high potential for hemostasis in microvascular lesions. Therefore, it might be used in future experimental studies for conservation of vessel patency after arterial catheterization and in experimental or clinical vascular surgery.

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A new method of applying fibrin glue at the microvascular anastomotic site: The “paintbrush” technique

Cited by 12 publications

References 9 publications

Fibrin Sealant: A Novel Method of Fixation for an Implantable Ultrasonic MicroDoppler Probe

Fibrin Sealant: A Novel Method of Fixation for an Implantable Ultrasonic MicroDoppler Probe

Sutureless and Reduced Suture Anastomosis of Hollow Vessels With Fibrin Glue: A Review

Closing microvascular lesions with fibrin sealant-attached muscle pads

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