Comparison of the topical haemostatic agents for the prevention of suture hole bleeding. An experimental study.
OBJECTIVE
using a rabbit vascular graft model we investigated the use of fibrin glue (FG), gelatin-resorcinol-formaldehyde (GRF), and collagen (C) as a means of reducing suture hole bleeding.


METHODS
twenty-eight rabbits were divided into four groups: fibrin glue, gelatin-resorcinol-formaldehyde, collagen and control. A 1 cm incision was made in the abdominal aortic wall of each animal. Incisions were covered with a polytetrafluoroethylene patch sutured with a 7-0 polypropylene. Fibrin Glue, GRF, and C were applied to cover suture holes in the groups 1, 2 and 3, respectively, but nothing in controls (group 4). The fibrin clot was allowed to achieve strength for 3 minutes before the clamps were reopened. After reopening the clamps, blood was collected from the surgical site using a syringe for a total of 2 min.


RESULTS
mean blood loss was significantly lower in the FG, GRF, and C compared with control group (p=0.0022, p=0.0022, and p=0.0017, respectively). The volume of blood lost and the time of haemostasis in the group 1 (FG) was less than those in groups 2 and 3 (GRF and C, respectively) (p=0.001). The haemostasis (defined 2 min later) was achieved only in group 1 (FG) (p=0.00067).


CONCLUSIONS
FG, GRF and C all reduce blood loss. Fibrin glue containing factor XIII was the most effective.
Unlü
Yahya
Y
Department of Cardiovascular Surgery, Atatürk University, 25170 Erzurum, Turkey. yahyaunlu@hotmail.com
Vural
U
U
Koçak
H
H
Ceviz
M
M
Becit
N
N
Akbulut
O
O
D000287:Administration, Topical; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003094:Collagen / Q000627:therapeutic use; D004195:Disease Models, Animal; D004338:Drug Combinations; D004341:Drug Evaluation; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005557:Formaldehyde / Q000627:therapeutic use; D005780:Gelatin / Q000627:therapeutic use; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000627:therapeutic use*; D008955:Models, Cardiovascular; D010865:Pilot Projects; D011817:Rabbits; D012118:Resorcinols / Q000627:therapeutic use; D013536:Suture Techniques
D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D012118:Resorcinols; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin; D003094:Collagen