Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy

Davidson, Brian R; Burnett, Stuart; Javed, Mohammad; Am, Seifalian; Moore, D.; Doctor, Nilesh

doi:10.1046/j.1365-2168.2000.01427.x

Cited by 57 publications

(42 citation statements)

References 26 publications

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“…The use of adhesives as haemostatic agents following severe abdominal trauma to solid organs, in laparoscopic procedures, or in surgical cases on patients with coagulation disorders has been a recurring topic in a number of papers [29,30]. Experimental pig, dog, rat, and other models provide data to improve the therapeutic resources currently available [31,32]. …”

Section: Discussionmentioning

confidence: 99%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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Background: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. Methods: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing. The animals were divided into five groups: (1) sham (n = 3); (2) control (n = 6), untreated, standard punch injury created on the anterior left kidney; (3) TachoSil® (n = 27), punch injury treated with TachoSil®; (4) GelitaSpon® (n = 27), punch injury treated with GelitaSpon®, and (5) Adhflex® (n = 27), punch injury treated with the new elastic CyA adhesive. The parameters studied were bleeding time, peritoneal adhesions, and histopathological evaluation of wound healing on days 2, 6, and 18, including measurements of the gap between wound edges, inflammatory reaction (CD68), and vascular neoformation (CD31). Results: The bleeding time was significantly shorter (27.7 ± 12.9 s) in the Adhflex® group than in the control (135.8 ± 11.6 s; p < 0.01), TachoSil® (77.5 ± 7.4 s; p < 0.05), and GelitaSpon® (82.5 ± 14.4 s; p < 0.05) groups. The incidence of intraperitoneal adhesions in the animals treated with Adhflex® was 3.6 times higher than in the non-treated group. It was also higher (p < 0.04) than in the groups treated with TachoSil® and GelitaSpon®. The time point with the largest gap between the wound edges and most abundant granulation tissue was at day 6. The largest gap after 18 days was reported for the Adhflex® adhesive. With regard to the markers CD31 and CD68, Adhflex® showed the largest areas 2 days after surgery, but no differences were found after 6 and 18 days versus the other treatments. The expression of the immunomarkers on the renal samples treated with Adhflex® was consistent with a normal healing process. Conclusions: In this experimental model of renal injuries, the new elastic CyA (Adhflex®) resulted in the shortest bleeding time. It offers rapid sealing of the bleeding produced by renal injuries, fixation to adjacent tissues, and reduced occurrences of relapse. The evolution of the scarring is similar to other procedures. Given that traumatic renal injuries are always an emergency due to haemorrhage, Adhflex® might offer additional benefits over conventional treatment methods in human clinical practice.

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Section: Discussionmentioning

confidence: 99%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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“…The use of adhesives in hepatic bleeding has been researched as a hemostasis alternative in severe traumatic injury with associated wounds, in traumatic injury which videoassistence surgery and on transparietal biopsies in patients with coagulation deficiencies 10,11 . Experimental studies in pigs, dogs and rats contributed for a safer and more efficacious use of this therapeutic resource 10,11,12,13,14 . This research attempted to make an experimental model in rabbits producing a standardized wound, which was established from the study of a pilot group.…”

Section: Discussionmentioning

confidence: 99%

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

2006

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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 ...

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“…As discussed above, because the method and quantity of haemostatic material was at the surgeon’s discretion, it was not possible to evaluate the inherent haemostatic properties of the materials themselves. In a porcine model of partial hepatectomy [16], in which both wound and applications were standardised, there were no significant differences between Vivostat sealant and Surgicel; both products significantly reduced the bleeding time and blood loss of a resected wound surface (both p < 0.001), compared with an untreated control.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Haemostatic Effect of Vivostat<sup>®</sup> Patient-Derived Fibrin Sealant with Oxidised Cellulose (Surgicel<sup>®</sup>) in Multiple Surgical Procedures

2003

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Aim: To evaluate the haemostatic properties of Vivostat^® patient-derived fibrin sealant in a broad range of surgical procedures. Method: In a prospective, randomised, multicentre, clinical study, typical surgical wounds of 69 patients (cardiothoracic, general, obstetric and gynaecologic, and vascular), requiring intervention to control bleeding, were treated with either Vivostat-derived sealant (n = 35) or Surgicel^® (n = 34) as required and the time taken to arrest bleeding was assessed. Results: Compared with Surgicel, the mean time to haemostasis of Vivostat-derived sealant was significantly shorter (1.6 vs. 3.3 min, p < 0.0001) and more patients were successfully treated (i.e. no additional haemostatic measures required; 94 vs. 65%, p = 0.003). Conclusion: Vivostat-derived sealant is a more reliable and rapidly effective surgical haemostat than Surgicel.

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Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy

Abstract: The novel fibrin sealant, Vivostat, is as effective as Surgicel cellulose gauze in achieving haemostasis after porcine partial hepatic lobectomy.

Cited by 57 publications

References 26 publications

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

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

A Comparison of the Haemostatic Effect of Vivostat<sup>®</sup> Patient-Derived Fibrin Sealant with Oxidised Cellulose (Surgicel<sup>®</sup>) in Multiple Surgical Procedures

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