Splenic salvage using biologic glue
H. B. Kram, W. C. Shoemaker, S. T. Hino and D. P. Harley
Fibrin sealant (FS) is a biologic adhesive containing highly concentrated
human fibrinogen that is effective in the face-to-face sealing of tissues,
and in establishing hemostasis. We evaluated FS in 32 experimentally
produced splenic injuries in six adult mongrel dogs. Complete hemostasis
was achieved in all animals prior to closure. The dogs were reexplored
postoperatively at intervals varying from four hours to six weeks (mean +/-
SD, 21 +/- 20 days). When the dogs were killed, there was no gross evidence
of splenic disruption or recurrent bleeding; all of the spleens had
developed well-healed capsules. Histologic examination demonstrated a
regenerated fibrous capsule extending over the superficial injuries as well
as into the deep injuries, without significant inflammatory response. We
conclude the following: that FS provides adequate hemostatic control of
superficial and deep splenic injuries, FS has good systemic and local
compatibility, it can be applied to bleeding parenchymal wounds, it reduces
the need for parenchymal sutures that may be traumatic, and it promotes
splenic wound healing.
