Effects of fibrin glue on hemostasis.
In order to decrease complications following incomplete hemostasis, we tried to make a safe, efficient and highly concentrated fibrin glue by thawing single-donor fresh frozen plasma. Using a unique animal model, in which arterial bleeding was created, fibrin glue and some related hemostatic agents were tested to evaluate their hemostatic effectiveness. The results demonstrated that: 1) the concomitant use of cryoprecipitate-thrombin tissue glue with adjuvant (aprotinin or calcium chloride) had a better hemostatic effect than the use of cryoprecipitate-thrombin tissue glue alone (p < 0.05); 2) impregnation of fibrin glue with a suitable vehicle was advisable to accelerate the coagulation plug formation and to enhance the mechanical strength of the adhesive plug; 3) Gelform, used as a vehicle to hold the fibrin glue, had a more efficient hemostatic effect than gauze, collagen fleece and Surgicel (p < 0.05); 4) systemic heparinization attenuated the effectiveness of the hemostatic agents and aggravated the bleeding problem, but a low hematocrit level did not; 5) fibrin glue had its own limitations, especially under systemic heparinization, on hemostatic effectiveness in a high-pressure system. Understanding the characteristics of fibrin glue, as mentioned above, definitely improved the hemostatic effectiveness of the glue, especially after failure of the usual methods of controlling bleeding.
Chang
H
H
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
Wu
G J
GJ
Perng
W L
WL
Hwang
F Y
FY
Hung
C R
CR
D000818:Animals; D004285:Dogs; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006400:Hematocrit; D006438:Hemodilution; D006488:Hemostasis, Surgical / Q000379:methods*; D006493:Heparin / Q000627:therapeutic use
D015718:Fibrin Tissue Adhesive; D006493:Heparin