Histopathological effects of modern topical sealants on the liver surface after hepatectomy: an experimental swine study

Abstract

The present study aimed to determine the impact of different sealant materials on histopathological changes to the liver surface after liver resection. Thirty-six landrace pigs underwent left anatomical hemihepatectomy and were assigned to a histopathological control group (HPC, n = 9) with no bleeding control, a clinically simulated control group (CSC, n = 9) with no sealant but bipolar cauterization and oversewing of the liver surface, and two treatment groups (n = 9 each) with a collagen-based sealant (CBS) or a fibrinogen-based sealant (FBS) on resection surface. After postoperative day 6, tissue samples were histologically examined. There were no significant differences in preoperative parameters between the groups. Fibrin production was higher in sealant groups compared with the HPC and CSC groups (both p < 0.001). Hepatocellular regeneration in sealant groups was higher than in both control groups. A significantly higher regeneration was seen in the FBS group. Use of sealants increased the degree of fibrin exudation at the resection plane. Increased hepatocellular necrosis was seen in the CBS group compared with the FBS group. The posthepatectomy hepatocellular regeneration rate was higher in the FBS group compared with the CBS group. Randomized studies are needed to assess the impact of sealants on posthepatectomy liver regeneration in the clinical setting.

COCu: A Robust Self‐Regenerative Hydrogel with Applicability as Both Hydrated Gel Dressing and Dry Suture for Seamless Tissue Fixation and Repair

“…This is probably partly owing to the locally released copper ions by the COCu hydrogel, which promote vascular regeneration and tissue repair. [33,[43][44][45] Further, the rat liver regeneration ability and recovery were evaluated according to the expression levels of the proliferative nuclear antigen (PCNA), as measured by a quantitative reverse transcription -polymerase chain reaction (qRT-PCR) assay and Western blot (WB) for the different groups. In general, after liver tissue injury, the expression of PCNA first increases (within 24 h) and then decreases, leveling off at 72 h to 120 h. The level of PCNA thus can be used as an indicator of the liver recovery and regeneration.…”

“…In contrast, in the dtCOCu group, there is barely any adhesion, with no hydrogel remaining on the incision surface, and the incision wound is healed with a flat and pale white new tissue (Figure 8a, 7d dtCOCu, yellow dotted line). In addition, the intra-abdominal adhesions were assessed for their qualitative aspects as in the previous literature, [43,44] and adhesion scores of each group are summarized in Table 1. The adhesion scores of COCu (1.8 ± 0.2) and dtCOCu (1.2 ± 0.2) are lower than those of the GG (2.6 ± 0.25) and CG (2.4 ± 0.25) groups, respectively, most likely owing to the anti-inflammatory and antibacterial properties of the copper.…”

“…This is probably partly owing to the locally released copper ions by the COCu hydrogel, which promote vascular regeneration and tissue repair. [ 33,43–45 ]…”