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.
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
H
H
Chang
G J
GJ
Wu
W L
WL
Perng
F Y
FY
Hwang
C R
CR
Hung
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