Postoperative Adhesion Formation following Ovarian Reconstruction with Fibrin Glue in the Rabbit

Abstract

To compare postoperative adhesion formation following ovarian reconstruc tion with fibrin glue or the microsurgical suturing technique, an experimental study was performed on sixteen adult female rabbits. While left ovaries were reapproximated with 6-0 coated polyglactin using a microsurgical technique, right ovaries were reconstructed with fibrin glue following ovarian bisection. Four weeks later, second-look laparotomies were performed to evaluate the adnexal adhesions. These were scored according to the American Fertility Society classification. Mean adnexal adhesion scores were 8.2 ± 2.3 in the sutured ovary and 5.0 ± 1.1 in the glued ovary (p > 0.05). Ovarian reconstruc tion with fibrin glue does not reduce postoperative adhesion when compared with the usual suturing technique.

The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat

“…Animal or human studies have used autologous fibrin, 20 cryoprecipitate, 12,16 or commercial fibrin sealants such as Beriplast™ 19,22,26 or Tisseel (or its equivalents, TissuCol™, Hemaseel™), which contain a fibrinolysis inhibitor (aprotinin). 11,[13][14][15]17,18 The effectiveness of the fibrin preparation may be partly related to its persistence on tissue, which in turn is related to its ability to resist degradation by plasmin. Some commercial products contain aprotinin, a protein derived from bovine lung.…”

Use of Fibrin Sealant for Reproductive Surgery: A Randomized Study in the Rabbit Model

“…In the rabbit model, De Iaco et al [10] demonstrated that postoperative adhesion scores in animals after laparoscopic fibrin sealant application on uterine horn lesions are significantly lower compared to control animals. Bilgin et al [11] recently demonstrated in the rabbit model that ovarian reconstruction with fibrin glue does not reduce postoperative adhesion forma tion when compared with microsurgical suturing. How ever, as underlined by the authors, studies comparing fibrin glue reconstruction with leaving the ovary open are needed [11].…”

“…Bilgin et al [11] recently demonstrated in the rabbit model that ovarian reconstruction with fibrin glue does not reduce postoperative adhesion forma tion when compared with microsurgical suturing. How ever, as underlined by the authors, studies comparing fibrin glue reconstruction with leaving the ovary open are needed [11]. In the present study we found no difference in periovarian and periuterine adhesion formation be tween the fibrin sealant-covered side and the control uncovered, unsutured side in a model in which each ani mal served as its own control.…”

“…Fibrin sealant, obtained by mixing a source of highly concentrated fibrinogen with aprotinin, thrombin and calcium chloride, is one of the newly introduced agents, but experimental data concerning its efficacy in prevent ing postoperative adhesion formation are inconclusive [6][7][8][9][10][11], In a recent paper by Bilgin et al [11], ovarian reconstruction with fibrin glue did not result in reduced postoperative adhesion formation when compared with microsurgical techniques. A call for further studies com paring fibrin sealant application with leaving the ovary open was made in the above study [11].…”

“…A call for further studies com paring fibrin sealant application with leaving the ovary open was made in the above study [11].…”