Fibrin sealants in supporting surgical techniques: the importance of individual components

Wozniak, Gernold

doi:10.1016/s0967-2109(03)00067-x

Cited by 38 publications

(28 citation statements)

References 24 publications

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“…Introduction of additional crosslinks in the fibrin gels with crosslinking agents like glutaraldehyde lowers pore size as well as susceptibility to proteolysis [33,66,67]. Genipin, isolated from Gardenia jasminoides fruits, was used successfully by Dare et al [68] as a less toxic alternative to glutaraldehyde for crosslinking of fibrin matrices and induce chondrogenic differentiation of human primary articular chondrocytes.…”

Section: Use Of Bifunctional Reagentsmentioning

confidence: 99%

Fibrin matrices: The versatile therapeutic delivery systems

Ahmad

Fatima

Hoque

et al. 2015

International Journal of Biological Macromolecules

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Section: Use Of Bifunctional Reagentsmentioning

confidence: 99%

Fibrin matrices: The versatile therapeutic delivery systems

Ahmad

Fatima

Hoque

et al. 2015

International Journal of Biological Macromolecules

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“…Similar to collagen, fibrin gels can achieve high seeding efficiency and uniform cell distribution. Fibrin can be formed by autologous fibrinogen, and the degradation rate of fibrin gels can be controlled by addition of fibrinolytic inhibitors such as aprotinin or ⑀-aminocaproic acid (38). In contrast to collagen, fibrin stimulates synthesis of collagen and elastin and yields TEV constructs with improved mechanical properties (14,23,35), suggesting that fibrin may be a more appropriate scaffold for cardiovascular tissue engineering.…”

mentioning

confidence: 99%

Engineering of fibrin-based functional and implantable small-diameter blood vessels

Swartz¹,

Russell²,

Andreadis³

2005

American Journal of Physiology-Heart and Circulatory Physiology

248

196

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We engineered implantable small-diameter blood vessels based on ovine smooth muscle and endothelial cells embedded in fibrin gels. Cylindrical tissue constructs remodeled the fibrin matrix and exhibited considerable reactivity in response to receptor-and nonreceptor-mediated vasoconstrictors and dilators. Aprotinin, a protease inhibitor of fibrinolysis, was added at varying concentrations and affected the development and functionality of tissue-engineered blood vessels (TEVs) in a concentration-dependent manner. Interestingly, at moderate concentrations, aprotinin increased mechanical strength but decreased vascular reactivity, indicating a possible relationship between matrix degradation/remodeling, vasoreactivity, and mechanical properties. TEVs developed considerable mechanical strength to withstand interpositional implantation in jugular veins of lambs. Implanted TEVs integrated well with the native vessel and demonstrated patency and similar blood flow rates as the native vessels. At 15 wk postimplantation, TEVs exhibited remarkable matrix remodeling with production of collagen and elastin fibers and orientation of smooth muscle cells perpendicular to the direction of blood flow. Implanted vessels gained significant mechanical strength and reactivity that were comparable to those of native veins. Our work demonstrates that fibrin-based TEVs hold significant promise for treatment of vascular disease and as a biological model for studying vascular development and pathophysiology. matrix degradation/remodeling; vascular disease; vascular reactivity; vascular tissue engineering; smooth muscle; endothelial cells MANY APPROACHES HAVE BEEN taken to replace diseased or damaged blood vessels. Synthetic conduits of polytetra-flouroethylene (Teflon, ePTFE) or polyethylene terephthalate (Dacron) have been used extensively with a great degree of success in replacement of large-diameter (Ͼ6 mm) vessels (9). However, small-diameter synthetic grafts displayed high failure rates due to thrombus and plaque formation. Adsorption of proteins or endothelial cells to the luminal surface of the grafts decreased thrombogenicity but did not restore vasoreactivity and long-term patency (8,9,11,26,37). Allogeneic grafts demonstrated long-term patency and reactivity, but their clinical use is prevented by high immunogenicity. Autografts, predominantly from saphenous veins or radial arteries, are the most widely used for small-diameter vessel replacement procedures such as coronary artery bypass. Although autologous grafts are currently the gold standard, limited availability, especially for repeat grafting procedures, and the pain and discomfort associated with the donor site necessitate the development of alternative technologies.Tissue engineering approaches that use natural or synthetic biomaterials as three-dimensional scaffolds for cell growth have been proposed. Natural biomaterials, derived from decellularized tissues, demonstrated successful infiltration of host cells and near physiological level of vasoreactivity after longte...

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“…These different products, while they all rely on the same principle for their adhesive, sealing, and hemostatic function, all have a different composition regarding salts and excipients [12]. Fibrinogen is a molecule that is very sensitive to small changes in the solvent composition, which can have a profound effect on the resulting fibrin network.…”

Section: Discussionmentioning

confidence: 99%

Optimized thrombin dilution protocol for a slowly setting fibrin sealant in surgery

Goessl

Redl

2005

Eur Surg

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Zusammenfassung. Grundlagen: Bei vielen chirurgischen Anwendungen (z. B. plastische und rekonstruktive Chirurgie) von Fibrinkleber ist eine längere Verarbeitungszeit von etwa 30-60 s vorteilhaft. Das kann durch eine Verdünnung der Thrombin-Komponente auf etwa 5 IU/ml erreicht werden. Ziel dieser Studie war es, ein optimales Verdünnungsmedium für die Thrombin-Komponente zu definieren, welches einerseits keine Veränderungen in den funktionellen Parametern des Fibrinklebers mit sich bringt und andererseits einfach und mit im OP vorhandenen Bestandteilen hergestellt werden kann.Methodik: Folgende Methoden kamen zur In-vitro-Beurteilung der Verdünnungsmedien zum Einsatz: Klebefestigkeit im Rattenhaut-Modell, Turbidimetrie und Rasterelektronenmikroskopie zur Bestimmung der Clot-Struktur, Reißfestigkeit der Fibrinclots durch Messen der zum Reißen nötigen Kraft. Die Fibrin-Quervernetzung in Abhängig-keit der Ca 2+ -Konzentration wurde durch quantitative Elektrophorese bestimmt.Ergebnisse: Das Verdünnungsmedium, das in vielen Kriterien die besten Ergebnisse gezeigt hat, enthält nur Kalziumchlorid in einer Konzentration von etwa 20 mM. Verdünnungsmedien mit einer zu hohen Ionenstärke ergaben Clots, die durch schlechte Reiß-und Klebefestigkeit, dünne Fibrinfasern und geringe Clot-Elastizität gekennzeichnet waren. In Abwesenheit von Kalzium kam es zu schlechter Fibrinquervernetzung und daraus resultierend zu schwachen und schlecht adherierenden Fibrinclots.Schlussfolgerungen: Das optimale Verdünnungsme-dium für die Verdünnung von Thrombin für einen langsamer bindenden Fibrinkleber wird angegeben.Schlüsselwörter: Fibrinkleber, Thrombin, Reißfestig-keit, Klebefestigkeit, Fibrinclot-Mikrostruktur.Summary. Background: Fibrin sealants find applications in many surgical fields (e.g., plastic and reconstructive surgery) where a slower setting time of about 30 to 60 s is beneficial. This can be achieved by diluting the thrombin component of the fibrin sealant to a concentration of about 5 IU/ml. This work was carried out to define an optimal dilution medium for thrombin which maintains all relevant functional parameters of the fibrin sealant and which is easy to prepare with components available in most operating theaters.Methods: Different performance criteria of a fibrin sealant were tested in vitro by the following methods: adhesive strength in a rat skin adhesion model, turbidimetry and scanning electron microscopy to determine the fibrin clots structure, tensile strength of the fibrin clots by measuring the force at break. The cross-linking of the fibrin sealant by factor XIII (FXIII) as a function of the calcium concentration was assessed by quantitative electrophoresis.Results: A dilution medium containing only calcium chloride in a concentration of about 20 mM performed best in most of the applied test systems. Dilution media with high ionic strength resulted in clots with low adhesive and tensile strength, thin fibrin fibers, and low clot elasticity. Dilution media without calcium prevented proper crosslinking of the result...

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Fibrin sealants in supporting surgical techniques: the importance of individual components

Cited by 38 publications

References 24 publications

Fibrin matrices: The versatile therapeutic delivery systems

Fibrin matrices: The versatile therapeutic delivery systems

Engineering of fibrin-based functional and implantable small-diameter blood vessels

Optimized thrombin dilution protocol for a slowly setting fibrin sealant in surgery

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