title: Basic in vitro experiment on the adhesive effects of sheet-type hemostatic agents used in combination with a liquid fibrin sealant.
abstract: OBJECTIVE
  Various hemostatic agents have been used quite effectively for hemostasis, as well as for providing effective adhesion during laparoscopic partial nephrectomies. In this study, we investigated the adhesiveness to the renal tissue of some sheet-type hemostatic agents used in combination with a liquid fibrin sealant.
  
  
  METHODS
  In Experiment A, component solutions of the fibrin glue (liquid fibrin sealant) were dripped onto a kite string placed annularly on a porcine kidney slice. Then, one of the sheet-type hemostats--namely, the collagen, gelatin, or cellulose hemostat--was placed on the slices, and a string scale was used to measure the force needed to pull the string apart vertically from the kidney slice. Twelve slices were used for each group, and the weight data were analyzed statistically. The tissue adhering to each sheet-type hemostatic agent was fixed in formalin and sliced and then examined by light microscopy after hematoxylin and eosin staining. In Experiment B, the solutions were dripped onto the sheet-type hemostatic agent placed first on the slice, and the force needed for pulling apart the hemostat sheet from the slice was similarly examined.
  
  
  RESULTS
  The combination of fibrin glue plus a collagen hemostat was clearly superior in Experiment A, but the hemostat and renal tissue could be pulled apart more easily in Experiment B. These results showed that fibrin glue could not exert its expected adhesive effect unless it is used in combination with another hemostatic agent or is directly applied to renal tissue.
  
  
  CONCLUSIONS
  It is important to obtain further comparative data among agents and select the appropriate agents, taking into consideration the type of surgery.
authors.affiliation: Osaka City University, Graduate School of Medicine, Osaka, Japan. ishii-1212@tcct.zaq.ne.jp
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ishii
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawashima
authors.forename: Takuma
authors.initials: T
authors.lastname: Hayama
authors.forename: Sumika
authors.initials: S
authors.lastname: Mayabashira
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Toshikado
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000818:Animals; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D006490:Hemostatics / Q000494:pharmacology*; D066298:In Vitro Techniques; D007668:Kidney / Q000187:drug effects* / Q000473:pathology; D034421:Sus scrofa; D014014:Tissue Adhesives / Q000494:pharmacology*
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014014:Tissue Adhesives