Analysis of the hemostatic potential of modern topical sealants on arterial and venous anastomoses: an experimental porcine study

作者：Fonouni Hamidreza; Kashfi Arash; Majlesara Ali; Stahlheber Oliver; Konstantinidis Lukas; Kraus Thomas W; Mehrabi Arianeb^*; Oweira Hani

来源：Journal of Materials Science: Materials in Medicine , 2017, 28(9): 134.

DOI：10.1007/s10856-017-5932-5

One of the widely accepted adjunctive agents in the variety of surgical modalities are sealants. Our study aim was to compare four commonly used modern sealants in a standardized experimental setting to assess their feasibility, and hemostatic efficacy in vascular anastomosis. Forty landrace pigs (weight: 24.7 +/- 3.8 kg) were randomized into the control (n = 8) and four sealant groups; TachoSil (R) (n = 8), Tissucol Duo (R) (n = 8), Coseal (R) (n = 8), and FloSeal (R) (n = 8). After doing a portal vein end-to-end anastomosis as well as stitches of aortic incision, the sealants were applied on anastomotic site. The control group was left intact. In portal vein anastomosis, the sealants led to a complete hemostasis significantly better than control group. The mean of blood loss was also significantly reduced. In successful subgroups, there was a difference in the mean-time to reach complete hemostasis ranging from 15 s in Coseal (R) to 76 s in FloSeal (R) group (p < 0.05). In aortotomy experiments, except Tissucol Due (R), which had insufficient hemostasis, other sealants led to a complete hemostasis. The mean blood loss was significantly reduced in sealants groups as well. The four sealants are effective in reducing the suture-hole bleeding in portal vein anastomosis. However, the hemostatic potential is heterogeneous among sealants. This means that "one-size-fits-all" approach is not appropriate for application of sealants in diversity of vascular surgery and it should be based on the type and the severity of injury and the structure of tissue.

• 出版日期2017-9