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

Abstract

The objective of the research was to determine the effect of the type, dose, and volume of anti-fibrinolytic agents (tranexamic acid, aprotinin) added to fibrin formulations, on adhesion development. Adhesions were induced in 228 male rats by creating apposing parietal and visceral peritoneal defects. Animals were randomized to receive no treatment or a fibrin formulation containing aprotinin or tranexamic acid. Seven days later the incidence of adhesions, and the force and energy required to detach them, were determined. Adhesions developed in 13/13 rats in the control and aprotinin groups. Treatment with fibrin (100 mg/ml tranexamic acid) resulted in adhesions in 4/14 rats (as strips, p < or = 0.0005), 4/10 rats (as spray, p < or = 0.0036), and 12/15 rats (by drip). The reduction of adhesions was dependent on the concentration of tranexamic acid with strip and spray application. Using commercial formulations, tranexamic-acid-containing fibrin (10/15, p = 0.042), but not aprotinin-containing fibrin (13/15), reduced the incidence of side-wall adhesions from 15/15 in controls. Fibrin containing either tranexamic or aprotinin reduced the incidence and severity of adhesions. This effect was greater when tranexamic acid was used and was dependent on the mode of administration, the volume, and to a degree, the concentration of tranexamic acid.

Commercial Fibrin Sealants Are Not Equivalent in a Rabbit Liver-Resection Model Which Quantitatively Evaluates Hemostasis and Formation of Adhesions

“…The seal formed with sealant 3 appears to be more secure postoperatively, resulting in a lower incidence and severity of re-bleeding. This may be at least partly attributable to tranexamic acid (nominal 95 mg/ml) in the formulation of sealant 3, Quixil [9,10] .…”

A prospective, controlled, randomized, multicenter, exploratory pilot study evaluating the safety and potential trends in efficacy of Adhexil

“…Animal studies have been conducted with Adhexil in both abdominal wounds (rat models) and uterine horn wound (rabbit models). These studies have shown effectiveness of this product in prevention and/or reduction of postsurgical adhesions, in both the absence and presence of bleeding (27,28).…”

Significance of Cyclooxygenase-2 Induced via p38 Mitogen-Activated Protein Kinase in Mechanical Stimulus-Induced Peritoneal Adhesion in Mice

“…Therefore, the severest adhesion formation could receive a score of 12. Second, the maximum force required to detach the adhered cecum completely was determined using a piezo-electrical device, as described in a previous report (Wiseman et al, 2004). Finally, the cecum and intestine were opened along the mesenteric attachment for performance of planimetry (Muller et al, 2003).…”