Anti-adhesion properties of a thrombin-based hemostatic gelatin in a canine laminectomy model: a biomechanical, biochemical, and histologic study.
METHODS
An in vivo study on the effects of an agent for scar prevention in a dog laminectomy model.


OBJECTIVE
To examine the anti-adhesion properties of a thrombin-based hemostatic gelatin (FLOSEAL; Baxter International Inc., Deerfield, IL).


BACKGROUND
Postlaminectomy dural adhesion sometimes causes symptomatic problems. Although a new type of hemostatic agent, a thrombin-based hemostatic gelatin, has been developed, its effect on postlaminectomy scar prevention is unknown.


METHODS
A 4-level lumbar laminectomy was performed on 11 adult mongrel dogs. There were 2 levels randomly chosen to receive the thrombin-based hemostatic gelatin treatment, while the remaining levels were untreated (control). Dogs were euthanized 8 weeks after surgery. To assess the tenacity of adhesion between the dura and scar, peel-off testing was performed. Gross, biochemical, and histologic analyses were then used to examine the samples.


RESULTS
Peel-off stiffness was significantly decreased in the treatment group (64.8% of the control, P = 0.032; 2-tailed unpaired t test). Histologically, there was significantly less scar tissue formation in the treatment group (P = 0.04). The gross analyses showed a trend toward a smaller amount of scar tissue and tenacity of adhesion between the dura and scar in the treatment group. Biochemically, there was a trend toward a lower collagen cross-links content in the treatment group (P = 0.07).


CONCLUSIONS
The thrombin-based hemostatic gelatin decreases the tenacity of adhesion between the dura and scar at laminectomy sites.
Miyamoto
Kei
K
Department of Orthopedic Surgery, Rush Medical College at Rush University Medical Center, Chicago, IL 60612, USA.
Masuda
Koichi
K
Inoue
Nozomu
N
Okuma
Masahiko
M
Muehleman
Carol
C
An
Howard S
HS
D000818:Animals; D001696:Biomechanical Phenomena; D002417:Cattle; D002921:Cicatrix / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004195:Disease Models, Animal; D004285:Dogs; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D013917:Thrombin / Q000627:therapeutic use*; D000267:Tissue Adhesions / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*
C411004:FloSeal Matrix; D006490:Hemostatics; D013917:Thrombin