November 1984

Splenic Salvage Using Biologic Glue

Author Affiliations

From the Departments of Surgery (Drs Kram, Shoemaker, and Harley) and Pathology (Dr Hino), Los Angeles County, Harbor—UCLA Medical Center, Torrance, Calif, and the UCLA School of Medicine.

Arch Surg. 1984;119(11):1309-1311. doi:10.1001/archsurg.1984.01390230075018

• Fibrin sealant (FS) is a biologic adhesive containing highly concentrated human fibrinogen that is effective in the face-to-face sealing of tissues, and in establishing hemostasis. We evaluated FS in 32 experimentally produced splenic injuries in six adult mongrel dogs. Complete hemostasis was achieved in all animals prior to closure. The dogs were reexplored postoperatively at intervals varying from four hours to six weeks (mean ± SD, 21 ± 20 days). When the dogs were killed, there was no gross evidence of splenic disruption or recurrent bleeding; all of the spleens had developed well-healed capsules. Histologic examination demonstrated a regenerated fibrous capsule extending over the superficial injuries as well as into the deep injuries, without significant inflammatory response. We conclude the following: that FS provides adequate hemostatic control of superficial and deep splenic injuries, FS has good systemic and local compatibility, it can be applied to bleeding parenchymal wounds, it reduces the need for parenchymal sutures that may be traumatic, and it promotes splenic wound healing.

(Arch Surg 1984;119:1309-1311)