Hemostatic Efficacy and Safety of the Novel Medical Adhesive, MAR VIVO-107, in a Rabbit Liver Resection Model

Abstract

Background: Topical hemostatic agents are useful when hepatic hemorrhage is difficult to control. The aim of this study was to evaluate the hemostatic efficacy and safety of a biodegradable polyurethane-based adhesive, MAR VIVO-107 (MAR), in comparison with a clinically used fibrin glue. Methods: Thirty female New Zealand white rabbits were randomly assigned to 3 study groups as follows: MAR (n = 10), fibrin glue (n = 10), and saline groups (n = 10). After standardized partial liver resection was performed, each agent was immediately applied to the wound area. Bleeding time until hemostasis and blood loss were recorded. After 7 days, body weight, hematology parameters, and serum levels of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase were measured. Simultaneously, the severity of intra-abdominal adhesion was evaluated. Results: The mean bleeding time in the MAR (38 ± 10 s) and fibrin glue groups (65 ± 17 s) was significantly shorter than that in the saline group (186 ± 12 s). Similarly, the mean blood loss in the MAR (9 ± 3 g) and fibrin glue groups (9 ± 3 g) was significantly less than that in the saline group (23 ± 4 g). No significant differences in bleeding time and blood loss were found between the MAR and fibrin glue groups. The postoperative survival rate was 100% in all the groups. Body weight as well as hematological and serum biochemical values on day 7 were within the small and physiological range when compared with the preoperative baseline values, and significant differences were not detected among the MAR, fibrin glue, and saline groups. The severities of adhesion were similar between the 3 groups. Conclusion: Our data demonstrated that MAR was not inferior to fibrin glue in terms of hemostatic efficacy and safety.

Mechanical strength and hydrostatic testing of VIVO adhesive in sutureless microsurgical anastomoses: an ex vivo study

“…The tissue adhesive VIVO showed good adhesion in mass bleeding and wet tissues 18 , 19 . In addition, our results show that VIVO has sufficient tensile strength 1.33 ± 0.46 [N] and burst pressure 299 ± 4.47 [mmHg], to adhere adequately to wet tissue, making it a suitable material for seamless vascular anastomoses.…”

“…Therefore, the application of adhesives on wet tissues is considered particularly challenging 17 . In contrast, VIVO has shown significant hemostatic results in mass bleeding porcine liver resection models 18 and long-term rabbit mass bleeding liver resection models 19 . Both investigations were conducted in liver tissue that was bleeding heavily and moist.…”

Efficacy of a Novel Medical Adhesive for Sealing Lung Parenchyma: An in vitro Study in Rabbit Lungs

“…Recent studies have reported the use of the novel medical adhesive VIVO based on polyurethane/urea technology [10, 11]. VIVO is composed of 2 ingredients: an isocyanate-functionalized prepolymer as an adhesive agent and a curing agent mixture mainly based on amine-functionalized aspartic acid ester(s) and filling agent(s) (Fig.…”

“…VIVO is composed of 2 ingredients: an isocyanate-functionalized prepolymer as an adhesive agent and a curing agent mixture mainly based on amine-functionalized aspartic acid ester(s) and filling agent(s) (Fig. 1) [10][11][12]. A static mixing unit was used to mix the 2 components, which could easily be applied to the wound surface.…”

“…The wound surface remains visible due to the transparent color. The VIVO syringe was prepared as follows: a double-chamber syringe was added to its tip in a vertical position for approximately 20 s to obtain bubble-free glue [10][11][12].…”