Autologous fibrin gel: bactericidal properties in contaminated hepatic injury.
Fibrin glue is an effective hemostatic agent in a variety of clinical situations; its utility is limited by potential transmission of viral infection. We studied the bactericidal properties of fibrin gel (FG) in a murine contaminated hepatic injury model and in vitro by agar plate culture method. Intra-abdominal abscess formation and adhesion rate were assessed following controlled liver injury in association with abdominal contamination with 10(7) Bacteroides fragilis and hepatorrhaphy (H, n = 15) or FG (n = 12). Animals treated by hepatorrhaphy had a significantly greater intra-abdominal abscess rate (15/15 vs. 4/12, p less than 0.05) and adhesion rate (14/15 vs. 6/12, p less than 0.05) than animals treated with FG. Fibrin gel is bactericidal to Bacteroides fragilis, Enterobacter faecium, Escherichia coli, and Staphylococcus aureus but has no effect against Klebsiella pneumoniae or Pseudomonas aeruginosa; the plasma component appears active. Fibrin gel demonstrates significant improvement in adhesion formation and intra-abdominal abscess rate when compared with suture hepatorrhaphy. Fibrin gel appears protective in contaminated hepatic injury.
Dulchavsky
S A
SA
Department of Surgery, School of Medicine, State University of New York, Stony Brook.
Geller
E R
ER
Maurer
J
J
Kennedy
P R
PR
Tortora
G T
GT
Maitra
S R
SR
D000038:Abscess / Q000209:etiology / Q000382:microbiology; D000818:Animals; D001442:Bacteroides Infections / Q000209:etiology / Q000382:microbiology; D001441:Bacteroides fragilis / Q000254:growth & development*; D002118:Calcium / Q000494:pharmacology; D002951:Citrates / Q000494:pharmacology; D019343:Citric Acid; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology* / Q000627:therapeutic use; D006490:Hemostatics / Q000494:pharmacology*; D008099:Liver / Q000293:injuries*; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D013917:Thrombin / Q000494:pharmacology; D014947:Wounds and Injuries / Q000150:complications / Q000382:microbiology
D002951:Citrates; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D019343:Citric Acid; D013917:Thrombin; D002118:Calcium