Use of concentrated fibrinogen in experimental splenic trauma.
This study evaluated Fibrin Sealant (FS), a two-component biologic adhesive that is effective in establishing hemostasis, in 27 experimentally produced splenic injuries in five adult mongrel dogs. Ten small superficial lacerations (2.0 cm in length), six large superficial lacerations (3.0-6.0 cm in length), three small wedge resections, and eight stab wounds extending into the splenic hilum were effectively repaired with FS without suture splenorrhaphy or temporary splenic hilar occlusion. Complete hemostasis was achieved in all animals prior to skin closure. Dogs were reexplored postoperatively at intervals varying from 4 h to 6 weeks. When animals were killed, there was no gross evidence of splenic disruption or recurrent bleeding; the spleens all had developed well-healed capsules. Histologic examination demonstrated a regenerated fibrous capsule extending over the injuries without significant inflammatory response. We conclude that FS provides adequate hemostatic control of superficial and deep splenic injuries; has good systemic and local compatibility; can be applied to bleeding parenchymal wounds; organ ischemia is generally not required; avoids the use of parenchymal sutures, which may be traumatic; and may promote splenic wound healing. Thus, use of FS is an effective technique for splenic preservation after trauma.