Efficiency of TachoSil® to prevent postsurgical adhesion development on laparoscopic rat model

Abstract

The aim of this study was to evaluate the effectiveness of a fibrinogen and thrombin-coated hemostatic sponge (TachoSil®) in the prevention of postsurgical adhesions in a laparoscopic rat model and its histological effects on uterine and peritoneal parenchyma. Design was a prospective randomized blinded study. Setting was in International Laparoscopic Surgery Centre, ClermontFerrand, France. There were 100 sexually mature female Sprague-Dawley rats weighing 240 to 300 g and aged 6-8 weeks. A standardized severe surgical injury induced by scissors and 40-W bipolar coagulation in the rat uterine horn, corpus, and peritoneum was performed to induce adhesion formation. After trauma, group 1 (n=50) received no treatment and group 2 rats (n=50) received TachoSil® applied on injured areas. Twelve weeks after the procedure, repeat laparoscopy was performed and adhesions were scored according to their extent and severity. A hysterectomy and a peritoneal biopsy in the injured area were achieved by laparotomy in order to investigate on a possible earlier effect of TachoSil® on the uterine and peritoneal parenchyma in 49 rats of each group. TachoSil® group adhesion scores showed a significant decrease on the three injured areas: peritoneum (12.96 vs. 21.66), uterine horn (7.22 vs. 15.20), and uterine corpus (5.88 vs. 34.52). TachoSil® group also demonstrated a major decline of uterine fibrosis and inflammation. This study revealed that TachoSil®, an absorbable biomaterial, can reduce postoperative adhesions after laparoscopic surgery on a rat model. TachoSil® also prevents thermo-induced injuries on uterine parenchyma (less fibrosis and less inflammation).

The Contribution of a Collagen Patch Coated With Fibrin Glue in Sealing Upper Gastrointestinal Defects: An Experimental Study

“…An important result of the present study is the fact that the Tachosil ® group showed fewer adhesions than the control group. Similar results were reported by two experimental studies where Tachosil ® reduced postoperative adhesions following laparoscopic surgery on a rat model and did not provoke adhesion formation in a pig model (28,29).…”

Experience with TachoSil in obstetric and gynecologic surgery

“…Other potential indications for the use of TachoSil include the reduction of postoperative adhesions after laparoscopic surgery and the prevention of heat-induced injuries to the uterine parenchyma (decline in fibrosis and inflammation), as indicated by findings in a rat model [15]. TachoComb was also capable of reducing adhesion reformation in a rabbit model [16].…”

Adhesions, infl ammatory response and foreign body giant cells infi ltration of the topical hemostats TachoSil®, Hemopatch™ and Veriset™ – An Animal Study

“…Hemopatch™ (Baxter AG, Austria) is made from bovine collagen with reactive pentaerythritol polyethylene glycol ether tetra-succinimidyl glutarate (NHS-PEG) on the active side, which initiates the organisms own clotting mechanisms [8,9]. Veriset™ (Covidien, USA) is a cellulose matrix with a nonspecifi ed polyethylene glycol (PEG) on the active side [10,11].…”