Important Factors Influencing the Strength of Autologous Fibrin Glue; the Fibrin Concentration and Reaction Time &amp;ndash; Comparison of Strength with Commercial Fibrin Glue

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A controlled study was performed to evaluate the effectiveness and biocompatibility of ethanol-prepared fibrin sealant for closure of an experimental pulmonary air leak in pigs. The sealant was based on co-administration of fibrinogen concentrate prepared from plasma by ethanol precipitation and thrombin solution. Standardized wedge resections were created bilaterally in the lungs of 5 pigs and sutured on both sides. The lungs were randomized for treatment with fibrin glue or as a control no sealant. Chest tubes were inserted and the volume of leaked air measured at regular intervals for 2 h after sealant application. In 3 pigs, survival studies were performed to assess the persistence and biocompatibility of the glue. The sealant, prepared either from human plasma or autologous pig plasma, was instilled onto the intact pleura through a thoracoscope. Histological examination of the clots was performed after 3, 7 and 21 days. The mean air leak from the fibrin-sealed lungs was 16 ml/min versus 213 ml/min from the control lungs. The reduction in air leak averaged 92% (95% confidence interval, 74-99%). Infiltration with cells was seen early, and fibroblasts were proliferating after 7 days. At 21 days, the clots were organized and partly resorbed. No differences were seen between the cellular reactions to human or porcine fibrin sealant. In conclusion, air leak after experimental lung surgery was significantly reduced by the use of fibrin glue prepared from plasma. The fibrin sealant appeared to be biocompatible and to function as a scaffold for cell growth. The glue is suitable for autologous use in humans.

Section: Discussionmentioning

confidence: 64%

Effectiveness of Autologous Fibrin Sealant in Experimental Lung Surgery

Kjærgård¹,

Axelsen²

1996

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“…However, few comparative studies have been undertaken to date [5,9]. In the current study, we compared the physical properties of two conventional non-autologous fibrin sealants (prepared from lyophilised fibrinogen and thrombin) with an autologous fibrin sealant, Vivostat (prepared from individual blood donations and free from added thrombin).…”

Section: Discussionmentioning

confidence: 99%

“…Since these physical properties appear to vary according to fibrin concentration [5] as well as other biochemical or chemical factors in the fibrin sealant [6][7][8], it is reasonable to assume that there will be variations in the performance characteristics of different fibrin sealants. The properties of the sealant may also vary depending on the efficiency of mixing of the components and the method of application.…”

Section: Introductionmentioning

confidence: 99%

Physical Characteristics of Vivostat<sup>®</sup> Patient-Derived Sealant

Velada

Hollingsbee²

2001

This study compared the physical characteristics of Vivostat^® patient-derived sealant with two conventional fibrin sealants, Tissucol^® and Beriplast^®. Vivostat sealant exhibited greater elasticity without compromising tensile strength. Vivostat sealant polymerised at low temperatures (4 and 25°C) or at high temperature (70°C) exhibited similar viscoelastic properties as when polymerised at normal physiological temperature (37°C). Vivostat fibrin I solution can be stored at room temperature for up to 8 h without affecting the mechanical properties of the derived sealant. These physical characteristics of Vivostat patient-derived sealant suggest that it may have suitable stability and performance characteristics for use in a wide range of surgical procedures.

“…Two important factors influencing the strength of a fibrin sealant are its fibrin concentration and the reaction time [14]. The Vivostat System processor unit is designed to produce a constant fibrin concentration of 20 mg/ml.…”

Section: Discussionmentioning

confidence: 99%

Development of a Model for Measurement of Adhesion Strength of Fibrin Sealant to Human Tissue

Kjærgård

Velada²,

Pulawska³

et al. 1999

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It is crucial for the surgeon to know the physical properties of a surgical sealant. Current test methods of fibrin sealant involving animal testing or in vitro testing of sealant using artificial substrates have little clinical relevance. Most of these test methods also lack accuracy and reproducibility. A new model was developed for testing strength and in vitro adhesion of fibrin sealant to vital human tissue using fresh vein leftover from coronary artery bypass grafting. The vein leftover was cut into samples and fastened in a tensiometer linked to a computer. Patient-derived fibrin sealant (0.1 ml) was applied to the tissue, and the surfaces of the tissue samples were held together for 5 min, and then automatically pulled apart by the tensiometer. Data were generated in a load cell and recorded and analysed by the computer. The reproducibility for the adhesion strength was 6.6%, adhesion energy 9.8%, and elongation at break 8.4%. The method has been considered ethical and has good reproducibility. The method can be used for standardised measurements and comparison of different types of fibrin sealant without the sacrifice of animals.