Evaluation of Canine-Derived Fibrin Sealant as a Hemostatic Agent |
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| Authors: | LYNN G WHEATON DVM Diplomate acvs RANDY M GREENSHIELDS dvm KENNETH MEYERS PhD K JANE WARDROP dvm MS MICHAEL MOORE DVM MS Diplomate ACVIM |
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| Institution: | Departments of Veterinary Clinical Sciences, Veterinary and Comparative Anatomy, and Physiology and Pharmacology, College of Veterinary Medicine, Washington State University, Pullman, WA. |
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| Abstract: | The purpose of this study was to determine whether canine-derived fibrinogen concentrate applied with bovine thrombin was a safe and effective topical hemostatic agent. A canine liver biopsy model was selected to test this product. Cryoprecipitate was prepared from frozen canine plasma using two freeze/thaw/centrifugation cycles. Six healthy adult dogs (weighing more than 18 kg) were used in the fibrin sealant study, and an additional three dogs were used as controls for the liver biopsy. A 1 × 3 cm liver biopsy specimen was obtained, digital pressure was applied to reduce bleeding, and the fibrinogen concentrate was immediately sprayed on the bleeding surface simultaneously with bovine thrombin (1,000 IU/mL). The mean ± standard error of the mean (SEM) blood pressure at time of biopsy was 98 ± 9 mm Hg, and the rate of hemorrhage from the cut liver edge was 8.0 ± 1.1 mL/min. The total blood loss during fibrin sealant application was 37 ± 9 mL and total time for hemostasis was 5.5± 1.3 minutes. There was no additional hemorrhage after application of the fibrin sealant. In the three control dogs, fibrin sealant was not applied and only digital compression was used to decrease hemorrhage. Before digital compression, the rate of hemorrhage from the cut liver edge was 13.1 ±3.1 mL/min. Bleeding had not stopped after 10 minutes of compression and the mean postcompression rate of hemorrhage was 4.0 ± 2.6 mL/min. Signs of secondary bleeding after fibrin sealant was applied were not evident during the immediate postoperative period or over the next 14 days. The coagulation profile, alanine amino transferase (ALT), alkaline phosphatase (AP), and bile acids were not significantly different on day 14 from preoperative values, suggesting that the liver was only mildly affected. The dogs were euthanatized and gross and histological examinations of the biopsy site were performed on day 14. There were minimal or no adhesions at the biopsy site. In all dogs, the hepatic capsule was less than 1 mm thick and histological signs of secondary bleeding, hepatocellular damage, thrombosis, infection, or inflammation were not observed. In this study, canine-derived fibrin sealant was a safe and effective topical hemostatic agent. |
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