title: Hemostasis and healing of superficial splenic injuries using Nd:YAG laser and nonsuture techniques: preliminary report.
abstract: This study was designed to compare Nd:YAG laser to fibrin glue, electrocautery, and avitene in the management of superficial splenic injury. Six dogs were submitted to laparotomy. A #11 blade scalpel was used to sharply excise the splenic capsule inflicting four 1" x 1" superficial injuries on each spleen. The lesions were treated. All animals had a second laparotomy ("first relaparotomy"); 2 dogs each were reexplored on postop days 3, 7, and 14. Morphologic and histologic observations were made. A third and final relaparotomy was performed on all dogs at 21 days with repeated morphologic and histologic assessments. Hemostatic times, grades of adhesions, and microscopic changes were not significantly different among the various treatments (P > 0.25). Capsular plaque formations were significantly different at the first relaparotomy (P < 0.01) and at final relaparotomy (P < 0.05). Both adhesions and capsular plaque formation were least at fibrin glue-treated sites, whereas Nd:YAG (1.06 microns) was most effective for average hemostatic time (mean = 109.67 s). Electrocautery produced the greatest necrosis at treatment sites. We conclude that all modalities are effective in controlling hemorrhage.
authors.affiliation: Department of Surgery, North Oakland Medical Center, Pontiac General Hospital Division, Michigan 48341-1651.
authors.forename: C C
authors.initials: CC
authors.lastname: Vanterpool
authors.forename: F H
authors.initials: FH
authors.lastname: Alrashedy
authors.forename: T
authors.initials: T
authors.lastname: Gurchumelidze
authors.forename: M E
authors.initials: ME
authors.lastname: Gales
authors.forename: Y J
authors.initials: YJ
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Libcke
authors.forename: M A
authors.initials: MA
authors.lastname: Schork
mesh_terms: D000818:Animals; D003094:Collagen / Q000627:therapeutic use; D004285:Dogs; D004564:Electrocoagulation; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006488:Hemostasis, Surgical / Q000379:methods*; D053685:Laser Therapy; D009336:Necrosis; D013154:Spleen / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D000267:Tissue Adhesions; D014945:Wound Healing / Q000502:physiology
chemical_list: D015718:Fibrin Tissue Adhesive; D003094:Collagen