Fibrin adhesive versus sutured anastomosis: A comparative intra-individual study in the small intestine of pigs

Hjortrup, A; Nordkild, Peter; Kiærgaard, J.; Sjøntoft, Erik; Olesen, H. P.

doi:10.1002/bjs.1800730928

Cited by 44 publications

(19 citation statements)

References 9 publications

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“…7], An allergic reaction, as suggested by other authors [7,8], does not seem to be the reason for the impaired mechanical strength of FGA as this requires a repeated contact to the foreign antigen [6,8]. Another explanation for the reduced mechanical strength could be a different composition of the fibrin sealant in comparison to spon taneously secreted fibrin [7], This finding confirms an earlier study where a de crease of bursting pressure of FGA was observed on the 5th postoperative day [5], However, other studies did not reveal any significant differences on the 7th postop erative day [9,10], Up to now, there is no sufficient explanation for the reduced mechanical strength of FGA at the 24th postop erative hour in comparison to SLA under normal condi tions.…”

Section: Discussionsupporting

confidence: 74%

Effect of Fibrin Sealant on Anastomotic Healing in Peritonitis and Ischemia

D¹,

Sklarek²,

Izbicki³

et al. 1989

Dig Surg

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The effect of fibrin sealant on breaking strength of colonic anastomosis was evaluated in peritonitis and ischemia. (1) Under normal conditions, breaking strength of sutureless anastomosis (SLA) increased up to the 24th postoperative hour, while breaking strength of fibrin-glued anastomosis (FGA) remained on continuously low levels. (2) In peritonitis, breaking strength of FGA was significantly higher than that of SLA after 6 and 24 h. (3) In ischemia, SLA failed completely, even after temporary adaptation for more than 3 h. Breaking strength of FGA of ischemic bowel was as high as SLA under normal conditions.

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Section: Discussionsupporting

confidence: 74%

Effect of Fibrin Sealant on Anastomotic Healing in Peritonitis and Ischemia

D¹,

Sklarek²,

Izbicki³

et al. 1989

Dig Surg

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“…Thus, enwrapment of ischemic small bowel anastomosis by a greater omentum successfully prevented anastomotic leakage [16]. Animals, surviving the first 3 postoperative days, exhibited a marked enhancement of formation of perianastomotic adhesions reflecting revascularization of the ischemic bowel segments, as described by other au thors [17][18][19][20] and confirmed by our microangiographic findings.…”

Section: Discussionsupporting

confidence: 73%

Effects of Local Ischemia and Bacterial Flora on Healing of Experimental Colonic Anastomoses

D¹,

Izbicki²,

Sklarek³

et al. 1992

Dig Surg

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In the present study the effects of local bowel perfusion on anastomotic healing of experimental colonic anastomoses were evaluated in 54 female chinchilla rabbits. Local ischemia was induced by devascularization of the sigmoid colon. Animals were randomly allocated to 4 operative groups. In the animals of group 1 a colo-colonic anastomosis was performed in an area graded as ischemia grade A (intact perfusion). Animals of group 2 received a colo-colonic anastomosis in the sigmoid colon segment, graded as ischemia grade B (marginal perfusion). Group 3 received pretreatment with neomycin and was otherwise treated like group 2. Animals of group 4 a colo-colonic anastomosis was performed in the ischemia grade-C region (total ischemia). The rate of anastomotic leakage was monitored by periodic double contrast enemas. The experiment was terminated on the 8th postoperative day, and microangiography to assess revascularization was performed followed by assessment of perianastomotic adhesions. The rate of anastomotic failure as well as the occurrence of anastomotic failure over time highly depended on the severity of ischemia. Bowel sterilization by neomycin significantly reduced the rate of anastomotic leakage. The development of perianastomotic adhesions correlated with the severity of ischemia. Microangiography suggested that revascularization originated in the perianastomotic adhesions.

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“…Data shown are the mean from 12 determinations. Similar experiments were carried out at 1,5,10,20,40,60 and 120 min after application of the fibrin glue to determine the time course of tensile strength. Elasticity was evaluated by spraying the fibrinogen concentrate and the thrombin on a flat surface und pulling the resulting fibrin film with a forceps.…”

Section: Tensile Strength and Elasticitymentioning

confidence: 99%

“…fering from coagulopathy) [9] and provides air and fluid tightness [10], thus reducing the incidence of fistula forma tion [11][12][13][14], Fibrin glue has been used increasingly in nu merous surgical applications including for partial or com plete replacement of sutures in skin grafts [15,16], nerve [17] and vessel [18] anastomoses, or surgery of parenchymal tissues of liver [19], lung [20], or spleen [21]. This product avoids inflammatory reactions often encountered when su tures are employed; thus its use in surgery of soft tissues, where sutures may be traumatic, is especially helpful.…”

Section: Introductionmentioning

confidence: 99%

Biochemical and Physical Properties of a Solvent-Detergent-Treated Fibrin Glue

Burnouf-Radosevich¹,

Burnouf²,

Huart³

1990

Vox Sanguinis

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A fibrin glue preparation has been obtained from pooled human plasma using a procedure which includes a solvent-detergent (SD) treatment to inactivate lipid-enveloped viruses. The SD treatment inactivated ≥5.5 log(10) of HIV in less than 45 min, and ≥5 log(10) and ≥6.5 log(10) of VSV and Sindbis virus, respectively, in less than 2 h. The product was found to contain high quantities of fibrinogen (116±2.49 g/l; n = 12), factor XIII (35±2.88 U/ml) and von Willebrand factor (23±1.9 U/ml ristocetin cofactor activity), and relatively low levels of fibronectin (5.9±0.51 g/l). Plasminogen, the precursor of plasmin, which may play a negative role by decreasing the resistance of the fibrin clot, was at only 0.03 g/l. Cellulose acetate electrophoresis showed 95% gamma-proteins and 5% alpha-2-beta proteins. Sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions detected three main protein bands with apparent molecular weights of 65, 56 and 47 kilodaltons, probably corresponding to the alpha, beta, and gamma fibrinogen subunits. Other characteristics of the product included (1) high clottability of fibrinogen (over 85%); (2) absence of low molecular weight fibrin degradation products; (3) rapid solubilization at room temperature (less than 10 min); (4) high tensile strength (202±27 g/cm^2 after 2 h of application), and (5) high elasticity of the fibrin clot. In addition, scanning electron microscopy revealed a highly organized structure showing tridimensional arrangement of the fibrin fibers. SD treated fibrin glue should efficiently replace autologous fibrinogen or cryoprecipitate preparations for surgical application.

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Fibrin adhesive versus sutured anastomosis: A comparative intra-individual study in the small intestine of pigs

Cited by 44 publications

References 9 publications

Effect of Fibrin Sealant on Anastomotic Healing in Peritonitis and Ischemia

Effect of Fibrin Sealant on Anastomotic Healing in Peritonitis and Ischemia

Effects of Local Ischemia and Bacterial Flora on Healing of Experimental Colonic Anastomoses

Biochemical and Physical Properties of a Solvent-Detergent-Treated Fibrin Glue

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