This study evaluated Fibrin Sealant (FS), a two-component biologic adhesive that is effective in establishing hemostasis, in 27 experimentally produced splenic injuries in five adult mongrel dogs. Ten small superficial lacerations (2.0 cm in length), six large superficial lacerations (3.0-6.0 cm in length), three small wedge resections, and eight stab wounds extending into the splenic hilum were effectively repaired with FS without suture splenorrhaphy or temporary splenic hilar occlusion. Complete hemostasis was achieved in all animals prior to skin closure. Dogs were reexplored postoperatively at intervals varying from 4 h to 6 weeks. When animals were killed, there was no gross evidence of splenic disruption or recurrent bleeding; the spleens all had developed well-healed capsules. Histologic examination demonstrated a regenerated fibrous capsule extending over the injuries without significant inflammatory response. We conclude that FS provides adequate hemostatic control of superficial and deep splenic injuries; has good systemic and local compatibility; can be applied to bleeding parenchymal wounds; organ ischemia is generally not required; avoids the use of parenchymal sutures, which may be traumatic; and may promote splenic wound healing. Thus, use of FS is an effective technique for splenic preservation after trauma.

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Use of concentrated fibrinogen in experimental tracheal repair.

Tracheal stenosis is a devastating complication of tracheal resection that may be related to improper suture selection and technique, as well as extensive surgical devascularization. This study evaluated Fibrin Sealant (FS) (Immuno AG, Vienna, Austria), a two-component biologic adhesive, as a method for reducing the need for sutures in tracheal surgery. This adhesive has been found to be effective in face-to-face sealing of tissues, wound healing, and in establishing hemostasis. Six adult mongrel dogs underwent tracheal repair with FS. Three had tracheal hemitransections (approximately three quarters of the circumference) and were repaired using one absorbable suture and FS, and three had complete transections (with resection of two tracheal rings each) repaired using five absorbable sutures and FS. The animals were killed at varying intervals ranging from 6 h to 6 weeks. No animal had gross evidence of significant tracheal stenosis, and the endotracheal mucosa appeared well healed. We conclude that the use of FS in tracheal reconstruction results in a stable, leakless trachea, and that it significantly reduces the number of sutures needed; this may lead to a decreased potential for anastomotic ischemia and tracheal stenosis.

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PubMedDate not supplied