Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy.
BACKGROUND
Ensuring adequate haemostasis is a major difficulty in the field of liver surgery. This study aimed to evaluate a novel fibrin sealant (Vivostat), designed for autologous preparation, in a porcine model of partial hepatectomy.


METHODS
Thirty-six Large White Landrace pigs underwent partial left hepatectomy by finger fracture under portal vascular inflow occlusion. Animals were randomized to treatment of the resected surface with either fibrin sealant (Vivostat, n = 12) or regenerated oxidized cellulose gauze (Surgicel, n = 12), or were left untreated (controls, n = 12). Blood loss from the resection margin was measured at 2-min intervals for 10 min, and the time to haemostasis was recorded. Following complete haemostasis the animals recovered for 7 days.


RESULTS
Median (range) blood loss in the control group was 94.3 (17.3-467.0) g, and was significantly reduced with Vivostat (13.8 (5.5-150.9) g) and Surgicel (22.8 (5.8-67.3) g). Median (range) time to haemostasis in controls (31 (12-52) min) was also significantly reduced by Vivostat (8 (0-32) min) and Surgicel (10 (0-19) min) (both P < 0.001 versus controls, Kruskal-Wallis test).


CONCLUSIONS
The novel fibrin sealant, Vivostat, is as effective as Surgicel cellulose gauze in achieving haemostasis after porcine partial hepatic lobectomy.
Davidson
B R
BR
University Department of Surgery and Comparative Biology Unit, Royal Free and University College School of Medicine, London, UK.
Burnett
S
S
Javed
M S
MS
Seifalian
A
A
Moore
D
D
Doctor
N
N
D000818:Animals; D016063:Blood Loss, Surgical; D003250:Constriction; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D008099:Liver / Q000098:blood supply; D011168:Portal System / Q000502:physiology; D013552:Swine
D015718:Fibrin Tissue Adhesive