Abstract
To evaluate the flow, tear pressure, the need of reinforcement stitches in sutured arteries reinforced or not using fibrin sealant after a cross-section. Tissucol fibrin sealant was used. The femoral and carotid arteries of seventeen swine from the same breed (weighing from 15 to 20 kg) were cross-sectioned after heparinization and subjected to anastomoses using a single continuous plane of prolene 7-0. We worked with 68 artery samples, 34 in the Treatment Group and 34 in the Control Group. For each animal, one carotid and one femoral artery randomly received fibrin sealant with the contralateral side being used as a control. The need and the number of reinforcement stitches were recorded. Ten minutes after protamine infusion, the animals were sacrificed and the arteries were catheterized. The arteries were measured and placed on a flow meter. The arteries were then subjected to air infusion at increasingly higher pressures (stepwise increases of 25 mmHg), the grafts were dipped in saline solution, the first air leakage was observed and the tear pressure recorded. The external diameters and thickness of the arteries were similar in both the Treatment and Control Group. There was no significant difference between the groups regarding the tear pressure (p=0.329), flow rate (p=0.943) and the number of samples with a tear pressure above 200 mmHg. However, the sealant reduced the number of reinforcement stitches necessary (p=0.029). Fibrin sealant reduces the need of additional stitches.
Highlights
Even with the frequent combination of sealants with arterial sutures, the number of experimental works in the literature on this subject is small
Fibrin sealant reduces the need of additional stitches
As it is derived from blood, presents risks inherent to its use, such as infections similar to those caused by blood transfusions, including parvovirus B19 [16], factor V and antithrombin antibody deficiency; as well as the risk of embolization
Summary
Even with the frequent combination of sealants with arterial sutures, the number of experimental works in the literature on this subject is small. Several experimental studies have been made to perform arterial anastomoses without sutures [13,14]. No research has evaluated the reinforcement that sealants provide to arterial sutures, even though many surgeons use sealant for this purpose. Fibrin sealant, as it is derived from blood, presents risks inherent to its use, such as infections similar to those caused by blood transfusions, including parvovirus B19 [16], factor V and antithrombin antibody deficiency; as well as the risk of embolization. This study has the objective of evaluating the rupture pressure, the flow, and the necessity of reinforcement stitches in arteries sutured after sectioning, reinforced using Tissucol® fibrin sealant or not
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