Introduction

Fibrin glue has recently been used in various surgical fields,on the assumption that it causes only very few foreign body reactions or none at all (1,2,3,4)

The aim of this experimental study was to determine whether fibrin glue causes foreign body reactions if applied to injured colon.

Material and method

This experiment was performed on 20 Wistar rats weighing 200 to 250 g. A single intraperitoneal dose of sodium pentobarbital (50 mg / kg body weight) was injected as an anesthetic and the abdomen shaved.The abdomen was opened by a median lapatomy incision.The descending colon of 10 rats was perforated approximately 4 mm after then the wound was sealed with fibrin glue (Group D).

In the control group (Group K),the colon wound performed in the same manner but was not sealed with glue.

The animals in both groups were surprisingly survived,so they were sacrificed on the 11 the postoperative day.The perforated colon segment were resected for histopathological examinations stained with H & E.

Results

The abdomen was opened through the previous incision.

Gross examination showed adhesions of omentum and genitalia to the wounded colon. There seemed no evidence of peritonitis or leakage.All ten rats of group D displayed inflammatory foreign body reactions in the serosa and adherent omentum where fibrin glue had been applied (Fig.1).The control groups showed no such reaction (Fig.2).

Discussion

The principle of fibrin glue mimics the end stage of blood clotting (3).It is a human biologic substance and resolves in 6-8 weeks.Before application,it is heated to about 37 *C and its protein part is treated with aprotinine and the thrombin part with CaCl2.

The activated factor XIII stabilizes the fibrin polymer and aprotinine inhibits local fibrinolysis (3).

The fibrin network,occurring at the application site,encourrages the formation of new capillaries and granulation tissue,so the contamination risk decreases (4).

In the literature ,it is said that fibrin glue is in accordance with the tissues,hence it causes only very few foreign body reactions or none at all (1,2,3,4).Because of these advantages,it has been recommended for use in clinical practice.

After this experimental study,it appeared that in the wounds which healed spontaneously (Group K),there was no obvious foreign body reaction.On the other hand,in the rats,where we used fibrin glue for wound healing (Group D) foreign body recations have been observed.

This in contrast with the literature.

References

1) Blair GK,Castner P,Taylor G,Newman D,Santosa B : Esophageal atresia -- A rabbit model to study anastomotic healing and the use of tissue adhesive fibrin sealent.J Pediatr Surg 23 (1988) 740-743

2) Dodat H : Intereet de I' utulisation du Tissicol en urologie pediatrigue.Ann Urol 20 (1986) 401- 404

3) Haukipuro KA,Hulkko OA, Alavaikko MJ,Laitinen ST : Sutureless colon anastomosis with fibrin glue in the rat.Dis Colon Rectum 31 (1988) 601-604

4) Spehr CH : Anwendung von Fibrinleber bei plastisch rekonstruktiven Eingriffen am kindlichen Genitale. Springer - Veriag,Berlin,Heidelberg,1985