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Terry Dubrow, MD; Robert J. Schwartz, MD; John McKissock, MD; Samuel E. Wilson, MD

Arch Surg. 1991;126(1):80-83.

Abstract
• The potential deleterious effects of aerosolized fibrin on contaminated procedures were investigated in a rat model of peritonitis. One hundred forty rats were divided into two groups. In the control group, gelatin capsules containing feces (10⁷ bacteria per milliliter) and barium sulfate at various dilutions were placed into the abdomen; in the second experimental group, a solution of cryoprecipitate, thrombin, and calcium was sprayed diffusely into the peritoneal cavity after similar fecal contamination. Fecal inocula with low bacterial concentrations (0.01, 0.1, and 0.15 mL) caused few deaths from peritonitis or abscess formation in either group. Heavy peritoneal contamination (0.25, 0.3, and 0.5 mL) caused early deaths from peritonitis in both groups, with 80% of the deaths due to sepsis in the first 48 hours. However, in the moderately contaminated rats (0.2 mL) of fecal inoculate), fibrin aerosol reduced the 10-day mortality from 80% to 10%. In all survivors in the fibrin-treated group, intraperitoneal abscesses developed. With intraperitoneal bacterial concentrations of 2 x 10⁶ organisms, early acute mortality from fibrinopurulent peritonitis is decreased at the expense of late, localized, nonlethal abscess formation. Aerosolized fibrin solution must be used with caution in contaminated surgery.

(Arch Surg. 1991;126:80-83)

Author Affiliations
From the Department of Surgery, Harbor-UCLA Medical Center, Torrance, Calif (Drs Dubrow, Schwartz, and Wilson); Maricopa Medical Center, Phoenix, Ariz (Dr McKissock); and UCLA School of Medicine, Los Angeles, Calif (Dr Wilson).

Footnotes
Accepted for publication September 23, 1990.

Read before the Tenth Anniversary Meeting of the Surgical Infection Society, Cincinnati, Ohio, June 15, 1990.

Reprint requests to Department of Surgery, Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA 90509 (Dr Wilson).

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