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Autologous fibrin gel: bactericidal properties in contaminated hepatic injury
S A Dulchavsky1, E R Geller, J Maurer
1Department of Surgery, School of Medicine, State University of New York, Stony Brook.
Abstract:
Fibrin glue is an effective hemostatic agent in a variety of clinical situations; its utility is limited by potential transmission of viral infection. We studied the bactericidal properties of fibrin gel (FG) in a murine contaminated hepatic injury model and in vitro by agar plate culture method. Intra-abdominal abscess formation and adhesion rate were assessed following controlled liver injury in association with abdominal contamination with 10(7) Bacteroides fragilis and hepatorrhaphy (H, n = 15) or FG (n = 12). Animals treated by hepatorrhaphy had a significantly greater intra-abdominal abscess rate (15/15 vs. 4/12, p less than 0.05) and adhesion rate (14/15 vs. 6/12, p less than 0.05) than animals treated with FG. Fibrin gel is bactericidal to Bacteroides fragilis, Enterobacter faecium, Escherichia coli, and Staphylococcus aureus but has no effect against Klebsiella pneumoniae or Pseudomonas aeruginosa; the plasma component appears active. Fibrin gel demonstrates significant improvement in adhesion formation and intra-abdominal abscess rate when compared with suture hepatorrhaphy. Fibrin gel appears protective in contaminated hepatic injury.
Insights
Fibrin gel (FG) effectively reduced intra-abdominal abscesses and adhesions in liver injury models. FG demonstrated bactericidal properties against common pathogens, offering a protective advantage over traditional hepatorrhaphy.
Area of Science:
- Surgical Innovation
- Infectious Disease Research
- Biomaterials Science
Background:
- Fibrin glue is a hemostatic agent with potential viral transmission risks.
- Bacterial contamination poses a significant risk in surgical hepatic injury.
- Evaluating novel applications for fibrin-based materials in surgery is crucial.
Purpose of the Study:
- To investigate the bactericidal properties of fibrin gel (FG).
- To compare the efficacy of FG versus hepatorrhaphy in a murine contaminated hepatic injury model.
- To assess FG's impact on intra-abdominal abscess formation and adhesion rates.
Main Methods:
- In vitro agar plate cultures assessed FG's bactericidal activity against specific bacteria.
- A murine model of contaminated hepatic injury was used.
- Animals were treated with either hepatorrhaphy (H) or FG following liver injury and bacterial contamination (Bacteroides fragilis).
Main Results:
- Fibrin gel (FG) significantly reduced intra-abdominal abscess rates (4/12) compared to hepatorrhaphy (15/15).
- FG treatment resulted in significantly lower adhesion rates (6/12) versus hepatorrhaphy (14/15).
- FG exhibited bactericidal activity against Bacteroides fragilis, Enterobacter faecium, Escherichia coli, and Staphylococcus aureus.
Conclusions:
- Fibrin gel (FG) demonstrates significant protective effects in contaminated hepatic injury models.
- FG is superior to suture hepatorrhaphy in reducing post-operative abscesses and adhesions.
- The plasma component of FG appears to be responsible for its observed bactericidal properties.