Fibrinolysis inhibitors adversely affect remodeling of tissues sealed with fibrin glue.
Experiments have been carried out to determine if aprotinin and epsilon -amino caproic acid increases the quality of Fibrin glue. A rat model was used for tissues such as liver and skin while rabbits were used for application of glue in dura mater. Apposition of all the tissues, glued with fibrin was found to be good and remnants of the polymerized fibrin were seen even on the seventh day of application, though inhibitors were not incorporated with the glue. In skin, excessive amounts of fibrin remained as a result of addition of aprotinin and epsilon -amino caproic acid, as compared to the glue applied without any inhibitor. After dural sealing, the wound repair and new bone formation at craniotomy site progressed well in the fibrin glue applied area as compared to the commercially available glue that contained aprotinin. The adhesive strength of the glue without or with fibrinolysis inhibitors was found to be similar, after 1h grafts on rat back. The observations from this study suggests that the use of aprotinin with fibrin glue may not be required because, even liver tissue that is known to have high fibrinolytic activity was sealed and repaired well in the absence of plasminogen inhibitors. On the other hand, it was found that if inhibitors were added, nondegraded matrix remained in the tissue even after 15 days and affected migration of repair cells. Thus, the inhibition of fibrinolysis after fibrin glue application is found detrimental to wound healing.
Krishnan
Lissy K
LK
Thrombosis Research Group, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695012, India. lissykk@sctimst.ker.nic.in
Vijayan Lal
Arthur
A
Uma Shankar
P R
PR
Mohanty
Mira
M
D015119:Aminocaproic Acid / Q000009:adverse effects*; D007611:Aprotinin / Q000009:adverse effects*; D015718:Fibrin Tissue Adhesive; D005342:Fibrinolysis / Q000187:drug effects*; D014014:Tissue Adhesives
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D007611:Aprotinin; D015119:Aminocaproic Acid