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Fibrin glue as a biologic vascular patch--a comparative study.

B Barton, E E Moore, W H Pearce

    The Journal of Surgical Research
    |May 1, 1986
    PubMed
    Summary
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    Fibrin sealant (FS) effectively seals arterial injuries, demonstrating superior strength compared to other hemostatic agents. However, its efficacy on venous injuries was not significantly different from other tested materials.

    Area of Science:

    • Vascular Surgery
    • Biomaterials
    • Hemostasis

    Background:

    • Fibrin sealant (FS) is a two-component biologic adhesive used for hemostasis.
    • FS has shown efficacy in sealing arterial injuries without sutures and as a material for vascular grafts and anastomoses.
    • Venous distensibility limits the efficacy of FS at higher pressures.

    Purpose of the Study:

    • To characterize the sealant ability of fibrin sealant on open arterial and venous injuries.
    • To compare the efficacy of fibrin sealant with other hemostatic agents (oxidized cellulose, microcrystalline collagen, and microcrystalline collagen plus thrombin).

    Main Methods:

    • Canine peripheral arteries and veins were isolated and perforated with a 16-gauge needle.
    • Injuries were treated with fibrin sealant (FS), oxidized cellulose (OC), microcrystalline collagen (MC), or MC plus thrombin (MCT).

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  • Intralumenal pressure was progressively increased to determine the bursting threshold of the sealant.

    • Main Results:

    • The arterial bursting threshold for FS (250 +/- 59.7 mm Hg) was significantly higher than for OC, MC, or MCT (P < 10^-6).
    • The bursting threshold for FS applied to veins (17.5 +/- 11.7 mm Hg) was not significantly different from other agents (P < 0.05).
    • FS demonstrated superior sealant capability in arterial injuries compared to conventional hemostatic agents.

    Conclusions:

    • Fibrin sealant is a highly effective agent for sealing arterial injuries, providing superior strength.
    • Fibrin sealant's efficacy on venous injuries is comparable to other tested hemostatic agents.
    • FS shows promise as a sealant for vascular repairs, particularly in arterial applications.